认知疗法在骨科慢性疼痛性疾病患者护理中的应用价值

目的：探讨认知疗法在骨科慢性疼痛性疾病患者护理中的应用价值。方法选取广东省揭阳市惠来县人民医院骨科诊断为慢性疼痛性疾病的患者资料200例,将其采用随机数字表法分为两组,各100例,对照组患者给予骨科常规护理,观察组患者在其基础上加以认知疗法护理。比较两组患者治疗后的疼痛程度。结果观察组患者护理后疼痛率明显低于对照组;且观察组 SDS、SAS 评分下降水平也明显优于对照组,差异均有统计学意义（均 P＜0.05）。结论对骨科慢性疼痛性疾病患者的护理中施以认知疗法,能有效缓解患者的疼痛和焦虑。     

Modeling economic implications of alternative treatment strategies for acute bacterial skin and skin structure infections

Objective:

The economic implications from the US Medicare perspective of adopting alternative treatment strategies for acute bacterial skin and skin structure infections (ABSSSIs) are substantial. The objective of this study is to describe a modeling framework that explores the impact of decisions related to both the location of care and switching to different antibiotics at discharge.

Methods:

A discrete event simulation (DES) was developed to model the treatment pathway of each patient through various locations (emergency department [ED], inpatient, and outpatient) and the treatments prescribed (empiric antibiotic, switching to a different antibiotic at discharge, or a second antibiotic). Costs are reported in 2012 USD.

Results:

The mean number of days on antibiotic in a cohort assigned to a full course of vancomycin was 11.2 days, with 64% of the treatment course being administered in the outpatient setting. Mean total costs per patient were $8671, with inpatient care accounting for 58% of the costs accrued. The majority of outpatient costs were associated with parenteral administration rather than drug acquisition or monitoring. Scenarios modifying the treatment pathway to increase the proportion of patients receiving the first dose in the ED, and then managing them in the outpatient setting or prescribing an oral antibiotic at discharge to avoid the cost associated with administering parenteral therapy, therefore have a major impact and lower the typical cost per patient by 11–20%. Since vancomycin is commonly used as empiric therapy in clinical practice, based on these analyses, a shift in treatment practice could result in substantial savings from the Medicare perspective.

Conclusions:

The choice of antibiotic and location of care influence the costs and resource use associated with the management of ABSSSIs. The DES framework presented here can provide insight into the potential economic implications of decisions that modify the treatment pathway.     

160例老年高血压患者药物治疗的调查分析

目的了解高校社区老年高血压患者的病情与药物治疗情况,探讨药师参与定期回访指导患者合理用药,对提高老年高血压治疗控制率的意义。方法通过对学校健康管理中心北校区社区160例确诊的老年高血压患者随访调查,按照《中国高血压防治指南》2010年修订版进行治疗达标评估分析。结果 160例老年高血压中约71.9%患有心脑血管疾病、糖尿病等并发症;药物治疗率为83.1%;血压控制率为70.6%。结论该社区老年高血压药物治疗率、控制率均较高,但在合理使用药物治疗方面还存在一些误区,医生和药师应指导老年高血压患者合理使用降压药物,从而提高其药物治疗效果。     

美国纳米传感器技术发展计划与战略部署

10余年来,美国政府十分重视对纳米传感器技术的研发支持,与之相关的发展计划分布于美国《国家纳米技术计划》的各个层面,众多国家机构结合各自研究领域积极开展纳米传感器技术的研究与开发,其研究遍及国防军事、航空航天、生物医药以及电子通讯等领域,尤以涉及国家安全和人类生命健康的领域为重点。通过分析美国相关机构各年度纳米传感器技术发展计划,不难了解：近期,美国政府提出要加强机构间的合作与交流,既要加快下一代纳米传感器技术的研究与开发,同时也为开展纳米传感器技术在健康、安全与环境方面的研究提供支撑。     

Assessing the economic value of avoiding hospital admissions by shifting the management of gram+ acute bacterial skin and skin-structure infections to an outpatient care setting

Abstract

Objective:

To estimate, from a US payer perspective, the cost offsets of treating gram positive acute bacterial skin and skin-structure infections (ABSSSI) with varied hospital length of stay (LOS) followed by outpatient care, as well as the cost implications of avoiding hospital admission.     

Centre‐based and expedition‐based (wilderness) adventure experiential learning regarding personal effectiveness: an explorative enquiry

The purpose of this study is to compare a centre‐based adventure programme (CBAP) with an expedition‐based wilderness programme (EBWP) with regard to personal effectiveness. In comparing these two programmes, this study made use of a crossover research design with data collection according to DE Vos. Participants were 28 third‐year students (14 men and 14 women), aged 20 to 23 ( x = 21.6 ± 0.7) from the Northwest University (Potchefstroom Campus) in South Africa. Both interviews and questionnaires (n = 28) were used to gather comprehensive data. Results indicated medium‐(d = 0.5) to‐practically significant (d ≥ 0.8) changes in most of the ROPELOC (Review of Personal Effectiveness and Locus of Control) variables. Each programme offered unique benefits. The EBWP resulted mainly in improvements in terms of the personal aspects of the ROPELOC, whereas the CBAP mainly delivered in terms of its social aspects. Even though both programmes seem to be beneficial for the facilitation of personal effectiveness, each programme should be selected according to the envisaged outcomes and intervention criteria. For the improvement of personal effectiveness, the EBWP seems to be of relatively more value – mainly on account of the impact of the wilderness environment. This translates into unique experiences of solitude, privacy and freedom of choice, spiritual upliftment, and restoration.     

Gradualism Versus Shock Therapy: (Re)Interpreting the Chinese and Russian Experiences

The concepts of gradualism and shock therapy are reconsidered in respect of the Chinese and Russian experiences. It is suggested that success in reform is determined not only by sharp and speedy measures for attaining macroeconomic financial stabilization, but also, more importantly, how rapidly a critical mass of genuine market forces and competition can be achieved in the microeconomic sphere. In contrast to the orthodox interpretation, it is concluded that the ‘weighted combination’ of macroeconomic and microeconomic reforms in China can be regarded as true ‘shock therapy’, which has brought the Chinese reforms to a successful outcome. In contrast, despite initial macro-financial shock, the Russian reforms have been slow and inconsistent and, for that reason, less successful than in China.     

胃癌的化疗和综合治疗进展

回顾了近年来国内外众多关于治疗胃癌的文献，系统阐述了癌症的治疗反应和评估方法的研究进展，尤其是药物剂量、疗效、适应证、生存率等。化疗或综合治疗可用于晚期病人以及术前和／或术后病人。术前化疗可以提高根治性切除率。用于术后病人可能减少复发、转移。术后于腹腔内注入化疗药，可能预防腹膜播散。总之，化疗及综合治疗可能降低胃癌的复发，并对延长生存期有益。