Parents' experiences of having their children take part in participatory action research creating a serious game about radiotherapy

IntroductionRadiotherapy (RT) is one of several treatment modalities used for children diagnosed with cancer. Several studies have designed interventions aimed to alleviate the stress that can occur in conjunction with RT. To include children in the design of interventions is rare and dependent on the parents giving consent to participation in research on their children's behalf. The aim was to illuminate, from the parents' perspective, the experience of their children being part in the co-creation of a serious game and their previous experiences of RT.MethodsTen parents of children taking part in a participatory action research study of the development of a serious game were invited to an interview and seven parents consented. An inductive, manifest content analysis was performed.ResultsThe analysis resulted in an overarching theme: Parents' pre-understanding from their child's cancer treatment created a sensitivity to their child's wishes and a willingness to contribute to science. Four categories are presented: Intrinsic factors influenced the intent to participate, Extrinsic factors that had an effect on participation, Parents role in the game development, and Radiotherapy impinged the child and the parent.ConclusionTo be able to pay it forward to healthcare and other families with a child diagnosed with cancer was a contributing factor for parents' willingness to consent to participation after their children had undergone RT, especially since their children wanted to do so. Parents indicated interest in the developmental process and in following their children being part of the creation of a serious game about RT.Implication for practiceTo understand why parents allow their children to participate in studies creates opportunities for the research community to structure studies that facilitate participation.     

重型渗出性多型性红斑临床研究

目的 探讨重型渗出性多型性红宽的病因、临床表现、治疗及预后。方法 对14例患者的病因、临床表现、治疗及预后进行回顾性分析。结果 本病发病与药物有较高的相关性,以抗茵素,解热镇痛药和抗癫痫药物为多见;临床表现为皮肤黏膜同时受损,皮疹形态多样,疱疹为主,可累及内脏;适量应用肾上腺皮质激素是本病治疗之关键。本病愈后较好。结论 重型多型性红斑惠者大多具有诱发因素,对于药物引起者旱期应用肾上腺皮质激素是治疗的关键。其它诱发因素引起者也可考虑应用。     

早期大剂量应用纳洛酮对重型颅脑损伤后意识恢复的对比研究

目的 研究早期使用大剂量纳洛酮注射液对重型颅脑损伤病人所产生的意识障碍的治疗效果及其作用机制。方法随机选取50例经过纳洛酮治疗的重型颅脑损伤病人作为治疗组,并按照接近治疗组患者的受伤机制及病情,选取50例未给予纳洛酮治疗的病人作对照组。通过对两组病人GCS计分的总分平均值以及睁眼、言语反应和运动反应的记分值进行统计学分析。结果 治疗前两组病人意识障碍程度无显著差异。治疗后治疗组意识障碍有明显改善,总分平均值、睁眼及运动反应得分值显著增加(P<0.05),而病人的言语反应分值增加不明显(P>0.05)。结论 早期使用大剂量纳洛酮对重型颅脑损伤病人所产生的意识障碍有较好的治疗效果。     

抑郁的亚综合征(SSD)两年后随访研究

目的探讨SSD(Subsyndromal symptomatic depremion)疾病的性质与归类。方法对121例SSD进行两年后的再诊断,并对其认知功能、应激功能、经济损失情况进行分析、测定,且与重症抑郁进行比较。结果提示SSD中有72．5％两年后仍维持原诊断不改变,两组存在同样的认知曲解,但SSD有更多的应激存在于疾病的发生发展过程中。SSD与重症抑郁可造成同样严重的经济损失,SSD主要表现在检查资源的浪费,而重症抑郁花费更多的药费、住院费用。而在缓解期所挣得的工资、误工费两者比较无统计学意义。结论SSD可考虑作为一种独立的疾病单元。     

我院114例抗感染药致严重不良反应报告分析

目的:了解抗感染药致严重不良反应的特点,为临床安全、合理用药提供参考。方法:对我院2000～2009年收集到的抗感染药致严重不良反应报告进行分析与评价。结果:114例严重不良反应涉及14种抗感染药。其中居前3位的是抗结核药、头孢菌素类与喹诺酮类。不良反应的临床表现主要为肝损害(占34.59%),其次为肾损害(占26.32%)与皮肤及其附件损害(占14.29%)。108例好转或治愈,3例死亡,2例预后不详,1例有后遗症。38例患者有明确的药物过敏史(33.33%)。结论:常用抗感染药致严重不良反应主要为肝、肾损害,部分患者发生不良反应过程隐匿,若及时发现适当处理,大部分患者可短期内治愈或好转。临床医药人员应根据这些特点加强对相关药物的监测,提高合理用药水平。     

ω-3鱼油脂肪乳对重症急性胰腺炎大鼠肠黏膜通透性的影响

目的：观察重症急性胰腺炎大鼠经ω-3鱼油脂肪乳剂治疗后,肠黏膜屏障通透性与血浆D-乳酸和肠脂肪酸结合蛋白（I-FABP）的表达水平的关系,探讨ω-3鱼油脂肪乳剂对重症急性胰腺炎早期肠黏膜通透性的影响。方法：雄性wistar大鼠48只随机分为3组,假手术组（A组,n=16）,鱼油组（B组,n=16）和0.9%氯化钠溶液组（C组,n=16）。通过胰管逆行注射法建成重症急性胰腺炎模型,尾静脉注射鱼油和0.9%氯化钠溶液治疗。检测大鼠血浆D-乳酸和I-FABP的水平。结果：鱼油组中D-乳酸,I-FABP的表达明显低于0.9%氯化钠溶液组（P〈0.05）。结论：ω-3鱼油脂肪乳剂通过降低D-乳酸和I-FABP的表达水平,降低肠黏膜的通透性,从而保护肠黏膜屏障。     

12-step facilitation for the dually diagnosed: A randomized clinical trial

There are few clinical trials of 12-step treatments for individuals with serious mental illness and alcohol or drug dependence. This randomized trial assessed the effects of adding a 12-session 12-step facilitation therapy (TSF), adapted from that used in Project MATCH, to treatment as usual in an outpatient dual diagnosis program. Participants were 121 individuals dually diagnosed with alcohol dependence and a serious mental disorder, followed during 12 weeks of treatment and 36 weeks post-treatment. Participants receiving TSF had greater participation in 12-step programs, but did not demonstrate greater improvement in alcohol and drug use. However, considered dimensionally, greater participation in TSF was associated with greater improvement in substance use, and greater 12-step participation predicted decreases in frequency and intensity of drinking. Findings suggest that future work with TSF in this population should focus on maximizing exposure to TSF, and maximizing the effect of TSF on 12-step participation.     

中/长链甘油三酯在儿科ICU的临床应用研究

目的研究中/长链甘油三酯(MCT/LCT)营养支持治疗儿科危重疾病的效果。方法　本研究为随机双盲、平行对照,需要肠外营养的50例ICU患儿分为2组,每组25例。根据营养配方选用的脂肪乳不同,分为对照组(长链甘油三酯,LCT)和MCT/LCT组,比较2周后两组的疗效和对细胞免疫、细胞外环境的影响。结果两组的营养治疗均有效、安全,但MCT/LCT组在淋巴细胞CD4/CD8和对细胞外环境的影响方面优于对照组(P<0.05)。结论　对于儿科ICU中危重患儿,中/长链甘油三酯更容易耐受,不会严重干扰细胞免疫和细胞外环境稳态。     

146例严重药品不良反应报告分析

目的分析严重药品不良反应（ADR）报告表,探讨预防严重ADR发生的方法。方法对146例严重ADR报告表,分别按患者年龄、性别、报告人职业、引起ADR的药品、给药途径、临床表现等方面进行回顾性统计分析。结果146例严重ADR中,静脉给药方式引起的严重ADR例数最多（89例,60．96％）,其次为口服给药（52例,35．62％）;抗菌药物引起的严重ADR最多,其次为心脑血管药物和中药制剂;ADR临床表现以过敏性休克、药物性肝炎、重症皮疹等表现为主;90例严重ADR导致住院或住院时间延长,42例危及生命。结论严重ADR的发生与多种因素有关,应增强合理用药意识,以减少和避免严重ADR的发生,保证药物治疗安全、有效。