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关键词： Cannabis dependence   cognitive behavioral therapy   contingency management   criminal justice system   randomized clinical trial  

摘要： Aims To evaluate reciprocal enhancement (combining treatments to offset their relative weaknesses) as a strategy to improve cannabis treatment outcomes. Contingency management (CM) with reinforcement for homework completion and session attendance was used as a strategy to enhance cognitivebehavioral therapy (CBT) via greater exposure to skills training;CBT was used as a strategy to enhance durability of CM with rewards for abstinence. Setting Community-based out-patient treatment program in New Haven, Connecticut, USA. Design Twelve-week randomized clinical trial of four treatment conditions: CM for abstinence alone or combined with CBT, CBT alone or combined with CM with rewards for CBT session attendance and homework completion. Participants A total of 127 treatment-seeking young adults (84.3% male, 81.1% minority, 93.7% referred by criminal justice system, average age 25.7 years). Measurements Weekly urine specimens testing positive for cannabis, days of cannabis use via the time-line follow-back method. Findings Within treatment, reinforcing homework and attendance did not significantly improve CBT outcomes, and the addition of CBT worsened outcomes when added to CM for abstinence (75.5 versus 57.1% cannabis-free urine specimens, F = 2.25, P = 0.02). The CM for abstinence condition had the lowest percentage of cannabis-negative urine specimens and the highest mean number of consecutive cannabis-free urine specimens (3.3, F = 2.33, P = 0.02). Attrition was higher in the CBT alone condition, but random effect regression analyses indicated this condition was associated with the greatest rate of change overall. Cannabis use during the 1-year follow-up increased most rapidly for the two enhanced groups. Conclusions Combining contingency management and cognitivebehavioural therapy does not appear to improve success rates of treatment for cannabis dependence in clients involved with the criminal justice system.

关键词： Contingency management   Implementation   Probation   Community corrections   Problem-solving courts   Drug courts   Acceptability  

摘要： Contingency management (CM) is widely recognized as an evidence-based practice, but it is not widely used in either treatment settings or justice settings. CM is perceived as adaptable in justice settings given the natural inclination to use contingencies to improve compliance to desired behaviors. In the Justice Steps implementation study, 5 federal district court jurisdictions agreed to consider implementing CM in specialized problem-solving courts or probation settings. A baseline survey (N = 186) examined the acceptance and feasibility of using rewards as a tool to manage offender compliance. The results of the survey revealed that most of the respondents believe that rewards are acceptable, with little difference between social and material rewards. Survey findings also showed that female justice workers and those who were not probation officers were more accepting of material rewards than their counterparts. Findings are consistent with prior research in drug treatment settings where there is little concern about using rewards. (C) 2012 Elsevier Inc. All rights reserved.

关键词： 清朝   总理回疆事务参赞大臣   浩罕   外事管理  

摘要： 清朝平定大小和卓叛乱后,在回疆地区设置参赞大臣对其地进行管辖。参赞大臣不仅具有处理回疆内部事务之权,而且还拥有处置涉外事务之权,对浩罕事务的处理便是其集中体现,包括政治、经济方面。

关键词： 外事管理   机制建设   人才培养  

摘要： "外事管理"是管理活动的一个重要领域,是外事依据国家的方针政策来指导、规范、处理涉外领域的事务和问题。我国的外事管理实行"统一领导、归口管理、分级负责、协调配合"的原则。由于历史和客观原因,相对于快速变化的国内外形势、不断扩大的对外开放和日益繁重的外交外事任务,我国的外事管理体制还不能完全适应形势发展的需要,一些问题亟待得到重视和解决。本文旨在探讨我国外事管理体制的现状、存在的问题和提出的对策建议,以供探讨交流。

关键词： 国家中医药管理局   外事工作   公立医院   代表团   亚健康   加拿大  

摘要： 2012年8月3日台湾公立医院代表团访问我局； 2012年8月3～8日赴加拿大参加第四届国际中医药与亚健康学术大会；

关键词： Contingency management   difference-in-differences   health services utilization  

摘要： Aim To determine the impact of standard care and contingency management treatments on the utilization of general health-care services by substance abusers. Participants, design and measurements This secondary analysis pooled 1028 treatment-seeking substance abusers from five randomized clinical trials that compared the effects of standard care (SC, n = 362) to standard care plus contingency management (CM, n = 666). In each trial, subjects in the CM condition showed significantly greater reductions in substance use than their SC counterparts. For each subject, utilization of 15 general health-care services was measured 1 year prior to treatment intake and up to 9 months following treatment intake. Post-intake utilization data were prorated to be comparable to the 1-year pre-intake data. Paired t-tests evaluated changes in service utilization pre- and post-intake, and difference-in-differences regression models were used to estimate the impact of CM, compared to SC, on changes in the utilization of each of the 15 health services. Setting Out-patient community substance abuse clinics in Connecticut and Massachusetts, USA. Findings Utilization of several types of out-patient services increased significantly between the pre- and post-intake periods [e.g. dental visits (0.47, P < 0.001), community health center visits (0.50, P < 0.001), visits to a mental health professional office (1.03, P = 0.001)], while in-patient hospital care for mental health problems decreased significantly (-3.50 nights, P < 0.001). A substantial portion of these changes occurred during the treatment period. No significant differences were found between the two treatment conditions. Conclusions Initiating out-patient substance abuse treatment is associated with changes in general health-care service utilization, independent of the type of treatment offered.

关键词： 国家中医药管理局   外事工作   国际疾病分类   世界卫生组织   传统医学  

摘要： 2012年7月5日传统医学国际疾病分类研讨会在我局召开； 2012年7月9～11日我局人员赴澳门参加世界卫生组织第一次区域间合作培训；

关键词： contingency management   pregnancy   substance use disorders  

摘要： Background: Contingency management (CM) has shown promise for treating substance use disorders in pregnant women. Methods: A randomized clinical trial compared the relative efficacy of three conditions on the measures of opioid and cocaine abstinence and days retained in treatment. A total of 133 pregnant patients attending treatment for substance use disorders were randomized either to an escalating reinforcement condition, a fixed reinforcement condition, or an attendance control condition. Conditions were compared on drug abstinence rates and days retained in treatment. Results: As expected, the pooled escalating + fixed conditions received a greater total amount of voucher money than the control condition mean [M = 392.40 (SE = 40.47) vs. 219.74 (SE = 39.78)], respectively;p < .001. However, the escalating and fixed conditions did not differ on the outcome variables of drug abstinence and treatment retention. Conclusions: The CM conditions examined in the current study did not emerge as superior to the control condition. The lack of significant differences among study conditions may be attributed, in part, to study sample size. Additionally, methodological issues related to the CM intervention may also have compromised outcomes, including delay in reinforcement following the target behavior and limited contact with the reinforcer. Scientific Significance: This study highlights the importance of key CM implementation features, including immediate reinforcement, and adequate access to the reinforcer. It may also be that the reset feature for missing samples in CM interventions is an essential contingency for promoting behavior change.

关键词： 实践教学   管理模式   外事服务   沈阳市   职场   学校   工作流程   管理基础  

摘要： 沈阳市外事服务学校在保障规范、有效、良性的日常教学管理基础上,着力构建实践教学＂职场化＂管理模式,以具体岗位中真实的工作任务、工作流程为导向,将岗位职业活动的内容、技能、流程和标准贯穿实践教学全过程,使教师和学生在＂教、学、

关键词： 高校   外事工作   外事档案管理   解决方案  

摘要： 随着高校对外交流工作的不断扩大与深化,外事工作部门的业务量逐年递增,这对高校传统档案管理工作的方法和理念提出了新的挑战。本文通过剖析现阶段外事档案管理工作中存在的几点突出问题并提出解决方案,使档案管理工作更好地配合高校外事工作,服务于高校对外合作与交流的发展大局。