医疗安全问题经济后果及构成因素

医疗安全问题导致了严重的经济后果.本文分别从个人、医院、社会三个方面详细阐述了住院病人医疗安全经济后果的构成因素,以及国内外关于医疗安全经济后果的研究现状和研究进展,提出我国的医院管理中致力于医疗安全研究的必要性.     

医疗安全问题经济后果及构成因素

医疗安全问题导致了严重的经济后果。本文分别从个人、医院、社会三个方面详细阐述了住院病人医疗安全经济后果的构成因素,以及国内外关于医疗安全经济后果的研究现状和研究进展,提出我国的医院管理中致力于医疗安全研究的必要性。     

脂肪细胞因子与2型糖尿病的防治

脂肪细胞因子与2型糖尿病并发症关系密切,随着对胰岛素抵抗(IRS)在2型糖尿病作用的认识,脂肪细胞因子的提出,使2型糖尿病并发症防治观念发生了根本的转变,提出了2型糖尿病并发症关防治新策略:从以降糖治疗为主到全面综合防治.对脂肪细胞因子和脂肪细胞因子与2型糖尿病并发症的关系的认识,体现了循证医学的思想和创新思维的启动.     

脂肪细胞因子与2型糖尿病的防治

脂肪细胞因子与2型糖尿病并发症关系密切,随着对胰岛素抵抗(IRS)在2型糖尿病作用的认识,脂肪细胞因子的提出,使2型糖尿病并发症防治观念发生了根本的转变,提出了2型糖尿病并发症关防治新策略:从以降糖治疗为主到全面综合防治。对脂肪细胞因子和脂肪细胞因子与2型糖尿病并发症的关系的认识,体现了循证医学的思想和创新思维的启动。     

基于不公平感的谣言对转基因风险评价的影响

谣言是常见的社会现象,但其传播过程的"心理黑箱"还是缺乏探索的问题。在情绪评价理论的基础上,采用对照实验,通过转基因食品情景模拟来考察不公平谣言及辟谣行为对风险认知评价及情绪的影响。结果表明:(1)转基因风险评价产生的情绪可分为后果型和伦理型;(2)不公平感会导致更强烈的伦理型及后果型情绪,并使得被试倾向于高估转基因风险;(3)辟谣对转基因风险评价能起到一定干预作用,但不能完全抵消谣言对情绪的影响。     

胰岛素抵抗与2型糖尿病关系的新思考

胰岛素抵抗(IR)与2型糖尿病关系密切,对IR的认识,经历了几十年反复的过程,胰岛素抵抗综合征(IRS)的提出使2型糖尿病防治观念发生了根本的转变,提出了2型糖尿病防治新策略:从以降糖治疗为主到全面防治心血管疾病.对IR的认识和IR与2型糖尿病的关系,体现了辩证唯物主义认识论和系统论的观点.     

2型糖尿病辨证分型与客观指标研究进展

总结近年2型糖尿病中医辨证分型和客观量化指标之间关系的研究进展,认为某些客观指标和糖尿病的辨证分型有一定的相关性,可为2型糖尿病中医辨证客观化指标提供依据,提出目前2型糖尿病辨证分型客观化存在的一些问题,初步探讨解决问题的思路和研究方向.     

2型糖尿病辨证分型与客观指标研究进展

总结近年2型糖尿病中医辨证分型和客观量化指标之间关系的研究进展,认为某些客观指标和糖尿病的辨证分型有一定的相关性,可为2型糖尿病中医辨证客观化指标提供依据,提出目前2型糖尿病辨证分型客观化存在的一些问题,初步探讨解决问题的思路和研究方向。     

2型糖尿病胰岛素治疗探讨

过去,人们(包括医护人员)对2型糖尿病的胰岛素治疗存在许多误区。通过糖尿病的流行病学,2型糖尿病的发病机制,早期胰岛素治疗对2型糖尿病的意义,及胰岛素的种类、剂型,和使用方法(包括补充疗法和替代疗法),以及2型糖尿病的治疗现状,来阐述胰岛素治疗对2型糖尿病的必要性。     

2型糖尿病胰岛素治疗探讨

过去,人们(包括医护人员)对2型糖尿病的胰岛素治疗存在许多误区.通过糖尿病的流行病学,2型糖尿病的发病机制,早期胰岛素治疗对2型糖尿病的意义,及胰岛素的种类、剂型,和使用方法(包括补充疗法和替代疗法),以及2型糖尿病的治疗现状,来阐述胰岛素治疗对2型糖尿病的必要性.     

系统思维方法在2型糖尿病综合治疗中的应用

分析系统方法主要基本原则在2型糖尿病治疗中的指导性作用。揭示在医学科学研究中自觉,主动运用辩证法思维方法和系统科学方法,可以拓展研究的新思路,为糖尿病的治疗提供更好方案。     

Subjective Wellbeing Among Adults with Diabetes: Results from Diabetes MILES—Australia

This study examines the subjective wellbeing of Australian adults with diabetes who completed the Diabetes MILES—Australia survey, investigating by diabetes type and treatment, and by comparing with the subjective wellbeing of the general Australian adult population. In addition, the extent to which depression and socio-demographic factors account for subjective wellbeing is investigated. People with type 1 or type 2 diabetes have significantly lower subjective wellbeing compared to the general population, even after controlling for covariates (demographic and socio-economic status, diabetes duration, body mass index, number of diabetes-related complications, and depression). Furthermore, adults with type 2 diabetes using insulin to manage their condition report the lowest levels of subjective wellbeing, and are also most likely to report dissatisfaction with their current health. These findings suggest that living with diabetes, and in particular, living with type 2 diabetes and using insulin, strongly challenges the maintenance of subjective wellbeing.     

The effectiveness of a proactive coping intervention targeting self-management in diabetes patients

Objective: The study’s aim was to investigate psychological, behavioral and medical long-term outcomes of an existing self-management intervention targeting the development of proactive coping skills (e.g. goal setting and identifying barriers) in type 2 diabetes patients. The study aimed to replicate prior research showing the intervention’s effectiveness, and to extend it by (a) adding booster sessions and (b) prolonging the period of follow-up measurement to capture long-term effects.

Design/outcome measures: A total of 141 type 2 diabetes patients were included in the intervention. The intervention employed a 5-step approach to target proactive coping skills. Psychological (e.g. proactive coping and self-efficacy) and behavioural variables (e.g. self-care, diet and physical activity) were assessed at baseline (T1), after the initial phase of the intervention (T2), after the booster phase (T3) and at follow-up (T4), comprising a total period of 15 months. Medical variables were assessed at T1 and T4.

Results: Employing piecewise Latent Growth Curve Modelling, results showed that participants improved on all psychological and behavioural variables during the initial phase and maintained these improvements over 12 months. The booster phase yielded no further improvements. Mixed findings were obtained on medical outcomes.

Conclusion: The original intervention is effective, but the added value of the booster sessions is uncertain.     

妊娠期糖尿病管理策略

妊娠期糖尿病(gestational diabetes mellitus,GDM)是指妊娠期发生或首次发现的不同程度的糖代谢异常。未加控制的妊娠期高血糖可对母子产生极大的围产期和远期危害。妊娠后糖代谢发生明显变化妊娠期血糖的管理和控制与非孕期不同。GDM一经确诊,应及时干预,加强母儿监测,控制妊娠期血糖,以降低母儿并发症,改善围生儿结局;产后对母儿严密随访,异常者给予相应处理,以减少或延缓产妇在产后发展为成为2型糖尿病的可能及预防子代发生肥胖、高血压、糖尿病等代谢综合征的发生。     

癫痫的诊治与人文思想

癫痫是神经科常见的疾病之一,对于患者的学习、生活和工作均有不同程度影响。它的发病机制尚不十分清楚,主要是以药物治疗为主。在癫痫的诊断中要根据病情和患者的实际情况选择合适的检查;在癫痫的治疗中须按照最优化的医疗原则选择最佳的治疗方案。在治疗中要注意结合人文思想来提高癫痫的治疗效果。     

The Effect of Genetic Counseling for Adult Offspring of Patients with Type 2 Diabetes on Attitudes Toward Diabetes and its Heredity: A Randomized Controlled Trial

The aim of this study is to investigate the effect of diabetes genetic counseling on attitudes toward diabetes and its heredity in relatives of type 2 diabetes patients. This study was an unmasked, randomized controlled trial at a medical check-up center in Japan. Subjects in this study are healthy adults between 30 and 60 years of age who have a family history of type 2 diabetes in their first degree relatives. Participants in the intervention group received a brief genetic counseling session for approximately 10 min. Genetic counseling was structured based on the Health Belief Model. Both intervention and control groups received a booklet for general diabetes prevention. Risk perception and recognition of diabetes, and attitude towards its prevention were measured at baseline, 1 week and 1 year after genetic counseling. Participants who received genetic counseling showed significantly higher recognition about their sense of control over diabetes onset than control group both at 1 week and 1 year after the session. On the other hand, anxiety about diabetes did not change significantly. The findings show that genetic counseling for diabetes at a medical check center helped adults with diabetes family history understand they are able to exert control over the onset of their disease through lifestyle modification.     

Positive emotion and health: going beyond the negative.

This study examined the relationships between positive emotions and health. Two positive emotions were considered, hope and curiosity, in conjunction with 3 physician-diagnosed disease outcomes: hypertension, diabetes mellitus, and respiratory tract infections. Medical data were abstracted over a 2-year period from 1,041 patient records from a multispecialty medical practice, and emotions were assessed through a mailed questionnaire. Across 3 disease outcomes, higher levels of hope were associated with a decreased likelihood of having or developing a disease. Higher levels of curiosity were also associated with decreased likelihood of hypertension and diabetes mellitus. Results suggest that positive emotion may play a protective role in the development of disease.     

A Methodological Review of Faith-Based Health Promotion Literature: Advancing the Science to Expand Delivery of Diabetes Education to Black Americans

Non-traditional avenues, such as faith-based organizations (FBOs), must be explored to expand delivery of diabetes self-management education (DSME) to benefit Black Americans with type 2 diabetes (T2D). The purpose of this study was to methodologically review the faith-based health promotion literature relevant to Blacks with T2D. A total of 14 intervention studies were identified for inclusion in the review. These studies detailed features of methods employed to affect health outcomes that DSME similarly targets. Analysis of the faith-based studies?? methodological features indicated most studies used (1) collaborative research approaches, (2) pre-experimental designs, (3) similar recruitment and retention strategies, and (4) culturally sensitive, behaviorally oriented interventions with incorporation of social support to achieve positive health outcomes in Black Americans. Findings indicate FBOs may be a promising avenue for delivering DSME to Black Americans. Informed by the findings, a focused discussion on advancing the science of faith-based interventions to expand delivery of DSME to Black Americans with diabetes is provided.     

控制糖尿病的新观念和基本方略之管见

跟踪糖尿病发展趋势、吸收新理论和新技术、做好科普宣传、推行超强化治疗、坚持医学理性精神是控制糖尿病的新观念.其基本方略就是超强化治疗、控制高血压,拮抗新生2型糖尿病及其并发症、控制相关危险因素.     

下腰痛综合征的诊治与人文思想

下腰痛是一种常见的骨科病症,轻者可影响患者生活,重者可使患者丧失劳动力。它的发病原因有很多,治疗方法各有不同。在下腰痛的诊断中要按照适度医疗的原则选择合适的检查;在下腰痛的治疗中须按照最优化医疗的原则选择最佳的治疗方案。在治疗中要注意结合人文思想来提高下腰痛的治疗效果。