药学评估思维在住院患者药学干预中的应用

临床药师在药学查房工作中建立药学评价和药师干预评估思维,为药学查房工作提供参考。临床药师对住院患者的治疗全过程做出药学评估,包括对初始治疗方案的合理性、风险、矛盾的评估,治疗过程中对病情变化、治疗方案变化的评估,出院时对出院后病情防复发、防进展、防恶化以及如何康复的评估。临床药师应将药学评估思维运用到住院患者治疗过程中,利用药学专业优势,参与临床药物治疗,在临床治疗团队中真正发挥作用,能促进患者合理用药。

     

FDA儿童药物临床试验规范化对我国的启示

对美国食品药品监督管理局（Food and Drug Administration,FDA）儿童药物临床试验的规范化进行界定,发现我国面临儿童用药方面存在安全隐患、儿童药物临床试验存在需求缺口、儿童药物临床试验审查不够规范等现实困境,引发规范儿童药物临床试验的关键性思考。借鉴FDA对儿童药物临床试验的规范化实践,总结FDA儿童药物临床试验相关法案、临床试验指南文件以及对伦理审查委员会的监管措施,得出完善儿童药物临床试验专门法规和指南、加强相关伦理委员会监管和指导、规范儿童药物临床试验伦理审查、加大儿童受试者保护力度等对我国的启示。

     

工作投入研究的现状

工作投入指的是一种与工作相关的积极、完满的情绪与认知状态,具有持久性和弥散性的特点。工作投入对个体的工作绩效和某些工作态度及行为变量,以及顾客满意度、生产力、利润率和单位总体绩效等组织结果变量均具有一定的影响。工作投入的影响因素包括个体特征因素、与工作相关的因素以及与家庭相关的因素等3个方面。文章在对工作投入的相关研究进行全面述评的基础上,指出未来的研究有必要进一步加强对工作投入的干预机制等五方面问题的探讨     

领导-部属交换的多维结构及对工作绩效和情境绩效的影响

通过两项研究,对领导-部属交换的结构及其对员工的工作绩效和情境绩效进行了探讨。采用探索性因素分析、验证性因素分析、分层回归分析等方法对来自不同企业的员工及其主管的问卷调查结果进行了分析。 结果表明,领导-部属交换是一个多维度的结构,由情感、忠诚、贡献和专业尊敬四个维度组成。单维度的领导-部属交换和多维度的领导-部属交换都对员工的工作绩效和情境绩效具有预测作用,但多维度领导-部属交换的预测作用更强。     

环境中的风险认知特征

采用多维度的心理测量范式,研究公众在“影响程度”、“可控性”、“了解程度”、“影响的持续性”、“发生的可能性”、“结果的严重性”六个维度上对39个环境条目的风险认知特征。研究结果验证了“风险程度指标”,并将环境风险划分为“生态环境”“疾病与灾害”“生活环境”三个大类并探讨其风险认知特征。结果显示,由“客观认识”和“主动作用”两维度形成的认知地图可有效地指导风险沟通。     

Differences in High and Low Anxiety Sensitive Women's Responses to a Laboratory‐Based Cold Pressor Task

Anxiety sensitivity (AS) has been linked to a variety of disabling chronic health conditions, including pain‐related conditions. A recent study has found that healthy women with high AS reported significantly higher levels of sensory and affective pain on an experimental cold pressor task compared to women with low AS. However, this study found no differences between AS groups for pain tolerance or pain threshold. In the present study, which was designed to replicate and extend these findings, 90 undergraduate university women were selected for inclusion in 1 of 2 AS groups (high or low) based on their screening scores on a 16‐item measure of AS. Participants were tested individually on a lab‐based cold pressor task using a variety of self‐report and observer‐measured variables. Data analyses revealed that, as expected, the high AS participants reported significantly more fear in response to the cold pressor on a relevant item of the McGill Pain Questionnaire – Short Form (SF‐MPQ) than did the low AS participants. Also as expected, the high AS participants reported more pain in response to the cold pressor on the Present Pain Index (PPI) of the SF‐MPQ than did the low AS participants. High AS participants did not differ from low AS participants on other aspects of the cold pressor response (e.g. pain threshold, pain tolerance, pain recovery). These results support the role of pain‐related fear as a mediating variable between AS and increased perceived pain intensity.     

个人化设计在临床研究中的应用——从个体角度研究个体差异

本文从有关研究证据的基础上,介绍了个人化设计的理论基础和实验设计,并在此基础上讨论了个人化设计在临床研究领域中的应用价值,总结出一种适合临床病人使用的研究程序。个人化设计允许对个体的个人价值进行分析,并能同时研究不同刺激信息的作用,在个体水平上分析个体差异。通过简化了的实验程序,个人化设计为解决临床研究中的问题提供了一种新的思维方式。文中还对相关研究法的局限进行了讨论。     

Psychometric properties and factor structure of the Fear Questionnaire phobia subscale items in two normative samples

Normative data for the Fear Questionnaire (Marks & Mathews, 1979), a popular self-report instrument measuring phobic concerns, were collected from both a community and a collegiate sample. The covariation and internal consistency of the blood-injury phobia (BI), social phobia (SO), and agoraphobia (AG) subscales were assessed in each sample, and the factor structure of the items from these three subscales was examined. Results indicated that, in general, community subjects reported more phobic concerns than did collegiate subjects, and females reported greater phobic concerns than did males. Results from confirmatory factor analyses suggest that the three factors of BI, SO, and AG did not emerge from either data set. Follow-up exploratory factor analyses did identify the general factors of blood-injury phobia and agoraphobia. Normative data from the present study are compared to those obtained previously, and directions for future research are provided.     

In search of average growth: Describing within-year oral reading fluency growth across Grades 1–8

Measures of oral reading fluency (ORF) are perhaps the most often used assessment to monitor student progress as part of a response to intervention (RTI) model. Rates of growth in research and aim lines in practice are used to characterize student growth; in either case, growth is generally defined as linear, increasing at a constant rate. Recent research suggests ORF growth follows a nonlinear trajectory, but limitations related to the datasets used in such studies, composed of only three testing occasions, curtails their ability to examine the true functional form of ORF growth. The purpose of this study was to model within-year ORF growth using up to eight testing occasions for 1448 students in Grades 1 to 8 to assess (a) the average growth trajectory for within-year ORF growth, (b) whether students vary significantly in within-year ORF growth, and (c) the extent to which findings are consistent across grades. Results demonstrated that for Grades 1 to 7, a quadratic growth model fit better than either linear or cubic growth models, and for Grade 8, there was no substantial, stable growth. Findings suggest that the expectation for linear growth currently used in practice may be unrealistic.     

The protection of patients’ rights in clinical trials

The Helsinki Declaration is a very important document regarding the protection of patients’ rights in clinical trials and one of the fundamental sources of operational principles for every ethics committee. Although they have been updated, the international guidelines for ethics committees continually fail to address certain issues pertaining to the protection of patients’ rights in clinical trials. These issues include, most significantly, the method of electing ethics committees (a free, secret ballot should be preferred to direct appointment), the avoidance of conflict of interest during the election of ethics committee members, and the necessary insurance coverage for the participants of clinical trials. Polish law should, on the other hand, be developed in such way as to not limit the effectiveness of ethics committees in protecting patients’ rights in clinical trials. The ideal solution would be to draft a uniform law concerning not only clinical trials, but all medical experiments. The opinions of experts who have been reviewing medical research projects for several years may prove to be especially valuable in this setting. This paper was presented at the 6th International Bioethics Conference on the subject of ‘The Responsible Conduct of Basic and Clinical Research’, held in Warsaw, Poland, 3–4 June 2005. The author is Chairman, Bioethics Committee of the Warsaw Regional Chamber of Physicians and Dentists.