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21.
《Clinical gerontologist》2013,36(1):101-112
Abstract This paper describes a novel shared-interest group intervention program to promote socialization and enhance self-efficacy in a sample of 276 older adults who resided in several low-income senior independent living settings. Shared interest groups were initiated and informally evaluated. They were very well received by residents overall, and suggest their value for reducing loneliness and promoting satisfying relationships. Specific recommendations are provided to help initiate such groups in other residential settings. 相似文献
22.
Adriaan Tuiten Kim van Rooij Jos Bloemers Christoph Eisenegger Jack van Honk Rob Kessels Sheryl Kingsberg Leonard R. Derogatis Leo de Leede Jeroen Gerritsen Hans P.F. Koppeschaar Berend Olivier Walter Everaerd Henderik W. Frijlink Daniël Höhle Robert P.J. de Lange Koen B.E. Böcker James G. Pfaus 《The journal of sexual medicine》2018,15(2):201-216
Background
In women, low sexual desire and/or sexual arousal can lead to sexual dissatisfaction and emotional distress, collectively defined as female sexual interest/arousal disorder (FSIAD). Few pharmaceutical treatment options are currently available.Aim
To investigate the efficacy and safety of 2 novel on-demand pharmacologic treatments that have been designed to treat 2 FSIAD subgroups (women with low sensitivity for sexual cues and women with dysfunctional over-activation of sexual inhibition) using a personalized medicine approach using an allocation formula based on genetic, hormonal, and psychological variables developed to predict drug efficacy in the subgroups.Methods
497 women (21–70 years old) with FSIAD were randomized to 1 of 12 8-week treatment regimens in 3 double-blinded, randomized, placebo-controlled, dose-finding studies conducted at 16 research sites in the United States. Efficacy and safety of the following on-demand treatments was tested: placebo, testosterone (T; 0.5 mg), sildenafil (S; 50 mg), buspirone (B; 10 mg) and combination therapies (T 0.25 mg + S 25 mg, T 0.25 mg + S 50 mg, T 0.5 mg + S 25 mg, T 0.5 mg + S 50 mg, and T 0.25 mg + B 5 mg, T 0.25 mg + B 10 mg, T 0.5 mg + B 5 mg, T 0.5 mg + B 10 mg).Outcomes
The primary efficacy measure was the change in satisfying sexual events (SSEs) from the 4-week baseline to the 4-week average of the 8-week active treatment period after medication intake. For the primary end points, the combination treatments were compared with placebo and the respective monotherapies on this measure.Results
In women with low sensitivity for sexual cues, 0.5 mg T + 50 mg S increased the number of SSEs from baseline compared with placebo (difference in change [Δ] = 1.70, 95% CI = 0.57–2.84, P = .004) and monotherapies (S: Δ = 1.95, 95% CI = 0.44–3.45, P = .012; T: Δ = 1.69, 95% CI = 0.58–2.80, P = .003). In women with overactive inhibition, 0.5 mg T + 10 mg B increased the number of SSEs from baseline compared with placebo (Δ = 0.99, 95% CI = 0.17–1.82, P = .019) and monotherapies (B: Δ = 1.52, 95% CI = 0.57–2.46, P = .002; T: Δ = 0.98, 95% CI = 0.17–1.78, P = .018). Secondary end points followed this pattern of results. The most common drug-related side effects were flushing (T + S treatment, 3%; T + B treatment, 2%), headache (placebo treatment, 2%; T + S treatment, 9%), dizziness (T + B treatment, 3%), and nausea (T + S treatment, 3%; T + B treatment, 2%).Clinical Implications
T + S and T + B are promising treatments for women with FSIAD.Strengths and Limitations
The data were collected in 3 well-designed randomized clinical trials that tested multiple doses in a substantial number of women. The influence of T + S and T + B on distress and the potentially sustained improvements after medication cessation were not investigated.Conclusions
T + S and T + B are well tolerated and safe and significantly increase the number of SSEs in different FSIAD subgroups.Tuiten A, van Rooij K, Bloemers J, et al. Efficacy and Safety of On-Demand Use of 2 Treatments Designed for Different Etiologies of Female Sexual Interest/Arousal Disorder: 3 Randomized Clinical Trials. J Sex Med 2018;15:201–216. 相似文献23.
医学伦理学教育虽然得到了医学教育界的广泛重视,但在实际教学中,部分医学生对于医学伦理学的学习却缺乏应有的重视.基于医学伦理学教育的现状,从医学生的视角剖析当前医学生不重视医学伦理学学习的原因有:对实用主义的片面认识,市场化的冲击,应试教育的影响以及医学伦理学教学自身存在的一些问题.进而提出调整医学伦理学的开课时间、在教学中应尽力澄清道德立场、增加现代网络和实践教学手段、改变医学伦理学考核方式等设想. 相似文献
24.
中国特有的家庭文化发端于宗亲制度,成熟于儒家思想。它以家庭为核心,强调家庭成员之间的相互义务,在保护家庭成员利益方面发挥了重要作用。家庭文化对知情同意实践的影响主要表现在患者利益主体以及主体的权利责任的确定和保障等方面。其积极的影响主要是它有利于保护患者的利益和家庭整体的利益;有利于增强家庭成员之间的义务感,加深家庭成员之间的感情,促进家庭和谐。其存在的主要问题有患者和家庭之间主体的确认以及家庭成员之间的主体权利与责任问题。我们应该发扬中国传统文化的优势,努力在实践中解决存在的问题。 相似文献
25.
《Brain stimulation》2022,15(5):1269-1278
BackgroundDeep brain stimulation of the internal globus pallidus (GPi DBS) is an invasive therapeutic modality intended to retune abnormal central nervous system patterns and relieve the patient of dystonic or other motor symptoms.ObjectivesThe aim of the presented research was to determine the neuroanatomical signature of GPi DBS modulation and its association with the clinical outcome.MethodsThis open-label fixed-order study with cross-sectional validation against healthy controls analysed the resting-state functional MRI activity changes induced by GPi DBS in 18 dystonia patients of heterogeneous aetiology, focusing on both global (full brain) and local connectivity (local signal homogeneity).ResultsCompared to the switched-off state, the activation of GPi DBS led to the restoration of global subcortical connectivity patterns (in both putamina, diencephalon and brainstem) towards those of healthy controls, with positive direct correlation over large-scale cortico-basal ganglia-thalamo-cortical and cerebellar networks with the clinical improvement. Nonetheless, on average, GPi DBS also seemed to bring local connectivity both in the cortical and subcortical regions farther away from the state detected in healthy controls. Interestingly, its correlation with clinical outcome showed that in better DBS responders, local connectivity defied this effect and approached healthy controls.ConclusionsAll in all, the extent of restoration of both these main metrics of interest towards the levels found in healthy controls clearly correlated with the clinical improvement, indicating that the restoration of network state towards more physiological condition may be a precondition for successful GPi DBS outcome in dystonia. 相似文献
26.
27.
职业兴趣调查表的编制 总被引：9，自引：3，他引：6
目的：编制一套适用于我国的职业兴趣量表。方法：以Ｈｏｌａｎｄ理论为框架,在职业、工作活动、娱乐活动和自我评价四个方面收集了符合我国文化与职业分类情况的项目２６８条。在长沙地区５所高校１７个系２８个专业的３～４年级大学生取样１２７０人。结果：用因素分析的方法在职业、工作活动和自我评价三个方面内容中得到了符合Ｈｏｌａｎｄ理论的ＲＩＡＳＥＣ因素结构。建立了区域性大学生男、女均数常模和Ｔ分常模,量表的信度和效度符合测量学要求。结论：所制定的量表达到了心理测量学要求。 相似文献
28.
29.
通过实例,分析刊登在国际著名SCI医学期刊上的生物医学英语论文中常见的与医学伦理和科研道德相关问题,着力讨论生物医学英语论文写作过程中应注意的作者署名和贡献问题、材料与方法部分所涉及人体或动物为研究受试体时的伦理问题、致谢辞的撰写、参考文献选取,有关利益冲突等问题,并进一步论述了上述问题的相关处理方法。 相似文献
30.
创设情境激发聋儿说话兴趣 总被引：1，自引：0，他引：1
王宏杰 《中国听力语言康复科学杂志》2005,(4):41-42
在聋儿语言康复教育中，创设良好的情境，是聋儿学好语言的关键。创设良好的情境不仅能激发聋儿学语的积极性，而且还能够让聋儿在情境中锻炼运用语言及主动运用语言与人沟通交流的能力。 相似文献