药物治疗的风险及其处理

造成药物治疗风险的因素包括药物因素、病情因素、患者因素、用药因素及管理因素等。通过对药物进行严格监管,对医药从业人员加强培训和教育,对民众开展科普教学和用药指导,可以降低药物治疗的风险。风险事件主要表现为用药差错、药物不良反应或药物治疗无效。在药物治疗中,首先必须时刻警惕和及时发现风险;其次需要全面评估风险,还要对疾病风险和药物治疗风险进行比较。应尽可能避免药物治疗的风险,对于必须承受的风险,需采取相应措施,减少风险事件发生的概率和严重程度。如果存在较大风险,务必同时设计处理风险事件的预案,并与患者及其家属保持良好的交流和沟通。     

Effect of brand name on consumers' risk perceptions of online shopping

The purpose of the present study was to investigate the relationship between brand names and consumers' perceived risk. Hypotheses dealt with whether the presence of a product's brand name affects consumers' perceived risk towards shopping online; whether the familiarity with a brand name influences consumers' perceived risk; and whether online shoppers and non‐shoppers perceive risk towards shopping online differently. Results indicate that the presence or absence of a product's brand name affects online shoppers' perceived risk, but in the opposite direction to that expected. There was no significant difference between online shoppers' perceived risk vis‐à‐vis brand familiarity; however, online shoppers possessed lower perceived risk than non‐shoppers. Implications and limitations are discussed and recommendations for future research are provided. Copyright © 2004 Henry Stewart Publications Ltd.     

Remembering the Summer of 2020

How will historians and theologians remember the summer of 2020? This article leverages a socio-ethical analysis and response to twenty years of sacralized and sacrificial U.S. war-culture, and the meaning of this history, given the shifting cultural tectonic plates in the summer of 2020, and intersecting social ills of climate crisis, racism, inequality, and pandemic.     

Préservation d’une image positive de soi dans un cadre de vie « à risque »

According to social identity theory (Tajfel, 1972), individual try to maintain a positive self-image. Places at which he/she is attached contribute to identity building (Proshansky et al., 1983; Twigger-Ross & Uzzell, 1996). Therefore, individual will try to maintain a positive a positive and stable image of such places. Our study is interested in what is the representation of their living area for individuals living in coastal area considered as exposed to erosion/flood risk, and attached to it. We are focused on how this representation influences their perception to coastal risk. We assume that individual attached to a place which he/she consider as “at risk” will put in place a strategy to preserve the positive image of this place and of himself/herself. Analyzing answers to a questionnaire, results demonstrate that individuals considering a place which they are attached as “at risk” mitigate the danger impact on that space. Thus, they conciliate probability of such negative event on place which they identifying themselves with positive image of this place and, by extension, of themselves.     

Bullies,blades, and barricades: Practical considerations for working with adolescents expressing concerns regarding gender and identity

ABSTRACT

Background: Adolescents, by their very nature and need for maturity, struggle with issues of the self and identity, while challenging the very systems that are there to support them. However, gender diverse adolescents may become detached and overwhelmed as a trans identity solidifies during this time. Bullies, blades and barricades describes the challenges, hardship and dispossession that some gender diverse adolescents face from interpersonal and intrapersonal conflicts, societal pressure and hostility.

Method: This paper utilizes the current research on safety and risks affecting trans youth, the authors clinical experience of trans and gender diverse adolescents, and recommendations in the literature for professional care and support of gender diverse adolescents to identify the various ways gender diverse adolescents are negatively affected by their experiences.

Results: Bullying is not limited to school or peer environments and may be present in adolescents' homes, in local communities, in professional services or from sources of information such as the media. The physical dangers gender diverse adolescents face may arise from victimization, violence or rejection, or self-harming behaviors due to negative beliefs, fear or frustration. Barriers preventing disclosure and expression of gender and/or identity may stem from negative experiences, rejection, pubertal changes, imposed limitations, dependence upon school, home or legal environments, or other spheres of influence.

Discussion: Affirmative approaches, individual focus, recognition of family dynamics, inclusion of significant others, advocacy in school and local community environments as well as professional training are the most commonly recommended interventions. This paper provides an inclusive review of the myriad of challenges confronting gender diverse adolescents including often unrecognized forms of pressure, oppression and restrictions. This paper aims to support clinicians by contextualizing the adversity that gender diverse adolescents face and offers strategies for engagement and intervention.     

Cognitive development in children of adolescent mothers: The impact of socioeconomic risk and maternal sensitivity

BackgroundAdolescent motherhood is accompanied by a constellation of risk factors that translate into developmental risk for the off-spring. Socioeconomic risk that is associated with adolescent motherhood as well as maternal interactive behaviors may contribute to the impact of adolescent motherhood on children’s developmental outcome.ObjectiveTherefore, the aim of the current study was to investigate differences in children’s cognitive development between children of adolescent and adult mothers in their first two years of life and to examine whether socioeconomic risk (e.g. such as educational and financial problems) and/or maternal sensitivity mediate developmental differences between children of adolescent and adult mothers.MethodsAdolescent mothers (<21 years; N = 64) and adult mothers (>25 years; N = 34) and their infants were included in the current study. Child cognitive development and maternal sensitivity were assessed at three different time points (T1: mean child age 5.26 months; T2: mean child age 14.69 months; T3: mean child age 21.16 months).ResultsChildren of adult mothers showed better cognitive performance at T3 compared to children of adolescent mothers but not at T1 and T2. A multiple mediation model including socioeconomic risk and maternal sensitivity as serial mediators demonstrated that the effect of adolescent motherhood on cognitive development was mediated in a causal effect chain with socioeconomic risk negatively affecting maternal sensitivity and maternal sensitivity affecting children’s cognitive development.DiscussionThe present findings demonstrate that maternal interactive behaviors are not only a simple predictor of cognitive development but may also act as a mediator of the association between more distal variables such as socioeconomic risk and cognitive development in adolescent mothers. This supports the need to promote prevention and intervention programs for adolescent mothers during the early postpartum period to reduce socioeconomic problems and enhance maternal interactive behaviors.     

Attachment styles and clinical correlates in people at ultra high risk for psychosis

Evidence suggests that attachment styles may influence subclinical psychosis phenotypes (schizotypy) and affective disorders and may play a part in the association between psychosis and childhood adversity. However, the role of attachment in the initial stages of psychosis remains poorly understood. Our main aim was to describe and compare attachment styles in 60 individuals at ultra high risk for psychosis (UHR) and a matched sample of 60 healthy volunteers (HV). The HV had lower anxious and avoidant attachment scores than the UHR individuals (p < .001). Sixty-nine percentage of the UHR group had more than one DSM-IV diagnosis, mainly affective and anxiety disorders. The UHR group experienced more trauma (p < .001) and more mood and anxiety symptoms (p < .001). Interestingly, in our UHR group, only schizotypy paranoia was correlated with insecure attachment. In the HV group, depression, anxiety, schizotypy paranoia, and social anxiety were correlated with insecure attachment. This difference and some discrepancies with previous studies involving UHR suggest that individuals at UHR may compose a heterogeneous group; some experience significant mood and/or anxiety symptoms that may not be explained by specific attachment styles. Nonetheless, measuring attachment in UHR individuals could help maximize therapeutic relationships to enhance recovery.     

Are Decisions Made by Group Representatives More Risk Averse? The Effect of Sense of Responsibility

We tested the hypothesis that a sense of responsibility drives group representatives' decisions to be more risk averse compared with decisions made by individuals. The hypothesis was supported when the monetary considerations (i.e., payoff inequality and the magnitude effect) were controlled for in the potential gain domain as well as in the potential loss domain. Evidence showed that this is because the group representatives were concerned about how they would view themselves (e.g., guilt and self‐blame) and also how they would be viewed by others (i.e., to avoid being blamed and looked down upon by others). This study provided new insights into understanding group representatives' decision making under risk. Copyright © 2017 John Wiley & Sons, Ltd.     

Comparing What to What,on What Scale? The Impact of Item Comparisons and Reference Points in Communicating Risk and Uncertainty

The mandated public availability of individual hospital's audit data for children's heart surgery in the UK creates a challenging scenario for communicating these complex and sensitive data to diverse audiences. On the basis of this scenario, we conducted three experiments with the aim of understanding how best to help lay people understand these data and the practical goal of improving the public presentation of these data. The experiments compared different outcome measures for displaying the survival rate (percentage scale versus the ratio of the predicted/observed rates) and presentation formats (individual hospital versus all hospitals shown) for outcomes data presented relative to prediction intervals generated by a risk model that adjusts for case mix. Our data highlight how easily inappropriate comparisons can influence evaluations of complex data: for instance, both a survival ratio of 1 and the presence of other hospitals seemingly provided reference points that resulted in inappropriately harsh evaluations of some hospitals. By drawing on evaluability theory, we demonstrate how to enhance people's understanding of these complex data while also discouraging inappropriate comparisons, which has implications for communicating risk and uncertainty and for choice architecture design in a range of contexts. Copyright © 2018 John Wiley & Sons, Ltd.