新型农村合作医疗中的道德风险及防范

以“新乡模式”为例对商业保险公司参与承办新型农村合作医疗进行了有益的探索。对商业保险公司利益激励不足致使其参与新农舍的积极性不高,而激励不足主要是源于制度不足导致对新农合中的道德风险约束无力。探讨了对道德风险的防范措施。     

对建立我国艾滋病防治督导与评估体系的思考

随着我国艾滋病防治工作的持续深入,定期对艾滋病防治工作进行督导与评估越来越重要。但是,到目前为止,我国尚未建立国家综合协调的艾滋病防治督导与评估体系。通过对建立国家艾滋病防治督导评估体系的必要性、可行性及存在的问题进行分析,围绕如何构建一个统一、综合、有效的督导评估体系提出政策建议。     

加强我国农民工职业病防治工作的思考

我国现有两亿多农民工,且遭受不同程度的职业病危害,以致近年新发现的职业病人几乎是农民工,但他们却没享受法律规定的平等待遇,为此中央领导多次批示,要求制定有利于《职业病防治法》贯彻落实和职业病防治工作的制本之策。结合广西开展农民工职业病防治工作的实践,指出其6个方面的主要原因和防治对策。     

中国古代辟疫思想的当代启示

通过对以未病先防为主导的中国古代主要辟疫思想及方法的回顾与思考,探讨了其对今天传染病预防的参考价值。认识到在当代传染病预防工作中,借鉴中国古代医学的思想与实践之精粹或许可为当代新发传染病的防治另辟新径,以期能对现代传染病的预治有所启示。     

Implementation and Assessment of an Empirically Validated Intervention Program to Prevent Tobacco Use Among African-American Middle-School Youth

Evaluated Project Towards No Tobacco Use (TNT), a tobacco-use prevention program delivered in schools with primarily African-American students. Students were assigned randomly by classroom to either the intervention (n=58) or to a no-treatment control group (n=40). Students in the intervention group received a curriculum-based program over the course of 10 sessions. Pre-and post-assessments of tobacco knowledge, attitudes, communication, peer refusal, and smoking tendency were gathered. Students in the intervention group differed from their peers in the control group by evidencing greater knowledge and communication skills. We found this tobacco-use prevention program useful for African-American students.This investigation was supported in full by the American Cancer Society Grant Award ACS IRG 97-151.     

The effects of stress and stress hormones on human cognition: Implications for the field of brain and cognition

In this review, we report on studies that have assessed the effects of exogenous and endogenous increases in stress hormones on human cognitive performance. We first describe the history of the studies on the effects of using exogenous stress hormones such as glucocorticoids as anti-inflammatory medications on human cognition and mental health. Here, we summarize the cases that led to the diagnosis of glucocorticoid-induced 'steroid psychosis' in human populations and which demonstrated that these stress hormones could thus cross the blood-brain barrier and access the brain where they could influence cognition and mental health. We then summarize studies that assessed the effects of the exogenous administration of glucocorticoids on cognitive performance supported by the hippocampus, the frontal lobes and amygdala. In the second section of the paper, we summarize the effects of the endogenous release of glucocorticoids induced by exposure to a stressful situation on human cognition and we further dissociate the effects of emotion from those of stress on human learning and memory. Finally, in the last section of the paper, we discuss the potential impact that the environmental context to which we expose participants when assessing their memory could have on their reactivity to stress and subsequent cognitive performance. In order to make our point, we discuss the field of memory and aging and we suggest that some of the 'age-related memory impairments' observed in the literature could be partly due to increased stress reactivity in older adults to the environmental context of testing. We also discuss the inverse negative correlations reported between hippocampal volume and memory for young and older adults and suggest that these inverse correlations could be partly due to the effects of contextual stress in young and older adults, as a function of age-related differences in hippocampal volume.     

Perceived Physical Attractiveness, Sexual History, and Sexual Intentions: An Internet Study

This study was designed to examine the influence a potential date’s physical attractiveness and sexual history has on an individual’s intentions to engage in safer sex. Over 1,200 participants completed an Internet survey. The questionnaire presented a randomized biography and photograph and asked participants to rate their interest in dating and having a sexual relationship with the target. Participants were randomly assigned to one of six conditions based on the target’s physical attractiveness (low vs. high) and sexual experience (low, medium, or high). Results indicated that men reported greater intentions to have sex than women did, and all participants reported greater likelihood of having sex when the potential partner was highly attractive. Participants rated men and more experienced targets as more risky sexual partners, and the level of a target’s sexual experience was directly related to participants’ willingness to discuss sexual risks. Results indicate a continuing need to include discussion of cognitive factors in all HIV prevention efforts.     

用科学的证据和科学的管理指引心血管疾病的防治

心血管疾病的防治不仅仅是心血管医生的问题,还是一个在循证医学引领下的一个全民生活方式改变的问题,也需要多学科相关专业的联盟,涉及心血管疾病治疗规范的形成与普及,对于疾病发生、发展各个阶段的科学管理更是冠心病的防治效果的重要保障。本文针对心血管病冠心病预防的具体实施,从几方面打开了一个全新的视野。     

控制心血管疾病的根本出路在于预防

心血管疾病的根本发病基础是动脉粥样硬化血栓形成,在这一认识基础上,近年来在冠心病预防方面提出了一系列颠覆性的概念,如“冠心病等危症“、“心血管疾病是代谢性血管疾病”等。本文以全新的理念、形象地描述、深入地分析,从动脉粥样硬化血栓形成的各个阶段,阐述了冠心病综合预防在控制冠心病过程中的重要作用。