玉米须的HPLC指纹图谱

目的:建立玉米须HPLC指纹图谱的测定方法。方法:采用Agilent ZORBAX SB-C18色谱柱(4.6 mm×250 mm,5μm),检测波长273 nm,柱温30℃,进样量10μL,流速0.8 m L·min-1,以甲醇(A)-0.2%磷酸水溶液(B)为流动相梯度洗脱。结果:24批样品中的色谱峰得到了有效分离,确定了18个共有峰,其中11号峰是芦丁,15号峰是芹菜素。结论:HPLC指纹图谱对饮片的质量评价分类也应参考聚类分析和主成分分析,本实验建立的HPLC指纹图谱为玉米须饮片质量标准的评价提供了参考。     

Measuring Stigma in Chronic Pain: Preliminary Investigation of Instrument Psychometrics,Correlates, and Magnitude of Change in a Prospective Cohort Attending Interdisciplinary Treatment

Chronic pain is a potentially stigmatizing condition. However, stigma has received limited empirical investigation in people with chronic pain. Therefore, we examined the psychometric properties of a self-report questionnaire of stigma in people with chronic pain attending interdisciplinary treatment. Secondarily, we undertook an exploratory examination of the magnitude of change in stigma associated with interdisciplinary treatment in a prospective observational cohort. Participants attending interdisciplinary treatment based on acceptance and commitment therapy completed the Stigma Scale for Chronic Illness 8-item version (SSCI-8; previously developed and validated in neurological samples), and measures of perceived injustice, pain acceptance, and standard pain outcomes before (n = 300) and after treatment (n = 247). A unidimensional factor structure and good internal consistency were found for the SSCI-8. Total SSCI-8 scores were correlated with pain intensity, indices of functioning, and depression in bivariate analyses. Stigma scores were uniquely associated with functioning and depression in multiple regression analyses controlling for demographic factors, pain intensity, pain acceptance, and perceived injustice at baseline. SSCI-8 total scores did not significantly improve after treatment, although an exploratory subscale analysis showed a small improvement on internalized stigma. In contrast, scores on perceived injustice, pain acceptance, and pain outcomes improved significantly. Taken together, these data support the reliability and validity of the SSCI-8 for use in samples with chronic pain. Further research is needed optimize interventions to target stigma at both the individual and societal levels.PerspectiveThis study supports the use of the SSCI-8 to measure stigma in chronic pain. Stigma is uniquely associated with worse depression and pain-related disability. Research is needed to identify how to best target pain-related stigma from individual and societal perspectives.     

Addiction, agency, and the politics of self-control: doing harm reduction in a heroin users' group

Our 2007-2009 ethnography describes and analyses the practice of harm reduction in a heroin users' group in the midwestern United States. While dominant addiction interventions conceptualize the addict as powerless - either through moral or physical weakness - this group contested such "commonsense," treating illicit drug use as one of many ways that modern individuals attempt to "fill the void." Insisting on the destigmatization of addiction and the normalization of illicit drug use, the group helped its members work on incremental steps toward self-management. Although "Connection Points" had very limited resources to improve the lives of its members, our work suggests that the users' group did much to restore self-respect, rational subjectivity, and autonomy to a group historically represented as incapable of reason and self-control. As the users cohered as a community, they developed a critique of the oppressions suffered by "junkies," discussed their rights and entitlements, and even planned the occasional political action. Engaging with literature on the cultural construction of agency and responsibility, we consider, but ultimately complicate, the conceptualization of needle exchange as a "neoliberal" form of population management. Within the context of the United States' War on Drugs, the group's work on destigmatization, health education, and the practice of incremental control showed the potential for reassertions of social citizenship within highly marginal spaces.     

Residual stigma: psychological distress among the formerly overweight

Little is known about the psychological state of those who leave a stigmatized group. We examined individuals who previously belonged to a stigmatized group, the overweight, and then became normal weight. Negative stereotypes, including those relating to obesity, are internalized from the time of childhood onward; therefore, it was assumed they would become lingering self-stereotypes among individuals who were no longer externally targeted. Drawing on a nationally representative sample, we examined for the first time whether formerly overweight individuals are susceptible to any anxiety disorder, any depressive disorder, and suicide attempts. As predicted, the likelihood of any anxiety disorder and any depressive disorder for the formerly overweight group was significantly greater than for the consistently normal-weight group, and not significantly different from the consistently overweight group. Further, the formerly overweight group was significantly more likely to attempt suicide than the other groups. Also as predicted, perceived weight discrimination partially mediated the relationship between weight status and these outcomes. The cohort consisted of 33,604 participants in the United States. The results suggest that losing a self-image shaped by stigma is a more protracted process than losing weight.     

Adapting the minority stress model: associations between gender non-conformity stigma, HIV-related stigma and depression among men who have sex with men in South India

Marginalization and stigmatization heighten the vulnerability of sexual minorities to inequitable mental health outcomes. There is a dearth of information regarding stigma and mental health among men who have sex with men (MSM) in India. We adapted Meyer's minority stress model to explore associations between stigma and depression among MSM in South India. The study objective was to examine the influence of sexual stigma, gender non-conformity stigma (GNS) and HIV-related stigma (HIV-S) on depression among MSM in South India. A cross-sectional survey was administered to MSM in urban (Chennai) (n=100) and semi-urban (Kumbakonam) (n=100) locations in Tamil Nadu. The majority of participants reported moderate/severe depression scores. Participants in Chennai reported significantly higher levels of GNS, social support and resilient coping, and lower levels of HIV-S and depression, than participants in Kumbakonam. Hierarchical block regression analyses were conducted to measure associations between independent (GNS, HIV-S), moderator (social support, resilient coping) and dependent (depression) variables. Sexual stigma was not included in regression analyses due to multicollinearity with GNS. The first regression analyses assessed associations between depression and stigma subtypes. In Chennai, perceived GNS was associated with depression; in Kumbakonam enacted/perceived GNS and vicarious HIV-S were associated with depression. In the moderation analyses, overall GNS and HIV-S scores (subtypes combined) accounted for a significant amount of variability in depression in both locations, although HIV-S was only a significant predictor in Kumbakonam. Social support and resilient coping were associated with lower depression but did not moderate the influence of HIV-S or GNS on depression. Differences in stigma, coping, social support and depression between locations highlight the salience of considering geographical context in stigma analyses. Associations between HIV-S and depression among HIV-negative MSM emphasize the significance of symbolic stigma. Findings may inform multi-level stigma reduction and health promotion interventions with MSM in South India.     

精神疾病病耻感研究进展

本文对近年来国内学者对精神疾病病耻感的研究涉及不同人群、测评工具、公众态度、病耻感现状分析、相关影响因素及干预措施等研究现状进行了总结,旨在为深入研究精神疾病患者病耻感的影响因素及干预方法等提供依据。     

护理干预对改善精神分裂症患者病耻感的效果观察

目的:探讨护理干预改善精神分裂症患者病耻感的效果,从而提高患者的治疗依从性和改变其求医方式和行为。方法:将符合条件的精神分裂症患者60例,随机分为干预组和对照组,各30例;对照组患者采用精神科护理常规进行护理,干预组患者则采用系统化的护理干预措施连续进行护理4个月。结果:连续护理干预患者4个月后,干预组患者的病耻感明显减轻,生活动力提高,个体的自信心增强;住院生活质量得到提升;与对照组比较,差异有统计学意义。结论:对精神分裂症患者进行完善的健康宣教,心理辅导等系统性护理干预,从疾病、心理、社会等各个方面进行多元化预见性护理,可明显减轻患者的病耻感,提高患者的生活质量。     

Marginalised voices in wound care: Experiences of people who inject drugs living with leg ulceration “The Gutter,the Nick or a Box!!”

Portraying the authentic voice of people who inject drugs (PWID) through narrative means is novel in contemporary literature. The study explored the experiences of PWID living with chronic leg ulceration using qualitative methodology set in a naturalistic paradigm. Led from the perspective of a nurse-researcher in the field of wound management, the study is original from a purist narrative perspective and offers a unique opportunity to gain a rare glimpse into the daily life of PWID as reported in their own words.The methodology chosen was diaries conducted over four weeks, followed by semi-structured interviews. The study was set in North London (UK); participants were recruited from three sites: a general acute NHS hospital, the community and a non-NHS clinical facility. Complete data collection took over 12 months. Open coding was used for word-by-word scrutiny of each diary entry and thematic analysis. The qualitative data software tool NVivo Version-10 was used to support this analysis.Ten participants completed the data collection process: seven males and three females (age range 35–62 years), with heterogeneous socio-economic and cultural backgrounds. The findings revealed the detailed suffering participants endured living with their ulcer: pain, shame and healing were among the emerging themes. The self-blame and punishment triggered by stigma was a detriment to the mental and physical health of participants. Those in contact with specialist wound care services saw a significant improvement in wound healing and this had a positive impact on their wellbeing and their overall outlook on life.This research contributes to science and practice by understanding the lives of PWID living with leg ulceration. It provides a platform from which to engage both generalist and specialist healthcare practitioners and has the potential to inform and improve current service provision of leg ulcer care for this population and to influence medical and social policy-making in this field.