Contingency Management applied to Alcohol Use Disorder: Systematic Review / Manejo de Contingência Aplicado ao Transtorno por Uso de Álcool: Revisão Sistemática

Abstract This systematic review evaluated the efficacy of applying Contingency Management (CM) to Alcohol Use Disorder. We followed the PRISMA recommendation and consulted the following databases: Cochrane Library, MEDLINE Complete, PsycINFO and Pubmed. A total of eight randomized controlled trials were included in this review, all of them with good methodological quality. In seven of these, CM was more effica​cious in promoting continuous abstinence. Both trials that evaluated treatment retention found statistically significant results favorable to CM. On two of the three trials presenting follow-up results, CM was more efficacious in promoting abstinence. The large-scale application of CM can promote substantial public health improvements and should be encouraged.

Resumo Esta revisão sistemática avaliou a eficácia do Manejo de Contingência (MC) no tratamento do Transtorno por Uso de Álcool. Para isso, foi utilizada a recomendação PRISMA e consultadas as bases de dados: Cochrane Library, MEDLINE Complete, PsycINFO e Pubmed. Foram incluídos oito ensaios clínicos randomizados nesta revisão. Em sete, o MC foi mais eficaz em promover abstinência continuada. Dos dois que avaliaram a retenção no tratamento, ambos encontraram resultados estatisticamente favoráveis ao MC. Dos três que apresentaram resultados de avaliação de seguimento, em dois o MC foi mais eficaz em promover abstinência. Todos apresentaram boa qualidade metodológica. A aplicação do MC em larga escala pode promover melhorias substanciais para a saúde pública e deve ser encorajada.

Nosocomial infection control strategy in cabin hospital during the outbreak of COVID-19 / 中华医院管理杂志

The construction of mobile Cabin hospitals is a pioneering effort for the prevention and controlling of the patients with mild symptoms during the outbreak epidemic of Novel Coronavirus Pneumonia. It is a prerequisite and important guarantee for the hospital to manage the hospital infection and prevent the spreading of the epidemic. Our team is located in Dongxihu mobile Cabin hospital, which is one of the first three Cabin hospitals in Wuhan. This article takes the operation process of this hospital as a clue, and discusses aspects of personal protection, environmental sanitation management, item management, occupational exposure disposal, and discharged patient management. It also analyzed common and critical problems in operation. With a view to provide reference for other Cabin hospitals or temporary treatment agencies.

Analysis on the application status of artificial intelligence in COVID-19 / 中华医院管理杂志

Since December 2019, an outbreak of novel coronavirus pneumonia (COVID-19) in Wuhan, Hubei Province, which has caused wide public concern all through the world. Although artificial intelligence is a priority development fields in recent years, there is no study on the application and effect of AI in this epidemic. Based on the application of AI scenarios in typical cases, the research analyzes the practice and effectiveness of AI in epidemic surveillance, clinical diagnose, public health management and other related scientific research. Besides, combined with the current situation of development, some suggestions are put forward in order to better play the role of artificial intelligence in the public health emergency system in China.

Contingency management is effective in promoting abstinence and retention in treatment among crack cocaine users with a previous history of poor treatment response: a crossover trial

Background: Crack use has become a severe health problem in Brazil. Contingency management has shown robust evidence of efficacy in the treatment of cocaine use disorder (CUD) in high-income countries; however, it is still unclear how this intervention can impact treatment in low-income countries. Objective: To evaluate the efficacy of contingency management in the treatment of CUD among individuals with a previous history of poor treatment response in Brazil. Methods: Six months after the end of treatment, 32 participants previously allocated to the usual care condition (UCC) were invited to receive an additional 12 weeks of treatment in a contingency management condition (CMC), and 16 accepted the invitation. We compared data obtained from only the 16 participants (14 male) exposed to both treatment conditions. Results: Participants attended more treatment sessions and were retained in treatment for a longer period during the CMC than during the UCC (p < .01 for both). The proportion of negative cocaine samples submitted, the mean longest duration of cocaine abstinence, and the odds of being abstinent from cocaine during the 12 weeks of treatment were significantly higher during treatment in the CMC when compared to the UCC (p < .05). Conclusions: This study provides further evidence that contingency management is effective in promoting abstinence and retention in treatment among individuals with CUD with a history of poor treatment response. Our findings argue for the incorporation of CM among public treatment services for CUD in Brazil. Trial registration: This study was registered at ClinicalTrials.gov as NCT01815645 on March 21, 2013.

Problem Work, Pattern Work

@#In this Unit we describe the first 2 types of intervention arising out of the extended consultation. In Problem work, the basic idea is to determine whether the patient’s behavior is a maladaptive response to antecedent stimuli, or the result of cognitive bias. We use counter-conditioning and contingency management to deal with maladaptive response. We use cognitive therapy to trace cognitive distortions that give rise to NATs and take steps to counter them. The problem approach is integrated as Cognitive Behavioral Therapy. The SMART solution to problems is deployed when there is no maladaptive behavior or cognitive bias at play. In pattern work, the salient life experiences of the patient which are selectively stored as narratives are examined. Such narratives may reflect a negative life pattern of thought and feeling. This is the problem-saturated story. Patients can be helped to change their pattern of thought and feeling and thus store their life experiences as preferred positive stories. The 4Rs – Re-membering, Re-framing, Re-authoring and Re-telling – help us to construct the new stories. When we do this consistently, the pattern work creates present and future stories of hope for the sufferer.