Age and Body Satisfaction Predict Diet Adherence in Adolescents with Inflammatory Bowel Disease

The aim of the current study was to determine whether age and body satisfaction predict dietary adherence in adolescents with Inflammatory Bowel Disease (IBD), and whether older females are less adherent than younger males and females. Forty-four participants aged 10–21 with IBD were recruited. Participants provided informed consent and demographics. Body satisfaction was measured by a questionnaire and a task in which participants selected their current and ideal body image out of silhouettes depicting bodies ranging from underweight to obese. Adherence was measured by marking a 100 mm visual analog scale, the 1-week completion of a dietary log, and a questionnaire evaluating coping strategies used for overcoming obstacles to dietary adherence. Age was related to dietary adherence, with younger children being more likely to adhere. Participants more satisfied with their body reported better dietary adherence. Findings remained consistent across multiple measures of body satisfaction and adherence. Healthcare providers and parents should be informed of these findings in order to improve adherence.     

药物经济学在疾病管理中的应用

随着近年来慢性病患者的增多,慢性病防治成本的增加,各国政府急需一种方法来降低慢性病患者医疗保健费用,减少卫生资源的浪费;而疾病管理作为解决上述问题的一种有效模式,本文讲述了其定义以及其实施的动因。同时指出药物经济学作为疾病管理中有效的评价工具及其在改善卫生保健资源利用方面的重大作用,阐述了其定义和评价方法,及其在疾病管理中应用时的选取,然后描述了其应用过程中存在的问题及解决对策。     

Acute effects of alcohol on cardiovascular reactivity to stress in college-age Type A (coronary prone) individuals

Healthy college-age males and females classified as Type A or Type B were randomly assigned to an alcohol (N=24) or a no-alcohol condition (N=24). Subjects were exposed to a verbal stress quiz while blood pressure, heart rate, peripheral vascular response (PVR), and self-reported anxiety indices were monitored. Results indicated that alcohol effected a reduction in resting levels of systolic blood pressure and a tonic reduction in the peripheral vascular response. Alcohol attenuated the systolic blood pressure, heart rate, and PVR to stress and efffected a decrease in anxiety following the Stressor. When analyzed relative to the participants' drinking experience, data indicated that the strongest stress-modulating effect of alcohol was evidenced by Type A subjects who have been identified as long-term drinkers. During recovery from stress Type A subjects identified as short-term drinkers maintained high levels of PVR. Types A and B subjects who did not ingest alcohol evidenced high PVR levels during stress. The findings are discussed in terms of the protective action of moderate chronic alcohol use on cardiovascular disease risk reduction in persons evidencing the coronary-prone behavior pattern.     

健康与疾病的划界：困境与出路

简单回顾了医学对健康和疾病的认识与划界,重点分析了生物医学模式的划界标准、前提,以及它在医学认识与实践中面临的困境。在此基础上,探讨了19世纪以来医疗界走出困境的主要路径。     

Neuropsychological Functioning in Chronic Lyme Disease

Lyme disease is currently the most common vector-borne illness in the United States. The disease is multisystemic, and chronic disease, in particular, may be associated with neuropsychological deficits. However, to date, only a few empirical studies exist, which examine the neuropsychological sequelae associated with chronic Lyme disease. A review of the literature shows that the deficits observed in adults with chronic Lyme disease are generally consistent with the deficits that can be seen in processes with primarily frontal systems involvement. These observations are generally consistent with neuroradiologic findings. The clinical presentation in chronic Lyme disease and the nature of the neuropsychological deficits are discussed, as are several central issues in understanding neuropsychological functioning in chronic Lyme disease, such as the impact of chronic illness, response to treatment, and the relationship between neuropsychological performance and depression, fatigue, and neurological indicators of disease.     

Increased regional cerebral glucose metabolism and semantic memory performance in Alzheimer's disease: A pilot double blind transdermal nicotine positron emission tomography study

Nicotinic receptor dysfunction and impaired semantic memory occur early in Alzheimer's disease patients (AD). Previous research implied that nicotine's ability to enhance alertness, arousal, and cognition in a number of nonclinical populations was a function of its ability to stimulate CNS nicotinic cholinergic receptors. In this study it was hypothesized that transdermal administration of nicotine would increase both regional cerebral glucose metabolism (rCMRglc) and semantic memory (as assessed by verbal fluency). Two mild AD and two elderly controls underwent positron emission tomography scanning during a double blind nicotinic agonist verbal fluency challenge procedure. rCMRglc increases occurred in both AD patients, but not controls. In the two AD patients, verbal fluency scores increased by an average of 17%. One elderly control's verbal fluency increased, and the other decreased. These findings suggest that nicotine's effect on metabolism and verbal fluency is due to its ability to stimulate the cholinergic system.     

疫情防控“成功悖论”的伦理解析

疫情防控会造成个人与社会之间的“成功悖论”：虽然疫情防控给社会带来了整体利益,但具体的参与者个人却似乎没有得到什么实际的利益;于是,当疫情防控成功一段时间之后,一些强制性防控措施就会日益受到质疑,越来越多的人会选择逃避防控的“免费搭车”行为,直到再次暴发疫情。“成功悖论”反映出疫情防控中个人权利与公共健康之间的冲突：为了社会整体健康而限制个人权利是否能够得到伦理辩护？悖论的根源在于自由主义价值观导致了个人与社会的割裂,而强调人类命运共同体与人类卫生健康共同体的社会主义价值理念有助于克服这一悖论。     

困惑与忧思:医学的边界在何处

现代医学将治未病的理想变成了现实。对疾病危险因素的控制, 癌症前期病变的基因检测, ECT等高清晰度的影像技术对人体微细病变的勾画, 以及生命的正常过程、个人和社交问题的医疗化, 疾病诊断标准不停歇的放宽, 使得健康与疾病的界线愈来愈模糊, 医学进步到没有健康人了。区分生命正常过程与疾病的不同, 明确医学的边界, 避免医学对人体过度的破坏性的干预, 杜绝对医疗资源的浪费, 是当今医学迫需努力解决的课题。     

老年人健康风险因素与干预意愿研究——以高校退休教师调查为例

为了解高校离退休教师健康风险因素与干预意愿, 调查了1 342名高校退休教师的健康状况并收集其健康体检数据, 对比分析其健康风险因素危险度评分、慢性病发病率及其干预意愿。结果显示, 健康风险因素危险度评分为51.26±8.91分;慢性病发病率为68.24%, 年龄增加危险度评分和发病率数值增加, 不同年龄段数据对比差异有统计意义 (P<0.01) ;不同性别、职业、职称的差异无统计意义 (P>0.05) 。干预意愿依序是健康管理、健康教育和健康咨询。认为高校离退休教师健康风险因素及慢性病发病率随年龄显著增加, 健康管理应该是未来风险干预的方向。