Shared decision making in consultations for hypertension: Qualitative study in general practice

BackgroundHypertension is mainly managed in primary care. Shared decision making is widely recommended as an approach to treatment decision making. However, no studies have investigated; in detail, what happens during primary care consultations for hypertension.AimTo understand patients’ and clinicians’ experience of shared decision making for hypertension in primary care, in order to propose how it might be better supported.DesignLongitudinal qualitative study.SettingFive general practices in south‐west England.MethodInterviews with a purposive sample of patients with hypertension, and with the health‐care practitioners they consulted, along with observations of clinical consultations, for up to 6 appointments. Interviews and consultations were audio‐recorded and observational field notes taken. Data were analysed thematically.ResultsForty‐six interviews and 18 consultations were observed, with 11 patients and nine health‐care practitioners (five GPs, one pharmacist and three nurses). Little shared decision making was described by participants or observed. Often patients’ understanding of their hypertension was limited, and they were not aware there were treatment choices. Consultations provided few opportunities for patients and clinicians to reach a shared understanding of their treatment choices. Opportunities for patients to engage in choices were limited by structured consultations and the distribution of decisions across consultations.ConclusionFor shared decision making to be better supported, consultations need to provide opportunities for patients to learn about their condition, to understand that there are treatment choices, and to discuss these choices with clinicians.Patient or Public ContributionA patient group contributed to the design of this study.     

新疆和田红葡萄体外抑制肿瘤作用的研究

目的：研究和田红葡萄体外抑瘤效果。方法：采用体外细胞培养方法观察和田红葡萄与红葡萄皮的醇提液对四株细胞株。即：正常小鼠成纤维细胞株（3T3）、胃癌细胞株（MGC－803,NKM）和肝癌细胞株（Q3）细胞存活率及蛋白质含量影响。结果：（1）和田红葡萄醇提液与和田红葡萄皮醇提液都显著抑制NKM和Q3存活（P＜0．01）,后者对MGC－803存活率亦显著影响（P＜0．01）,最强作用浓度0．01g/ml。两种醇提液作用于NKM、Q3、MGC－803的抑制率分别为11．0％、14．0％、24．0％。葡萄皮醇提液抑瘤效果强于葡萄醇提液（P＜0．05）;（2）两种醇提液皆对细胞蛋白质含量无影响（P＞0．05）;（3）葡萄醇提液促进3T3生长作用较葡萄皮醇提液强（P＜0．05）。结论：和田红葡萄可能具有一定的体外抑癌作用。     

发皇古义，继承创新——孙桐教授谈中医基础理论的继承与发展

中医基础理论现代化是整个中医药学现代化的基础,其研究方式可以从文献学角度、实验角度、中西医结合角度等多方面展开,当务之急是统一中医理论中一些最基本的概念和术语,用现代精确的科学术语来表述它们,使之规范化、标准化。     

正常人人迎寸口脉动相关性的季节观察

目的 进行正常人人迎寸口脉动相关性的季节观察。方法 借助经颅多普勒血流检测仪（简称TCD）分别于1月中旬（冬季）、7月中旬（夏季）检测随机选择的62例正常人的迎脉寸口脉搏情况,并分不同性别、不同年龄比较分析了人迎脉,寸口脉的变化。结果 ①正常人人迎脉与寸口脉的血流速度无明显差异（P＞0.05）,在不同了组、不同年龄组、不同性别组中均是如此;②下人冬季的寸口脉的血流速度 较夏季稍大;正常人夏季的人迎脉的血流速度较冬季稍大,但均无显著性差异（P＞0.05）;③正常人冬季寸口脉的血汉速度稍大于人迎脉的血流速度 ,人迎的血流速度稍大于寸口脉的血流速度,在不同性别组中是如此,在不同年龄组中基本如此,唯60－75岁组夏季的寸口脉反而稍大于人迎脉。结论 初步建立了正常人不同季节人迎脉、寸口脉脉动及其相关性的TCD指标。     

夏商周断代工程的研究途径与阶段性成果

国家“九五”期间重点科技攻关计划项目“夏商周断代工程” ,经过200位专家学者前后5年的集体努力 ,已于2000年9月通过验收 ,同年11月公布了《夏商周断代工程1996-2000年阶段成果报告 (简本 )》。这一项目采取自然科学与人文社会科学多学科结合的研究途径 ,制定了《夏商周年表》 ,为我国古代夏商周这一重要历史时期的年代学提供了科学依据 ,使进一步探索中国古代文明起源及其早期发展有了可靠的基础。     

Research trends of prostatitis over past 20 years: A bibliometric analysis

In the past two decades, thousands of documents in the field of prostatitis have been published. This bibliometric analysis aimed to assess the characteristics, hotspots and frontiers trend of global scientific output on prostatitis. With the trend of moderate growth, altogether 2,423 papers were reviewed. The leading role of the United States in global prostatitis research was obvious, while China had developed rapidly in recent years. Queen's University and JOURNAL OF UROLOGY were the most prolific affiliation and journal respectively. Nickel, J. C made the greatest contribution to the field of prostatitis. Five hotspots have been confirmed: (a) male infertility associated with prostatitis and the molecular mechanisms; (b) diagnosis and treatment of prostatitis; (c) inflammation, pain and bladder irritation symptoms; (d) relationship between chronic prostatitis/chronic pelvic pain syndrome, benign prostatic hyperplasia and prostate cancer; (e) epidemiology, complications of prostatitis and improvement of acupuncture. This bibliometric analysis reveals that the international cooperation was becoming more and more close. Hotspot analysis shows that the molecular mechanism of prostatitis will be a hotspot in the future, mainly focussing on inflammatory immunity and oxidative stress.     

Current status and solutions for gender equity in anaesthesia research

Despite increasing numbers of women entering anaesthesia, they remain persistently under-represented within academic anaesthesia and research. Gender discordance is seen across multiple aspects of research, including authorship, editorship, peer review, grant receipt, speaking and leading. Women are also under-represented at higher faculty ranks and in department chair positions. These inequities are further magnified for women with intersectional identities, such as those who identify as Black, indigenous and women of colour. Several barriers to participation in research have been identified to date, including a disproportionate amount of family responsibilities, a disproportionate burden of clinical service, gender bias, sexual harassment and the gender pay gap. Several strategies to improve gender equity have been proposed. Increasing access to formal mentorship of women in academic medicine is frequently cited and has been used by healthcare institutions and medical societies. Senior faculty and leaders must also be conscious of including women in sponsorship and networking opportunities. Institutions should provide support for parents of all genders, including supportive parental leave policies and flexible work models. Women should also be materially supported to attend formal educational conferences targeted for women, aimed at improving networking, peer support and professional development. Finally, leaders must display a clear intolerance for sexual harassment and discrimination to drive culture change. Peers and leaders alike, of all genders, can act as upstanders and speak up on behalf of targets of discrimination, both in the moment or after the fact. Gender inequities have persisted for far too long and can no longer be ignored. Diversifying the anaesthesia research community is essential to the future of the field.