Ethnicity Is an Inherent Criterion for Assessment of Individualized Music for Persons With Alzheimer’s Disease

A growing number of ethnically diverse persons are diagnosed with Alzheimer’s disease and related disorders (ADRD). Cognitive impairment is a key antecedent to agitation in persons with ADRD. There is increased recognition for the identification and testing of non-pharmacological interventions for the management of agitation in ethnically diverse populations. The evidence-based guideline of individualized music, currently in its 5th edition (Gerdner, 2013a), is one such intervention. This guideline has been tested in eight countries. In keeping with the holistic approach to this intervention, this article focuses on the importance of incorporating the role of ethnicity in the assessment of individualized music. This is underscored with a previously unpublished case example of a Mexican American man.     

个体化给药方案的发展

本文说明了治疗药物监测的定义,叙述了个体化给药的过去、现在和将来,指明了群体药动学和一点反馈法在临床合理用药中的作用。     

Effectiveness of individualized neurodevelopmental care in the newborn intensive care unit (NICU)

The individual infant's neurodevelopmental process provides an integrative framework for the delivery of medical care needed to assure the infant's survival and quality of outcome. The infant's neurobehavioral functioning and expression provides an opportunity for caregivers to estimate the individual infant's current strengths, vulnerabilities and threshold to disorganization, as well as to identify the infant's strategies in collaborating in his or her best progression. This perspective supports caregivers in seeing themselves in a relationship with the infant, and in considering opportunities to enhance the infant's strengths and reduce apparent stressors in collaboration with the infant and the family. The results of several randomized studies supporting the effectiveness of such a neuro developmental approach to NICU care will be presented, and suggest implications for staff education and nursery-wide implementation.     

Perceptions on individualized approaches to mental health care

Ways of working on acute psychiatric units have come under intense scrutiny in order for service users to receive modern care and treatment. This has led to various ways not only to improve the therapeutic milieu on psychiatric wards, but also to develop standardized approaches to care. This paper reports on a study on the development of a care pathway for people diagnosed with schizophrenia, with the aim of standardizing the care process. Action research was used to develop the care pathway and views were collected, and observations made from a range of mental health professionals. Not all respondents were in agreement with a care pathway and this led to clinicians defending the individualized nature of psychiatric care. Implementation of a care pathway may help not only to rekindle the therapeutic purpose of psychiatric care, but also to build in the individualized approach to carrying out hospital care. Limitations of the study have also been briefly reported.     

Transcultural nursing: the relationship between individualist ideology and individualized mental health care

This article attempts to clarify and underpin the view that individualized mental health nursing is culture biased and politically instrumental, adding weight to the transcultural argument that mental health care should be more culture sensitive than is often the case within conventional UK settings. It examines the political history of individualist ideology, and then uses social conflict theory to explore the potentially counter-therapeutic relationship of individualism and individualized nursing care in the UK mental health sector. The article challenges the widespread idea that individualized mental health nursing is 'liberal', 'democratic', 'holistic' and 'scientific', and in so doing extends the transcultural agenda to large scale infracultural differences within the UK population. It also explores the potential for policy change towards a more pluralistic service, and outlines some of the practical steps which may be taken to access alternative care approaches. It is a power analysis, which may be of transferable value to nurses in mental health care inpatient units where conventional individualized approaches are failing to reintegrate service users into the community. A glossary of terms is presented at the end of this article.     

老年人重症急性胰腺炎的临床特点

目的：总结老年重症急性胰腺炎的临床特点及治疗经验。方法：回顾性分析26例老年重症急性胰腺炎的临床资料,并与同期收治的56例非老年重症急性胰腺炎患者作比较。结果：胆源性和特发性胰腺炎是老年患者最常见病因;老年患者住院时间长,APACHEⅡ评分以及合并症和并发症的发生率均高于非老年患者,老年患者更易出现器官衰竭。结论：老年重症急性胰腺炎患者早期症状不典型,合并症比较多,病情复杂,宜早期积极预防和治疗并发症。     

Infrared measurement of human skin temperature to predict the individual maximum safe radiant exposure (IMSRE)

BACKGROUND AND OBJECTIVES: Radiant exposure (RE) is a critical treatment parameter to be optimized for laser hair removal (LHR). An objective and quantitative method to assess the individual maximum safe radiant exposure (IMSRE) would help clinicians optimize LHR while at the same time providing the safest possible laser therapy. STUDY DESIGN: Pulsed photo-thermal radiometry (PPTR) measurements were on a total of 403 spots on 13 volunteers. The radiometric signal at 20 milliseconds after the diagnostic laser pulse was used to predict the IMSRE using a simple analytic relationship. Laser pulses (wavelength 755 nm, 3 milliseconds pulse, 50 milliseconds cryogen spray cooling, 30 milliseconds delay) with RE's below and above the predicted IMSRE (range: 10-100 J/cm(2)) were applied and resulting injuries quantified through blind scoring. RESULTS: IMSRE can be predicted quite robustly with PPTR for the broad range of human skin photo-types (I-IV) considered in this study. CONCLUSIONS: The method presented herein should be useful in helping clinicians optimize LHR on an individual patient basis, with the highest possible safety.     

Individualized cancer chemotherapy integrating drug sensitivity tests, pathological profile analysis and computational coordination - an effective strategy to improve clinical treatment

BACKGROUND: Most current cancer chemotherapy is unsatisfactory. There is a trend towards changing the norm for drug selection; one approach is to seek individualized cancer chemotherapy (ICC). METHODS AND RESULTS: ICC is an approach to maximizing the efficacy of chemotherapy and reducing its adverse effects to a minimum. It involves choosing anticancer drugs through the following critical steps: (i) performing drug sensitivity tests in vivo and/or in vitro; (ii) analyzing pathogenic information from morphology, histology and bioinformatics, so that targeted therapy can be offered to disrupt the escalating tumorigenic molecules and pathways; (iii) introducing mathematical and computational systems to assist in improving the quality of decision-making. CONCLUSION: Increasing clinical evidence indicates that drug sensitivity tests, pathological profile analyses and computational coordination are ways to improve therapeutic quality. In future, each patient should have his own unique chemotherapy protocol.     

个体化方案治疗自发性脑室出血

目的：探讨自发性脑室出血的治疗方法。方法：回顾性分析我院137例自发性脑室出血的临床资料,29例行保守或仅行腰穿（或腰大池引流）治疗,64例行单侧或双侧脑室外引流术,44例行开颅血肿清除＋脑室外引流术。全组病例急性期行血管检查32例,发现颅内动脉瘤3例（前交通动脉瘤2例,小脑后下动脉瘤1例）,烟雾病5例,血管畸形7例。结果：全组病例随访6月至1年,平均（9．4±2．2）月,根据GOS预后评分,恢复良好46例（33．6％）,轻度残疾28例（20．4％）,重度残疾32例（23．4％）,植物生存13例（9．5％）,死亡18例（13．1％）。结论：自发性脑室出血具有较高的发病率和致残率,结合病人的具体病情采取个体化治疗方案有助于改善患者的预后。     

颅内转移瘤患者不同个体化治疗方案疗效比较

目的:探讨颅内转移瘤患者最适合的治疗方案,为改善颅内转移瘤患者生存质量及延长生存时间提供依据。方法：本组颅内转移瘤患者186例,根据患者病情及影像学资料分为Ⅰ组（手术+放疗+化疗组）81例、Ⅱ组（放疗+化疗组）66例、Ⅲ组（化疗组）14例、Ⅳ组（放疗组）14例及Ⅴ组（支持治疗组）11例。比较各组患者颅内高压、神经压迫症状治疗的有效率及平均生存期,对可随访到患者的近期和远期疗效进行统计学分析。结果：Ⅰ组患者颅内高压、神经压迫症状治疗的有效率及平均生存期分别较Ⅱ、Ⅲ及Ⅴ组明显提高,差异均有统计学意义(P<0.05),而Ⅰ组与Ⅳ组组间比较差异无统计学意义(P>0.05)。结论：颅内转移瘤患者要采用个体化治疗方案,对一般状况较好的患者,首选为手术联合放疗和化疗,其次为放疗。