Remembering Hospice

This book review essay discusses The Crisis of US Hospice Care: Family and Freedom at the End of Life (2019), by Harold Braswell.     

2型糖尿病患者饮食决策平衡与大五人格特征的相关性研究

目的 探讨2型糖尿病患者饮食决策平衡现状及其与大五人格特征的相关性,以期为临床个体化健康饮食教育提供参考.方法 便利抽样法选取重庆市3所三级甲等医院内分泌科住院的192例2型糖尿病患者为研究对象,采用饮食决策平衡量表和大五人格量表简化版(neuroticism extraversion openness five fa...     

上海市农村居民自我药疗行为环节及风险的质性研究

目的探寻居民自我药疗决策行为的环节及可能发生的风险,以提高居民在自我药疗过程中的安全意识,为相关部门提出降低自我药疗风险的策略提供依据。方法采用现象学研究方法,对10名上海市农村居民就自我药疗行为及风险进行半结构式访谈,并采用Colaizzi的现象学分析法进行资料处理与分析。结果自我药疗决策行为包括药物获取、药物使用及药效自评3个环节。不合理的自我药疗可导致掩盖严重病情、延误治疗、引发严重的不良反应、使疾病恶化甚至威胁生命等风险,且可影响个人履行家庭职责,增加就医成本和加重家庭的经济负担。讨论自我药疗是一个完整的决策过程,必然存在一定的风险,且任何一个环节中出现差错均会导致风险的发生。在保证合理安全的自我药疗中,获取正确的药物是其前提,正确地使用药物是关键,注意用药后效果评价及正确的不良反应处理是保障。     

Decision-making after ultrasound diagnosis of fetal abnormality

During the last few decades, the use of ultrasonography for the detection of fetal abnormalities has become widespread in many industrialised countries. This resulted in a shift in timing of the diagnosis of congenital abnormalities in infants from the neonatal period to the prenatal period. This has major implications for both clinicians and the couples involved. In case of ultrasound diagnosis of fetal anomaly, there are several options for the obstetric management, ranging from standard care to non-aggressive care and termination of pregnancy. This essay explores the context of both clinical and parental decision making after ultrasound diagnosis of fetal abnormality, with emphasis on the Dutch situation. While normal findings at ultrasound examination have strong beneficial psychological effects on the pregnant woman and her partner, the couple is often ill prepared for bad news about the health of their unborn child in the case of abnormal findings. This is, in particular, true in settings where ultrasonography for the detection of fetal abnormalities is offered as an integral part of antenatal care without appropriate counselling. An important question is to what extent the couple should be supported in decision making when a fetal abnormality is diagnosed. In this context, the parental perception of having a choice varies markedly. When parents consider end-of-life decisions, they experience both ambivalent and emotional feelings. On the one hand, they are committed to their pregnancy, while on the other hand, they want to protect their child, themselves and the family from the burden of severe disability. These complex parental reactions have implications for the counselling strategy.

高校图书馆参与决策咨询服务面临的问题及其解决办法

探讨了高校图书馆参与决策咨询服务面临的主要问题,并结合中国药科大学图书馆的参与决策咨询服务的实践经验提出解决问题的建议,为其他高校图书馆参与决策咨询服务提供参考。     

Establishing a New Research Agenda for Studying Psychiatric Emergency Room Treatment Decisions

With the growing complexity of treatment decisions made at presentation to a psychiatric emergency room (PER) and the increasing influence of managed care on the decision-making process, it is increasingly important to establish a new and more sophisticated research agenda for studying PER decision making. The main goal of this paper is to propose a comprehensive conceptual model of the PER decision-making process that will facilitate active pursuit of such a research agenda. The proposed model presents both traditional and emerging elements of the PER decision-making process (i.e., determinants, mediating mechanisms, and outcomes) and explicates the nature of the relationships among them at different levels of analysis. The model's theoretical and empirical implications for future research are discussed and suggestions are made as to the research designs and methods needed to pursue this agenda.     

医患心灵交融,科学临床决策的前提

良好而科学的临床决策取决于众多因素,但医患互信,乃至医患心灵交融将给医患双方以充分的信心和力量,在战胜疾病的过程中起到极大的推动作用,也是科学临床决策的灵魂,没有医患充分互信将使得临床科学决策变成一句空话,甚至不可能。互相猜疑的医患关系不但扰乱疾病诊断与治疗,还将阻碍医学的发展,带给患者极大的损失与痛苦。推动建立良好的医患关系是医学发展需要,是建立和谐社会的一部分,更是患者所期盼的,应该得到社会的高度重视。     

药物快速卫生技术评估方法及应用

快速评估作为一种快速决策工具,通过简化卫生技术评估/系统评价方法和流程,快速评估药物的有效性、安全性和经济性,为决策者提供证据支持。由于该方法具有快速的特点,日益被重视并用于决策制定(如新药遴选)。本研究介绍快速评估、系统评价和卫生技术评估的联系和区别,并介绍快速评估的方法和流程:(1)明确待评估的问题及目的;(2)制定计划书;(3)文献检索及筛选;(4)数据提取及方法学质量评价;(5)证据的合成和分析;(6)证据质量的评价和结论;(7)形成评估报告;(8)结论的推广及后效评价。最后,以沙格列汀为例,快速评估其治疗2型糖尿病的有效性、安全性和经济性。     

Impulsivity differences in recreational cannabis users and binge drinkers in a university population

Background

Recreational cannabis use and alcohol binge drinking are the most common drug consumption patterns in young adults. Impulsivity and several psychopathological signs are increased in chronic drug users, but the implications of recreational use are still poorly understood.

Methods

We evaluated impulsivity, sensation-seeking traits, impulsive decision-making, inhibitory control and possible symptoms of depression, anxiety and psychosis in three groups of young university adults: recreational cannabis users (N = 20), alcohol binge drinkers (N = 22) and non-drug users (N = 26).

Results

The cannabis and binge drinking groups had increased scores for impulsivity and sensation-seeking traits. Both groups also exhibited increased impulsive decision-making on the two-choice task and the Iowa Gambling task; however, only the cannabis group was significantly different from the non-drug group regarding inhibitory control (Go/No-Go and Stop tasks). The cannabis and binge drinking groups did not show differences in the psychopathological symptoms evaluated.

Conclusions

Our observations of this population of non-dependent drug users are consistent with the increased impulsivity traits and behaviors that have been described previously in chronic drug abusers. In this study, compared to no drug use, the recreational use of cannabis was associated with a major dysfunction of the different facets of impulsive behaviors. However, alcohol binge drinking was related only to impulsive decision-making. These results suggest that impulsivity traits and behaviors are present not only in chronic drug abusers but also in recreational drug users. Future work should continue to investigate the long-term effects of these common consumption patterns on various impulsive behaviors and psychopathological symptoms.