Resilience in Women’s Sexual Pain After Female Genital Cutting: Adaptation Across Time and Personal and Cultural Context

Archives of Sexual Behavior -     

The use of benzodiazepines among injecting drug users

Benzodiazepine use among injecting drug users (IDUs) presents a major clinical and public health problem that may increase in importance. The current paper examines the research on the extent of benzodiazepine use among IDUs and the harmful consequences associated with such use. Numerous studies have found benzodiazepine use to be widespread among IDUs, and to be associated with greater levels of risk-taking and polydrug use, and poorer psychosocial functioning than other IDUs. The injection of benzodiazepines has also been reported, and presents problems in itself. The implications of existing research for both clinical practice and research are discussed.     

A stepwise approach to the evaluation and selection of a hospital pharmacy information system

The current demands for cost reduction, increased efficiency, and quality care placed upon hospital pharmacy departments underscores the need for an effective information system. In this article, we describe the stepwise approach we used to evaluate and select a new pharmacy information system. The importance of involving staff in the evaluation process is discussed, along with the mechanisms we used to learn as much as we could about the vendors before making our selection.     

Computerized bone densitometric analysis: operator-dependent errors

PURPOSE: To determine the nature and relative frequency of operator-dependent data analysis errors in dual x-ray absorptiometry. MATERIALS AND METHODS: Over 40 months, 2,528 dual x-ray absorptiometric examinations of the forearm, femoral neck, and lumbar spine were performed by 11 technologists by using standard techniques and software. Each analysis was reviewed by a radiologist; errors were recorded and corrected. RESULTS: There were no forearm analysis errors. There were 24 (0.9%) femoral neck analysis errors, of which 23 resulted from misplacement of the analysis region. There were 33 (1.3%) spinal analysis errors, of which 24 resulted from misplacement of intervertebral disk space markers. Analysis errors of the femur and spine resulted in six misdiagnoses (0.2%). CONCLUSION: Misdiagnosis due to analysis errors is rare. Femoral neck analysis errors were easily detectable, but accurate spinal analyses depended on accurate identification of vertebral end plates and posterior elements. Nonetheless, these potentially serious errors can be detected and corrected if the analyses are reviewed and interpreted by a supervising physician who is familiar with the relevant anatomy, proper analysis techniques, and factors--such as artifacts--that adversely affect the accuracy of the analysis.     

Anti-social personality disorder and response to methadone maintenance treatment

A sample of 183 current methadone maintenance patients were interviewed on their drug use history, criminal history, current drug use, and symptoms of Anti-social Personality Disorder (ASPD). Thirty-nine percent of patients met the DSM-III-R criteria for a diagnosis of ASPD. ASPD patients had an earlier onset of drug use, drug injecting, heroin use, had wider polydrug using histories and had been arrested earlier and more frequently than other patients. Despite the different pretreatment histories of ASPD and other patients, there were no differences between the two groups in retention in treatment, methadone dosage or heroin use. It is concluded that heroin-dependent ASPD patients can be successfully retained in methadone treatment, on similar methadone doses and with similar in-treatment drug use patterns as those of non-ASPD heroin dependent patients.     

An invisible health and social policy issue: homeless/runaway youth

Among the most 'invisible' people of this society are homeless and runaway youth. They present a major public health issue for society. Health problems, physical and mental, acute and chronic, are commonly found in studies of such youth. Many of their problems are exacerbated by and related to social policies of our society both in genesis and severity.     

Department of pharmacy-initiated program for streamlining empirical antibiotic therapy

The outcome of a department of pharmacy-initiated "streamlining" study designed to promote cost-conscious modifications of empirically selected antibiotic therapy is described. Two hundred forty-one evaluable adult patients started on restricted-use antibiotics at this university-affiliated community private teaching hospital were enrolled in a 9-week prospective streamlining study. Patients were alternately assigned to a Control (i.e., no pharmacist-initiated streamlining recommendations offered based on culture and susceptibility reports) or a Pharmacist Intervention group (i.e., pharmacist offers recommendations to streamline therapy). A statistically significant greater number of patients had their empiric antibiotic treatment courses modified to more appropriate antibiotic choices after receipt of culture and susceptibility reports among private prescribers in the Pharmacist Intervention group (83%) than in the Control group (38%) (p = .006). Additionally, pharmacists were overall successful in gaining prescriber acceptance for 64% of recommended changes of empiric antibiotic treatment courses before the receipt of culture and susceptibility reports (e.g., dose and/or frequency changes). There was no program effect observed with respect to improved physician response to microbiologic data that would allow streamlining empirical antibiotic choices in the Housestaff (i.e., medical or surgical residents), or infectious disease consultant prescriber groups. Projected overall annual cost savings that would be achieved as a result of continued efforts by pharmacists directed at streamlining empirical "restricted" antibiotic regimens is approximately +40,000.     

Identification and validation of genes involved in the pathogenesis of colorectal cancer using cDNA microarrays and RNA interference.

PURPOSE: The purpose of this study was to profile gene expression changes in colorectal tumors to identify new targets and strategies for the management of this disease. EXPERIMENTAL DESIGN: cDNA microarray analysis was used to detect differences in gene expression between normal tissue and colon tumors and polyps isolated from 20 patients. To identify genes that are important in regulating the growth properties of colorectal cancer, RNA interference (RNAi) was used to disrupt expression of several of the overexpressed genes in a colon tumor cell line, HCT116, which showed similar patterns of gene expression as many of the patient tumors. RESULTS: Expression changes of > or =2-fold in approximately one-third of the patients were consistently observed for 2632 of a total of 9592 genes (574 up-regulated genes and 2058 down-regulated genes). Subsequent analysis of 13 genes by quantitative real-time PCR confirmed the reliability of this analysis. RNAi-mediated disruption of the expression of one of these genes, survivin, a potent inhibitor of apoptosis, severely reduced tumor growth both in vitro and in an in vivo xenograft model. CONCLUSIONS: The combined use of microarray analysis and RNAi provides an excellent system to define the role of specific genes that are up-regulated in cancer lead to the increased in vitro and in vivo growth of colon tumors.     

澳大利亚医疗服务质量管理的理念和做法

澳大利亚认为质量是组织绩效的组成部分，管理者对服务质量和安全应承担更大的责任。政府推行临床治理，加强改善质量和安全管理的研究机构，制定标准和评价指标。医院将质量和安全问题纳入机构日常和战略管理的计划并付诸实施。同时，政府和医疗机构重视病人和社区参与质量和安全管理。文章在探讨澳大利亚医疗服务质量理念、实践经验和质量评价指标的基础上，讨论澳大利亚经验对我国医疗服务管理的借鉴。     

维多利亚州住院病人满意度监测的方法学

文章全面地介绍了维多利亚州住院病人满意度监测的方法，包括工具设计的目的、原则和开发过程、问卷的结构、数据采集和分析方法，以及监测结果的表达和应用方式。