A pilot placebo-controlled study of trazodone and buspirone in alzheimer's disease

The pharmacological management of behavioural symptoms in Alzheimer's disease is limited by the dearth of effective agents in this area. The purpose of this study was to determine whether trazodone or buspirone are helpful in the treatment of behavioural disturbance in AD. Ten patients meeting NINCDS criteria for AD with behavioural complications were administered trazodone (up to 50 mg tid), buspirone (10 mg tid), and placeboin a 12-week double-blind, crossover design. Outcome measures were the Brief Psychiatric Rating Scale (BPRS), the Dementia Mood Assessment Scale (DMAS), and the Buschke Selective Reminding Task. The data were analysed by ANOVA. Compared to placebo, trazodone produced a small but significant reduction in BPRS and DMAS scores (p<0.05), indicating improvement in behaviour but no change in cognitive measures. In contrast, buspirone has no significant effect on either behavioural or cognitive measures compared to placebo. The results of this pilot study suggest a beneficial role for trazodone, but not buspirone, in the treatment of behavioural disturbance in AD. Further studies using a wider range of doses of trazodone in more behaviourally disturbed AD patients should now be initiated in an attempt to replicate and expand on this preliminary finding.     

Pilot study on use of PMPs

Patient management problems (PMPs) have been used for many years in an attempt to design tests capable of measuring clinical problem-solving ability. Problems have arisen particularly related to criterion validity, though some studies have suggested that content and construct validity are satisfactory. One of the major problems has been that a common definition of problem-solving ability has not been developed yet. In addition, various formats have been used with considerable variety in construction, possibly influencing outcomes, and scoring procedures have not been standardized. A serious charge has been that PMPs are content specific and therefore are unreliable and not valid for measuring any general characteristic such as problem-solving ability (assuming this exists).     

医学本科生科研创新能力培养实践

首都医科大学在“本科生科研创新项目”实施过程中,发现学生存在科研能力如文献检索、专业英语、数据统计和论文撰写能力等方面的不足。同时,指导教师存在科研时间安排、科研经验和科研经费管理等方面的不足。可通过健全规范培养制度、加大经费投入、建立奖励机制和增加科研能力培训课程等措施进一步推动“本科生科研创新项目”的开展。     

A pilot study of Screening,Brief Intervention,and Referral for Treatment (SBIRT) in non-treatment seeking smokers with HIV

Introduction

PLHIV have higher rates of smoking and lower motivation to quit smoking; thus to impact smoking rates, cessation interventions need to be acceptable to a wider range of PLHIV smokers as well as feasible to implement in a busy clinical setting. The purpose of this study was to evaluate the acceptability, feasibility, and effects of a Screening, Brief Intervention, and Referral for Treatment (SBIRT) model in an HIV/AIDS clinic among a sample of PLHIV.

Methods

PLHIV smokers (N = 40) were randomized at baseline, irrespective of their self-reported discrete smoking cessation motivation status, to receive either 8-weeks of combination nicotine replacement therapy (NRT) in conjunction with brief counseling (SBIRT framework) (n = 23) or usual care (n = 17). Smoking outcome measures included cigarettes smoked per day, nicotine dependence, smoking urge, and smoking withdrawal symptoms.

Results

The SBIRT intervention appeared to be acceptable and feasible, and produced medium to large reductions in cigarettes smoked per day, physical nicotine dependence, smoking urge, and smoking withdrawal symptoms, even for smokers not ready to quit within 6 months.

Conclusions

Findings provide preliminary support for the integration of an SBIRT model in an HIV/AIDS clinic setting to screen and provide active treatment to all smokers, regardless of readiness to quit smoking. Given the high prevalence and incredible health burden of continued smoking in this population, identifying brief and effective interventions that are easily translated into clinical practice represents an enormous challenge that if met, will yield significant improvements to overall patient outcomes.     

医院科研项目管理工作之我见

从掌握最新学术动态,及时发布,积极组织全院申报;加强科研管理,完善科研管理制度;完善学术讲座制度,营造浓郁的学术氛围;突出重点,加强人才培养,加强科技创新;严格把关、加强形式审查,组织专家评审;加强督促,建立科研考核机制,力争项目如期完成;设立专项科研经费,专款专用,合理使用;转变观念,突出重点,促进成果转化8方面探讨医院科研项目管理机制,指出科研项目必须控制在完整的管理体系之内,从项目的选择开始到项目的立项、计划实施,直至项目的完成,要有一套完整的规范流程,以促进医院强化科技意识,加强科研管理和技术创新,推动科研项目管理工作步入制度化、规范化、科学化的轨道,进而提高医院的科研水平和学术地位,保证医院科研项目的正常开展。     

心理护理干预对疗养飞行员失眠的影响

目的观察心理护理干预对疗养飞行员失眠的影响。方法75例患失眠症的疗养飞行员随机分为实验组和对照组,实验组38例,给予心理护理干预;对照组37例,给予一般护理。4周后应用匹兹堡睡眠质量指数（PSQI）评估实验前后的飞行员睡眠改善情况结果干预前后实验组PSQI各因子及总分差异均有统计学意义（P〈0.05）,干预后实验组和对照组比较除入睡时间外,PSQI各因子及总分差异均有统计学意义（P〈0.05）,结论心理护理干预对飞行员失眠有明显改善作用。     

DRGs付费制度实施难点问题探讨

结合工作实际,根据《国家医疗保障DRG分组与付费技术规范》和《国家医疗保障DRG(CHS-DRG)分组方案》,探讨了DRGs在实施过程中遇到的难点,并针对性地提出相关建议,以供试点城市和医疗机构参考。