广西药品经营企业实施新版GSP的思考

目的：结合广西壮族自治区新版GSP实施过程中存在的困难,提出对策建议,保障新版GSP的顺利实施。方法：基于广西壮族自治区GSP的实施现状,采用新旧版GSP认证对比分析等方法开展研究。结果与结论：新版GSP实施面临着人员、资金与成本等问题。应加强培训,强化监督,给予适当的政策扶持,确保新版GSP的实施。     

Prevalence and potential predictors of gambling disorder among people living with HIV

Specific subsets of the adult population are at an increased risk of problem gambling behaviors. Previous research among these subsets has found increased rates of disordered gambling among those with drug use, alcohol use, mood, anxiety, and personality disorders. To what extent this may apply to the HIV population, known to have a high burden of co-occurring substance use and mental disorders, is not known The current study also examined the effectiveness of The Brief Biosocial Gambling Screen (BBGS) for the diagnosis of gambling disorder.

This study examined the prevalence of gambling behaviors and disordered gambling in patients enrolled in an urban HIV clinic. 100 people living with HIV (PLWH) were assessed on gambling behaviors, impulsivity, and criterion on disordered gambling. Screening for gambling disorder using the BBGS was compared to the American Psychiatric Association DSM-5 criterion.

The mean age was 53, 44% were female, 60% completed high school or above, and 80% self-identified as unemployed/disabled. 13% met four or more criteria for gambling disorder according to DSM-5 criteria. Participants that met criteria were more likely to report marijuana (p?=?.044) and heroin (p?=?.002) use, and greater impulsivity (p?<?0.00001) when compared to participants who did not meet criteria. The BBGS was able to effectively screen individuals for disordered gambling with a sensitivity of 100%, specificity of 90.8%, positive predictive value of 56.2%, and a negative predictive value of 100%.

These results suggest that urban HIV clinics may need to consider actively screening for gambling disorders, and referring to appropriate counseling and treatment for those who screen positive.     

Assessing Adolescent Personality Disorders With the Shedler–Westen Assessment Procedure for Adolescents

This two‐part study describes the development and validation of a method for quantifying adolescent personality pathology using the latest edition of the Shedler–Westen Assessment Procedure for Adolescents (SWAP‐II‐A), an instrument designed to be used by clinically experienced observers. In Study 1, experienced psychologists and psychiatrists described a normative clinical sample of 950 North American patients. Study 2 applied the SWAP‐II‐A in a day treatment setting. Results indicated that SWAP‐II‐A personality disorder (PD) scales evidenced high internal consistency, construct validity with Diagnostic and Statistical Manual of Mental Disorders (5th ed.) symptoms and diagnoses, and concurrent validity with Child Behavior Checklist (CBCL) ratings. Independent observers saw patients similarly, and PD assessments were significantly associated with CBCL scale scores and ward behavior.     

Femoral malrotation after intramedullary nailing in obese versus non-obese patients

Objective

Intramedullary nailing (IMN) of obese patients with femoral fractures can be difficult due to soft tissue considerations and overall body habitus. Complications including malrotation can occur and have significant impact on postoperative function. The purpose of this study was to evaluate femoral rotation after intramedullary nailing of obese and non-obese patients to see if there was a difference in rotation, complications and any risk factors for malrotation.

Materials and methods

Between 2000 and 2009, 417 consecutive patients with femur fractures treated with IM nail at Level I trauma and tertiary referral center. Of these, 335 with postoperative computed tomography (CT) scanogram of the bilateral lower extremities were included in this study. Baseline demographic, perioperative and postoperative femoral version calculations were included in the dataset. Statistical analysis included chi-squared test for categorical data, t-test for continuous data, and univariate and multivariate regression analysis. Significance was set at p < 0.05.

Results

Of the 417 patients with femur fractures between 2000 and 2009, 335 met criteria for this study. There were 111 patients with a BMI <25, 129 with BMI 25–29.9, and 95 patients with a BMI >30. When BMI was categorised into 3 groups (<25, 25–29.9, or 30+), none of these groups were predictive of version in univariate or multivariate regressions. Among only obese patients (BMI 30+), BMI of 35+ was not a significant predictor of version when compared to BMI 30–34.9. There were no significant differences in femoral version based on entry point (antegrade vs. retrograde) in any BMI category. There were also no significant difference between groups of patients with a DFV of >15? (p = 0.212).

Conclusions

Based on this study, BMI did not have an effect on postoperative difference in femoral version. In fact, in our multivariate regression analysis, BMI of over 30 was actually predictive of significantly lower difference in femoral version. While other studies have documented the intraoperative difficulties encountered with obese patients with femur fractures, the outcome of femoral rotation is not affected by an increasing BMI.     

Noxious family environments in relation to adult and childhood caries

BackgroundThe authors tested hypotheses that more noxious family environments are associated with poorer adult and child oral health.MethodsA community sample of married or cohabiting couples (N = 135) and their elementary school–aged children participated. Dental hygienists determined the number of decayed, missing and filled surfaces via oral examination. Subjective oral health impacts were measured by means of questionnaires completed by the parents and children. The parents completed questionnaires about interparental and parent-to-child physical aggression (for example, pushing) and emotional aggression (for example, derision), as well as harsh discipline. Observers rated the couples’ hostile behavior in laboratory interactions.ResultsThe extent of women's and men's caries experience was associated positively with their partners’ levels of overall noxious behavior toward them. The extent of children's caries experience was associated positively with the level of their mothers’ emotional aggression toward their partners.ConclusionsNoxious family environments may be implicated in compromised oral health. Future research that replicates and extends these findings can provide the foundation to translate them into preventive interventions.Practical ImplicationsNoxious family environments may help explain the limitations of routine oral health preventive strategies. Interprofessional strategies that also address the family environment ultimately may prove to be more effective than are single modality approaches.     

中文版偏头痛患者药物依赖性问卷信度和效度研究

目的评价中文版偏头痛患者药物依赖性问卷的信度和效度。方法选取115例合并药物依赖综合征的偏头痛患者,收集其临床资料并进行中文版偏头痛患者药物依赖性问卷的测试。采用重测信度、内部一致性信度评价分析问卷信度,采用内容效度和结构效度评价分析问卷效度。结果量表的重测信度除条目11和条目16为0.558和0.443以外,其余条目的重测信度均大于0.7。总量表的Cronbach’α系数为0.820,各个维度的Cronbach’α系数均0.7。量表的各条目得分和相应维度总分之间的相关系数在0.595~0.962之间。因子分析共提取7个特征根大于1的因子,可解释总变异的76.3%,在相应项目上均有较强的因子载荷。结论中文版偏头痛患者药物依赖性问卷具有较好的信度和效度,适合临床推广应用。