ABSTRACT
BACKGROUND: The community reinforcement approach (CRA) is an evidence-based practice for the treatment of substance use disorders and achieving and maintaining abstinence, but few studies have systematically explored the effect of CRA on secondary, yet also important outcomes, such as social functioning. OBJECTIVES: The purpose of this study was to examine whether an internet-based version of the CRA plus contingency management is associated with improved social functioning of individuals seeking substance use disorder treatment in a multi-site clinical effectiveness trial. METHODS: Social functioning was measured using the 54-item Social Adjustment Scale assessing role performance in six domains (work, social and leisure activities, extended family relationships, marital relationship, parenting, and immediate family). Generalized linear mixed models tested the effects of treatment, time, sex, baseline abstinence, baseline social functioning and baseline psychological distress on overall social functioning and across social functioning subscales at the end of the 12-week treatment phase and 3 and 6 months post treatment. RESULTS: Results showed no significant association between treatment and total social functioning score or any subscale scores. Being male was significantly associated with better social functioning overall at the end of treatment (p = .024). Higher levels of psychological distress at baseline predicted significantly worse social functioning at the end of treatment overall (p = .037). CONCLUSIONS: The addition of an internet-based version of the CRA was not associated with greater improvements in social functioning compared to standard outpatient care after 12 weeks of treatment. Implications for internet-delivered CRA are discussed.
Subject(s)
Internet , Substance-Related Disorders/psychology , Adolescent , Adult , Behavior Therapy/methods , Female , Humans , Male , Reinforcement, Psychology , Social Adjustment , Substance-Related Disorders/therapy , Therapy, Computer-Assisted , Treatment Outcome , Young AdultABSTRACT
Papillary transitional cell carcinoma of the bladder (PTCCB) is characterized by a high recurrence rate with infiltration of bladder wall and surrounding tissues. The outcome is poor in 10-20% of the cases and these cannot be detected by conventional methods. Different methods have been utilized to identify this high risk patient group, such as the tumor growth factor (TGF). This is obtained with the KI-67 antibody, which identifies a nuclear protein in the cells in the active cellular cycle (G1, G2, S and mitosis). TGF represents the percentage of KI-67 positive tumor cells. The aims of the present study were: 1) to determine the correlation of the histological features and TGF in PTCCB; 2) to determine the percentage, if any, of superficial low grade lesions with a high TGF. Thirty-one transurethral biopsies of patients with PTCCB were analyzed to determine the histological grade (following the criteria described by Ash), wall infiltration (according to the IUAC criteria) and TGF (using the PAP technique). The study revealed 16 (52%) were low grade and 15 (48%) were high grade tumors, 20 (64.5%) were superficial (PTa-PT1), 9 (29%) were deep (PT1-PT4) and the degree of wall infiltration could not be determined in two cases. Of the 20 superficial tumors, 15 (75%) had a low (0-15%) and 5 (25%) had a high (> or = 16%) TGF. The 9 cases with deep infiltration of the bladder wall (PT2-PT4) had a high TGF.(ABSTRACT TRUNCATED AT 250 WORDS)
Subject(s)
Carcinoma, Transitional Cell/pathology , Urinary Bladder Neoplasms/pathology , Cell Division , HumansABSTRACT
A study was designed to establish baseline normative responses to the MIT/Canadian Spacelab vestibular test battery. Three tests used a linear acceleration sled to measure otolith function: 1) perception of linear motion (threshold determination); 2) compensatory eye movements (linear VOR); 3) closed-loop nulling, in which the blindfolded subject nulls his velocity with a joystick under the influences of a pseudorandom sled disturbance. Rotational VOR was measured at 0.3 and 0.8 Hz in the dark and the light. Static visual-vestibular interaction was tested with a standard rod and frame apparatus, while dynamic interaction was assessed by susceptibility to roll vection induced by a rotating peripheral visual field. Two examples are presented of how results from this study can aid in the interpretation of data from preflight/postflight testing of Space Shuttle/Spacelab crews on these same experiments.
