智能家居环境中的连接性设计语义

借助日趋电脑化的力量,我们的居家环境越来越智能化,居住环境中设备与设备之间的嵌入式传感器及网络连接很可能会让使用者感到茫然.用户交互从一开始操作单一的设备转变为了一系列生态事件组成的庞大系统.人们变成了现实世界与不可见的数码世界之间的调解员.本文主要通过展示部分正在进行中的研究调查,该调研是关于如何利用简洁的设计语义来传达明智居家环境中设备连接的抽象概念.使使用者理解并且构建有意义的智能环境,与之进行相应的互动.我们将通过示范来让用户在一个居家娱乐案例中掌握这种不可见的无线仪器连接.     

The structure of self-reported health in chronic disease patients.

A multidimensional model of self-reported health status in 1,980 patients with 1 or more chronic medical conditions was evaluated. Two dimensions of health were hypothesized: Physical health was defined by measures of physical functioning, role limitations, satisfaction with physical ability, and mobility; mental health was defined by depression, positive affect, anxiety, and feelings of belonging. Physical and mental health were correlated but distinct, sharing about 20% of variance in common. Correlations of 11 other indicators of health with the physical and mental health constructs corresponded to a priori hypotheses. It is concluded that self-reports of physical and mental health are distinguishable and that both constructs need to be represented for comprehensive assessment of health status. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Integrating behavioral and social sciences research at the National Institutes of Health, U.S.A

Readers of Social Science & Medicine may find it interesting to know that in 1993 the United States Congress established the Office of Behavioral and Social Sciences Research (OBSSR) at the National Institutes of Health (NIH) in the belief that scientific research on behavioral and social factors in order to facilitate a growth in this important area of research. As is discussed in this paper, the philosophy of the OBSSR is that, although discoveries in the behavioral and social sciences are as critical for health as those from the biomedical sciences, knowledge from both areas must ultimately be integrated. Such integration will accelerate our understanding and treatment of physical and mental illnesses in both the developed and the developing world. This paper briefly presents the scientific evidence supporting this philosophy, outlines the mandated responsibilities of the OBSSR, and discusses some of its current and planned activities.     

Building Healthy Workplaces: What We Know So Far.

By way of introduction to this Special Issue of the Canadian Journal of Behavioural Science, we hope to achieve three interrelated goals. First, we define what we mean by a "healthy workplace," and we delineate the ways in which work is associated with mental health. We argue that work is both a causal factor in mental and physical ill-health as well as a potential health resource that both may protect us and assist in our recovery from psychological ill-health. Second, we review the individual, organizational, and societal costs of unhealthy work and workplaces, and, consequently, of poor mental and physical health. Our argument is simply that we are incurring horrific economic and social costs when we have unhealthy workplaces. Finally, we provide a framework in terms of a healthy workplace model to help summarize this literature, and to present the articles in this Special Issue. Throughout this introduction, we emphasize that these goals are highly compatible with organizations' traditional focus on enhancing productivity and profitability. Put simply, what is good for Canadian workers is good for Canadian industry. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

La constitution d’un milieu de travail sain: Ce que nous savons jusqu’à maintenant.

By way of introduction to this Special Issue of the Canadian Journal of Behavioural Science, we hope to achieve three interrelated goals. First, we define what we mean by a "healthy workplace," and we delineate the ways in which work is associated with mental health. We argue that work is both a causal factor in mental and physical ill-health as well as a potential health resource that both may protect us and assist in our recovery from psychological ill-health. Second, we review the individual, organizational, and societal costs of unhealthy work and workplaces, and, consequently, of poor mental and physical health. Our argument is simply that we are incurring horrific economic and social costs when we have unhealthy workplaces. Finally, we provide a framework in terms of a healthy workplace model to help summarize this literature, and to present the articles in this Special Issue. Throughout this introduction, we emphasize that these goals are highly compatible with organizations' traditional focus on enhancing productivity and profitability. Put simply, what is good for Canadian workers is good for Canadian industry. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Using literature in health care: reflections on "the yellow wallpaper"

OBJECTIVE: To discuss how literature can be used to educate healthcare practitioners and students about the patient's physical and emotional response to treatment. DATA SOURCES: A MEDLINE search (January 1975-November 1997) of English-language literature pertinent to using literature in health care was performed. Additional literature was obtained from a search of the New York University Web site on medicine and humanities, biographies of Charlotte Perkins Gilman, and a search of the MLA and INFOTRAC database. SELECTION AND DATA EXTRACTION: All articles and literature were considered for possible inclusion in this article. Pertinent information, as judged by the author, was selected for discussion. SUMMARY: Literature can pose a wealth of information to the healthcare professional. The short story "The Yellow Wallpaper" is analyzed in this article as one example of how literature portrays the patient's emotional response to disease. This short story describes a 19th-century woman's "descent into madness" and the ineffective treatment attempted by her well-meaning physician husband. The author, Charlotte Perkins Gilman, loosely based the story on her own experience with the respected physician, S Weir Mitchell and his famous rest cure. Some biographical information about Mitchell and Perkins is included, as well as a commentary on the treatment of depression in the 19th century. CONCLUSIONS: Short stories such as "The Yellow Wallpaper," novels, and other short stories can help to remind the healthcare professional of the subjective nature of even our most proven therapies. As we strive to teach and deliver pharmaceutical care, we can use literature to help us understand the emotional impact of our drug therapies.     

Promoting a sense of connectedness among individuals by scientifically demonstrating the existence of a planetary consciousness?

The subjective experience of feeling consciously connected with others and our environment-to that which is larger than ourselves-has been found to promote physical and mental health, or well-being. Various ways of evaluating this sense of connectedness have been studied under controlled scientific conditions. Through these studies, more has been learned about the effect of connectedness, ways of facilitating a sense of connection, and how to approach some objective understanding of its physical basis and human value. Evidently, we do share a interconnected rapport with others and with nature. However, we may have formed the contrary habit of dissociating and repressing a sense of connectedness for reasons strategic to their individual survival. Nevertheless, individual and global health could depend on therapeutically confronting these choices-both personally and socially.     

Employment and women's health: Effects of paid employment on women's mental and physical health.

This article reviews empirical evidence concerning the effects of paid employment on women's mental and physical health, with special attention to variations in the effects of employment depending on the characteristics of women and their jobs. We highlight methodological issues and focus primarily on studies with longitudinal data for representative samples of women. We conclude that women's employment does not have a negative effect on their health, on the average. Indeed, employment appears to improve the health of unmarried women and married women who have positive attitudes toward employment. Possible mediators linking employment to health outcomes are discussed. Current evidence suggests that increased social support from co-workers and supervisors may be one important mediator of the beneficial health effects of employment. Given the paucity of available longitudinal studies, we encourage additional prospective research examining the mental and physical health consequences of employment according to job characteristics, personal characteristics, and disease outcome. We also recommend research on several promising mediators of employment–health relationships. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Female veterans' use of Department of Veterans Affairs health care services

OBJECTIVES: As access of women to mental health services has become increasingly important, empirical research has begun to examine the determinants of mental health care utilization across gender. This article examines the effect of being an extreme minority on utilization of Department of Veterans Affairs (VA) health services by female veterans. METHODS: Data were collected on a representative national sample of veterans in 1992 as part of the National Survey of Veterans. These data included information on sociodemographic variables, military service variables, physical health and disability, and health services utilization. The authors examined whether women who used health services in 1992, and who were eligible for VA care, differed from men on the likelihood of using any VA health services and on the likelihood of use of VA outpatient and inpatient health services. In addition, we compared VA health care utilization among subgroups of veterans with physical and mental disorders, and compared self-reported reasons for choice of health care provider, across gender. RESULTS: Results indicated that female veterans were less likely than male veterans to use VA health services. This difference was explained by lower utilization by women of VA outpatient services, since inpatient admission rates were the same across gender. The lower outpatient utilization was specific to women with self-reported mental disorders. Women with physical conditions did not differ from men with similar conditions in their VA outpatient utilization. Finally, men and women did not differ on their reasons for choosing VA or non-VA care. CONCLUSIONS: The authors conclude that extreme gender minority status appears to affect outpatient utilization rates at the VA among women with mental disorders, perhaps because of the more personal or sensitive nature of the services involved. Further research is needed to understand why certain women may be underutilizing VA outpatient services and on the consequences of minority gender status for health service utilization, more generally.     

Influence of dispositional coping strategies on physical complaints and life satisfaction in the elderly

Well-being and mental and physical health in old age are influenced in a significant way by the fact that it is possible to cope successfully with ongoing hazards, threats and problems. In recent years coping research has shown increasing interest in coping processes in the elderly. Most of the studies are focused on age-related differences in coping processes and on the issue of change or stability of coping in old age. However, the goal of our study was to examine the impact of dispositional coping strategies, conceptualized as consistent personality characteristics, on physical complaints and life satisfaction among the elderly. We recurred on the model of coping modes by Krohne, which postulates two statistically independent person-specific coping dimensions named "vigilance" and "cognitive avoidance". Based on this model it is possible to identify the "classical" coping styles of "sensitization" (high vigilance and low cognitive avoidance) and "repression" (low vigilance and high cognitive avoidance). In our study, including 766 subjects older than 60 years, we found a higher frequency of "repressors" than of "sensitizers". Results show that dispositional coping strategies are significant moderator variables of both physical complaints and life satisfaction: Older people who prefer a cognitive-avoidant coping strategy ("repressors") are more satisfied with their life and have less complaints than "sensitizers".     

Predictors of mental and physical health service utilization among Vietnam veterans.

This study investigated predictors of mental and physical health care service utilization among 1,632 male (n = 1,200) and female (n = 432) Vietnam veterans who participated in the National Vietnam Veterans Readjustment Study. Using Anderson's theory as a model (Anderson & Bartkus, 1973), the authors examined both direct and mediated relationships among predisposing factors (i.e., age, marital status, and combat exposure), enabling factors (e.g., household income and insurance), and need factors (e.g., medical and psychological symptomatology) and physical and mental health care utilization outcomes. Need factors were the most consistent and strongest mediators of predisposing variables for both physical and mental health care service utilization, although there were differences between male and female veterans. For men, combat exposure indirectly predicted mental health care utilization through the need variables (with the effects of posttraumatic stress disorder being greatest). For women, physical health problems mediated the relationship between combat exposure and physical health outpatient care utilization. These findings have implications for screening and outreach efforts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

From the community mental health movement to the war on drugs: A study in the definition of social problems.

In the 1980s, the Reagan and Bush administrations reduced funding for community mental health programs and began instead to support substance abuse treatment agencies. One reason for this shift in policy was that the social problem of mental illness had been captured by progressives in the community mental health movement. Conservatives, therefore, needed a new problem to redefine and use to enact new social control policies. The conservatives' claim that substance abuse is primarily the result of a defect in the character or constitution of the abuser has had profound effects on both social policy and the research community. Greater awareness is needed on the part of researchers as to how social problems have been defined and how government research grants affect our thinking about substance abuse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Affective and cardiovascular effects of experimentally-induced social status.

Objective: Observational research suggests subordinate social status is associated with negative mental and physical health outcomes. However, observational studies have limitations, including confounding of social status with other factors, limited ability to infer causality, and difficulty of obtaining detailed affective and physiologic data. This study used experimental methods to test the hypothesis that subordinate social status per se causes psychological distress and cardiovascular arousal. Design: Forty-four women were randomly assigned to an induced subordinate or dominant status condition. Social status was manipulated using a procedure derived from status construction theory. Main Outcome Measures: Affective responses were assessed via self-report. Cardiovascular responses were assessed by measures of systolic and diastolic blood pressures obtained with an automated blood pressure machine. Results: Participants in the subordinate condition perceived themselves as lower in status; the reverse was true for dominant condition participants. Compared with induced dominant status, induced subordinate status produced increased negative affect and systolic blood pressure over the course of the study. Conclusion: Findings suggest social status can be experimentally manipulated and short-term induction of subordinate status can have adverse effects on affect and stress-related physiological systems. Results have implications for understanding how socioeconomic status "gets under the skin" to influence health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Spirituality in medical practice

Body, mind, and spirit are integrally connected. Medical training in the Western world has been strong concerning the more easily measured physical aspects, and on the mental needs it has been virtually mute on how to minister to the spiritual needs of our patients. Learning the spiritual aspects of medical care is not a typical part of the medical school curriculum, and yet it is emerging as something that our patients want and expect us to do as part of our caring for them. Herein I discuss the role of spirituality in medical practice, how it relates to alternative medical practices, methods to use to grow spiritually, and ways to apply your spirituality to medical practice.     

How does service workers’ behavior affect their health? Service climate as a moderator in the service behavior–health relationships.

To address the question of whether providing high-quality service deteriorates or benefits workers’ health, a contingency model was tested that focused on service climate as a moderator. This interacts with service behavior to affect workers’ perceptions of emotional exhaustion, hence their physical and mental health. Findings of this study with 328 nurses from 66 nursing units indicated that congruent conditions of service climate and behaviors benefited workers’ health, whereas incongruent conditions affected it adversely. The findings are discussed in light of stress, and emotion–work perspectives. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Angiocardiographic digital still images compressed via irreversible methods: concepts and experiments

OBJECTIVE: Primary care occupies a strategic positive in the evaluation, treatment, and prevention of the mental disturbances of later life. This article highlights four themes that are crucial to understanding mental disturbances among older adults: 1) subsyndromal depression, 2) coexisting depression and anxiety, 3) comorbidity of depression and chronic medical conditions, and 4) risk factors for cognitive impairment. METHOD: The literature was selectively reviewed for each theme to ask the central question, "What can primary care physicians learn about mental disturbances of their older patients from epidemiologic and community studies?" RESULTS: The primary care setting itself is an important venue for an examination of aging issues and mental health. Workers in the "middle ground of psychiatric epidemiology"--primary health care--have not yet reached a full appreciation for the value of research in the primary care setting for enhancing our understanding of the mental disturbances of late life, and how these intersect with other salient factors. CONCLUSIONS: Primary care physicians and others who work in primary care should advocate for further mental health integration and research in primary care. Research is needed that will lead to new ways of maximizing the health and quality of life of older adults and their families.     

Supply dynamics of the mental health workforce: implications for health policy

The U.S. mental health workforce is varied and flexible. The strong growth in supply of nonphysician mental health professionals, ranging from psychologists to "midlevel" professionals like social workers and nurse specialists, helps to offset the dwindling numbers of medical graduates entering the field of psychiatry. Primary care physicians often see patients who have some form of mental illness, which they are not always trained to recognize and treat. The data on the supply of several specialists--psychiatrists, clinical psychologists, and clinical social workers--indicate that the distribution of mental health professionals varies widely by state. The composition, supply, and distribution of workers in this field also affect the care of vulnerable populations. Broader policy questions, including the lack of parity between mental and physical health insurance coverage and barriers to entry by nonphysician professions, may limit the cost-effective expansion of this diverse and dynamic workforce.     

Adaptation of medical care to the changing disease spectrum of adolescents

The spectrum of diseases affecting today's children and adolescents has changed. Today's urgent health problems are no longer acute and infectious disorders but much rather psychosomatic and chronic disorders. However, the present health delivery system has not adapted its structure to this changed spectrum of disease. This paper reports on a study carried out by the project "Health Risks and Structures of Medical and Mental Health Care." The project belongs to the North Rhine-Westphalian Consortium for Public Health, and the study was carried out in cooperation with the Special Research Unit 227: "Prevention and Intervention in Childhood and Adolescence." Results show that a small proportion of adolescents actually consult general practitioners. Inadequate cooperation between medical and mental health care services as well as insufficient links between these services and the life world of adolescents have led to a situation in which the use of professional assistance meets with barriers. As a result, adolescents continue to avoid visiting a physician even when they have already become ill. For this reason, there is an increasingly strong need to consider how to change the structures of medical and mental health care. Proposals are developed that meet the needs of adolescents and are oriented toward the requirements arising from the changing spectrum of disease.     

Perceived discrimination and health: A meta-analytic review.

Perceived discrimination has been studied with regard to its impact on several types of health effects. This meta-analysis provides a comprehensive account of the relationships between multiple forms of perceived discrimination and both mental and physical health outcomes. In addition, this meta-analysis examines potential mechanisms by which perceiving discrimination may affect health, including through psychological and physiological stress responses and health behaviors. Analysis of 134 samples suggests that when weighting each study’s contribution by sample size, perceived discrimination has a significant negative effect on both mental and physical health. Perceived discrimination also produces significantly heightened stress responses and is related to participation in unhealthy and nonparticipation in healthy behaviors. These findings suggest potential pathways linking perceived discrimination to negative health outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Population-health concept challenges dominance of clinical medicine

As the emerging policy concept of population health challenges the dominance of clinical medicine in health care, many question how it will affect "grass-roots" physicians. Although primarily a planning tool for policymakers that provides a framework to study the determinants of health, health outcomes and health interventions, population health can also be applied to medical practice. The CMA identified population health as a priority issue in March 1994, and has sponsored several presentations and workshops on the issue. On Jan. 23 three CMA Councils will meet jointly to discuss the implications this new policy holds for physicians.