HIV感染者/AIDS患者情绪问题及其相关因素分析

目的：了解长沙市新确认的HIV感染者/AIDS患者情绪问题发生现状并分析其相关因素,为更好地开展 该人群的精神卫生服务提供基础数据。方法：将2013年3月1日至2014年2月28日在长沙市艾滋病综合防治信息系统 中新确认登记的、符合入组条件的感染者/患者作为连续样本,在知情同意的原则下,采用病人健康问卷抑郁量表 (PHQ-9)、广泛性焦虑量表(GAD-7)、社会支持评定量表(SSRS)及艾滋病压力量表(HIV/AIDS Stress Scale)进行调查。 结果：370例HIV感染者/AIDS患者的抑郁阳性率为40.3%(PHQ-9≥10分),焦虑阳性率为30.5%(GAD-7≥10分)。重 度抑郁症状(PHQ-9≥20分)及重度焦虑症状(GAD-7≥15分)分别占8.1%,14.3%。分层回归分析结果显示：工作状况 (b=–3.407,P<0.001;b=–2.799,P=0.001)、性取向(b=1.903,P=0.008;b=1.314,P=0.034)、居住情况(b=–1.995, P=0.012;b=–2.167,P=0.002)、出现HIV感染相关症状(b=4.578,P<0.001;b=3.652,P<0.001)、艾滋病相关压力 (b=0.081,P<0.001;b=0.090,P<0.001)是HIV感染者/AIDS患者抑郁、焦虑情绪的预测因子,社会支持(b=–0.046, P=0.044)是抑郁情绪的预测因子,并且抑郁(ΔR2=55.8%,P<0.001)、焦虑(ΔR2=54.7%,P<0.001)互为强显著预测因子。 结论：在新确认的HIV感染者/AIDS患者中,抑郁、焦虑等情绪问题较为严重,在对该人群进行登记管理的同时应考 虑提供必要的心理社会支持及基本的精神卫生服务。     

替格瑞洛和氯吡格雷在老年冠心病患者抗血小板治疗中有效性及安全性的Meta分析

目的：探讨替格瑞洛和氯吡格雷在老年冠心病患者抗血小板治疗中的疗效及安全性,阐明更合理的抗血小板治疗策略。方法：应用计算机检索Cochrane试验资料库、Ovid-Medline全文数据库、EMBase数据库、PubMed数据库、中国学术文献总库（CNKI）、万方数字化期刊库、维普数据库（VIP）及中国生物医学文献数据库（CBM）,收集分为替格瑞洛组和氯吡格雷组治疗老年冠心病的随机对照试验（RCT）,2组患者分别给予替格瑞洛联合其他药物及氯吡格雷联合其他药物治疗,应用RevMan5.3统计软件进行Meta分析,观察抗血小板治疗有效性相关不良事件[即主要心血管不良事件（MACE）、心肌梗死（MI）、支架内血栓、全因死亡及卒中]和安全性相关不良事件（出血事件）的发生情况。结果：按照纳入和排除标准,共纳入15篇符合入选标准的RCT。Meta分析,与氯吡格雷组比较,替格瑞洛组MACE发生率（RR=0.59,95% CI：0.46~0.76,Z=4.08,P<0.01）、MI发生率（RR=0.48,95% CI：0.28~0.81,Z=2.74,P=0.006）、支架内血栓发生率（RR=0.16,95% CI：0.06~0.48,Z=3.30,P=0.001）和全因死亡发生率（RR=0.52,95% CI：0.30~0.89,Z=2.41,P=0.02）均明显降低,卒中发生率（RR=0.76,95% CI：0.39~1.47,Z=0.81,P=0.42）差异无统计学意义,出血发生率（RR=1.57,95% CI：1.20~2.05,Z=3.28,P=0.001）明显增加。结论：对于老年冠心病患者,替格瑞洛抗血小板治疗的有效性优于氯吡格雷,但可增加出血发生率。     

高龄患者麻醉中瑞芬太尼和芬太尼的比较分析

目的 探讨瑞芬太尼和芬太尼在高龄手术患者麻醉中的应用效果.方法 选择56例高龄手术患者,随机分为对照组和实验组,每组28例.记录术中不同时间点的心率、血压,记录术后拔管、意识恢复、自主呼吸恢复时间.所获数据采用方差分析t检验.结果 麻醉后两组患者的血压、心率较诱导前明显下降（P＜0.05）;插管和切皮时实验组血压、心率明显低于对照组,（P＜0.05）具有统计学意义;术后拔管、意识恢复、自主呼吸恢复时间均明显低于对照组,（P＜0.05）具有显著性差异.结论 瑞芬太尼比芬太尼更适合高龄患者的麻醉要求.     

康复科护理人员对残疾人态度、工作成就感与人性化护理能力的关系

目的 了解康复科护理人员人性化护理能力的现状,并探讨其与对残疾人的态度和工作成就感间的关系。方法 2020年12月至2021年3月,便利抽取锦州市、盘锦市、营口市和抚顺市8所综合性三甲医院的196例康复科护理人员,采用医护人员对残疾人态度量表、工作成就感量表、护士人性化护理能力量表进行调查。结果 康复科护理人员人性化护理能力总分为(73.39±10.75),总条目均分(3.86±0.57);康复科护理人员人性化护理能力与对残疾人态度和工作成就感均呈正相关(r=0.208～0.774, P <0.01);工作成就感在康复科护理人员对残疾人态度和人性化护理能力间起部分中介作用,中介效应为0.420,占总效应的52.83%。结论 康复科护理人员人性化护理能力较差。对残疾人态度越好,工作成就感越高,人性化护理能力会越强。康复科护理人员对残疾人态度不仅可以直接作用于人性化护理能力,也可以通过工作成就感间接影响人性化护理能力。     

中青年脱发需治肝

根据邓中甲教授对中青年脱发的认识和治疗经验,结合历代医家的论述,认为其发病机理主要是肝气郁滞,痰湿内阻导致气血运行不畅,头发失于濡养。采用疏肝解郁,清化痰湿的治疗方法可取得满意的疗效。     

Evidence-based health promotion for older people and instrumentalisation: comparing the influence of policy contexts in Austria and England

Health promotion (HP) amongst older people is an increasingly prominent policy concern for governments. The development of an evidence-base and the advocacy of effective interventions in the light of this act as legitimation tools for the overall HP phenomenon – assisting the growth of state and non-state funding for public health initiatives for older people. In structuring decision-making as to which individual projects/initiatives receive funding, frameworks for acknowledging efficacy impact on formats of HP work both positively and negatively. Drawing on recent research across the EU and focusing on the specific national contexts of Austria and England, this comparative policy analysis triangulates best-practice modelling, evaluation data and interviews with project coordinators to explore how policy contexts impact on the nature and format of HP interventions. Amidst a developing awareness of what effective practice looks like, successful HP initiatives must advocate their legitimacy within narrow rules of quality, where measurable outcomes have become the keys which unlock financial resources. Findings across both countries suggest that this instrumentalisation of legitimation, driven by economic pressures and bureaucratic generalisability, threatens the rationality of HP. From a Habermasian perspective, tensions emerge between projects’ remaining reflexive towards processes and their need to articulate the ‘success’ of the interventions in a language of outcomes. Over time, in an era where resources are increasingly scarce and competition over these intensifies, a danger exists whereby the instrumentality of HP begins to separate from, and impinge upon, the capacity for projects to think and act holistically.     

Consuming identities: Alcohol marketing and the commodification of youth experience

Marketing has successfully used the postmodern turn in conceptualisations of the human subject and incorporated contemporary theorising of identities and self into its understanding of the key drivers of consumption. Such developments clearly converge in alcohol marketing practices that target young people, where commercialised youth identities available for consumption and engagement are a significant element. This article reports data from young people that reflect the uptake of such identities and considers the challenges that these developments represent for public health and the well-being of young people.     

Do bonding and bridging social capital affect self-rated health,depressive mood and cognitive decline in older Japanese? A prospective cohort study

Little is known regarding the longitudinal effects of bonding and bridging social capital on health. This study examined the longitudinal associations of bonding and bridging social capital with self-rated health, depressive mood, and cognitive decline in community-dwelling older Japanese. Data analyzed in this study were from the 2010 (baseline) and 2012 (follow-up) Hatoyama Cohort Study. Bonding social capital was assessed by individual perception of homogeneity of the neighborhood (the level of homogeneity among neighbors) and of networks (the amount of homogeneous personal networks) in relation to age, gender, and socioeconomic status. Bridging social capital was assessed by individual perception of heterogeneity of networks (the amount of heterogeneous personal networks) in relation to age, gender, and socioeconomic status. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to evaluate the effects of baseline social capital on poor health outcome at follow-up by logistic regression analysis. In total, 681 people completed baseline and follow-up surveys. The mean age of participants was 71.8 ± 5.1 years, and 57.9% were male. After adjusting for sociodemographics, lifestyle factors, comorbidity, functional capacity, baseline score of each outcome, and other bonding/bridging social capital, stronger perceived neighborhood homogeneity was inversely associated with poor self-rated health (OR = 0.55, 95% CI = 0.30–1.00) and depressive mood assessed by the Geriatric Depression Scale (OR = 0.58, 95% CI = 0.34–0.99). When participants who reported a depressive mood at baseline were excluded, stronger perceived heterogeneous network was inversely associated with depressive mood (OR = 0.40, 95% CI = 0.19–0.87). Neither bonding nor bridging social capital was significantly associated with cognitive decline assessed by the Mini-Mental State Examination. In conclusion, bonding and bridging social capital affect health in different ways, but they both have beneficial effects on the health of older Japanese. Our findings suggest that intervention focusing on bonding and bridging social capital may improve various health outcomes in old age.