Tackling Addiction with Integrated Care

Addiction is recognised as one of the chronic illnesses, often leading to medical, psychological, economic, and social problems, making multi-dimensional care for these people within the existing system a challenge. This loads an already loaded primary and secondary care system. The Verslavingskoepel Kempen (VKK) is an initiative to answer this challenge as it aims to integrate the care provided by the zeroth to third-line care around addiction treatment. Zeroth refers to the care and support provided by the human context of the patients, such as family and peers. This extends the integrated care model that is suggested by the WHO. The aim of the dissertation is firstly, to identify the organizational aspects crucial for the success of the network. The Findings show that success is confirmed by participating local communities when highlighting the importance of the intramural connection between their community social services and professionals, hospitals, and experience holders. All interviewees recognize collateral and process leadership with resources emerging from different partners and without hierarchical management. The second aim considers whether success must be attributed to the instrumental organizational aspects of the collaboration or the values of the different caregivers. The Findings show that in this network the organizational aspects and the caregivers’ values are complementary. The third aim is to develop conclusions on the transferability of the network model. This is confirmed;however, the governmental policy is not accompanied by a funding system within the institutionalized remuneration and reimbursement structure. It makes the initiative dependent on the motivation of partner organizations to participate financially, raises doubt about the sustainability of the initiative, and sets conditions for as well as limitations on transferability.

Tackling Addiction with Integrated Care

Addiction is recognised as one of the chronic illnesses, often leading to medical, psychological, economic, and social problems, making multi-dimensional care for these people within the existing system a challenge. This loads an already loaded primary and secondary care system. The Verslavingskoepel Kempen (VKK) is an initiative to answer this challenge as it aims to integrate the care provided by the zeroth to third-line care around addiction treatment. Zeroth refers to the care and support provided by the human context of the patients, such as family and peers. This extends the integrated care model that is suggested by the WHO. The aim of the dissertation is firstly, to identify the organizational aspects crucial for the success of the network. The Findings show that success is confirmed by participating local communities when highlighting the importance of the intramural connection between their community social services and professionals, hospitals, and experience holders. All interviewees recognize collateral and process leadership with resources emerging from different partners and without hierarchical management. The second aim considers whether success must be attributed to the instrumental organizational aspects of the collaboration or the values of the different caregivers. The Findings show that in this network the organizational aspects and the caregivers’ values are complementary. The third aim is to develop conclusions on the transferability of the network model. This is confirmed;however, the governmental policy is not accompanied by a funding system within the institutionalized remuneration and reimbursement structure. It makes the initiative dependent on the motivation of partner organizations to participate financially, raises doubt about the sustainability of the initiative, and sets conditions for as well as limitations on transferability.

Genesis of Schizophrenia: An Introspective Review

Research and Results: Schizophrenia begins with nasal obstruction, disrupting supraschalemic nucleus output and lateralized ultradian body rhythms. If one nostril is blocked, vaso-choking occurs in the ipsilateral brain hemisphere cortex, which has vesicles connected to the nose. This disturbs the ultradian balance of the body and brain hemispheres causing abnormal behavior and bizarre thinking. The brain has a bidirectional connection and communication with the body via the nervous system. The Hypothalamic-Pituitary-Adrenal (HPA) axis, Autonomic Nervous System (ANS), and vagus nerve are linked. ANS lateralization can switch from parasympathetic to sympathetic due to vagus nerve changes. Schizophrenia is characterized by Basic Rest Activity Cycle (BRAC) energy balance disruption. Let’s examine how a disruption in the lateralization of the nasal cycle can lead to pathology in the mind. Purpose and Method: A literary search is conducted in comparison with authors’ introspective insights to summarize schizophrenia’s genesis after curing this disease to fill the knowledge gap between a few relevant theories to build a percept of the disease through this (mini) narrative review. Conclusion: Nasal cycle and vagus nerve toning can play roles in mental health.

性别发育异常性心理发育评估及价值研究进展

性别发育异常患儿的性别分配复杂,需要包括内分泌科、泌尿外科及心理科在内的多学科学组及患儿父母的共同讨论决定。其中心理学方面的评估越来越引起人们的重视。儿童性别认同及性别角色的全面评估可避免成年期性别焦虑的发生,目前有多种儿童性别角色行为心理评估量表,学龄前儿童活动量表和儿童性别角色量表评估相对简单,可为性别分配、后续激素替代和外阴整形手术提供参考依据。

心理健康服务设备发展研究与应用

随着我国经济社会飞速发展,出现心理问题、行为异常和精神障碍的人数逐年增多,对心理健康服务的需求大幅增加。其中,基于互联网技术的心理健康服务相关设备和产品研发,是强化心理健康服务的重要保证,也是构成心理健康服务体系的重要组成部分。心理健康服务的方式是多种多样,心理咨询服务是重要方式之一,心理咨询室设备和产品按功能室配套各不相同,各有侧重。目前,心理咨询服务专业化、网络化、智能化、中医化趋势显著,在互联网+时代下,心理咨询服务设备网络系统的完善,会使心理咨询成效提升更为明显。

美国关于学校性教育的争论（美国学校性教育现状简介之二）

本文是概括性介绍了“单纯禁止性交教育”和“综合性性教育”争论的历史、二者的异同及争论的焦点．

Perception and Attitude of Employers towards Employees with AUD in an Emerging Economy: A Qualitative Enquiry

Background: The disease, addiction to chemical substances or drugs such as alcohol (ethanol, C2H5OH) 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. Methods: 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. Results: 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. Conclusions: 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.

Effect of Sleep Quality on Mental Health during COVID-19 Lockdown

The study was done with the aim of understanding the“Effect of Sleep Quality on Mental Health of Adults during COVID-19 Lockdown”.136 adults aged between 18 to 32 years were selected through snowball sampling from social media platforms for being a part of the study sample.The Sleep Condition Indicator(Espie,2014)and General Health Questionnaire(GHQ-12)(Goldberg and Williams,1988)were used to measure their sleep quality and mental health.It was hypothesized that the sleep quality will have a significant effect on the mental health of adults.It was found out that sleep quality is a significant predictor of mental health.The researcher stated that clinicians and psychologists should investigate about the sleeping patterns and quality of sleep in patients reporting mental health issues,and screen sleeping disorders regularly in population to avoid development of mental health disorders.

综合性学校性教育指导纲要（美国学校性教育现状简介之三）

本文是作者概括性地介绍美国学校性教育现状的系列文章(共三部份)之第三部份。较详细地介绍了<综合性学校性教育指导纲要>。

Preliminary Receiver Operating Characteristic Analysis on Voice Handicap Index of Laryngeal Inflammation in Greek Patients

Objective(s): Laryngeal inflammations lead to voice disorders. Medical conditions such as chronic laryngitis, gastroesophageal reflux, laryngopharyngeal reflux, Reinke edema and/or vocal folds hemorrhage, result in diverse symptoms including chronic cough, throat cleaning and dysphonia (e.g. hoarseness). In turn, the dysphonic symptoms can be evaluated via subjective and objective procedures. The objective procedures usually include self-perceived questionnaires like the Voice Handicap Index (VHI). Studies reported that VHI can distinguish objectively dysphonic and non-dysphonic populations using the cut-off points of Receiver Operating Characteristic Curves. The purpose of this study was to calculate the cut-off points for individuals exhibiting voice symptoms which had been developed from laryngeal inflammatory diseases in Greece. Methods: One hundred and twelve participants (90 non-dysphonic and 22 dysphonic) filled in the Hellenic Voice Handicap Index (VHI) and the Greek translated version of Voice Evaluation Template (VEF) were administrated. All subjects were evaluated by an Otolaryngologist and a Speech-Language Pathologist. Results: The group with voice disorders exhibited higher VHI scores (in total and in its 3 subdomains) compared to non-dysphonic subgroup. Statistical significant differences were found for all VHI’s total cut-off point of 19.50 (sensitivity: 0.882, 1-specificity: 0.011) and for its three subdomains [functional 6.50 (sensitivity = 0.636, and 1-specificity = 0.022);physical 9.50 (sensitivity = 0.636, and 1-specificity = 0.000);emotional 6.50 (sensitivity = 0.455, and 1-specificity = 0.133)]. Conclusion: The preliminary results showed that VHI could discriminate individuals having voice disorders from laryngeal inflammations. The Voice Handicap Index can be used as a primary health care tool and a self-monitoring procedure in acute and sub-acute phases of the laryngeal inflammation.

Storylines of family medicine Ⅳ:perspectives on practice—lenses of appreciation

Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine,as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world.In‘Ⅳ:perspectives on practice—lenses of appreciation’,authors address the following themes:‘Relational connections in the doctor–patient partnership’,‘Feminism and family medicine’,‘Positive family medicine’,‘Mindful practice’,‘The new,old ethics of family medicine’,‘Public health,prevention and populations’,‘Information mastery in family medicine’and‘Clinical courage.’May readers nurture their curiosity through these essays.

苯巴比妥和卡马西平应用于儿童期癫痫的副作用:随机对照研究

目的比较两种最常用的抗癫痫药物——苯巴比妥和卡马西平在孟加拉儿童癫痫患者中应用时的行为学副作用。设计前瞻性随机对照单中心研究。地点孟加拉 Dhaka 儿童专科医院。对象 108例2～15岁全身性强直-阵挛发作(51例)或局限性继发全身性发作(57例)的患儿。主要结局评估指标癫痫控制和行为学副作用。结果 91例患儿随访12个月。6例需改用其他抗癫痫药物。比较了85例患儿的药物副作用。药物治疗和随访1年,在随访中的后1/4时间,71例患儿未再癫痫发作。随机分组后,苯巴比妥组32例102天、卡马西平组39例74天未再癫痫发作。10例患儿行为学问题增多,其中4例不能接受(苯巴比妥组1例,卡马西平组3例)。但独立 t 检验显示,两组试验药物间没有显著性差异。结论在资源缺乏的国家,苯巴比妥不引起癫痫儿童过多的行为学副作用。临床试验注册号 NCT00381537[ClinicalTrials.gov]。

The Science of Happiness

In the introduction to his 2004 book The Geography of Thought：How Asians and Westerners Think Differently…and Why,U.S.social psychologist Richard E.Nisbett describes how a＂brilliant young student＂from China prompted him to switch his focus to cultural psychology with the statement：＂you know,the difference between you and me is that I think the world is a circle and you think it＇s a line.＂

面部移植 一种修复重度面部损伤的新方法

世界上第一例面部移植手术已经由法国报道了，但是判断它是否是整形再造外科一个新领域开始的标志，还要根据其临床结果而定。长期以来，面部移植手术一直被认为是技术上的挑战，但它在临床上是可行的。。对面部重度畸形的患者来说，这项手术的优点是对其功能、美容和心理均有所改善，而缺点是要求长期应用免疫抑制剂，所以争论的关键在于该手术是否利大于弊。