Social class inequalities in health among occupational cohorts from Finland,Britain and Japan: A follow up study

We examined whether relative occupational social class inequalities in physical health functioning widen, narrow or remain stable among white collar employees from three affluent countries. Health functioning was assessed twice in occupational cohorts from Britain (1997–1999 and 2003–2004), Finland (2000–2002 and 2007) and Japan (1998–1999 and 2003). Widening inequalities were seen for British and Finnish men, whereas inequalities among British and Finnish women remained relatively stable. Japanese women showed reverse inequalities at follow up, but no health inequalities were seen among Japanese men. Health behaviours and social relations explained 4–37% of the magnitude in health inequalities, but not their widening.     

Building an International Community of Paediatric Anaesthesiologists: An interview with Dr Edward Sumner

Dr Edward Sumner (1940) enjoyed a remarkably productive career as consultant pediatric anesthetist at the Great Ormond Street Hospital for Children. His leadership in clinical care helped his department rise to eminence. He trained hundreds of registrars in pediatric anesthesia and educated thousands more through invited lectures and by co‐editing leading textbooks of neonatal and pediatric anesthesia. During his long tenure as Editor‐in‐Chief of Pediatric Anesthesia, he led the growth of the young journal to prominence. Based on an interview and a long‐standing professional and personal friendship of forty‐four years, this article reviews Ted Sumner's outstanding contributions to the specialty of pediatric anesthesia and to the development of a strong international community of pediatric anesthesiologists.     

英格兰社区药房服务及其对中国社会药房发展的启示

目的:探讨英格兰社区药房服务对中国社会药房发展的启示。方法:回顾和探讨2000-2008年英国社区药房各种制度和政策对社区药房服务内容的影响,提出对中国社会药房未来发展的建议。结果与结论:英格兰社区药房的基本服务内容包括配药、重复配药、回收药物、公共健康、提供转诊指导、自我保健以及临床管理。此外,英国皇家药学会也不断推出各项社区药房的额外服务以提高其效能,如抗凝血剂监测服务、特定疾病专用药物管理服务等。这些举措对中国社会药房的发展具有较大启示,也有实际可行性。     

Are APLS formulae for estimating weight appropriate for use in children admitted to PICU?

Aim

To determine if the revised APLS UK formulae for estimating weight are appropriate for use in the paediatric intensive care population in the United Kingdom.

Methods

A retrospective observational study involving 10,081 children (5622 male, 4459 female) between the age of term corrected and 15 years, who were admitted to Paediatric Intensive Care Units in the United Kingdom over a five year period between 2006 and 2010. Mean weight was calculated using retrospective data supplied by the ‘Paediatric Intensive Care Audit Network’ and this was compared to the estimated weight generated using age appropriate APLS UK formulae.

Results

The formula ‘Weight = (0.5 × age in months) + 4’ significantly overestimates the mean weight of children under 1 year admitted to PICU by between 10% and 25.4%. While the formula ‘Weight = (2 × age in years) + 8’ provides an accurate estimate for 1-year-olds, it significantly underestimates the mean weight of 2–5 year olds by between 2.8% and 4.9%. The formula ‘Weight = (3 × age in years) + 7’ significantly overestimates the mean weight of 6–11 year olds by between 8.6% and 20.7%. Simple linear regression was used to produce novel formulae for the prediction of the mean weight specifically for the PICU population.

Conclusions

The APLS UK formulae are not appropriate for estimating the weight of children admitted to PICU in the United Kingdom. Relying on mean weight alone will result in significant error as the standard deviation for all age groups are wide.     

英国药师职业发展体系介绍及启示

目的：调查英国药师职业发展体系、内容和特点,为完善我国执业药师职业发展体系提出建议。方法：通过文献研究和专家访谈的方式,收集近年来英国药师职业发展的各项资料,整理出英国药师管理部门、职业发展体系、教育培训内容和职业发展特点。并对照分析我国的药师职业发展情况。结果与结论：我国执业药师职业发展培训内容偏向理论,缺乏实用性;培训方式比较单一,对不同岗位、不同能力的执业药师没有针对性;执业药师职业发展认证机制不完善。应借鉴英国职业发展体系,从完善药师职业发展认证机制,促进职业发展多元化,尽早培养执业药师职业发展意识等方面来完善我国执业药师职业发展体系。     

Acupuncture compared with placebo in post-herpetic pain

A single blind randomised controlled study of auricular and body acupuncture compared with placebo (mock transcutaneous nerve stimulation) was performed in 62 patients with post-herpetic neuralgia. There was no difference in the amount of pain relief recorded in the two groups during or after treatment; 7 patients in the placebo group and 7 patients in the acupuncture group experienced significant improvement in their pain at the end of treatment. This suggests that acupuncture is of little value as an analgesic therapy for post-herpetic neuralgia. However the study method and the use of a mock transcutaneous nerve stimulator as a placebo may be of value when assessing the effects of acupuncture in other conditions.     

Bella and the white water rapids

Abstract

This article is an exploration of the feeling state engendered in the art psychotherapist when working with a child who had been emotionally and sexually abused. It attempts to discover the meaning of what happened in a therapy when no verbal or thinking interaction could initially take place. It describes the difficulty of finding a way to articulate the fragmented information available, both to bring to consciousness the snippets of memory presented, and to structure them into an organised story.

Thinking appeared to be what the child was desperate to avoid. It was far too painful for her, so anger and abuse were used as a defence. Noise was produced during therapy, so that the artwork, the games and in particular the experience of projective identification could not be thought about. The noise often led to the art psychotherapist being silenced and also unable to think.

Countertransference feelings were communicated, including shame, hatred, love and fear. These were explored to help find meaning, which led to understanding that the child needed to experience attachment to a constant and non-retaliatory Other. This made the experience of both merging and separation from the therapist an enabling space in which to find symbol and thought.