Source Reliability in Auditory Health Persuasion: Its Antecedents and Consequences

Persuasive health messages can be presented through an auditory channel, thereby enhancing the salience of the source, making it fundamentally different from written or pictorial information. We focused on the determinants of perceived source reliability in auditory health persuasion by investigating it from two distinct angles. First, inferences on the voice (pleasantness) and person (e.g., similarity) significantly predicted perceived source reliability. In a second (experimental) study, three contextual factors (message framing, level of processing, gender matching) affected perceived reliability independently. Furthermore, perceived reliability mediated the effect of message framing on persuasion. The evaluation on source reliability in auditory persuasion seems to be affected by several factors, partly unique to auditory communication. These studies may inspire further research on auditory (health) persuasion.     

Causes and Consequences of Incomplete HIV RNA Suppression in Clinical Trials

Abstract

The current goal of antiretroviral treatment is suppression of HIV RNA below 50 copies/mL. However, there is evidence for residual low-level plasma viraemia below 50 copies/mL for people with HIV RNA suppression on antiretroviral treatment. It is not clear whether more profound suppression of HIV RNA would lead to a lower risk of virological failure on antiretroviral treatment or emergent drug resistance. There is high variability in the currently used HIV RNA PCR assays for samples with HIV RNA levels close to the detection lower limit of 40–50 copies/mL. For patients who have HIV RNA levels just above 50 copies/mL (often called “single blips”), a repeat sample should be taken to investigate the possibility of technical error. In a systematic review of 48-week effi cacy from randomized clinical trials (N = 8,083), patients were signifi cantly more likely to show HIV RNA levels between 50–400 copies/mL while taking fi rst-line boosted PI-based HAART (7.3%) compared with fi rst-line NNRTI-based HAART (4.5%) (p < 0.01). However in a systematic review of emergent drug resistance at failure in the same trials, there was also a signifi cantly lower risk of emerging drug resistance after virological failure of boosted PI-based HAART (p < 0.01). Therefore, HIV RNA blips between 50–400 copies/mL may have different consequences for different classes of antiretrovirals. The most widely used method to analyse HIV RNA in clinical trials — time to loss of virological response (TLOVR) — uses two consecutive HIV RNA measurements to define both virological success and failure. However, other methods may improve precision and increase statistical power.     

双极"D"形电切圈套器的体外实验研究和临床应用体会

目的　评价双极“D”形电切圈套器的应用效果及安全性 ;方法　对体外乙状结肠假息肉用双极“D”形电切圈套器和单极椭圆形圈套器行电切 ,并对其结肠壁标本进行病理学检查 ,比较临床效果 ;结果　双极“D”形电切圈套器具有操作简单、方便等特点 ,10例中出现迟发性出血 1例 ,即时性大出血 1例 ,与用单极椭圆形圈套器比较时间和能量需求差别无显著性 ;病理学检查提示 ,用双极者组织损伤明显小于用单极者 ,损伤达肌层者分别为 10 %和 90 % ,边缘损伤范围分别为 (0 .4 2± 0 .13)mm和 (1.4 7± 0 .5 8)mm ;结论　双极“D”形电切圈套器用于电外科治疗具有组织损伤小、操作简单和方便、相对安全性高等优点 ,但临床应用尚需积累更多的经验     

Natural History and Clinical Consequences of Hepatitis B Virus Infection

Despite the existence of Hepatitis B vaccination, hepatitis B virus (HBV) infection is still prevalent worldwide and accounts for significant morbidity and mortality. It is encouraging that majority of patients do recover from the acute infection, however, those that progress to chronic disease state is at great risk of developing complications such as hepatocellular carcinoma, cirrhosis and liver failure. Hepatitis B virus infection can be influenced by many factors such as host immune status, age at infection, and level of viral replication. The discovery about the existence of various genotypes and its association with different geographic distribution as well as the knowledge regarding mutant species has aid us in better understanding the nature of HBV infection and in delivering better care for patients. It is especially important to recognize those individuals with HBeAg-negative chronic HBV as they have a poorer prognosis compare with their counterparts, HBeAg-positive. Tremendous progress has been made over the years in understanding the behavior and clinical course of the disease; however, the natural history of HBV is complex and we still have much to explore and learn.     

三段式临床护理实践教学在临床护生实习中的应用

目的 探讨三段式临床护理实践教学在临床护生实习中的应用.方法 选择在我院实习的护生180人,分为观察组与对照组,每组90人,对照组应用传统的带教方式,观察组应用三段式临床护理实践教学.比较两组学生的学习效果,并对两组学生及带教老师进行问卷调查.结果 两组学生理论测验成绩比较,观察组学生的理论成绩明显高于对照组,两组学生实践技能考核成绩比较,观察组学生的成绩明显高于对照组(P<0.05).观察组学生的满意率明显高于对照组,观察组带教老师满意度明显高于对照组(P<0.05).结论 三段式临床护理实践教学能针对学生的特点进行科学化、合理化的临床教学训练,教学质量明显提高,学生及带教老师的满意程度高,为临床护理实践教学提供一种新的参考模式.     

Manual-Based Treatment and Clinical Practice

The role of empirically supported, manual-based treatments in clinical practice is controversial. This article attempts to clarify misunderstandings that may impede their effective use. Manual-based treatments encourage focal interventions, facilitate training and supervision of therapists, and expedite clinical audit. They are consistent with an actuarial approach to treatment, which, on average, is likely to prove superior to subjective clinical judgment. Treatment manuals can provide greater flexibility and self-correcting features than is often assumed. Comorbidity does not exclude their use. Far from hampering innovation, their use is likely to spur new developments. Manual-based treatments require specific therapeutic skills. Although effective, empirically supported manuals fall short of helping large numbers of patients. Treatment manuals must become more "therapist friendly" by including richer practical details on their use, as well as greater specification of some of the "nonspecific" factors in therapy.     

Recognizing Anger in Clinical Research and Practice

Cassiello‐Robbins and Barlow (2016) offer a long‐overdue critical analysis of the nature and function of anger in emotional disorders and their treatment. If not unrecognized, the basic emotion of anger has certainly been underemphasized in the prevailing diagnostic classification system and focus on diagnosis‐specific treatments for single disorders. In this commentary, I briefly highlight a few examples of complementary clinical resources where anger is more consistently and explicitly addressed. The chosen examples are intentionally selected from multiple theoretical orientations to demonstrate that anger has been unrecognized primarily within a specific context, and that there is considerable convergence in how anger is being considered across seemingly divergent approaches. Finally, I offer some of my own recommendations for practice and training.     

积极心理学在临床实践中的运用

目的 旨在对积极心理学在临床实践中的运用进行概要的介绍与评述.方法 通过对积极心理学文献资料的回顾,分析了积极心理学在幸福的概念构成、测量评估及积极干预方面的主张.结果 幸福是积极心理学的研究主题,积极心理学将幸福的概念划分为快乐、投入、意义3个层次,并且分别都已有实用有效的评估工具可以用于临床.越来越多的证据表明了积极干预在建构快乐、投入与意义方面的功效,积极干预将成为预防和治疗心理疾病有效的补充.结论 积极心理学将有助于拓宽临床心理学的视野,打破仅仅关注于痛苦和如何减轻痛苦的局限.     

Endoscopic Sphincterotomy in Clinical Practice

Endoscopic sphincterotomy was performed in 22 patients with biliary obstruction. Nineteen patients had obstructing choledocholithiasis and three patients had distal common-bileduct obstruction due to malignant disease. All patients had excellent biliary decompression. Three patients had complications that responded to medical management. Endoscopic sphincterotomy is a safe and effective procedure for the nonsurgical management of obstructive-biliary-tract disease.