Randomized controlled trial of an intervention to prevent adherence failure among HIV-infected patients initiating antiretroviral therapy.

OBJECTIVE: Compare the efficacy of a multicomponent social support intervention to standard-of-care counseling on medication adherence among HIV-infected patients initiating antiretroviral therapy. DESIGN: Randomized controlled trial. Generalized estimating equations tested for differences in the percentage of participants achieving 90% adherence. MAIN OUTCOME MEASURES: Pill-taking, electronically monitored over 6 consecutive months; plasma viral load (VL), assessed at 3 and 6 months following initiation of therapy. RESULTS: Of 226 participants who were randomized and began the trial, 87 (38%) were lost to the study by 6 months. The proportion of adherent participants declined steadily over time, with no time by group interaction. Sustained adherence was associated with increased odds of achieving an undetectable VL (OR=1.78; 95% CI=1.01, 3.13). In intention-to-treat analyses, a larger proportion of the intervention group than the control group was adherent (40.15% vs. 27.59%, p=.02) and achieved an undetectable VL p=.04). However, the majority of participants who remained on study experienced some reduction in VL (>or=1-log drop or undetectable), regardless of experimental condition. CONCLUSION: The multicomponent social support intervention significantly improved medication adherence over standard-of-care counseling; evidence for improved virologic outcomes was inconsistent. Early discontinuation of care and treatment may be a greater threat to the health of HIV patients than imperfect medication-taking.     

COVID-19, Sex,Addictions, Women's Health,Care of the Elderly,and Medical Education

Journal of Religion and Health -     

A review of research on chaplains and community-based clergy in the Journal of the American Medical Association, Lancet, and the New England Journal of Medicine: 1998-2000

Based on the content analysis of quantitative research appearing in three medical journals, the authors conclude that, despite the shared ideal of providing spiritual care to patients on the part of physicians and chaplains, there is little attention given in these journals demonstrating and promoting this shared perspective. Suggestions for future research that would focus on this common medicine/religion interface and concern are noted.     

Arguments for adjuncts

It is commonly assumed across the language sciences that some semantic participant information is lexically encoded in the representation of verbs and some is not. In this paper, we propose that semantic obligatoriness and verb class specificity are criteria which influence whether semantic information is lexically encoded. We present a comprehensive survey of the English verbal lexicon, a sentence continuation study, and an on-line sentence processing study which confirm that both factors play a role in the lexical encoding of participant information.     

脂多糖激活所致大鼠抑郁样行为及对海马神经细胞钾电流变化的影响

采用细胞因子刺激剂脂多糖(lipopolysaccharide, LPS)为免疫激活手段, 研究LPS诱导的免疫激活产生的抑郁样行为及对海马神经细胞电压依赖钾电流变化的影响。应用膜片钳技术对海马神经细胞钾电流进行全细胞记录, 比较抑郁样行为大鼠与正常大鼠钾离子通道电流密度和激活特性的变化。结果发现, 与生理盐水对照组相比, 一次LPS注射后2 hr, 实验组动物产生抑郁样行为, 同时急性观察的海马神经细胞的钾离子通道的电流密度呈现显著升高(p<0.01); 而一次LPS注射后24 hr, 动物的抑郁样行为消失, 且急性观察的海马神经细胞的钾离子通道与对照组相比较, 其电流密度和激活曲线没有显著性变化。结论：LPS诱导的抑郁样行为, 与LPS诱导的海马神经细胞电压依赖钾电流的上调在时程上同步, 提示钾离子通道可能参与免疫激活所致的抑郁样行为。     

父母心理控制与小学生的欺负行为:敌意归因和冷酷无情的作用检验

采用班级整群抽样法选取1847名3~6年级小学生（男生987名;平均年龄10.73±1.16岁）及其家长为被试,采用问卷法考察父母心理控制与小学生欺负行为的关系,同时探讨敌意归因和冷酷无情的中介作用。结果发现：（1）父母心理控制显著正向预测小学生的欺负行为;（2）冷酷无情在父母心理控制与小学生欺负行为间的关系中存在中介作用,敌意归因不发挥中介作用;（3）父母心理控制对小学生欺负行为影响的中介机制不存在显著的性别差异和学段差异。本研究结果表明,冷酷无情是父母心理控制影响小学生欺负行为的重要机制,但敌意归因不是。研究者和实践者应注重对欺负者情感加工能力的关注和干预。     

帕金森病与重症抑郁障碍两者中的抑郁及睡眠障碍特征对比

由于帕金森病早期常仅存在抑郁、睡眠障碍等非运动症状表现,其与重症抑郁障碍难以鉴别.本研究通过对帕金森病患者及重症抑郁障碍患者行汉密尔顿抑郁量表、匹兹堡睡眠指数及多导睡眠监测评定抑郁及睡眠特征,尝试发现两者之间差异,为早期鉴别及诊断帕金森病提供理论基础.     

基于利益相关者角度分析居民健康档案存在的问题及对策

居民健康档案对政府、卫生机构、居民都具有重要意义.健康档案工作开展时间不长,还存在诸多不足.主要总结其在管理、质量、利用、信息化建设、管理对象等方面存在的不足,从利益相关者角度分析影响因素,并针对政府、基层医疗卫生机构、卫生人员这三方具有较大影响力的利益相关者提出促进健康档案实施建议.     

Smiles as signals of lower status in football players and fashion models: Evidence that smiles are associated with lower dominance and lower prestige

Across four studies, the current paper demonstrates that smiles are associated with lower social status. Moreover, the association between smiles and lower status appears in the psychology of observers and generalizes across two forms of status: prestige and dominance. In the first study, faces of fashion models representing less prestigious apparel brands were found to be more similar to a canonical smile display than the faces of models representing more prestigious apparel brands.?In a second study, after being experimentally primed with either high or low prestige fashion narratives, participants in the low prestige condition were more likely to perceive smiles in a series of photographs depicting smiling and non-smiling faces. A third study of football player photographs revealed that the faces of less dominant (smaller) football players were more similar to the canonical smile display than the faces of their physically larger counterparts. Using the same football player photographs, a fourth study found that smiling was a more reliable indicator of perceived status-relevant personality traits than perceptions of the football players' physical sizes inferred from the photographs.     

从不同高血压防治指南的比较看高血压治疗策略的变化

为减少因高血压造成的各种心血管事件,世界不同地区制定或修订了适合自己的高血压防治指南。通过对JNC7、ESH/ESC及2004年中国高血压防治指南的比较及分析,以便能更全面、正确地理解和发展我国新的高血压指南,并将该指南灵活运用于实际工作。