Why people enter treatment for alcohol problems: Findings from UK Alcohol Treatment Trial pre‐treatment interviews

Aim: To develop a model of why people seek professional treatment for drinking problems, grounded in what clients say about the process at treatment entry.

Participants: Three sets of consecutive entrants to the UK Alcohol Treatment Trial, sets commencing at intervals during trial recruitment (total n = 98).

Location: Statutory and non‐statutory alcohol problem treatment agencies in three areas of England and Wales.

Data: Open‐ended interviews according to a brief interview guide, leading to 400–800‐word post‐interview reports used for analysis (tape recordings used for auditing the interview and analysis process).

Analysis: Reports analysed by a team according to grounded theory principles, involving an iterative process with successive refinement of interviewing and analysis with each successive set of data.

Findings: A model of professional treatment entry was developed, refined and “tested” with the last set of data. The process of seeking professional treatment was depicted in the model as involving a realization of worsening, accumulating and multiple problems related to drinking, especially in health and family domains; in conjunction with, in most cases (but not all), a trigger event and/or family or professional influence; combined with rejection of the possibility of unaided change or non‐professional help; leading to the seeking or accepting of professional help.

Conclusions: The findings support conclusions already in the literature about the process of seeking professional help for a drinking problem, but provide further refinement of existing ideas: for example regarding the accumulation of drinking‐related problems, the ways in which a realization of those problems combines with triggers or pressure, and the complex role of the family and primary care professionals in assisting motivation to seek treatment.     

从“王贝之死”看医疗整形美容业监管的困惑与思考

通过回顾超女王贝接受整形手术死亡的事件,分析了当前医疗整形美容行业存在的问题及其原因,提出了规范医疗整形美容行业的思考：完善医疗整形美容业的相关法律、明确监管责任,提高医疗美容行业准入标准、循证建立医疗整形手术标准和指南以及建立全国性的医疗整形美容资格认证和公示制度。     

Troubleshooting adult ECMO

The following scenarios explore some of the common problems encountered during extracorporeal membrane oxygenation (ECMO) in adults. In each scenario, the circuit is comprised of a centrifugal pump and a polymethylpentene oxygenator.     

Zero‐order asymptotic solution of a class of singularly perturbed linear‐quadratic problems with weak controls in a critical case

We consider a linear‐quadratic optimal control problem where the second power of a small parameter stands in front of the derivative and a control in a state equation and in front of a quadratic form with respect to control in a performance index; moreover, in the state equation, the nonhomogeneity has the first order of the power of a small parameter, and a matrix in front of the state variable is singular if the small parameter is equal to zero. Using immediate substituting a postulated asymptotic expansion of a solution, containing a regular series and four boundary layer functions series, into the problem condition, we obtain problems for finding asymptotic terms of the zero order for the optimal control and the first order for the optimal trajectory. An illustrative example is given.     

我国医学信息学人才培养探讨

介绍国内外医学信息学学科人才培养现状,分析我国医学信息学人才培养存在的问题,从本科课程设置、研究生培育模式、教师职业素养及继续教育几方面提出建议。     

Psychosocial work environment and psychological well‐being: assessment of the buffering effects in the job demand–control (–support) model in BELSTRESS

The Karasek Job Demand–Control model has as its central tenet the so‐called ‘strain hypothesis’, stating that the most adverse health outcomes are to be expected in ‘high strain’ jobs characterized by high job demands and low job control. Later, this model was elaborated, stating that ‘isolated’ high strain workers experiencing low worksite social support are even more worse off. This is labelled the ‘iso‐strain hypothesis’. However, in the literature, the question was raised whether a high level of job control may (1) mitigate or buffer the effects of high job demands on psychological well‐being, or alternatively whether (2) a high level of social support may buffer the negative impact of high strain on psychological well‐being. In this study among 16 335 male workers and 5084 female workers in Belgium, four indicators of psychological well‐being are considered: feelings of depression, feelings of fatigue, sleep problems and use of psychoactive drugs. Both in men and in women, the general strain hypothesis and the iso‐strain hypothesis alike are corroborated regarding the cross‐sectional associations adjusted for age, level of education and living situation. This is most clear with respect to feelings of depression, less so with respect to the use of psychotropic drugs. The buffer hypotheses however are definitely not supported by our data. Copyright © 2002 John Wiley & Sons, Ltd.     

Convergence of Physics-Informed Neural Networks Applied to Linear Second-Order Elliptic Interface Problems

With the remarkable empirical success of neural networks across diversescientific disciplines, rigorous error and convergence analysis are also being developed and enriched. However, there has been little theoretical work focusing on neural networks in solving interface problems. In this paper, we perform a convergenceanalysis of physics-informed neural networks (PINNs) for solving second-order elliptic interface problems. Specifically, we consider PINNs with domain decompositiontechnologies and introduce gradient-enhanced strategies on the interfaces to deal withboundary and interface jump conditions. It is shown that the neural network sequenceobtained by minimizing a Lipschitz regularized loss function converges to the uniquesolution to the interface problem in $H^2$ as the number of samples increases. Numericalexperiments are provided to demonstrate our theoretical analysis.     

个性化护理沟通在皮肤激光美容护理中的应用

讨论在皮肤激光美容患者中采取个性化护理沟通的临床价值。方法 选取2022年6月-2023年8月于我院行皮肤激光美容的68例患者为研究对象,根据随机数字表法分为对比组和讨论组,每组34例。对比组美容期间采取常规基础护理,讨论组在此基础上行个性化护理沟通措施,比较两组并发症发生情况、心理状态、生活质量及护理满意度。结果 讨论组并发症发生率为2.94%,低于对比组的23.53%,差异有统计学意义（P＜0.05）;讨论组护理后焦虑、抑郁评分均低于对比组,差异有统计学意义（P ＜0.05）;讨论组生活质量各项评分均高于对比组,差异有统计学意义（P ＜0.05）;讨论组护理满意度为100.00%,高于对比组的82.35%,差异有统计学意义（P ＜0.05）。结论 与常规基础护理相比较,联合使用个性化护理沟通方案的干预效果更为突出,有利于提高患者对医疗服务的满意度,且对于改善患者不良心理状态、减少并发症具有积极意义。     

烧伤整形患者心理问题分析及心理干预的研究进展

烧伤是由热力因素造成的组织损伤,其不仅可使患者受到生理性损害,烧伤带来的痛苦和外形遭到的破坏还会使患者出现负性情绪。虽然临床可以通过整形手术来改善患者外貌美观度,但沉重的心理负担会对其身体健康和治疗依从性造成严重影响,进而影响整形手术的顺利进行及术后康复,因此临床需要对烧伤整形患者做好心理干预,以缓解其心理障碍,促进术后康复。本文对烧伤整形患者存在的心理问题进行分析,并对其心理干预的研究进展进行总结,以期为烧伤整形心理护理研究提供理论依据。     

2017年北京市成年人睡眠与血清TG/HDL-C的关联性研究

背景　血清三酰甘油（TG）与高密度脂蛋白胆固醇（HDL-C）的比值（TG/HDL-C）是系统性反映血脂水平的指标,不良的睡眠状况可能是血脂异常的危险因素,探索睡眠问题对TG/HDL-C的影响并识别危险人群,有助于有针对性地通过改善睡眠减少血脂异常的发生。目的　了解2017年北京市成年人睡眠问题现状及其与血清TG/HDL-C的关联,旨在为改善睡眠质量及控制血脂水平提供依据。方法　数据来源于2017年北京市成年人慢性病与危险因素监测,在北京市16区采用多阶段分层整群抽样方法抽取18~79岁常住居民,收集调查对象年龄、性别、婚姻状况、受教育程度等人口学信息,高血压、糖尿病、血脂异常等慢性病患病情况,吸烟、饮酒等生活行为方式,睡眠时长及打鼾/窒息、入睡困难、中间觉醒≥2次、早醒、服用安眠药等睡眠问题,测量身高、体质量、腰围、血压,抽取空腹静脉血进行血脂四项检测。采用t检验、非参数Kruskal-Wallis H检验、Mann-Whitney U检验、χ2检验、多因素Logistic回归分析睡眠与TG/HDL-C的关联。结果　13 240例调查对象平均年龄为（44.79±15.47）岁,平均睡眠时长为（7.47±1.30）h/d,中位TG/HDL-C为0.99（0.84）,6 490例（49.02%）30 d内存在睡眠问题。睡眠处于9 h/d者TG/HDL-C水平最低,中位数为0.95（0.82）,不同睡眠时长的女性人群TG/HDL-C比较,差异有统计学意义（χ2=37.14,P<0.01）。按是否存在睡眠问题进行分组,组间TG/HDL-C水平比较,差异有统计学意义（P<0.01）。在控制性别、年龄、婚姻状况、城乡、受教育程度、现在吸烟、30 d内饮酒、身体活动不足、高血压、糖尿病、BMI等协变量之后,多因素Logistic回归分析结果显示,存在≥1种睡眠问题是TG/HDL-C升高的影响因素〔OR（95%CI）=1.05（1.01,1.08）〕;相比于无睡眠问题的人群,男性或18~44岁人群存在≥1种睡眠问题是高TG/HDL-C的影响因素〔OR男（95%CI）=1.05（1.01,1.09）;OR18~44岁（95%CI）=1.06（1.01,1.10）〕。结论　北京市18~79岁成年人睡眠时长过长或过短,打鼾/窒息/入睡困难、服用安眠药等睡眠问题可能影响血清TG/HDL-C,男性及45岁以下人群作为高危人群应采取改善睡眠的措施。