Prospective feasibility study of a mindfulness-based program for breast cancer patients in the southeastern US

BackgroundMindfulness interventions can improve psychological distress and quality of life (QoL) in cancer survivors. Few mindfulness programs for cancer recovery exist in Southeastern U.S. The primary objective of this study was to assess the feasibility of a modified mindfulness-based stress reduction (MBSR) program for breast cancer patients in Birmingham, Alabama. The secondary objective was to explore potential program effects on mindfulness skills and QoL.MethodsThis study was a prospective, quasi-experimental feasibility study conducted over 10 months at a university hospital. Feasibility was achieved if 80% of eligible patients screened enrolled in the study and 70% of enrolled patients attended all 8 program sessions. Effectiveness was estimated by changes in mindfulness and QoL indicators measured with validated scales administered at 3 time points and assessed with a non-parametric Friedman test. Sessions included meditation, yoga, and an attention practice called body scan. There were 3 groups of 2–5 patients.ResultsThe sample totaled 12 patients. Forty-four percent (12/27) of eligible patients enrolled in the study, and two out of 12 enrolled patients completed 8 program sessions, resulting in 16.7% (2/12) retention. However, more than half (66.7%) of participants completed at least 7 sessions. Between baseline and 8-week follow-up, patients demonstrated statistically significant improvements in distress, general wellbeing, and fatigue-related QoL.ConclusionsFeasibility objectives were not achieved. However, a majority of participants (66.7%) completed 7 of 8 program sessions. Program effects were promising for distress, fatigue, and wellbeing. Results warrant further research on MBSR-like programs for breast cancer patients in Alabama.     

Error-related processing during a period of extended wakefulness

The nature of error detection as manifested by the error-related negativity was examined in both a Sternberg memory search task and a visual search task. Both tasks were performed in conditions with consistent or varied stimulus-response mapping and loads of three or six letters. After subjects were trained extensively in all conditions, they performed the tasks throughout the night without sleeping. The data suggest that the effectiveness of error detection decreases over time because of a decrease in the quality of perceptual processing. Error detection also suffers when performance requires more search-related resources. In both cases, the representation of the correct response is compromised. These results indicate that error detection depends on the same perceptual and cognitive processes that are required for correct performance.     

伽玛刀的医学技术评估

伽玛刀是世界上最昂贵的医疗设备之一,我国从１９９２年开始引进。１９９５年卫生部等联合发文暂缓装备。为了规范提供方和患方的行为,以及为卫生行政部门提供决策依据,我们开展了伽玛刀的技术评估。在评估前拟定评估步骤,然后确定评估内容与方法。评估结果,国外１９９４年有５６台伽玛刀,平均每台治疗１９０例,治疗病种是：动静脉畸型病人占３２％,肿瘤病人占６５％,功能性疾病占２％。我国１３台伽玛刀到１９９５年底共治病人７０００例,前６位病种是转移瘤等,虽然比例和顺位与世界有差异,但病例分析结果完全一致。     

转轨时期医院经营管理效益量化评价方法研究

效益评价是医院经营管理中的一项重要工作。医院经营管理的效益分为社会效益和经济效益。两个效益的人为脱节和社会效益指标的虚化,形成了效益评价的难点。本文采取层次分析法,将医院的社会效益、经济效益与医院的投入、消耗和产出的１９个指标有机结合起来,使两个效益在有机统一的前提下指标量化,这样既增强了两个效益评价工作的可操作性,也增强了效益评价结果对医院经济工作指导的操作性。     

护理质量评价体系的改进及其软件开发

通过对《军队医院护理质量主要评价指标》在运用过程中存在不足之处的分析,结合实际对原评价体系的评价方法,评价内容进行了补充和完善,形成了一套既能从宏观上全面反映医院护理质量达标情况。又能从微观上具体反映各临床科室护理质量达标程度及名次排列的评价体系,使护理质量管理更具针对性。在此基础上又介绍了研制出的适合医院护理工作特点的《护理质量综合评价》软件。     

A comparison of the acute behavioral effects of flunitrazepam and triazolam in healthy volunteers

Flunitrazepam is an hypnotic benzodiazepine marketed in different European countries. Epidemiological studies have shown that it is frequently abused by opioid addicts. In a survey, liking scores for flunitrazepam in methadone maintenance patients were higher than ratings for other benzodiazepines. A double-blind, placebo controlled, crossover clinical trial was conducted to assess the acute behavioral effects of flunitrazepam (0.05 and 2 mg) and triazolam (0.25 and 0.50 mg) in healthy male volunteers. Drug effects on physiological measures, psychomotor performance, and subjective rating scales, including specific questionnaires to evaluate abuse liability (e.g., ARCI or liking scores), were assessed before and 6 h after drug administration. Flunitrazepam 2 mg produced the most intense disruptive effects on all the performance tasks, triazolam 0.50 impaired performance except balance. All study drugs at all doses produced sedation symptoms in all or part of the subjective effects questionnaires. Only flunitrazepam 2 mg induced significative increases in some of the scales (liking, good effects, high) that could be related to a possible abuse potential. The results seem to indicate that flunitrazepam, when administered to healthy subjects, produces some pleasurable subjective feelings, that could indicate a higher abuse liability of this drug as compared with other benzodiazepines.Presented in part at the 54th Annual Scientific Meeting of the College on Problems of Drug Dependence, Toronto, 1993     

Electroencephalographic effects of cigarette smoking

The effects of cigarette smoking on the electroencephalogram (EEG) of smokers were examined in a study involving both task and no-task conditions. Nonsmoking subjects were employed as controls. In light inhaling smokers, (depth of inhalation inferred from preto post-smoking changes in tidal breath carbon monoxide), smoking was found to attenuate EEG activity in the delta, theta, and alpha frequency bands, as well as facilitate behavioral performance. For theta, the attenuation was lateralized over the right frontal cerebral hemisphere. In deep inhaling smokers, smoking produced a symmetrical central midline increase in beta2 magnitude, an EEG effect that in the benzodiazepine literature is associated with anxiety relief.A preliminary version of these data was presented during the symposium Psychophysiology of Nicotine, held at the Thirtieth Annual Convention of the Society for Psychophysiological Research, Boston, October, 1990     

Scopolamine Effects on Visual Information Processing, Attention, and Event-Related Potential Map Latencies

We measured performance and event-related brain potential (ERP) map latencies in 12 subjects during four visual discrimination tasks to compare the timing of scopolamine effects on information processing and attention. "Topographic component recognition" found ERP map latencies at times of best fit with a component model map. This "common topography" criterion minimized topographic differences among conditions to facilitate latency interpretations. Scopolamine slowed N1 latency in all tasks, and P3 and reaction time in some tasks. The drug delayed responses to easy targets more than to hard targets. It also induced a disproportionate N1 delay for unilateral high spatial frequency gratings. Both effects reflect a scopolamine-induced impairment when processing targets that usually capture attention. Scopolamine also impaired accuracy for unilateral high spatial frequency gratings, and for gratings presented at probable locations, confirming and extending previous findings. Scopolamine-induced P1 and N1 delays showed that visual processing was affected. Several results were inconsistent with a serial stage model. We suggest that scopolamine both delays selected processes and impairs a processing mode based on automatic capture of attention, inducing more serial processing.     

Mood and performance of poor sleepers during repeated use of flurazepam

The effects of flurazepam on the mood and performance of poor sleepers were studied over a 10-day drug period. Twelve poor sleepers, selected on the basis of subjective and objective criteria, were divided into two equal groups after a 7-day placebo baseline period. One group received 30 mg flurazepam 15 min before bedtime for 10 consecutive nights while the other group continued to receive placebo in a double-blind paradigm. Three placebo follow-up nights were run on each subject 2–3 weeks after the final drug night. Performance was tested in the morning, 30–45 min after arousal. Flurazepam significantly impaired performance on a 4-choice reaction time task and the Digit Symbol Substitution Test (DSST) but not on a shortterm memory test. Performance impairment on the DSST showed a drug-tolerance effect across the 10-day drug period while performance impairment on the reaction time task showed no tolerance effect. Flurazepam had no significant effect on mood or feelings of sleepiness in the morning or at bedtime despite subjective ratings of a more restful and better sleep and improved sleep latencies. The placebo baseline mood and performance of the 12 poor sleepers were compared to the mood and performance of 12 good sleepers. Performance did not differ significantly between the two goups. Poor sleepers rated themselves as significantly more tense, confused, fatigued, and less vigorous than the good sleepers.     

卫生技术干部全面量化考核方法的研究

在卫生技术干部人才管理过程中,研究制定出一套全面量化考核标准和考核方法。考核内容分学历、任职年限、政治思想表现、业务技术水平、创新能力、科研(医疗)成果、专业论文发表和外语水平八大项。对每项内容制定了考核标准的隶属度,并根据考核内容的权重大小,定出每项内容的分配系数。采取述职、考查、测评、答辩等形式进行考核,然后运用综合分析方法,对卫生技术干部作出“优秀、称职、基本职称、不称职”的评价。