糖尿病防治的策略转变——从关注糖化血红蛋白到着眼心血管事件

通过对2型糖尿病心血管终点事件的观察,更多的临床证据提示,糖尿病的治疗目标应该以减少心血管事件为主。糖尿病防治从策略上发生了两个转变,即以血糖为中心转向以防治心血管事件为中心的多危险因素综合防治策略;以糖化血红蛋白检测作为血糖评价的金标准转向以血糖量、质、时程控制的全面评价策略。     

中国人群脂肪肝主要影响因素的荟萃分析

为系统评价中国居民脂肪肝发病的主要危险因素,检索文献数据库,收集国内1997年～2008年有关脂肪肝发病危险因素的16篇文献,利用Meta分析方法,进行综合统计分析,累计病例7200例,对照11884例。结果超重（23≤BMI〈25）、肥胖（BMI≥25）、过量饮酒、吸烟、高脂饮食、食用蔬菜、饮绿茶、爱好运动、运动少、高脂血症、高HDL—Ch、低HDL-Ch、高血压、高血糖、高血总胆固醇（≥6．5mmol／L）及糖尿病合并0R值（95％CI）分别为1．68（0．68～3．90）、5．01（3．23～7．76）、3．52（1．52～8．15）、1．18（1．01～1．37）、2．82（1．50～5．31）、0．45（0．37～0．55）、0．52（0．43～0．64）、0．32（0．14～O．74）、3．49（1．26～9．65）、4．91（2．69～8．96）、0．31（0．17～0．57）、2．14（1．50～3．03）、2．19（1．43～3．35）、2．75（1．66～4．58）、2．96（0．26～32．98）、2．29（1．30～4．01）。结论为目前影响中国人群脂肪肝发生的危险因素依次为肥胖、高脂血症、饮酒、运动少、高脂饮食、高血糖、糖尿病、高血压、低HDL—Ch和吸烟;保护因素为饮用绿茶,食用蔬菜,以及高HDL—ch;尚不能确定与中国人脂肪肝发生的相关性因素为超重和高血胆固醇。     

他汀类降低心血管危险作用模式的探讨

大量临床实验结果及流行病学资料已证实3-羟基3-甲基戊二酰辅酶A（HMG-CoA）还原酶抑制剂（简称他汀类）,在冠心病防治中能显著降低心血管危险。但他汀类是通过何种模式产生这一作用,至今仍未得出定论。四种模式可用来描述他汀类降低心血管危险可能的作用机制。通过对这四种模式的探讨,能使我们对他汀类的作用机理有更为全面的认识,也为临床工作者进一步研究及确定他汀类降低心血管危险的作用模式奠定基础。     

Delay, Probability, and Social Discounting in A Public Goods Game

A human social discount function measures the value to a person of a reward to another person at a given social distance. Just as delay discounting is a hyperbolic function of delay, and probability discounting is a hyperbolic function of odds-against, social discounting is a hyperbolic function of social distance. Experiment 1 obtained individual social, delay, and probability discount functions for a hypothetical $75 reward; participants also indicated how much of an initial $100 endowment they would contribute to a common investment in a public good. Steepness of discounting correlated, across participants, among all three discount dimensions. However, only social and probability discounting were correlated with the public-good contribution; high public-good contributors were more altruistic and also less risk averse than low contributors. Experiment 2 obtained social discount functions with hypothetical $75 rewards and delay discount functions with hypothetical $1,000 rewards, as well as public-good contributions. The results replicated those of Experiment 1; steepness of the two forms of discounting correlated with each other across participants but only social discounting correlated with the public-good contribution. Most participants in Experiment 2 predicted that the average contribution would be lower than their own contribution.     

Trait anger and anger expression style in children's risky decisions

In this study, 104 children completed a task, measuring risk decision-making, and the State-Trait Anger Expression Inventory for Children and Adolescents. Subjects were also asked to evaluate the degree of danger, benefit, fun and fear perceived for each risky choice. Analyses indicated that (a) risk decision-making was predicted by both trait anger and outward expression of anger; (b) appraisal of danger fully mediated the relationship between trait anger and risk; (c) perceptions of benefit, scare and fun partially mediated the relationship between trait anger and risk; and (d) appraisal of danger partially mediated the relationship between outward expression of anger and risk decision-making. The results provide evidence for a relationship between dispositional anger and risk decision-making during childhood, suggesting a possible explanation of the mechanisms below. In particular, risk decision-making can be viewed as the output of cognitive and emotive processes, linked to dispositional anger that leads children to be amused, optimistic and fearless in potentially risky situations. These findings substantiate the importance of incorporating cognitive and emotive factors in theories that seek to explain the relationship between personality traits and risk decision-making across a broad age range.     

计划行为模型在HIV性风险行为领域的应用与发展*

整理和回顾了计划行为模型在HIV性风险行为领域的应用与进展。该模型在不同文化背景、不同样本中,对于HIV性风险行为呈现良好的解释力,但是其整体预测力及内部变量的显著程度仍不时波动。21世纪以来,通过核心变量操作化、新变量引入和结构关系调整,模型获得了较大的扩展和完善。但在模型效度再检验、纳入社会性别视角、克服个体行为模型缺陷,以及强化模型的干预适用性方面仍有较大的发展空间     

Community-Based Interventions to Reduce Low Income, African American Women's Risk of Sexually Transmitted Diseases: A Randomized Controlled Trial of Three Theoretical Models

A community-based sample of disadvantaged African American women (n = 445) was recruited to participate in 1 of 3 theoretically driven experimental interventions based on either the theory of gender and power, social learning theory, or cognitive behavioral theory. Intervention outcomes were compared with a waiting list control condition. From baseline to postintervention, women in the experimental interventions showed differential change on cognitive indices (knowledge and attitudes) and skill acquisition (partner negotiation skills, correct condom application, lubricant selection, and information-provision to social networks) whereas control participants were unchanged. Women in the 3 experimental interventions also completed follow-up assessments for 1 year following the interventions. In all 3 experimental conditions, condom use increased relative to the control group and there were no differences between the experimental interventions. Women who participated in one of the theoretically grounded interventions continued to increase condom use over the following year. Women entering new relationships reported significantly more condom use than did women who remained in ongoing relationships. The findings suggest that intervention models that have proven effective for women who engage in high-risk behavior may be less effective for women in established relationships for whom risk is primarily derived from the extrarelationship behavior of their partners.     

Resilience in the Face of Maternal Psychopathology and Adverse Life Events

Maternal psychopathology has long been recognized as a risk factor for psychopathology in offspring; however, some resilient youth achieve a favorable outcome in the presence of maternal psychopathology. We identified factors that predicted resilience among youth who were exposed to adverse life events, and also examined whether the same factors protected youth against maternal psychopathology and adverse life events. Main and interaction effects of child and family factors were examined employing cross-sectional data from a household probability sample of 1285 youth aged 9 through 17 collected at four sites. On average, children exhibited a greater degree of resilience when they had higher IQ, closer parental monitoring, better family functioning, higher educational aspiration, and were female. Interaction between maternal psychopathology and IQ was significant, and there was a trend between maternal psychopathology and gender. A higher IQ is a protective factor against both maternal psychopathology and adverse life events; whereas being a girl seems to be a protective factor against maternal psychopathology, but not adverse life events.     

Thin-Ideal Internalization: Mounting Evidence for a New Risk Factor for Body-Image Disturbance and Eating Pathology

Body-image disturbance and eating disorders are a significant physical and mental health problem in Western countries. We describe emerging work on one newly identified variable that appears to be a potent risk factor for the development of these problems internalization of societal standards of attractiveness. Work conducted independently in our labs over the past decade has included scale development, correlational studies, prospective risk-factor studies, randomized experiments, and randomized prevention trials. Findings collectively suggest that internalization is a causal risk factor for body-image and eating disturbances, and that it appears to operate in conjunction with other established risk factors for these outcomes, including dieting and negative affect. Future research is needed to examine the specific familial, peer, and media influences that promote internalization and to replicate and extend our prospective and experimental studies.