Accelerating children's risk for injury: Mothers' decisions regarding common safety rules

Although safety rules are one of the primary preventative tactics used by parents to avoid childhood injury, very little is known about how rules are applied within families. In this preliminary study in the area of application of family safety rules, we found that mothers tended to impose rules consistently more often than inconsistently, and where they were inconsistent, they tended to regard a risky behavior as unacceptable, even if there was no family rule outlawing the behavior. The number of rules was negatively related to the number of injuries, suggesting that rules may indeed have the preventative properties that parents believe them to have. The importance of understanding how rules may prevent or fail to prevent injuries is underlined and future research challenges are described.     

Pharmacokinetic evaluation of stable piecewise cubic polynomials as numerical integration functions

A numerical integration method based on piecewise cubic polynomial for computing the area under the curve in pharmacokinetics is presented. The method has been found to produce stable and monotone interpolations irrespective of experimental error. Spurious oscillations occasionally associated with cubic splines are eliminated. Comparisons with the previously available methods suggest that more reliable and less biased areas under the plasma concentration curve, AUC, or areas under the first moment of plasma curve, AUMC, can be generated by the present method.     

两种治疗2型糖尿病并发尿路感染用药方案的药物经济学分析

目的：探讨不同药物治疗方案对2型糖病并发尿路感染所产生的效果。方法：选择2型糖病并发尿路感染患者48例，随机为2组。A组给予头孢噻肟钠2g,1次／d，静脉滴注；B组给予哌拉西林钠6g,1次／d，静脉滴注，运用药物经济学成本－效果分析方法，对2组治疗方案进行回顾性分析，评价。结果：A组5－7d，治愈率100%,B 为63．63％，总成本平均每人：A组为721．08元，B组为1262．24元，结论：药物经济学在优化治疗方案，指导合理用药，提高经济效益方面重要意义。     

医学生思想发展变化规律和教育对策的研究──对医学生思想状况的5年追踪调查报告

为探讨医科大学生思想行为发展变化的规律，提出改进和加强学生思想政治教育的对策。对同济医科大学医疗系九Ｏ级某大班１５０名学生进行了连续５年的纵向追踪调查，追踪研究结果显示：医学生在其成长过程中一般要经历３个特殊的适应阶段，学生思想行为的发展具有阶段性和渐变性特点。其中医学生的政治观、价值观、职业理想和道德意识及心理素质的改变明显。至毕业时，学生的综合素质有了显著的提高，表明大学的思想教育对医学生的成长起着不可替代的重要作用。     

多孔直杆扭转问题的边界元法

讨论了用边界元法解多孔直杆弹性扭转问题，证明了求具有等值面边界条件的非局部边值问题的解与求对应的边界积分方程的解是等价的，并将计算中出现的区域积分全部化为边界积分，从而减少了所需准备的初始数据和计算时间。     

Cross-cultural adaptation and validation of a European Portuguese version of the 8-item Morisky medication adherence scale

Introduction and Objective

The 8-Item Morisky Medication Adherence Scale (MMAS-8) is one of the most widely used instruments to assess medication adherence, but a validated European Portuguese version of MMAS-8 does not exist. Our aim was to develop and validate a European Portuguese version of the MMAS-8.

戴明循环法降低门诊自动发药系统发药差错率的研究

目的:运用戴明循环(PDCA)法,降低门诊自动发药系统发药差错率,提高患者用药安全性和合理性。方法:选取医院门诊药房质量管理数据,将2017年7-12月门诊药房实施常规管理的623591张处方数据纳入对照组,将2018年1-6月实施PDCA循环法管理的651397张处方数据纳入观察组;建立门诊药房质量管理小组,按照PDCA循环法的管理程序,针对门诊药房发药差错率进行详细的查找问题、改进方案、加强检查和总结分析,对比分析两组数据门诊发药差错率以及药品错误、规格错误、数量错误、剂量错误、剂型错误及其他错误等分类汇总的差错率。结果:对照组的发药差错率为0.61‰,观察组为0.29‰,两组发药差错率对比差异有统计学意义(x2=72.63,P<0.01);观察组的药品错误、数量错误、剂量错误和剂型错误差错率明显低于对照组,其差异有统计学意义(x2=39.44,x2=48.44,x2=30.78,x2=9.25;P<0.05)。结论:运用PDCA循环法对医院门诊药房进行管理,可降低门诊药房发药差错率,在一定程度上提高患者用药安全。     

重庆市某社区卫生服务中心门诊高血压患者用药情况分析

目的分析重庆市某社区卫生服务中心门诊高血压患者用药情况,为指导社区高血压患者合理用药提供依据。方法收集2018年1-12月重庆市某社区卫生服务中心门诊处方(临床诊断为高血压的处方)3779张,对抗高血压药的应用品种、销售金额、用药频度(DDDs)、日均费用(DDC)及药物联用情况等进行统计分析。结果所有处方共涉及843例高血压患者,其中男性358人,女性485人;年龄范围31~97岁。55岁以上的中老年患者共740人(87.79%)。抗高血压药物中销售金额最高的为钙通道阻滞剂(CCB)类(54.66%),其次为血管紧张素Ⅱ受体阻断剂(ARB)类(38.67%)。DDDs排序居前3位的药品分别为苯磺酸左旋氨氯地平片、坎地沙坦酯片和替米沙坦片。在843例患者降压药的使用中,单一用药386例(45.79%),二联用药336例(39.86%),三联用药36例(4.27%)。在二联降压治疗中,以CCB和ARB联用为主(82.73%)。在三联降压治疗中,以CCB+ARB+β受体阻断剂(β-RB)联用为主(52.78%)。结论该社区门诊抗高血压药物应用种类及降压治疗方案使用基本合理,但在考虑用药的经济性方面欠佳,多药联用方案仍需进一步进行规范。此外,临床药师对社区高血压患者进行合理用药宣教时,应重点关注CCB及ARB类药物的使用情况,特别注意潜在的药物相互作用,以降低药物不良反应发生率,提高患者用药依从性。