论《伤寒论》的保胃气思想及其临床意义

中医辨证论治之鼻祖的《伤寒论》始终贯穿着保胃气的思想,十分重视脾胃在人体发病和辨证论治中的作用,顾护脾胃的思想和保胃气之秘旨贯穿于《伤寒论》六经辨证论治体系和杂病辨证论治体系通篇。从承前启后重视脾胃,六经发病重在脾胃,六经传变脾胃为枢,治疗原则无犯胃气,立法处方法重脾胃,调理脾胃寒热虚实,提出治禁源于护胃,煎服调护顾护脾胃,预后吉凶胃气为本,病瘥调理继培后天等10个方面进行论述。     

明清诸名医对脾胃学说发展之概略

明清时期,脾胃学说在理论与实践上均有重大发展。除温病学派、温补学派外,尚有不少名医家,如戴思恭、缪希壅、龚延贤、李用粹、傅青主、唐容川等都对脾胃学说有进一步发展。     

初级卫生保健发展回顾与疾控作用的思考

  目的  评价国家基本公共卫生服务项目的实施效果,为基本公共卫生服务项目的可持续发展与实施提供循证依据与政策建议。  方法  以Donabedian质量理论为理论框架,从结构、过程、结果3个维度对中国2009 — 2019年公开发表的研究报告和现场定性访谈中基本公共卫生服务项目的实施效果进行综合评价。  结果  中国基本公共卫生服务体系逐步建立,筹资水平与服务内容不断提升,绩效考核机制不断完善,人民健康水平有所改善,城乡健康差距不断缩小,基层服务能力有所提升;但服务项目的动态调整机制尚未建立,“医防两张皮”现象普遍,基层信息化水平仍需提高。  结论  国家基本公共卫生服务项目取得了明显的成效,但在服务项目调整机制、医防融合及信息化建设等方面仍需改进。     

基于Watson关怀理论护理改善肺癌患者癌因性疲乏的研究

目的 探讨基于Watson关怀理论护理改善肺癌患者癌因性疲乏的作用.方法 选取2018年1月至2019年1月间陕西省西安市中医医院收治的行同步放化疗的132例非小细胞肺癌患者.根据采用的护理方法 不同进行分组,其中,采用常规护理干预的66例患者纳入对照组,采用基于Watson关怀理论护理干预的66例患者纳入观察组.比较...     

Pharmacy Students’ Attitudes Toward Reporting Serious Adverse Drug Events

Objectives. To determine pharmacy students’ attitude toward and knowledge of reporting serious adverse drug events (ADEs) to the Food and Drug Administration (FDA).Method. A 58-item survey questionnaire constructed to measure respondents’ intention to report ADEs (3 items), attitude toward reporting ADEs (20 items), knowledge of ADE reporting (9 items), and demographic data was administered to all third-year (final-year) pharmacy students at the Appalachian College of Pharmacy.Results. The majority of the 58 students who responded (91% response rate) intended (84%) and planned (85.3%) to report serious ADEs when they encounter them. Most respondents had favorable attitudes toward reporting serious ADEs to the FDA; respondents believed that reporting serious ADEs was valuable (5.6 ± 1.5, mean ± SD), good (3.0 ± 1.7), and beneficial (5.7 ± 1.5). Many students also believed that ADE reporting resulted in increased risk of malpractice, compromised relationships with physicians, broken trust with patients, disruption of the normal workflow, and was time consuming. Many students had inadequate knowledge on reporting ADEs.Conclusion. Although pharmacy students had strong intentions and favorable attitudes toward ADE reporting, they had inadequate knowledge of how to report serious ADEs.     

An Innovative Seminar Course in Business Etiquette for Pharmacy Graduate Students

Objectives. To develop and implement a seminar course for graduate students in the social and administrative pharmaceutical sciences to enhance knowledge and confidence with respect their abilities to demonstrate appropriate business etiquette.Design. A 1-credit graduate seminar course was designed based on learner-centered constructivist theory and application of Fink’s Taxonomy for Significant Learning.Assessment. Eleven students participated in the spring 2011 seminar course presentations and activities. Students completed pre- and post-assessment instruments, which included knowledge and attitudinal questions. Formative and summative assessments showed gains in student knowledge, perceived skills, and confidence based on observation and student-reported outcomes.Conclusion. Graduate student reaction to the course was overwhelmingly positive. The etiquette course has potential application in doctor of pharmacy education, other graduate disciplines, undergraduate education, and continuing professional development.     

Opportunities for Improving Post-Hospital Home Medication Management Among Older Adults

SUMMARY

Effective post-hospital home medication management among older adults is a convoluted, error-prone process. Older adults, whose complex medication regimens are often changed at hospital discharge, are susceptible to medication-related problems (e.g., Adverse Drug Events or ADEs) as they resume responsibility for managing their medications at home. Human error theory frames the discussion of multi-faceted, interacting factors including care system functions, like discharge medication teaching that contribute to post-hospital ADEs. The taxonomy and causes of post-hospital ADEs and related risk factors are reviewed, as we describe in high-risk older adults a population that may benefit from targeted interventions. Potential solutions and future research possibilities highlight the importance of interdisciplinary teams, involvement of clinical pharmacists, use of transitional care models, and improved use of informational technologies.     

Bayesian analysis and classification of two enzyme‐linked immunosorbent assay tests without a gold standard

Reconciling two quantitative enzyme‐linked immunosorbent assay tests for an antibody to an RNA virus, in a situation without a gold standard and where false negatives may occur, is the motivation for this work. False negatives occur when access of the antibody to the binding site is blocked. On the basis of the mechanism of the assay, a mixture of four bivariate normal distributions is proposed with the mixture probabilities depending on a two‐stage latent variable model including the prevalence of the antibody in the population and the probabilities of blocking on each test. There is prior information on the prevalence of the antibody, and also on the probability of false negatives, and so a Bayesian analysis is used. The dependence between the two tests is modeled to be consistent with the biological mechanism. Bayesian decision theory is utilized for classification.The proposed method is applied to the motivating data set to classify the data into two groups: those with and those without the antibody. Simulation studies describe the properties of the estimation and the classification. Sensitivity to the choice of the prior distribution is also addressed by simulation. The same model with two levels of latent variables is applicable in other testing procedures such as quantitative polymerase chain reaction tests, where false negatives occur when there is a mutation in the primer sequence. Copyright © 2013 John Wiley & Sons, Ltd.     

Interacting institutional logics in general dental practice

We investigate the organisational field of general dental practice and how agents change or maintain the institution of values associated with the everyday work of health care provision. Our dataset comprise archival literature and policy documents, interview data from field level actors, as well as service delivery level interview data and secondary data gathered (2011–12) from 16 English dental practices. Our analysis provides a typology of institutional logics (prevailing systems of value) experienced in the field of dental practice. Confirming current literature, we find two logics dominate how care is assessed: business-like health care and medical professionalism. We advance the literature by finding the business-like health care logic further distinguished by values of commercialism on the one hand and those of accountability and procedural diligence on the other. The logic of professionalism we also find is further distinguished into a commitment to clinical expertise and independence in delivering patient care on the one hand, and concerns for the autonomy and sustainability of a business enterprise on the other.     

Caucasian and Mexican American low‐income children's thoughts about vegetables and fruits

The objective of this study was to determine behavioral, personal, and environmental factors that influence low‐income children's fruit and vegetable intake. Focus group questions were developed using the social cognitive theory (SCT). Four Caucasian (27 children) and six Mexican American focus groups (30 children) were conducted. Mexican‐American children stated they had the ability to prepare vegetables and fruits whereas Caucasian children expressed they would rather have their parents do the preparation. This is an example of the behavioral capability construct of SCT. Both ethnic groups mentioned they did not know where vegetables and fruits were stored in the home and this is an environmental construct of SCT. Personal factors of the SCT included Caucasian children preferring to add peanut butter and Ranch dip to vegetables compared to Mexican‐American children preferring to add salt, lime, and chili to vegetables. Sweetness, sourness, juiciness, and crunchiness were seen as good characteristics. All focus groups perceived vegetables and fruits as healthy. All of these issues need to be considered when developing nutrition programming for children.