Cognitive defusion versus experiential avoidance in the reduction of smoking behaviour: an experimental and preliminary investigation

Background: Brief procedures that reduce smoking behaviour may be useful in reaching the many people that do not seek help for smoking addiction.

Objectives: The current study aimed to determine if one component of Acceptance and Commitment Therapy (ACT), cognitive defusion, could be useful in reducing smoking behaviour in a sample of students.

Methods: The study employed a between-subjects three-arm design. For one week, participants were asked to reduce their cigarette consumption. To aid them in their reduction, participants were randomly allocated to one of three conditions: the first received a defusion procedure, the second received an experiential avoidance procedure and a control condition received no procedure. For a second week, the instruction to reduce cigarette consumption was lifted. During both weeks participants were required to monitor their smoking behaviour via a tally diary system.

Results: The defusion condition smoked significantly less than the control condition during week one and significantly less than the control and experiential avoidance conditions during week two.

Conclusion: Results are discussed in terms of the potential utility of defusion in this domain, and the limitations of this preliminary research that would need to be addressed in future investigations.     

深圳市龙岗区护理人员工作满意度的影响因素分析

目的 探讨影响深圳市护理人员工作满意度的相关因素,为改善护理人员的工作满意度、提高护理质量、减少护理人员流失、完善护理人力资源管理制度提供依据。方法对在深圳市龙岗区医院工作的445名护理人员,采用一般资料问卷、明尼苏达满意问卷（MSQ）、组织承诺量表（OCQ）、离职意愿量表进行调查,分别以工作满意度量表、组织承诺量表、离职意愿量表总分为应变量,以护理人员的年龄、学历、婚姻、职称、职务、劳动关系、工龄、是否注册护士和其他两个量表总分为自变量进行多元逐步回归分析。结果护理人员工作满意度与组织承诺、年龄呈正相关,与劳动关系和离职意愿呈负相关（P〈0．001）。结论护理人员的工作满意度与组织承诺、年龄、劳动关系和离职意愿等因素关系密切。需采取有针对性的干预措施,提高护理人员的工作满意度。     

男护士心理资本、组织承诺与离职倾向的相关性研究

目的调查男护士心理资本、组织承诺及离职倾向的现状,探讨三者之间的关系。方法采用一般资料调查表、心理资本量表、组织承诺量表、离职倾向量表对8所三级甲等医院102名男护士进行调查。结果男护士心理资本总分为(16.44±2.76)分,组织承诺总分为(69.02±13.37)分,离职倾向总分为(16.31±3.19)分;男护士心理资本与组织承诺及离职倾向均显著相关(P<0.01或P<0.05),心理资本在组织承诺与离职倾向之间起到部分中介作用。结论护理管理者应重视提高临床男护士心理资本及组织承诺水平,从而避免离职倾向的产生。     

眼视光学生专业承诺及影响因素的调查分析

目的:调查西安医学院眼视光专业学生专业承诺的状况及其存在的问题,为专业的发展进一步提出相应的建议与对策提供科学依据。方法:采用整群抽样,利用《大学生专业承诺量表》问卷,对西安医学院2008/2010年级眼视光专业148名学生进行问卷调查。结果:西安医学院三个年级中2009级专业承诺均值最高;3个年级学生的专业承诺之间有一定的差异;男生与女生在规范承诺上有显著差异;调剂学生的专业承诺均值低于其他报考第一、二、三、四志愿学生。结论:眼视光教育不仅要对学生进行专业思想教育,也要通过各种渠道向社会群体宣传眼视光专业的特点和专业发展的必要性。     

Strengthening vaccination policies in Latin America: An evidence-based approach

Despite many successes in the region, Latin American vaccination policies have significant shortcomings, and further work is needed to maintain progress and prepare for the introduction of newly available vaccines. In order to address the challenges facing Latin America, the Commission for the Future of Vaccines in Latin America (COFVAL) has made recommendations for strengthening evidence-based policy-making and reducing regional inequalities in immunisation. We have conducted a comprehensive literature review to assess the feasibility of these recommendations. Standardisation of performance indicators for disease burden, vaccine coverage, epidemiological surveillance and national health resourcing can ensure comparability of the data used to assess vaccination programmes, allowing deeper analysis of how best to provide services. Regional vaccination reference schemes, as used in Europe, can be used to develop best practice models for vaccine introduction and scheduling. Successful models exist for the continuous training of vaccination providers and decision-makers, with a new Latin American diploma aiming to contribute to the successful implementation of vaccination programmes. Permanent, independent vaccine advisory committees, based on the US Advisory Committee on Immunization Practices (ACIP), could facilitate the uptake of new vaccines and support evidence-based decision-making in the administration of national immunisation programmes. Innovative financing mechanisms for the purchase of new vaccines, such as advance market commitments and cost front-loading, have shown potential for improving vaccine coverage. A common regulatory framework for vaccine approval is needed to accelerate delivery and pool human, technological and scientific resources in the region. Finally, public–private partnerships between industry, government, academia and non-profit sectors could provide new investment to stimulate vaccine development in the region, reducing prices in the long term. These reforms are now crucial, particularly as vaccines for previously neglected, developing-world diseases become available. In summary, a regionally-coordinated health policy will reduce vaccination inequality in Latin America.     

接纳与承诺疗法在中青年维持性血液透析患者中的应用

目的探讨接纳与承诺疗法对中青年维持性血液透析患者自我效能和创伤后成长的影响。方法采用方便抽样法,选择2018年2月—2019年2月在连云港市第二人民医院接受维持性血液透析的患者作为研究对象。采用随机数字表法,随机分为试验组和对照组各42例,对照组采用常规护理,试验组在常规护理的基础上实施接纳与承诺疗法干预,采用一般自我效能感量表(GSES)、创伤后成长量表(PTGI)比较两组干预效果。结果试验组1例中途退出研究,最终试验组41例、对照组42例患者完成研究。干预6周后,试验组患者GSES量表(30.85±3.12)分,PTGI量表总分(67.89±8.43)分,均高于对照组,差异均有统计学意义(t值分别为12.254、10.002;P<0.05)。结论接纳与承诺疗法可改善中青年维持性血液透析患者创伤后成长水平,提高患者自我效能。     

Exploitation of stem cell plasticity

For many years, adult haemopoietic stem cells (HSCs) have been considered 'plastic' in their proliferative and differentiation capacities. Recently, evidence that supports newer concepts of adult stem cell plasticity has been reported. In particular, stem cells from haemopoietic tissues seem to have 'extraordinary' abilities to generate or switch between haemopoietic and nonhaemopoietic lineages, exhibiting an unexpected degree of developmental or differentiation potential. The mechanisms by which cell fate reprogramming occurs are still poorly understood. Nevertheless, an increasing number of studies is challenging one of the main dogmas in biology, namely that mammalian cell differentiation follows established programmes in a hierarchical fashion, and once committed to a particular somatic cell lineage, cells do not change into another somatic lineage. The 'nonhierarchical', 'reversible' phenotype of stem cells in haemopoietic tissues, if it exists, would be an advantage that could be exploited in regenerative medicine. Here, we review the recent advances in HSC biology and discuss the general concepts of adult stem cell plasticity with respect to these cells and how these might be exploited clinically.