Segmental Hair Analysis—Interpretation of the Time of Drug Intake in Two Patients Undergoing Drug Treatment

The present study involved segmental testing of hair in two clinical cases with known dosage histories. Hair analysis confirmed the first patient's exposure to the prescribed sertraline and citalopram for several months. Citalopram was generally distributed along the hair shaft in accordance with the drug ingestion period. By contrast, “false” positive results were observed for sertraline in distal hair segments, corresponding to a period of no sertraline exposure, which may indicate incorporation from sweat or sebum, which transport the drugs along the hair surface. The second patient received various drugs during her treatment for brain cancer. Metoclopramide, morphine, oxazepam, paracetamol, sumatriptan, tramadol, and zopiclone, which had been part of the therapy, were all detected in the proximal hair segment. The results of these two cases indicated that results—especially concerning the time of drug intake—must be interpreted with caution and allow for the possibility of incorporation from sweat or sebum.     

Community mobilisation and HIV activism in Zimbabwe

ABSTRACT

Community mobilisation and activism is thought to encourage HIV testing and treatment and assist patient recovery. This article draws on interviews conducted with 60 people living with, and affected by HIV, in four marginalised areas of Harare, Zimbabwe. The lenses of civil society and social movements are used to analyse how people living with HIV draw on, and construct, systems of support based on the ways in which their communities know and understand the epidemic. I consider how neighbourhoods negotiate and assert community and individual needs in relation to HIV and how such systems can develop into community networks and wider coalitions. The article concludes by positing that, by interrogating official responses to the epidemic, HIV-related activism and social movements can help to domesticate formal commitments to international health protocols and compliance, particularly in terms of the intent, as well as the participatory rhetoric, of health based rights.     

电针预处理对缺血再灌注损伤大鼠脑自由基含量的影响

目的：观察电针预处理对脑缺血再灌注大鼠脑组织的二醛（MDA），谷胱甘肽（GSH）含量的影响，方法：用线栓法复制大鼠局灶性脑缺血模型，观察大鼠缺血2h再灌注后24h脑组织MDA，GSH的含量，结果：电针预处理能够显降低脑缺血再灌注大鼠脑组织MDA的含量（P＜0．01），同时GSH含量有升高趋势（P＞0．05），结论：电针预处理可以抑制大鼠脑缺血再灌注过程中自由基的生成，增强自由基清除力，从而起到抗脑缺血再灌注引起的自由基损伤，实现对中枢神经元的保护作用。     

Parent–child contact problems and family intensive interventions: The crisis of adolescent suicidality and the role of social media

Although clinicians, educators and parents have been alarmed by the decline in the mental health of children and adolescents commensurate with the Covid-19 pandemic, statistics indicate there has been a downward spiral over the last decade. This has been evident in the overall increase in suicide rates for young people. For legal and mental health professionals working in the Family Court system, this has provided unique challenges. Most vulnerable has been those children and adolescents embroiled in high conflict divorces, especially those exhibiting parent child contact problems. This article focuses upon that population exhibiting parent child contact problems, and their treatment, specifically Family Intensive Intervention. Building Family Resilience is an Intensive family treatment program that has had to address this deterioration in child and adolescent mental health and increase in suicidality. The role of social media in both exacerbating and/or ameliorating mental health issues is explored.     

A Bloodless Guerrilla Warfare: Why U.S. White Leftists Renounced Violence Against People During the 1970s

Between 1968 and the late 1970s, a significant number of U.S. white leftist groups escalated their protest to armed struggle. After experimenting briefly with violence, they opted for low-intensity armed propaganda that targeted property and avoided hurting people. By contrast, European leftist groups and anti-colonial organizations in the U.S. made extensive use of antipersonnel violence. Why did U.S. leftists eschew attacks against civilians? Scholarship does not explain this case, as it focuses either on the internal dynamics of a single group or on structural variables. Conversely, this article addresses this question through a historical reconstruction and a multilevel analysis. The research identifies the critique and ensuing de-solidarization by the radical milieu as the main factor accounting for the restraint of violence. This article demonstrates that the radical milieu censored and isolated armed groups as soon as they escalated and began to endanger human lives. Therefore, in order to safeguard the solidarity pact with their constituencies, violent fringes moderated their repertoires of action. This article employs primary sources and original interviews with militants to support this claim and to assess the relevance of three concurrent factors: the trauma generated by the “townhouse incident,” the deterrence by law enforcement, and the militants’ socio-economic background.     

Mentalisation-based therapy (MBT) in a high-secure hospital setting: expert by experience feedback on participation

Evidence for mentalisation-based therapy (MBT) is increasing in relation to the treatment of personality disorder. Individuals with personality disorder are over-represented in inpatient, forensic and forensic inpatient mental health services. This study explores MBT within a forensic setting as an intervention designed to moderate deficits linked to violence and to improve adaptive coping. Interpretative phenomenological analysis was conducted on interviews with four patients who completed MBT at a high-secure hospital. Findings suggest that MBT-enhanced participants’ mentalising which had a positive impact upon their capacity to manage their behaviour and emotions. MBT further enabled participants to process past experiences of violence and develop some degree of empathy for others, which led to a trend in abstinence from risk behaviours. Findings contribute a secure inpatient perspective on the experience of MBT and to MBT clinical outcomes.     

针刺调节缺血性脑卒中患者颅内动脉血流动力学参数临床观察

目的 采用经颅彩色多普勒检查评价针刺对缺血性脑卒中患者脑血流动力学参数的影响。方法 将100例缺血性脑卒中患者随机分为联合组和对照组,每组50例。联合组采用针刺风池、风府配合常规针刺治疗,对照组采用常规针刺治疗。采用改良爱丁堡+斯堪的纳维亚评分观察两组临床疗效;针刺后即刻、针刺2个疗程后,分别测定两组颅内各动脉平均血流速度(mean flow velocity,Vm)和血管搏动指数（pulsatility index,PI）。 结果 ①联合组临床疗效优于对照组（P<0.05）。②针刺后即刻,联合组各动脉Vm较针刺前均显著增加（P<0.01）,且联合组大脑后动脉(posterior cerebral artery,PCA)、大脑前动脉（anterior cerebral artery, ACA）、椎动脉（vertebral artery, VA）、基底动脉（basilar artery, BA）Vm较对照组显著增加（P<0.05,或P<0.01）;两组各动脉PI值与针刺前比较,及两组之间比较,差异均无统计学意义（P>0.05）。③针刺2个疗程后,两组各动脉Vm均较针刺前显著增加（P<0.01）;且联合组各动脉Vm均显著高于对照组（P<0.05）;联合组PCA、VA、BA的PI值较针刺前显著降低（P<0.05,或P<0.01）,且联合组PCA、VA的PI值显著低于对照组（P<0.05）。结论 针刺风池、风府配合常规针刺对缺血性脑卒中有较好的治疗作用,且脑血流量增加,脑血液循环改善明显。     

谈世博类大型安保检查站警员的自我调适

在上海世博、北京奥运等安保工作中都出现了＂护城河＂检查站。参加这样大型安保工作的检查站警员会因多种因素而导致出现诸多身心问题。因此,参加世博类大型安保检查站工作的警员要努力适应检查站的安全要求、树立正确的荣辱观、尽快找到归属感、学会自我激励、选择实施行为疗法,以保持自身旺盛的战斗力。     

Is regulatory innovation fit for purpose? A case study of adaptive regulation for advanced biotherapeutics

The need to better balance the promotion of scientific and technological innovation with risk management for consumer protection has inspired several recent reforms attempting to make regulations more flexible and adaptive. The pharmaceutical sector has a long, established regulatory tradition, as well as a long history of controversies around how to balance incentives for needed therapeutic innovations and protecting patient safety. The emergence of disruptive biotechnologies has provided the occasion for regulatory innovation in this sector. This article investigates the regulation of advanced biotherapeutics in the European Union and shows that it presents several defining features of an adaptive regulation regime, notably institutionalized processes of planned adaptation that allow regulators to gather, generate, and mobilize new scientific and risk evidence about innovative products. However, our in-depth case analysis highlights that more attention needs to be paid to the consequences of the introduction of adaptive regulations, especially for critical stakeholders involved in this new regulatory ecosystem, the capacity and resource requirements placed on them to adapt, and the new tradeoffs they face. In addition, our analysis highlights a deficit in how we currently evaluate the performance and public value proposition of adaptive regulations vis-à-vis their stated goals and objectives.     

Multidimensional Family Therapy in Theory and in Practice

This article reviews the family therapy case of an adolescent substance abuser through the lens of multidimensional family therapy (MDFT). Initially, the adolescent presented with suicidal ideation, depression, academic difficulties, and behavior problems. The family experienced chronically high levels of conflict, which related to the mother's depression, the father's harsh discipline, and the adolescent's sister's frequent suicidal threats and outbursts. Family therapeutic interventions helped to decrease family conflict and improve the adolescent's grades and behavior. In particular, conjoint work with the parents had a stabilizing effect on the family system. As predicted by MDFT, this stabilizing effect was shown to place the adolescent on a healthier developmental trajectory. Limitations of the case and implications for future research are also presented.