Comparison of Screening Instruments for Alcohol Problems Between Black and White Emergency Room Patients from Two Regions of the Country

A number of brief screening instruments to identify alcohol dependence exist, but the validity of these instruments across ethnic groups or regions of the country is not well established. The sensitivity and specificity of a number of standard screening instruments (CAGE, brief MAST, AUDIT, TWEAK, and RAPS), as well as other measures (History of Trauma Scale, breathalyzer reading, self-reported drinking before the event, and consuming five or more drinks at a sitting at least monthly) are compared against ICD-10 and DSM-IV criteria for alcohol dependence between probability samples of Black and White emergency room patients in Santa Clara County, CA (n= 716) and in Jackson, MS (n= 1330). Variability in the sensitivity of screening instruments among current drinkers was found to be greater between samples for both Blacks and Whites, than for Blacks compared with Whites within the same sample. The AUDIT, TWEAK, and RAPS seemed to perform well by gender and injury status for both Blacks and Whites in the two samples, and no significant differences were found in the performance of these instruments across sample sites. To evaluate the influence of regional differences in alcohol dependence on differences found in the performance of screening instruments, using logistic regression with the simultaneous entry of demographic variables (age, gender, ethnicity, injury status, and site) and drinking variables (breathalyzer reading, serf-reported drinking before the event, and drinking five or more drinks at a sitting at least monthly) to predict alcohol dependence in a merged sample of these patients (Jackson vs. Santa Clara) site was not found to be significant Data suggest that, whereas region of the country may not be important in predicting alcohol dependence in emergency room populations, regional differences in the performance of screening instruments for alcohol dependence may exist, even when ethnicity is taken into account Given distinct regional differences in drinking patterns and problems in the U.S., further research on commonly used screening instruments is needed to determine those screeners most efficient for identifying problem drinking.     

Impulsivity, Sensation Seeking, and Behavioral and Emotional Responses to Alcohol

Three hundred forty-two male and female subjects from the Colorado Alcohol Research on Twins and Adoptees returned a mailed questionnaire that included the Eysenck Impulsivity-Venturesomeness-Empathy scales. These subjects had previously been tested in a procedure in which they were given a 0.8 g/kg dose of ethanol to bring their peak blood alcohol concentration (BAC) to near 0.10 g/dl, given topping doses to maintain this BAC over a 3-hr period, and repeatedly tested on a battery of diverse physiological, psychomotor, perceptual speed, and mood measures. Impulsivity was significantly correlated with higher levels of self-reported alcohol use and the occurrence of alcohol use problems in males, while both impulsivity and venturesomeness (sensation seeking) were significantly correlated with lessened motor impairment following alcohol use in males. These personality measures, however, were not significantly correlated with mood measures following initial alcohol dosing. Impulsivity and venturesomeness were uncorrelated with alcohol use and responses to alcohol in females, but as with males, impulsivity was related to the occurrence of alcohol use problems in females.     

A Longitudinal Examination of the Relationships Among Stress, Coping Strategies, and Problems Associated with Alcohol Use

This study examined the longitudinal relationships among family history of alcoholism (FH+), stress levels, utilization of coping methods, and alcohol-related problems. Data used in this study were obtained from a nonclinical sample of subjects who were originally interviewed when they were 12, 15, or 18 years of age and followed-up twice more at 3-year intervals for a longitudinal sample size of 1270. Although a greater percentage of females in this sample reported a FH+ background as well as higher levels of stress, they tended to utilize positive coping strategies more often and reported fewer numbers of alcohol problems than males. In general, younger subjects who reported high levels of stress experienced more alcohol-related problems regardless of coping method chosen. In older subjects, the effect of stress on problems appeared to be buffered when coupled with the use of support seeking. Subjects whose stress preceded problems exhibited no significant difference from subjects whose problems preceded stress and symptom-free and "stressed-only" subjects were not significantly different from each other in number of problems at time 3, suggesting that a direct effect of stress alone on alcohol-related problems is questionable.     

医学伦理学应重视对问题和案例的研究——以李丽云案例的最终司法处理结论为例

李丽云案例的最终处理存在医学伦理缺憾,有关法律和司法解释至今仍未破解该案例引发的医学伦理难题,医学伦理学应该重视案例研究,多研究些问题。     

我国海洋中药产业发展面临的问题及建议

海洋蕴藏着丰富的药用生物资源,被称为“蓝色药库”。海洋中药是我国中药的重要组成部分,临床历史悠久,有着良好的发展前景。近年来海洋资源的过度开发,以及海洋环境变化导致海洋生物资源减少,以及海洋中药的质量标准缺失等问题已逐渐成为海洋中药产业化发展过程中的瓶颈问题。据此,本文提出建立海洋中药资源保护体系、构筑质量控制标准体系、加强海洋中药学科建设等建议,以期加快海洋中药产业化进程。     

药品集中招标采购对医院药事管理的影响及建议

自2010年7月起实行以省（区、市）为单位的医疗机构网上药品集中招标采购以来,对近3年医院在药品采购过程中遇到的问题加以总结,并对产生的原因进行分析,存在的问题直接影响医疗机构药事管理和持续改进,从医院药事管理方面提出建议,希望引起相关部门的重视,及时完善补救措施,达到规范和推动药品集中采购工作的目的。     

吴考槃教授精研经典解惑学术真谛

[目的]探讨吴考槃教授研究《素问》《灵枢》《难经》等名著的学术思想。[方法]通过对吴老研究素、灵等名著而发表的相关论文与出版著作的系统收集,采用文献研究的方法进行挖掘整理研究。[结果]吴老对经典名著的研究不仅运用校勘、训诂、注解、今译的方法,并通过归类、分析、阐发等挖掘与加工,将经文中的理论精髓和蕴涵的学术思想给予揭示剖析。[结论]对中医经典的研究不仅要有基本的中医基础理论功底,更重要的具有博而精的文献底蕴。     

Gray matter morphology and the level of functioning in one-year follow-up of first-episode schizophrenia patients

Schizophrenia is a condition with a highly variable course that is hard to predict. The aim of the present study was to investigate if local gray matter volume (GMV) can differentiate poor (PF) and good (GF) functioning patients using voxel-wise analysis in a group of first-episode schizophrenia subjects (FES).