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。     

Body dissatisfaction,eating disorders,and depression: A developmental perspective

McCarthy (1990) contends that a cultural ideal of thinness (the thin ideal) causes depression and eating disorders to occur more frequently in women than men. She believes eating disorders are a way of coping with depression and hypothesizes that the thin ideal has its greatest impact during puberty when sexual attractiveness becomes important and changes in physical appearance increase the discrepancy between the adolescent girl's actual and ideal body image. The present study used a cross-sectional design of 5th, 8th, and 12th grade males and females (N = 599) to test several predictions from McCarthy's model. As expected, 8th and 12th grade females preferred a thinner than average body shape. They were more dissatisfied with their bodies than males and scored higher on measures of disordered eating. In contrast, before puberty (5th grade) boys were more depressed than their female peers but this pattern was reversed in 8th grade boys and girls. Paralleling changes in depression, disordered eating scores were highest in 8th and 12th grade girls. Both of these findings underscore the role of maturational factors in the onset of eating disorders. Although the sample was ethnically diverse and mainly from middle and low socioeconomic groups, there was a surprisingly high incidence of body dissatisfaction and symptoms of disordered eating. This illustrates the pervasiveness of thinness as a standard of feminine beauty in our society and the damaging effects it can have.     

A dimensional analysis of claustrophobia

The present study investigated whether situational and cognitive dimensions of claustrophobia exist. To this end, the Claustrophobia Situations Questionnaire (CSQ) and the Claustrophobia General Cognitions Questionnaire (CGCQ) were developed and exploratory factor analyses were performed on these scales. Two-factor solutions for both the anxiety and the avoidance ratings on the CSQ were obtained, accounting for 40.1% and 34.2% of the variance, respectively. Two subscales were created from the two-factor solution of the anxiety section of the CSQ: (1) Fear of Entrapment and (2) Fear of Physical Confinement. Two subscales were also created from the two-factor solution of the avoidance section of the CSQ: (1) Avoidance of Crowds and (2) Avoidance of Physical Confinement. A three-factor solution was obtained for the CGCQ, accounting for 54.4% of the variance, from which the following three subscales were created: (1) Fear of Loss of Control, (2) Fear of Suffocation, and (3) Fear of Inability to Escape. Cronbach alphas for all subscales ranged from .84 to .94. Exploratory correlational analyses were conducted between the situational and the cognitive dimensions.     

Marital discord and psychiatric disorder in children and adolescents

The relationship between marital discord and any DISC-2.1/DSM-III-R child psychiatric diagnosis was explored. Interview data from a community sample of 90 parent/child pairs and a clinic sample of 37 parent/child pairs were analysed. The data were collected at Columbia University/the New York State Psychiatric Institute as part of the pilot project of a multi-site methodological study. Rates of marital discord and DISC diagnoses were found higher in the clinic sample than in the community sample. The association between marital discord and any diagnosis remained significant when other risk and protective factors were controlled. Policy implications and recommendations for future research strategies suggested by the current exploratory study were discussed.     

脑卒中患者家属的焦虑状况及其影响因素分析

了解脑卒中患者家属的焦虑状况及其影响因素。采用焦虑自评量表（SAS）及自制的一般状况调查问卷对240名脑卒中患者家属进行问卷调查。脑卒中患者家属的焦虑状况明显高于国内常模（P〈0．01）;其中家属的性别、年龄、文化程度、与患者关系、患者神经功能缺损程度及医疗费用的缴付方式与患者家属的焦虑有关（P〈0．01）。患者家属的...     

城市居民生活满意度及其影响因素研究

为研究城市居民生活满意度的状况和影响生活满意度的因素,采用问卷方法对227名天津市居民在各项满意度上进行测量。结果显示宏观社会环境对城市居民生活满意度有重要影响．当前总体生活满意度基本乐观,多元回归分析表明,与生活满意度显著相关的因素有乐观、自尊、自由、满足、离异、欢愉和下岗等,表明基本生活保障达到一定满足后．乐观的情绪等。0理品质在生活满意度上具有重要意义。通过改善宏观社会环境和引导个人增强应对重大生活事件的能力及积极调整心态等可以保持和提高生活满意度。     

亚临床甲状腺功能减退与冠状动脉粥样硬化性心脏病

对冠心病高危因素积极地预防及治疗,可降低冠心病的患病率和病死率。已经得到公认的临床甲状腺功能减退通过引起代谢及血流动力学紊乱而参与了冠状动脉粥样硬化的发生与发展。目前,国内外许多临床研究显示亚临床甲状腺功能减退通过多种途径参与冠心病的发生和发展,是冠心病的重要危险因素之一。     

男性理想体型变化及其影响因素

现代男性对自身体型的关注程度日益升高,理想体型也发生变化,从单一的肌肉发达体型发展为低体脂高肌肉的双维度体型。影响男性理想体型的因素主要分为两类:生物因素和社会文化因素。生物因素方面,不同性别、年龄和性取向的群体拥有不同的男性理想体型;社会文化方面,社会文化通过家庭、同伴和媒体三个渠道向理想体型施加影响。未来的研究应该进一步通过实验确立体脂与肌肉双维度的男性理想体型,并结合纵向研究验证生物及社会文化因素的影响,完善男性理想体型的理论系统,为政府制定身体意象相关的干预措施和政策提供详实有力的理论依据。     

伴家族史的2型糖尿病危险因素的病例对照研究

为探讨2型糖尿病代谢特征及发病的危险因素,选取大连地区91例有家族史的T2DM患者为病例组,以44例患者的配偶（糖耐量正常）为对照组,进行流行病学问卷调查和体格检查,同时测定空腹血糖、空腹胰岛素、总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白等指标,采用稳态模型法计算两组的胰岛素抵抗指数和β细胞功能指数,并进行多因素非条件Logistic回归分析。结果显示：TG、腰臀比和Ln（HOMAIR）病例组高于对照组,而Ln（HOMAβ）则病例组低于对照组,均具有统计学意义（P〈0．05）。多因素非条件Logistic回归分析结果提示,影响T2DM发病的因素有心血管疾病史、Ln（HOMAIR）及Ln（HOMAβ）。由此可见T2DM患者存在血脂代谢异常;心血管疾病史和Ln（HOMAIR）为发病的危险因素,Ln（HOMAβ）为保护因素。     

From Mental Health to Juvenile Justice: What Factors Predict This Transition?

We identify youth who are at risk for a critical transition from mental health to juvenile justice. A statewide longitudinal sample of Medicaid-eligible youth (aged 10–17) in the public mental health system (n = 5,455), during approximately one fiscal year (July 1, 1994–August 30, 1995), was used to determine the risk factors for, and timing of, a subsequent juvenile justice detention or commitment during the three subsequent fiscal years (1994–1997). Logistic regression and Cox Proportional Hazards modeling were used. Risk factors for juvenile justice detention or commitment included being: male, black or Hispanic, in junior high school, involuntarily admitted to mental health, having a DSM-IV diagnosis of conduct disorder, alcohol problems, a constellation of risk behavior, and receiving prior mental health services. Factors that accelerate the timing of detention or commitment in the juvenile justice system after a mental health visit included most of the general risk factors except risk behavior and involuntary admission were no longer significant and having a DSM-IV nonalcohol drug use diagnosis, antisocial behavior, and school problems became significant. Our study helps to identify youth who are at risk for multiple system use so that they may be provided appropriate services to prevent multiple system use.