The Present and Future of Clinical Psychology in Private Practice

This article discusses clinical psychologists' current concerns, challenges, and opportunities in private practice. The future of clinicians in independent practice is presented within two paradigms, namely, psychology as a health profession, and psychology as life enhancement. Finally, the author argues that psychotechnology, corporate clinical psychology, and psychology as life enrichment will evolve within the future of clinical psychological independent practice.     

Melatonin Lowers Plasma Prolactin Levels in Female Red Deer (Cervus elaphus)

The aim of the study was to determine the effect of exogenous melatonin treatment on circulating prolactin levels in red deer. Melatonin was administered from 12 June 1984 (day 1) to lactating and non-lactating hinds in the feed daily at 1600 h, and to non-lactating hinds by a subcutaneous implant. Average concentrations (ng/ml) of prolactin in plasma taken serially over 15-h periods were significantly higher for untreated hinds than for melatonin-treated animals on day 15 whether lactating (66-133 v. 23-28, P less than 0.05) or non-lactating (28-174 v. 8-13, P less than 0.01), remained higher on day 36 (lactating: 41-152 v. 15-21, P less than 0.05; non-lactating: 21-50 v. 1-7, P less than 0.001) but had decreased to similar levels on day 72 (lactating: 5-24 v. 7-17; non-lactating: 2-9 v. 0-4). The advanced reduction in plasma prolactin for all melatonin-treated hinds was associated with an advanced onset of seasonal breeding activity.     

Sulphasalazine and Sulphapyridine Serum Levels in Children to Mothers Treated with Sulphasalazine during Pregnancy and Lactation

ABSTRACT. Serum concentrations of sulphasalazine and sulphapyridine were measured during the first week of life in 15 children whose mothers had been on sulphasalazine during pregnancy. The serum concentrations of sulphapyridine and sulphasalazine were similar in the children and their mothers at delivery. The elimination rate of the drugs in the newborn children was slow but the concentrations were not so high that a bilirubin displacing effect could be expected. In eight mothers who were breast-feeding and taking sulphasalazine, analyses were done of mothers'serum, breast-milk and serum from their children. The results showed that the amount of sulphasalazine and sulphapyridine transferred to the child via the breast-milk is negligible with regard to the risk of kernicterus. It is concluded that a woman in need of sulphasalazine treatment can continue the medication throughout pregnancy and lactation without risk of development of kernicterus in her child. Only term infants without haemolytic disease were included in the study. Thus our conclusion is not necessarily valid for the prematurely born child or the child with haemolytic disease.     

Inhibition of Tuberoinfundibular Dopaminergic Neural Activity During Suckling: Involvement of μ and κ Opiate Receptor Subtypes

Previous studies have shown that mu (μ) and kappa ( κ ) opioid antagonists inhibit suckling-induced prolactin release. Prolactin responses elicited by pup suckling or opioid administration are mediated, at least in part, by suppression of dopamine (DA) release from tuberoinfundibular dopaminergic (TIDA) neurons in the hypothalamus. We examined the effects of the μ opiate receptor antagonist, β -funaltrexamine ( β -FNA), and the κ opiate receptor antagonist, nor-binaltorphimine (nor-BNI) on the activity of TIDA neurons in lactating rats. TIDA neuronal activity was determined by measuring DOPA accumulation in the caudate putamen (CP) and median eminence (ME). The effects of opioid antagonist treatment were determined in pup-deprived (low circulating prolactin levels) or pup-suckled rats (high circulating prolactin levels). The accumulation of 5-hydroxytryptophan (5-HTP) in the medial preoptic area (MPOA), the anterior hypothalamus (AH) and the median eminence (ME) was quantified as an index of serotonergic activity in the same animals for comparative purposes.     

鸡精促进产后乳汁分泌效果的临床观察

目的观察鸡精用于产后乳汁分泌的临床效果。方法产后每日早晚各服白兰氏鸡精70ml，共服3d，并与对照组、中药材催乳组对比。结果鸡精有促进早泌乳与增加泌乳量的作用。结论鸡精用于产妇有滋养身体，恢复产妇体力，促进早泌乳和增加泌乳量的作用，且饮用方便，效果好，无不良反应。     

Anaesthetic agents and excretion in breast milk

This review is an update on anaesthetic agents and their excretion into breast milk; it presents the reported effects on suckling infants, and discusses the precautions which should be considered. For most anaesthetic agents, there is very sparse information about breast milk excretion and even less published knowledge about the possible effects on the suckling infant. Generally, when an anaesthetic agent is given on a single–dose basis, there is no evidence that it is excreted in breast milk in clinically significant amounts, even if there are detectable concentrations of the drug in the milk. Most anaesthetics are rapidly cleared from the mother, and, consequently, it should be possible to allow suckling as soon as practically feasible after surgery. However, repeated administration of certain opiates and benzodiazepines has been reported to cause adverse effects in neonates, with premature neonates apparently being more susceptible. Thus, in long–term treatment with these drugs, the importance of uninterrupted breast feeding should be assessed against possible adverse drug effects in the neonate.     

哺乳妇女单次注射迪波盖司通~长效避孕针后血清和乳液中MPA浓度变化

目的:探讨中国妇女哺乳期使用迪波盖司通后血清和乳液醋酸甲羟孕酮(MPA)浓度变化。方法:10名产后哺乳妇女单次注射迪波盖司通(含MPA150mg),在注射后的第1、2、4、6、8、10和12周采集血样和乳液样本,用放射免疫方法测定MPA。结果:血清MPA浓度于注射后第1周最高,到第2、4周时下降明显,第4周后浓度下降趋势逐渐缓慢。乳液MPA浓度在第1周为最高,第2周比第1周降低了约1/2,之后10周平均浓度变化波动在5.09-8.15ng/ml之间。观察期间乳液/血清MPA浓度比值和曲线下浓度面积比值均为0.55。对象之间和同一对象不同时间点乳液/血清MPA浓度存在明显个体差异。结论:哺乳期使用迪波盖司通,将导致血液和乳液中含有一定量的MPA。     

实时在线咨询系统的功能与设计

结合国外图书馆网上实时参考咨询服务的研究与试验情况,详细阐述和分析了基于实时的虚拟参考咨询系统的功能和设计策略.     

Bioactivity of prolactin isoforms: lactation and recovery of menses in nursing women

To assess whether plasma prolactin (PRL) characteristics relate to lactogenesis and absence or presence of menstrual cycles, we measured bioactive PRL (BIO-PRL) using the Nb2 assay, immunoreactive PRL (IR-PRL) by radio-immunoassay, calculated equations describing the BIO-PRL-IR-PRL relationship and separated charged PRL isoforms (by chromatofocusing) in five amenorrhoeic and five cycling nursing women at 6 months postpartum and in 10 cycling non-nursing women. Plasma samples were drawn before and 30 min after a suckling episode at 0800, 1600 and 2400 h in nursing women and at the same hours in non-nursing women. BIO-PRL and IR-PRL concentrations were highest in amenorrhoeic nursing women, intermediate in cycling nursing women and lowest in cycling non-nursing women. The BIO-PRL-IR-PRL relationship shows that a given amount of IR-PRL corresponds to equivalent amounts of BIO-PRL in cycling nursing and cycling non-nursing women, and to a larger extent in amenorrhoeic nursing women. IR-PRL was present in plasma as several charge isoforms. Bioactive isoforms eluting at pH 6.0-5.1 were found in amenorrhoeic and cycling nursing women, reaching similar concentrations after suckling. Bioactive isoforms eluting at pH 7.0-6.1 were found only in amenorrhoeic nursing women. We speculate that isoforms eluting at pH 6.0-5.1 may play a role in lactation and isoforms eluting at pH 7.0-6.1, in lactational amenorrhoea.