A biopsychosocial model for depressive symptoms following acute coronary syndromes

A partial latent structural regression analysis was used to evaluate the influence of perceived stress and coping resources on depression following acute coronary syndromes (ACS) in a sample of 113 participants (25 females and 88 males with a mean age of 57.61 years (SD = 12.63). Out of them, 55 participants were Australian born and 48 were born elsewhere, with 53 of the patients scoring in the mild to high depression range on the Beck Depression Inventory and the Cardiac Depression Scale. Perceived stress and coping resources, after controlling for age and smoking explained 89% of the variance in the latent variable depression. Higher perceived stress levels and fewer coping resources predicted higher levels of depression. Higher levels of perceived stress predicted fewer coping resources and fewer coping resources predicted higher levels of depression. There was a significant direct and indirect effect of perceived stress through coping on depression. Cognitive and physical coping resources were the best predictors of the depression construct. These results have potential implications for the treatment of depression post-ACS. In particular, cognitive and physical coping mechanisms and perceived stress reduction need to be addressed when treating depression post-ACS.     

Effects of photoaging information and UV photo on sun protection intentions and behaviours: A cross-regional comparison

The physical environment is thought to influence walking; however, daily variations in perceived environment have received little attention. The current study sought to examine if key within-person factors (i.e., implementation intentions, social support, affect and self-efficacy) would be associated with walking and if perceived access to supportive environments (e.g., access to nice walking paths) and perceived environmental barriers (e.g., bad weather and safety issues) were uniquely associated with walking after controlling for other constructs. Participants (N?=?14, 50.0% men, 78.6% White, M age?=?59.4?±?6.4) were in the intervention arm of an 8-week controlled trial promoting walking via personal digital assistants. Participants completed electronic surveys twice a day (total entries?=?804) in which they reported brisk walking levels and psychosocial and environmental factors. Multilevel modelling was used to examine within-person variations in constructs as determinants of walking. Results suggested that daily variations in implementation intentions, social support and positive affect were positively associated with walking. Further, perceived access to supportive environments, though not perceived environmental barriers, was positively associated with walking after controlling for other constructs (p?<?0.05). Future research should explore intervention components that target context-specific information about perceived access to supportive environments as part of a broader perspective on intervention development.     

Testing compensatory health beliefs in a UK population

Compensatory health beliefs, beliefs that healthy behaviours can compensate or neutralise unhealthy behaviours, have been proposed as one way of understanding why people engage in health-risk behaviours (Knäuper, B., Rabiau, M., Cohen, O., & Patriciu, N. (2004). Compensatory health beliefs scale development and psychometric properties. Psychology and Health, 19, 607–624). However, measuring compensatory health beliefs has proved a challenge, with several recent studies being unable to replicate the psychometric properties of Knäuper et al.'s (2004) scales. The aims of this study were to: (1) test the factor structure of the compensatory health beliefs scale in the UK, (2) examine the predictive validity of the scale by testing the relationships between compensatory health beliefs and health behaviours over a six-month time interval and (3) assess the 6-month test–retest reliability of the scale. A total of 393 participants completed measures of compensatory health beliefs and health behaviours at two time points separated by six months. The findings were potentially problematic for research into compensatory health beliefs: the factor structure was not confirmed, there was little evidence of predictive validity, and test–retest reliability was poor. Further research is required to understand the operation of compensatory health beliefs and to develop the measurement of compensatory health beliefs.     

J波、fQRS、Tp-ec对ST段抬高性心肌梗死溶栓治疗后恶性心律失常的预测价值

探讨ST段抬高性心肌梗死(STEMI)患者成功溶栓治疗后J波、校正Tp-e间期(Tp-ec)、碎裂QRS波(fQRS)对恶性心律失常事件(MAE)的预测价值及其相关性.选择STEMI患者108例,成功溶栓治疗后随机分为MAE组(29例)和非MAE(NMAE)组(79例),72例正常人的心电图作为对照组.结果示MAE组J波阳性、fQRS阳性、Tp-ec≥100ms显著高于NMAE组(P＜0.05);STEMI患者Tp-ec较对照组显著延长(P＜0.05),经溶栓治疗后,Tp-ec1周和1个月时逐渐恢复,但Tp-ec仍较对照组显著延长(P＜0.05);J波阳性(OR=3.612)、fQRS阳性(OR=2.905)、Tp-ec≥100ms(OR=3.226)(均P＜0.05)与MAE的发生独立相关.以此认为J波、Tp-ec、fQRS和MAE正相关,对溶栓后MAE有预测作用.     

Decline in executive control during acute bouts of exercise as a function of exercise intensity and fitness level

Studies on the effects of acute bouts of cardiovascular exercise on cognitive performances show contradictory findings due to methodological differences (e.g., exercise intensity, cognitive function assessed, participants’ aerobic fitness level, etc.). The present study assessed the acute effect of exercise intensity on cognition while controlling for key methodological confounds. Thirty-seven participants (M_age = 23. 8 years; SD = 2.6) completed a computerized modified-Stroop task (involving denomination, inhibition and switching conditions) while pedalling at 40%, 60% and 80% of their peak power output (PPO). Results showed that in the switching condition of the task, error rates increased as a function of exercise intensity (from 60% to 80% of PPO) in all participants and that lower fit individuals showed increased reaction time variability. This suggests that acute bouts of cardiovascular exercise can momentarily alter executive control and increase performance instability in lower fit individuals.     

Strengthening Voices

SUMMARY

As a therapist I have chosen to work with adolescent girls whose voices are among the weakest in our society. They have been sexually, physically and/or emotionally abused as children. Many have seen their mothers beaten by their boyfriends or husbands. Many have body-perfection obsessions such as anorexia and bulimia. Almost all of them have run away from home, hung out downtown, stolen property, relied on drugs and alcohol, and purposefully hurt themselves to take away their feelings. Many have resorted to selling their bodies on the streets or within their peer groups. They all operate from a self-belief of worthlessness, a belief that has gender socialization and abuse at its core. It is at this core that the therapeutic relationship must begin. This article describes a therapy relationship with a 14-year-old girl. This work with adolescent girls is described as being guided by three main principles, that of relationship, justice and soul work.     

急性脑干梗死的治疗进展

脑干梗死为脑梗死中较为少见的一种,病死率和残疾率均较其他部位高。近年来,随着医学的不断发展,尤其是循证医学证据的增多,急性脑干梗死的治疗方法有了许多新的进步。本文就近年来国内外急性脑干梗死治疗方面的最新进展进行综合性介绍,内容涉及静脉溶栓、动脉溶栓、动静脉联合溶栓、超声辅助溶栓、抗血小板治疗、抗凝治疗、脑保护治疗、卒中单元等,以期为-临床医生的治疗决策提供参考。     

患者的依从性与治疗效果——对两例急性会厌炎使用硬管放大喉镜检查的体会

为了提高无呼吸困难的急性会厌炎患者对治疗的依从性,对两名明确诊断为急性会厌炎,因自觉症状轻而忽视该病、拒绝接受医生治疗意见的患者,本着医患之间相互理解与信任的原则,非常规地应用冷光源硬管放大喉镜成像技术对患者进行检查,让患者观察到自身病变的影像,充分认识治疗的必要性,积极配合医生治疗,取得良好治疗效果。     

重症急性胰腺炎预防抗生素治疗的争议

重症急性胰腺炎伴随高病死率,细菌和真菌感染是其导致死亡的主要原因之一。目前治疗一般采取预防性抗生素治疗,但预防性抗生素治疗又可能会加重二重感染。目前研究结果数量有限,结果不一。是否应该应用预防抗生素治疗仍然存在争议,期待更多设计合理的随机对照试验。     

Sociocultural correlates of compulsive exercise: is the environment important in fostering a compulsivity towards exercise among adolescents?

Sociocultural factors hypothesised to be influential in eating disorders were assessed for their relationship with compulsive exercise. A sample of 828 adolescent boys and girls completed measures assessing sociocultural messages to change body shape as well as pressure to be thin, and also measures of compulsive exercise and disordered eating. Results showed that the sociocultural influences differed slightly between boys and girls. Hierarchical regressions showed that, after controlling for disordered eating and BMI, messages to become more muscular and media pressure to be thin significantly predicted compulsive exercise in boys, while the same regression in girls reported only media pressure to be thin as a significant predictor of compulsive exercise. These findings demonstrate the influence of the media in boys’ and girls’ compulsive exercising, as well as highlight the influence of body shape messages to become more muscular on boys’ compulsive exercise.