媒体医药信息对辽宁省居民自我诊疗行为影响

目的了解媒体医药信息对居民自我诊断、自我药疗行为的影响。方法采用多阶段分层整群随机抽样方法对辽宁省2 981名城乡居民进行问卷调查。结果 43.8%和11.7%的居民关注或信任媒体健康信息,11.6%的居民曾参加过商家举办的产品推广活动;根据媒体信息进行自我诊断和自我药疗的发生率分别为36.8%和43.2%;单因素分析显示,城市户籍、40~59岁、高收入、高中文化水平的居民自我诊断、自我药疗和诊断治疗发生率均明显高于其他人群;关注、信任、参加活动居民的自我诊疗率明显高于无以上行为居民;经多因素分析,城市居民自我诊疗行为是农村居民的1.50~2.87倍,自我诊疗行为随健康状况的下降而升高,关注、信任媒体医药信息、参加相关推广活动使自我诊疗行为增加0.48~2.14倍。结论媒体医药信息对居民自我诊疗行为产生明显影响,政府应加大信息发布的审批和监管力度,减少居民不合理用药的行为。     

中医病案及其在临床诊疗支持系统中的应用研究

通过对中医学理论发展中医案所起的独特作用及其在传统中医临床应用的特点的分析。本文提出了将医案采用案例分析的方法应用于中医临床诊断和治疗全过程的新思想。临床诊疗支持系统通过对医学专家诊疗过程思维模式的模拟。并借助医案库中丰富的经典病例,能在对患者进行临床诊治过程中,为医生提供全程决策支持,同时也为中医理论信息研究提供了一条新的途径。     

新疆伊犁州某卫生学校护生自我诊疗现状调查与分析

目的 了解中职护生患病后的自我诊疗现状,分析探讨其原因及危害性,为规范中职护生的就医行为提供参考.方法 采取整群随机抽样方法,抽取410名中职在校一年级和二年级护生进行自我诊疗情况问卷调查,并对结果进行统计分析.结果 中职护生中有67.9％的学生认为自己具备对常见疾病的诊治能力;有33.8％的学生患病后先进行自我诊治;有40.3％的学生曾在医院以外的场合给同学输液、打针治疗,且二年级护生（60.6％）高于一年级护生（18.6％）,差异有统计学意义.结论 中职护生患病后自我诊疗情况十分普遍,其医疗行为规范意识及法律意识淡薄,甚至不少学生还存在错误的健康观念,中职护生所学专业较为特殊,学校及医疗机构需要给予正确引导,使其树立正确的就医观念,并提供良好的医疗服务,防止护生因不规范的自我诊疗行为而发生医疗意外.     

积极人格与大学生心理素质的关系

目的:研究大学生希望、乐观、自我效能感与主观幸福感、心身症状的关系。方法:采用成人性情希望量表(ADHS)、一般自我效能感量表(GSES)、生活取向测验修订版(LOT-R)、牛津幸福量表修订版(ROHS)和症状自评量表(SCL-90)对2578名在校大学生进行调查和测量。结果:(1)大学生主观幸福感和SCL-90总均分及每一个因子都负相关,特别是和抑郁因子负相关最高。(2)路径思维、动力思维、希望、自我效能和乐观与主观幸福感呈正相关;与SCL-90总均分及每一个因子都呈负相关。(3)以路径思维、动力思维、希望、自我效能和乐观为自变量,以主观幸福感和症状自评量表总均分为因变量,分别进行逐步回归分析,结果希望、乐观、自我效能都进入方程,三个因素分别对主观幸福感和心身症状的解释率为42.1%和7.1%。结论:无论单独考虑(相关分析)还是综合考虑(回归分析),希望、乐观和自我效能这三种积极人格都与主观幸福感呈正相关而与心身症状呈负相关。     

医学生临床思维培养存在的问题与分析

了解临床带教过程中对医学生临床思维培养的现状与存在的问题,为临床采用自行设计的问卷表,调查本院医学生对带教老师启发临床思维的感受和实习过程中对临床诊疗活动的应对方式。发现临床实习带教过程中不同程度地存在不能更好地结合临床实际引导和启发医学生的临床思维,医学生自我观察、思考及综合分析问题的意识有待培养。应加强对临床实习带教老师教育学理论和带教技能的培训,健全教学管理制度,利用临床教学查房、病例讨论,引导、启发和培养医学生的临床思维。     

构建以人为本的医院文化

先进的医院文化是实现人文管理的重要载体.文章通过管理者对员工的人本化管理,对病人的人性化服务,阐述了构建以人为本的医院文化的理念和方法.通过人文的思维和实践,促进员工自我发展和自我实现意识及能力的提高,并将自我发展与医院愿景结合起来;在为患者提供人性化服务,治疗患者躯体疾病的同时,关注患者生理、心理和社会适应状态的变化...     

论中医现代化的背景及八点内涵

本文从国际、国内科学发展背景及中医学自身发展需要等方面,论速了中医现代化是一个时代提出的重大命题和必须实现的目标,并对现代化与传统的关系作了深刻的辨析;全文侧重从继承、移植、创新的指导思想,对中医理论形态、诊疗体系的变革、研究方法的更新,学科前沿的确立以及国际化等方面,论述了中医现代化的内涵,对中医学未来的发展提供了思维模式。     

新医改模式下多学科一体化诊疗的实践与思考

多学科一体化诊疗服务模式是新医改形势下中医医院坚持以病人为中心,顺应医学模式的转变,遵循中医思维模式而实施的医疗服务管理的改革。通过诊疗理念的革新和服务流程的再造,积极开展以病种为主线,以创建多专业服务平台为主要形式的一体化诊疗服务,突出了中医药特色优势,强化了综合诊疗服务,提高了临床疗效,较好地打造了中医服务品牌,推动中医医院服务能力的提升和整体医疗的发展。     

提高社会信任度是民营医院发展的关键

本文从医患关系、诊疗过程、公平待遇和社会地位等方面,分析了民营医院信任危机的症结所在。提出了民营医院发展的关键,在于推进信任度建设、加快诊疗透明、规范,提供相对公平待遇和提供社会活动机会以改变形象等建议。     

中医医院多学科一体化诊疗服务探讨

多学科一体化诊疗服务模式是新医改形势下中医医院坚持“以病人为中心”、顺应医学模式的转变、遵循中医思维模式而实施的医疗服务管理的改革.通过诊疗理念的革新和服务流程的再造,开展以病种为主线、以创建多专业服务平台为主要形式的一体化诊疗服务,突出中医药特色优势,强化综合诊疗服务,推动服务能力的提升和整体医疗的发展.     

The proposal of Saraceno's psychosocial rehabilitation: is it a model of self-organization?

We discuss the theory of Psychosocial Rehabilitation proposed by Benedetto Saraceno, using the theory of Self-Organizing Systems, developed by Michel Debrun and others as a reference framework. We observe that Saraceno's proposal satisfies several aspects of self-organizing processes. However, it is not completely fit. Based on this discussion, the difficulties found in rehabilitation practice in the Mental Health area can be better understood.     

预印本自组织同行评议的通证激励机制研究

【目的】 将通证激励机制应用于预印本自组织同行评议的框架之中,解决该同行评议模式缺乏激励机制的问题。【方法】 将“通证经济”的理念与激励机制相结合,解决预印本系统中自组织同行评议的激励问题,并通过案例分析方法,以Steemit为参考模式,研究其通证激励机制的原理与特点。【结果】 通证激励模式下的预印本系统是一种建立在区块链技术上,以学术共同体为核心的自组织内容发表系统,利用通证激励,充分调动系统的所有成员参与到论文发表的过程中。【结论】 将通证激励应用于预印本的自组织同行评议中,能够对作者和评议专家的角色行为进行正向引导和激励,从而保证预印本系统良性自运转,形成良好的学术生态。     

The behavioral economics of young adult substance abuse

Alcohol and drug use peaks during young adulthood and can interfere with critical developmental tasks and set the stage for chronic substance misuse and associated social, educational, and health-related outcomes. There is a need for novel, theory-based approaches to guide substance abuse prevention efforts during this critical developmental period. This paper discusses the particular relevance of behavioral economic theory to young adult alcohol and drug misuse, and reviews of available literature on prevention and intervention strategies that are consistent with behavioral economic theory. Behavioral economic theory predicts that decisions to use drugs and alcohol are related to the relative availability and price of both alcohol and substance-free alternative activities, and the extent to which reinforcement from delayed substance-free outcomes is devalued relative to the immediate reinforcement associated with drugs. Behavioral economic measures of motivation for substance use are based on relative levels of behavioral and economic resource allocation towards drug versus alternatives, and have been shown to predict change in substance use over time. Policy and individual level prevention approaches that are consistent with behavioral economic theory are discussed, including brief interventions that increase future orientation and engagement in rewarding alternatives to substance use. Prevention approaches that increase engagement in constructive future-oriented activities among young adults (e.g., educational/vocational success) have the potential to reduce future health disparities associated with both substance abuse and poor educational/vocational outcomes.     

Oregon's transition to a managed care model for Medicaid-funded substance abuse treatment: steamrolling the glass menagerie

The approval of a Health Care Financing Administration (now called Centers for Medicare and Medicaid Services) 1115 Medicaid waiver in Oregon allowed the state to design and implement an expanded publicly funded health care system, the Oregon Health Plan (OHP). Integral to OHP is the administration of physical and behavioral health services, including outpatient substance abuse treatment, through contracted managed care organizations. The two overarching changes to the outpatient substance abuse treatment system were expanded Medicaid eligibility and new operating procedures for the outpatient substance abuse treatment system. The authors used grounded theory to examine the effects of this transition on the treatment system, with an emphasis on the experiences of treatment providers.     

Experimental test of the affect-regulation theory of bulimic symptoms and substance use: a randomized trial

OBJECTIVE: Conduct a randomized trial to test whether a cognitive behavioral intervention designed to decrease depressive symptoms produces subsequent decreases in bulimic and substance use symptoms. METHOD: Female participants (N = 145) with elevated depressive symptoms were randomly assigned to a 4-session depression intervention or a measurement-only condition and assessed through 6-month follow-up. RESULTS: Relative to control participants, intervention participants showed decreases in depressive symptoms. Intervention participants also showed significantly greater reductions in bulimic symptoms, but not substance use, and change in depressive symptoms mediated this effect for bulimic symptoms. CONCLUSION: The results provide experimental support for the theory that affect disturbances contribute to bulimic pathology, but do not support the affect regulation theory of substance use.     

Substance misuse intervention research in remote Indigenous Australian communities since the NHMRC ‘Roadmap’

Objective : Describe program theories of substance misuse interventions with Aboriginal and Torres Strait Islander (Indigenous) Australians funded by the National Health and Medical Research Council (NHMRC) since the ‘Roadmap’ for Indigenous health. Methods : Projects funded 2003–2013 were categorised by intervention strategies. Realist concepts informed the program theory: intended resources and responses; influence of context on outcomes; explicit and implicit program assumptions. Results : Seven interventions were included. Three randomised controlled trials targeted tobacco using psychosocial interventions in primary health centres using the program theory: “Local Indigenous health workers extend and sustain the effects of conventional clinical brief intervention by engendering social and cultural resources”. Four pragmatic trials of multiple‐component, community‐based interventions using controlled, semi‐controlled or before‐and‐after designs used the program theory: “Discrete intervention components targeting locally defined substance misuse issues will activate latent capacities to create an environment that favours cessation.” Publications did not report clear effect, implementation fidelity or explicit mechanisms affecting participant thinking. Conclusions : Rigorous intervention designs built on ‘Roadmap’ principles neither reduced substance use in the populations studied nor identified transferable mechanisms for behaviour change. Implications for public health : Substance misuse impacts among Indigenous Australians remain severe. Theoretical mechanisms of behaviour change may improve intervention design.     

Differential Effects of Parental “drug talk” Styles and Family Communication Environments on Adolescent Substance Use

The current study examines the relationships among adolescent reports of parent–adolescent drug talk styles, family communication environments (e.g., expressiveness, structural traditionalism, and conflict avoidance), and adolescent substance use. ANCOVAs revealed that the 9th grade adolescents (N = 718) engaged in four styles of “drug talks” with parents (e.g., situated direct, ongoing direct, situated indirect, and ongoing indirect style) and these styles differed in their effect on adolescent substance use. Multiple regression analyses showed that expressiveness and structural traditionalism were negatively related to adolescent substance use, whereas conflict avoidance was positively associated with substance use. When controlling for family communication environments and gender, adolescents with an ongoing indirect style reported the lowest use of substance. The findings suggest implications and future directions for theory and practice.     

Explicating How Parent–Child Communication Increases Latino and European American Early Adolescents’ Intentions to Intervene in a Friend’s Substance Use

This study used primary socialization theory and a focus theory of normative conduct to examine whether anti-substance-use norms mediated targeted parent–child communication against substance (alcohol, cigarette, and marijuana) use’s effects on Latino and European American early adolescents’ intentions to intervene in a friend’s substance use. Further, this study investigated whether familism interacted with targeted parent–child communication to predict anti-substance-use norms, and whether this mediated moderation model functioned differently for Latino and European American early adolescents. Self-reported longitudinal survey data were collected from 6th-8th grade students (N?=?627), attending rural IL public schools. Multigroup mediated moderation analyses revealed that as Latino and European American early adolescents engaged in targeted mother–child communication against substance use, they were more likely to develop anti-substance-use parent injunctive norms, and in turn, more likely to report anti-substance-use personal norms. Thus, they were more likely to report that if their friend used substances, they would talk to their friend, seek help from others, and end the friendship. They were, however, less likely to ignore the friend’s substance use. Familism was not a significant moderator, and the hypothesized effects did not differ for Latino and European American early adolescents. The results suggest that parents of Latino and European American adolescents may discourage substance use by engaging in targeted parent–child communication, which may indirectly benefit their children’s friends, as well.     

Characteristics of Effective Substance Abuse Prevention Programs for High-Risk Youth

The last two decades have witnessed a rapid development of substance abuse prevention programs. Most efforts to evaluate these programs have been limited to single program studies, and nearly all studies involving multiple drug prevention programs have involved school-based programs for general youth populations. In 1995, the Center for Substance Abuse Prevention (CSAP), with the Substance Abuse and Mental Health Administration (SAMHSA), funded the CSAP National Cross-site Evaluation of High Risk Youth Programs, a five-year, multi-site evaluation study involving 46 programs and over 10,500 youth at high risk for substance use (CSAP, 2002(a)). This article reports findings from this evaluation, focusing on program characteristics that help explain reductions in 30-day substance use among program participants. Programs found to be most effective in reducing substance use were those that offered strong behavioral life skills development content, emphasized team-building and interpersonal delivery methods, emphasized introspective learning approaches focusing on self-reflection, were based upon a clearly articulated and coherent program theory, and provided intense contact with youth. Programs utilizing these positive program components produced consistent and lasting reductions in substance use. These findings provide a solid basis for the adoption of positive program characteristics in the development of future prevention programming for high-risk youth.     

Advanced REACH Tool: development and application of the substance emission potential modifying factor

The Advanced REACH Tool (ART) is an exposure assessment tool that combines mechanistically modelled inhalation exposure estimates with available exposure data using a Bayesian approach. The mechanistic model is based on nine independent principal modifying factors (MF). One of these MF is the substance emission potential, which addresses the intrinsic substance properties as determinants of the emission from a source. This paper describes the current knowledge and evidence on intrinsic characteristics of solids and liquids that determine the potential for their release into workplace air. The principal factor determining the release of aerosols from handling or processing powdered, granular, or pelletized materials is the dustiness of the material, as well as the weight fraction of the substance of interest in the powder and the moisture content. The partial vapour pressure is the main intrinsic factor determining the substance emission potential for emission of vapours. For generation of mist, the substance emission potential is determined by the viscosity of the liquid as well as the weight fraction of the substance of interest in the liquid. Within ART release of vapours is considered for substances with a partial vapour pressure at the process temperature of 10 Pa or more, while mist formation is considered for substances with a vapour pressure ≤ 10 Pa. Relative multipliers are assigned for most of the intrinsic factors, with the exception of the weight fraction and the vapour pressure, which is applied as a continuous variable in the estimation of the substance emission potential. Currently, estimation of substance emission potential is not available for fumes, fibres, and gases. The substance emission potential takes account of the latest thinking on emissions of dusts, mists, and vapours and in our view provides a good balance between theory and pragmatism. Expanding the knowledge base on substance emission potential will improve the predictive power of occupational exposure models and thereby the accuracy and precision of the exposure estimates.