灾难心理护理人员的基本要素与心理护理程序

近年来突发性灾难事件发生的频率较高、危害很大,给一些地区造成巨大损失。许多医院针对灾难伤者开展了心理护理实践,但普遍存在计划不周密、效果不显著等问题。本文通过介绍灾难伤者的心理特征和灾难心理护理者应具备的基本要素,归纳灾难心理护理的程序,使灾难心理护理更具科学性和可操作性,以期为提高灾难心理护理的质量提供参考。     

新疆乌鲁木齐市脑力工作者职业倦怠状况调查

目的了解目前脑力工作者的职业倦怠情况,为脑力工作者职业倦怠的防治工作提供依据。方法通过分层整群随机抽样选取新疆乌鲁木齐市脑力作业人员1 200名,采用职业倦怠量表进行问卷调查,然后对其中1 100份有效问卷进行分析。结果 1脑力工作者的情感耗竭、人格解体和个人成就感降低3个维度的总检出率分别为17.45%、45.91%和60.91%,轻度、中度和重度倦怠的检出率分别为33.27%、37.91%和8.64%,其中科研人员职业倦怠的检出率、中度和重度职业倦怠的检出率均高于管理人员和专业技术人员;2科研人员在人格解体、个人成就感降低维度上的得分均高于管理人员和专业技术人员;3不同民族在职业倦怠各维度和职业倦怠总得分上均无差异,女性、未婚、低收入及低教育水平者较容易发生职业倦怠;4脑力工作者出现职业倦怠更可能是在工作早期。结论脑力工作者职业倦怠状况较严重,并且以科研人员的职业倦怠情况最为严重,因此应该受到重视。此外,脑力劳动者的职业倦怠情况因人口学特征不同而异。     

明晰医学临床试验研究中的申办者、研究者及医学伦理委员会的职责

现代医学临床试验研究的宗旨是：在充分保障受试者权益和利益的前提下,进行符合人类自身发展需要的科学技术研究.显然,保障受试者权益和利益是科学研究的第一要素.现阶段,探索在医学临床试验研究中申办者以契约（保险）的形式保障受试者权益和利益的方法,同时,从根本上解决伦理委员会保障受试者权益和利益的指标-申办者为受试者购买相关保险,二者显得尤为重要,将在临床试验研究受试者权益的保护方面发挥重要作用.     

研究者在临床研究中需考虑的伦理学问题探讨

通过我院接受国家中医药管理局＂中医药临床研究伦理审查平台建设与评估＂检查中所发现的一系列问题,列举了当前在临床研究中针对主要研究者及研究团队需注意的几类伦理学问题,进而促使临床研究者提高伦理意识,更好地完成保护受试者的中心任务。     

Cross-sector sponsorship of research in eosinophilic esophagitis: A collaborative model for rational drug development in rare diseases

Like many rare diseases, eosinophilic esophagitis (EoE) is a poorly understood disorder, and assessment tools to accurately determine disease activity, remission, and natural history have long been inadequate. Clinical outcome end points able to assess the effectiveness of candidate therapeutic agents in clinical trials have been a particular deficiency and are urgently needed. With no approved therapy available to patients and with the prevalence of EoE on the increase, collaborative approaches to drug development are becoming ever more important. We describe a collaborative effort mobilized across institutions, including both the public and private sectors, that was initiated within the past 18 months expressly to address the need for further clinical research into the cause and treatment of EoE. Collaborators include the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition; the International Gastrointestinal Eosinophilic Researchers; and the US Food and Drug Administration. This effort has resulted in the elucidation of several parameters essential for effective EoE registration trials, including the need for clinically meaningful end points that measure changes in clinical symptoms in addition to the assessment of intraepithelial mucosal eosinophilia. The development and use of biomarkers, particularly in early-phase drug development, have become an important focus for investigations that might reduce clinical reliance on serial invasive monitoring. The concerted efforts described here to develop rational therapeutics and drug development paradigms in EoE also appear to provide a model for effective collaboration in the context of drug development for rare diseases and perhaps more generally for public health initiatives.     

浅谈医院图书馆馆员如何帮助科研人员做好科研选题

从医院临床医学科研选题的原则及课题的种类入手，着重论述了图书馆馆员如何帮助医院临床医务科研人员做好科研选题，以及图书馆馆员在辅助科研选题时应具备的素质。     

Risk of herpes/herpes zoster during anti-tumor necrosis factor therapy in patients with rheumatoid arthritis. Systematic review and meta-analysis

BackgroundTNF blockers have demonstrated efficacy in inflammatory rheumatic diseases (IRDs). The drugs are associated with a moderate but definite risk of bacterial infection, but risk of viral infection is not clearly known.ObjectiveTo assess the risk of herpes zoster (HZ) reactivation in patients with rheumatoid arthritis (RA) receiving TNF blockers as compared with DMARDs.MethodsA systematic search of literature up to March 2013 was performed, in MEDLINE, EMBASE, the Cochrane library and abstracts from the ACR and EULAR congresses from 2008 to 2011. Studies were included if they reported the incidence of HZ, respectively, in patients receiving anti-TNF and conventional DMARDs.ResultsThe literature search identified 3446 articles and 88 congress abstracts; a manual search retrieved seven articles. Finally, 26 articles and nine abstracts were included; six articles and one abstract were of meta-analyses estimating the relative risk of HZ in patients with RA with a total follow-up of 163,077 patient-years. From the meta-analyses of data for seven registries, the pooled risk ratio for HZ with TNF blockers was 1.61 [95%CI 1.16–2.23] (P = 0.004). Proportions of severe HZ ranged from 4.9% to 20.9% with TNF-blockers and from 2.0% to 5.5% with conventional DMARDs, in the different registries.ConclusionsThis meta-analysis revealed a significantly increased risk of HZ, up to 61%, in patients with IRD receiving TNF blockers. These data raise the issue of systematic prophylactic treatment with known history of HZ or vaccination without this history.     

如何提高教师科研工作的积极性

随着时代的发展,改革的深入,高校承担的科研任务越来越多,科研工作者工作压力越来越大,在这样的现实下,科研人员＂科研懒惰＂现象屡见不鲜。为此建立一套客观、公正、量化和长效的创新机制,调动科技人员的积极性,对确保高校完成科研发展目标具有很现实的意义。     

临床研究中伦理学若干问题思考

本研究建立在浙江中医药大学附属第一医院接受国家中医药管理局"中医药临床研究伦理审查平台建设与评估"基础上。临床研究伦理审查平台是一个完整的体系——"受试者保护体系",包括医疗卫生组织机构、伦理委员会、伦理委员会办公室、研究科室与研究人员4大方面。其中,研究科室与研究人员平台建设尤为关键,所有与受试者保护体系密切相关的治疗、保护、风险控制、不良事件监督都是通过研究者完成的。但在评估过程中不难发现临床研究者伦理意识相对薄弱,对伦理审查流程不熟悉,没有把受试者保护和临床研究摆在同样的高度。这类问题同样在国内其他医疗机构的伦理审查评估中凸显出来,成为当前建立受试者保护体系的短板。为此,本研究参考《中医药临床研究伦理审查平台评估标准》评估要点,从伦理委员会角度出发,提出临床研究者在受试者保护和方案设计与实施方面需注意的伦理学问题,并针对研究者临床研究伦理现状提出改进建议,进而促使临床研究者提高伦理意识,熟悉伦理审查流程,更好地完成保护受试者的中心任务。