Impact of menstrual cycle on smoking cessation: A review / El impacto del ciclo menstrual en el abandono de tabaco: Una revisión

Abstract Background Information on the way menstrual cycle phases can influence the achievement of tobacco abstinence is contradictory. Objective A scope review was conducted to determine the effect of the menstrual cycle on tobacco abstinence, considering the phases of the cycle, hormone levels, and premenstrual syndrome. Method A literature search was conducted in Scopus, PubMed, MEDLINE, and PsycINFO databases. Ten articles comparing the phases of the menstrual cycle or analyzing the association between premenstrual syndrome and a withdrawal condition (length of abstinence or withdrawal symptoms) were included. Results Two main results were identified: 1) there is no difference in withdrawal symptoms and craving between menstrual cycle phases and 2) abstinence rates in the studies were higher during the luteal phase. Discussion and conclusion The advisability of suggesting that women wishing to quit smoking should begin to do so at the start of the luteal phrase is discussed. However, smoking cessation interventions must consider all the symptoms experienced during the luteal phase.

Resumen Antecedentes La información sobre cómo las diferentes fases del ciclo menstrual pueden influir en el logro de la abstinencia de tabaco es contradictoria. Objetivo Se realizó una revisión de alcance con el fin identificar la evidencia relacionada al efecto del ciclo menstrual en la abstinencia de tabaco, considerando las variables fases del ciclo, niveles hormonales y síndrome premenstrual. Método Se llevó a cabo una búsqueda de la literatura en las bases de datos Scopus, PubMed, MEDLINE y PsycINFO. Se incluyeron diez artículos que realizaban comparaciones entre las fases del ciclo menstrual o bien análisis entre el síndrome premenstrual y una condición de abstinencia (tiempo de abstinencia o síntomas de abstinencia). Resultados Se identificaron dos resultados principales 1) no hay diferencia en los síntomas de abstinencia y el deseo por fumar entre las fases del ciclo menstrual y 2) las tasas de abstinencia de los estudios fueron mayores durante la fase lútea. Discusión y conclusión Se discute si en la fase lútea se puede sugerir el inicio de la abstinencia en mujeres que buscan dejar de fumar, sin embargo, las intervenciones para dejar de fumar deben tomar en cuenta todos los síntomas que se experimentan en la fase lútea.

Frecuencia de consumo de drogas adictivas ilícitas en gestantes o puérperas y su detección en recién nacidos en un hospital materno-infantil de Asunción

Introducción: la adicción a sustancias ilícitas constituye un problema de salud pública, del cual no están exentas las embarazadas. Los efectos deletéreos sobre el feto pueden tener consecuencias catastróficas. Objetivo: Determinar la frecuencia de uso de drogas ilícitas en mujeres gestantes y caracterizar a estas mujeres y sus recién nacidos de julio de 2020 a julio de 2021. Material y método: Estudio transversal, descriptivo, observacional con madres con sospecha de uso de drogas y sus recién nacidos (RN). Se buscó asociación entre variables estudiadas. Se utilizó escala de Finnegan para síndrome de abstinencia neonatal (SAN) y se determinó presencia de drogas en orina. Resultados: Fueron incluidos 107 binomios madres -hijos. Prevalencia de madres adictas de 11,42%. Edad promedio de madres 24,5 años y 29,9% en situación calle. 70% fueron partos vaginales, 90,5% con APGAR de 7-10. 26,1% fueron RN prematuros. RCIU 34,5%, PEG 35,5%. 93,3% mujeres se autorreportó como consumidora, 57,9% tuvo control prenatal nulo. 56% de gestantes presentó signos evidentes de ser consumidora de drogas ilícitas al ingreso. La droga más consumida fue la cocaína (COC) 85%. Detección de cocaína en RN fue 81,3%. SAN en 24,2% RN. Se encontró Cocaína en la orina de 18/26 de los pacientes con SAN, y en 64/77 de los pacientes sin síndrome de abstinencia. Tuvo Lues el 25,9%. Se encontró asociación de SAN con la presencia de COC en el RN. Conclusiones: el consumo de drogas en la embarazada expone al RN a drogas deletéreas, siendo la droga más frecuentemente consumida la COC. La prevalencia de SAN fue baja, encontrándose asociación entre esta entidad y la presencia de COC en RN.

Introduction: Addiction to illicit substances constitutes a public health problem, from which pregnant women are not exempt. The deleterious effects on the fetus can have catastrophic consequences. Objective: To determine the frequency of illicit drug use in pregnant women and to characterize these women and their newborns during the time period from July 2020 to July 2021. Materials and methods: this was a cross-sectional, descriptive, observational study with mothers suspected of drug use and their newborns (NBs). An association was sought between the studied variables. The Finnegan scale for neonatal abstinence syndrome (NAS) was used and the presence of drugs in urine was determined. Results: 107 mother-child pairs were included. The prevalence of addicted mothers was 11.42%. Average age of mothers was 24.5 years and 29.9% were living on the street. 70% were vaginal deliveries, 90.5% with an APGAR score of 7-10. 26.1% were premature newborns. IUGR 34.5%, SGA 35.5%. 93.3% women self-reported as drug consumers, 57.9% had zero prenatal control. 56% of pregnant women presented obvious signs of being an illicit drug user upon admission. The most consumed drug was cocaine (COC), 85%. Detection of cocaine in newborns was 81.3%. NAS was diagnosed in 24.2% NB. Cocaine was found in the urine of 18/26 of the patients with NAS, and in 64/77 of the patients without withdrawal syndrome. 25.9% had Lues. An association of NAS with the presence of COC in the newborn was found. Conclusions: drug use in pregnant women exposes the newborn to deleterious drugs, COC being the most frequently used drug. The prevalence of NAS was low, although we found an association between NAS and the presence of COC in newborns.

A neutralidade analítica em questão: um percurso clínico-político / The issue of analytical neutrality: A clinical-political trajectory / La neutralité analytique en question: un parcours clinique-politique / La neutralidad analítica en cuestion: un percurso clínico-político

O objetivo deste artigo é examinar os múltiplos sentidos atribuídos à noção de neutralidade analítica. Tal palavra foi usada pela primeira vez por Strachey na tradução inglesa do texto "Observações sobre o amor transferencial" e emergiu nas discussões clínicas dos pós-freudianos e psicólogos do ego sobre abstinência e contratransferência. Em seguida, uma investigação sobre a história do movimento psicanalítico brasileiro demonstra, mediante notícias e relatos do Caso Amílcar Lobo, candidato a analista envolvido com a tortura política, que a noção de neutralidade foi empregada para ocultar a omissão das instituições nacionais e internacionais frente à violência de Estado durante a ditadura militar. Defendemos a importância de entrelaçar ambas as perspectivas teórica e sociopolítica para considerar a questão da neutralidade com a devida complexidade.

The objective of this article is to examine the multiple meanings attributed to the notion of analytical neutrality. Such a word was used for the first time by Strachey in the English translation of the text "Observations on Transference-Love" and emerged in post-Freudians and Ego psychologists' clinical discussions about abstinence and countertransference. A subsequent investigation into the history of Brazilian's psychoanalytical movement demonstrates, through news items and published reports of the Amílcar Lobo Case, analyst candidate involved with political torture, that the notion of neutrality was employed to conceal the omission of national and international institutions towards State violence during the military dictatorship. We defend the importance of interlacing both theoretical and sociopolitical perspectives to consider the issue of neutrality with appropriate complexity.

L'objectif de cet article est d'examiner les multiples sens attribués à la notion de neutralité analytique. Tel mot a été utilisé par la première fois dans la traduction anglaise faite par Strachey du text "Observations sur l'amour de transfert", et a emergé dans les discussions cliniques sur l'abstinence et le contre-transfert chez les post-freudiens et les psychologues de l'ego. Ensuite, une investigation sur l'histoire du mouvement psychanalytique brésilien démontre, par le biais des nouvelles et récits du Cas Amílcar Lobo, celui-ci candidat à la position de psychanalyste et impliqué dans des cas de torture politique, que la notion de neutralité a été employé pour occulter l'omission des institutions nationaux et internationaux face à la violence de l'État pendant la dictature militaire. On défend l'importance d'entrelacer tous les deux perspectives téoriques et sociopolitiques pour approcher la question de la neutralité politique avec la complexité requise.

El objetivo de este artículo es examinar los múltiples sentidos atribuidos a la noción de neutralidad analítica. Tal palabra fue usada por primera vez por Strachey en la traducción inglesa del texto "Observaciones sobre el amor de trasferencia" y emergió en las discusiones clínicas de los post-freudianos y psicólogos del ego sobre la abstinencia y la contratrasferencia. Una investigación subsiguiente sobre la historia del movimiento psicoanalítico brasileño, mediante los artículos y relatos del caso Amílcar Lobo, analista-candidato enzarzado con la tortura política, que la noción de neutralidad fue empleada para ocultar la omisión de las instituciones nacionales e internacionales frente a la violencia estatal de la dictadura militar. Defendimos la importancia de entrelazar ambas perspectivas teórica y sociopolítica para considerar la cuestión de la neutralidad con la debida complejidad.

A cross-sectional survey:analysis of the current status and factors influencing smoking abstinence self-efficacy in Chinese patients with smoking stroke / 中国实用护理杂志

Objective:To investigate the current smoking status and smoking abstinence self-efficacy of stroke smoking patients, to clarify the factors associated with the smoking abstinence self-efficacy in stroke patients, and to provide a theoretical basis for subsequent targeted interventions and guidance for smoking cessation.Methods:A total of 196 stroke patients admitted to the Neurology Department of Tianjin Huanhu Hospital from September to December in 2021 were surveyed adopted cross-sectional survey method by the General Information Questionnaire, the Fagerstrom Test for Nicotine Dependence, the Tobacco Hazard Perception Score, and the Smoking Abstinence Self Efficacy Scale. Multiple linear regression was used to analyze the factors associated with patients' smoking abstinence self-efficacy.Results:The overall score of self-efficacy for smoking in stroke patients was (20.78 ± 6.47), and the scores of each dimension in descending order were habit/addiction, negative/emotional and positive/social situations. Multiple linear regression analysis showed that occupation, nicotine dependence score and cognition score of tobacco harm were the influencing factors of smoking abstinence self-efficacy, which could explain 37.4% variation of smoking abstinence self-efficacy.Conclusions:The self-efficacy level of smoking patients with stroke needs to be improved, and helping patients to improve their perception of tobacco harm and reduce their nicotine dependence can improve their self-efficacy level to increase the success rate of smoking cessation, thus reducing or even quitting the health risks caused by smoking behavior.

Relationship between smoking abstinence self-efficacy， smoking rationalization belief and willingness to quit smoking—a questionnaire survey of 336 male smokers in Shanghai / 上海预防医学

ObjectiveTo explore the influencing factors of willingness to quit smoking in smokers， and to provide reference for further smoking cessation intervention. MethodsThrough purposive sampling， smokers were recruited from 4 residential communities and 3 companies in Shanghai for an online questionnaire survey. The survey included general demographic characteristics， willingness to quit smoking， smoking condition， tobacco addiction， awareness of influence of smoking， smoking abstinence self-efficacy， and smoking rationalization belief. T-test， χ2 test and multiple logistic regression were used to analyze the data. ResultsA total of 336 valid questionnaires were collected. The average age of the smokers was （37.1±10.2） years， and most of their education level was college or above （58.3%）. The daily number of cigarette use was （11.46±7.22） and most of smokers were classified as low nicotine dependence （58.3%）. Today 248 smokers planned to quit smoking in the next six months. Compared with smokers with low smoking abstinence self-efficacy， smokers with high self-efficacy were more likely to quit smoking （OR=2.406，95%CI： 1.357‒4.267）； Smokers with low smoking rationalization belief were more likely to quit smoking than those with high rationalization belief （OR=2.112， 95%CI： 1.167‒3.821）. ConclusionSmoking abstinence self-efficacy has a positive impact on willingness to quit smoking， while smoking rationalization belief has a negative impact on the willingness to quit smoking. Efforts to improve smoking abstinence self-efficacy and dispel smoking rationalization beliefs of smokers should be made to promote the intention to quit among smokers.

Severe irritability in a critically ill preterm infant: a case of delirium at the neonatal intensive care unit / Grave irritabilidade em prematuro criticamente doente: um caso de delirium na unidade de terapia intensiva neonatal

ABSTRACT Delirium is a common disorder in intensive care units, being associated with greater morbidity and mortality. However, in neonatal intensive care units, delirium is rarely diagnosed, due to the low familiarity of the neonatologist with the subject and the difficulties in the applicability of diagnostic questionnaires. This case report aimed to assess the presence of this disorder in this group of patients and identify the difficulties encountered in the diagnosis and treatment. We report the case of a premature newborn with necrotizing enterocolitis during hospitalization and underwent three surgical approaches. The newborn exhibited intense irritability, having received high doses of fentanyl, dexmedetomidine, clonidine, ketamine, phenytoin, and methadone, without the control of the symptoms. A diagnosis of delirium was then made and treatment with quetiapine was started, with a complete reversal of the symptoms. This is the first case reported in Brazil and the first describing the withdrawal of the quetiapine.

RESUMO Delirium é uma síndrome comum em unidades de terapia intensiva, associando-se a maiores morbidade e mortalidade. No entanto, nas unidades de terapia intensiva neonatal, ele raramente é diagnosticado em razão da baixa familiaridade do neonatologista com a suspeita diagnóstica e das dificuldades na aplicabilidade dos questionários diagnósticos. Este relato de caso tem como objetivos mostrar que delirium está presente nesse grupo de pacientes e apontar as dificuldades encontradas no seu diagnóstico e tratamento. Relatamos o caso de um recém-nascido prematuro com enterocolite necrosante, submetido a três abordagens cirúrgicas. O recém-nascido apresentou intensa irritabilidade, tendo recebido altas doses de fentanil, dexmedetomidina, clonidina, cetamina, fenitoína e metadona, sem controle dos sintomas. Em seguida, foi feita a hipótese diagnóstica de delirium e iniciado tratamento com quetiapina, com reversão completa dos sintomas. Este é o primeiro caso notificado no Brasil e o primeiro que descreve a suspensão da quetiapina.

Delirio, dolor, abstinencia. ¿Cuáles son las causas de las asincronías de mi enfermo con COVID-19? / Delirium, pain, withdrawal. What are the causes of the asynchrony of my patient with COVID-19? / Delirium, dor, abstinência. Quais são as causas da assincronia do meu paciente com COVID-19?

Resumen: Los pacientes con infección por COVID-19 presentan complicaciones extrapulmonares cada vez más frecuentes, tales como trastornos neurológicos, cardiovasculares, renales, entre otros. Las asincronías, el dolor y la abstinencia a opioides mientras se encuentran en ventilación mecánica son casusas frecuentes de retardo en la liberación de soportes que acarrean otros problemas relacionados como la injuria auto infringida, infecciones, debilidad, desnutrición y muerte. Presentamos una propuesta de manejo de este tipo de enfermos.

Abstract: Patients with COVID-19 infection present more and more frequent extrapulmonary complications, such as neurological, cardiovascular, and kidney disorders, among others. Asynchronies, pain, and opioid withdrawal while on mechanical ventilation are frequent causes of delayed release of supports that lead to other related problems such as self-inflicted injury, infections, weakness, malnutrition, and death. We present a proposal for the management of this type of patient.

Resumo: Pacientes com infecção por COVID-19 apresentam complicações extrapulmonares cada vez mais frequentes, como distúrbios neurológicos, cardiovasculares, renais, entre outros. Assincronias, dor e retirada de opióides durante a ventilação mecânica são causas frequentes de liberação tardia de suportes que levam a outros problemas relacionados, como lesões autoinfligidas, infecções, fraqueza, desnutrição e morte. Apresentamos uma proposta para a gestão deste tipo de doentes.

Faith-based intervention, change of religiosity, and abstinence of substance addicts

Objective: To investigate the effects of developing religiosity on abstinence of substance abuse among recovering addicts in a faith-based and a secular-based treatment program. Methods: Religiosity of recovering addicts was measured using the 38-item Brief Multidimensional Measure of Religiousness/Spirituality at three points in time: at initiation of substance addiction treatment (wave 1), discharge from treatment (wave 2), and 6 months after treatment (wave 3). Latent growth curve modeling was used to assess the dynamic and developing effects of religiosity on after-treatment abstinence. Secular-based treatment emphasized the role of biological, psychological, and environmental determinants of substance abuse and provided detoxification interventions, such as counseling and group therapies, skill training, health care, and social support, however also relying on religious and spiritual growth to help recovery. Faith-based treatment fundamentally emphasized the Christian theory of addiction to consider substance abuse a sin caused by one's spiritual void and separation from God, although it also acknowledged the importance of biological, psychological, and social needs of rehabilitants. Results: Recovering addicts in faith-based treatment had significantly higher levels of religiosity at each wave (intercept factor) and better religious development across the three waves (slope factor). This contributed to after-treatment abstinence and mediated the effect of treatment mode on after-treatment abstinence. Conclusion: Service practitioners and researchers should note the importance of dynamic and developing nature of religiosity in relation to the maintenance of abstinence after treatment is completed.

The effect of age and abstinence time on semen quality: a retrospective study / 亚洲男科学杂志(英文版)

This study analyzed the effects of male age and abstinence time on semen quality and explored the best abstinence time for Chinese males among different age groups. Semen parameters, including sperm kinetics, morphology, and DNA fragmentation index (DFI), were reviewed from 2952 men. Samples were divided into six age groups (≤25 years, 26-30 years, 31-35 years, 36-40 years, 41-45 years, and >45 years) and were divided into six groups according to different abstinence time (2 days, 3 days, 4 days, 5 days, 6 days, and 7 days). The differences in semen quality between the groups were compared, and the effect of age and abstinence time on semen quality was analyzed. Significant differences were observed in semen volume, progressive motility (PR), and DFI among the age groups (all P < 0.05), and no significant differences were observed in sperm morphological parameters (all P > 0.05). There were significant differences in semen volume, PR, and DFI among different abstinence time groups (all P < 0.05) and no significant differences in sperm morphological parameters (all P > 0.05). Pearson analysis showed that male age and abstinence time were both significantly correlated with sperm kinetics and DFI (both P < 0.05), while no significant correlation was found with sperm morphological parameters (all P > 0.05). The box plots and histograms of men's age, abstinence time, and semen quality show that most semen quality parameters differ significantly between the 2 days and 7 days abstinence groups and other groups at different ages. Except for the sperm morphology parameters, sperm kinetic parameters and sperm DFI are linearly related to male age and abstinence time.

Lactente em abstinência de cocaína, relato de caso / Neonatal abstinence from cocaine, a case report

Objetivo: descrever o caso de um lactente exposto à cocaína e as repercussões clínicas da sua ingestão por meio do leite materno. Relato do caso: lactente, com um mês e três dias de vida e peso de 3.920g vem à emergência, por quadro de hipoatividade, rebaixamento de sensório, choro e sangramento nasal. Afebril, irritada, chorosa, sem sinais de esforço ventilatório ou sangramentos ativos. Exames mostraram leucocitose 13490/uL, acidose metabólica discreta, aumento de transglutaminase oxalacética e provas de coagulação alargadas. Demais exames laboratoriais sem alterações e culturas negativas. Screening toxicológico revelou cocaína no plasma da lactente. O Centro de Informações Toxicológicas, recomendou monitorização e suporte clínico. A paciente recebeu alta da unidade de terapia intensiva para enfermaria cinco dias após admissão, com melhora do sensório, seguindo acompanhamento com a equipes especializadas. Conclusão: o pronto reconhecimento da síndrome de abstinência neonatal permite o melhor manejo da mesma em benefício dos pacientes. O diagnóstico diferencial com quadro séptico pode ser de grande importância em quadros como este.

Objective: describing a case of an infant exposed to cocaine through breast milk and its clinical repercussions. Case report: infant, one month and three days old, weighing 3,920g, came to the emergency room due to hypoactivity, sensory impairment and nose bleeding. Afebrile, irritated, tearful, no signs of ventilatory effort or active bleeding. Tests showed leukocytosis 13490/uL, mild metabolic acidosis, increased serum glutamic-oxaloacetic transaminase and enlarged coagulation tests. Other laboratory tests were normal. Toxicological screening revealed cocaine in the infant's plasma. Toxicological Information Center, recommended monitorization, and clinical support. The patient was discharged from the intensive care unit to the ward five days after admission, with sensorium improvement and a follow-up with specialized teams. Conclusions: prompt recognition of the neonatal abstinence syndrome allows for better management of it and high chances of recovery for patients. The differential diagnosis with septic condition can be of great importance in conditions like this one.

Increase in serum brain-derived neurotrophic factor levels during early withdrawal in severe alcohol users

Abstract Introduction Changes in brain-derived neurotrophic factor (BDNF) have been linked to the neuroadaptative consequences of chronic alcohol use and associated with disease severity and prognosis. Few studies have evaluated the influence of drug withdrawal and clinical and sociodemographic data on BDNF levels in severe alcohol users. Objectives Our goals were (1) to evaluate variation in BDNF levels during alcohol withdrawal and, (2) to assess the influence of putative confounding factors on BDNF levels. Methods Our sample consists of 62 men with alcohol use disorder undergoing a detoxification process. Serum BDNF levels were measured using a commercial sandwich-ELISA kit, at two points: before and after the detoxification period. Results We found an increase in BDNF levels during alcohol withdrawal (25.4±9.6 at admission vs. 29.8±10.2 ng/ml at discharge; p < 0.001), even after controlling for potential confounders (positive family history, number of days between blood sample collections, and age) (Generalized Estimating Equation: coefficient = -4.37, 95% confidence interval [95%CI] -6.3; -2.4; p < 0.001). Moreover, individuals who had first-degree relative with alcohol dependence had smaller increases in BDNF levels than individuals with no family history (14.8 [95%CI -5.3; 35.6] vs. 35.3 [95%CI 15.4; 74.8]; p = 0.005). Conclusions In summary, variation in BDNF levels seems to be influenced by withdrawal in severe alcohol users. A positive family history of alcohol dependence could also be a factor that influences variation in this biomarker.

A analista grávida e o paradoxo da transferência / The pregnant psychoanalyst and the transference paradox / La psicoanalista embarazada y la paradoja de la transferencia / La psychanalyste enceinte et le paradoxe du transfert

A partir de duas vinhetas clínicas que remontam a atendimentos feitos quando estava grávida, a autora trata do paradoxo da transferência: a exigência do uso do inconsciente do analista e a necessidade de manutenção de sua posição abstinente. Seria a positivação de seu corpo um entrave ao setting ou, pelo contrário, abriria espaço para pensar a potência desse encontro como um ato vivo e pulsional? A autora trabalha com a hipótese de que essa experiência, a partir da situação de um analista impedido de "tirar o corpo fora", revela a possibilidade de este funcionar como resto diurno para o sonhar do paciente em sessão.

Based on two clinical reports that go back to the time when the analyst was pregnant, this article deals with the paradox of transference: the requirement to use the analyst's unconscious and the need to maintain her abstinent position. Would the presence of her body be an obstacle to the setting or, on the contrary, would it open space to think about it as a live and creative act? Our hypothesis is that this experience reveals that the analyst, unable to walk away, could function as day´s residues for the patient's dream in session.

A partir de dos fragmentos clínicos que se remontan a consultas realizadas por la analista durante el embarazo, este artículo aborda la paradoja de la transferencia: la exigencia de utilizar el inconsciente del analista y la necesidad de mantener su posición abstinente. ¿La positivización de tu cuerpo sería un obstáculo para el setting o, por el contrario, abriría un espacio para pensar en la potencia de este encuentro como un acto vivo y creativo? Trabajamos con la hipótesis de que esta experiencia revela la posibilidad de que el analista funcione como un resto diurno para el sueño del paciente en sesión.

À partir de deux fragments cliniques qui remontent aux consultations faites par l'analyste pendant sa grossesse, cet article traite du paradoxe du transfert : l'exigence de l'utilisation de l'inconscient de l'analyste et le besoin de maintenir sa posture de s'abstenir. La positivisation du corps de l'analyste serait-elle un obstacle au cadre ou, au contraire, ouvrirait-elle un espace pour réfléchir à la puissance de cette rencontre comme acte vivant et pulsionnel ? Nous partons de l'hypothèse que cette expérience, à partir d'un analyste qui est empêché de « se laver les mains ¼, révèle la possibilité qu'il fonctionne comme le reste diurne du rêve du patient en séance.

Propiedades psicométricas del Test de Dependencia al Teléfono Móvil (TDMB) en Argentina y sus relaciones con la impulsividad / Psychometric Properties of the Mobile Phone Dependency Test (TDMB) in Argentina and its Relationship with Impulsivity

Resumen El uso de teléfonos celulares ha aumentado exponencialmente en la mayoría de los países del mundo. Desde una perspectiva psicológica, se han desarrollado diferentes técnicas para evaluar el nivel de dependencia hacia el uso del teléfono móvil, y el test TDMB es una de las más utilizadas. Objetivo. El objetivo principal del trabajo fue realizar la adaptación y validación al contexto argentino del cuestionario TDMB y sus relaciones con la impulsividad. Método. Participaron del estudio 339 adultos residentes en Argentina, con edades entre los 18 y 65 años (M = 37.66; DT = 12.87), siendo el 74.3% mujeres. La batería de evaluación incluyó el TDMD, la UPPS-P para evaluar impulsividad y variables ad-hoc relacionadas con el uso del teléfono celular. Resultados. Se obtuvieron propiedades psicométricas adecuadas para la versión argentina del TDMB. Asimismo, se observaron relaciones entre todas las dimensiones del cuestionario y la impulsividad, como también diferencias según la edad y el sexo de los participantes. Se discuten los alcances y límites de la prueba, así como sus relaciones con la impulsividad y el uso cotidiano del teléfono móvil.

Abstract. The use of cell phones has increased exponentially in most countries of the world. From a psychological perspective, different techniques have been developed to assess the level of dependence towards the use of the mobile phone, the TDMB test being one of the most used. Objective. The aim of the research was to adapt and validate the TDMB and its relations with impulsivity. Method. 339 adults residing in Argentina participated in the study, with ages between 18 and 65 years (M = 37.66; SD = 12.87), of which 74.3% were women. The evaluation included the TDMD, the UPPS-P to evaluate impulsivity and ad-hoc variables related to cell phone use. Results. Adequate psychometric properties were observed for the Argentine version of the TDMB. Likewise, relationships were observed between all dimensions of the questionnaire and impulsivity, as well as differences according to the age and gender of the participants. The scope and limits of the test are discussed, as well as its relationships with the impulsivity and daily use of the mobile phone.

Application effect of timing theory in alcohol abstinence intervention for patients with alcoholic liver disease / 中国实用护理杂志

Objective:To explore the effect of alcohol abstinence intervention based on timing theory on patients with alcoholic liver disease.Methods:A total of 106 patients with alcoholic liver disease hospitalized in the Department of liver disease of Taian Medical District, 960th Hospital of Chinese PLA from July 2018 to June 2019 were selected by convenience sampling method and divided into observation group and control group by random digits table method, 53 cases in each group. The control group received routine nursing, and through the improvement of patients' cognition and support system, implemented short abstinence intervention during hospitalization; the observation group received abstinence intervention based on timing theory on the basis of the control group intervention. At 1 month and 6 months after discharge, the differences of rehydration rate, alcohol dependence and physical and mental status between the two groups were compared.Results:Finally, 49 cases in the control group completed the study, and 51 cases in the observation group completed the study. The rehydration rates of the observation group were 21.57%(11/51) and 15.69%(8/51) respectively at 1 month and 6 months after discharge, while those of the control group were 40.82%(20/49) and 36.73%(18/49) respectively at 1 month and 6 months after discharge. The difference was statistically significant ( χ2 values were 4.328, 5.754, P<0.05). The alcohol dependence scores were 0(2,3), 0(1,2) in the observation group and 2(0,3), 3(1,4) in the control group at 1 month and 6 months after discharge, and the difference was statistically significant ( Z values were -6.719, -7.345, P<0.01). There was no significant difference in the score of Symptom Checklist-90(SCL-90) before intervention and 1 month after discharge between the two groups ( P>0.05). Six months after discharge, the score of SCL-90 was 8.26 ± 1.37 in the observation group and 10.11 ± 1.68 in the control group, and the difference was statistically significant( t value was 6.046, P<0.01). Conclusions:The application of timing theory in alcohol abstinence of patients with alcoholic liver disease can significantly reduce the relapse rate and the degree of alcohol dependence of patients with alcoholic liver disease, improve the physical and mental state of patients.

Sexual health intervention for couples with difficulty in sexual abstinence

Purpose@#Nurses in the forefront of reproductive health services face the challenge of motivating clients to adapt fertility awareness-based methods, or making them continue with the method due to concerns about handling sexual abstinence. To assist nurses and other reproductive health providers, a sexual health intervention was developed. Thus, this study aimed to determine the effectiveness of the sexual health intervention called Kalabit-kalabit (sexual desire), Irap (abstinence), and Sanggang-dikit (shared behavioral plan) (KIS) on the sexual scripts, motivation, and behavior of couples with difficulty in sexual abstinence in natural family planning. Specifically, it aimed to identify the sexual scripts on pagkatao (personhood), pagkalalaki (manhood), pagiging lalaki (masculinity), pagkababae (womanhood), pagiging babae (femininity), pagtatalik (sexual intercourse), and pagpipigil (abstinence), as well as the sexual motivation and behavior of couples with difficulty in abstinence before and after KIS.@*Methods@#Embedded multiple-case study with purposive sampling using the replication logic was used to satisfy the inquiry. Four couples qualified using the assumption that difficulty with abstinence is caused by illogical sexual scripts, and inappropriate sexual motivation and behavior of either one or both spouses as a template to determine KIS’s effectiveness. Pattern matching, cross-case synthesis, and logic model were used for analytic generalization. Prior to the conduct of the study, the research protocol underwent scrutiny by the Independent Ethics Committee of De La Salle Medical and Health Sciences Institute.@*Result@#KIS was found to be effective in (a) decoding and denouncing illogical sexual scripts and inappropriate sexual motivation and behavior, (b) reframing them to logical sexual scripts and appropriate sexual motivation and behavior, and (c) sharing mutual behavioral plans if accompanied with openness and full acceptance of self and spouse coupled with conviction, cooperation, commitment, and determination.@*Conclusions@#Decoding, challenging, reframing, and sharing mutual behavioral plans facilitate couples' competence in achieving sexual abstinence with ease.

Alcohol Cessation in Late Life is Associated with Lower Risk of Cognitive Impairment among the Older Adults in China / 生物医学与环境科学（英文）

Objective@#Evidence regarding alcohol consumption and cognitive impairment is controversial. Whether cessation of drinking alcohol by non-dependent drinkers alters the risk of cognitive impairment remains unknown. This study prospectively evaluated the potential association between the history of lifetime alcohol cessation and risk of cognitive impairment.@*Methods@#This study included 15,758 participants age 65 years or older, selected from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) that covered 23 provinces in China. Current alcohol use status, duration of alcohol cessation, and alcohol consumption before abstinence were self-reported by participants; cognitive function was evaluated using Mini-mental State Examination (MMSE). Cause-specific hazard models and restricted cubic splines were applied to estimate the effect of alcohol use on cognitive impairment.@*Results@#Among the 15,758 participants, mean (± SD) age was 82.8 years (± 11.9 years), and 7,199 (45.7%) were males. During a mean of 3.9 years of follow-up, 3,404 cases were identified as cognitive impairment. Compared with current drinkers, alcohol cessation of five to nine years [adjusted @*Conclusion@#A longer duration of alcohol cessation was associated with a lower risk of cognitive impairment assessed by MMSE. Alcohol cessation is never late for older adults to prevent cognitive impairment.

Assistência de enfermagem na síndrome de abstinência alcoólica: fluxograma de atendimento / Cuidados de enfermería en el síndrome de abstinencia de alcohol: diagrama de cuidado / Nursing care in alcohol withdrawal syndrome: care flowchart

RESUMO Objetivo: realizar revisão da literatura e pela síntese de evidências elaborar um fluxograma de assistência de Enfermagem na síndrome de abstinência alcoólica (SAA). Método: foram executadas as primeiras etapas de elaboração de um protocolo clínico de Enfermagem. Na etapa "a" definiu-se o objetivo do protocolo; na etapa "b" realizou-se pesquisa da literatura científica para levantamento de evidências; e na etapa "c", a partir das evidências, elaborou-se um fluxograma de assistência de Enfermagem na SAA. A coleta de dados ocorreu em janeiro de 2019 nas bases de dados: Biblioteca Virtual em Saúde, PubMed, CINAHL, PSYINFO e MEDLINE. Os resultados foram apresentados em tabelas e figuras. Resultados: oito estudos foram incluídos na revisão. As evidências subsidiaram a elaboração do fluxograma de assistência de Enfermagem na SAA sistematizado nas seguintes fases: acolhimento e abordagem dos usuários de álcool com manifestação de sinais e sintomas de SAA; rastreio; intervenções; e encaminhamento. Conclusão: com a síntese das evidências foi possível a elaboração de um fluxograma de assistência de Enfermagem na SAA, o qual pode contribuir para o aprimoramento das respostas em saúde a esse problema, bem como é suficiente para dar seguimento às etapas de validação de um protocolo clínico.

RESUMEN Objetivo: revisar la literatura y, a través de la síntesis de evidencia, elaborar un diagrama de flujo de los cuidados de enfermería en el síndrome de abstinencia alcohólica (SAA). Método: se realizaron los primeros pasos para desarrollar un protocolo clínico de enfermería. En el paso "a" se definió el objetivo del protocolo; en el paso "b" se realizó una búsqueda de la literatura científica para recolectar evidencia; y en el paso "c", con base en la evidencia, se elaboró un diagrama de flujo de la atención de enfermería en la SAA. La recolección de datos se realizó en enero de 2019 en las siguientes bases de datos: Biblioteca Virtual en Salud, PubMed, CINAHL, PSYINFO y MEDLINE. Los resultados se presentaron en tablas y figura. Resultados: se incluyeron ocho estudios en la revisión. La evidencia apoyó la elaboración del diagrama de flujo de cuidados de enfermería en el SAA sistematizado en las siguientes fases: recepción y abordaje de consumidores de alcohol con manifestación de signos y síntomas de SAA; Seguimiento; intervenciones; y reenvío. Conclusión: con la síntesis de evidencias, fue posible desarrollar un diagrama de flujo de cuidados de enfermería en el SAA, que puede contribuir a la mejora de las respuestas de salud a esta problemática, además de ser suficiente para dar seguimiento a los pasos de validación de un protocolo clínico.

ABSTRACT Objective: to review the literature and, through the synthesis of evidence, elaborate a flowchart of Nursing care in the alcohol withdrawal syndrome (AWS). Method: the first steps of elaboration of a clinical Nursing protocol were carried out. In step "a" the objective of the protocol was defined; in step "b" a search of the scientific literature was carried out to gather evidence; and in step "c", based on the evidence, a flowchart of Nursing care in the AWS was elaborated. Data collection took place in January 2019 in the following databases: Virtual Health Library, PubMed, CINAHL, PSYINFO and MEDLINE. The results were presented in tables and figures. Results: eight studies were included in the review. The evidence supported the elaboration of the Nursing care flowchart in the AWS systematized in the following phases: reception and approach to alcohol users with manifestation of AWS signs and symptoms; Tracking; interventions; and forwarding. Conclusion: with the synthesis of evidence, it was possible to develop a flowchart of Nursing care in the SAA, which can contribute to the improvement of health responses to this problem, as well as being sufficient to follow up on the steps of validation of a clinical protocol.

Diminuição no uso de bebidas alcoólicas e a violência pelo parceiro íntimo / Decreased use of alcoholic beverages and intimate partner violence / Disminución del uso de bebidas alcohólicas y violencia de pareja

Introdução: A violência praticada por parceiro íntimo refere-se ao comportamento de parceiros ou ex-parceiros íntimos que resulta em dano físico, sexual ou psicológico, incluindo agressão física, coerção sexual, abuso psicológico e comportamento controlador. Sabe-se que o etilismo está associado ao aumento de tal violência. Objetivo: Analisar se a acompanhante do paciente em abstinência alcoólica referia menor índice de violência nesse período em relação ao tempo em que o mesmo fazia abuso de álcool. Métodos: Estudo observacional transversal no qual foram selecionados homens ex-etilistas atendidos no CAPSad de Maringá e suas parceiras. Foi utilizado um questionário para violência contra parceiro (HITS) composto de 4 perguntas objetivas, cuja pontuação varia de 4 até 20. Valores iguais ou superiores a 10 indicam violência. Resultados: Foram entrevistadas 53 mulheres de diversas faixas etárias e escolaridades. Desse total, 84,9% das participantes apresentaram pontuações menores no teste com o parceiro em abstinência em relação ao período em que o mesmo estava em uso/abuso de álcool. Das mulheres 15,1% não notaram diferença no nível de violência do acompanhante, estivesse ele em uso ou em abstinência alcoólica. Conclusões: Demonstrou-se claramente que o fato de cessar o consumo de bebidas alcoólicas reduziu o índice de violência infligida pelo parceiro.

Introduction: Intimate partner violence refers to the behavior of intimate partners or ex-partners resulting in physical, sexual, or psychological harm, including physical aggression, sexual coercion, psychological abuse, and controlling behavior. It is known that alcoholism is associated with increase of this type of violence. Objective: The aim of this study was to analyze whether the partner of the patient in alcohol withdrawal reported a lower rate of violence in this period compared with the period of alcohol abuse. Methods: cross-sectional study in which we selected male former drinkers attended at the CAPSad of Maringá, and their partners. A questionnaire regarding partner violence (HITS), consisting of 4 objective questions with scores ranging from 4 to 20, was used. Values equal to or greater than 10 indicate violence. Results: We interviewed 53 women of different ages and schooling. Of this total, 84.9% of the participants had scores in the test with the partner in withdrawal lower than in the period in which he was in use/abuse of alcohol. 15.1% of the women did not notice a difference in the level of violence of their partners, whether he was in use or withdrawal. Conclusions: It was clearly demonstrated that the cessation of alcohol consumption reduced the rate of violence inflicted by the partner.

Introducción: La violencia practicada por un compañero íntimo se refiere al comportamiento de parejas o ex compañeros íntimos que resultan en daño físico, sexual o psicológico, incluyendo agresión física, coerción sexual, abuso psicológico y comportamiento controlador. Se sabe que el etilismo está asociado al aumento de tal violencia. Objetivo: analizar si la compañera del paciente en abstinencia alcohólica refería menor índice de violencia en ese período en relación al tiempo en que el mismo hacía abuso de alcohol. Método: estudio tranversal en el que se seleccionaron hombres ex etilistas del CAPSad de Maringá y sus parejas. Se utilizó un cuestionario para violencia contra parejas (HITS) compuesto de 4 preguntas objetivas cuya puntuación varía de 4 a 20. Valores igual ou superiores a 10 indican violencia. Resultados: Se entrevistaron a 53 mujeres de diversas edades y escolaridades. De ese total, el 84,9% de las participantes presentó puntuaciones menores en la prueba con el compañero en abstinencia en relación al período en que el mismo estaba en uso / abuso de alcohol. El 15,1% de las mujeres no notaron diferencia en el nivel de violencia del acompañante, esté en uso o abstinencia alcohólica. Conclusión: Se demostró claramente que el hecho de cesar el consumo de bebidas alcohólicas redujo el índice de violencia infligido por el compañero.

Neonatal Abstinence Syndrome in an Infant Born to a Woman on Oxycodone for Cancer Pain: A Case Report

Few pregnant women are prescribed oxycodone for cancer pain. Here, we report a case of neonatal abstinence syndrome in an infant born to a woman using oxycodone long term for cancer pain. During pregnancy, rather than the expected effects on pregnant women for oxycodone use, fetal growth was also favorable. However, the infant presented with respiratory failure after birth and required ventilator management. In addition, the infant required treatment for neonatal abstinence syndrome.

Síndrome de abstinência alcoólica: conhecimentos e cuidados da Enfermagem na clínica cirúrgica do hospital geral / Alcohol withdrawal syndrome: knowledge and nursing care at a clinical surgery unit at a general hospital / Síndrome de abstinencia alcohólica: conocimientos y cuidados de la enfermería en la clínica quirúrgica de un hospital general

OBJETIVO: investigar o conhecimento da equipe de Enfermagem sobre a síndrome de abstinência alcoólica e descrever os cuidados prestados por essa equipe às pessoas com síndrome de abstinência alcoólica internadas na clínica cirúrgica. MÉTODO: estudo descritivo e qualitativo com 22 profissionais de Enfermagem que atuavam na clínica cirúrgica de um hospital geral e responderam a uma entrevista semiestruturada gravada e posteriormente transcrita. A Análise de Conteúdo e a Análise Temática foram utilizadas para avaliar os dados. RESULTADOS: foram identificadas as categorias "O conhecimento da equipe de Enfermagem sobre a síndrome de abstinência alcoólica" e "Os cuidados prestados pela equipe de Enfermagem diante de pessoas em síndrome de abstinência alcoólica". A equipe de Enfermagem reconhece os sinais e sintomas da síndrome de abstinência alcoólica, mas não os diferencia em orgânicos e psíquicos. Prioriza-se a contenção mecânica associada à farmacoterapia na prestação dos cuidados. CONCLUSÃO: recomenda-se sensibilizar e qualificar as equipes de Enfermagem para uma assistência pautada nas reais necessidades das pessoas com síndrome de abstinência alcoólica, pois esse é um desafio a ser superado para oferecer maior segurança no processo cirúrgico.

OBJECTIVE: to investigate the nursing team's knowledge about alcohol withdrawal syndrome and to describe the care provided by this team to people with alcohol withdrawal symptoms admitted to the surgical clinic. METHOD: descriptive and qualitative study. Twenty-two nursing professionals who worked in the surgical clinic of a general hospital answered a semi-structured interview that was recorded and later transcribed. Content analysis and thematic analysis were used to analyze the data. RESULTS: the following categories were identified: "Knowldge of the Nursing Team on the alcoholic withdrawal syndrome" and "Care provided by the nursing team to persons with alcoholic withdrawal syndrome". The nursing team recognizes the signs and symptoms of alcohol withdrawal syndrome, but does not differentiate them into organic and psychic. Priority is given to mechanical containment associated with pharmacotherapy in the provision of care. CONCLUSION: it is recommended to sensitize and qualify the nursing teams for an assistance based on the real needs of people with alcohol withdrawal syndrome is a challenge to be overcome to offer greater safety in the surgical process.

OBJETIVO: investigar el conocimiento del equipo de enfermería sobre el síndrome de abstinencia alcohólica y describir los cuidados prestados por ese equipo a las personas con síndrome de abstinencia alcohólica internadas en la clínica quirúrgica. MÉTODO: estudio descriptivo y cualitativo. Veintidós profesionales de enfermería que actuaban en la clínica quirúrgica de un hospital general respondieron una entrevista semiestructurada que fue grabada y posteriormente transcrita. El análisis de contenido y el análisis temático se utilizaron para analizar los datos. RESULTADOS: fueron identificadas las categorias: "El conocimiento del equipo de enfermeira sobre la síndrome de abstinencia alcohólica" y "Los cuidados oferecidos por el equipo de enfermeira para las personas com síndrome de abstinencia alcohólica". El equipo de enfermería reconoce los signos y síntomas del síndrome de abstinencia alcohólica, pero no los diferencia en orgánicos y psíquicos. Se prioriza la contención mecánica asociada a la farmacoterapia en la prestación del cuidado. CONCLUSIÓN: se recomienda sensibilizar y calificar a los equipos de enfermería para una asistencia pautada en las reales necesidades de las personas con síndrome de abstinencia alcohólica es un desafío a ser superado para ofrecer mayor seguridad en el proceso quirúrgico.