生活方式对血压及高血压患病率的影响

不健康生活方式使慢性病发病率升高,对公共卫生带来巨大负担［1,2］。高血压是心脑血管疾病的危险因素之一。青春期血压偏高,成年后患高血压风险增加［3］。及早控制血压能防止心脑血管疾病的发生。改变生活方式可以降低血压。成人血压高低与钾、钙、蛋白质、粗纤维等摄入量成反比［4］。多吃水果和蔬菜可以预防血压升高［5］。通过体育运动等控制体重,可使血压得到控制。尽管改变生活方式被推荐为控制高血压首选方法,但少有大样本的研究报告浙江人生活方式对血压的影响。因此,本研究旨在通过大样本调查生活方式和高血压患病率之间相关性。     

社区高血压病人遵医行为的调查与分析

高血压为慢性终身性疾病，如果血压长期控制不良，可引起心血管、脑、肾等多脏器的疾病，病死率较高。我国其患病人数随着人民生活水平的提高，社会生活节奏的加快，人口老龄化，生活方式改变而又迅速增加的趋势，且患病年龄也日渐年轻，现已成为影响人民健康的常见病和多发病。高血压病人的长期治疗需要病人多数是以药物来控制疾病发展，     

戒烟限酒对于治疗高血压的疗效分析

本文旨在探讨用戒烟限酒的方式来干预高血压患者的作用和疗效,以达到有效地控制血压的目的。联系当今高血压疾病的研究现状,比较国内外对高血压患者生活方式的干预效果,着重强调吸烟嗜酒对于高血压疾病的危害,得出戒烟限酒的生活方式改变对高血压治疗具有积极的意义。通过戒烟限酒的护理干预,降低高血压危险因素水平,达到有效预防和控制高血压,改变不良生活方式,满足现代人对于生活质量的追求,望能为高血压疾病治疗的临床研究提供参考。     

循证护理在高血压病患者健康教育中的应用

目的 应用循证护理理论为高血压病患者探讨科学的、经济的、有效的健康教育方法.方法 选择2010年3～8月在湛江市赤坎区某社区高血压筛查中发现的高血压病患者96例,随机分为观察组和对照组各48例,应用循证护理理论对观察组进行个性化健康教育,对照组采用常规的健康教育方法.结果 两组患者在对疾病的认识、身体锻炼、监测血压、生活方式改变、血压控制等方面差异均有统计学意义(P＜0.05).结论 应用循证护理理论对高血压患者进行健康教育,可使患者自我保健意识增强,有效地改变生活方式,自觉应用科学的方法控制血压,提高血压控制达标率.     

护理干预对初发高血压病患者的血压水平以及生活方式的影响

目的:探讨护理干预对改善初发高血压病患者的血压水平以及生活方式的效果.方法:对2009年3月至2012年3月收治的初发高血压病患者56例进行疾病知识、生活方式、饮食、个体用药等评估,根据评估结果进行认知干预、饮食干预、运动干预等护理措施,比较干预前、干预后3个月、6个月患者血压水平、生活方式等变化.结果:护理干预后3个月、6个月患者的血压、饮食、运动等方面均较干预前明显好转(P＜0.05).结论:护理干预可通过提高患者自我保健意识,改变不良的生活方式,有效控制血压,提高患者自我管理疾病能力.     

老年高血压病人血压控制影响因素的研究进展

随着我国人口老龄化的快速发展以及人们生活方式的改变,老年高血压病人的患病率在不断增加,而高血压又显著增加老年人发生缺血性心脏病、脑卒中、肾衰竭、主动脉和外周动脉疾病等靶器官损害的风险,导致老年高血压病人生活质量受到严重的影响。本文通过介绍老年高血压病人的血压特点和影响老年高血压病人血压控制的因素,从而为探讨选择合理的控制血压方法、降低高血压的并发症和提高老年人的生活质量提供切实可行的护理参考依据。     

以行为改变整合理论为基础的护理随访对高血压患者生活质量的影响

目的:探讨以行为改变整合理论为基础的护理随访对高血压患者生活质量的影响。方法:将就诊的150例高血压患者根据随机数字表分为观察组和对照组各75例,对照组应用常规性健康教育,观察组以行为改变整合理论为基础实施护理随访,干预时间为6个月;比较两组干预前后血压变化情况、生活方式改变情况及生活质量情况。结果:干预后观察组收缩压(SBP)、舒张压(DBP)水平均低于对照组(P0.01),血压管理能力、饮食管理能力、运动锻炼管理能力、用药管理能力、并发症管理能力评分均高于对照组(P0.01),社会领域、心理领域、生理领域、环境领域及生活质量总评分均高于对照组(P0.01)。结论:以行为改变整合理论为基础的护理随访能有助于高血压患者建立健康的生活方式,控制患者血压水平,提高患者生活质量。     

中老年高血压病人血压控制不佳的调查分析

总结了中老年高血压病人血压控制不佳的原因与有效控制血压的护理措施。包括用药依从性差、缺乏良好的心态、不能合理地安排生活、饮食结构不合理等原因,认为通过营养、用药、生活方式、健康知识方面的指导将有利于控制中老年病人血压在正常范围内波动,从而降低心脑血管疾病的发病率和病死率.     

社区健康教育对高血压患者自我管理能力的影响

目的 探讨健康教育对高血压患者自我管理能力的影响.方法 对282例社区高血压患者进行高血压病的基础知识、饮食和运动知识、自我保健及高血压的危害等进行教育,分别于健康教育前和健康教育后3个月、6个月进行问卷调查高血压病相关知识的掌握、用药依从性、心理及生活行为方式和血压水平,对结果进行统计分析.结果 患者健康教育后3个月、6个月的疾病认知水平、用药依从性、心理水平、生活行为方式、血压水平较健康教育前明显好转(P＜0.01或0.05).结论 健康教育可以提高患者自我保健意识和保健能力,改变不合理的饮食结构及不良的生活方式,有效控制血压,提高患者自我管理疾病能力.     

社区健康教育对高血压患者自我管理能力的影响

目的 探讨健康教育对高血压患者自我管理能力的影响.方法 对282例社区高血压患者进行高血压病的基础知识、饮食和运动知识、自我保健及高血压的危害等进行教育,分别于健康教育前和健康教育后3个月、6个月进行问卷调查高血压病相关知识的掌握、用药依从性、心理及生活行为方式和血压水平,对结果进行统计分析.结果 患者健康教育后3个月、6个月的疾病认知水平、用药依从性、心理水平、生活行为方式、血压水平较健康教育前明显好转(P＜0.01或0.05).结论 健康教育可以提高患者自我保健意识和保健能力,改变不合理的饮食结构及不良的生活方式,有效控制血压,提高患者自我管理疾病能力.     

Empathy, identity and engagement in person-centred medicine: the sociocultural context

AIMS: This paper considers in outline the complexity of the empathic process from subjective, philosophical and psychological perspectives, and suggests that compassionate empathy is a core requirement of a person-centred approach to health care delivery. Empathy is facilitated by secure attachments in infancy (intersubjectivity) and a subsequent firm sense of self and personal identity. Empathic understanding is enhanced by the medical humanities, but the neglect of musical appreciation in this regard is surprising. CONCLUSIONS: The biopsychosocial model is reviewed, and a body-mind-spirit paradigm is proposed as a more optimal framework for health care delivery in a multicultural society.     

门诊肠道寄生虫病感染状况的纵向观察

本文对 1981-2 0 0 0年门诊病人肠道寄生虫感染资料进行统计分析 ,总感染率为 30.89% ( 33607/ 10 8795 ) ;其中肠道蠕虫感染占 78.14% ,肠道原虫感染占 21.86 %。主要感染虫种为蛔虫、蓝氏贾第鞭毛虫、钩虫、肠滴虫、猪带绦虫和阿米巴。 2 0年间肠道寄生虫感染率呈明显下降趋势 ,由 1981年的 46.61%下降到 2000年的 12.82 % ;但近年来肠道蠕虫感染率下降速度变缓 ,而肠道原虫感染率呈现上升趋势 ,优势虫种亦由蛔虫、钩虫为主转为蓝氏贾第鞭毛虫、蛔虫居前。虽然肠道寄生虫感染 2 0年间变化较大 ,但每年的季节分布仍未打破 ,感染率以第三季度最高 ,第一季度最低。结果表明 ,目前人体肠道寄生虫病感染率还比较高 ,尤其是肠道原虫。因此 ,仍需根据季节、虫种、人群等具体情况 ,搞好肠道寄生虫病的防治工作.     

Opioids in chronic non-cancer pain, indications and controversies.

The use of opioid analgesics for long term management of chronic non-cancer pain is now an accepted, although still a controversial medical practice. In some well selected patients with long-lasting or recurrent pain, severe enough to markedly reduce their quality of life, and for whom no other more effective and less risky therapy is available, opioid analgesics may reduce intensity of pain, increase functioning and improve quality of life for prolonged periods. The type of pain and pain history of the patients do not predict reliably the chance of long term success or risk of complications from opioid therapy. However, the outlook for successful long term opioid therapy is better in a patient with a stable psychosocial situation having nociceptive type pain that is markedly relieved by a moderate dose of a long lasting oral or transdermal opioid, than a patient from a complex and unstable psychosocial background having neuropathic type pain that is relieved only partly by a higher dose of a potent opioid. When a patient is managed by a multidisciplinary team, the compliance is better and risk of loss of control and complications are less than when a single doctor is managing the patient. The evidence base for this type of pain management is meagre because the needed randomized controlled trials, which ideally should last for several years, have not been performed. Therefore a number of national and international guidelines are being published, recommending experts' opinion on appropriate use and responsible follow-up of long term treatment with opioids for chronic non-cancer pain.     

ANNUAL REPORT OF COUNCIL FOR THE YEAR ENDING 30th JUNE, 1949

The thinning guide presented with this paper is a graph of stocking per acre on predominant height, and it indicates what is considered to be the optimum range of stocking within which thinning should maintain P. radiata stands in South Australia, if an optimum compromise between certain factors is to be achieved.

These factors include a commercial first thinning as a pre-requisite, full site use, reasonable rates of diameter growth, and stability to wind.

It is suggested that representation of a thinning guide in terms of stand height and in graphical form gives it a flexibility to individual stand characteristics which is not possible in tabular form, and that such flexibility is necessary if a thinning guide is to be a ready practicable guide to logging officers. A special value of the graphical form is that past and proposed thinning of a stand can be represented diagrammatically, against a background of growth and stability criteria. By indicating long-term possibilities, this should assist with short-term decisions.     

A new statistical test based on the wavelet cross-spectrum to detect time-frequency dependence between non-stationary signals: application to the analysis of cortico-muscular interactions

The study of the correlations that may exist between neurophysiological signals is at the heart of modern techniques for data analysis in neuroscience. Wavelet coherence is a popular method to construct a time-frequency map that can be used to analyze the time-frequency correlations between two time series. Coherence is a normalized measure of dependence, for which it is possible to construct confidence intervals, and that is commonly considered as being more interpretable than the wavelet cross-spectrum (WCS). In this paper, we provide empirical and theoretical arguments to show that a significant level of wavelet coherence does not necessarily correspond to a significant level of dependence between random signals, especially when the number of trials is small. In such cases, we demonstrate that the WCS is a much better measure of statistical dependence, and a new statistical test to detect significant values of the cross-spectrum is proposed. This test clearly outperforms the limitations of coherence analysis while still allowing a consistent estimation of the time-frequency correlations between two non-stationary stochastic processes. Simulated data are used to investigate the advantages of this new approach over coherence analysis. The method is also applied to experimental data sets to analyze the time-frequency correlations that may exist between electroencephalogram (EEG) and surface electromyogram (EMG).     

Unusual case of De Garengeot hernia: femoral hernia containing purulent appendicitis in a 69-year-old man

A De Garengeot hernia is a rare type of femoral hernia that involves a vermiform appendix within a femoral hernia sac. Because of the rarity of this disease, a standard surgical procedure has not been established, and most cases are diagnosed intraoperatively. Preoperative diagnosis of a De Garengeot hernia is quite difficult. Computed tomography is the most sensitive and specific technique among the available imaging tests for preoperative diagnosis of a De Garengeot hernia. Although a standard surgical procedure is lacking, prompt surgery has become the consensus. The most common procedure is the open anterior approach; this allows exploration of the hernia sac and rapid treatment of its contents, routine appendectomy through a single incision, and preperitoneal repair of the femoral hernia.     

Community-based Service Delivery in Rehabilitation: The Promise and the Paradox

Purpose : According to many researchers, rehabilitation is being prevented from developing as a distinct profession due to two major problems. First, it has been claimed that rehabilitation is in need of a professional identity and a sense of cohesion if it is to emerge as a discipline. Second, it has been recognized that there is a need for a rehabilitation framework to challenge the restorative approach that continues to dominate rehabilitation, linking it back to the medical model from which it has attempted to escape. The model of community-based rehabilitation (CBR) is offered as a model that can provide the impetus for an attitudinal shift from the restorative tradition and unite rehabilitation workers through a cohesive framework. Method : Unfortunately, the implementation of community-based rehabilitation in urban societies has been disappointing. The current paper is a conceptual discussion of communitybased rehabilitation that explores some potential causes of this poor implementation. Results : To some extent, the implementation failure of community-based rehabilitation can be attributed to the paradoxes that are inherent in its fundamental construct sempowerment and community inclusion. These paradoxes occur at a conceptual level, a practical level and a contextual level. Conclusions : Some solutions are offered to enable the paradigm to be implemented more fully. In particular, it is suggested that there is a need to develop useful working definitions of these constructs, favourable attitudes among rehabilitation workers and a focus on community development.     

Bayesian statistics in medical research: an intuitive alternative to conventional data analysis

Statistical analysis of both experimental and observational data is central to medical research. Unfortunately, the process of conventional statistical analysis is poorly understood by many medical scientists. This is due, in part, to the counter-intuitive nature of the basic tools of traditional (frequency-based) statistical inference. For example, the proper definition of a conventional 95% confidence interval is quite confusing. It is based upon the imaginary results of a series of hypothetical repetitions of the data generation process and subsequent analysis. Not surprisingly, this formal definition is often ignored and a 95% confidence interval is widely taken to represent a range of values that is associated with a 95% probability of containing the true value of the parameter being estimated. Working within the traditional framework of frequency-based statistics, this interpretation is fundamentally incorrect. It is perfectly valid, however, if one works within the framework of Bayesian statistics and assumes a 'prior distribution' that is uniform on the scale of the main outcome variable. This reflects a limited equivalence between conventional and Bayesian statistics that can be used to facilitate a simple Bayesian interpretation based on the results of a standard analysis. Such inferences provide direct and understandable answers to many important types of question in medical research. For example, they can be used to assist decision making based upon studies with unavoidably low statistical power, where non-significant results are all too often, and wrongly, interpreted as implying 'no effect'. They can also be used to overcome the confusion that can result when statistically significant effects are too small to be clinically relevant. This paper describes the theoretical basis of the Bayesian-based approach and illustrates its application with a practical example that investigates the prevalence of major cardiac defects in a cohort of children born using the assisted reproduction technique known as ICSI (intracytoplasmic sperm injection).     

Model extraction from magnetic resonance volume data using the deformable pyramid

A general framework for automatic model extraction from magnetic resonance (MR) images is described. The framework is based on a two-stage algorithm. In the first stage, a geometrical and topological multiresolution prior model is constructed. It is based on a pyramid of graphs. In the second stage, a matching algorithm is described. This algorithm is used to deform the prior pyramid in a constrained manner. The topological and the main geometrical properties of the model are preserved, and at the same time, the model adapts itself to the input data. We show that it performs a fast and robust model extraction from image data containing unstructured information and noise. The efficiency of the deformable pyramid is illustrated on a synthetic image. Several examples of the method applied to MR volumes are also represented.