2013年-2017年某三甲医院住院病例死因分析

目的分析冀鲁豫交界某三甲医院5年住院患者死因构成特点,为提升医疗技术与质量管理、合理配置医疗资源提供参考。方法收集某三甲医院2013年1月1日-2017年12月31日1329例住院死亡病例相关基本信息,按照ICD-10分类标准,采用统计描述、趋势分析、χ^2检验等统计方法进行回顾性分析。结果2013年-2017年某院共出院患者319481人次,死亡1329例,病死率为4.16%,住院患者病死率随年份有线性上升趋势。男性死亡845例,死亡率为0.55%,女性494例,死亡率为0.29%,男女死亡率差异有统计学意义;≥65岁年龄组病死率最高为1.07%,5岁~14岁年龄组病死率最低为0.09%,不同年龄组病死率差异有统计学意义。前5位死因及顺位为循环系统疾病(35.99%)、肿瘤(24.92%)、损伤及中毒(14.16%)、呼吸系统疾病(8.66%)、消化系统疾病(4.74%)。循环系统疾病前5位病种死因构成比为70.71%,恶性肿瘤前5位病种死因构成比为71.0%,损伤、中毒前5位病种死因构成比为96.81%。结论循环系统为重要死亡原因,医院应着重提高医疗技术与多学科综合协作救治能力,采取措施降低中低风险死亡率,重视循环系统疾病的早期筛查和干预,还要加强对高年龄患者慢性病的防治和心理疏导。     

Mental health as perceived by persons with mental disorders – an interpretative phenomenological analysis study

In this interpretative phenomenological analysis study, we explored how persons with mental disorders perceive mental health. Adapting a salutogenic theoretical framework, 12 former inpatients were interviewed. The analysis revealed experiences of mental health as a movement, like walking up and down a staircase. Perceived mental health is expressed both verbally in an everyday language and through body language. Mental health is an aspect of being that is always present and which is nourished by four domains of life: the emotional; physical; social and spiritual domains. Mental health is experienced in everyday life as a sense of energy, and as more or less wellbeing. Exploring persons' meanings of mental health from a subjective perspective can extend the knowledge base that can be used in mental health promotion strategies.     

Body Piercings and Posttraumatic Stress Disorder Symptoms in Young Adults

Body piercing, which is prevalent in young adults, has been suggested to be associated with features usually related to posttraumatic stress disorder (PTSD) such as high‐risk behaviours and psychopathological symptoms and might be motivated by a wish to deal with prior traumatic experiences. However, to date, no research has investigated the relationship between this practice and PTSD symptoms. The present research aims to investigate the possible relationship between body piercing and PTSD symptoms in French‐speaking young adults. According to our results, having two or more body piercings was associated with a twofold increased risk for scoring above the cut‐off score for PTSD on the PTSD checklist. Our findings suggest that two or more body piercings might serve as an identifiable marker for PTSD symptoms and may have important implications for clinical screening. Copyright © 2012 John Wiley & Sons, Ltd.     

论《中医体质量表》的修订

《中医体质分类与判定》标准及《中医体质量表》自正式颁布以来,已被广泛应用于科研、临床和健康管理。然而在多年的使用过程中,不少学者发现体质判定标准及体质量表自身存在一定问题,给体质辨识造成困惑。通过梳理目前体质量表的应用现状及有关体质量表应用中存在的问题,发现《中医体质量表》及《中医体质分类与判定》标准的修订具有可行性和必要性。     

王琦教授调体治疗过敏性疾病方法探微?

过敏性疾病为临床难治性疾病,王琦教授临证时采用"辨体-辨病-辨证"相结合的诊疗模式治疗过敏性疾病,收效显著。笔者在跟师学习中总结出王琦老师调体治疗过敏性疾病的以下特点:用药以扶正法为主,祛邪为辅;用药的同时适当接触过敏原;根据过敏性疾病的发病规律,选择特定的用药时间;缓解期调体用药与疾病发作期用药相比更为轻灵精简。     

“I don't want to look like an AIDS victim”: A New Zealand case study of facial lipoatrophy

The development of antiretroviral (ARV) drugs to treat HIV has turned what was once a death sentence into a chronic disorder. However, a focus on absence of disease in the form of an undetectable viral load and the dismissal of the so‐called “cosmetic” complications of the disease ignores perceptions of health and well‐being of those living with HIV. Facial lipoatrophy is a stigmatising side effect of treatment for HIV as it betrays the presence of the virus within the body. The study took a longitudinal qualitative approach, interviewing 11 people twice over a period of 1 year on their experience of living with HIV. Two participants were given cameras and asked to take photos which represented what it was like for them to live with this condition and were interviewed four times at four monthly intervals. This paper looks at one man's struggle to conceal or veil his facial lipoatrophy. His story is presented in the form of “selfies” and extracts from in‐depth interviews. It tells of an emotional (ongoing) journey of frustration, anger, excitement, depression and resignation which had a profound effect on his sense of social and psychological well‐being. This suggests a more holistic approach to treating people living with HIV is needed. While an undetectable viral load is indeed vital, it should not be seen as the only essential outcome of treatment.     

Psychological effects of belonging to a Facebook weight management group in overweight and obese adults: Results of a randomised controlled trial

This study was conducted to test whether the weight outcomes in an online social networking group were mediated by changes to psychological outcome measures in overweight and obese individuals, following a weight management programme delivered via Facebook. The data analysed in this study were collected during a three‐armed, randomised, controlled clinical weight management trial conducted with overweight and obese adults over 24 weeks. Two intervention groups were given the same weight management programme: one within a Facebook group, along with peer support from other group members (the Facebook Group); the other group received the same programme in a pamphlet (the Pamphlet Group). A Control Group was given standard care. The primary outcome was weight; secondary outcomes included the following domains from self‐reported questionnaires: energy intake and expenditure; psychological health, social relationships, physical health, quality of life, depression, anxiety, stress, health anxiety, happiness, as well as Facebook Group participants’ opinion of this group. The Facebook Group experienced a reduction in their baseline weight measurement by week 24, significantly compared to the Control Group (p = .016). The Facebook Group recorded a significant increase in the psychological health domain during the trial (at week 12) relative to their baseline measurement, and significant compared to the Control Group (p = .022). Mediation analysis indicated a statistical trend, but not statistical significance, for psychological health as a mediator to weight loss in the Facebook Group. While both intervention groups showed significant changes in psychological outcome measures, the Facebook Group was the only group to experience statistically significant weight loss by the end of the 24 weeks. Therefore, an examination of other psychological and/or behavioural outcome measures undertaken in larger studies in the future may help to identify significant mediators to improved weight loss outcomes in online social networking groups.     

Mental health cost of terrorism: Study of the Charlie Hebdo attack in Paris

This study examines whether a terrorist attack in a developed country, which does not cause major damage to its capital stocks, affects the mental health of its residents. By exploiting variations in survey dates of the European Social Survey, we use a difference‐in‐differences strategy to show that the attack adversely affects subjective well‐being and mental health measures of French respondents. These negative effects are stronger for immigrants and low‐income individuals. The impact is less dramatic for politically extreme right‐wing supporters. The distance from origin has little impact on these measures.     

Do capability and functioning differ? A study of U.K. survey responses

A core feature of the capability approach is that a person's capabilities (what they are able to do and be in their life) can differ from their functionings (what they actually do and are in their life). However, the degree to which capability and functioning differ in practice is unclear. This paper investigates this issue, focusing on capability and functioning differences (CFD) across different aspects of life and different individuals. In the study, the ICECAP‐A capability questionnaire was modified to measure both functionings and capabilities and was completed by U.K.‐based convenience sample of 943 people. Around one third of people reported CFD in at least one area of their life, most commonly in terms of their “achievement.” People were more likely to report CFD when they had a degree‐level education and when they had impaired health. An additional finding was that capability varied more with education whereas functioning varied more with health status. This finding needs further examination, but it suggests that the choice of evaluative space may influence how priorities are set for public spending.