壳聚糖絮凝法用于脑清口服液澄清工艺的探讨

目的：探讨壳聚糖絮凝法代替乙醇沉淀法用于脑清口服液(葛根，黄芪等)制备的可行性。方法：考察两种澄清法的沉淀效果、过滤难易、对主要有效成分含量影响并对稳定性进行了比较。结果：壳聚糖絮凝法与酵沉法同样能使药液澄清，前者能更有效地保留药液中的有效成分，又能保证制剂的稳定性，缩短生产周期，降低成本。结论：壳聚糖絮凝法可代替乙醇沉淀法用于脑清口服液的澄清工艺。     

芍丹乙肝口服液澄清工艺的研究

目的优选芍丹乙肝口服液的澄清工艺。方法通过对水浸出物收率、总多糖含量及芍药苷含量的测定，比较了乙醇沉淀法、高速离心法、吸附澄清技术3种澄清工艺的差异。结果3种澄清工艺对3个指标均有不同程度的影响，其中吸附澄清技术能使水浸出物收率降至18％左右，有效成分保留率在80％以上，且溶液澄清。结论吸附澄清技术可作为芍丹乙肝口服液的澄清工艺，     

Feasibility,acceptability, and effectiveness of a decision aid versus an informational website to promote clinical trial decision-making among cancer patients: A pilot randomized controlled trial

ObjectiveTo assess intervention feasibility and acceptability, and compare the effectiveness of the CHOICES Decision Aid (DA) versus the National Cancer Institute (NCI) Cancer Clinical Trials (CCT) website to improve knowledge about CCTs and preparedness to make an informed decision.MethodsOncology patients (n = 101) with a scheduled clinic visit were enrolled and randomized. Decision-making variables were collected at two timepoints. Post-intervention scores were examined via paired t-tests and multivariate regression analyses. Predictors of the magnitudes of the change in scores were examined in multivariable regression analyses.ResultsThe interventions were feasible to implement and acceptable to participants. Both interventions increased objective and subjective knowledge, improved clarity of opinions, and reduced decisional conflict (p-values < 0.01). Improvements in the belief that one could find out about CCTs were observed in the CHOICES DA arm (p < 0.001). Multivariable analyses controlling for educational attainment showed no significant differences in the magnitude of change in outcome variables between intervention arms, but did find that improvements in some variables in the NCI arm – but not CHOICES DA arm – were associated with previous educational attainment.ConclusionsInterventions were feasible to implement and acceptable. Improvements in knowledge and decision-making outcomes were observed in both arms, supporting the view that interventions to improve CCT decision making are effective and feasible. Our results suggest that the CHOICES DA may be more effective than an informational website in improving decision-making outcomes regardless of participants’ educational attainment.Practice implicationsCCT resources should support informed decision-making among all cancer survivors, regardless of educational attainment.     

Combining deliberation and intuition in patient decision support

Objective

To review the strengths and weaknesses of deliberative and intuitive processes in the context of patient decision support and to discuss implications for decision aid (DA) design.

Methods

Conceptual review of the strengths and weaknesses of intuitive and analytical decision making and applying these findings to the practice of DA design.

Results

DAs combine several important goals: providing information, helping to clarify treatment related values, supporting preference construction processes, and facilitating more active engagement in decision making. Many DAs encourage patients to approach a decision analytically, without solid theoretical or empirical grounding for this approach. Existing research in other domains suggests that both intuition and deliberation may support decision making. We discuss implications for patient decision support and challenge researchers to determine when combining these processes leads to better outcomes.

Conclusions

Intuitive and analytical decision processes may have complementary effects in achieving the desired outcomes of patient decision support.

Practice implications

DA developers should be aware that tools solely targeted at supporting deliberation may limit DA effectiveness and harm preference construction processes. Patients may be better served by combined strategies that draw on the strengths and minimize the weaknesses of both deliberative and intuitive processes.     

凹凸棒石对总有机酸的吸附作用

目的 考察凹凸棒石作为吸附沉淀剂对山楂水煎液及山楂化滞丸水提液中无效杂质的去除作用和对总有机酸的吸附影响.方法 以总固形物保留率和总有机酸保留率为评价指标,分别用普通凹凸棒石和酸化凹凸棒石沉淀山楂水煎液及山楂化滞丸水提液,评价吸附沉淀效果和对总有机酸含量的影响.并与自然沉淀法进行平行比较.结果 凹凸棒石在去除中药水煎液中无效杂质方面具有一定的作用;普通凹凸棒石对总有机酸有一定程度的吸附作用,而酸化凹凸棒石无影响.结论 凹凸棒石可以作为吸附沉淀剂应用于中药水煎液的纯化,对以有机酸类作为主要成分的制剂,应考虑使用酸化凹凸棒石以减少对有效成分的吸附.此外,仍有必要对凹凸棒石进行表面结构修饰方面的研究.     

壳聚糖与乙醇用于舒乳消痛口服液澄清工艺的比较

 目的：探讨壳聚糖絮凝法代替醇沉用于舒乳消痛口服液澄清工艺的可行性。方法：壳聚糖用于舒乳消痛口服液的澄清，通过对总固型物、正丁醇浸出物、芍药苷含量的测定，对壳聚糖的用量、药液的密度进行了优选，并与醇沉工艺进行了比较。结果：壳聚糖絮凝法与醇沉法同样能使药液澄清，在总体有效成份的保留上，前者优于后者，但皂苷成份的保留量后者略大于前者。结论：壳聚糖絮凝法能代替醇沉用于舒乳消痛口服液的澄清工艺，缩短生产周期，降低成本，但成份的微小差异对临床治疗的影响尚待进一步的探讨。     

Options counseling: techniques for caring for women with unintended pregnancies

An unplanned pregnancy is a crisis in a woman's life. She may request assistance from the health care provider in reviewing her options of becoming a parent, continuing the pregnancy and placing her baby for adoption, or terminating the pregnancy. To facilitate the decision-making process for women facing these choices, the clinician must first examine her own values and biases. To aid the clinician in providing nonjudgmental and nondirective counseling, this article provides factual information about abortion and adoption, values clarification exercises, and concrete approaches to help women examine their beliefs.     

Creativity: a refinement of the concept for nursing practice

AIMS: This paper seeks to remove some of the ambiguity surrounding the conceptual meaning of creativity using techniques of concept refinement to advance the concept. BACKGROUND: Creativity is an essential component of nursing practice that occurs daily in nurse's interactions with clients, families and other nurses. Failure to acknowledge and encourage creativity in beginning nurses may hinder future development and innovations in nursing practice and in nursing science. In order to promote the development of creativity it is first necessary to clarify and refine the concept as it applies to nursing. DESIGN/METHODS: A comprehensive review of a variety of computer and online databases resulted in thousands of articles on creativity between the years 1966 and 1999. The final sample (n = 48) was obtained using both stratified random and purposive sampling techniques. A content analysis of the literature was conducted using methods identified by Morse and illustrated in the work of Hupcey et al. Having determined the concept to be partially mature, the concept was advanced using techniques of concept refinement. FINDINGS: Content analysis of the literature yielded three differing definitions for creativity: revelation, birth and reincarnation. Creativity occurs in the presence of intrinsic motivation and a nurturing environment. While value is often used to identify whether a product is creative, the value of the product cannot determine whether the process has occurred. The product produced determines evidence of the process of creativity. LIMITATIONS: Limitations of this investigation are the use of secondary sources and the relatively small sample size (n = 48). CONCLUSIONS: Refinement of the concept of creativity indicates that it is a process that may be developed and influenced by the environment and is recognized by the product produced. Further investigation is needed to explore methods and techniques for developing creativity in nursing.     

Achieving transparency in implementing abortion laws.

National and international courts and tribunals are increasingly ruling that although states may aim to deter unlawful abortion by criminal penalties, they bear a parallel duty to inform physicians and patients of when abortion is lawful. The fear is that women are unjustly denied safe medical procedures to which they are legally entitled, because without such information physicians are deterred from involvement. With particular attention to the European Court of Human Rights, the UN Human Rights Committee, the Constitutional Court of Colombia, the Northern Ireland Court of Appeal, and the US Supreme Court, decisions are explained that show the responsibility of states to make rights to legal abortion transparent. Litigants are persuading judges to apply rights to reproductive health and human rights to require states' explanations of when abortion is lawful, and governments are increasingly inspired to publicize regulations or guidelines on when abortion will attract neither police nor prosecutors' scrutiny.