Reducing craving and lapse risk in alcohol and stimulants dependence using mobile app involving ecological momentary assessment and self-guided psychological interventions: Protocol for a randomized controlled trial

BackgroundThe prevalence of alcohol consumption in Poland is estimated to be as high as 80% of the adult population. The use of stimulants is the second most common reason for seeking addiction treatment. However, treatment outcomes remain unsatisfactory, as 40–85% of individuals who complete various treatment programs relapse and fall back into addiction within 2 years following program completion.MethodsThe 13-armed randomized controlled trial aimed to assess the effectiveness of a mobile app-based self-guided psychological intervention delivered via a smartphone app (Nałogometr) in reducing craving and lapse risk in problematic alcohol or stimulants use. Participant recruitment and data collection will be performed from June 2022 to September 2022. The 4-week mobile intervention program will include short-term and long-term intervention modules based mainly on mindfulness and cognitive-behavioral therapy. Intervention effectiveness assessment will include Ecological Momentary Assessment. That is, we will collect longitudinal data on a set of characteristics of day-to-day functioning. The primary outcomes will include a self-reported number of lapses and addiction craving level. In contrast, the secondary outcomes will be the severity of problematic substance use, anxiety and depression scores, and life satisfaction scores.ConclusionThis study will establish how mobile app-based self-guided psychological interventions can help reduce craving and lapse risk in alcohol and stimulant dependence. If successful, this randomized controlled trial (RCT) may provide an innovative, easily available, and cost-effective mHealth approach for craving and lapse risk in substance addictions.Clinical trial registration[https://clinicaltrials.gov/], identifier [NCT054 34429]

An Empirical Study of Affective and Cognitive Functions in Compulsive Sexual Behavior Disorder

BACKGROUND AND AIMS: Despite the inclusion of the Compulsive Sexual Behavior Disorder (CSBD) in the International Classification of Diseases, very little is known about the underlying affective and cognitive processes. To fill this gap, we compared CSBD subjects and Healthy-Controls (HC) across negative/positive valence, cognitive and sensorimotor systems, as proposed by the Research Domain Criteria framework. METHODS: 74 heterosexual CSBD and 66 matched HC males were studied with 10 questionnaires and 8 behavioral tasks. Analyses were conducted with frequent and Bayesian statistics. RESULTS: CSBD individuals showed significantly higher (than HC) punishment sensitivity, anxiety, depression, compulsivity, and impulsivity symptoms. Frequentist statistical analysis revealed significant interaction between subject group and condition in Incentive Delay Task, concerning the strength of motivation and hedonic value of erotic rewards. Bayesian analysis produced evidence for the absence of group differences in Facial Discrimination Task, Risk-Ambiguity Task, and Learning Task. Also, Bayesian methods provided evidence for group differences in the Emotional Stroop Task and the Incentive Delay Task. Sexual Discounting Task, Attentional Network Task, and Stop Signal Task produced mixed results. CONCLUSIONS: Higher punishment sensitivity and impulsivity among CSBD subjects, along with significant interaction between these groups and erotic vs. non-erotic reward processing is in line with previous findings on negative/positive valence alterations in CSBD patients. This result shows that there are similarities to substance and behavioral addictions. The absence of group differences and mixed results related to cognitive and sensorimotor systems raise concerns to what extent CSBD resembles a wide spectrum of impairments observed in disorders, and demand further research

Threats to Mental Health Facilitated by Dating Applications Use Among Men Having Sex With Men.

In the last years, dating applications (DAs) have had a significant impact on the way in which people seek sexual and romantic relationships. Social groups, such as men having sex with men (MSM), who can experience discrimination and social isolation, find DAs especially engaging and helpful in finding sexual partners. Previous studies have provided evidence showing vulnerability to mental health problems among the MSM population-these problems can be potentially facilitated by DAs use. Excessive use of DAs is associated with lower well-being and life satisfaction, depression, higher substance use, and lower sleep quality. Therefore, there is a need for a better understanding of psychological functioning and risk factors associated with the use of DAs among MSM, which we focus on in this review. We also discuss two relatively new research areas: compulsive sexual behavior disorder and chemsex, and their relation to geosocial-networking mobile technologies. Finally, we point out the limitations of available studies on the mental health of MSM using DAs and propose further research directions

Antibiotic therapy in children with pneumonia treated in hospital

Introduction: Pneumonia is one of the most common causes of paediatric hospitalisations. Aim of the study: To analyse antibacterial treatment of pneumonia in children hospitalised in 2017 at the Department of Paediatrics, Paediatric Nephrology and Allergology of the Military Institute of Medicine in Warsaw. Material and methods: Medical documentation data of 360 children with clinical diagnosis of pneumonia was subjected to a retrospective analysis. Age, gender, antibiotics used before and during hospitalisation and time of treatment were considered. Results: Of all the children hospitalised at the Department (2,207), 360 pneumonias were reported (16.3% of all hospitalisations). The mean total time of antibiotic therapy was 10.76 ± 3.57 days. Out of 176 children (48.9% of all pneumonias) who reported to a general practitioner 91 (51.7%) received symptomatic treatment and 85 (48.3%) – antibiotic. On admission to hospital the type of antibiotic treatment was modified for 63/85 children (74.1%) and the form of antibiotic delivery was changed from oral to intravenous for 74/85 (87.1%). Antibacterial treatment in general practice was compliant with recommendations in 18/85 children (21.2%) and during hospitalisation – in 69/360 patients (19.2%). Conclusions: The most common infectious cause of paediatric hospitalisations was pneumonia. In general practice a significant problem is to diagnose community-acquired pneumonia with bacterial aetiology because of an uncharacteristic onset of symptoms. There is significant discrepancy between the everyday practice and recent guidelines on antibiotic use.Wstęp: Zapalenie płuc stanowi jedną z najczęstszych przyczyn hospitalizacji dzieci. Cel pracy: Analiza sposobu leczenia przeciwbakteryjnego dzieci z zapaleniem płuc w Klinice Pediatrii, Nefrologii i Alergologii Dziecięcej Wojskowego Instytutu Medycznego w Warszawie, hospitalizowanych w 2017 roku. Materiały i metody: Przeanalizowano dane medyczne 360 dzieci z rozpoznaniem klinicznym zapalenia płuc i oceniono: wiek, płeć, rodzaj zastosowanej antybiotykoterapii przed hospitalizacją i w jej trakcie oraz czas leczenia. Wyniki: Spośród 2207 dzieci hospitalizowanych w Klinice odnotowano 360 przypadków zapalenia płuc (16,3% wszystkich hospitalizacji). Całkowity średni czas antybiotykoterapii stosowanej zarówno ambulatoryjnie, jak i w trakcie hospitalizacji wynosił 10,76 ± 3,57 dnia. Do lekarza podstawowej opieki zdrowotnej zgłosiło się 176 dzieci (48,9% wszystkich zapaleń płuc), z czego 91/176 (51,7%) otrzymało leczenie objawowe, a 85/176 (48,3%) – leczenie przeciwbakteryjne. Przy przyjęciu do szpitala zmieniono rodzaj stosowanej antybiotykoterapii u 63/85 (74,1%) dzieci oraz drogę podania z doustnej na dożylną u 74/85 (87,1%). Leczenie przeciwbakteryjne w warunkach ambulatoryjnych zastosowano zgodnie z aktualnymi zaleceniami u 18/85 (21,2%) dzieci, a podczas hospitalizacji – u 69/360 (19,2%) pacjentów. Wnioski: Najczęstszą przyczyną hospitalizacji dzieci wymagających leczenia przeciwbakteryjnego było zapalenie płuc. W podstawowej opiece zdrowotnej istotnym problemem dla lekarzy jest rozpoznanie infekcji bakteryjnej ze względu na niecharakterystyczny początek objawów. Występują znaczne rozbieżności między stosowanym leczeniem a aktualnymi rekomendacjami

PRE-FEASIBILITY STUDY FOR TREATMENT WETLAND APPLICATION FOR WASTEWATER TREATMENT IN DISPERSED DEVELOPMENT

The aim of the paper is to present the conducted analyses of pre-feasibility study of different approaches for wastewater management in a settlement of 180 persons. In the assessment both technical and economic aspects were analyzed. The costs were calculated for three different and, at the same time, most popular as well as possible technical solutions like: (i) construction of local wastewater treatment plant with gravitational and pressurized networks, (ii) construction of single family wastewater treatment plants, (iii) construction of sealed septic tanks. Carried out analyses of investment and maintenance costs revealed that at the stage of construction the most expensive is local sewer network with treatment plant, while the construction of a single family treatment plant has similar cost regardless of the technology used. When the long term operation and investment cost are accounted the most economical reasonable solution is the application of wetland treatment for household wastewater treatment

Reducing Craving and Lapse Risk in Addiction in In-Treatment and Post-Treatment Patients Using a Mobile App Involving Ecological Momentary Assessment and Mindfulness-Based Interventions

We aim to determine the effectiveness of mobile app-based support solutions for individuals with SUD with concurrent in-patient and out-patient treatment in clinics

Evaluating the effectiveness of mobile app-based self-guided psychological intervention to reduce craving and lapse risk in problematic substance use and behaviors: Protocol for a randomized control trial in the general population.

BACKGROUND: The prevalence of substance and behavioral addiction is estimated between 10 and 15% of the global population and remains a severe public health concern. Moreover, addiction treatment has several barriers, such as a lack of access to professional treatment or stigmatization. Mobile health interventions emerge as a promising solution. METHODS: This two-armed randomized controlled trial (RCT) aims to assess the efficacy of a mobile app-based self-guided psychological intervention delivered via a smartphone app (Nałogometr) in reducing craving and lapse risk in problematic behaviors and substance use compared to a control condition. Participant recruitment and data collection will start in June 2022 and end in September 2022. Due to the nature of the study, i.e., a nationwide study of problematic substance use and behaviors, we will aim to recruit all individuals willing to participate. The four-week intervention condition includes short-term and long-term modules based mainly on mindfulness and cognitive behavioral therapy. Longitudinal data on several variables related to craving and lapse risk are collected daily using ecological momentary assessment (EMA). The primary outcomes of interest will be the self-reported number of lapses and craving level in daily EMA. Moreover, a questionnaire battery assessment is administered at baseline in the first week following onboarding, after five weeks, and after six months. The secondary outcome measures will include the severity of problematic substance use or behaviors, anxiety and depression, and life satisfaction. RESULTS: Results will be submitted for publication in peer-reviewed journals. CLINICAL TRIAL REGISTRATION: [https://clinicaltrials.gov/], identifier [NCT054 34,429]

Evaluating the effectiveness of mobile app-based self-guided psychological intervention to reduce craving and lapse risk in problematic substance use and behaviors: Protocol for a randomized control trial in the general population

Background: The prevalence of substance and behavioral addiction is estimated between 10 and 15% of the global population and remains a severe public health concern. Moreover, addiction treatment has several barriers, such as a lack of access to professional treatment or stigmatization. Mobile health interventions emerge as a promising solution. Methods: This two-armed randomized controlled trial (RCT) aims to assess the efficacy of a mobile app-based self-guided psychological intervention delivered via a smartphone app (Nałogometr) in reducing craving and lapse risk in problematic behaviors and substance use compared to a control condition. Participant recruitment and data collection will start in June 2022 and end in September 2022. Due to the nature of the study, i.e., a nationwide study of problematic substance use and behaviors, we will aim to recruit all individuals willing to participate. The four-week intervention condition includes short-term and long-term modules based mainly on mindfulness and cognitive behavioral therapy. Longitudinal data on several variables related to craving and lapse risk are collected daily using ecological momentary assessment (EMA). The primary outcomes of interest will be the self-reported number of lapses and craving level in daily EMA. Moreover, a questionnaire battery assessment is administered at baseline in the first week following onboarding, after five weeks, and after six months. The secondary outcome measures will include the severity of problematic substance use or behaviors, anxiety and depression, and life satisfaction. Results: Results will be submitted for publication in peer-reviewed journals. Clinical trial registration: [https://clinicaltrials.gov/], identifier [NCT054 34,429]