Nicotine withdrawal symptoms following a quit attempt: An ecological momentary assessment study among adolescents

Contains fulltext : 77491.pdf (publisher's version ) (Open Access)The present study describes growth curves of withdrawal symptoms among 138 daily smoking adolescents before, during, and after a quit attempt. Participants reported their levels of withdrawal symptoms (craving, negative affect, and hunger) three times a day over a period of 28 days: 1 week prior to and 3 weeks following a quit attempt. All withdrawal symptoms were quite stable at a relatively low level during the 5 days prior to the quit day. At Day 8, withdrawal symptoms (especially craving) increased substantially. A significant decrease in symptoms was visible during the week following the quit day, and within 2 weeks postquit, both abstinent and relapsed adolescents had reverted to levels comparable to those during the prequit period. The course over time for craving and hunger were best described by a quadratic term, and a linear model best suited negative affect. Individual intercepts and slopes of the growth curves were used to predict abstinence during the last week of the study and at the 2-month follow-up. Analyses revealed that higher levels of craving at the beginning of the prequit week and on the target quit day (intercepts) decreased the odds of being abstinent during the last week of the study. In addition, the quadratic term for hunger predicted abstinence during the last week. Finally, among all three symptoms, none of the growth model characteristics predicted abstinence at follow-up. The findings generally suggest that smoking cessation among daily smoking adolescents does not largely depend on how their withdrawal symptoms evolve over time after achieving abstinence.8 p

Pathways to alcohol use among Dutch students in regular education and education for adolescents with behavioral problems: The role of parental alcohol use, general parenting practices and alcohol-specific parenting practices

Contains fulltext : 55936.pdf (publisher's version ) (Closed access)12 p

Epidural anaesthesia for caesarean section: a double blind comparison between 0.5% ropivacaine and 0.5% bupivacaine.

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The anatomy of the thoracic spinal canal investigated with magnetic resonance imaging (MRI)

Background and Objectives : Anesthesiologists are reluctant to consider higher levels for spinal anesthesia, largely due to direct threats to the spinal cord. The goal of this study is to investigate, with magnetic resonance imaging (MRI), the distances between the relevant structures of the spinal canal (spinal cord, thecal tissue, etc.) to determine modal anatomical positions for neuraxial anesthesia. Method : A group of 19 patients were imaged with an MRI scanner in supine position. Medial sagittal slices of the thoracic and lumbar spine were measured for the relative distances between anatomical structures, including epidural space, dura, and spinal cord. Results : The posterior dura – spinal cord distance is significantly greater in the middle thoracic region than at upper and lower thoracic levels (e.g. T6 9.5 ± 1.8 mm, T12 3.7 ± 1.2 mm, p < 0.001, T1 4.7 ± 1.7 mm, p < 0.001). There is variation in modal distances between the structures important for neuraxial anesthesia, at different levels of the spinal canal. Conclusions : The spinal cord tends to follow the straightest line through the imposed geometry of the spine. Considering the necessary angle of entry of the needle at mid-thoracic levels, there is relatively (more than at upper thoracic and lumbar levels) substantial separation of cord and surrounding thecal tissue. Anesthesiologists perform spinal blockades up to the L2-L3 interspace, but avoid higher levels for fear of neurological damage. The information that there is substantially more space in the dorsal subarachnoid space at thoracic level, might lead to potential applications in regional anesthesia. In contrast, the cauda equina sits more dorsally in the lumbar region.Biomedical EngineeringMechanical, Maritime and Materials Engineerin