Comprehensive Treatment Model Research Articles

Several suggestions for improving diagnosis and management of patients with neurofibromatosis type 1

Neurofibromatosis type 1 (NF1) is an autosomal dominant genetic disease caused by the mutations in the NF1 gene, with an incidence of approximately 1/3 000. Affecting multiple organs and systems throughout the body, NF1 caused a wide variety of clinical symptoms. A comprehensive multidisciplinary diagnostic and treatment model is needed to meet the diverse needs of NF1 patients and improve their quality of life. In recent years, the emergence of targeted therapies has further benefited NF1 patients, and the number of clinical consultations has increased dramatically. However, due to the rarity of the disease itself and insufficient attention previously, the standardized, systematic, and precise diagnosis and treatment model of NF1 still needs to be further improved. In this paper, we reviewed the current status of comprehensive diagnosis and treatment of NF1 in China, combine with our long-term experiences in diagnosis and treatment of this disease. Meanwhile, we propose future directions and several suggestions for the comprehensive diagnosis and treatment model for Chinese NF1 patients.

Identifying and Characterizing Models of Substance Use Treatment in Outpatient Substance Use Treatment Facilities.

Given that individuals with substance use disorders (SUDs) have a variety of needs beyond substance use, it is critical to examine the comprehensiveness of services offered within outpatient SUD treatment facilities, where many individuals with SUDs receive care. This study's objective is to develop clusters of services offered, and assess organizational, policy, and environmental characteristics associated with having a more comprehensive treatment model. We conducted a principal component analysis (PCA) using data on SUD treatment facilities (n=8, 197) from the 2022 Mental Health and Addiction Treatment Tracking Repository, a national database of SUD treatment facilities. We applied a K-means cluster analysis on the generated components to cluster facilities by service offerings, and calculated the mean for different organizational, policy and environmental characteristics for each cluster. We retained five components from the PCA which represented the availability of different services (Pharmacotherapies, Infectious Disease and Harm Reduction, Supportive and Social Determinant of Health (SDOH) Services, Psychosocial Services, and General Healthcare.) The cluster analysis resulted in five SUD service models, with the most comprehensive having the highest percentage of accredited and Medicaid-accepting facilities, and facilities that were government-operated and located in a Medicaid expansion state, and the least comprehensive having lowest percentage of accredited, licensed and Medicaid-accepting facilities, and the highest percentage of private for-profit facilities. Our study found that SUD treatment facilities varied in the availability of five treatment components, but more comprehensive service models had a higher percentage of facilities that were licensed, accredited, and accepting Medicaid.

STAT: schema therapy for addiction treatment, a proposal for the integrative treatment of addictive disorders.

The nature and origins of addictions and of their adjunctive behaviors, as well as their chronicity, call for treatments that conceptualize and treat them as the long-term and complex processes that they are. Addictions are often comorbid with personality problems and with trauma histories. Patients suffering from these disorders often show poor engagement with treatment and high rates of relapse, possibly because available treatments have yet to address the patient suffering from addiction in a more integrated or holistic manner. In particular, comprehensive treatment models for addictive disorders - like treatments for personality disorders or trauma - are likely to require the integration of behavioral, cognitive, and emotion-focused interventions within a facilitative therapeutic relationship. However, most current treatment models, including ones which are highly effective in stabilization or behavioral change, lack one or more components of treatment that could sustain longer term recovery, wellness, and health for a higher percentage of patients. In this article, I propose approaching addictions and their treatment from the perspective of schema therapy, an integrative, developmental model with a strong track record of positive outcomes in addressing personality disorder symptoms and long-standing trauma histories, commonly comorbid with addictive disorders. In advancing this proposal, I begin by providing some background tying together addictions, attachment, and personality, suggesting they be treated simultaneously to achieve improved outcomes. Then, after briefly reviewing the leading approaches to the treatment of addictions, I introduce the idea that schema therapy is well-situated - both theoretically and practically - to address many of the shortcomings of existing treatment options. In particular, I note how addictive and co-occurring colluding behaviors are deeply intertwined with both early and continued frustration of core developmental needs. I illustrate how the addictive cycle is perpetuated through the process of schema reinforcement and through the operation of schema modes. I then demonstrate how these key terms (i.e., needs, schemas, and modes) inform the patient's assessment and case formulation, guiding treatment interventions from a strong therapeutic relationship that focuses on integrating recovery behavior change, healing dysfunctional schemas and modes, and preventing relapse.

10-year retention of a comprehensive treatment model of buprenorphine for opioid use disorder

Background There has been extensive research demonstrating the effectiveness of medications for opioid use disorder (MOUD) but limited investigation into its long-term retention rate. Objective Assess the long-term treatment retention of a buprenorphine-based MOUD clinic with additional stratifications by age and gender. Methods This retrospective study analyzed 10-years of data from a MOUD clinic in West Virginia that served 3,255 unique patients during the study period (2009-2019). Retention was measured by summation of total treatment days with a new episode of care defined as re-initiating buprenorphine treatment after 60+ consecutive days of nonattendance. Kaplan-Meier survival analysis, with the log-rank test, was used to compare retention by gender and age. Results The mean age was 38 (SD = 10.6) and 95% were non-Hispanic white. Irrespective of treatment episode, 56.8% of patients were retained ≥ 90 days, and the overall median time in treatment was 112 days. Considering only the first treatment episode, 48.4% of 3,255 patients were retained at least 90 days and the overall median was 77 days. Female patients had a ≥ 90 day retention rate of 52.2% for the first admission and 60.1% for multiple admissions, both significantly higher than those of male subjects (44.1% and 53.0%). Additionally, patients ≤ 24 years old had the lowest rate of treatment retention, while patients aged ≥ 35 had the highest. Conclusions This study adds to the limited data regarding long-term retention in MOUD. Our findings indicate gender and age were highly correlated with retention in MOUD treatment.

Development of a family-based treatment for co-occurring intimate partner violence and child maltreatment: the MST-IPV model.

Intimate partner violence (IPV) is a significant global problem that affects the health of children, parents/caregivers and extended family. The effects can be lifelong and span generations. Treatments for IPV are focused largely on individual work with men as the primary aggressor. Even when the situation includes child maltreatment, generally all family members are referred to a host of providers for varied treatments. Traditionally, couples and family work does not occur. In this article, we detail the development and practice of a comprehensive treatment model for complex cases of co-occurring IPV and child maltreatment that is inclusive of the family and couple. Of particular note, the development of this model, Multisystemic Therapy for Intimate Partner Violence (MST-IPV), involved input from the IPV stakeholder community.

53 Adolescent Dialectical Behaviour Therapy: Levels of Care

Abstract Introduction/Background A growing body of research supports the efficacy of Dialectical Behavioural Therapy (DBT) for adolescents with various mental health diagnoses, but a traditional DBT program uses intensive resources (weekly individual and group therapy). To see whether a less intensive program could benefit certain participants, a complementary program called “DBT Lite” was designed and implemented at a large acute care Children’s Hospital. The group format (youth and parents together), therapeutic principals and coping skills taught were the same (based on “DBT Skills Manual for Adolescents”, Miller & Rathus, 2014), but DBT Lite involved only group therapy, and was offered over a shorter time frame (12 weeks vs. 19 weeks). Objectives The purpose of this study was to compare the effectiveness of “DBT Full” and “DBT Lite” on improving emotion regulation and family functioning/parental stress and decreasing emergency department (ED) visits and hospitalizations among adolescents age 13-17 with mental health diagnoses. Participants were not randomized; the treatment was selected according to severity of illness. We hypothesized that both treatment programs would show benefits but that “Full DBT” would result in greater improvements than “DBT Lite” due to its more comprehensive treatment model. Design/Methods Data was collected prospectively pre- and post-treatment from youth and parents participating in both programs over a 3-year period. The primary outcome measures were the DERS (Difficulties in Emotion Regulation Scale), the FACES-IV (Family Adaptability and Cohesion Scale, 4th Ed), and the PSS (Parental Stress Scale). Results were analyzed using paired-sample t-tests. We also examined ED and hospital admission data 6 months prior to starting the group and 6 months following completion of the group. Results In “Full DBT”, emotion regulation improved in both youth (n=9) and parents (n=12) post-treatment (DERS total score: youth p=0.02; parents p=0.01). Parents reported significant improvements on measures of parental stress (PSS p=0.002), and family functioning (FACES-IV family communication p=0.000, satisfaction p=0.008, and overall family functioning p=0.002). However, these improvements were not significant in youth measures. In “DBT Lite”, youth (n=16) and parents (n=17) did not report significant improvements in emotion regulation or family functioning, but did report decreases in parental stress (PSS p=0.005). Both groups resulted in measurable differences in acute care use: the percentage of patients with ED presentations 6 months pre- vs. 6 months post-group decreased from 70% to 27% for “Lite”, and 81% to 50% for “Full”. The percentage of patients requiring hospital admission decreased from 13% to 10% for “Lite”, and 56% to 28% for “Full”. Conclusion These results suggest that although “DBT Lite” may not have the same family functioning and emotion regulation benefits as its full-service counterpart, it can still reduce parental stress and decrease use of acute care resources. This study confirms the patient and family benefits of a full DBT program, but also has important implications for centres with limited mental health resources, given that “Full DBT” requires 38 clinician hours per patient to deliver, versus 12 hours for “DBT Lite”.

The optimization model of soil and water conservation ecological construction for power transmission and transformation projects in ecologically sensitive areas in Sichuan and Chongqing area in the new era is analyzed

In the construction and development of modern society, the overall characteristics of soil and water conservation ecological construction are not only reflected in the coordination of biological measures and engineering measures, but also in the sustainable development of economy and technology, which is the fundamental demand of the comprehensive treatment and optimization model of soil and water conservation for power transformation projects in ecologically sensitive areas of Sichuan and Chongqing in the new era. Therefore, after understanding the development requirements of ecological sensitive areas in Sichuan-Chongqing area, this paper mainly studies the optimization model of ecological construction of soil and water conservation according to the construction management content of power transmission and transformation projects, so as to provide technical support for urban construction and development in the new era.

What Are the Various Comprehensive Treatment Models to Improve Self-Efficacy and Self-Management in Adolescents with Diabetes Mellitus? A Scoping Review.

This review aimed to synthesize intervention models involving the role of adolescent and family support as part of comprehensive care to improve self-efficacy and self-management among adolescents with Diabetes Mellitus (DM). A review was conducted to conform to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) standards. We searched PubMed, Research Gate, Science Direct, Cochrane Library databases, and grey literature. We included articles exploring family intervention models on improving self-efficacy and self-management among adolescents with DM, published from January 1, 2009, to June 30, 2022, and in English. Articles were declared eligible, reviewed critically, and then synthesized narratively. We identified 487 abstracts and title records from the initial search and excluded 409 irrelevant studies. Sixty-six full-text articles were screened, and nine were included in the synthesis. Five articles presented findings from using models focusing on child and adolescent intervention, while in the remaining four articles, the intervention models involved adolescents and their caregivers or parents. Only two models provide comprehensive care that requires collaboration among healthcare providers, patients, and families. Adolescent self-efficacy and self-management schemes as intermediary variables are closely related to everything that can influence health behavior, metabolic control, and quality of life for adolescents, which requires support from a multidisciplinary collaborative team. Excellent comprehensive care team collaboration involving family support is essential to increase the self-efficacy and self-management of adolescents with DM.

Design and Analysis of a Radiation Resistant 12T SRAM Cell for Aerospace Applications

Introduction: Advanced low-power designs have been scaled down to the device parameters that increase single-event multi-node upset in memory elements. This degradation of the stability of the memory elements in aerospace applications is due to the high radiation environment and rapid temperature changes. Method: Hence, this paper presents a comprehensive treatment model for hardened storage elements with a soft error resulting in multi-node upset. A novel 12T SRAM memory cell configuration has been proposed, analysed, and simulated using Cadence Virtuoso gpdk 45 nm CMOS technology. Result: The proposed design counteracts the positive feedback induced due to the charged ion strike, as in past technical literature. The radiation environment has been realized with double exponential current sources, and temperature analysis has been carried out under parametric analysis. Conclusion: The novel 12T achieves good stability and remains resilient to bit-flip due to ion strikes for a wider range of voltage when the temperature varies from -50oC to 200oC. Moreover, the proposed structure features a lower susceptibility to single event upset, less write and read time, and reduced area compared to the reported RSP 14T.

Project T-SHARP: study protocol for a multi-site randomized controlled trial of tele-harm reduction for people with HIV who inject drugs

BackgroundThe resurgence of HIV outbreaks and rising prevalence among people who inject drugs (PWID) remain exigent obstacles to Ending the HIV Epidemic in the USA. Adapting a low threshold, comprehensive treatment model for PWID with HIV can leverage syringe services programs (SSPs) to increase availability and accessibility of antiretrovirals (ART), medications for opioid use disorder (MOUD), and hepatitis C cure. We developed Tele-Harm Reduction, a telehealth-enhanced, harm reduction intervention delivered within an SSP venue.MethodsThe T-SHARP trial is an open-label, multi-site, randomized controlled superiority trial with two parallel treatment arms. Participants (n=240) recruited from SSPs in Miami, Ft. Lauderdale, and Tampa, Florida, who are PWID with uncontrolled HIV (i.e., HIV RNA>200) will be randomized to Tele-Harm Reduction or off-site linkage to HIV care. The primary objective is to compare the efficacy of Tele-Harm Reduction for initiation of ART at SSPs vs. off-site linkage to an HIV clinic with respect to viral suppression across follow-up (suppression at 3, 6, and 12 months post randomization). Participants with HIV RNA<200 copies/ml will be considered virally suppressed. The primary trial outcome is time-averaged HIV viral suppression (HIV RNA <200 copies/ml) over 3-, 6-, and 12-month follow-up. Secondary outcomes include initiation of MOUD measured by urine drug screen and HCV cure, defined as achieving 12-week sustained virologic response (negative HCV RNA at 12 weeks post treatment completion). A cost-effectiveness analysis will be performed.DiscussionThe T-SHARP Trial will be the first to our knowledge to test the efficacy of an innovative telehealth intervention with PWID with uncontrolled HIV delivered via an SSP to support HIV viral suppression. Tele-Harm Reduction is further facilitated by a peer to support adherence and bridge the digital divide. This innovative, flipped healthcare model sets aside the traditional healthcare system, reduces multi-level barriers to care, and meets PWID where they are. The T-SHARP trial is a pragmatic clinical trial that seeks to transform the way that PWID access HIV care and improve HIV clinical outcomes.Trial registrationClinicalTrials.gov NCT05208697. Trial registry name: Tele-Harm Reduction. Registration date: January 26, 2022.

Retracted: Analysis of the Role of Comprehensive Treatment Model in the Treatment of Prostate Cancer.

[This retracts the article DOI: 10.1155/2022/2118823.].

The impact of different comprehensive treatment models on patients with adenocarcinoma of esophagogastric junction based on propensity score matching: a single center cohort study

Objective: To compare the prognostic influence and postoperative pathology of different comprehensive treatment models for adenocarcinoma of esophagogastric junction. Methods: Between January 2012 and December 2017, a total of 219 patients with adenocarcinoma of esophagogastric junction underwent surgery in Gastrointestinal Cancer Center, Peking University Cancer Hospital & Institute and were enrolled in this study. The clinicopathological data of these patients were collected. The patients were categorized into 3 groups according to different treatment models: surgery-first group, neoadjuvant chemotherapy (NAC) group and neoadjuvant chemoradiotherapy (nCRT) group. A trimatch propensity score analysis was applied to control potential confounders among the three groups by using R language software. A total of 7 covariates including gender, age, comorbidity, body mass index, clinical T stage, clinical N stage and Siewert type were included, and the caliper value was taken as 0.2. After matching, a total of 87 patients were included for analysis with 27 patients for each group. There were 82 males and 5 females, with a median age of 63 years (range: 38 to 76 years). The effect of preoperative treatment on postoperative tumor pathology among the three different comprehensive treatment models was explored by χ2 test, ANOVA or Wilcoxon rank sum test. Mann-Whitney U test or χ2 test were used to undergo pairwise comparisons. Kaplan-Meier method and Log-rank test were used to analyze the overall survival and progression-free survival. Results: The proportion of vascular embolism in the surgery-first group was 72.4% (21/29), which was significantly higher than NAC group (37.9% (11/29), χ2=6.971, P=0.008) and nCRT group (6.9% (2/29), χ2=26.696, P<0.01). The proportions of pathological T3-4 stage in nCRT group and NAC group were 55.2% (16/29) and 62.1% (18/29), respectively, which were significantly lower than the surgery-first group (93.1% (27/29), χ2=10.881, P=0.001; χ2=8.031, P=0.005). Compared with the NAC group (55.2% (16/29), χ2=6.740, P=0.009) and nCRT group (31.0% (9/29), χ2=18.196, P<0.01), the proportion of lymph node positivity 86.2% (25/29) were significantly higher in the surgery-first group. The 5-year overall survival rates were 62.1%, 68.6% and 41.4% for the surgery-first group, NAC group and nCRT group, respectively (χ2=4.976, P=0.083). The 5-year progression-free survival rates were 61.7%, 65.1% and 41.1% for the surgery-first group, NAC group and nCRT group, respectively. The differences in overall survival (χ2=4.976, P=0.083) and progression-free survival (χ2=4.332, P=0.115) among the three groups were nonsignificant. Conclusions: Postoperative pathology is significantly different among the three groups. Neoadjuvant chemotherapy and neoadjuvant chemoradiotherapy could decrease the proportions of vascular embolism, pathological T3-4 stage and lymph node positivity to achieve local tumor control. The prognosis of overall survival and progression-free survival are not significantly different among the three groups.

Targeted Arginine Metabolism Therapy: A Dilemma in Glioma Treatment.

Efforts in the treatment of glioma which is the most common primary malignant tumor of the central nervous system, have not shown satisfactory results despite a comprehensive treatment model that combines various treatment methods, including immunotherapy. Cellular metabolism is a determinant of the viability and function of cancer cells as well as immune cells, and the interplay of immune regulation and metabolic reprogramming in tumors has become an active area of research in recent years. From the perspective of metabolism and immunity in the glioma microenvironment, we elaborated on arginine metabolic reprogramming in glioma cells, which leads to a decrease in arginine levels in the tumor microenvironment. Reduced arginine availability significantly inhibits the proliferation, activation, and function of T cells, thereby promoting the establishment of an immunosuppressive microenvironment. Therefore, replenishment of arginine levels to enhance the anti-tumor activity of T cells is a promising strategy for the treatment of glioma. However, due to the lack of expression of argininosuccinate synthase, gliomas are unable to synthesize arginine; thus, they are highly dependent on the availability of arginine in the extracellular environment. This metabolic weakness of glioma has been utilized by researchers to develop arginine deprivation therapy, which ‘starves’ tumor cells by consuming large amounts of arginine in circulation. Although it has shown good results, this treatment modality that targets arginine metabolism in glioma is controversial. Exploiting a suitable strategy that can not only enhance the antitumor immune response, but also “starve” tumor cells by regulating arginine metabolism to cure glioma will be promising.

Efectividad de un modelo de tratamiento integral de la osteoartrosis

Introduction. Osteoarthrosis (OA) is the most frequent degenerative joint disease causing a significant social burden and being a frequent cause of disability. It also affects the mental health of patients and increases health care costs, including costs of hospitalization or admission to emergency services. The most deteriorated joints are the knees, hands, hips, and spine; above all among female patients. Obesity is the main risk factor. Despite the international recommendations, comprehensive patient management is rare and most therapeutic interventions are isolated and focused on the administration of non-steroidal anti-inflammatory drugs (NSAID), viscosupplementation, or intra-articular administration of corticosteroids. Objective. The objective of this non-comparative retrospective study was to test the effectiveness of a comprehensive medical treatment (CMT) model for OA that has been implenting in Mexico since 2006. Material and Methods. To determine the OA improvement in the patient receiving a CMT scheme that includes phytopharmaceuticals, rehabilitation, nutritional intervention, patient education, and a telephone attention program, the consumption of traditional medicines (NSAID) was compared before and after the intervention and clinimetrically measuring the visual analog evaluation, number of painful joints, number of swollen joints, evaluation global assessment of the disease by the patient, global assessment of the disease by the treating physician, muscle strength, Health Assessment Questionnaire, and adherence to treatment. Results. Approximately 18% (17.92%) of the patients in the sample were taking two or more medications at the beginning of the study; at the end, only 2.79% took them. The proportion of patients with no drug, monotherapy and combination of drugs and/or supplements is significant between the initial visit and the final visit. In the clinimetric domain, a statistically significant decrease (p&gt; 0.01) was found between the value of the initial visit and the final visit. The number of painful joints and swollen joints from the initial visit to the final visit decreased statistically significantly. The global assessment of the disease by the patient from the initial visit to the final visit decreased statistically significantly. Discussion. CMT with periodic monitoring, phytopharmaceutical patient education, nutritional intervention, rehabilitation, and a telephone service program is effective for the control of osteoarthritis.

Analysis of the Role of Comprehensive Treatment Model in the Treatment of Prostate Cancer.

The incidence of prostate cancer is gradually increasing. There are many methods for clinical treatment of prostate cancer, such as surgical treatment and endocrine treatment. In the case of advanced prostate cancer, we must not only extend patients' survival times but also enhance their quality of life. Endocrine medications are the most effective therapy for advanced prostate cancer. This research will investigate the therapeutic impact of a complete treatment model in prostate cancer in order to discover a trustworthy clinical treatment model. This research discovered that, as compared to endocrine treatment, radical resection of prostate cancer may diminish and reach lower serum PSA levels in a short amount of time, as well as sustain low PSA levels and delay progression to castration resistance. Moreover, the comprehensive treatment mode can effectively reduce the possibility of complications. The research results show that the comprehensive treatment model can play an important role in the treatment of prostate cancer.

Prognostic analysis of different comprehensive treatment models for locally advanced esophageal squamous cell carcinoma based on propensity score matching

Objective: To compare the effects of preoperative neoadjuvant chemotherapy and postoperative adjuvant chemotherapy on the long-term survival of patients with radical resection for esophageal squamous cell carcinoma. Methods: Totally 1 082 patients with stage T3-4aN0-3M0 thoracic esophageal squamous cell carcinoma were recruited in this study who underwent radical resection at Department of Thoracic Surgery, Fourth Hospital, Hebei Medical University from January 2005 to January 2015. There were 798 males and 284 females, with a median age of 61 years (range: 37 to 86 years). There were 138 patients undergoing preoperative neoadjuvant chemotherapy, 392 patients postoperative adjuvant chemotherapy, and 552 patients surgery alone. The neoadjuvant chemotherapy group was used as the benchmark group to match the propensity score with the adjuvant chemotherapy group and the surgery-only group respectively at a ratio of 1∶3. A total of 7 covariates including tumor location, number of positive lymph nodes, tumor invasion depth, tumor differentiation degree, surgical procedure, vascular tumor thrombus and nerve invasion were included, and the caliper value was taken as 0.1. After matching, a total of 699 patients were included for the analysis, including 128 patients in the neoadjuvant chemotherapy group, 267 patients in the adjuvant chemotherapy group, and 304 patients in the surgery alone group. The Kaplan-Meier method was used to generate the survival curves which was tested by the Log-rank method for survival analysis. Results: After matching analysis, the 5-year overall survival rate was 41.5% in the neoadjuvant chemotherapy group with a median overall survival time of 43 months (95%CI: 27 to 59 months), 57.6% in the adjuvant chemotherapy group with a median overall survival time unreached, and 24.9% in the surgery alone group with a median overall survival time of 28 months (95%CI: 25 to 31 months) (χ²=60.475, P<0.01). For overall survival after matching, the adjuvant chemotherapy group was better than the neoadjuvant chemotherapy group (χ²=11.384, P=0.001), the neoadjuvant chemotherapy group was better than the surgery alone group (χ²=8.654, P=0.003), and the adjuvant chemotherapy group was better than surgery alone group (χ²=60.234, P<0.01). Conclusion: Both preoperative neoadjuvant chemotherapy and postoperative adjuvant chemotherapy can improve the long-term survival of patients with locally advanced esophageal squamous cell carcinoma undergoing radical resection, and the improvement effect of postoperative adjuvant chemotherapy is more obvious.

Multisystemic Therapy - Building Stronger Families (MST-BSF): Substance misuse, child neglect, and parenting outcomes from an 18-month randomized effectiveness trial

BackgroundParental substance misuse impacts millions of children globally and is a major determinant of repeat maltreatment and out-of-home placement. There is little published research on family-based, comprehensive treatment models that simultaneously address parental substance misuse and child maltreatment. ObjectiveThis study reports outcomes from a randomized clinical trial examining the effectiveness of the Multisystemic Therapy – Building Stronger Families (MST-BSF) treatment model with families involved with Child Protective Services due to physical abuse and/or neglect plus parental substance misuse. Participants and settingNinety-eight families who had an open case with Child Protective Services in two areas of the state of Connecticut participated. MethodFamilies referred by the Connecticut Department of Children and Families were randomly assigned to MST-BSF or Comprehensive Community Treatment (CCT). Both interventions were delivered by community-based therapists. Outcomes were measured across 5 assessments extending 18 months post-baseline. ResultsIntent-to-treat analyses showed that MST-BSF was significantly more effective than CCT in reducing parent self-reported alcohol and opiate use and in improving child-reported neglectful parenting. Although means were in predicted directions, new incidents of abuse across 18 months did not differ between groups. The study features high recruitment and engagement rates for a population experiencing multiple involvements with child protection. ConclusionThe outcomes of this study support the effectiveness of MST-BSF, an intensive family- and ecologically- based treatment, for significantly reducing parental alcohol and opiate misuse and child neglect. These findings help in our understanding of how best to address the understudied issue of interventions for child neglect.

Analysis of PICC Based on Dysfunction Module Personalized Nursing Treatment in Chemotherapy of Advanced Esophageal Cancer.

Esophageal cancer is a common malignant tumor in some countries and regions in the world, which threatens the health of people all over the world. Due to esophageal cancer, about 400,000 people die every year. Among them, the number of cases and deaths of esophageal cancer in our country accounts for about 50% of the world. This article aims to study the clinical efficacy of PICC catheterization in the chemotherapy of advanced esophageal cancer based on the dysfunction module. For patients with advanced esophageal cancer, traditional surgery is still difficult to achieve satisfactory results. Therefore, in order to improve the therapeutic effect of esophageal cancer and obtain a higher clinical effective rate and pathological complete remission rate, it is necessary to explore a new comprehensive treatment model. In this paper, the theoretical knowledge of PICC is described in detail from the concept, advantages, and indications of PICC, and the SPSS statistical method is proposed. The SPSS statistical model, mean test, two-independent sample t-test, and regression analysis jointly explain the application principles and methods of SPSS statistical methods. After selecting the experimental subjects, the 180 eligible patients with esophageal squamous cell carcinoma were divided into two groups, each with 30 patients with stage II esophageal cancer, 30 patients with stage III esophageal cancer, and 30 patients with stage IV esophageal cancer. Grouping according to different variables, real-time recording of data, and SPSS statistical method to analyze the experimental data, the experimental results of this article show that the nursing satisfaction of the observation group is 92.2%, which is significantly higher than the 56.7% of the control group, so it can be seen that PICC plays an important role in the personalized care and treatment of advanced esophageal cancer.

Premature Death Risk from Young Adulthood Incarceration

ABSTRACT Drawing the National Longitudinal Survey of Youth 1979 data, a comprehensive treatment model indicates a strong positive influence of incarceration on premature death risk. Models adjust for numerous covariates of mortality, including demographics, family background, and a range of health and behavioral indicators measured during childhood, as well as selection into incarceration (“treatment”). This study expands extant research by observing much longer panel data, closer to the mortality curve. The main treatment effect reveals risk of premature death by one’s mid-fifties being increased by 13.9 percentage-points. Results also indicate that young adulthood incarceration shortens lives equally for Blacks and non-Blacks.

Research Trends and Issues of Comprehensive Treatment Models for Preschoolers with Autism Spectrum Disorders

종합적인 중재 모델(Comprehensive Treatment Models: CTMs)은 자폐 범주성 장애의핵심 결함 영역에 대하여 학습 및 발달에 영향을 미치기 위해 고안된 일련의 방법론적 실제로 구성된 프로그램으로, 체계적인 서비스를 통해 제공된다. 이러한 종합적인 중재 모델이 실제 실행을 통한 성과가 입증됨에 따라 자폐 범주성 장애 학생을 위한 증거 기반의 실제로 추천되고 있다. 따라서 본 연구에서는 자폐 범주성 장애 유아가 통합된 유아 교육 기관에서 실행된 종합적인 중재 모델에 대한 국외 연구를 분석하여 연구의 동향, 중재의 특성, 중재자 훈련 특성을 알아보았다. 분석 결과 종합적인 중재 모델은 자연적 중재와 응용행동분석 접근에 기반한 개별 교수전략들을 공통 요소로 포함하고 있었으며, 중재자 훈련으로는 초기교육과 지속적인 추수지도가 이루어졌다. 분석 결과를 근거로 국내 자폐 범주성장애 유아를 위한 종합적인 중재 모델 연구의 향후 과제에 대하여 논의하였으며, 우리나라교육현장에 시사하는 바를 제언하였다.