医学教育中隐性课程的相关性研究

近年来,隐性课程的研究成为一个热点问题,特别是在高等教育领域备受关注。从教育界对隐性课程的研究角度（隐性课程的概念、特征、功能、建设与管理几个方面）切入,对实践中存在的一些问题进行分析,以期对以后的研究有所帮助。     

Emerging adult identity following adolescent experiences with psychotropic medications: A retrospective study

This study examines the perceptions of mental illness identity among a group of emerging adults based on their retrospective experiences with diagnoses and psychotropic medication use during their earlier formative adolescent years. A short questionnaire was administered via online social media platforms to volunteers between the ages of 19 and 30 and who self-identified as having taken psychotropic medication between the ages of 12 and 18 (N = 46). Correlation analysis revealed that several variables were associated with a stronger illness identity, including participant’s happiness with their medication experiences, the belief that medication made them more like their “true” selves, and the belief that their diagnosis was accurate. Content analysis of participant narratives suggested themes related to discontinuation and barriers to adherence. These results contribute to the growing knowledge base around lived experiences of psychiatric medication use and suggest further study on how to advance more informed and compassionate mental health care.     

Obtaining Informed Consent When a Profession Labels Itself as Providing Treatment for Mental Illness

Abstract

This paper examines when informed consent laws mandating explanation of the risks and benefits for proposed treatments (some talk intervention) and alternative to the proposed treatments (e.g., medications) apply to the social work profession. The reasons why an explanation of alternative treatments, including explaining medications, might be part of securing informed consent are proffered. Following this, consideration of how the task of explaining alternatives might be addressed is examined. The particular example of antidepressant medications provides a context for considering how to discuss medications as a treatment alternative. The kind of information a social worker might be obligated to possess and then impart to the client in fulfilling the task of obtaining informed consent is considered.     

Elderly Women Show Neither a Shortage of Strategies nor an Overreliance on Drugs in Handling Aging and in Dealing with Minor Health Problems

ABSTRACT

Women 65 years old and over make up the fastest growing population segment in North America. They are, particularly among the underprivileged, known to be heavy consumers of prescribed and over-the-counter drugs. The objective of this study was to identify the role of medication in underprivileged elderly women's strategies for aging well and dealing with minor health problems. A qualitative study was conducted among 40 women aged 65 to 75. Results show that elderly women seldom mention resorting to medication to “age well” although they report using this strategy to deal with minor health problems. Overall, the elderly women mentioned a wide range of strategies to cope with aging and minor health problems, which suggests that they are well equipped to face the challenges of aging.     

Stimulant Medication Use,Misuse, and Abuse in an Undergraduate and Graduate Student Sample

In this study, the authors investigated the characteristics of use, misuse, and abuse of stimulant medication (primarily methylphenidate and variants) among students at a northeastern US university. Researchers sent an invitation to take an Internet survey to student e-mail addresses and passed 150 paper surveys in undergraduate classes, analyzing 1,025 (975 electronically) returned surveys. Sixteen percent of respondents reported abusing or misusing stimulant medication. Ninety-six percent of respondents who specified a medication preferred to abuse or misuse Ritalin. Men and women reported similar use patterns. Most respondents who abused or misused stimulant medication swallowed pills; 40% used intranasally. Reasons for abusing or misusing stimulant medication included improving attention, partying, reducing hyperactivity, and improving grades. Consistent with previous studies, results suggest that abuse of stimulant medication is a concern on college campuses. The results point to various reasons for and methods of abusing and misusing stimulant medication that may direct future research, prevention, and intervention.     

Isoniazid Completion Rates for Latent Tuberculosis Infection Among College Students Managed by a Community Pharmacist

Objective: The authors' objective was to document 9-month and previously recommended 6-month treatment completion rates for latent tuberculosis infection (LTBI) in a pharmacistmanaged LTBI clinic in a community pharmacy on a college campus, and to describe patient characteristics. Participants: Participants were university students diagnosed with LTBI. Methods: The authors conducted a retrospective review of pharmacy records from 2000 to 2006. Main outcome measures included 6-month and 9-month LTBI treatment completion rates, total isoniazid (INH) tablets taken, characteristics of completers versus noncompleters, average time to treatment completion, and reported adverse drug events. Results: The 9-month completion rate was 59%, and the 6-month completion rate was 67%. Among those not completing treatment, 15.2% experienced fatigue and 2.2% experienced a rash (p = .04 and p = .03, respectively). Conclusion: LTBI clinics are a unique niche for community pharmacies and can provide individualized patient care to ensure LTBI treatment adherence, monitoring for disease progression, and safety of INH.     

Medication Abortion Within a Student Health Care Clinic: A Review of the First 46 Consecutive Cases

Abstract

Objective: Medication abortion with mifepristone and misoprostol has been available in the United States since 2000. The authors reviewed the first 46 medication abortion cases conducted at a university-based student health care clinic to determine the safety and feasibility of medication abortion in this type of clinical setting. Participants: Female patients presenting for medication abortion at a student health care clinic between October 1, 2006, and April 1, 2009. Methods: Retrospective consecutive case review. Results: Successful completion not requiring uterine aspiration occurred in 85% of the cases that were not lost to follow-up. Six cases (15%) required uterine aspiration for completion: 3 underwent uterine aspiration only; 3 had aspiration after failing an additional dose of misoprostol. Only 1 patient visited the emergency room. There were no hospitalizations. Conclusions: Medication abortion services in a student health care clinic are safe and feasible. However, additional treatment may be required with some patients.     

Efficacy and safety of orally disintegrating tamsulosin tablets in Taiwanese patients with benign prostatic hyperplasia

Objectives: Tamsulosin is an alpha-1 adrenoceptor antagonist applied in treating lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH). This study aimed to evaluate safety, efficacy and acceptance of newly formulated orally disintegrating tamsulosin tablets in Taiwanese patients with LUTS/BPH. Methods: This single center, non-comparative, observational study enrolled 45 male patients over age 50 years. All patients received 0.2?mg tamsulosin orally disintegrating tablets daily and were evaluated at weeks 0, 4, 8, 12 of the 12-week treatment period. Tamsulosin efficacy was evaluated by International Prostate Symptom Score (I-PSS) with 7 questions on urinary symptoms and one disease-specific quality-of-life question, with scores ranging from 0 (no symptoms) to 35 (highly symptomatic). Maximum flow rate (ml/s), voided volume (ml), flow time (s), and mean flow rate (ml/s) were measured. Danish prostatic symptom sexual function scale rated severity and associated concerns of erection quality, ejaculatory function and pain/discomfort were also assessed. Results: Patients’ mean ± SD age was 62.47?±?7.77 (range: 50–89) and mean ± SD I-PSS was 13.98?±?5.50. Statistically significant changes from baseline were found in post-test I-PSS and quality of life (both P < 0.001). Mean ± SD I-PSS decreased from 14.30?±?9.34 to 6.73?±?0.88 at patients’ final visit. Statistically significant increases in mean maximum flow rate and mean flow rate were found over 12-week study period (P < 0.05). No adverse events were reported. No significant differences were found in pulse, SBP/DBP or sexual function. Conclusion: Orally disintegrating tamsulosin tablets demonstrate acceptable safety and efficacy for acceptance and well tolerance by Taiwanese LUTS/BPH patients.     

Abstracts of theses,July 1955: Smith College School for Social Work

Abstract

This commentary amplifies the dynamic strategies in Message in a Bottleto consider in working with clients who seek to augment psychotherapy with psychopharmacologic treatment. This commentary also addresses how to evaluate and enhance psychotherapy outcome independent of medications and reviews some of the factors which contribute to positive treatment outcome. In order for clinicians to resist the pervasive colonizing effects of the medical model, this commentary reevaluates some of the claims that medications seem to promise and reinforces data which demonstrate that psychotherapy remains a safe and effective first-line treatment.