Factors influencing routine cognitive impairment screening in older at-risk drinkers: Findings from a qualitative study in the United Kingdom

Cognitive Impairment (CI) screening is recommended for those engaged in harmful levels of alcohol use. However, there is a lack of evidence on implementation. This paper explores the barriers and facilitators to CI screening experienced across a service specifically for older drinkers. The findings draw on data gathered as part of an evaluation of a multilevel programme to reduce alcohol-related harm in adults aged 50 and over in five demonstration areas across the United Kingdom. It is based on qualitative interviews and focus groups with 14 service providers and 22 service users. Findings are presented thematically under the section headings: acceptability of screening, interpretation and making sense of screening and treatment options. It is suggested that engagement with CI screening is most likely when its fit with agency culture and its purpose is clear; where service providers have the technical skills to administer and discuss the results of screening with service users; and where those undertaking screening have had the opportunity to reflect on their own experience of being screened. Engagement with CI screening is also most likely where specific intervention pathways and engagement practices can be accessed to respond to assessed need.     

知识模式转换在医学科技创新中的作用

医学科技创新是医院赖以生存与发展的动力,医学科技创新的过程也是医学知识模式不断转换的过程,本文从知识模式转换的视角,探讨知识管理对医学科技创新的意义与作用     

论高校科技产业的创新与发展

２１世纪是以信息技术和生物工程技术为代表的高瓣技术及其产业迅猛发展的知识经济世纪,本文主要讨论了在新世纪里高校职能的变化及其在知识创新、技术创新和国家经济建设中的地位、作用等问题。作者认为,坚持创新是高校生存和发展的根本需要;高校科技产业则是具有中国特色的知识经济的产物。对完善我国教育体制、提高办学实力、调整我国的知识结构和产业结构都具有十分重要的意义。     

内蒙古医学病毒学研究进展

目的：总结改革开放２０年来,内蒙古医学病毒学取得的一些瞩目成绩。方法：查阅中国生物医学文献光盘数据库,分析宾些年来内蒙古医学病毒学各类科研究进展。结果：内蒙古医学病毒学各学科研究均取得了一睦成绩,其中乙型肝炎、出血热病毒、化状病毒、巨细胞病毒、艾滋病病毒以及人类基因工程研究方面的成果已达到国内先进水平。结论：２０世纪内蒙古的医学成果已为下一世纪的研究尊定了基础,相信内蒙古的医学病毒学研究在２１世纪     

Evidence that implementation intentions reduce self-harm in the community

Objectives

Implementation intentions are ‘IF-THEN’ plans that encourage goal-intended behaviour. This study was designed to test whether an intervention encouraging the formation of implementation intentions can reduce self-harm in the community.

Design

A randomized controlled design was used.

Methods

At pre-intervention, outcome variables (self-harm in both specified and unspecified critical situations and suicidality) and potential moderators of implementation intentions (goal intention, mental imagery, and exposure to self-harm) were measured using self-report questionnaires. The participants (N = 469, aged 18–66 years, 86.4% female, 6.8% male and 6.7% other) were then randomized to either an experimental (implementation intention) or control task. At three-months post-intervention, self-report questionnaires were used again to measure the outcome variables.

Results

There were no overall differences between the conditions at post-intervention. However, goal intention and mental imagery, but not exposure to self-harm, moderated the effects of condition on self-harm in specified critical situations. At high (mean + 1SD) levels of both goal intention and mental imagery, the experimental condition reported self-harming less frequently in the situations specified in their implementation intentions.

Conclusions

Implementation intentions therefore represent a useful intervention for reducing self-harm in specified critical situations for people in the community who wish to avoid self-harm and those who frequently experience self-harm and suicide related mental imagery.     

Bright Futures Ahead

Bright Futures will be an essential component in assuring quality in the implementation of Title XXI of the Social Security Act, the new State Child Health Insurance Program (SCHIP). With this federal announcement and with nationwide acceptance of Bright Futures: Guidelines for Health Supervision of Infants, Children and Adolescents, the Maternal and Child Health Bureau is supporting the National Center for Education in Maternal and Child Health (NCEMCH) in a multiyear implementation phase: Building Bright Futures. The publication Bright Futures in Practice: Oral Health is the first volume in the second generation of Bright Future's publications. Utilizing its successful methodology of collaborating with many partners, NCEMCH has formed multidisciplinary panels of experts to prepare population-specific publications and provide implementation tools and training to broaden the movement for a series of guidelines and materials that respond to current and emerging needs of children and adolescents.     

Basic Science in Medical Reasoning: An Artificial Intelligence Approach

A new generation of intelligent systems is growing up in the community of Artificial Intelligence in Medicine. The main goal of these systems is the representation and use of real theory of diseases, as they are represented in medical textbooks or in scientific articles, rather than the heuristic shortcuts of human experts. In this paper, we will argue that the difficulties in the integration of basic science and clinical knowledge in intelligent systems arise from ontological differences between these kinds of knowledge and that the solution can be found in their dynamic integration during the reasoning process. In order to illustrate this point, we will first describe an epistemological analysis of the interplay between basic science knowledge and clinical knowledge, and then we will provide the example of a computational architecture implementing this view. This revised version was published online in June 2006 with corrections to the Cover Date.     

The effects of d-cycloserine and MK-801 on the performance of rats in two spatial learning and memory tasks

The present study was undertaken to investigate the effects of modulation of the (NMDA) receptor on learning and memory. Thus, the performance of rats treated with d-cycloserine, a partial agonist at the glycine recognition site of the NMDA receptor complex, and MK-801, a noncompetitive NMDA receptor antagonist, either alone or concurrently were assessed in radial arm maze and water maze tasks. Administration of MK-801 (0.1 mg/kg, i.p.) impaired acquisition in the water maze (increased escape latency and distance) and working memory in the radial arm maze (increased re-entries) in rats. Moreover, in the radial arm maze, MK-801 disrupted locomotion (increased latencies and decreased arm entries per minute) and impaired the acquisition of reference memory (increased number of errors) performance of rats. d-Cycloserine (0.03, 0.3, 1.0, 3.0, 10 mg/kg, i.p.) had no effects on acquisition or memory performance of control or MK-801-treated rats in either of these tasks. However, d-cycloserine (0.03, 0.3, 3.0 mg/kg) reversed the MK-801-induced disruption in locomotion. Furthermore, 3.0 mg/kg d-cycloserine increased behavioral activity and also decreased the time needed to complete the task in control animals. To conclude, our results suggest that the consequences of NMDA receptor modulation on learning and memory processes and sensorimotor functions may be functionally different or have distinct anatomical locations.