Prevalence, Reasons for Use, and Risk Perception of Electronic Cigarettes among Post-Acute Coronary Syndrome Smokers

Purpose—The use of electronic cigarettes (e-cigarettes) has risen dramatically in recent years. However, there is currently no published data on use of e-cigarettes among cardiac patients. The current study reports on the prevalence, reasons for use, and perceived risks of e-cigarettes among post-Acute Coronary Syndrome (ACS) patients. The relationship between e-cigarette use and post- ACS tobacco smoking cessation is also explored. Methods—Participants were drawn from a randomized trial of smoking cessation treatments following hospitalization for ACS. The current study focuses on 49 participants that completed e- cigarette questions at 24 weeks post-ACS. Results—51.0% of participants reported ever use of an e-cigarette and 26.5% reported using an e-cigarette at some time during the 24 weeks post-ACS. Ever use and post-ACS use were both significantly associated with lower rates of abstinence from tobacco cigarettes. Participants perceived e-cigarettes as less harmful to cardiac health than tobacco use and Chantix, and similarly harmful as nicotine replacement therapy. Participant perceived likelihood of experiencing a heart attack in the next year was 34.6% if they were to regularly use e-cigarettes only, significantly lower than perceived risk of recurrence if they were to regularly smoke only tobacco cigarettes (56.2%) and significantly higher than perceived risk of recurrence if they were to use no nicotine (15.2%). Conclusions—A significant minority of patients are using e-cigarettes post-ACS. Providers should be prepared to discuss potential discrepancies between patient beliefs about the safety of e- cigarettes and the current state of the science

Behavioral activation for smoking cessation and mood management following a cardiac event: results of a pilot randomized controlled trial

Background: Smoking cessation following hospitalization for Acute Coronary Syndrome (ACS) significantly reduces subsequent mortality. Depressed mood is a major barrier to cessation post-ACS. Although existing counseling treatments address smoking and depression independently in ACS patients, no integrated treatment addresses both. We developed an integrated treatment combining gold standard cessation counseling with behavioral activation-based mood management; Behavioral Activation Treatment for Cardiac Smokers (BAT-CS). The purpose of this pilot randomized controlled trial was to test feasibility, acceptability, and preliminary efficacy of BAT-CS vs. Standard of Care (SC). Methods: Participants were recruited during hospitalization for ACS and were randomly assigned to BAT-CS or SC. The nicotine patch was offered in both conditions. Smoking, mood, and stress outcomes were collected at end-of-treatment and 24-week follow-up. Results: Fifty-nine participants (28 BAT-CS, 31 SC) were recruited over 42 weeks, and assessment completion was above 80% in both conditions. Treatment acceptability and fidelity were high. At 24 week follow-up adjusted odds ratios favoring BAT-CS were 1.27 (95% CI: 0.41–3.93) for 7-day point prevalence abstinence and 1.27 (95% CI: 0.42–3.82) for continuous abstinence. Time to first smoking lapse was significantly longer in BAT-CS (62.4 vs. 31.8 days, p = 0.03). At 24-weeks, effect sizes for mood and stress outcomes ranged from η2 of.07–.11, with significant between treatment effects for positive affect, negative affect, and stress. Conclusions: The design of this study proved feasible and acceptable. Results provide preliminary evidence that combining behavioral activation with standard smoking cessation counseling could be efficacious for this high risk population. A larger trial with longer follow-up is warranted. Trial registration: NCT01964898. First received by clinicaltrials.gov October 15, 2013

Recognition and property in Hegel and the early Marx

The article attempts to show, first, that for Hegel the role of property is to enable persons both to objectify their freedom and to properly express their recognition of each other as free, and second, that the Marx of 1844 uses fundamentally similar ideas in his exposition of communist society. For him the role of ‘true property’ is to enable individuals both to objectify their essential human powers and their individuality, and to express their recognition of each other as fellow human beings with needs, or their ‘human recognition’. Marx further uses these ideas to condemn the society of private property and market exchange as characterised by ‘estranged’ forms of property and recognition. He therefore uses a structure of ideas which Hegel had used to justify the institutions of private property and market exchange in order to condemn those same institutions. It is concluded that Marx’s adoption from Hegel of the idea that property as the means of self-objectification and of expressed recognition, leaves his vision of communism open to the charge that in it, just as in market society, the relations between human beings are mediated by things

Comment on "Local accumulation times for source, diffusion, and degradation models in two and three dimensions" [J. Chem. Phys. 138, 104121 (2013)]

In a recent paper, Gordon, Muratov, and Shvartsman studied a partial differential equation (PDE) model describing radially symmetric diffusion and degradation in two and three dimensions. They paid particular attention to the local accumulation time (LAT), also known in the literature as the mean action time, which is a spatially dependent timescale that can be used to provide an estimate of the time required for the transient solution to effectively reach steady state. They presented exact results for three-dimensional applications and gave approximate results for the two-dimensional analogue. Here we make two generalizations of Gordon, Muratov, and Shvartsman’s work: (i) we present an exact expression for the LAT in any dimension and (ii) we present an exact expression for the variance of the distribution. The variance provides useful information regarding the spread about the mean that is not captured by the LAT. We conclude by describing further extensions of the model that were not considered by Gordon,Muratov, and Shvartsman. We have found that exact expressions for the LAT can also be derived for these important extensions..

Minimal Informationally Complete Measurements for Pure States

We consider measurements, described by a positive-operator-valued measure (POVM), whose outcome probabilities determine an arbitrary pure state of a D-dimensional quantum system. We call such a measurement a pure-state informationally complete (PSI-complete) POVM. We show that a measurement with 2D-1 outcomes cannot be PSI-complete, and then we construct a POVM with 2D outcomes that suffices, thus showing that a minimal PSI-complete POVM has 2D outcomes. We also consider PSI-complete POVMs that have only rank-one POVM elements and construct an example with 3D-2 outcomes, which is a generalization of the tetrahedral measurement for a qubit. The question of the minimal number of elements in a rank-one PSI-complete POVM is left open.Comment: 2 figures, submitted for the Asher Peres festschrif

Depressed mood predicts pulmonary rehabilitation completion among women, but not men

SummaryBackgroundAs many as 30% of patients who start pulmonary rehabilitation (PR) fail to complete it, and depressed mood has been associated with PR non-completion. Depression is more common in women than men with COPD and historically women with COPD have been under studied. However, no studies to date have investigated gender-specific predictors of PR completion.MethodsThe study included 111 patients with COPD who enrolled in a community based outpatient PR program in Providence, RI. Patients who attended 20 or more sessions were designated “completers”. Depression was measured using the CES-D. Logistic regression models were evaluated to test depressed mood as a predictor of PR completion. Analyses controlled for demographic and health variables found to differ between completers and non-completers.ResultsPatients were 95% white and 49.5% women, and 74% had a GOLD stage ≥3. Sixty-eight percent of patients were PR completers. A logistic regression model, showed that lower depressed mood independently predicted PR completion across all patients (adjusted OR = 0.92, p = .002). In gender-stratified analyses, lower depressed mood was an independent predictor of PR completion for women (adjusted OR = .91, p = .024) but not men (adjusted OR = .97, p = .45). Greater 6-min walk test distance was also an independent predictor of PR completion among women.ConclusionDepressed mood is an important predictor of completion of community based PR among women. Screening and brief treatment of depression should be considered in practice

Effects of resistance training on depression and cardiovascular disease risk in black men: Protocol for a randomized controlled trial

Background Depression is severely undertreated in Black men. This is primarily because Black men are less likely to seek traditional psychiatric treatment, have less access and more barriers to treatment, and perceive more stigma associated with treatment. Depression contributes to cardiovascular disease (CVD), and Black men have the highest rate of mortality from CVD. Resistance training (RT) can have beneficial effects on both depression and CVD. This study will be the first randomized controlled trial to test the effects of RT on depression and cardiovascular health in a sample of depressed Black men. Method Fifty Black men with clinically significant symptoms of depression will be randomized to either (a) a 12-week RT or (b) an attention control group. Behavioral Activation techniques will be used to support adherence to home-based RT goals. Both groups will meet on-site twice/week during the 12-week program, and follow-up assessments will occur at the end-of-treatment and 3 months post-treatment. Qualitative interviews will be conducted after the 3-month follow-up. The objectives of this study are (1) to assess the feasibility and acceptability of recruitment, retention, and intervention procedures, (2) to obtain preliminary evidence of efficacy, and (3) to explore potential mediators of the effects of RT on depression. Discussion This study will advance the field of minority men\u27s health by producing new data on the effects of RT for depression, the potential mechanisms of action that may support its use, and its effects on markers of CVD risk in Black men

The differential effect of instructions on dysphoric and nondysphoric persons

The experimenters investigated whether dysphoric and nondysphoric persons differentially exhibited the traditional instruction-induced schedule-insensitivity effect (rule-governed behavior). Dysphoric and nondysphoric participants were given instructions to perform a matching-to-sample task (four blocks, 40 trials each). The instructions in the first half of the study were correct and in the second half, incorrect. Participants were assigned to one of two instructional control conditions in which they read the instruction either privately (tracking condition) or out loud to the experimenter (pliance condition). Dysphoric individuals demonstrated greater schedule sensitivity (less rule-governed behavior) than did nondysphoric persons. No other differences were found. Results indicate that deficits in rule-governed behavior may contribute to depression; however, this experiment did not incorporate procedures to directly test the role of rule-governed experiential avoidance

Acceptance-based Behavior Therapy for Depression With Psychosis: Results From a Pilot Feasibility Randomized Controlled Trial

Acceptance-based depression and psychosis therapy (ADAPT), a mindfulness/acceptance-based behavioral activation treatment, showed clinically significant effects in the treatment of depression with psychosis in a previous open trial. The goal of the current study was to further test the feasibility of ADAPT to determine the utility of testing it in a future clinical trial, following a stage model of treatment development. Feasibility was determined by randomizing a small number of patients (N = 13) with comorbid depression and psychosis to medication treatment as usual plus enhanced assessment and monitoring (EAM) versus ADAPT for 4 months of outpatient treatment. Both conditions were deemed acceptable by patients. Differences in between-subjects effect sizes favored ADAPT post-treatment and were in the medium to large range for depression, psychosocial functioning, and experiential avoidance (ie, the target mechanism). Thus ADAPT shows promise for improving outcomes compared to medications alone and requires testing in a fully powered randomized trial

Global REACH: Assessment of brady-arrhythmias in Andeans and Lowlanders during apnea at 4330m

BACKGROUND: Ascent to altitude increases the prevalence of arrhythmogenesis in low-altitude dwelling populations (Lowlanders). High altitude populations (ie. Nepalese Sherpa) may have arrhythmias resistant adaptations that prevent arrhythmogenesis at altitude, though this has not been documented in other High altitude groups, including those diagnosed with chronic mountain sickness (CMS). We investigated whether healthy (CMS-) and CMS afflicted (CMS+) Andeans exhibit cardiac arrhythmias under acute apneic stress at altitude. METHODS AND RESULTS: Electrocardiograms (lead II) were collected in CMS- (N=9), CMS+ (N=8), and Lowlanders (N= 13) following several days at 4330m (Cerro de Pasco, Peru). ECG rhythm and HR were assessed at both rest and during maximal volitional apnea (End-Expiratory [EXP]). Both CMS- and CMS+ had similar basal HR (69 ± 8 beats/min vs. 62 ± 11 beats/min), while basal HR was higher in Lowlanders (77 ± 18 beats/min; P<0.05 versus CMS+). Apnea elicited significant bradycardia (nadir -32 ± 15 beats/min; P<0.01) and the development of arrhythmias in 8/13 Lowlanders (junctional rhythm, 3° atrio-venticular block, sinus pause). HR was preserved was prior to volitional breakpoint in both CMS- (nadir -6 ± 1 beat/min) and CMS+ (1 ±12 beats/min), with 2/17 Andeans developing arrhythmias ( 1 CMS+ and 1 CMS-; both Premature Atrial Contraction) prior to breakpoint. CONCLUSIONS: Andeans showed an absence of arrhythmias and preserved HR response to volitional apnea at altitude, demonstrating that potential cardio-resistant adaptations to arrhythmogenesis exist across permanent HA populations. Acclimatized Lowlanders have further demonstrated an increased prevalence of arrhythmias at altitude