糖尿病患者生命质量评价量表及国内研究现状

糖尿病是一种严重危及人们健康的慢性疾病,而糖尿病患者的生命质量(QOL)越来越多地引起大家的关注和重视。健康相关生命质量被列为新一代健康指标和科学研究指标,可以全面评价糖尿病治疗效果。总结生命质量的概念及意义,分析用于糖尿病患者生命质量测评常用的生命质量量表的内容与目前国内的应用现状,有助于进一步改善和促进我国糖尿病患者的生命质量评价现状。目前我国缺乏适用于糖尿病患者的生命质量专用量表,应着重开发适合中国人群的生命质量量表。     

Marital violence and sexually transmitted infections among women in post-revolution Egypt

ObjectivesTo explore the relationship between past year physical or sexual partner violence against women and women’s self-report of sexually transmitted infection (STI) symptoms in post-revolution Egypt; and to examine the effects of men’s and women’s risky sexual behavioural characteristics and structural dimensions of poverty and gender inequality on this relationship.Study designThis study uses the nationally representative cross-sectional demographic and health survey data conducted in 2014. Multivariate logistic regression was used to assess the relationship between past year partner violence and self-report of STI symptoms among currently married women.Main outcome measureswomen’s self-report of STI was based on their responses to three questions; whether in the past year they had: got a disease through sexual contact?, a genital sore or ulcer?, or a bad smelling abnormal genital discharge? Women who gave an affirmative response to one or more of these questions were assumed to self-report STI.ResultsAlmost one-third of women self-reported symptoms of STI. Fourteen percent of women reported they had experienced physical or sexual violence by a male partner in the past 12 months. Abused women had a 2.76 times higher odds of self-reported STI symptoms (95% CI 2.25–3.38). The significant relationship between self-reported STI and past year partner violence against women did not alter when adjusting for men’s and women’s behavioural characteristics and factors related to poverty and gender inequality.ConclusionsPublic health interventions that address women’s sexual and reproductive health need to consider violence response and prevention strategies.     

The battering syndrome: A poor record of detection in the emergency department

A review of recent studies shows that physicians have a poor record in detection of cases of domestic violence, with only one battered woman in twenty-five diagnosed on physical examination. Emergency physicians who are more aware of the distinguishing features of the battering syndrome and provide appropriate crisis intervention may help victims to seek early legal and social aid, thereby preventing development of a chronic situation or a personal tragedy.     

Violence,mental health,and physical symptoms in an academic internal medicine practice

OBJECTIVE: To assess how physical and/or sexual intimate partner violence (IPV), child abuse, and community violence relate to long-term mental and physical problems; to examine the overlap between different forms of violence and the impact of experiencing multiple forms of violence. DESIGN: Cross-sectional survey. SETTING: Three general internal medicine practices affiliated with an academic medical center. PARTICIPANTS: English-speaking women aged 25 to 60. MEASUREMENTS: Telephone or in-person interview and chart review. RESULTS: One hundred seventy-four women completed interviews. A majority of participants experienced more than one form of violence. In separate multivariate analyses, each form of violence was associated with depressive symptoms or with at least 6 chronic physical symptoms, after adjustment for demographic factors and substance abuse. The degree of association with health outcomes was similar for each form of violence (odds ratio [OR], 2.4 to 3.9; P < .003). The association with chronic physical symptoms remained significant for IPV (OR, 3.3; P < .002) and community violence (OR, 3.4; P < .003), even after adjustment for depression and posttraumatic stress disorder. There were dose-response relationships between the number of forms of violence experienced and the odds of depressive symptoms and the odds of multiple chronic physical symptoms. CONCLUSIONS: Multiple types of victimizations may contribute to patients' current mental health and physical problems. Research or clinical protocols that only focus on one form of violence may underestimate the complexity of women's experiences and needs.     

Current research overstates American support for political violence

Political scientists, pundits, and citizens worry that America is entering a new period of violent partisan conflict. Provocative survey data show that a large share of Americans (between 8% and 40%) support politically motivated violence. Yet, despite media attention, political violence is rare, amounting to a little more than 1% of violent hate crimes in the United States. We reconcile these seemingly conflicting facts with four large survey experiments (n = 4,904), demonstrating that self-reported attitudes on political violence are biased upward because of respondent disengagement and survey questions that allow multiple interpretations of political violence. Addressing question wording and respondent disengagement, we find that the median of existing estimates of support for partisan violence is nearly 6 times larger than the median of our estimates (18.5% versus 2.9%). Critically, we show the prior estimates overstate support for political violence because of random responding by disengaged respondents. Respondent disengagement also inflates the relationship between support for violence and previously identified correlates by a factor of 4. Partial identification bounds imply that, under generous assumptions, support for violence among engaged and disengaged respondents is, at most, 6.86%. Finally, nearly all respondents support criminally charging suspects who commit acts of political violence. These findings suggest that, although recent acts of political violence dominate the news, they do not portend a new era of violent conflict.

Provocative recent work (1–3)—cited in PNAS (4, 5), The American Journal of Political Science (6), 60 other articles and books, and 40 news articles that, together, have garnered over 2,281,133 Twitter engagements—asserts that large segments of the American population now support politically motivated violence. These studies report that up to 44% of Americans would endorse hypothetical violence in some undetermined future event (1–3, 7). This survey work fits within a media landscape that regularly raises the specter of political violence. Since 2016, we counted 2,863 mentions of political violence on news television, more than 630 news stories about political violence, and over 10 million tweets on the topic of the January 6 riot alone (see SI Appendix, section 1 for details for all counts in this paragraph). Political violence, however, remains exceedingly rare in the United States, amounting to 48 incidents (8) in 2019 (the most recent year for which data are available) compared to 4,526 incidents of nonpolitical violent hate crimes (9) and 1,203,808 total violent crimes (10) documented by the Department of Justice.In this paper, we reconcile supposedly significant public support for political violence with minimal actual instances of violent political action. To do this, we use four survey experiments that assess respondents’ reactions to specific acts of violence, where we experimentally manipulate whether partisanship motivated the activity and the severity of the violence. Using these studies, we identify two reasons why current survey data overestimate support for political violence in the United States.First, ambiguous survey questions cause overestimates of support for violence. Prior studies ask about general support for violence without offering context, leaving the respondent to infer what “violence” means. Using detailed treatments and precisely worded survey questions, we resolve this ambiguity and reveal that support for violence varies substantially depending on the severity of the specific violent act. With our measures, assault and murder attract minimal support, while low-level property crimes gain higher (although still low) support. Moreover, even though segments of the public may support violence or report that it is justified in the abstract, nearly all respondents still believe that perpetrators of well-defined instances of severe political violence should be criminally charged.Second, disengaged survey respondents cause an upward bias in reported support for violence. Prior survey questions force respondents to select a response without providing a neutral midpoint or a “don’t know” option. This causes disengaged respondents—satisficers (11)—to select an arbitrary or random response (12). Current violence support scales are coded such that four of five choices indicate acceptance of violence. In the presence of arbitrary responding, such a scale will overstate support for violence. Across all four studies, we show that disengaged respondents report higher support for violence.Accounting for these sources of error, our four studies show that American support for political violence is less intense than prior work asserts (Fig. 1) and is contingent on the severity of the violent act. Depending on how the question is asked, we show that the median of existing estimates of the public’s support for partisan violence is nearly 6 times larger than the median of our estimates (18.5% versus 2.9%). While recent political events show that extreme political groups are willing to engage in violence, these groups are likely to overlap with the narrow segment of the population who already support political violence. As policy makers consider interventions designed to dampen support for violence, our results demonstrate that support for violence is not a mass phenomenon, indicating that antiviolence measures should be appropriately tailored to match the scale of the problem.Open in a separate windowFig. 1.We created a census of all reported estimates of support for violence using the Kalmoe–Mason measure in the media (this includes work done by authors other than Kalmoe and Mason). This figure shows their distribution. We report this in the full sample (A), for Republicans (B), and for Democrats (C). To contextualize the problems, in these estimates, we overlay the largest estimates (orange line) and smallest estimates (blue line) from the studies that follow. There is large variation in the reported values, but all are significantly larger than our preferred estimate. See SI Appendix for additional details.     

国产陶瓷托槽在转矩力作用下断裂强度的研究

目的 评价自主开发的国产多晶体氧化铝陶瓷托槽的断裂性能.方法 利用我科与北京理工大学合作开发的测量装置检测国产陶瓷托槽在转矩力作用下的断裂力和力矩,并与临床常用的进口陶瓷托槽Crystaline IV作对比.结果 在转矩力作用下,国产陶瓷托槽断裂时槽沟处的力为(4342.6±845.8) gm,力矩为(2779.3±541.3)gm-mm,与Crystaline IV无显著性差异,且显著高于文献中推荐的产生牙齿移动有效力矩.结论 国产陶瓷托槽在转矩力作用下的断裂强度能够满足临床使用的需要.     

El saber experiencial de las matronas de Atención Primaria en la detección de violencia de género durante el embarazo. Estudio cualitativo

AimTo use the reflections of primary care midwives to find out the barriers and facilitators for detecting IPV during pregnancy. The second aim is to determine proposals for measures to improve detection of IPV.MethodQualitative methodology with a interpretative phenomenological approach. In-depth interviews were conducted with 12 midwives, working in the sexual and reproductive health care centres of Hospitalet de Llobregat (Barcelona).ResultsThe difficulties in detection relate to the system of visits, the situation of women and barriers of practitioners themselves, such as fear. Follow-up of pregnancy and the relationship of trust with the midwife stand out as facilitators. The proposals for improvement were to increase training and use safe and reliable health care procedures.ConclusionsThe complexity of IPV makes it likely that IPV during pregnancy is undetected. It would be desirable to implement actions such as expanding training and agreeing on an internal work circuit that includes objective instruments to detect IPV, coordination with other services and ethical and legally appropriate way of recording in the clinical record.