The role of effective communication with children and their families in fostering adherence to pediatric regimens

Adherence to pediatric health enhancement, disease prevention, and medical treatment, particularly for chronic disease, can be challenging because of demanding regimens, children's progressing developmental stages, and varying family perspectives and relationships. This review examines adherence in the context of communication among providers, pediatric patients, and their families. The focus is on: the delivery of prevention and treatment information; trust in the therapeutic relationship; beliefs and attitudes in shaping acceptance of health care messages; social and cultural norms; building patient and family commitment to behavior change; family habits; barriers and pressures faced by patients and their families; the role of social networks and social support in fostering adherence, and the effects of family cohesiveness and family conflict. The unique challenges of fostering preventive health care and treatment for chronic disease in the context of transition to adolescence are also considered, and effective clinical solutions are reviewed.     

Demonstration of the effective of acupuncture on the autonomic nervous system by examination of the microcirculation

This study served to compare the effect of needling at true acupuncture points with that of needling at non-acupuncture points. Various parameters were used to quantify the results such as measurement of the peripheral blood circulation in finger tips and the nasal mucous membrane, measurement of the skin temperature at various sites of the body by means of infrared thermography or contact thermometry, testing of skin conductance, or recording of heart frequency and respiration. These are all indicators of the functional state of the autonomic nervous system. This model experiment was performed on healthy volunteers and showed identical, transient, quick reflex responses of the sympathetic nervous system after true acupuncture as well as after needling at non-acupuncture points. These reactions are related to pain and do not allow to draw any conclusions on the specificity of the points that were needled. The aim of this project was not to make a statement about the therapeutic efficacy of acupuncture. It was meant to be a model allowing the study of some basic regulatory mechanisms which are fundamental for most treatments in complementary medicine.     

Tangible reinforcement and feedback effects on the IQ scores of college students.

College students who retook an intelligence test under conditions that informed the student of each correct answer made significantly higher gains than a control group that retook the test under standard conditions. A group that retook the test under feedback and reward conditions did not differ significantly from the control group.     

Prior experiences associated with residents' scores on a communication and interpersonal skill OSCE

OBJECTIVE: This exploratory study investigated whether prior task experience and comfort correlate with scores on an assessment of patient-centered communication. METHODS: A six-station standardized patient exam assessed patient-centered communication of 79 PGY2-3 residents in Internal Medicine and Family Medicine. A survey provided information on prior experiences. t-tests, correlations, and multi-factorial ANOVA explored relationship between scores and experiences. RESULTS: Experience with a task predicted comfort but did not predict communication scores. Comfort was moderately correlated with communication scores for some tasks; residents who were less comfortable were indeed less skilled, but greater comfort did not predict higher scores. Female gender and medical school experiences with standardized patients along with training in patient-centered interviewing were associated with higher scores. Residents without standardized patient experiences in medical school were almost five times more likely to be rejected by patients. CONCLUSIONS: Task experience alone does not guarantee better communication, and may instill a false sense of confidence. Experiences with standardized patients during medical school, especially in combination with interviewing courses, may provide an element of "deliberate practice" and have a long-term impact on communication skills. PRACTICE IMPLICATIONS: The combination of didactic courses and practice with standardized patients may promote a patient-centered approach.     

Comparison of MMPI-2 scores of foreign Chinese and Caucasian-American students

MMPI-2 scores of foreign Chinese students (n= 25) were compared to those of a matched sample of Caucasian students (n = 21) and to normative data on American college students. Although responses for all groups were within normal limits, Chinese men appeared more socially introverted than Caucasian men. Relative to Caucasian women, Chinese women were more defensive, depressed, unaware of somatic and psychosocial problems, and gender astereotypic in interests. These tentative findings are discussed in terms of ethnicity and adjustment.     

Enhancing the relationship and improving communication between adolescents and their health care providers: a school based intervention by medical students

OBJECTIVE: To develop, implement and evaluate a workshop to help adolescents develop independent and active relationships with their physicians. METHODS: A needs-assessment survey informed the development of a workshop delivered by medical student volunteers and incorporated into the career and personal planning curriculum of high schools in Vancouver, Canada. RESULTS: Over a 6-year period, 64 workshops were delivered by 181 medical students to 1651 high school students in six schools. CONCLUSION: The workshop is acceptable, do-able, effective and sustainable, characteristics that arise from the mutual benefits to all the groups involved: the medical school, the school board, the medical students, the high school teachers and students. The workshop provides a model for providing health care education to adolescents in the community. PRACTICE IMPLICATIONS: Teaching adolescents the importance of good doctor-patient communication encourages them to take ongoing responsibility for their health care and is an alternative route to direct health care education.     

Knowledge and attitude of medical students in Delhi on postmortem examination

A survey proforma with multiple choice questionnaire was designed and asked to be filled in by two hundred medical students belonging to 3rd and 4th year of MBBS curriculum of a University medical college in Delhi. One hundred thirty-three (66.5) students responded. A large majority of 129 (96.9%) students were aware of the major use of the postmortem examination/autopsy. All students have the knowledge that postmortem involves examination of a body in detail both externally and internally. Sixty-four (48.1%) feel that it does not cause disfigurement of the body. One hundred fifteen (86.4%) students were the view that they possess satisfactory level of knowledge on postmortems. The main source of knowledge and information on the subject is teaching during medical curriculum as informed by 76 (57.1%) students. More than 50% were willing ti permit autopsy on the self/relative. While, only 7 (5.3% students showed reluctance to watch autopsy.     

Further examination of the impact of patient participation on physicians' communication style

Objective

Previous research in primary care has shown that physicians are more informative and/or patient-centered when they interact with high participation patients (e.g., those who ask questions, express preferences and concerns). This study contributes to this literature by examining parents’ participation and physicians’ discourse in a pediatric surgery context.

Methods

The audiotapes of 7 pediatric surgeons and 68 of their patients’ parents/guardians were coded and examined for physicians’ information exchange and support utterances as they interacted with parents/guardians with varying degrees of participation.

Results

The results of a multilevel regression analysis showed, consistent with related research, that the same physicians were more informative overall and provided more information in response to parents’ questions when interacting with high participation parents. However, participation was not associated with physicians’ volunteered information, general explanations, or support utterances.

Discussion and conclusion

The results are discussed with respect to the impact of participation on physicians’ information provision and implications for future research, particularly with respect to general explanations, volunteered information, and medical context.

Practice implications

This study suggests that surgeons may provide more detailed information to patients who are active participants in the preoperative interview, thereby improving the adequacy and validity of informed consent for surgical procedures.     

高等职业院校学生SCL-90评分的meta分析

目的:分析高职生的总体心理健康状况,为高职生心理健康教育提供理论依据。方法:对2001-2010年间的51项高职生90项症状自评量表(SCL-90)测试结果进行meta-分析。结果:高职生在SCL-90的强迫、人际关系敏感、恐怖和精神病性上的得分高于成人常模,在其余因子上的得分和成人常模差异无统计学意义;高职生和大学生在SCL-90各因子上得分差异均无统计学意义;高职生SCL-90各因子得分的性别和城乡差异均无统计学意义。结论:高职生的心理健康状况比普通人群差,和大学生没有差异,同时不存在高职生性别和城乡的差别。     

宫腔镜微创手术对于子宫内膜容受性的影响

目的：探讨宫腔镜微创手术对于子宫内膜容受性的影响。方法：选取本院妇产科2013年1月至2013年12月收治的98例体外受精–胚胎移植失败的患者,进行宫腔镜下活检以及微创手术,观察术后月经第5、10、15天的平均子宫内膜厚、整合素β3以及HOXA10表达情况以及术后ER以及PR的累计阳性率情况。结果：98例患者微创术后月经第5、10、15天的平均子宫内膜厚分别(7.5±1.3)、(12.3±2.3)、(14.5±3.2) mm,差异具有统计学意义(P<0.05);术后月经第5、10、15天整合素β3以及HOXA10表达显著上升,差异具有统计学意义(P<0.05);术后ER以及PR的累计阳性率相比于术前显著上升,并随着时间呈现出上升趋势(P<0.05)。结论：宫腔镜下微创手术治疗能显著改善子宫内膜术后容受性,有利于体外受精–胚胎移植术的成功。     

An electrophysiological correlate of Eating Attitudes Test scores in female college students

Eating Attitudes Test (EAT) scores of forty female college students were compared to their electrodermal activity (EDA) responses when offered a plate of chocolate chip cookies. A significant positive correlation was detected between the EAT scores and the skin conductivity measures associated with the presentation of food. Women with the highest EAT scores also exhibited the greatest sympathetic nervous system responses to a plate of cookies. This finding supports the conclusion that the EAT is capable of identifying individuals who are preoccupied with food or anxious about eating.