关于规范超声影像技术诊断结论的思考

为了提高超声诊断技术的临床价值,对目前超声诊断的地位、诊断结论中存在的不规范问题、如何进行规范和改进等进行分析,提出自己的观点和体会,为今后更进一步规范超声诊断的结论提供参考。     

Early environment, emotions, responses to stress, and health

A harsh early family environment is related to mental and physical health in adulthood. An important question is why family environment in childhood is associated with these outcomes so long after its initial occurrence. We describe a program of research that evaluates a model linking these variables to each other. Specifically, we hypothesize that low social competence and negative emotional states may mediate relations between a harsh early family environment and physiological/neuroendocrine responses to stress, as well as long-term health outcomes. We report evidence that the model characterizes self-rated health, cortisol responses to stress, and, in males only, elevated cardiovascular responses to stress. We discuss how the social context of early life (such as SES) may affect the family environment in ways that precipitate adverse health consequences. Perspectives on comorbidities in physical and mental health are discussed.     

Masculinities, Femininities, Behaviour and Health

Using the notion that gender is performed in daily life and through daily activities, I review some of the health behaviour literature which employs ideas about masculinity and femininity. I argue that recent theorising about both masculinities ( Connell & Messerschmidt, 2005 ) and femininities ( Schippers, 2007 ) can be extremely useful in this field. I consider two specific health behaviours in light of this theorising, namely healthy eating and drinking alcohol, and explore how and which versions of masculinities and femininities are played out, which are problematic, and what they mean for gender hegemony. I argue that across both areas (and across other health behaviours), there are three specific issues that are important and require further conceptual development and empirical work: (1) the relationality of gender; (2) masculinities and femininities as embodied; and (3) the local, contingent and intersectional nature of masculinities and femininities. This conceptual framework and the aspects of relationality, embodiment and intersectionality have important implications not only for understanding health behaviours, but for any social psychological work theorising identities and everyday social practice.     

Quantifying developing country research capacity in the areas of malaria,schistosomiasis, and leprosy

Implicit in addressing the issue of how to build and strengthen health related endogenous research capacity is that both donor organizations and developing country policymakers distinguish betweenhealth priorities andhealth research priorities. This distinction has important policy consequences in that the majority of developing countries are not in a position, either in financial or human resource terms, to simultaneously generate and implement broad-based priorities in both areas. In this context, it is important that health research priority setting be developed in tandem with existing research capacity. This underlines the importance of assessing the amount and nature of available expertise, and positioning research output, both in the national health needs, and the international science research contexts. The present article, which more properly constitutes a feasibility study, uses scientometric methods to assess the amount and nature of scientific output in three important tropical diseases: malaria, schistosomiasis and leprosy. The major goals of this study have been to i) compare the amount and nature of research produced in developed and developing countries for the three diseases; ii) determine in how far scientometric methods can be used to measure research capacity, and whether this measurement can facilitate the determination of health (research) priorities.     

Gender, stress, and health

Studying men and women and differences between them has long been a goal for researchers in health psychology. Recent advances in this endeavor, reflected in this special issue on the topic, have led to important information about the relationships between health and behavior. Of particular interest are possible differences in psychophysiological response, stress, and immune function. Clearly, more inclusive research strategies hold great promise for future scientific discoveries.     

Biomarkers, health, lifestyle, and demographic variables as correlates of reaction time performance in early, middle, and late adulthood

We aimed to identify demographic, health, and biomarker correlates of reaction time performance and to determine whether biomarkers explained age differences in reaction time performance. The sample comprised three representative cohorts aged 20-24, 40-44, and 60-64 years, including a total of 7,485 participants. Reaction time measures of intraindividual variability and latency were used. The measure of intraindividual variability used was independent of mean reaction time. Older adults were more variable than younger adults in choice reaction time performance but not simple reaction time performance. The most important correlates of reaction time performance after gender and education were biological markers such as forced expiratory volume at one second, grip strength, and vision. Few measures of physical or mental health or lifestyle were associated with poorer performance on reaction time measures. Biomarkers explained the majority of age-related variance in simple reaction time and a large proportion of variance in choice reaction time. We conclude that for the ages studied, biomarkers are more important than health factors for explaining age differences in reaction time performance.     

Appearance of symmetry, beauty, and health in human faces

Symmetry is an important concept in biology, being related to mate selection strategies, health, and survival of species. In human faces, the relevance of left-right symmetry to attractiveness and health is not well understood. We compared the appearance of facial attractiveness, health, and symmetry in three separate experiments. Participants inspected front views of faces on the computer screen and judged them on a 5-point scale according to their attractiveness in Experiment 1, health in Experiment 2, and symmetry in Experiment 3. We found that symmetry and attractiveness were not strongly related in faces of women or men while health and symmetry were related. There was a significant difference between attractiveness and symmetry judgments but not between health and symmetry judgments. Moreover, there was a significant difference between attractiveness and health. Facial symmetry may be critical for the appearance of health but it does not seem to be critical for the appearance of attractiveness, not surprisingly perhaps because human faces together with the human brain have been shaped by adaptive evolution to be naturally asymmetrical.     

心理健康素养：概念、评估、干预与作用

心理健康素养是促进心理健康的重要途径。狭义概念指帮助人们认识、处理和预防心理疾病的相关知识和信念; 广义概念指综合运用心理健康知识、技能和态度, 保持和促进心理健康的能力。心理健康素养常采用情景案例问卷、单维或多维评估量表等进行评估, 可以通过社会运动、学校教育、自助式应用程序、心理健康急救培训等方式进行有效干预提高, 其中心理健康知识、心理疾病识别、情绪调节、减少病耻感、积极的求助态度等成分都有促进心理健康的作用。未来研究可以在建构评估指标体系、探索作用机制、扩展涵盖群体与内容、加强实证干预研究等方面深入开展。     

Health Message Framing: Moderators,Mediators, and Mysteries

Health message framing is an important aspect of health communication. Over the past 20 years, researchers have sought to identify the contexts in which gain‐framed and loss‐framed health messages are most likely to motivate healthy behavior. Two major approaches have emerged: One approach focusing on matching the frame of the message to how people perceive the risks and uncertainties of the advocated health behavior and the other approach focusing on matching the frame of the message to the motivational orientation of the recipient. In this review, we describe these two major approaches to health message framing, identify the most likely psychological mediators that explain why these approaches motivate behavior, suggest a way to integrate these two approaches, and outline several key future directions for both basic and applied research in health message framing.     

Miscarriage,Religious Participation,and Mental Health

Approximately 15–20 percent of pregnancies result in miscarriage, yet pregnancy loss remains a socially taboo topic and one that has received limited attention in the literature. Utilizing nationally representative longitudinal data from the NLSY97, this study examines the influence of miscarriage on mental health and whether this relationship is moderated by religious participation. Results from this study suggest that miscarriage is associated with lower mental health among women who also experience a live birth. Results also suggest that religious participation moderates the relationship between miscarriage and mental health; religion is more likely to lead to increases in mental health among women who experience a miscarriage than among women who do not experience a miscarriage. Overall, evidence suggests that religion may be an important coping mechanism for women who deal with pregnancy loss.     

Social ethics,the philosophy of medicine,and professional responsibility

The social ethics of medicine is the study and ethical analysis of social structures which impact on the provision of health care by physicians. There are many such social structures. Not all these structures are responsive to the influence of physicians as health professionals. But some social structures which impact on health care are prompted by or supported by important preconceptions of medical practice. In this article, three such elements of the philosophy of medicine are examined in terms of the negative impact on health care of the social structures to which they contribute. The responsibilities of the medical profession and of individual physicians to work to change these social structures are then examined in the light of a theory of profession.     

Smoking,depression, & stress: predictors of fibromyalgia health status

The purpose of the present study was to examine the effects of smoking, stress, and depression on fibromyalgia health status. Fibromyalgia syndrome (FMS) is a chronic musculoskeletal pain condition that negatively affects health status. Health status is not only affected by the constellation of physical symptoms, but also by mood symptoms, stress levels, and patient behaviors (e.g. smoking). Participants were 491 individuals with a physician’s diagnosis of FMS. They completed self-report measures of their current levels of depression, stress, the number of cigarettes smoked per day, and health status. A linear regression analysis was conducted to determine whether these measures predicted FMS health status. All three measures predicted worse health status, predicting 51.5% of the variance in health status. However, it is important to evaluate and treat more than just the physical symptoms of FMS. Attention should also be paid to mental health status and to engagement in unhealthy behaviors in order to reduce their effects on FMS health status. Future researchers should design and evaluate interventions that target these modifiable risk factors to determine the extent to which they could improve health outcomes.     

Personality,health, and aging: prolegomenon for the next generation

The effect of personality characteristics on physical health continues to be an important topic in personality psychology, behavioral medicine, and health psychology. A more definitive methodological approach to the topic has evolved in recent years, emphasizing prospective designs, well-validated measures of personality, and unambiguous health outcomes. Further, this research is increasingly based on more detailed, physiologically plausible models of the possible mechanisms linking personality and health. Yet, one valuable perspective, life span development, has been relatively absent. As a guide to the next generation of studies on personality and health, we review conceptual and methodological issues, emphasizing the potential role of the life span perspective. We also illustrate these issues by reviewing recent reach on three personality characteristics studied as risk factors for physical disease—hostility, neuroticism, and optimism. The strengths of current personality and health research, recent developments in personality psychology, and the concepts and methods of life span approaches can be combined to construct a more complete and useful account of personality's effects on health and disease.     

Social Support. Physiological Processes, and Health

Social relationships serve important functions in people's everyday lives. Epidemiological research indicates that supportive relationships may also significantly protect individuals from various causes of mortality, including cardiovascular disease. An important issue is how social support influences such long-term health outcomes. In this article, we review evidence indicating that social support may influence mortality via changes in the cardiovascular, endocrine, and immune systems. These data suggest that it may be worthwhile to incorporate social-support interventions in the prevention and treatment of physical health problems.     

Betrayal Trauma,Health Care Relationships,and Health in Patients with a Chronic Neurovascular Condition

Individuals who have been exposed to trauma are at a greater risk of developing a chronic physical health condition and use health services more frequently than individuals who have not experienced trauma. The mechanism by which trauma affects health is not fully understood, but relationships with health care providers could be important in understanding this association. The purpose of this study was to explore the relationships among betrayal trauma, health care relationships, and physical and mental health in a chronic medical population. Participants (N = 272) diagnosed with a chronic neurovascular condition (cavernous malformation) completed an online survey. Questionnaires assessed self-rated health, instances of betrayal trauma, posttraumatic stress disorder (PTSD) and depression symptoms, income, and other demographic factors, and health care relationships. Level of income and the experience of betrayal trauma predicted mental health symptoms (depression, PTSD, or both) and also predicted health care relationships. After controlling for income and previous trauma, mental health symptoms significantly predicted health care relationships. Finally, mental health symptoms, health care relationships, and income predicted self-rated health, although the associations were not straightforward. These results suggest complex interrelations among trauma, mental health, income, health care relationships, and physical health, and a model is proposed for explaining these associations.     

Neuroeconomics,health psychology,and the interdisciplinary study of preventative health behavior

The goal of this article is to introduce readers to theories, tools, and evidence from the field of neuroeconomics and to describe how health psychology and neuroeconomics can be mutually informative in the study of preventative health behaviors. Preventative health behavior here refers to both individual actions that impact one's health (e.g., exercise) and broader behavioral patterns, such as those captured in personality constructs. Although neuroeconomic researchers have begun to incorporate health‐relevant behaviors into their studies, the full potential of this research to inform preventative health models is as yet unrealized. What is needed to “translate up” is the unification of rich theoretical content from health psychology with investigations by neuroeconomic researchers of the decision‐making process during health‐relevant choices. We identify choice as a central, shared feature across models of preventative health behavior that can serve as an inroad for neuroeconomics to contribute to existing models and highlight commonalities that might not otherwise be apparent. A central premise of our argument is that, because health decisions are nearly always multiply determined, a more precise and mechanistic understanding of how choices are made is an important but understudied topic in health psychology. A partnership between health psychologists and neuroeconomic researchers can yield valuable insights into how preventative health choice is made and to identify targets and methods for intervention.     

Religion,Spirituality, and Alternative Health Practices: The Baby Boomer and Cold War Cohorts

Research in religion and health has suggested positive relationships, and most recently has concentrated on the experience of religion, or spirituality. Currently, cohort studies have shown that the baby boomers differ significantly from their elders in their approach to religion, preferring to explore spirituality rather than the religious doctrine of their elders. They also differ in their approaches to health, including greater acceptance and use of alternative health practices. This study isolates the baby boomer and cold war cohorts in order to explore differences in religion, spirituality and alternative health practices. Findings indicate that, for boomers, increased spirituality is significantly related to increased positive health perceptions, while their elders' health perceptions are related to increased religiosity. Alternative health practices and spirituality, however, are not related for either cohort. However, this study does identify important distinctions between the two cohorts. Future studies must recognize differing cohort constructions of reality concerning the meanings of health, spirituality and religion.     

Prevention and health promotion: decades of progress, new challenges, and an emerging agenda.

Daily habits (e.g., smoking, diet, and exercise) and their immediate consequences (e.g., obesity) confer risk for most of the major health problems in industrialized nations. Hence, determinants of these behaviors and their modifications have been central topics in health psychology. Considerable scientific and applied progress has been made, but the field faces important challenges and opportunities in the future. These challenges and opportunities include changes in demographics and patterns of health, the need for a more comprehensive model of the domain of health behavior and prevention, the need to integrate behavioral and psychosocial risk and resilience, the incorporation of new technologies, and addressing a variety of professional and economic barriers to the implementation of prevention in health care.     

Stigma, obesity, and the health of the nation's children

Preventing childhood obesity has become a top priority in efforts to improve our nation's public health. Although much research is needed to address this health crisis, it is important to approach childhood obesity with an understanding of the social stigma that obese youths face, which is pervasive and can have serious consequences for emotional and physical health. This report reviews existing research on weight stigma in children and adolescents, with attention to the nature and extent of weight bias toward obese youths and to the primary sources of stigma in their lives, including peers, educators, and parents. The authors also examine the literature on psychosocial and physical health consequences of childhood obesity to illustrate the role that weight stigma may play in mediating negative health outcomes. The authors then review stigma-reduction efforts that have been tested to improve attitudes toward obese children, and they highlight complex questions about the role of weight bias in childhood obesity prevention. With these literatures assembled, areas of research are outlined to guide efforts on weight stigma in youths, with an emphasis on the importance of studying the effect of weight stigma on physical health outcomes and identifying effective interventions to improve attitudes.