Problematic substance use and digital interventions : researching intervention efficacy among Internet help-seekers, university students and patients in psychiatry

Background: Digital technologies are ever more present in our lives, and are being applied in numerous areas of our existence including the area of health care and health information. Problematic alcohol and drug use impose a major global burden on health, and it is of interest to find new ways of reaching out to those affected by the problem. Interventions delivered over the Internet and in the form of smartphone apps have the potential to be readily available at all times and places. Many apps are publicly available, but only a tiny proportion have been evaluated. Also, there are many evaluated self-help applications for the Internet, but research on the addition of counselor guidance over the Internet is very scarce. There is a need for scientific scrutiny before being able to either recommend or implement these applications into regular care. Aims: The aims of this doctoral project were: to carry out a preliminary evaluation of an Internet-based program for problematic use with guidance among Internet help-seekers; to investigate effects of three smartphone apps, two with estimated blood alcohol concentration (eBAC) feedback and a skills-training app, among university students; and to determine the prevalence of problematic substance use in a psychiatric population receiving treatment over the Internet, and to explore whether that substance use was associated with treatment outcomes. Methods: An Internet-based eight-module program was tested in a randomized controlled pilot study with 80 participants. Participants were randomized to: no guidance, guidance over secure email messaging, or choice between guidance over asynchronous secure email messaging or synchronous chat messaging (STUDY I). Effects of two smartphone apps, Promillekoll and PartyPlanner, both with real-time eBAC feedback, and one, PartyPlanner, offering the possibility to simulate a drinking event beforehand and compare afterwards to the real event, were tested in a randomized controlled trial with 1929 university students having problematic alcohol consumption. Both app groups were compared to assessment-only controls (STUDY II). The effects of offering university students with excessive drinking, already enrolled in an ongoing study similar to STUDY II, an additional app focused on skills training were investigated (STUDY III). One hundred and eighty six students were randomly assigned to either an intervention group, receiving access to the app immediately, or a waitlist group given access to the app after six weeks. Both groups were compared to each other and also to a group of assessment-only controls (n=144) from the ongoing study. In the final study, data from 1581 patients having been treated at the internet-based cognitive behavioral therapy (ICBT) clinic in Stockholm, Sweden for major depression, panic disorder or social anxiety disorder, were analyzed to identify the prevalence of problematic substance use at beginning of treatment. The association of problematic substance use with therapy outcomes was also analyzed (STUDY IV) Results: Study I: The guidance group (the secure email messaging and the choice of messaging mode groups were combined) had significantly lowered their alcohol consumption compared to the no-guidance group. Secure email messaging was the preferred mode of communication over chat for the choice group. Participants in the guidance group rated the program more favorably than participants in the no-guidance group. Study II: There were no differences between the apps and assessment-only controls on any alcohol related outcome, but one negative finding for the Promillekoll app, in that men in that group increased their drinking frequency. Study III: Both the intervention and the wait-list had lower proportions of excessive alcohol consumption compared to assessment-only controls at first follow-up. The intervention group lowered their drinking quantity at first follow-up and their drinking frequency at both follow-ups compared to controls. Study IV: Prevalence of problematic substance use was 32.4%. Exclusive problematic alcohol use was reported by 24.1%, 4.6% reported exclusive problematic drug use and 3.7% combined problematic alcohol and drug use. Problematic drug use among men and 25–34 year olds was associated with completing fewer treatment modules and combined substance use among women and 35–64 year olds negatively affected module completion. Baseline problematic substance use was not associated with worse therapy outcomes for patients treated for depression. However, hazardous alcohol use and probable dependence were associated with worse panic disorder treatment outcomes. Hazardous drug use as well as combined problematic alcohol use with either hazardous drug use or probable drug dependence were associated with worse social anxiety disorder outcomes. Conclusion: Using novel communications technology is effective for reaching individuals with problematic substance use. Adding counselor guidance to a web-based relapse prevention program has beneficial effects on problematic drinking. Smartphone apps relying on eBAC feedback do not show much promise at the moment. Skills-training smartphone apps may have a beneficial effect on excessive alcohol consumption. The prevalence of problematic substance use is high in ICBT-treated psychiatric outpatients, but for a variety of levels of baseline substance use, the negative effect on therapy outcomes seems limited

AUTOMATIC EXTRACTION OF SEMANTIC ASSOCIATION FROM POLISH TEXT

In the paper we presents a methodfor automatic construction of an association listfor a particular word. Association list is a set o f word, each o f which is in a semantic relation with the words.to dejine. To construct the association list we use statistic reasoning algory- thm, which works on the base o f the Polish inflection dictionary, text corpus, and the quan- titative dictionary createdfor the corpus. Experiments are encouraging enough - one may think that the association can serve as the basefor the entry in a semantic dictionary

Modelowanie języka polskiego z wykorzystaniem gramatyki struktur frazowych

Naszym celem jest modelowanie języka. Model językowy odgrywa ważną rolę w systemach automatycznego rozpoznawania mowy dużego słownika. W wielu do tej pory stosowanych modelach kolejność słów jest istotna. Jednakże w przypadku języków słowiańskich często kolejność słów nie ma dużego znaczenia. To jest przyczyną tego, że zastosowane modele są niedokładne dla języków słowiańskich.Naszym zdaniem lepszym rozwiązaniem jest zastosowanie gramatyki struktur frazowych. Przedstawiamy tutaj prostą gramatykę oraz nasze podejście do automatycznej ekstrakcji reguł za pomocą sieci neuronowej. Reguły te obejmują zależności między słowami według ich kategorii gramatycznych i zostaną użyte do generowania leksykonu gramatyki, który opisuje także zależności specyficzne dla poszczególnych słów

AUTOMATIC CLASSIFICATION OF NOUNS INTO SEMANTIC GROUPS USING A CORPUS OF TEXTS

This article presents a method of classification of nouns into semantic groups based on statistical inference. The algorithm uses the infiectional dictionary o f the Polish language and a corpus of texts to ana yse adjective-noun relationships. The semantic groups are consistent with the categorization in the WordNet dictionary. The classification of nouns into semantic groups is a smali step towards constructing a semantic dictionary for the Polish language

Binaurales Hören : Auf dem Weg zum räumlichen Hören mit Cochlea-Implantaten

Räumliches Hören soll verbessert werden. Während die Auditory Prosthetic Group (APG) der HNO-Klinik der Medizinische Hochschule Hannover (MHH) sich auf binaurale Soundcodierungsstrategien für Cochlea-Implantate sowie grundlegende Experimente am Menschen konzentriert, werden Wissenschaftler vom Institut für Informationsverarbeitung (TNT) der Leibniz Universität Hannover (LUH) an Kompressionsalgorithmen zur drahtlosen Übertragung von Audio und elektrischen Signalen für bilaterale Cochlea-Implantate arbeiten

Prevalence of colonic adenomas in patients with metabolic syndrome Występowanie gruczolaków jelita grubego u chorych z zespołem metabolicznym

Abstract Introduction: Seventy percent of colonic polyps are adenomas -benign neoplastic tissue deriving from epithelium with various grades of dysplasia. Metabolic syndrome is discussed as one of the risk factors for development of colonic adenomas. Aim: To evaluate the relation between metabolic syndrome and prevalence of colonic polyps. Material and methods: In 2008-2011, 151 patients (aged 50-70 years) from the city of Strzegom were enrolled in a prophylactic programme. Each patient had the following examinations performed: physical examination, abdomen ultrasound, chest X-ray, oesophagogastroduodenoscopy, colonoscopy, ECG and laboratory tests. In females mammography and gynaecological examination were performed, and in males prostate-specific antigen (PSA) level was evaluated. Results: The prevalence of adenomas was higher in patients with metabolic syndrome (33.3% vs. 20.6%, p < 0.05). Also higher prevalence of adenomas larger than 10 mm was found in patients with metabolic syndrome. HDL level above 95 mg% and HDL level 45-95 mg% with fulfilled criteria of metabolic syndrome were determined as risk factors of colonic adenoma development. Conclusions: Metabolic syndrome can be a risk factor for development of colonic adenomas. Adenoma growth can be accelerated in metabolic syndrome. HDL molecules can promote colonic proliferation and formation of adenomas

Alcohol and disadvantaged men : a feasibility trial of an intervention delivered by mobile phone

This project was funded by the UK National Institute for Health Research Public Health Research programme (09/3001/09).Introduction and Aims:  Disadvantaged men suffer substantial harm from heavy drinking. This feasibility study developed and evaluated the methods for a trial of a brief intervention delivered by text messages to disadvantaged men. It aimed to test the methods for recruitment and retention, to monitor engagement with the intervention and assess the overall acceptability of study methods. Design and Methods:  Disadvantaged men aged 25–44 years who had ≥2 episodes of binge drinking (≥8 units in one session) in the preceding month were recruited. Two recruitment strategies were assessed: recruitment from general practice registers and by a community outreach strategy. Theoretically and empirically based text messages were tailored to the target group. Results: The study recruited 67 disadvantaged men at high risk of alcohol-related harm, exceeding the target of 60. Evaluation showed that 95% of text messages were delivered, and the men engaged enthusiastically with the intervention. Retention at follow up was 96%. Outcomes were successfully measured on all men followed up. This provided data for the sample size calculation for the full trial. Post-study evaluation showed high levels of satisfaction with the study. Discussion and Conclusions: This study has shown that disadvantaged men can be recruited and follow-up data obtained in an alcohol intervention study. The study methods were acceptable to the participants. The men recruited were at high risk of alcohol-related harms. It also clarified ways in which the recruitment strategy, the baseline questionnaire and the intervention could be improved. The full trial is currently underway.Publisher PDFPeer reviewe

A proposal for the development of adaptive spoken interfaces to access the Web

Spoken dialog systems have been proposed as a solution to facilitate a more natural human–machine interaction. In this paper, we propose a framework to model the user׳s intention during the dialog and adapt the dialog model dynamically to the user needs and preferences, thus developing more efficient, adapted, and usable spoken dialog systems. Our framework employs statistical models based on neural networks that take into account the history of the dialog up to the current dialog state in order to predict the user׳s intention and the next system response. We describe our proposal and detail its application in the Let׳s Go spoken dialog system.Work partially supported by Projects MINECO TEC2012-37832- C02-01, CICYT TEC2011-28626-C02-02, CAM CONTEXTS (S2009/ TIC-1485

Computer-Based Interventions for Problematic Alcohol Use:a Review of Systematic Reviews

PURPOSE: The aim of this review is to provide an overview of knowledge and knowledge gaps in the field of computer-based alcohol interventions by (1) collating evidence on the effectiveness of computer-based alcohol interventions in different populations and (2) exploring the impact of four specified moderators of effectiveness: therapeutic orientation, length of intervention, guidance and trial engagement.  METHODS: A review of systematic reviews of randomized trials reporting on effectiveness of computer-based alcohol interventions published between 2005 and 2015.  RESULTS: Fourteen reviews met the inclusion criteria. Across the included reviews, it was generally reported that computer-based alcohol interventions were effective in reducing alcohol consumption, with mostly small effect sizes. There were indications that longer, multisession interventions are more effective than shorter or single session interventions. Evidence on the association between therapeutic orientation of an intervention, guidance or trial engagement and reductions in alcohol consumption is limited, as the number of reviews addressing these themes is low. None of the included reviews addressed the association between therapeutic orientation, length of intervention or guidance and trial engagement.  CONCLUSIONS: This review of systematic reviews highlights the mostly positive evidence supporting computer-based alcohol interventions as well as reveals a number of knowledge gaps that could guide future research in this field

In vitro assessment of adsorbents aiming to prevent deoxynivalenol and zearalenone mycotoxicoses

The high prevalence of the Fusarium mycotoxins, deoxynivalenol (DON) and zearalenone (ZON) in animal feeds in mild climatic zones of Europe and North America results in considerable economic losses, as these toxins affect health and productivity particularly of pigs from all age groups. The use of mycotoxin adsorbents as feed additives is one of the most prominent approaches to reduce the risk for mycotoxicoses in farm animals, and to minimise carry-over of mycotoxins from contaminated feeds into foods of animal origin. Successful aflatoxin adsorption by means of different substances (phyllosilicate minerals, zeolites, activated charcoal, synthetic resins or yeast cell-wall-derived products) has been demonstrated in vivo and in vitro. However, attempts to adsorb DON and ZON have been less encouraging. Here we describe the adsorption capacity of a variety of potential binders, including compounds that have not been evaluated before, such as humic acids. All compounds were tested at realistic inclusion levels for their capacity to bind ZON and DON, using an in vitro method that resembles the different pH conditions in the gastro-intestinal tract of pigs. Mycotoxin adsorption was assessed by chemical methods and distinct bioassays, using specific markers of toxicity as endpoints of toxicity in cytological assays. Whereas none of the tested substances was able to bind DON in an appreciable percentage, some of the selected smectite clays, humic substances and yeast-wall derived products efficiently adsorbed ZON (>70%). Binding efficiency was indirectly confirmed by the reduction of toxicity in the in vitro bioassays. In conclusion, the presented test protocol allows the rapid screening of potential mycotoxin binders. Like other in vitro assays, the presented protocol combining chemical and biological assays cannot completely simulate the conditions of the gastro-intestinal tract, and hence in vivo experiments remain mandatory to assess the efficacy of mycotoxin binders under practical conditions