肝硬化腹水防治中整体观的应用

1肝硬化现状和防治方面的问题 1.1肝硬化是日渐受到重视的医学、社会和公共卫生问题肝硬化分布全世界,不论国籍、不限民族,严重危害人民身体健康.1987年世界卫生组织(WHO)提供的数字表明肝硬化人群平均发病率约17.1/10万,每年全世界死于肝硬化的人数超出31万,近几年来已增加到50万[1].在西欧和美国,因肝硬化致死人数仅次于恶性肿瘤、心血管病、脑血管病和意外,居死亡原因第5位.在美国中年人中则为位居第4的死亡原因.我国肝硬化发病率占同时期住院病人总数的1%左右[2].以肝炎病毒感染致肝炎后肝硬化为多见.但近年来,酒精性肝硬化发生率明显增加.本病发病年龄以21～50岁多见,占83%左右,男女比例为4～8:1,中年男性患肝硬化最为突出,严重影响了社会生产力,是日渐受到重视的医学、社会和公共卫生问题.     

导言：要高度重视动脉狭窄和缺血性脑血管病的关系

目前,我国每年新发脑血管病患者250万,死于脑血管病超过150万,幸存者600万～700万,残疾率高达75％。脑血管病以其高发病率、高复发率、高致残率、高死亡率及逐年递增的防治费用造成巨大的社会、经济负担,已成为严重影响国计民生的重要公共卫生问题。而其中约70％的脑卒中是缺血性脑卒中。更为严重的是,随着人口老龄化、城市...     

循证医学在心血管危险控制中的应用

1　“心血管危险控制”的定位心血管疾病占全世界所有死亡原因的 2 5 % ,是各种原因死亡中比例最高者 ,因此有“第一杀手”(ｋｉｌｌｅｒｎｕｍｂｅｒｏｎｅ)之称。在发达国家 ,心血管疾病约占全部死亡病因的一半[1] 。根据 1995年我国卫生部公布的统计资料表明 ,我国的心血管疾病 (包括脑卒中 )死亡已居全部死因的首位 ,占总死亡的4 0 7% ,据此推算全国每年有 2 0 0多万人死于心血管疾病。就高血压病而言 ,全国有高血压患者 1亿多人 ,每年新增患者 32 0万 ,患病率每 10年递增5 0 % ;每年新发脑卒中病例高达 15 0万人 ,死亡 10 0万人 ,生存…     

正确处理前列腺手术与术后性功能的关系

随着人们生活水平的提高和医疗技术的完善 ,人类老龄化已成为一个社会课题摆在我们的面前。前列腺增生和前列腺癌发病率近年来在逐年上升 ,已成为威胁老年人健康的主要疾病之一 ,国内报道5 0～ 6 0岁的男性前列腺增生的发病率在 6 0 %左右 ,70岁以上的发病率可达 80 %以上。美国报道 ,其国内前列腺癌的发病率在各类癌症中达 2 0 %以上 ,黑人中可达 1/ 3。统计我院泌尿外科 5年来所做的各类手术中 ,前列腺手术占总手术量的 5 2 % ,在这类手术增加的同时 ,伴随着社会进步 ,人们对生活质量要求的提高 ,前列腺术后病人性能力的改变越来越受到临…     

美国直面成瘾——医学总监关于酒精、药物和健康的报告

1944年美国的《公共卫生法》要求组建公共卫生服务署(Public Health Service,PHS),作为当时卫生、教育和福利部(现改名为卫生和人类服务部)的一个重要部门。PHS包括该部所有执法的司局以及一支穿制服的执法队伍,雇用了6 500余名穿制服的公共卫生专业人员,每天24小时值班,在发生突发事件时由部长或助理部长调遣,目的是提供公共卫生、安全和疾病预防服务,以及推进公共卫生的科学研究,其中有环境和职业卫生、医学、护理学、牙医、药学、社会工作、医院管理、营养、工程、科学、兽医、卫生信息技术及其他与卫生有关的专业人员。执法队伍成员经常奋战在抗击疾病和不良卫生条件的第一线。PHS由助理部长监管。执法队伍身穿类似海军的蓝色制服,其级别也与海军类似,这支队伍的司令为医学总监(surgeon general),授四星Admiral(在海军里就是海军上将)或Vice Admiral(相当于海军中将)头衔,其也是美国联邦政府公共卫生问题的主要发言人,由美国总统提名,参议院确认。医学总监是该部的主要顾问,向助理部长报告工作,有义务就公共卫生问题教育美国公众选择健康的生活方式。自1966年开始,医学总监就一直要求在所有纸烟包装上印制警告,自1988年起,要求所有酒精饮料包装上印制警告。2016年11月,卫生和人类服务部发布《医学总监关于酒精、药物和健康的报告》(The Surgeon General’s Report on Alcohol,Drugs,and Health),题为《美国直面成瘾》(Facing Addiction in America),报告中提出了对待有精神活性成瘾物质滥用及其引起的物质使用障碍的新进路,即公共卫生的进路,以区别于目前的刑事司法进路。以下内容包括美国现任卫生和人类服务部部长Sylvia Burwell写的序言以及该报告的精选。     

老年人的心理与保健

随着医学的发达,人们物质、文化生活水平的提高,人类的平均寿命在显著增长。老年人的行列在不断扩大。解放前,我国男性平均寿命为36岁,女性为40岁。而目前,根据抽样调查发现,男性平均寿命上升到72岁,女性上升到75岁。老年人在总人口中的比例也由1％上升到10％。随着老年人口的增多,老年人的心理与健康问题,也就引起了社会各界的广泛关注。随着年龄的增长,社会环境、生活条件的改变,老年人的心理和生理也发生一些显著的变化,这些变化都会对他们的健康产生影响。     

社会经济地位对脑卒中发病率和死亡率的影响

社会经济地位是疾病与健康影响因素研究中的常用社会学指标,反映了社会成员社会地位的高低.众多研究显示,低收入、低职业等级均增加脑卒中发病和死亡的危险性;高社会剥夺亦增加脑卒中发病率.但这种影响存在年龄、性别和脑卒中亚型差异.在脑卒中预防与控制中,应关注低社会经济地位这一高危人群,并采取适当干预措施.     

社会经济地位对脑卒中发病率和死亡率的影响

社会经济地位是疾病与健康影响因素研究中的常用社会学指标,反映了社会成员社会地位的高低。众多研究显示,低收入、低职业等级均增加脑卒中发病和死亡的危险性;高社会剥夺亦增加脑卒中发病率。但这种影响存在年龄、性别和脑卒中亚型差异。在脑卒中预防与控制中,应关注低社会经济地位这一高危人群,并采取适当干预措施。     

从冠心病主要危险因素的流行特点谈医学模式的转变

随着人民生活水平的提高,冠心病的发病率呈逐年上升趋势,不仅造成个人很高的致残率或致死率,而且给家庭和社会带来沉重的经济负担,冠心病已成为当前一个重要的公共卫生问题。而冠心病是一个多病因疾病,是可防可控的。充分了解冠心病危险因素的流行现状及危害,转变理念,着眼预防,逐步改变目前"重治轻防"的医学模式,是我们心血管医生神圣的使命。     

从冠心病主要危险因素的流行特点谈医学模式的转变

随着人民生活水平的提高,冠心病的发病率呈逐年上升趋势,不仅造成个人很高的致残率或致死率,而且给家庭和社会带来沉重的经济负担,冠心病已成为当前一个重要的公共卫生问题.而冠心痛是一个多病因疾病,是可防可控的.充分了解冠心病危险因素的流行现状及危害,转变理念,着眼预防,逐步改变目前"重治轻防"的医学模式,是我们心血管医生神圣的使命.     

Extremes of self-esteem and narcissism and the experience and expression of anger and aggression

This study examined the level of self-esteem and narcissism as personality variables involved in the disposition to experience and express anger. Three hundred thirty-eight subjects were sampled across two higher education centres and one student teaching programme in the United Kingdom. It was reasoned that individuals with both high self-esteem and narcissism would report especially high tendencies to experience and express anger and aggression and that those with high self-esteem and low narcissism would report the lowest. These predictions were influenced by theories that emphasise the role of threats to high self-esteem in the production of aggression and violence. Results indicate that groups defined by their extreme scores on self-esteem and narcissism scales produced levels of anger expression in the predicted direction. The importance of considering extreme levels of self-esteem and narcissism (in conjunction with other factors) in an analysis of anger is discussed with reference to currently influential theories in the field. Aggr. Behav. 24:421–438, 1998. © 1998 Wiley-Liss, Inc.     

Social and Personal Determinants of Adolescent Use and Abuse of Alcohol and Marijuana

This article summarizes research on social and personal determinants of adolescent use and abuse of alcohol and marijuana to aid practitioners when designing interventions.     

Cognitive and Personality Characteristics of Masculinity and Femininity Predict Wayfinding Competence and Strategies of Men and Women

Bem (1974) reconceptualized masculinity and femininity as independent and orthogonal constructs that both men and women possess to varying degrees. This perspective was used as a starting point to investigate whether the contributions of gender-typed characteristics can help to account for commonly observed gender differences in wayfinding (the ability to identify one’s current location and successfully navigate to an unseen location in the environment) favoring men. We further divided gender-typed characteristics into cognitive and personality characteristics to assess their separate influence on wayfinding and explored whether gender-typed characteristics predicted self-reported use of masculine wayfinding strategies (i.e., orientation strategies) and self-reported wayfinding competence. Participants were 452 college women and men in a southern U.S. public university. They completed the Gender-Stereotypic Characteristics questionnaire (Diekman and Eagly 2000), a social comparison questionnaire (created by the authors), a wayfinding strategy questionnaire (Lawton 1994), and a wayfinding competence questionnaire (Hegarty et al. 2002). For both men and women, higher masculine cognitive characteristics significantly correlated with greater use of orientation wayfinding strategies typical of men. For men, both higher masculine and feminine cognitive characteristics predicted better overall wayfinding competence whereas for women, only higher masculine cognitive characteristics predicted better overall wayfinding competence. For both men and women, higher feminine personality characteristics predicted poorer wayfinding competence. These results demonstrated the importance of considering cognitive and personality characteristics of masculinity and femininity in explaining individual differences in wayfinding.     

Self-ratings of positive and negative affect and retrieval of positive and negative affect memories

Abstract

Based on analysis of self-ratings of mood, positive affect (PA) and negative affect (NA) have been proposed as basic, orthogonal mood dimensions (Watson & Tellegen, 1985). The present study asked subjects (N = 61) to not only provide self-ratings of PA and NA terms but also to retrieve personal memories associated with those terms. Self-rated PA was associated with latency to retrieve PA- but not NA-related memories; self-rated NA was associated with latency to retrieve NA- but not PA-related memories. Self-ratings of PA and NA were not significantly correlated, nor were retrieval latencies for PA and NA memories. Individual item correlations also revealed a strong direct relationship between self-ratings and retrieval latency. The dissociations involving a non-self report measure strengthen the distinction between PA and NA, and the individual item correlations are interpreted as showing that self-ratings of affect are based upon the ease of retrieval of personal memories.