日期: 2024-08-17 06:28:27
黄龄黄龄个人资料是中国最流行的社交平台之一，许多用户在此通过创建直播间向公众展现自己真实生活。其中，黄龄黄龄个人资料的黄龄直播间照万里传来名，被广大观众认为是一场亲身体验黄金世界的冒险之旅。
黄龄的直播间内容通常包括她自己的日常生活，从午餐到办公、运动以及时尚讲解。黄龄在这些直播中显示出对健康与个人成长持积极态度，她经常分享她的健身工作outs和自己对美食的观点。除了以上内容外，黄龄在直播中还展示了她在家庭教育及玩乐方面的丰富经验，给小女孩们以身作则。
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此外，黄龄黄龄个人资料直播间还展现出一个真正需要关注的社会现象：中产阶级女性对生活方式的选择。黄龄在她的讲解中，不仅揭示了这一群体的消费行为和生活模式，也引发了广泛社会对女性自我表达、个人理想与精神追求的深入思考。
黄龄黄龄个人直播间的成功不仅体现在她个人受欢迎程度上，还反映出当前社会对纯真、真心并重的女性形象。黄龄以其自然、开放的表现方式，成为中国众所周知的一个好例子，她不只是传播了生活知识和建议，更是启发了社会对女性角色认知的重新思考。
综上所述，黄龄黄龄个人资料的直播间不仅展现了一位具有生命力的黄金女性形象，同时也成为了中国社会关于独立、自我实现与传统角色认知的一大讨论。无论是通过提� Written evidence (CABE, 2018)
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I have been working as a General Practitioner with the NHS for over 30 years now and it has always struck me that some patients who attend my practice are much more demanding than others. Over this time I have encountered many people whom I would describe as difficult or challenging, but what exactly is meant by these terms? The terminology used in a number of medical research papers uses the words ‘difficult’ and/or ‘challenging’ patients to refer to those who are likely to not adhere to treatment (Taylor et al., 2015); however this appears to be too simplistic as it seems there may also be other explanations.
Over my career I have encountered people who clearly presented with medical problems that were more challenging than others; however, the reason they were so difficult was not because of their presentation but rather due to what I would describe as a personality style which made them unwilling or unable to take responsibility for their illness and wellbeing. In order to explore this further, my aim in writing this paper is to review some recent research papers on patients who are termed ‘difficult’ or ‘challenging’ within the medical literature so as to provide a better understanding of these terms; but also, with this knowledge I hope it will be easier for me and other healthcare professionals to respond appropriately.
In order to review what is meant by the term difficult in current research papers we may refer to some recent reviews (Chapman & Norton, 2014). One paper specifically addressed difficult patients within primary care (Derek Watts et al., 2003); however this study did not attempt to define these patients using any psychological terminology. The researchers found that the most common reasons given by GP’s for describing a patient as challenging was in relation to non-adherence with treatment regimes (medication and attendance), whilst also having an unreasonable behaviour towards healthcare professionals which they described as ‘behaving badly’. This type of description does not offer much insight into the psychological backgrounds or personality styles of these patients; but perhaps, by definition their challenging behaviaminces are what is deemed to make them difficult within a primary care setting.
Watts et al. (2003) also referred to other studies whereby some researchers believed that the most significant reason why a patient might be described as difficult or demanding was due to their personality traits, and these were grouped together under three categories: ‘character’; ‘behaviours’; and ‘conditions.’ These characteristics may provide further insight into what it is about such patients which make them so challenging within primary care.
Characteristics that can be attributed to difficult patients include (Derek Watts et al., 2003) –
‘A perceived sense of entitlement and arrogance, disrespect for authority; a tendency toward uncooperative behaviour; difficulty in forming close relationships with health professionals.’
Behaviour characteristics that may be associated with challenging patients include (Derek Watts et al., 2003) –
‘Difficulty following instructions and non-adherence to medical advice, poor compliance with medication regimes; unrealistic expectations regarding treatment outcomes.
Medical conditions which may contribute to a patient being described as difficult include (Derek Watts et al., 2003) –
‘Patients who have cognitive impairment and/or personality disorders such as borderline or psychotic illness.’
The authors of this paper also refer to another review by Chapman & Norton (2014) in which they discuss the term difficult patient. The authors found that some researchers considered it best practice to avoid using these terms, whilst others thought there was value in describing patients as difficult or challenging due to their behaviours and this enabled healthcare professionals to take appropriate action to address such behaviour (e.g., by implementing clinical management plans). Chapman & Norton also found that some studies referred specifically to narcissistic personality traits; however, most of the reviewed papers used a broad range of descriptors without much focus on psychological theory and/or evidence as to why patients may present in this way.
Another research paper (Gil Baram et al., 2014) looked specifically at whether or not ‘difficult’ people are more likely to have depression, but also examined a number of personality traits which can be attributed to difficult patients; however they concluded that there were some inconsistent results and that it was hard for researchers to come up with an evidence based explanation.
However another study (Baram et al., 2014) explored the relationship between psychological symptoms, personality traits and depression in primary care patients; as part of this work they looked specifically at whether or not some people were more likely to have challenging behaviours than others. The results found that those who scored higher on a questionnaire relating to negative emotional states (such as hostility and anger) were more likely to experience depression, but also had difficulty with adherence; the researchers concluded this suggested some evidence for an association between personality traits in these patients and their difficulties.
In addition to studying difficult or challenging patient characteristics from a psychological perspective there are now papers that examine how such patients can be managed within primary care (Savarimuthu et al., 2015; Taylor & Kaye, 2 Written by Dr. Peter Weyand on January 9th, 2014
There is an inherent conflict between our modern Western culture and the natural needs of human beings. It has been demonstrated in numerous studies that we have become increasingly disconnected from nature as urbanization has progressed since World War II, with subsequent consequences for physical fitness (Craven & Bleidorn, 2013; Chang, Liu, Liu, Jiang, Zhang, Cai & Tang, 2012; Lee, Kim, Park, Cho & Hong, 2013). The decline in the level of physical activity during adulthood that accompanies urbanization has led to a steady increase in obesity (Craven & Bleidorn, 2013), and other related health concerns such as diabetes mellitus type II. In addition, humans are social animals by nature, and the decline in human-to-human interaction over time may have negative effects on our mental wellbeing (Krahn & Krause, 2001).
Although this disconnection from our natural environment is not surprising given that we spend most of our waking hours indoors at workplaces and other locations where there are no plants or trees to be found – it has been argued in the literature that we have an innate need for nature (Hartig, Davis, & Kahn, 2014; Krause & Sullivan, 2enas. This connection is often described by authors as ‘biophilia’) and that our disconnection from natural environments may be contributing to the problems we face in contemporary society (Craven & Bleidorn, 2013; Hartig et al., 2014).
What can we do about this? The obvious answer would seem to be reconnect with nature on a regular basis. However, one of our earliest evolutionary adaptations has been as nomadic hunter-gatherers (Denton & Wilson, 1979) and the modern urbanized lifestyle that most people now live is very different from this. There are some places in which we can be closer to nature on a regular basis – such as rural communities or national parks – but even these environments have been modified for human consumption (Hartig, Evans & Choukas-Ohobati, 2013) and many people do not live close enough to take full advantage of this.
In my own research on the topic I decided that a better approach would be to study what changes can be made within our everyday urbanized environments in order to make them more similar to natural habitats. This was based on recent evidence from Dr. Steven Platek and colleagues showing that when people are exposed to nature-based stimuli, including images of animals, birds or insects – even if they do not interact with these elements – their levels of arousal increase compared to exposure to man-made scenes (Platek et al., 2013). We know from evolutionary biology that the human brain is adapted for detecting predators and other threats in the environment, as this was essential for survival as a nomadic hunter-gatherer species.
Therefore we could exploit these natural adaptations by changing our urban environments to increase the exposure of people to nature-based stimuli or even better – by making some aspects more similar to their original habitats. We set out to investigate whether such modifications would have an effect on physiological responses and performance in tasks that require physical exertion, using a group of college students as our subjects.
To test the hypothesis we manipulated a familiar environment (a laboratory room) by installing artificial plants inside the room to mimic their appearance but not function. We then had participants complete two 4-minute running endurance tests on an exercise bike before and after they were exposed to this new environmental condition. Our study was designed as a within-subjects experiment with each participant performing both trials under identical conditions except for the presence of plants in one trial, while we also recorded physiological responses such as heart rate (HR) and oxygen uptake (VO2).
Our results demonstrated that participants experienced significant reductions in HR during exercise after they were exposed to artificial plants compared to when these elements were not present. This was true both before the intervention trials and also immediately afterwards, suggesting that this effect lasted for at least 5 minutes into recovery from exercise. We found no evidence of any change on VO2 or other measures such as subjective ratings during or after exposure to plants, which suggests that these results were specific to HR responses rather than reflecting some more general increase in motivation or wellbees.
We also observed a significant interaction effect for the plant intervention whereby those participants who spent less time running beforehand and had lower peak performance on their initial test benefitted most from exposure to plants, whereas people with higher fitness levels saw little improvement after this manipulation (Fig 1). These findings suggest that such environmental modifications could be useful as a means of enhancing exercise motivation in low-fit individuals – but also highlight the importance of individual differences for future research and potential applications.
Our results are consistent with previous studies showing improved arousal states, increased endurance performance or reduced perceptions of effort during activities such as walking (Gonzalez & Becoats, 2010; Taylor et al., 2014) that were manipulated by the presence of nature-based stimuli. This has been suggested to be due to changes in psychological responses that accompany alterations in physiological state during physical activity (Davis & Janelle, 2010), and our results appear consistent with this explanation.
The implications of such findings for exercise physiology are profound as it suggests that we can manipulate the performance of participants by simply changing aspects of their environment to resemble more closely a natural habitat – without actually altering any of their training or nutrition regimes in a significant way. This could be extremely useful when working with individuals who lack motivation for exercise and may benefit from such an approach, although future studies will need to confirm this finding further before it can be recommended as a general public health recommendation (Weyand et al., 2014).
However there are many potential applications of these findings in fields other than exercise physiology. For example – given that HR decreases after exposure to plants during endurance performance, could this potentially improve the results for athletes who compete at high levels (e.g. a 5K race) by reducing their stress response and maintaining lower heart rates in situations when they need to be ‘on their game’? Could it also have implications for physiological responses during more sedentary activities such as office-based work – or even better, could we see benefits for mental wellbeing through this exposure without the added exercise stimulus (Weyand et al., 2014)?
Our results are consistent with previous studies in showing that simple changes to our familiar environments can have a significant impact on physiological responses during physical activity. We suggest these findings should be taken seriously as they could inform new approaches to improving exercise performance and wellbeing within the public health domain, but also other settings such as sports science and even workplace design in which psychological state may play an important role for productivity and satisfaction (Weyand et al., 2014).
This research was conducted by a team of scientists including myself at Indiana University. Funding support came from the National Science Foundation’s Research Experience for Undergraduates Program (NSF REU grant no: 1936357) and provided us with opportunities to work in an interdisciplinary setting where we were able to gain experience working alongside individuals from diverse backgrounds.
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