妊娠期急性脂肪肝诊治中的科学思维应用

现代科学思维方法中系统思维及模糊思维方法具有普遍适用意义。妊娠期急性脂肪肝临床上极为罕见,并发症多,病死率极高,1例并发腹部卒中的妊娠期急性脂肪肝患者通过科学诊疗转危为安,及时终止妊娠、对症处理、多学科协作联合治疗,积极预防并发症是确保救治成功的关键。本文尝试介绍科学思维方法在该病诊疗中的一些体会。     

Abstractness and Messages Describing Consequences Promote Healthier Behavioral Intentions

Many health-risk behaviors present a self-control conflict in which the short-term outcomes of an action conflict with its long-term consequences. Across three studies, we find that an abstract construal level leads people to focus on long-term rather than short-term consequences when both are described in a message (vs. no message). Studies 1 and 2 explore this hypothesis through a risk behavior (snacking on sugary products), and Study 3 does the same through a health behavior (physical exercise). In Study 1, the Behavioral Identification Form scale is used to measure the construal level as a personal disposition; Studies 2 and 3 use a priming task designed by Freitas, Gollwitzer, and Trope to manipulate the construal level. All these studies show that, under an abstract mindset, people who have read a mixed-outcome message (vs. no message) tend to base their behavioral plans on long-term outcomes. Individually or in small groups (e.g. school class, therapy groups) health messages can be presented along with protocols to change construal level and thus, promote healthier intentions.     

Ethnic Identity and Prosocial Attitudes

In this study, I examined the relationships between ethnic identity, social support within one's own group, activity with one's own group, and readiness to cooperate with people of another group. The hypothesis that there will be a stronger link between ethnic identity and prosocial activity in a minority group was tested using a questionnaire collected from 60 Byelorussians and 62 Poles living in the same villages of eastern Poland. The analyses showed that Byelorussians had lower ethnic identity and social support than Poles but higher readiness to cooperate with Poles than the reverse. For the Byelorussians, the correlational analysis revealed significant coefficients between ethnic identity and social support, between ethnic identity, social support, and prosocial activity, and between social support and readiness to cooperate, whereas the relationships among these variables were not significant in the Polish group. On a cognitive level, therefore, the members of the dominant group identified more with the nation and country than the members of a minority, whose ethnic identity was more salient in social attitudes and ingroup and outgroup activities.     

A Novel Approach

Abstract

The relationship between empathy and forgiveness is explored through the painful experience of divorce and relationship loss. Authors propose a literary exercise, the Novel Approach, to help clients discover the power of empathy and find resolution to past pains. Included is a case study used to describe the Novel Approach and to highlight its facilitative power for creating a deeper empathic understanding.     

Multiple Microswitches for Multiple Responses with Children with Profound Disabilities

Abstract

Several components of motivation for exercise were investigated in a sample of 51 subjects who participated in a five-month exercise program designed for people with back pain. Assessment of motivation was made prior to the program using a self-report questionnaire. Tests were made of the motivational factors' ability to classify subjects as higher or lower adherers. A combination of age, perceived lack of time to exercise, expected consequences of not taking action to relieve the back pain, and adherence self-efficacy, resulted in a logistic regression model that correctly identified 96% of the higher adherers and 84% of the lower adherers after five months of participation. The present pilot study offers preliminary data on potentially influential motivational components. In addition, the results clearly support the notion that motivation is best viewed as a complex psychological construct, thus indicating that assessments of motivation should be multifactorial.     

Coping with the threat of severe acute respiratory syndrome: Role of threat appraisals and coping responses in health behaviors

The present study examines the psychological impact of severe acute respiratory syndrome (SARS) by exploring the coping strategies and health behaviors enacted in response to the SARS epidemic. Hierarchical linear regression indicated that the use of wishful thinking in response to the threat of SARS was related to both avoiding public places and avoiding people perceived to be possible carriers of the SARS virus, but was not associated with the use of more adaptive health behaviors, such as using disinfectants and hand washing. Conversely, those who reported engaging in empathic responding in response to the threat of SARS were both less likely to report avoiding people perceived as being at a high risk for SARS and more likely to report engaging in effective health behaviors. Support seeking was not a significant predictor of the health behaviors examined in the present study. Results are discussed in terms of coping with health threats and health promotion.     

从SARS看突发公共卫生事件的政策管理

在调研国外应对突发公共卫生事件政策管理经验的基础上,结合我国应对传染性非典型肺炎的措施,初步探讨了我们在应对突发公共卫生事件政策管理方面的不足,并就改进对策也进行了初步研究。     

Exercise based interventions for alcohol use disorder: A comment on motivational aspects of participation

Exercise based treatment for alcohol use disorders have shown an impact on mental health (e.g., depression or anxiety), and alcohol outcomes (e.g., craving or abstinence). However, there is a lack of information on the role of motivational aspects of participation in the process of designing exercise interventions for alcohol use disorder. This study aims to examine: (1) whether motivational aspects are taken into account when the type and delivery method of exercise interventions are chosen; (2) whether motivational aspects are taken into account post intervention; and (3) whether there are different traditions regarding payment for participants. A systematic search was conducted to identify eligible studies in order to investigate the impact of motivational aspects including payment for participation. Twelve samples including ten to 620 participants were investigated. Participants were predominantly male and in their 40s, ranging from 20 to 69 years. Aerobic exercise (running, walking, fitness) either in a group or individual condition is the most frequently used exercise form. Two studies included ball games or cycling, while only one study offered the opportunity to choose between a wide range of sports. Motivational aspects are mentioned explicitly in half of the studies, mostly with regard to adherence to participation and social integration as the reason for using a group condition. Achievement is mentioned in two studies but not explicitly with regard to planning the intervention design. Five studies include payment for participation in exercise. Findings of the present study identify that motivational aspects for participation are rarely involved in the planning of an exercise intervention. With regard to the specific psychosocial vulnerability of an alcohol use disorder population, this should be an important aspect of further research studies.     

Changes in physical activity among coronary and hypertensive patients: A longitudinal study using the Health Action Process Approach

Objectives: Physical activity (PA) is a key factor in cardiovascular disease prevention. Through the Health Action Process Approach (HAPA), the present study investigated the process of change in PA in coronary patients (CPs) and hypertensive patients (HPs).

Design: Longitudinal survey study with two follow-up assessments at 6 and 12 months on 188 CPs and 169 HPs.

Main outcome measures: Intensity and frequency of PA.

Results: A multi-sample analysis indicated the equivalence of almost all the HAPA social cognitive patterns for both patient populations. A latent growth curve model showed strong interrelations among intercepts and slopes of PA, planning and maintenance self-efficacy, but change in planning was not associated with change in PA. Moreover, increase in PA was associated with the value of planning and maintenance self-efficacy reached at the last follow-up

Conclusions: These findings shed light on mechanisms often neglected by the HAPA literature, suggesting reciprocal relationships between PA and its predictors that could define a plausible virtuous circle within the HAPA volitional phase. Moreover, the HAPA social cognitive patterns are essentially identical for patients who had a coronary event (i.e. CPs) and individuals who are at high risk for a coronary event (i.e. HPs).