Updated Reference Standards for Cardiorespiratory Fitness Measured with Cardiopulmonary Exercise Testing: Data from the Fitness Registry and the Importance of Exercise National Database (FRIEND)

ObjectiveTo provide updated reference standards for cardiorespiratory fitness (CRF) for the United States derived from cardiopulmonary exercise (CPX) testing when using a treadmill or cycle ergometer.Patients and MethodsThirty-four laboratories in the United States contributed data to the Fitness Registry and the Importance of Exercise National Database. Analysis included 22,379 tests (16,278 treadmill and 6101 cycle ergometer) conducted between January 1, 1968, through March 31, 2021, from apparently healthy adults (aged 20 to 89 years). Percentiles of peak oxygen consumption for men and women were determined for each decade from 20 through 89 years of age for treadmill and cycle exercise modes, as well as when defining maximal effort as respiratory exchange ratio (RER) greater than or equal to 1.0 or RER greater than or equal to 1.1.ResultsFor both men and women, the 50^th percentile scores for each exercise mode decreased with age and were higher in men across all age groups and higher for treadmill compared with cycle CPX. The average rate of decline per decade over a 6-decade period was 13.5%, 4.0 mLO₂·kg^-1·min^-1 for treadmill CPX and 16.4%, 4.3 mLO₂·kg^-1·min^-1 for cycle CPX. Observationally, the mean peak oxygen consumption was similar whether using an RER criterion of greater than or equal to 1.0 or greater than or equal to 1.1 across the different test modes, ages, and for both sexes. The updated reference standards for treadmill CPX were 1.5 – 4.6 mLO₂·kg^-1·min^-1 lower compared with the previous 2015 standards whereas the updated cycling standards were generally comparable to the original 2017 standards.ConclusionThese updated cardiorespiratory fitness reference standards improve the representativeness of the US population compared with the original standards.     

昆明市社区居民精神卫生服务需求调查与分析

目的探讨昆明市社区精神卫生服务需求及其影响因素,为社区开展精神卫生服务工作提供参考依据。方法采用WHO推荐的"精神卫生服务需求调查表",对514名社区及学校人群进行问卷调查,调查内容包括精神卫生服务信息的重要性及可及性。结果大多数人认为精神卫生服务信息"非常重要",而获得精神卫生信息较困难,其中6项回答"不能得到"的比例最高,6项回答"部分能够"的比例最高。因素分析表明:对精神卫生服务部分信息的重要性的认识与收入水平、医疗保障途径以及精神卫生知晓情况有关;精神卫生服务信息的可及性则与其他社会学因素无关。结论昆明市社区居民迫切需要了解精神卫生服务的相关信息,但是居民需求并未得到基本的满足。因此,需要加强精神卫生服务的宣传和教育,提高社区精神卫生服务的可及性和方便程度,才能有效地利用社区精神卫生服务。     

临床护理管理的应用与护理工作开展的重要性

护理管理的重点在于：①了解管理、管理理念的概念及含义。②理解管理理念、管理创新。③熟悉管理的基本方法。④掌握管理对象的管理原则及管理创新的概念与内容。     

浅议医院成本管理

在探讨市场经济条件下实行医院成本管理的必要性后,从分析中医医院成本管理现状出发,提出了实行目标成本管理制度,加强用人成本、药品成本管理,降低单位业务量中固定成本等改善医院成本管理的措施建议。最后简要总结医院实施成本管理的重要意义。     

中成药学教学中的思考

随着社会生活节奏的加快,中成药以其疗效可靠、毒副作用小、服用方便等特点越来越受到人们的青睐.应运而生的中成药学课程在很多学校开始开设.但在中成药学教学工作中,笔者发现这一新兴学科并没有受到足够的重视.在一些学校只是为了丰富课程门类而设置,并没有投入足够的人力、物力进行课程建设.在此,笔者对开设这门课程的必要性、重要性以及课程教学中需注意的问题进行分析,希望能够引起人们对该课程的重视,以更好地建设该课程,使其健康发展,为培养现代中医药人才服务.     

高干病房老年住院患者基本需要状况调查

目的探讨老年住院患者各层基本需要的重要程度、满足程度及其相关因素。方法选取96例高干病房老年患者为研究对象,通过问卷形式调查其一般资料及对基本需要的重要程度及满足程度并统计比较。结果96例老年患者中,生理需要及安全需要重要程度得分最高,分别为（9．40±0．83）,（9．67±0．87）分,其次为社交及尊重需要,分别为（7．17±2．47）,（6．19±2．53）分,自我实现需要的重要程度得分最低为（3．58±2．27）分;在满足程度方面,以安全需要的得分最低为（2．54±0．94）分;老年患者生理需要,安全需要,社交需要及审美需要的重要程度与其满足程度无关（P〉0．05）,尊重需要,认知需要及自我实现需要的重要程度与满足程度呈中度的负相关关系（r分别为-0．435,-0．535,-0．610;P〈0．05）;老年患者生理需要的重要程度与其年龄呈正相关（r=0．225,P〈0．05）;老年患者安全需要的满足程度与年龄呈负相关（r=-0．264,P〈0．05）而与其文化程度呈正相关（r=0．254,P〈0．05）。结论医护人员应重视老年患者的需求特点,在满足老年患者生理需要及安全需要的基础上,根据不同老年患者的需求特点满足其较高层次的需要。     

Sexual life and self-esteem in married elderly

The elderly population in South Korea is increasing. But traditionally in Korea, there is a tendency for the elderly to be cautious and sensitive to how their children view them, and younger generations tend to consider elderly sexuality to be a subject of taboo. Nevertheless, a person's sexual life is a general condition that affects the body, mental health and personality. Therefore, it is important to examine the relationship between the actual conditions of sexual life of elderly and self-esteem during old age. Sexual life was important for 38.5% of the research subjects and very important for 23.7%. Sexual partners were spouses for 93.4%. The self-esteem range was 20-38 with an average of 28.23. Those who were maintaining a sexual life had significantly higher self-esteem than those who were not (t = 2.222, p = 0.028). Those who felt very satisfied with their current sexual life had a significantly higher self-esteem than those who did not (F = 2.824, p = 0.028). The results show that it is important to have sexual life in late life. It will be necessary to develop and apply programs that will actively support elderly sexual life, as well as continue research in this area.     

中医原创思维研究的意义

中医原创思维模式是中国传统医学认识自然生命现象,解决医疗实践问题的开拓性的、特有的、与众不同的、创造性的思维方式。它是古人对生命、健康与疾病的概括性的反映,是中医学理论与临床实践的结晶,具有哲学和科学层面的双重内涵。研究中医原创思维具有重要意义,可以阐明中医理论认知特点,明确医疗实践活动的思维模式,实现理论飞跃;可以回应文化责疑,建立文化认同,并为当代思维科学的发展提供借鉴。     

Implicit and Explicit Self-Esteem and Attractiveness Beliefs among Individuals with Body Dysmorphic Disorder

Body Dysmorphic Disorder (BDD) is characterized by a preoccupation about imagined or slight defects in one’s appearance. In the present study, we evaluated explicit and implicit biases among individuals diagnosed with BDD (n = 15), individuals with subclinical BDD symptoms (n = 20), and healthy control participants (n = 20). Specifically, we used the Implicit Association Test [(IAT; Greenwald, McGhee, & Schwartz, (1998) Journal of personality and social psychology, 74, 1464] to measure automatic associations related to self-esteem (evaluations of the self vs. others as good vs. bad) and the importance of attractiveness (evaluations of attractiveness vs. kindness as important vs. meaninglessness). Results indicated that, as predicted, BDD participants had significantly lower implicit self-esteem, relative to healthy control participants, and the subclinical BDD participants were intermediate between these groups. Further, lower implicit self-esteem was positively related to each of the other implicit and explicit BDD-relevant indicators, including explicit beliefs about attractiveness. However, no group differences were observed on the implicit importance of attractiveness task. These findings mostly support cognitive-behavioral models of BDD that suggest vulnerable persons exaggerate the significance of appearance for self-evaluation.

静疗小组对静疗工作的影响效果观察

目的探讨分析静疗小组对静疗工作的影响效果。方法选取于2017年1～12月期间的60例静疗患者展开研究,根据静疗中不同护理方式分为两组,对照组和观察组各30例,对照组行常规静疗护理,观察组行静疗小组管理护理,对比两组患者的临床效果。结果观察组留置针使用率高于对照组,差异有统计学意义(P0.05),观察组临床不良反应发生率低于对照组,差异有统计学意义(P0.05);观察组患者满意度高于对照组,差异有统计学意义(P0.05)。结论通过对静疗患者行静疗小组管理护理,能够有效提升护理疗效,减少并发症等不良情况发生率,提高患者满意度,具有临床推广意义。