<strong>Background:</strong> The disease, addiction to chemical substances or drugs such as alcohol (<i>ethanol, C<sub>2</sub>H<sub>5</sub>OH<span style="white-space:n...<strong>Background:</strong> The disease, addiction to chemical substances or drugs such as alcohol (<i>ethanol, C<sub>2</sub>H<sub>5</sub>OH<span style="white-space:normal;"></span></i>) is still not accepted as a diagnostic nosology by many in Ghana. Many consider addiction as a moral challenge, rather than a medical condition. This perception is propagated even in the Ministry of Health’s Occupational Health and Safety (OHS) policy document which punishes symptoms of substance use disorders. This study seeks to explore the perception and attitude of employers towards employees with alcohol use disorders (AUD) and to ascertain the level at which employee assistance programs (EAPs) are implemented in organizations. <strong>Methods: </strong>To infer outcomes, the study adopted the qualitative approach. In-depth interviews and observations which describe the perceived attitudes of employers (using HR managers as proxy) towards employees with AUD of some selected hospitals (private and public) in the Greater-Accra Metropolis. The interview was conducted face-to-face using an interview guide, which included open-ended questions. The structure of the guide helped the researchers to observe the participants and the conversations were also audio-taped after seeking the consent of the participants. On average, the interview lasted between 45 and 60 minutes. <strong>Results:</strong> Findings from the 10 interviews revealed that a number of factors such as biological, environmental, social and psychological accounted for AUD among employees regardless of the nature of their work. Although the HR managers had knowledge on the possible causes of AUD, some of them explained that they could not identify alcohol use in their organisations. The few that admitted to AUD at their workplace reported that alcohol use did not have any effect on their productivity and most of these workers were temporal or causal workers, hence were not perceived as permanent staff. In spite of prevalence of AUD in some hospitals, it was interesting to know that majority of these facilities had no EAPs and the few that had policies on AUD were not implementing them. <strong>Conclusions:</strong> This paper focused on some aspect of HR managers’ perceived attitude toward an aspect of their employees’ mental wellbeing which is AUD in a work setting. However, there are other pertinent issues that are crucial to employee total wellbeing that can be addressed in future research.展开更多
目的·探究酒精使用障碍(alcohol use disorder,AUD)患者在不同情绪背景下的抑制控制表现及心理机制,了解情绪调节困难对抑制控制功能的影响。方法·招募28名男性AUD住院患者(AUD组)和28名年龄、受教育程度相匹配的健康对照(健...目的·探究酒精使用障碍(alcohol use disorder,AUD)患者在不同情绪背景下的抑制控制表现及心理机制,了解情绪调节困难对抑制控制功能的影响。方法·招募28名男性AUD住院患者(AUD组)和28名年龄、受教育程度相匹配的健康对照(健康对照组)。采用情绪Go/Nogo任务(愤怒/中性表情面孔)评估被试行为抑制功能,结合层级贝叶斯漂移扩散模型(hierarchical drift-diffusion model,HDDM)量化他们的认知参数(漂移率、决策阈值、非决策时间)。通过情绪调节困难量表(Difficulties in Emotion Regulation Scale,DERS)和酒精使用障碍筛查量表(Alcohol Use Disorders Identification Test,AUDIT)进行临床评估,并运用bootstrap法检验有调节的中介效应模型。结果·AUD组在DERS总分及所有子维度(目标导向行为、冲动控制、策略获取、情绪清晰性)得分均高于健康对照组,差异有统计学意义(均P<0.05)。行为层面,与健康对照组相比,AUD组误按率[F_((1,54))=8.62,P=0.005]与遗漏率[F_((1,54))=4.28,P=0.043]更高,且愤怒面孔刺激反应时普遍延长[F_((1,54))=12.26,P=0.001]。认知建模显示AUD组漂移率显著低于健康对照组[F_((1,54))=15.56,P<0.001],提示信息加工效率受损。有调节的中介模型显示,在愤怒面孔刺激条件下,漂移率部分中介组别对误按率的影响,总间接效应值为9.564(95%CI 3.874~16.387);进一步分析表明,高水平情绪调节困难(比平均值高1个标准差)条件下间接效应增强至10.133(95%CI 3.963~17.927),而低水平(比平均值低1个标准差)时效应为9.011(95%CI 3.778~14.921)。结论·AUD患者信息加工效率的降低部分解释了患者的抑制控制功能障碍,且该影响与个体情绪调节能力存在关联。提示社会威胁信息加工异常可能是AUD患者,特别是在情绪调节能力较弱的个体抑制控制功能损害的重要影响因素。展开更多
In the present study, we aimed to evaluate the intervention effect of prophylactic antibiotic use in thyroid surgery in a large hospital. From 2004 to 2012, 70 patients who underwent thyroid surgery were randomly sele...In the present study, we aimed to evaluate the intervention effect of prophylactic antibiotic use in thyroid surgery in a large hospital. From 2004 to 2012, 70 patients who underwent thyroid surgery were randomly selected each year. The quality of surgical antibiotic prophylaxis （SAP） was assessed each year in terms of antibiotic ratio, choice, duration, timing, combination, route of administration and so on. The result showed that the SAP ratio was 100% from 2004 to 2010. With our intervention, this SAP ratio was decreased to 45.7% in 2011, and it reached 2.9% in 2012. The AUD was consistently greater than 38 before 2010, while it rapidly declined to 1 in 2012. The number of DDDs per 100 operations was decreased from 431 to 3 after the intervention. The average cost of antibiotic drugs per patient was RMB 350.65 in 2010, whereas it was decreased to RMB 18.51 in 2012. The average duration of hospitalization showed no difference during the intervention. This study indicated that implementation of a multi-disciplinary protocol and clinical pharmacist interventions could improve the rational use of SAP.展开更多
目的:探究白假丝酵母的耐药率变迁与抗真菌药物使用强度(antibiotics use density,AUD)之间的相关性,为临床合理使用抗真菌药物提出参考。方法:抽取2013年—2018年医院住院病区收治的疑似真菌感染患者标本中分离出的白假丝酵母4026株,...目的:探究白假丝酵母的耐药率变迁与抗真菌药物使用强度(antibiotics use density,AUD)之间的相关性,为临床合理使用抗真菌药物提出参考。方法:抽取2013年—2018年医院住院病区收治的疑似真菌感染患者标本中分离出的白假丝酵母4026株,分析其对常用抗真菌药物的耐药率及其变化趋势,并采用Pearson法分析白假丝酵母的耐药率与常用抗真菌药物使用强度的相关性。结果:2013年—2018年分离出4026株白假丝酵母的药敏结果显示,其对氟康唑、伊曲康唑和伏立康唑的耐药率为3.42%~11.18%,呈现逐年升高趋势(P<0.05);而其对5-氟胞嘧啶的耐药率低于前3种抗真菌药物;但6年间其对两性霉素B的耐药率为0.00%;白假丝酵母对氟康唑、伊曲康唑和伏立康唑的耐药率与氟康唑的AUD呈显著正相关(r=0.908,P_(0.012)<0.05;r=0.939,P_(0.005)<0.05;r=0.838,P_(0.037)<0.05);对氟康唑和伊曲康唑的耐药率与卡泊芬净的AUD呈显著正相关(r=0.828,P_(0.042)<0.05;r=0.849,P_(0.033)<0.05)。结论:临床氟康唑和卡泊芬净的AUD与白假丝酵母对氟康唑等唑类抗真菌药物的耐药率具有高度正相关,规范合理使用氟康唑和卡泊芬净有利于降低白假丝酵母的耐药率。展开更多
文摘<strong>Background:</strong> The disease, addiction to chemical substances or drugs such as alcohol (<i>ethanol, C<sub>2</sub>H<sub>5</sub>OH<span style="white-space:normal;"></span></i>) is still not accepted as a diagnostic nosology by many in Ghana. Many consider addiction as a moral challenge, rather than a medical condition. This perception is propagated even in the Ministry of Health’s Occupational Health and Safety (OHS) policy document which punishes symptoms of substance use disorders. This study seeks to explore the perception and attitude of employers towards employees with alcohol use disorders (AUD) and to ascertain the level at which employee assistance programs (EAPs) are implemented in organizations. <strong>Methods: </strong>To infer outcomes, the study adopted the qualitative approach. In-depth interviews and observations which describe the perceived attitudes of employers (using HR managers as proxy) towards employees with AUD of some selected hospitals (private and public) in the Greater-Accra Metropolis. The interview was conducted face-to-face using an interview guide, which included open-ended questions. The structure of the guide helped the researchers to observe the participants and the conversations were also audio-taped after seeking the consent of the participants. On average, the interview lasted between 45 and 60 minutes. <strong>Results:</strong> Findings from the 10 interviews revealed that a number of factors such as biological, environmental, social and psychological accounted for AUD among employees regardless of the nature of their work. Although the HR managers had knowledge on the possible causes of AUD, some of them explained that they could not identify alcohol use in their organisations. The few that admitted to AUD at their workplace reported that alcohol use did not have any effect on their productivity and most of these workers were temporal or causal workers, hence were not perceived as permanent staff. In spite of prevalence of AUD in some hospitals, it was interesting to know that majority of these facilities had no EAPs and the few that had policies on AUD were not implementing them. <strong>Conclusions:</strong> This paper focused on some aspect of HR managers’ perceived attitude toward an aspect of their employees’ mental wellbeing which is AUD in a work setting. However, there are other pertinent issues that are crucial to employee total wellbeing that can be addressed in future research.
文摘In the present study, we aimed to evaluate the intervention effect of prophylactic antibiotic use in thyroid surgery in a large hospital. From 2004 to 2012, 70 patients who underwent thyroid surgery were randomly selected each year. The quality of surgical antibiotic prophylaxis （SAP） was assessed each year in terms of antibiotic ratio, choice, duration, timing, combination, route of administration and so on. The result showed that the SAP ratio was 100% from 2004 to 2010. With our intervention, this SAP ratio was decreased to 45.7% in 2011, and it reached 2.9% in 2012. The AUD was consistently greater than 38 before 2010, while it rapidly declined to 1 in 2012. The number of DDDs per 100 operations was decreased from 431 to 3 after the intervention. The average cost of antibiotic drugs per patient was RMB 350.65 in 2010, whereas it was decreased to RMB 18.51 in 2012. The average duration of hospitalization showed no difference during the intervention. This study indicated that implementation of a multi-disciplinary protocol and clinical pharmacist interventions could improve the rational use of SAP.
文摘目的:探究白假丝酵母的耐药率变迁与抗真菌药物使用强度(antibiotics use density,AUD)之间的相关性,为临床合理使用抗真菌药物提出参考。方法:抽取2013年—2018年医院住院病区收治的疑似真菌感染患者标本中分离出的白假丝酵母4026株,分析其对常用抗真菌药物的耐药率及其变化趋势,并采用Pearson法分析白假丝酵母的耐药率与常用抗真菌药物使用强度的相关性。结果:2013年—2018年分离出4026株白假丝酵母的药敏结果显示,其对氟康唑、伊曲康唑和伏立康唑的耐药率为3.42%~11.18%,呈现逐年升高趋势(P<0.05);而其对5-氟胞嘧啶的耐药率低于前3种抗真菌药物;但6年间其对两性霉素B的耐药率为0.00%;白假丝酵母对氟康唑、伊曲康唑和伏立康唑的耐药率与氟康唑的AUD呈显著正相关(r=0.908,P_(0.012)<0.05;r=0.939,P_(0.005)<0.05;r=0.838,P_(0.037)<0.05);对氟康唑和伊曲康唑的耐药率与卡泊芬净的AUD呈显著正相关(r=0.828,P_(0.042)<0.05;r=0.849,P_(0.033)<0.05)。结论:临床氟康唑和卡泊芬净的AUD与白假丝酵母对氟康唑等唑类抗真菌药物的耐药率具有高度正相关,规范合理使用氟康唑和卡泊芬净有利于降低白假丝酵母的耐药率。
