上海市虹口区离退休及低保妇女参与宫颈癌筛查相关因素研究

目的:了解影响社区妇女参与宫颈癌筛查的主要相关因素,为有效的干预提供基础。方法:采用自我效能量表和自行设计的知识态度及影响因素调查问卷,对上海市虹口区502例离退休及低保妇女进行问卷调查。问卷内容根据社会认知理论模型设计。结果:83.9%的调查对象曾经参与宫颈癌筛查,其中46.5%(所有调查对象中的39.0%)在3年内参加过宫颈癌筛查,多因素分析显示影响妇女曾经参与宫颈癌筛查的因素有:单位组织筛查、婚姻状况、医生推荐、周围人影响,且均为正向影响因素;而影响妇女3年内参与宫颈癌筛查的因素有:文化程度、社区组织筛查、离退休年数、医生推荐、宫颈癌及筛查相关知识、自我效能,这些影响除离退休年数为负向,其他均为正向相关因素。结论:上海市虹口区妇女3年内参与宫颈癌筛查率较低,应采取健康教育、提高妇女自我效能、提高医生对宫颈癌筛查的认识、提供免费筛查服务等多方面措施。在健康教育时应特别关注绝经后妇女,鼓励妇女家人同时参加。     

社区公共卫生服务界定的理论原则与方法步骤研究

社区公共卫生服务项目和内容的界定,是社区卫生工作者开展工作、政府确定经费投入标准以及对卫生人员的工作进行绩效考评等工作的前提。文章试在总结分析既往对社区公共卫生服务界定的理论原则的基础上,从明确当地主要卫生问题、建立服务项目库、对各项目进行初步分类、参考指标的计算、确定公共卫生服务项目和项目评价基础上的反馈调节等6个方面阐述了确定社区公共卫生服务项目的步骤及应用的方法。     

基于DS证据理论的大型医疗设备购置决策方法

提出了医院在采购大型医疗设备时的科学决策问题。利用证据决策理论中的Dempster融合法,根据专家对备选大型医疗设备基于技术性能、价格、维护成本、配套程度、经济效益和质量等因素的评判情况,确定基本概率分配函数、计算信度函数,获得了各备选设备的一个优势关系,从而为大型医疗设备购置的科学决策提供帮助。     

排队论数学模型在电子分诊系统中的应用体会

目的：探讨医院电子分诊系统的合理应用模式。方法：从排队论数学模型出发,分析并科学安排医护人员及医疗设备,使患者排队等待流程得到优化。结果：采用排队论数学模型的门诊分诊系统得到了成功应用。结论：利用排队论模型实现电子分诊系统是一种优化门诊排队和提高服务效率的可行方法。     

论中风起于“过用”

脑中风之发病原因起于过用,是从六气过用,七情内伤,五味不调,起居劳逸失节,治疗过用伤和方面分析中风之发病原因,同时中风起于过用是以整体观为基础,辩证的从人与自然、社会,以及情志、起居、劳倦、用药等多种因素相互关系的角度去维持人体内外环境平衡,全面的调整人体的生理病理机能,从而科学有效地指导中风的诊断及防治。     

叶天士络病理论研究

叶天士<临证指南医案>集中体现了叶天士目的络病思想.从<临证指南医案>中可以看到,叶天士将其广泛应用于中医各种病证目的辨治过程中.<临证指南医案>中目的络病病位广,病程长短不一,病因病机多种多样,具有独到目的治疗用药特色.可见,叶天士已总结出比较完善目的络病理论.叶天士对中医学目的发展作出了不可磨灭目的贡献.     

聚乳酸的酶降解动力学模型

将连续分布理论应用到聚乳酸的酶降解反应动力学中,模拟蛋白酶K降解聚乳酸的过程。将聚乳酸的酶降解过程分为3步：酶吸附在聚乳酸上;聚乳酸和酶形成具有活性的中间过渡体;生成特定断裂产物。运用矩的运算将积分微分方程转变成便于计算的普通微分方程,计算得到的降解产物的质量浓度随时间的变化与实验基本吻合。模型参数(k′,kE)与酶浓度、流量、pH和温度变化有关。     

New understanding of the basic theory of traditional Chinese medicine

Traditional Chinese medicine(TCM) plays an important role in the medical system used in health care and treatment of diseases.This article reviews the basic theory of TCM based on its formation and contributions.Two new personal points are proposed as follows:Six Zang(六脏) theory and deemphasization of the five-element theory.The basic theory of Chinese herbs is also discussed.     

Functioning and validity of a Computerized Adaptive Test to measure anxiety (A-CAT)

Background: The aim of this study was to evaluate the Computerized Adaptive Test to measure anxiety (A‐CAT), a patient‐reported outcome questionnaire that uses computerized adaptive testing to measure anxiety. Methods: The A‐CAT builds on an item bank of 50 items that has been built using conventional item analyses and item response theory analyses. The A‐CAT was administered on Personal Digital Assistants to n=357 patients diagnosed and treated at the department of Psychosomatic Medicine and Psychotherapy, Charité Berlin, Germany. For validation purposes, two subgroups of patients (n=110 and 125) answered the A‐CAT along with established anxiety and depression questionnaires. Results: The A‐CAT was fast to complete (on average in 2 min, 38 s) and a precise item response theory based CAT score (reliability>.9) could be estimated after 4–41 items. On average, the CAT displayed 6 items (SD=4.2). Convergent validity of the A‐CAT was supported by correlations to existing tools (Hospital Anxiety and Depression Scale‐A, Beck Anxiety Inventory, Berliner Stimmungs‐Fragebogen A/D, and State Trait Anxiety Inventory: r=.56–.66); discriminant validity between diagnostic groups was higher for the A‐CAT than for other anxiety measures. Conclusions: The German A‐CAT is an efficient, reliable, and valid tool for assessing anxiety in patients suffering from anxiety disorders and other conditions with significant potential for initial assessment and long‐term treatment monitoring. Future research directions are to explore content balancing of the item selection algorithm of the CAT, to norm the tool to a healthy sample, and to develop practical cutoff scores. Depression and Anxiety, 2008. © 2008 Wiley‐Liss, Inc.     

Cognitive vulnerability in fear of flying: the role of anxiety sensitivity

Previous research has indicated that more than 50% of air travel passengers experience hypoxia above clinical threshold. This condition produces a number of aversive somatic sensations such as difficulty breathing, elevated heart rate, dizziness, etc. Because these symptoms closely resemble the somatic symptoms of anxiety, it is interesting to look into a possible relationship between hypoxia-related symptoms and fear of flying. More specifically, the aim of this study is to clarify the role of anxiety sensitivity as a cognitive vulnerability marker in this relationship. Anxiety sensitivity is the specific tendency to interpret bodily sensations as threatening or harmful. Our hypothesis is that anxiety sensitivity moderates the relationship between hypoxia-related symptoms and fear of flying. When people with high anxiety sensitivity fly and experience somatic symptoms, they will make threatening interpretations causing fear and as a possible consequence avoidance behaviour leading to flight anxiety. About 160 participants were asked to complete the Flight Anxiety Situations Questionnaire, the Flight Anxiety Modality Questionnaire and the Anxiety Sensitivity Index. Results of a moderator analysis indicated that the relationship between somatic sensations and in-flight anxiety is stronger for people with high anxiety sensitivity than for people with low anxiety sensitivity. So it seems that anxiety sensitivity does indeed function as a moderator between the experience of somatic sensations while flying and in-flight anxiety. Clinical implications are discussed, as well as suggestions for further research.