Randomized controlled trial of brief cognitive-behavioural interventions for insomnia in recovering alcoholics

AIMS: To test the efficacy of a cognitive-behavioural approach to treating disturbed sleep in abstinent alcoholics. DESIGN: Sixty recovering alcoholics with insomnia were assigned randomly to individual therapy, self-help with telephone support or waiting-list control. SETTING: Participants were volunteers recruited from out-patient treatment programs and through the media. MEASUREMENTS: Outcomes were assessed at post-treatment, 3-month and 6-month follow-ups using sleep diaries, the Pittsburgh Sleep Quality Index, wrist actigraphs and time-line follow-back interviews. INTERVENTION: Five sessions of out-patient cognitive-behavioural therapy for insomnia or a self-help manual with five telephone support calls. Treatment duration was 7 weeks. FINDINGS: Treated participants were significantly more improved than control participants on diary measures of sleep quality, sleep efficiency, awakenings and time to fall asleep. No significant differences between the individual therapy and self-help treatment conditions on measures of insomnia severity were evident at post-treatment. Self-reported improvement in sleep was corroborated by clinician and spousal ratings of insomnia severity, but not by actigraph recordings of nocturnal activity. At 3- and 6-month follow-up assessments treatment gains were reasonably maintained in both treatment groups, although individual therapy was associated with a higher rate of clinically significant improvement. At the 6-month follow-up, 60% participants who were regular users of sedative medication at baseline discontinued the use of their medication. Treatment appeared to have little impact in preventing relapses to alcohol. CONCLUSIONS: Recovering alcoholics with insomnia can achieve better sleep by applying cognitive-behavioural strategies.     

Natural and treatment-assisted recovery from gambling problems: a comparison of resolved and active gamblers

Aim. An exploratory study was conducted to understand the process of recovery from gambling problems. Design. Media recruitment was used to identify a resolved ( n = 43) and a comparison group of active pathological gamblers (n = 63). Participants. Participants showed evidence of significant problems related to gambling as well as high rates of co-morbid mood and substance use disorders. The median length of resolution was 14 months with a range of 6 weeks to 20 years. Findings. Resolved gamblers reported a variety of reasons for quitting gambling, related mainly to emotional and financial factors. They did not experience a greater number of precipitating life events compared with active gamblers but did report an increase in positive and a decrease in negative life events in the year after resolution. Both resolved and active gamblers who had relatively more severe problems were more likely to have had treatment or self-help involvement, whereas those with less severe problems, if resolved, were "naturally recovered". Conclusions. The results support the need for a continuum of treatment options for problem gamblers and provide helpful information about recovery processes.     

Adsorption characteristics and inhibition effect of two Schiff base compounds on corrosion of mild steel in 0.5 M HCl solution: experimental,DFT studies,and Monte Carlo simulation

In this work, we report the synthesis of two Schiff bases of substituted gallic acid derivatives via amidation reaction and their characterization using ¹H-NMR spectroscopy to study their inhibition performance on the aggressive attack of HCl on mild steel (MS). The inhibitive performance was examined using chemical (weight loss) and electrochemical (Tafel and EIS) test methods. The results indicate that these derivatives significantly suppress the dissolution rate of mild steel via adsorption phenomena, which correlates to the Langmuir adsorption model. Tafel data display the mixed-type properties of these compounds and EIS results show that increasing Schiff base concentration not only leads to delaying the charge transfer (R_ct) of iron from 26.4 ohm cm⁻² to 227.7 ohm cm⁻² but also decreases the capacitance of the adsorbed double layer (C_dl) from 8.58 (F cm⁻²) × 10⁻⁵ to 2.55 (F cm⁻²) × 10⁻⁵. The inhibition efficiency percentage reaches the peak (90%) at optimum concentration of 250 ppm. The Monte Carlo simulations confirm the adsorption ability of the as-prepared compounds on the Fe (1 1 0) crystal. The SEM/EDX results revealed the presence of a protective film on the mild steel sample.

Structures of the synthesized Schiff bases inhibitor.     

Cue-induced brain activity in pathological gamblers.

BACKGROUND: Previous studies using functional magnetic resonance imaging (fMRI) have identified differential brain activity in healthy subjects performing gambling tasks and in pathological gambling (PG) subjects when exposed to motivational and emotional predecessors for gambling as well as during gambling or response inhibition tasks. The goal of the present study was to determine if PG subjects exhibit differential brain activity when exposed to visual gambling cues. METHODS: Ten male DSM-IV-TR PG subjects and 10 matched healthy control subjects underwent fMRI during visual presentations of gambling-related video alternating with video of nature scenes. RESULTS: Pathological gambling subjects and control subjects exhibited overlap in areas of brain activity in response to the visual gambling cues; however, compared with control subjects, PG subjects exhibited significantly greater activity in the right dorsolateral prefrontal cortex (DLPFC), including the inferior and medial frontal gyri, the right parahippocampal gyrus, and left occipital cortex, including the fusiform gyrus. Pathological gambling subjects also reported a significant increase in mean craving for gambling after the study. Post hoc analyses revealed a dissociation in visual processing stream (dorsal vs. ventral) activation by subject group and cue type. CONCLUSIONS: These findings may represent a component of cue-induced craving for gambling or conditioned behavior that could underlie pathological gambling.     

Patterns of opioid and cocaine co-use: a descriptive study in a Canadian sample of untreated opioid-dependent individuals

This study examined prevalence and patterns of co-use of opioids and cocaine in regular users of illicit opioids (N = 729) recruited from 5 Canadian cities. Fifty-seven percent (n = 417) reported having used both opioids and cocaine in the month and week preceding the interview; of these, 73% (n = 304) were able to identify a typical pattern of daily co-use. In a typical day, injectors of opioids and cocaine (n = 119) and injectors of opioids who inhaled cocaine (n = 111) showed stable opioid use but variable cocaine use, which peaked at 21 hr. Overall, 30% of the individuals used both drugs exclusively in a sequential fashion, 35% reported taking opioids and cocaine within the same hour, and 35% reported taking them together at the same time or mixing them. These findings indicate that different individuals display different patterns of opioids and cocaine co-use.