合理应用运动平板试验与冠脉CT诊断冠心病临床策略分析

本文针对临床诊断冠心病的两种常用手段即运动平板试验和冠脉CT进行分析,鉴于目前临床普遍存在重视采用冠脉CT,甚至达到滥用的地步,而逐渐忽视平板运动试验的现象,紧密结合临床,客观分析两者的特点,阐述各自优缺点。希冀通过本文以帮助临床医师正确选择应用,避免偏颇,最终达到将两者有机的结合,真正适合临床需要,提高冠心病患者的检出率,有利于更好地对冠心病进行二级预防。     

An Exercise in Psychological Growth*

The author presents a case report followed by a self- assessment exercise which was generated spontaneously in collaboration with the patient herself during the treatment process. The lists of questions, designed to provoke thought and stimulate maturation, were found to be quite helpful especially in making important life decisions. It is proposed as a learning tool and template for use by those confronting similar issues. Lois Gerby, MA, is a psychologist and family therapist in private practice, 32 Hapalmach St., Suite 32/7, Jerusalem, Israel 92542 (jack.friedman@mail.mcgill.ca). *Translation by Yacov Friedman and Haim Sherrf.     

Defining features of unhealthy exercise associated with disordered eating and eating disorder diagnoses

ObjectivesThe current study sought to compare different features of unhealthy exercise on associations with disordered eating and their ability to identify individuals with eating disorders. A secondary aim of the study was to compare prevalence and overlap of different aspects of unhealthy exercise and potential differences in their gender distribution.DesignCross-sectional epidemiological study.MethodsA community-based sample of men (n = 592) and women (n = 1468) completed surveys of health and eating patterns, including questions regarding exercise habits and eating disorder symptoms.ResultsCompulsive and compensatory features of exercise were the best predictors of disordered eating and eating disorder diagnoses compared to exercise that was excessive in quantity. Further, compulsive and compensatory aspects of unhealthy exercise represented overlapping, yet distinct qualities in both men and women.ConclusionsIncluding the compulsive quality among the defining features of unhealthy exercise may improve identification of eating disorders, particularly in men. Results suggest that the compensatory aspect of unhealthy exercise is not adequately captured by the compulsive aspect of unhealthy exercise. Thus, interventions that target unhealthy exercise behaviors among high-risk individuals, such as athletes, may benefit from addressing both the compulsive and compensatory aspects of unhealthy exercise. Future prospective longitudinal studies will aid in determining the direction of the association between these features of unhealthy exercise and the onset of eating pathology.     

孟子德性论的思维理路与儒家哲学认识和把握世界的基本方式

从性、天统一的德性论,到“德教”、“成德”的德性生成论,再到以德行仁的仁政学说,呈现出了孟子道德形上学的基本理路和环节。这一思维理路反映了中国哲学、尤其是儒家哲学认识和把握世界的基本方式。     

Seek,and You Will Find: The Influence of Expectations on Evaluations of Physical Activity

Despite hundreds of studies on the effects of expectations on evaluations, few commentaries have focused on summarising the relevance of these findings for physical activity pursuits. Moreover, a parsimonious framework on the nature of these relationships in physical activity is yet to be developed. Such a framework is important given the significance of physical activity evaluations in predicting future physical activity participation. Based on existing models on persuasion, it is premised that the self can be persuaded by one's own expectations about physical activity and that such persuasion can support or refute those expectations. Which of these effects are created, and the extent of one's psychological and physical involvement in the creation of physical activity evaluations, is likely to hinge on motivation and ability to confirm or disconfirm expectations. Evidence from related bodies of literature is presented to support the primary tenets of the model, which is termed the expectation‐to‐evaluation model, and recommendations for practitioners and future research are offered.     

Positive affect and physical activity: Testing effects on goal setting,activation, prioritisation,and attainment

Objective: The present research tested whether incidental positive affect promotes pursuit of physical activity goals. Four key features of goal pursuit were examined – setting physical activity goals (Study 1), goal activation (Study 2), and goal prioritization and goal attainment (Study 3).

Design: Participants (N_s = 80, 81, and 59, in Studies 1–3, respectively) were randomized to positive affect (joy, hope) or neutral affect (control) conditions in each study.

Main Outcome Measures: Questionnaire measures of goal level, goal commitment, and means selection (Study 1); a lexical decision task indexed goal activation (Study 2), a choice task captured goal prioritization and MET minutes quantified goal attainment (Study 3).

Results: Study 1 showed that positive affect led to a greater number of intended physical activities, and that joy engendered greater willingness to try activities. In Study 2, a positive affect induction led to heightened activation of the physical activity goal compared to the control condition. The joy induction in Study 3 led to greater physical activity, and a trend towards greater goal prioritization.

Conclusion: These findings suggest that positive affect enhances the pursuit of physical activity goals. Implications for health behavior theories and interventions are outlined.     

Effects of a single bout of moderate-to-vigorous physical activity on executive functions in children with attention-deficit/hyperactivity disorder: A systematic review and meta-analysis

ObjectivesThe aim of this study was to systematically review the literature investigating the acute effects of moderate-to-vigorous physical activity (MVPA) on executive functions (EFs) in children with attention-deficit/hyperactivity disorder (ADHD) and perform a meta-analysis of the effects of MVPA on task components that require lower and higher EF demand in this population.MethodsThe systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Six electronic databases, i.e., PubMed, Scopus, Web of Science, Embase, SPORTDiscus, and Education Resources Information Center (ERIC), were searched for eligible studies. Random-effects weights were used to pool the effect sizes. Publication bias was assessed by Egger’s regression test and Rosenthal’s fail-safe N. This study is registered on PROSPERO, number CRD42020184082.ResultsThe electronic database search yielded 12 studies, which met the inclusion criteria, comprising a total of 375 participants. Eleven studies with data from 275 participants were included in the meta-analysis to examine the acute effects of MVPA on tasks with lower and higher EF demand. A single bout of MVPA had a small positive effect on tasks with lower (n = 10, g = 0.32, 95% CI = 0.123–0.517) and higher (n = 10, g = 0.25, 95% CI = 0.13–0.371) EF demand. No publication bias was found.ConclusionsA single bout of MVPA may have a general facilitative effect on cognition, indicating that acute MVPA may be a transient nonpharmacological adjunctive treatment for childhood ADHD.     

Agentic extraversion moderates the effect of physical exercise on executive shifting performance

The present study investigated the impact of physical exercise on the executive shifting function in 24 participants low and 24 participants high in agentic extraversion and tested whether agentic extraversion moderated the exercise effect. Participants accomplished a shifting task and a control task that employed the same materials and response procedure as the shifting task but required less central-executive processing. Physical exercise was varied within subjects. The order of conditions was counterbalanced. After resting, the high agentic extraversion group showed higher cognitive flexibility than the low agentic extraversion group, whereas only the low agentic extraversion group improved after exercise. The results showed that agentic extraversion moderated the exercise effect on shifting performance. Implications concerning the hypothetical dopaminergic mediation were discussed.     

Does Exercising with Another Enhance the Stress-Reducing Benefits of Exercise?

This study sought to determine if the stress-reducing benefits of exercise are improved by exercising with others rather than alone. One hundred and thirty-six participants completed a series of questionnaires measuring levels of tension, calmness, energy, and tiredness before exercise, immediately following exercise, and later that day before bedtime. Participants exercised on a laboratory stationary bicycle for 30 minutes at moderate intensity either alone, with another person while talking, or with another person while remaining silent. A series of ANOVA procedures revealed that participants generally experienced more energy and calmness and less tiredness after exercise. Furthermore, exercising with someone resulted in more calmness but also more tiredness than when exercising alone. Males generally reported more positive psychological effects than females. Results suggest that exercise with someone may be calming but more tiring due to a potential increased competition or workload.     

The Impact of Exercise on Hormones Is Related to Autonomic Reactivity to a Mental Task

This study examined the effects of an acute physical stressor on salivary testosterone (Tsal) and cortisol (Csal) and their relationship with the autonomic responsiveness to a mental task in fit young men (n = 30). Salivary testosterone (Tsal) and cortisol (Csal) levels were determined before and after a maximal bicycle exercise. Heart rate (HR) and skin conductance levels (SCL) were continuously recorded before, during, and after a Stroop task. Tsal and Csal levels diminished while HR and SCL increased in response to stressors in all the sample. When subjects were distributed in function of their endocrine response to the physical stressor, high Tsal responders showed higher HR reactivity than low responders, and high Csal responders showed higher SCL reactivity and lower reaction time in the Stroop task. These results show that the influence of an acute physical stressor on hormones is associated with the autonomic responses to a mental task.