Coping with adverse drug events in patients with heart failure: Exploring the role of medication beliefs and perceptions

This study describes coping strategies that patients with heart failure (HF) use to manage adverse drug events (ADEs). The included coping strategies were social support seeking, information seeking, non-adherence and taking alleviating medication. The role of beliefs about medication and ADE perceptions in explaining these coping strategies was assessed using the Self-Regulation Model. We performed a cross-sectional study including 250 HF patients who experienced an ADE. Patients completed validated questionnaires assessing their coping strategies, ADE perceptions and medication beliefs. Social support (60%) and information seeking (32%) were the most commonly used strategies to cope with ADEs. Non-adherence was reported by 7% of the patients. Multivariate linear regression analysis showed that demographics, clinical factors and medication beliefs explained only a small amount of the variance in coping strategies, whereas ADE perceptions explained a substantial amount of variance. Path analysis showed that patients’ perceptions about the timeline, consequences and controllability of ADEs by the health care provider were directly related to their coping behaviour. The effect of patients’ medication beliefs on their coping strategies was consistent with mediation through their ADE perceptions. Our results support the value of the Self-Regulation Model in understanding patients’ coping behaviour with regard to ADEs.     

重组人粒细胞集落刺激因子预防肿瘤化疗后Ⅲ度以上骨髓抑制的疗效分析

探讨重组人粒细胞集落刺激因子(rhG-CSF)对初诊晚期肿瘤患者化疗后骨髓抑制的合理预防用药时机.采用前瞻性随机方法,筛选首次化疗后出现Ⅲ度～Ⅳ度骨髓抑制的肿瘤患者,以化疗前24h内给予rhG-CSF的为预防治疗组;以化疗前未预防性给药为对照组,采用组间对照法,比较两组化疗后骨髓抑制的发生情况.结果发现两组的骨髓抑制发生率,预防组明显低于对照组,且Ⅲ度以上骨髓抑制发生率也明显降低.首次化疗后出现Ⅲ度～Ⅳ度骨髓抑制的肿瘤患者,下次化疗前24h内预防性给予rhG-CSF,能有效控制肿瘤化疗后骨髓抑制的发生,降低感染的风险,值得推广.     

心力衰竭的药物及非药物治疗

神经内分泌激活、心室重构是收缩性心力衰竭进展的关键机制,针对上述机制的生物学治疗包括血管紧张素转换酶抑制剂、β受体阻滞剂、盐皮质激素受体拮抗剂等可显著改善心力衰竭患者预后,利尿剂、洋地黄等常规药物治疗可改善心力衰竭症状、降低心力衰竭住院风险,为神经内分泌拮抗剂的应用奠定基础;近年来,从阻断心力衰竭发生机制方面研发了很多新药,但尚没有一种能对长期生存率有显著改善.器械治疗(植入型心脏复律除颤器、心室再同步和心室再同步心脏复律除颤器)可降低特定心力衰竭患者病死风险,预防猝死发生,显著改善预后;心室辅助装置及干细胞治疗则为心力衰竭治疗带来新的曙光.     

On anxiety-specific actions of tranquilizers

Abstract

This study examined the role of social support in the relationship between work demand and psychological distress (GHQ 12) in correctional officers (N=419), a high stress occupational group. Work demands were positively associated with strain. There was no evidence that social support buffered the negative impact of work demands. Rather, consistent with most previous research findings, support showed direct benefits and these were discussed in the context of worker participation and control. The hypothesis that officers high in negative affectivity, as measured by trait anxiety would show greater reactivity to work demands was not supported. However, trait anxiety appeared to inflate the relationship between work stressors (work demand and work support) and psychological distress supporting recent suggestions that the role of trait anxiety in occupational stress should not be disregarded. Trait anxiety combined additively with work demand to predict individual differences in psychological distress, however social support moderated the impact of trait anxiety on strain.     

Evidence That Episodic Memory Impairment During Tobacco Abstinence Is Independent of Attentional Mechanisms

Previous studies have demonstrated reductions in episodic memory during nicotine withdrawal. However, these studies have been unable to dissociate memory reductions from losses in attention associated with tobacco abstinence. In the present study, the authors sought to determine whether episodic memory reduction is a primary effect of nicotine withdrawal during tobacco abstinence. Heavy smokers were tested when smoking normally and following 24 hrs of abstinence. Participants were tested with a recognition memory task in which items were studied under full and divided attention conditions. Forward digit span and backward digit span were also included as control measures. Withdrawal was associated with a reduction in memory performance that was independent of attention at encoding. The authors conclude that impairment of episodic memory is a primary effect of nicotine withdrawal during tobacco abstinence. Further research is required to determine if this is associated with continued use of tobacco and cessation failures.     

Infant Expressions in an Approach/Withdrawal Framework

Since the introduction of empirical methods for studying facial expression, the interpretation of infant facial expressions has generated much debate. The premise of this article is that action tendencies of approach and withdrawal constitute a core organizational feature of emotion in humans, promoting coherence of behavior, facial signaling, and physiological responses. The approach/withdrawal framework can provide a taxonomy of contexts and the neurobehavioral framework for the systematic, empirical study of individual differences in expression, physiology, and behavior within individuals as well as across contexts over time. By adopting this framework in developmental work on basic emotion processes, it may be possible to better understand the behavioral principles governing facial displays, and how individual differences in them are related to physiology and behavioral function in context.     

Severe Social Withdrawal: Cultural Variation in Past Hikikomori Experiences of University Students in Nigeria,Singapore, and the United States

Hikikomori (social withdrawal that lasts six months or longer) is a growing problem among Japanese adolescents and young adults, with recent estimates that approximately 1% of Japanese youths will suffer from an episode of hikikomori in their lifetimes. What remains unclear is whether hikikomori is a culture-bound syndrome or a condition impacting youths around the globe. Hence, the self-reported prevalence and psychosocial correlates of past experiences with hikikomori were examined in cross-sectional samples of university students from Singapore (n?=?147), Nigeria (n?=?151), and the United States (n?=?301). Following tests of measurement invariance, comparisons showed that past experiences with hikikomori were related to elevated levels of current loneliness and depressive symptoms in each sample. However, analyses also revealed evidence of cultural variation in both the prevalence and the psychosocial correlates associated with past experiences of hikikomori, which taken together, provide preliminary evidence that the culture-bound characterization of hikikomori may not be appropriate.     

The Orsino complex: Men who love themselves as love objects

Abstract

The Duke Orsino, in Shakespeare's Twelfth Night, is cited as the archetypal embodiment of a psychological complex which, it is argued, may affect many men in modern patriarchal societies. This condition named the ‘Orsino complex’ is characterized by the subject's experience of being in love with himself as a love object. It is the consequence of the subject's very early experience of his mother's dual psychological reactions to him as a male child. The first of these, and the more significant, I have called maternal phallic projection, while the second I term maternal withdrawal. I also consider the influence of the father upon this complex.

While this paper remains speculative in its present form—that is, its central thesis is based on fictional and not on clinical material—it might, I hope, assist all of us working psychodynamically in understanding further some of the severe problems that male clients present in their relationships with women, as well as directing further research into the complexities of gender identity in contemporary society.     

斑马鱼模式动物在神经功能环路研究中的应用

斑马鱼是发育、遗传以及药物发现研究中常用的模式动物.作为重要的脊椎动物模式系统之一,斑马鱼与人类基因有高度同源性,中枢神经系统也与哺乳动物相似.近来,斑马鱼在神经科学研究以及生理心理学相关问题的研究中的应用日益广泛.研究者们对斑马鱼幼鱼及成鱼的行为表现及行为发育开展了多方面的研究.基于斑马鱼模式动物的特点及优势,遗传突变和药物筛选在对动物行为表现的分子机制的研究中起到重要的推动作用.