Alternatives to standard hemodialysis

Survival of patients on hemodialysis remains poor, but the benefits of increasing urea clearance have probably been maximized within our current treatment schedules. Long dialysis sessions (8 hr) produce impressive outcomes, with mortality 53% to 55% lower than conventional schedules. Even increasing from 4 to 5 hr may improve survival. Increased frequency of dialysis (6 times weekly) produces impressive reductions in left ventricular mass and could conceivably be implemented in‐center. Preliminary data suggest a 61% reduction in mortality with increased frequency. Nightly dialysis combines longer sessions with increased frequency and has produced remarkable clinical gains in blood pressure, left ventricular mass, serum phosphate, and sleep apnea. However, the data are mainly from case series and impact on mortality remains unknown. Expansion of home hemodialysis would be necessary for this modality to grow. Convective therapies remove middle molecules more effectively, and observational data suggest hemodiafiltration has the potential to improve mortality by 35% to 36%. Hemodiafiltration has the advantage of being relatively easy to implement. The uremic milieu is complex and further investigation of the underlying pathophysiology is needed to inform future dialysis interventions. The survival data above are from observational studies, and hence benefits are likely to be exaggerated. Randomized trials of dialysis interventions are desperately needed. They remain difficult to perform, because of the complexity of both the patient population and the interventions, and because of limited available funding.     

An ecological-transactional understanding of community violence: Theoretical perspectives.

Community violence has emerged as a major risk factor for the development of mental health problems in children and adolescents. If mental health providers are to meet the needs of children and communities dealing with community violence, then they will need to integrate principles from various subdisciplines in psychology (e.g., developmental psychology, school psychology, developmental psychopathology) as well as disciplines outside of psychology (e.g., sociology, public health, medicine) to understand fully the developmental impact of exposure to community violence. The development of such a model is necessary to identify the pathways, risk, and protective factors on which prevention and intervention programs can be built. The goal of this article is to present an ecological-transactional model of community violence as a conceptual framework for understanding the existing literature and for guiding future research on community violence exposure and child development. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Religion and spirituality: Linkages to physical health.

Evidence is presented that bears on 9 hypotheses about the link between religion or spirituality and mortality, morbidity, disability, or recovery from illness. In healthy participants, there is a strong, consistent, prospective, and often graded reduction in risk of mortality in church/service attenders. This reduction is approximately 25% after adjustment for confounders. Religion or spirituality protects against cardiovascular disease, largely mediated by the healthy lifestyle it encourages. Evidence fails to support a link between depth of religiousness and physical health. In patients, there are consistent failures to support the hypotheses that religion or spirituality slows the progression of cancer or improves recovery from acute illness but some evidence that religion or spirituality impedes recovery from acute illness. The authors conclude that church/service attendance protects healthy people against death. More methodologically sound studies are needed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Individual differences in self-assessed health: An information-processing investigation of health and illness cognition.

In 2 studies, the relation between measures of self-assessed health (SAH) and automatic processing of health-relevant information was investigated. In Study 1, 84 male and 86 female undergraduate students completed a modified Stroop task. Results indicated that participants with poorer SAH showed enhanced interference effects for illness versus non-illness words. In Study 2, 27 male and 30 female undergraduate students completed a self-referent encoding task. Results offered a conceptual replication and extension of Study 1 by confirming the specificity of the relation between SAH measures and automatic processing of health (vs negative or positive general trait) information. These studies provide evidence that individual differences in SAH are reflected in schematic processing of health-relevant information. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

生活中的慢性杀手--石化合成洗剂

文章回顾了石化合成洗剂的发展历史，从经历的五代产品的发展过程中可以看出它经历了一个环保到不环保再到环保的曲折过程分析了石化合成洗剂的主要成分及其清洗去污的作用原理着重指出目前使用的石化合成洗剂虽然给生活带来便利，但同时也给人体健康和生态环境都造成严重的危害；倡导使用新型环保型的第五代洗剂已成为新世纪中清洗剂发展的必然趋势。     

Toward the reduction of population obesity: Macrolevel environmental approaches to the problems of food, eating, and obesity.

The authors reviewed the evidential basis of three environmental approaches to reducing population obesity: What are the effects of (a) taxing or subsidizing foods, (b) manipulating the ease of food access, and (c) restricting access to certain foods? A narrative review evaluated evidence using National Heart, Lung, and Blood Institute criteria. There was strong evidence that subsidization influences food purchases, but not necessarily food consumption or body weight. Ease of food access may influence food purchases, and possibly food intake and body weight. Data on restriction were lacking. More studies are needed to justify that altering these macro-environmental variables will necessarily reduce population obesity. A proposed conceptual model posits that the steps through environmental interventions may exert intended and unintended influences on body weight and obesity prevalence. Contemplated policy changes should weigh scientific evidence with social judgments and values concerning changes to the environment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

西安绿色康居小区规划设计剖析

通过对西安绿色康居小区规划设计的实例分析，阐明了小康型住宅区的标准和要求，在旧城住宅区改造中的落实和运用，试图探索下一世纪旧城住宅区的改造之路．     

The development and maturation of humanitarian psychology.

Humanitarian psychological support as an organized field is relatively young. Pioneers in the field were involved primarily in providing psychological support to refugees and internally displaced persons in conflict and nonconflict situations. This article describes basic principles for the design of psychological support programs and interventions. The International Federation of Red Cross and Red Crescent Societies (IFRC) began a psychological support program in 1991. The IFRC chose psychological first aid as its model for implementation in developing countries. Psychological first aid fits all the principles for psychological support program design and is adapted to individual communities. The first generation of psychological support programs differed dramatically depending on the countries in which they were developed. A second generation of psychological support programs evolved in response to the earthquake/tsunami of December 26, 2004. The Inter-Agency Standing Committee international guidelines consolidated the advances of second-generation programs and provided a clear indication of the wide acceptance of the importance of psychological support. A glimpse is provided of the third generation of psychological support programs, and an admonition is made for a more empirical evaluation of the effectiveness of interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

关于河流健康内涵与评价方法的综合评述

在可持续发展观念的推动下，河流健康问题引起各界广泛的重视。本文对河流健康的概念与内涵进行了剖析，分析了河流健康与河流生态系统健康的异同，提出了河流健康应包括三方面的内涵：河流自身结构功能完备，能发挥其正常的生态环境效益，并满足人类社会发展的合理需求。系统地总结了河流健康评价方法、评价标准、评价指标及评价模型，指出了评价的主体应当是河流系统，评价的河流不同，评价指标的选取和权重的确定也随之不同，依其具体特征而定。为我国河流健康评价的发展提供了一定的参考价值。     

Reply to Silverman.

Responds to commentary by I. Silverman (see record 2007-08963-001) entitled "Review of Pure types are rare": Comment on book review. I do not think that either one of us will change his position, and therefore it is up to the interested (yet disinterested) reader to adjudicate our dispute by checking Professor Silverman's book and his references. In the process, the reader will be forced to consider the thought-provoking implications for our mental health system of some of the incidents which the author describes so vividly, and that will not be a bad thing. There is one point, however, which is worth pursuing further here, for Professor Silverman persists in an elementary statistical fallacy. Let us take the situation which he cites, where the base rate for diagnosing schizophrenia is 50%. Suppose with the same base rate the degree of agreement is in fact 53%; this is far above chance level. It must be emphasized, however, that the 53% agreement under discussion came not from a study where the base rate for diagnosing schizophrenia was 50%, but from one where the conditions were far more stringent since the base rate for diagnosing schizophrenia was around 20%. (PsycINFO Database Record (c) 2010 APA, all rights reserved)