人乳头瘤病毒疫苗带来的伦理问题

人乳头瘤病毒疫苗的问世使宫颈癌的预防进入崭新的时代,自其问世以来便饱受伦理争议.通过分析目前全球医学文献中比较重视和争议的伦理问题,如Gardasil与Cervarix哪种更为有效,能否在发展中国家顺利推广,应当“强制接种”还是“自愿接种”,男性是否应常规接种等.基于伦理学的基本原则,提出正确的宣教是解决的经由之路.     

Development of a Screening Instrument for Early Language Delay in Hong Kong Chinese: A Preliminary Study

Having language delay—one of the common neurodevelopmental difficulties during childhood—does not only imply an impairment in communication in the 1st few years of life. Previous studies have suggested that language problems have long-term implications for social, emotional, and intellectual development. Researchers have found that early identification and intervention of speech and language delay yields better treatment effects. However, unlike most of the motor developmental assessment tools, language assessment tools are not readily transferred across cultures because of the different linguistic features and the developmental stages of such features in a particular language or dialect. The present study presents an empirical example of the initial development of a culturally sensitive screening protocol, using vocabulary size as the indicator to minimize the effect of linguistic differences.     

The Rise and Decline of the American Asylum Movement in the 19th Century

This paper traces the history of the American public asylum from the 1840s through the late 19th century. The focus is on social factors that contributed to the establishment of public institutions at the urging of reformers, the attempts to model them on the architecture and “moral treatment” offered by the best private institutions, the crowding of the asylums, the growing criticism aimed at the asylums and their superintendents, and the effects of calls for other approaches and for scientific management. Knowledge of the asylum's history may be useful today, as we stand at the crossroads in the treatment of the mentally ill.     

Community Living Skills

Persons with chronic mental health problems are frequently found living in the community at varying quality of life levels. Though rehabilitation programs are suitable for patients with acute exacerbations of mental health pathology, these programs are necessary but not sufficient to meet the needs of the chronic person. Long-term reliance on biomedically-based rehabilitation can produce dependence on the system and maintain reliance on the "sick role" which is counterproductive for current trends related to deinstitutionalization and "least restrictive environment." The intent of this article is to focus on an one alternative service delivery model- psychoeducation. The potentials for this mode to normalize or maximize independence is discussed and two community living skills programs for the chronically mentally ill are described to exemplify the application of psychoeducation.     

Psychological and behavioural effects of bone density screening for osteoporosis

Abstract

To examine the psychological effects of bone density measurement, 298 women were assessed two weeks before the bone density scan, immediately before the scan, after the results, a week later and three months later. For the group as a whole, ratings of anxiety and perceived vulnerability were lower at the three month follow-up than at the initial assessment. Women who received a low bone mineral density (BMD) result were more anxious and reported more osteoporosis-preventive behaviours at the three month follow-up than women who received a high BMD result; these differences had not been apparent at the initial assessment Women with low BMD results had higher ratings of perceived vulnerability after the scan, although for some of these ratings there were group differences before the scan. Women with a low BMD result showed a decrease in ratings of the seriousness of a below-average result, which may reflect minimization of the health threat     

Emotional approach coping: Gender differences on psychological adjustment in young to middle-aged cancer survivors

Objective : The effect of emotional approach coping (EAC) varies by gender. However, this gender difference has not yet been investigated in cancer survivors. We investigated whether the effects of two kinds of EAC – emotional processing (EP) and emotional expression (EE) – vary by gender and whether EAC has effects above and beyond the effect of other coping strategies.

Design : EAC and other coping strategies were assessed at baseline in a sample of 248 young to middle-aged adult (between the age of 22 and 55) cancer survivors. One hundred and sixty-six survivors responded to psychological adjustment one year later.

Results : EAC had different relationships with Time 2 adjustment in men and women. Hierarchical regression analyses showed that for men, EE predicted lower intrusive thoughts and, for women, EP was associated with higher positive affect when other coping strategies and EE were controlled.

Conclusion : Gender differences held true in cancer survivors, and EAC was effective when other coping strategies were controlled. Further, EE was effective in reducing negative adjustment in men while EP was helpful in promoting positive adjustment in women.     

Development and validation of an appearance motivation attitudes scale for sun protection

A reliable two-factor instrument measuring appearance motivation attitudes for sun protection was developed using a longitudinal sample of beachgoers. At baseline, data on sun protection and appearance motivation attitudes were collected on 2324 individuals. Principal components analyses (PCA) indicated a two-factor solution measuring attitudes toward tan attractiveness and skin protection with only 2 items loading on the skin protection factor. At 12-months, the instrument was revised and shortened but including 3 new skin protection items. Split-half analyses were conducted to further refine and develop the instrument. PCA on half of the sample revealed a two-factor solution, which was confirmed using structural equation modeling on the remaining half. This resulted in a two correlated-factor, 10-item measure. Each factor was summed to create two scales. Both scales were internally consistent and demonstrated good external validity, correlating with sun protection specific Transtheoretical model variables. The tan attractiveness attitudes scale significantly improved prediction of sun protection outcomes over 24 months, over and above TTM variables.     

Busy lifestyles and mammography screening: Time pressure and women’s reattendance likelihood

Time pressure is often cited as a reason for non-attendance at mammography screening, although evidence from other areas of psychology suggests that time pressure can improve performance when barriers such as time pressure provide a challenge. We predicted that time pressure would negatively predict attendance in women whose self-efficacy for overcoming time pressure is low, but positively predict attendance when self-efficacy is high. Time pressure was operationalised as the self-reported number of dependent children and others, and average number of working hours per week. Australian women were surveyed after being invited to attend second or subsequent screenings at a free public screening service, and subsequent attendance monitored until six months after screening was due. The majority (87.5%) attended screening. Women with more dependent children and higher self-efficacy showed greater attendance likelihood, and women with fewer non-child dependants and lower self-efficacy were less likely to attend. Working hours did not predict attendance. Findings provide partial support for the idea that time pressure acts as a challenge for women with high self-efficacy.     

Predicting uptake of a routine cervical smear test: A comparison of the health belief model and the theory of planned behaviour

Abstract

This paper reports on a study carried out to identify predictors of uptake of cervical screening among 142 women (59% response rate) in inner London. Two social cognition models were used: The Health Belief Model (HBM; Becker, 1974) and the Theory of Planned Behaviour (TPB; Ajzen, 1991) and in addition anticipated affect following non-attendance for screening was assessed. The TPB emerged as by far the superior model for predicting screening intentions, explaining 51% of the variance in comparison with only 4% explained by the HBM variables. However, neither model was able to predict a significant amount of variance in uptake of screening three months later. Possible reasons for the poor prediction of this type of behaviour are discussed.