Intranasal corticosteroid and oxymetazoline for chronic rhinitis: a systematic review.

OBJECTIVE: This study aimed to summarise the evidence for efficacy of combination treatment of intranasal corticosteroid spray with oxymetazoline hydrochloride nasal spray for chronic rhinitis. METHOD: Nine databases were systematically searched from study inception in September 2016 to 1 June 2020. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was followed. RESULTS: A total of 130 studies were screened, and 4 randomised controlled trials comprising 838 patients met inclusion criteria. The study found superior improvement of nasal congestion from onset of treatment to completion in intranasal corticosteroid spray and oxymetazoline hydrochloride groups compared with control groups. Intranasal corticosteroid spray and oxymetazoline hydrochloride use resulted in higher nasal volume (standard error of mean 1, 15.8 + 1.1 ml; p < .03) compared with either placebo (12.1 + 0.9 ml) or oxymetazoline hydrochloride (12.4 + 0.8 ml) alone (p = 0.003). CONCLUSION: Intranasal corticosteroid spray and oxymetazoline hydrochloride combination treatment may be superior in reducing rhinitis symptoms compared with either intranasal corticosteroid spray or oxymetazoline hydrochloride alone, without inducing rhinitis medicamentosa.

Lifetime characteristics of participants and non-participants in a smoking cessation trial: implications for external validity and public health impact.

BACKGROUND: Detailed information about the characteristics of smokers who do and do not participate in smoking cessation treatment is needed to improve efforts to reach, motivate, and treat smokers. PURPOSE: The aim of this study is to explore a broad range of characteristics related to participation in a smoking cessation trial. METHODS: Eligible smokers were recruited from a longitudinal birth cohort. Participants and non-participants were compared on a broad range of sociodemographics, smoking, psychiatric and substance abuse disorders, personality, and prospective measures from early childhood. Eligible smokers were compared to a matched regional subsample of the Behavioral Risk Factor Surveillance System (BRFSS). RESULTS: Few differences were observed, most of which were statistically significant but not clinically meaningful. Compared to non-participants, participants were more likely to be single, have lower income, be more nicotine-dependent, be more motivated to quit, and have higher levels of depressed mood and stress even after covariance of gender, income, and marital status. Sociodemographic differences between participants and the BRFSS sample reflect the skew toward lower socioeconomic status in the original birth cohort. CONCLUSIONS: The encouraging conclusion is that smokers who enroll in cessation trials may not differ much from non-participants. Information about treatment participants can inform the development of recruitment strategies, improve the tailoring of treatment to individual smoker profiles, help to estimate potential selection bias, and improve estimates of population impact.

Interventions to reduce harm associated with adolescent substance use.

A major proportion of the disease burden and deaths for young people in developed nations is attributable to misuse of alcohol and illicit drugs. Patterns of substance use established in adolescence are quite stable and predict chronic patterns of use, mortality, and morbidity later in life. We integrated findings of systematic reviews to summarise evidence for interventions aimed at prevention and reduction of harms related to adolescent substance use. Evidence of efficacy was available for developmental prevention interventions that aim to prevent onset of harmful patterns in settings such as vulnerable families, schools, and communities, and universal strategies to reduce attractiveness of substance use. Regulatory interventions aim to increase perceived costs and reduce availability and accessibility of substances. Increasing price, restricting settings of use, and raising legal purchase age are effective in reducing use of alcohol and tobacco and related harms. Screening and brief intervention are efficacious, but efficacy of a range of treatment approaches has not been reliably established. Harm-reduction interventions are effective in young people involved in risky and injecting substance use.

Pain and depression experienced by women with interstitial cystitis.

The goal of this study was to better understand the experience of women suffering from interstitial cystitis (IC), a chronic pain condition that has, as of yet, received little attention from psychosocial investigators. Eighty women with IC participated. The results from this study demonstrate that, in addition to frequency of voiding (the hallmark symptom of the disorder), IC sufferers also endure significant pain and depression. Levels of pain experienced by IC patients during their most painful flares exceed levels of pain experienced by other chronic pain patients. Similarly, levels of depression experienced by IC patients exceed those evidenced by the general population and by other populations of chronic pain patients. Furthermore, the pain and depression experienced by IC patients may be predicted by cognitive factors. Severity of pain is associated with self-efficacy for coping with pain. Severity of depression is associated with pain, self-efficacy for coping with pain, and self-stigmatization.

Domestically violent and nonviolent male inmates' responses to their partners' requests for condom use: testing a social-information processing model.

This study used a model derived from social-information processing theory to investigate how men with a history of domestic violence would react to a condom request. The study used path analysis to examine men's attributional and evaluative responses as potential predictors of coercion and condom use compliance. Men responded to a hypothetical situation in which their main partner requested that they use a condom. Among 100 county jail inmates, men who used severe forms of domestic violence differed from moderately violent and nonviolent men in their tendency to react negatively to condom requests. Condom-specific attributions were significant predictors of condom use and coercive actions but were not consistently different across abuse groups. Attributions that increased the likelihood of negative responding were infidelity, selfishness, competition for dominance, or suspicion of the man's fidelity.

The experiences of ataques de nervios: towards an anthropology of emotions in Puerto Rico.

Ataques de nervios are an idiom of distress used by Puerto Ricans and other Latinos to express dislocations in the social world of the family. This paper contributes to the growing study of the "anthropology of the emotions". Through detailed interviews with 121 people in Puerto Rico, 78 of whom had had an ataque de nervios, we are developing a thick description of both the prototypical models for ataques de nervios and the varied individual experiences of ataques. The interview used in this study is a version of the Explanatory Model Interview Catalogue specifically adapted for use in a community study of ataques de nervios in Puerto Rico. Responses to questions on the experience of ataque de nervios were analyzed using a team of reviewers who represented differing knowledge and experience with Puerto Rican culture and mental health practice. The experience of ataques de nervios involves a loss of control in several important domains of experience: emotional expressions, bodily sensations, action dimensions and alterations in consciousness. That loss of control is closely linked to important social contexts relating to major life problems and the experience of suffering.

Examining mediators of change in traditional chemical dependency treatment.

OBJECTIVE: Few studies have examined processes that mediate positive outcomes in the treatment of substance use disorders. The present study used a theory-driven approach to assess mechanisms hypothesized as curative by the traditional chemical dependency treatment approach. Several specific disease model processes such as accepting powerlessness over alcohol and two processes common to both the disease model and other treatment approaches (commitment to abstinence and intention to avoid high-risk situations) were studied. It was hypothesized that patients entering treatment would manifest high levels of denial, that there would be significant reduction of denial and increased endorsement of disease model and common processes as a result of treatment and that processes would mediate outcome. METHOD: Patients (N = 79; 54 men) in intensive traditional alcohol/drug treatment were assessed at entry into treatment, at the end of treatment and 1 month following treatment. Both self-report and clinician ratings of processes were assessed. RESULTS: Overall, results provided little support for study hypothesis. Subjects showed low levels of denial at treatment entry. Specific disease model, but not common processes, increased during treatment. Common processes, but not disease model processes, predicted relapse. Patients with higher levels of commitment to abstinence and greater intentions to avoid high-risk situations were at lower risk for relapse. However, greater commitment to Alcoholics Anonymous and belief in a Higher Power predicted reduced severity of relapse among those who did relapse. CONCLUSIONS: Findings do not support prevailing practitioner views regarding how traditional treatment works and suggest that interventions in these treatments may be mismatched to patient needs.