后医学时代的数字化证据——评杨功焕著《中国人群死亡及其危险因素流行水平、趋势和分布》

杨功焕教授的著作《中国人群死亡及其危险因素流行水平、趋势和分布》,调查20世纪80年代~90年代非人口因素对死亡的影响占81%,人口因素占19%。说明20世纪90年代是人群死亡模式发生巨大转变的10年。吸烟和饮食为主要行为因素。必须进行行为干预,靠非卫生部门的努力,包括医疗保险、实行健康促进战略、进行行为革命、对全部医务人员再教育,以适应后医学时代。     

温州鹿城区群众角膜捐献意识现状调查与分析

由于传统观念和宗教信仰的禁锢,由于社会宣传的欠缺、法律法规的滞后等多方面因素影响,角膜移植术遭遇群众的角膜移植意识水平低下带来的角膜缺乏的尴尬。因此,我们需要通过各种各样措施促使群众不断正确认识和客观评价角膜捐献。     

Age differences in the prevalence of physical aggression among 5-11-year-old Canadian boys and girls

It has been proven extremely difficult in the past to estimate the prevalence of physical aggression in children for two main reasons: (a) a heterogeneous sampling of behaviors (i.e., mix between physically aggressive and non-physically aggressive antisocial behaviors), and (b) a lack of a "gold standard" to identify children who exhibit physically aggressive behaviors on a frequent basis. The goal of this study was to test for age differences in the prevalence of physical aggression in the Canadian population of school-aged boys and girls, using cross-sectional data from the National Longitudinal Survey of Children and Youth (NLSCY). The first wave of the NLSCY included a representative sample of 12,292 Canadian children aged 5-11 years. We used latent class analysis to identify children whose propensity to exhibit physically aggressive behaviors was much higher than that of other children of the same age and sex in the population. The prevalence of physical aggression was estimated at 3.7% in 5-11-year-old boys and ranged from .5% to 2.3% in 11 and 5-year-old girls, respectively. Hence, the results show a decreasing trend in the prevalence of physical aggression with age for girls, but not for boys. These findings suggest the importance of considering the developmental pathways of physical aggression for boys and girls separately.     

Ethnic differences in BMI, weight concerns, and eating behaviors: comparison of Native American, White, and Hispanic adolescents

Evidence suggests that substantial proportions of adolescents, regardless of ethnicity or gender, are engaged in excessive weight control behaviors. Crago and Shisslak (2003), however, have noted that small samples and poorly validated instruments have limited the value of previous ethnic difference studies. Using the McKnight Risk Factor Survey, we compared Native American, White, and Hispanic adolescents. Native students were divided into groups with one (NA-mixed) or two (NA) Native American biological parents. Surveys were completed by 5th through 10th grade students. BMI z-scores were significantly higher for boys and girls in the NA group, and boys in this group were significantly more engaged in weight control behaviors, including purging. A higher percentage of Native and Hispanic girls preferred a larger body size. BMI was positively correlated with weight and shape concerns and with weight control behaviors, regardless of ethnicity or gender. Overweight among Native adolescents may put them at greater risk for eating problems than their White peers.     

中学生一般生活满意度与家庭因素的关系研究

通过对兰州市190名中学生进行父母教养方式、生活满意度以及相关家庭因素的问卷调查发现：（1）家庭所在地,家庭经济水平,父母职业、文化程度对中学生一般生活满意度无显著影响;亲子关系满意度、对父母婚姻幸福程度的评价对中学生一般生活满意度的影响显著;（2）情感温暖型教养方式与中学生一般生活满意度显著正相关,惩罚严厉、拒绝否认型教养方式与中学生一般生活满意度显著负相关。（3）亲子关系满意度、父亲拒绝否认、母亲惩罚严厉型教养方式是预测中学生一般生活满意度的有力因子。     

韧性（resilience）——在压力下复原和成长的心理机制

韧性是指面对丧失、困难或者逆境时的有效应对和适应。当生活变化对人们造成威胁时,这种自我保护的生物本能就会展现出来。来自个人、家庭、社会三方面的保护性因素之间会相互作用而组成动力系统,共同抵抗环境的不利影响。韧性的过程模型认为韧性是瓦解和重新整合之后达到的更高平衡状态,与一般意义上的“复原”有区别。在不同人生发展阶段上,韧性呈现出具有不同适应意义的层次结构,其内涵也会因情境而变化。尽管在如何测量韧性的问题上研究者们仍未达成一致意见,但一些简便有效的韧性量表得到了广泛应用。韧性研究的目的是探索个人生存和成长的力量源泉,在教育、医疗、社区和企业中开展的韧性干预训练已经显示出良好效果。     

The Mediating Role of Executive Functioning in the Relation Between Difficult Temperament and Physical Aggression

The present investigation tested the hypothesis that executive functioning (EF) would mediate the relation between difficult temperament (DT) and aggressive behavior. This model was tested in 310 adult men and women. DT was measured using the Dimensions of Temperament Scale—Revised, EF was measured using 7 well-established neuropsychological tests, and aggression was assessed using the Buss–Perry Aggression Questionnaire. EF successfully mediated the DT–aggression relation for men, however, the model did not hold for women. Results are discussed with regard to how they influence current models of aggressive behavior as well as their implications for future violence prevention efforts.     

我国脑卒中的经济负担及影响因素分析——临床决策要关注病人的经济负担

通过综合近10年来的脑卒中经济负担的相关文献,主要描述了我国脑卒中的直接经济负担和间接经济负担,并对其经济负担的影响因素作了分析,提出了减轻脑卒中的经济负担的有效途径,表明关注病人的经济负担是临床决策的重要课题。     

正确认识心理因素在颞颌关节紊乱病中的作用

颞颌关节紊乱病(temporomandibular disorder,TMD)是口腔颌面部常见的疾病之一。TMD病因比较复杂,目前认为是多种因素作用的结果,主要为心理因素、牙合因素等。但是目前对于心理因素在TMD的发生、发展、治疗和转归方面,很多学者尚持有异议。运用系统论中的整体性原则、动态性原则、系统涨落理论、综合性原则和最佳化原则等阐明如何才能获得对心理因素在TMD中的作用的全面认识,并指出重视心理因素在TMD中的作用也是顺应医学模式转变,体现人文关怀的需要。     

对影响“临床决策”负面因素的剖析与探讨

临床决策是医疗实践过程中的中心环节,直接关系到病人的治疗效果。在决策形成和实施过程中受到各方面因素的制约,主要包括两个方面医生自身方面因素,如医生素质、技术水平、决策思维能力等;医生自身以外的因素,如卫生政策、药品及其它医疗器材的流通环节、医保制度、医院经营方针,其它因素如社会、伦理、法律、经济等无不影响着医疗决策的正确实施。因此,要排除干扰,努力实施科学的临床决策,不仅要加强医生本身的素质和技术层面的培养和提高,更需要全社会、患者和广大公众给予理解和支持。