中国人口健康转型与医学整合

当前中国处于人口健康转型阶段,慢性病主要危险因素处于失控状况,潜在危险日益严重,疾病的直接、间接负担呈明显的加速趋势,健康形式不容乐观。推进医疗、预防、保健的整合,从保健政策上支持医学整合,是控制危险因素,遏止、扭转和减少慢性病的蔓延非常关键性的措施。     

国际健康目标与卫生改革的新导向——重视预防保健的作用

由于认识到卫生系统的大部分资源主要花费在疾病的治疗上,这种资源配置不当不仅导致巨额医疗费用负担和低效率,并没有获得好的健康结果;因此,近年许多发达国家的健康目标与卫生改革出现了一个新的导向,日益重视预防保健的作用;并采取优先选择的方式,确保资源优先配置给对人群健康最需要、资源投入最具有成本效果的保健服务。这种改革已取得了一些成效。这一改革导向对我国正在进行的医药卫生体制改革的制度设计与政策开发提供了启示。     

国际健康目标与卫生改革的新导向——重视预防保健的作用

由于认识到卫生系统的大部分资源主要花费在疾病的治疗上,这种资源配置不当不仅导致巨额医疗费用负担和低效率,并没有获得好的健康结果;因此,近年许多发达国家的健康目标与卫生改革出现了一个新的导向,日益重视预防保健的作用;并采取优先选择的方式,确保资源优先配置给对人群健康最需要、资源投入最具有成本效果的保健服务.这种改革已取得了一些成效.这一改革导向对我国正在进行的医药卫生体制改革的制度设计与政策开发提供了启示.     

从哲学眼界论医学、健康安全与卫生经济

从哲学眼界看,医学与健康都是多元的概念,是许多相互交叉、渗透、影响、制约的因素互相作用的结果。医学、健康保健应适应经济水平,即我们应向患者及社会提供一个安全的、科学的、用的起的、可持续的医疗与健康保健服务。较多贪婪的、不安全的医学时代,最好的计划是不断进行几元钱的预防医学投入和适当的姑息医学。     

从哲学眼界论医学、健康安全与卫生经济

从哲学眼界看,医学与健康都是多元的概念,是许多相互交叉、渗透、影响、制约的因素互相作用的结果.医学、健康保健应适应经济水平,即我们应向患者及社会提供一个安全的、科学的、用的起的、可持续的医疗与健康保健服务.较多贪婪的、不安全的医学时代,最好的计划是不断进行几元钱的预防医学投入和适当的姑息医学.     

已婚育龄少数民族妇女生殖健康现状调查研究

已婚育龄妇女的生殖健康水平影响家庭经济和后代素质,存在着民族差异.笔者调查少数民族已婚育龄妇女生殖健康现状,从社会、经济、文化等方面分析发现,民族、文化水平、经济状况、社会生殖保健服务体系是其影响因素.在生活方式、禁忌习俗与社会风尚方面,如何兴利除弊、因势利导和促进男女平等是改善各民族生殖健康状况的关键.     

唐山市社区居民“三高”疾病认知调查

本研究通过一对一的访谈方式,针对唐山市中老年居民高血压、高血糖、高血脂的患病率及认知率进行了调查问卷。运用Epidata进行数据录入,SPSS软件进行统计描述。分析结果显示样本人群“三高”患病率较高,并有较高的认知度,但认识存在盲区和偏差。该调查分析为有针对性地提出预防与控制策略提供信息支持。因此,为了提高人们对健康体检的认识,必须加强“三高”疾病的健康教育,提高人们对“三高”的知晓率,纠正错误认识,加强自我预防。     

药物替代品电子记录可改变医师处方习惯：一个具有代表性的观察研究

本研究背景为一家健康保健维护组织（HMO）提供给医生有关HMO的推荐药物的替代品的电子记录。目的是调查研究影响医师遵守和评估相关的医疗成本节约的因素。此研究的设计是一个横断面观察研究,研究对象是从2005年6月至2006年2月HMO的诊所的所有医生。     

浅谈健康体检管理与人文关怀的渗透

健康观念的更新催生了各式各样的健康体检机构，健康体检服务成为时下最受欢迎的医疗服务项目之一，而且存在着巨大的市场空间，预示着医疗服务业体检经济的到来。如何做好体检服务满足人们不断提升的健康服务需求，提高自身竞争力，是健康体检管理者永远的课题。     

乌鲁木齐市流动人口社区卫生服务需求与利用调查分析

基于问卷调查所得数据,通过描述性统计分析及多元Logistic回归分析,结果显示,样本流动人口对健康指导、定期健康体检、孕期保健、老人或小孩保健服务等社区卫生服务项目的主观需求较高;但当他们生小病时,选择去社区卫生服务中心/站就诊的比例只有19.0%,其中,民族、文化程度、在户籍地参加医疗保险类型、来乌鲁木齐务工时间4个因素会影响流动人口的就医选择;同时,样本流动人口两周患病率较低,而且患病者中一半以上的人会选择治疗,其中就诊机构选择方面,选择去社区卫生服务中心/站的较高。     

Suicidal Ideation and Associated Factors Among School-Going Adolescents in Harare,Zimbabwe

This study determined the prevalence and associated factors of suicidal ideation among school-going adolescents in Harare, Zimbabwe. Data on 1970 respondents were obtained from a cross sectional study of the Global School-based health survey. Respondents were selected using a two-stage probability sampling technique. The prevalence of suicidal ideation was 21.6%. Males were less likely to have suicidal ideation than females (OR=0.70; 95% CI 0.54,0.91). Worrying (OR=1.81; 95% CI 1.29,2.56), feeling of loneliness (OR=2.04; 95% CI 1.43,2.90), cigarette smoking (OR=1.87; 95% CI 1.11, 3.16), and drinking alcohol (OR=1.74; 95% CI 1.17, 2.60) were associated with suicidal ideation. Public health programs designed to control cigarette smoking and alcohol use may also impact positively on suicidal ideation.     

Concurrent drinking and smoking among college students: An event-level analysis

Cigarette smoking and drinking commonly co-occur among college students, a population that is at high risk for developing alcohol and nicotine use disorders. Several studies have been conducted that have examined predictors of drinking or smoking to gain a better understanding of the antecedents of engaging in these behaviors. Yet, few studies have examined specific factors that influence concurrent smoking and drinking in this population. The current study used data from a 21-day electronic diary-based study of college students (n=86) who engaged in concurrent drinking and smoking to examine event-level associations between alcohol use and cigarette smoking in the student's natural environment. We specifically focused on within-person analyses of contexts in which students reported smoking and drinking simultaneously in comparison to contexts in which students reporting drinking without smoking. Situational contexts included environmental setting, whether s/he was alone or with others, and changes in stress and urges to smoke before initiating drinking. Results indicated that students drank more while smoking and smoked three times as many cigarettes, on average, during drinking episodes. Being with others at a party or a bar was associated with increased odds of smoking while drinking. Likewise, increased stress since the prior assessment predicted a greater likelihood of smoking while drinking. Based on the findings from the present study, it is important for future prevention and intervention efforts to consider social settings and heightened stress among students as potential risk factors for engaging in concurrent drinking and smoking.     

Examination stress and changes in mood and health related behaviours

Abstract

The present exploratory study evaluated the effect of stress (an examination period) on changes in mood and health related behaviours. 83 medical students completed measures of mood and health related bchaviours at baseline and four weeks later either during their examinations period (the stress condition) or after a comparative control period (the control condition). All subjects also completed ratings of stress mediating variables: social support, perceived control and coping style at baseline. The results showed deterioration in mood in terms of increases in depression and anxiety and changes in health related behaviours in terms of increased numbers of subjects who identified thcmsehes as smokers, and dcmascs in alcohol consumption, exercise and food intake in subjects in the stress condition. The results also suggest that social support moderated the effects of the examination stress and was related to greater decreases in smoking, decrcases in alcohol craving and increases in eating behaviour. In addition, an avoidance coping style (problem avoidance, wishful thinking) was related to greater decreases in eating behaviour. 'Ihe nsults an discussed in the context of the stress/illness link and the role of behavioural change.     

Prevalence and predictors of transitions in smoking behavior among college students.

The prevalence of smoking among college students is surprisingly high and represents a significant public health issue. However, there are few longitudinal studies of smoking in this population. This study examined the prevalence and predictors of transitions in smoking behavior among a cohort of 548 college students. Over the course of 4 years, 87% of daily smokers and almost 50% of occasional smokers continued to smoke. Among nonsmokers, 11.5% began smoking occasionally and none became daily smokers. In general, predictors of smoking behavior change were significant only among baseline occasional smokers and included gender, smoking outcome expectancies, and affect regulation expectations. Peer and parental smoking, demographics, affect, stress, and alcohol use were generally not predictive of change. Tobacco control interventions targeted at college students are clearly warranted.     

Alcohol use among adults in Kenya: Results from the National Non-Communicable Diseases Risk Factor survey, 2015

The aim of this study was to assess the prevalence and correlates of alcohol use among Kenyan adults. We analysed data from the Kenya cross-sectional national Non-Communicable Diseases Risk Factor survey, 2015. The survey sampled 4 469 adults (median age 38.0 years, interquartile range = 23, age range of 18–69 years). Results indicate that 6.7% were hazardous or harmful alcohol users and 12.8% past month binge-drinkers. In adjusted logistic regression analysis, being male, middle aged, belonging to the Luhya or Kalenjin ethic group, tobacco use, and having hypertension increased the odds for hazardous or harmful alcohol use. Socio-demographic and health factors appear to influence risk for hazardous or harmful alcohol use among adults in Kenya.     

Marijuana Use Among Daily Tobacco Smokers: Relationship to Anxiety-Related Factors

The present investigation evaluated the incremental validity of regular marijuana use and frequency of such use in relation to anxiety and depressive symptoms and perceived health among young adult tobacco smokers (n = 202). Approximately 72% of the sample were current marijuana smokers, using this drug on an average of 7.6 (SD = 9.2) times per week. As expected, after controlling for theoretically-relevant smoking (cigarettes per day), alcohol use, and affect factors (i.e., negative affectivity and anxiety sensitivity), marijuana use predicted anxiety symptoms and perceived general health, whereas frequency of marijuana use predicted only anxiety symptoms. These results are discussed in relation to better understanding the role of regular marijuana use in terms of anxiety-relevant emotional vulnerability and beliefs about physical health among regular smokers.     

Personality types and risky health behaviors in Norwegian students

Typological research has received increasing interest in recent years, but is still regarded as substandard by personality psychologists. The current investigation shows how a typological approach can enhance our understanding of the influence of personality on risky health behaviors. We focused on Torgersen's eight personality types that represent unique configurations of high and low Extraversion, Neuroticism, and Constraint (Vollrath & Torgersen, 2000). Participants were 606 Norwegian university students. Measures assessed personality factors, smoking, abuse of drugs and alcohol, drunk driving, and risky sexual behaviors. Results replicated earlier research showing that types combining either high Extraversion and low Constraint (Hedonists, Impulsives) or high Neuroticism and low Constraint (Insecures) engage in more risky health behaviors. The discussion focuses on demonstrating that the study of types is a valuable supplement to the dimensional tradition in personality psychology.     

Postdeployment Psychological Health and Interpersonal Problems Among Air Force Mental Health Personnel

This study is one of the first to use validated screening measures to examine the rates of self-reported mental health and interpersonal problems following deployment of military mental health personnel (MMHP). Research has examined the impact of deployment on military personnel finding 10.2% to 29.0% screen positive for at least one mental health problem. However, little is known about impacts of deployment among MMHP. Utilizing health data collected three to twelve months post-deployment from a sample of 759 Air Force MMHP, this study examined rates of positive screens for psychological health or interpersonal problems, subsequent confirmation of positive screens by a medical provider upon examination, and the demographic characteristics associated with psychological health or interpersonal problems. The study found 13.9% screened positive for “possible or probable PTSD,” 4.6% for depressive symptoms, 3.9% for alcohol problems, and 12.6% for interpersonal problems. In total, nearly 26% screened positive for one or more psychological or interpersonal problem. Of those who screened positive, 48.5% of depressive problems, 36.0% of PTSD, 20.0% of alcohol problems and 29.7% of interpersonal problems were confirmed upon subsequent examination by a medical provider. Those who screened positive were more likely to be (a) female, (b) separated, widowed, or divorced, (c) a mental health nurse or psychiatric nurse practitioner, and (d) deployed to Iraq or Afghanistan. The significance, limitations, and implications of the results, along with recommendations for future research are discussed.     

Alcohol use and problem drinking in South Africa: Results from a national-population-based survey 2014-2015

The aim of this study was to estimate the pattern of alcohol use among South African adults by their socio-demographic and health status indicators. We analysed data from a 2014–2015 South African national population-based survey which sampled 22 752 adults (mean age 37.1 years, SD?=?17.6, age range of 15–109 years). Results indicate 3.9% were hazardous or harmful alcohol users. In adjusted logistic regression analysis, both men and women who self-reported to use tobacco, and women to have hypertension, were at higher risk for harmful alcohol use. Age and socioeconomic status moderated harmful alcohol use among men so that those in middle age (35–49 years) and with above average household income were at lower risk for hazardous or harmful alcohol use. Socio-demographic factors appear to primarily influence risk for hazardous or harmful alcohol use among South African adults.