关于社区精神分裂症人群个案管理的两年前瞻性病例对照研究(英文)

背景:以社区为基础的康复方案是精神分裂症患者综合治疗的基本要素。目标:评估以社区为基础的个案管理为精神分裂症患者提供康复服务的长期效果。方法:从上海两区共招募730名符合ICD-10精神分裂症诊断标准的社区居民,380名纳入个案管理组和350名纳入对照组。个案管理涉及每月培训拜访患者和他们的家庭成员,侧重于鼓励患者坚持服药。在24个月中参加者每3个月使用Camberwell需求评价量表(CAN),阳性和阴性症状量表(PANSS),世界卫生组织残疾评定量表(WHO-DAS)和生活质量表(QOLS)进行一次评估。那些没有得到医生批准而停止服用抗精神病药物一个月或更长的患者被归为"自行决定停药"。结果:相比于常规治疗组(即每3个月的随访管理),参加个案管理计划的患者两年随访后停止服药率显著降低,阴性症状的严重程度显著降低,复发率降低并且再住院率也降低了。对停止服药有独立影响的其他因素包括文化程度(受教育程度越高,停药率越高),用药缺乏家庭监督,用药剂量较高,以及与药物相关的不良反应。结论:个案管理是一种可行而且有效的长期方法,可以改善社区精神分裂症患者的康复效果。我们的研究结果强调家人需要参与患者的用药管理,使用药物的最小有效剂量,并积极处理所有的副作用。     

Problem Drinking’s Associations with Social Structure and Mental Health Care: Race/Ethnicity Differences

This research used a nationally representative sample of 12,756 respondents self-identified as White, Black, Hispanic, or Asian to examine problem drinking in relationship to social structure and mental healthcare factors. Associations between problem drinking and particular factors varied by racial/ethnic group. Results also indicated that Whites’ problem-drinking rates were higher than those of Hispanics, Blacks, and Asians. Americans sometimes use alcohol to manage stress stemming from social disadvantage and inadequate material resources. Across racial/ethnic groups, drinking level was associated with the type and degree of such disadvantage. Additionally, the presence of a mental health problem was associated with problem drinking.     

河南扶沟县2007~2013年剖宫产率及剖宫产指征变化原因分析

目的分析河南扶沟县2007~2013年剖宫产率及各项剖宫产指征的变化原因,探讨降低剖宫产率的对策。方法对2007~2013年扶沟县妇幼保健院5 606例剖宫产产妇进行回顾性分析。结果剖宫产率呈逐年上升趋势,社会因素、瘢痕子宫、胎儿宫内窘迫、巨大儿为剖宫产主要指征,且比例逐年上升,其中社会因素上升最快;以胎位异常、妊娠合并症、产程异常为剖宫产指征的比例逐年下降。结论严格掌握剖宫产指征,减少因社会因素而行的剖宫产,提高产科质量,广泛开展分娩镇痛是降低剖宫产率的关键。     

心理护理和社会支持对老年痴呆患者生活能力的影响

目的探讨心理护理和社会支持干预对老年痴呆患者生活能力和语言能力的影响,为临床护理提供参考依据。方法将80例老年痴呆患者随机分为观察组和对照组各40例,对照组给予常规护理,观察组在常规护理的基础上加用心理护理和社会支持干预,比较两组患者干预前后语言能力和生活能力改善情况。结果观察组康复锻炼依从性优良率为82.50%,高于对照组（60.00%）,两组比较差异有统计学意义（P〈0.05）;观察组日常生活能力评分为（67.62±11.74）分,高于对照组的（56.93±10.62）分,两组比较差异有统计学意义（P〈0.05）;观察组书写和阅读、复述、听觉理解、自发言语、信息量、流畅度得分均显著高于对照组（均P〈0.05）。结论心理护理和社会支持有效改善患者的语言能力和生活能力,提高患者生活质量。     

“Brown Bag” Simulations to Teach Drug Utilization Review

Objective. To teach drug utilization review (DUR) skills to pharmacy students and assess their abilities and confidence before and after training.Design. Profile reviews and online and live drug-utilization-review activities of increasing difficulty were incorporated into the first (P1), second (P2), and third (P3) years of the Pharmacy Skills Training Laboratory sequence in a doctor of pharmacy (PharmD) curriculum.Assessment. An online survey instrument was administered to gauge how comfortable students were with specific DUR skills before and after the activities. Students’ confidence in performing specific DUR skills improved after completing the activities.Conclusion. Profile reviews, as well as online and live medication reviews, gave students numerous opportunities to practice drug utilization review skills throughout the first 3 years of the pharmacy curriculum. Students’ confidence in performing specific drug utilization review skills improved after the activities. Students’ ability to perform the skills also improved as measured with the developed checklist in section V and VI of the Pharmacy Skills Laboratory sequence.     

A Nontraditional Faculty Development Initiative Using a Social Media Platform

Objective. To assess the outcomes from an 11-year nontraditional professional development activity implemented by female faculty members at several colleges and schools of pharmacy.Design. Within the context of an online fantasy football league, faculty members practiced community-based faculty development strategies, including peer mentoring, skills development, constructive feedback and other supportive behaviors.Assessment. Data were extracted from curriculum vitae to characterize the academic progress of participants and to quantify scholarly work collaborations among league members. Analyses were limited to members who had participated in the league for 10 or more consecutive years. Seventy-one collaborative scholarly works occurred among team managers, including presentation of 20 posters and 2 oral presentations at national or international meetings, publication of 29 peer-reviewed articles and 15 book chapters, and funding of 5 research projects.Conclusion. Social media platforms can foster nontraditional faculty development and mentoring by enhancing connectivity between pharmacy educators who share similar interests.     

Effects of MDMA and Intranasal Oxytocin on Social and Emotional Processing

MDMA (±3,4-methylenedioxymethamphetamine, ‘ecstasy'') is used recreationally, reportedly because it increases feelings of empathy, sociability, and interpersonal closeness. One line of evidence suggests that MDMA produces these effects by releasing oxytocin, a peptide involved in social bonding. In the current study, we investigated the acute effects of MDMA and oxytocin on social and emotional processing in healthy human volunteers. MDMA users (N=65) participated in a 4-session, within-between-subjects study in which they received oral MDMA (0.75, 1.5 mg/kg), intranasal oxytocin (20 or 40 IU), or placebo under double-blind conditions. The primary outcomes included measures of emotion recognition and sociability (desire to be with others). Cardiovascular and subjective effects were also assessed. As expected, MDMA dose-dependently increased heart rate and blood pressure and feelings of euphoria (eg, ‘High'' and ‘Like Drug''). On measures of social function, MDMA impaired recognition of angry and fearful facial expressions, and the larger dose (1.5 mg/kg) increased desire to be with others, compared with placebo. Oxytocin produced small but significant increases in feelings of sociability and enhanced recognition of sad facial expressions. Additionally, responses to oxytocin were related to responses to MDMA with subjects on two subjective measures of sociability. Thus, MDMA increased euphoria and feelings of sociability, perhaps by reducing sensitivity to subtle signs of negative emotions in others. The present findings provide only limited support for the idea that oxytocin produces the prosocial effects of MDMA.     

我院药物咨询工作的实践分析与技能探讨

目的:提高药物咨询的服务质量,促进合理用药。方法:对我院2013年8-11月药物咨询记录进行分析与总结,并结合实际案例对咨询技能作一深入探讨。结果:咨询者中患者及其家属比例为76.9%,医护人员比例为23.1%;咨询方式以药物咨询室和电话咨询居多;咨询内容主要涉及药物用法用量、不良反应、适应证、药物相互作用;咨询药物以抗菌药和心脑血管类药物比例最高;咨询结果的满意比例较高,达85.2%;针对咨询患者的实际情况,有技巧地作出相应回复可有效帮助提高合理用药水平和用药依从性。结论:开展药物咨询是药学服务的重要内容,也是提高药学服务质量的重要环节,同时为医护人员获取较为全面的医药信息提供了平台。注重对药物咨询的实践分析和咨询技能的使用,对提高患者用药依从性、促进合理用药起到了推动作用。     

有异性性经历的男男性行为人群艾滋病传播风险研究

目的:了解有异性性经历的男男性行为(MSM)人群的人口学特征和艾滋病高危行为特征、面临的社会压力、艾滋病知识知晓情况,从而研究HIV从MSM人群向一般人群的传播风险。方法:依托Internet平台对MSM人群开展专题调查,调查内容包括人口学特征、艾滋病高危行为等情况。使用SPSS18.0软件对调查数据进行统计。结果:共收集473份有效问卷。本次调查对象的平均年龄是31.41岁,自我认为性取向为同性恋的占43.3%、双性恋的占55.4%;调查显示:MSM人群性伴不固定,只有1名同性性伴的仅占4.2%;76.5%的MSM主要通过互联网寻找性伴。该人群存在着知识与行为的严重分离。结论:有异性性经历的MSM隐蔽性非常强,感染艾滋病的高危行为仍广泛存在,艾滋病从MSM人群向一般人群蔓延的风险很大。