我国强制隔离戒毒治疗人群的大麻使用现状

目的 了解我国强制隔离戒毒治疗人群大麻使用特征,为我国大麻禁毒政策提供参考。方法 利用2016年公安部重点城市毒品滥用规模评估项目数据,对全国30个省、自治区和直辖市的55个省会城市和重点城市的强制隔离戒毒治疗人群中大麻使用者社会人口学、毒品使用特征进行描述性分析,采用χ²检验、Fisher精确检验和Kruskal-Wallis秩和检验比较不同人群中大麻、海洛因、合成类毒品和混合毒品使用率的差异,以及大麻使用者中多药使用情况及地区间的差异。 结果 共纳入强制隔离戒毒治疗人员25 366人,大麻使用率为2.2%(546/25 366)。在大麻使用人群中,男性占83.5%,少数民族占41.0%,初中及以上学历占30.8%,无业人员占44.1%,平均年龄为(33.3±8.2)岁,平均首次吸毒年龄为(24.8±7.7)岁,首次吸毒到首次强制隔离戒毒的平均间隔时间为(5.4±4.6)年。35岁及以下、少数民族、在职、新疆的强制隔离戒毒人群大麻使用率较高。使用大麻的546人中,91.4%人存在多药使用情况,13.6%只合用海洛因,42.1%只合用合成类毒品,35.7%混合使用海洛因和合成类毒品。49.6%的大麻使用者集中在新疆维吾尔族自治区、江苏和上海三个地区。新疆大麻使用者中少数民族和初中及以下人群所占比例较高,有79.6%大麻使用者合用海洛因;江浙沪地区大麻使用者中汉族和高中及以上人群所占比例较高,有92.7%大麻使用者合用甲基苯丙胺。结论 我国强制隔离戒毒治疗人群中大麻使用率较监测吸毒人群中的大麻使用率高,并且存在地域聚集性和较高的多药使用现象,提示宜针对不同地区和人群,加强对大麻使用情况的监测,加大对大麻的管控力度,制定符合我国国情的禁毒政策。     

The state and the market: the impact of pharmacy licensing on the geographical distribution of pharmacies

In Norway and Finland the state controls the number and location of pharmacies through a system of pharmacy licensing. In New Zealand pharmacy numbers and location are determined by the decisions of individual pharmacists. Pharmacy licensing is designed to improve access to pharmacy services in rural areas, while leading to lower numbers of pharmacies than more market-driven systems. This paper looks at whether licensing achieves these goals. While recognizing that pharmacy numbers and location are affected by other factors, it concludes that licensing allows governments to improve access to pharmacies in rural areas without increasing the total number of pharmacies.     

执业医师考试融入《医学微生物学》实验教学的初步研究

执业医师分阶段考试要求医学生具备应用基础医学知识解决临床综合问题的能力,而传统的《医学微生物学》实验教学方法已不能满足其要求。为使学生尽早应对执业医师考试,依据《医学微生物学》实验教学特点,有计划地将本课程教学大纲和内容与执业医师考试有机结合,并综合应用多种教学方法和课程形成性评价,有效提升了课堂教学效果,激发了学生的课堂学习兴趣,切实加强了对学生早期临床思维能力和创新能力的培养。     

TGF-β1-Licensed Murine MSCs Show Superior Therapeutic Efficacy in Modulating Corneal Allograft Immune Rejection In Vivo

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上海市执业医师考试通过率变化趋势分析

目的:分析2005—2016年上海市执业医师考试通过率(以下简称"医考通过率")的变化趋势,为上海市住院医师规范化培训政策提供相关循证证据。方法:对上海市2005—2016年医考通过率进行趋势分析。结果:上海市医考总通过率呈稳步上升趋势,且2011年起增长明显,增幅达15%。规培机构中临床专业住院医师规范化培训对象(以下简称"住培医师")的医考通过率明显高于非规培机构。二级医院的医考通过率呈现较大波动。本科学历住培医师的医考通过率呈上升趋势。结论:上海市住院医师规范化培训对医考通过率有潜在影响,但还需要更多的证据支持。规培政策出台促进了住培医师医考通过率的提升,尤其对临床专业住培医师和本科住培医师影响显著。     

“In their perception we are addicts”: Social vulnerabilities and sources of support for men released from drug treatment centers in Vietnam

BackgroundAmid the global transition to treat opioid addiction as an illness, many people who inject drugs (PWID) face heterogeneous legal environments that include both punitive and harm reduction measures. In Vietnam, many PWID, who have a high burden of HIV, are sent to drug treatment centers, or “06 centers”, for compulsory detoxification, vocational training, and labor for up to four years. This study investigates the challenges and facilitators of reentry into community and family life among men who are released from “06 centers” and provides insights and recommendations for developing policies and interventions that address special needs of this vulnerable population.MethodsIn-depth interviews were conducted in 2011 by trained interviewers among a sample of 43 male PWID released within the past 2 years from “06 centers” in Hanoi, Vietnam to investigate the above issues and to recommend potential interventions. Participants were recruited from outpatient HIV clinics that serve PWID (n = 22) and through peer referral from self-help groups for PWID (n = 21). Interviews were audiotaped, transcribed, translated, entered into Atlas.TI qualitative data analysis software and analyzed for key themes.ResultsThe interviews revealed persistent drug-related stigmatization, frequently paired with HIV-related stigmatization and discrimination, which hindered employment, increased participants’ social isolation and exacerbated their struggles with addiction. Families were participants’ primary source of financial, employment, and emotional support, but addiction-related family tensions also had negative psychological effects. Participants identified methadone maintenance treatment as an effective means of overcoming addiction, yet few could fully benefit from this treatment due to its limited availability.ConclusionOur study suggests that PWID released from “06 centers” would greatly benefit from the scale-up of community-based harm reduction measures that include addiction and HIV treatment, coupled with employment-support and family centered mental health services.     

康复期海洛因依赖强制隔离戒毒者自我效能的相关因素分析

目的探讨康复期海洛因依赖强制隔离戒毒者的自我效能水平及其相关因素。方法采用一般情况调查表、一般自我效能量表、社会支持评定量表及Zung自评抑郁量表,对90例康复期海洛因依赖强制隔离戒毒者进行调查,并对调查结果进行分析。结果90例康复期海洛因依赖强制隔离戒毒者自我效能得分均值为（20．97±2．26）分,多元回归分析显示,抑郁、社会支持、海洛因日使用量是其自我效能感的主要影响因素,共解释59．1％的变异量。结论提高海洛因依赖者的自我效能,可以改善其身心健康水平,降低复吸率。     

Private Service,Public Rights: The Private Children's Residential Group Care Sector in Ontario,Canada

This article explores the core themes and issues of private residential service delivery for children and youth in Ontario, with a specific focus on staffed group care within this sector. Such exploration highlights the juxtaposition of the public rights of children with the private world of service provision. Based on twenty interviews with owners of private residential care facilities and an examination of government and professional writing and reports about residential care in Ontario, there is no obvious reason to dismiss or be critical of private residential care. However, both private and public residential care in Ontario are under-regulated, resulting in significant variations in terms of organizational structures, the quality of staffing and training, accountability and transparency, and ultimately, the efficacy of specific residential services.     

State Medicaid Home Health Licensing and Certification

ABSTRACT

This study collected and analyzed data on the number of licensed and certified home health care agencies and licensed home care/personal care agencies in the US. The study also examined the state laws and regulations pertaining to Medicaid home health agency requirements. There were 14,045 licensed home health agencies and 801 other licensed home care or personal care agencies in the US, but only 59 percent of these agencies were certified in 1998. The percent of certified agencies ranged from 22 percent in Maryland to 100 percent in ten states that only allowed certified agencies to provide home care. There was a wide range in the number of agencies in states with the average being 6.1 agencies per 100,000 population. The 41 states with state licensing of home health agencies had a wide range of policies but most were more lenient than the federal Medicare certification requirements.