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家庭医生提供更多综合性医疗服务与更低医疗费用及更少住院率有关

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中国全科医学 2015年第25期18卷 3006-3009页

作者： Andrew Bazemore stephen petterson Lars E.Peterson Robert L.Phillips 魏亚萌美国华盛顿特区Robert Graham中心美国肯塔基州列克星敦市家庭医学专科委员会中国全科医学杂志社

1引言〈br〉 2009年患者保护与平价医疗法案（ACA）开始再次关注基层医疗及其在实现美国三重目标--人群健康改善、医疗服务改进、医疗费用降低方面的作用。考虑到美国人口的老龄化、人口数目的增长及参保人口的增多，数十年的证据支持... 详细信息

1引言〈br〉 2009年患者保护与平价医疗法案（ACA）开始再次关注基层医疗及其在实现美国三重目标--人群健康改善、医疗服务改进、医疗费用降低方面的作用。考虑到美国人口的老龄化、人口数目的增长及参保人口的增多，数十年的证据支持基层医疗具备改善已超过整体经济增长数十年且仍可能继续增长的医疗费用状况的潜能。在已明确的基层医疗特征里，医疗的综合性或其覆盖健康问题、年龄阶段及治疗形式的广泛性及多样性使基层医疗发挥着积极的作用。在1996年出版的一本经常被引用的基层医疗图书中，美国医学研究所将医疗综合性定义为“……临床医生为解决绝大多数人群的医疗卫生需求而提供的综合、可获取的医疗卫生服务。”世界卫生组织于2008年对基层医疗综合性的价值进行了重申。基层医疗的另一项原则是要对患有未分化疾病的患者进行首诊，这需要医疗服务具备综合性以有效地辨别患者的症状和主诉，并在必要时进行诊断和治疗。同样，医患关系的连续性（被研究最多的基层医疗特征之一）及其在许多行医地点中的协调性都依赖于基层医疗的综合性。从理论上来讲，医疗综合性可以“在正确的时间与地点提供正确的医疗服务”，且很有可能避免之后再进行花费高的治疗。

关键词：综合性医疗服务费用分析全科医学家庭医学

Habitual sedentary time and stationary time are inversely related to aerobic fitness

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Sports Medicine and Health Science 2022年第4期4卷 260-266页

作者： Myles W.O'Brien Madeline E.Shivgulam Jennifer L.petterson Yanlin Wua Ryan J.Frayne Said Mekari Derek S.Kimmerly Division of Kinesiology School of Health and Human PerformanceFaculty of HealthDalhousie UniversityHalifaxNova ScotiaCanada Department of Family Medicine Universitéde SherbrookeSherbrookeQuebecCanada

A one metabolic-equivalent-of-task increase in peak aerobic fitness(peak MET)is associated with a clinically relevant improvement in survival risk and all-cause *** co-dependent impact of free-living physical behaviours on aerobic fitness are poorly *** purpose of this study was to investigate the impact of theoretically re-allocating time spent in physical behaviours on aerobic *** hypothesized that substituting sedentary time with any physical activity(at any intensity)would be associated with a predicted improvement in aerobic *** volume rate of oxygen uptake(VO_(2)peak)was assessed via indirect calorimetry during a progressive,maximal cycle ergometer protocol in 103 adults(52 females;[38±21]years;[25.0±3.8]kg/m^(2);VO_(2)peak:[35.4±11.5]ml⋅kg^(-1)⋅min^(-1)).Habitual sedentary time,standing time,light-(LPA),moderate-(MPA),and vigorous-physical activity(VPA)were assessed 24-h/day via thigh-worn inclinometry for up to one week(average:[6.3±0.9]days).Isotemporal substitution modelling examined the impact of replacing one physical behaviour with *** time(β=0.8,95%CI:[-1.3,-0.2])and standing time(β=0.9,95%CI:[-1.6,-0.2])were negatively associated with VO_(2)peak,whereas VPA was positively associated with relative VO_(2)peak(β=9.2,95%CI:[0.9,17.6]).Substituting 30-min/day of VPA with any other behaviour was associated with a 2.4–3.4 higher peak *** standing time was associated with a lower aerobic *** little as 10-min/day of VPA predicted a clinically relevant 0.8–1.1 peak MET ***,replacing any time with relatively small amounts of VPA is associated with improvements in aerobic fitness.

关键词： Physical activity intensity Cardiorespiratory fitness Objective activity monitoring Sedentary activity Isotemporal substitution modelling

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外出偷马

作者： (挪)佩尔·帕特森(Per petterson)

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外出偷马

作者： (挪)佩尔·帕特森(Per petterson)

人工膝关节表面置换候选患者疾病特异性的性别差异

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中华骨科杂志 2008年第3期28卷 I0007-I0013页

作者： S.C. petterson L. Raisis A. Bodenstab L. Snyder-Mackler 张卫国(译) Investigation performed at the University of Delaware Newark Delaware 大连医科大学附属第一医院骨科 116011

背景：女性膝骨关节炎患者尽管常感觉关节功能障碍较重，但仍不愿意积极选择人工膝关节表面置换。本研究旨在探讨膝关节置换术前骨关节炎相关功能障碍类型、程度方面的性别差异。方法：221例膝关节置换候选患者（男性95例，女性126例）... 详细信息

背景：女性膝骨关节炎患者尽管常感觉关节功能障碍较重，但仍不愿意积极选择人工膝关节表面置换。本研究旨在探讨膝关节置换术前骨关节炎相关功能障碍类型、程度方面的性别差异。方法：221例膝关节置换候选患者（男性95例，女性126例），44例性别、年龄、体重指数等方面与病例组患者具可比性的健康对照组。伴发对侧肢体损伤或病变、心血管系统疾病、神经系统疾病及其他可能影响患者活动疾病者除外。分别记录：简明医学健康测量量表-36（Medical OutcomesStudy Short Form-36，SF-36）心理、身体评分两部分，膝关节日常活动评分量表，膝关节活动度，起立-行走计时试验（timedup—and—gotesttime，TUGT）、登楼梯试验时间，6min行走距离，标准化股四头肌肌力和随意肌激活能力等。结果：关节置换组，女性比男性患者SF-36、膝关节日常活动评分得分较低，TUGT、登楼梯耗时较长，6min行走距离较短，股四头肌肌力较小。对照组女性比男性登楼梯耗时较长，6min行走距离较短。病例组、对照组比较结果显示：关节置换组和对照组女性股四头肌肌力均比男性弱；对照组女性随意肌激活能力比男性高，而病例组则相反。结论：肌力和关节功能存在性别差异，这种差异在病例组明显增大。膝骨关节炎患者肌力和关节功能下降可以作为预示病变发展的指征而被严密监测，术前治疗应该考虑性别差异对病变的影响。

关键词：人工膝关节表面置换心血管系统疾病性别差异候选关节功能障碍健康对照组膝关节置换男性患者

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外出偷马

作者： (挪)佩尔·帕特森(Per petterson)

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摄影与观察艺术

摄影与观察艺术

作者： F.·帕特森(F. petterson)

Genetic Correlation between Agronomically Important Traits in Yellow Passion Fruit

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American Journal of Plant Sciences 2013年第11期4卷 2112-2117页

作者： Leonarda Grillo Neves Claudio Horst Bruckner Marcelo Coutinho Picanco Severino de Paiva Sobrinho Kelly Lana Araújo petterson Baptista da Luz Marco Antonio Aparecido Barelli Willian Krause Laboratóriode Melhoramento Genético Vegetal Universidade do Estado de Mato GrossoCáceresBrasil Departamento de Fitotecnia Universidade Federal de VicosaVicosaBrasil Departamento de Entomologia Universidade Federal de VicosaVicosaBrasil Departamento de Agronomia Universidade do Estado de Mato GrossoCáceresBrasil

Breeding programs have sought to determine the minimum period of genotype evaluation, which is a long term-process. The objective of this work was to determine the association between qualitative traits of yellow passion fruit (Passiflora edulis Sims) and relate maturity to other characteristics. To carry out this work, 113 families of full-sibs and half-sibs were planted in Viçosa (MG), Brazil, in a randomized block experimental design arranged in sets (treatment groups). The association between the analyzed characteristics was studied using path analysis and canonical correlation techniques. It was found that lower-yielding but larger-fruit bearing genotypes of passion fruit plant also require more days until reaching anthesis. Round-shaped fruits are linked to higher contents of total soluble solids. More intense pulp color also indicates higher contents of total soluble solids. The riper the fruit, the more intensely orange is the color of the pulp. The ratio between the levels of total soluble solids and total titrimetric acidity was the main determinant of pulp color for passion fruit.

关键词： Canonical Correlation Passiflora edulis Path Correlation

Genetic Divergence in Mango and Obtaining Minimum Efficient Descriptors

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American Journal of Plant Sciences 2013年第12期4卷 2318-2322页

作者： Sandra da Costa Preisigke Adryellison Lemes de Campos Nadsley Seraglio Souza Leonarda Grillo Neves Marco Antonio Aparecido Barelli petterson Baptista da Luz Kelly Lana Araújo Severino de Paiva Sobrinho Agronomy Department Mato Grosso State University Cáceres Brazil Plant Breeding Department Mato Grosso State University Cáceres Brazil

Mangifera indica (mango) is a typically tropical fruit with considerable economic value. Brazil features a wide variety of cultivars of this fruit, most of which are known under several different names. Indeed, the nomenclature of mango varieties is still quite confusing. Up to now there has been no well-defined scientific principle to differentiate them. The objective of the present work is to compare the different clustering methods in assessing genetic divergence among mango accessions, as well as identify the minimum efficient descriptors for that crop. A total of 20 mango accessions in Cáceres, Mato Grosso state, Brazil were evaluated. When building dissimilarity matrices, the descriptors were divided according to the following groups: leaf, flower/inflorescence, fruit, seed and growth habit/ripening period. With these divisions, combinations were performed among the groups of descriptors. The similarity index was used to obtain the dissimilarity matrices. Later, the accessions were clustered using the methods of Tocher, Ward and UPGMA. The study observed that it was possible to reduce the number of descriptors from 64 to 35, and that the clustering methods were compatible with the study of the genetic diversity of mango.

关键词： Mango Multicategorical Variables Morphological Descriptors