Preference awareness education as stress management training for academic staff

This paper describes a response directed stress management intervention (SMI) in the form of a Jungian based preference awareness education (PAE). It uses the Insights System of personality types to increase awareness of behaviour and communication preferences of self and different others. Eighteen self‐recruited academic employees participated for 7 weeks and received feedback about work preferences and personality type. The aim was to reduce perceptions of stress and interpersonal stress and to increase feelings of job satisfaction and interpersonal satisfaction. The data were analysed using two‐tailed t‐tests. No significant findings were observed for the total sample after training, however, interesting results were found for certain sub‐sample groups. Extravert‐thinking types, reported decreased stress levels (p > 0.018), and participants suffering high stress/interpersonal stress pre‐PAE, reported decreased stress levels (p > 0.010–0.018). Participants suffering low job/interpersonal satisfaction pre‐PAE, reported increased job satisfaction (p > 0.015–0.016). These results suggest that individuals who report high levels of stress and dissatisfaction are most likely to benefit from this type of intervention. Future PAE research might: (a) use pilot studies to meet the intervention preferences of employees that are reluctant to participate in SMIs; (b) include a wait‐list control group; use: (c) a follow up education/measures; (d) and organizational level (stressor directed) SMIs at the same time as response directed initiatives. Copyright © 2005 John Wiley & Sons, Ltd.     

Screening for major depression in persons with HIV infection: the concurrent predictive validity of the Profile of Mood States Depression‐Dejection Scale

Major Depressive Disorder (MDD) is among the most prevalent but underdiagnosed psychiatric disorders in persons with HIV infection. Given the known adverse impact of comorbid MDD on HIV disease progression and health‐related quality of life, it is important both for research and for efficient, effective clinical care, to validate existing screening measures that may discriminate between MDD and the somatic symptoms of HIV (such as fatigue). In the current study, we evaluated the concurrent predictive validity of the Profile of Mood States (POMS) Depression‐Dejection scale in detecting current MDD in 310 persons with HIV infection. The Structured Clinical Interview for DSM‐IV (SCID) diagnosis of MDD and the Cognitive‐Affective scale from the Beck Depression Inventory (BDI‐CA) served as comparative diagnostic and severity measures of depression, respectively. Results demonstrated that the POMS Depression‐Dejection scale accurately classified persons with and without MDD SCID diagnoses, with an overall hit rate of 80%, sensitivity of 55%, specificity of 84%, and negative predictive power of 91% using a recommended cutpoint of 1.5 standard deviations above the normative mean. Moreover, the POMS performed comparably to the BDI‐CA in classifying MDD. Findings support the predictive validity of the POMS Depression‐Dejection scale as a screening instrument for MDD in persons with HIV disease. Copyright © 2006 John Wiley & Sons, Ltd.     

内乳动脉插管介入治疗胸部病变

目的 探讨内乳动脉在胸部疾病中的血管造影表现及其在介人治疗中的价值。方法 应用seldinger法，对3l例病灶为内乳动脉供血或参与主要供血的胸部疾病患者进行了内乳动脉造影及介人治疗。结果3l例患者中，20例肺癌患者进行单纯内乳动脉或与其他供血动脉共同灌注化疗，部分行明胶海绵颗粒栓塞治疗，疗效满意。4例中、晚期乳癌灌注化疗后肿块明显缩小。1例低度侵袭性胸腺瘤灌注化疗后明显缩小转放疗。6例大咯血经内乳动脉和其他出血动脉灌注止血药物及明胶海绵栓塞后完全止血。结论 内乳动脉在一些胸部疾病中为主要供血动脉，经该动脉进行介入治疗有重要价值。     

Stenting of coronary bifurcation lesions by using modified crush technique with double kissing balloon inflation (sleeve technique): immediate procedure result and short-term clinical outcomes.

BACKGROUND: Sleeve technique is a modified version of crush technique. It is specifically designed to increase the success rate of final kissing balloon inflation, which used to be a major limitation of the latter. OBJECTIVES: The aim of this study was to examine the feasibility, safety, and early clinical outcomes of sleeve technique in stenting different types (de novo, in-stent restenotic or in-stent bifurcation) of coronary bifurcation lesions at different locations. METHODS: From August 2005 to May 2006, 41 consecutive patients with symptomatic, nonleft-main coronary bifurcation stenoses of diameter narrowing >or=50% were treated with two-stent strategy, using sleeve technique. RESULTS: The mean age was 63.6 +/- 11.6 years with male predominance (70.7%). High prevalence of diabetes mellitus (31.7%), total occlusion (22.0%), and multi-vessel disease (65.9%) was observed in this cohort. Intravenous abciximab was given in 35 (85.4%) patients. Final kissing balloon inflation was successfully performed in all patients. The minimal luminal diameter in main vessel and side branch was increased from 0.97 +/- 0.53 mm and 0.81 +/- 0.45 mm to 2.76 +/- 0.34 mm and 2.22 +/- 0.35 mm, respectively. The mean procedure time was only 66.6 +/- 24.6 min. There was one (2.4%) case of subacute stent thrombosis presented as non-Q-wave myocardial infarction at day 3 postprocedure. The resultant in-hospital and 30-day major adverse cardiac event rate were both 2.4%. CONCLUSIONS: Sleeve technique is a feasible and efficient approach in stenting of coronary bifurcation stenoses.     

心理干预对错[牙合]畸形治疗中合作行为及结果的影响

目的：观察心理干预对错[牙合]畸形患者正畸治疗中合作行为及结果的影响。方法：对门诊口腔科60例青少年[牙合]畸形患者随机分为干预组和对照组各30例。两组均由从事正畸工作5年以上的主治医师采用标准方丝弓技术进行矫正治疗，干预组同时实施心理干预等心理治疗。将两组治疗中的合作行为和结果进行比较分析。结果：心理干预组自律性、主动性、自觉性、矫治时间、满意度等均明显优于对照组，差异有显著性（P〈0．01）。结论：心理干预对青少年正畸患者治疗中合作行为和结果有明显影响，通过心理干预能提高矫治的效果，保证治疗的顺利完成。     

失眠症患者心理防御机制与社会支持的相关研究

目的　探讨失眠症患者心理防御特征和社会支持 ,并分析两者的关系。方法　采用心理防御方式问卷 (DSQ )、社会支持评定量表 (SSRS)对失眠症患者和正常健康者各 5 0例进行评定。结果　患者组心理防御方式 (不成熟型、中间型防御因子和掩饰因子的因子分高 ,成熟防御因子分低 )和社会支持 (社会支持总分、主观支持分、对支持利用度低 )与对照组相比差异有显著性 (P <0 .0 5或 0 .0 1) ;相关分析发现 ,患者组不成熟防御机制与SSRS的支持总分、主观支持分、对支持利用度呈负相关 (P均 <0 .0 5 ) ,中间型防御机制与SSRS的主观支持呈负相关 (P <0 .0 5 )。结论　失眠症患者心理防御机制的成熟程度较正常人低 ,社会支持差 ,两者存在一定的关系。     

Adverse learning strategy: the Adelaide Diagnostic Learning Inventory and its subscale replicability in a medical student population

The Adelaide Diagnostic Learning Inventory (ADLIMS) is a measure of learning styles and learning pathologies that was designed to investigate the impact of traditional approaches to learning versus problem-based learning and to identify students whose approach to learning tasks predicted poor academic performance. In this study, some important psychometric properties of the ADLIMS were examined, including its factor structure. In this study, factor replicability across samples was argued to provide a more robust and psychologically meaningful factor solution than that which can be obtained using traditional mathematical criteria. The results of the factor analysis did not confirm the presence of the four factor solution earlier reported for the ADLIMS, but did identify three clear factors that had very high replicability. An inspection of the items comprising these three factors showed that factor 1 tapped subjective distress related to poor study habits, lack of motivation to study, and distraction from social activities. Factor 2 tapped distress arising from high achievement expectations that were hampered by superficial or disorganized study habits that did not enable the student to grasp the relationships between concepts and ideas. Factor 3 tapped positive feelings and a sense of satisfaction associated with a problem-based approach to the learning of new study material. Although the internal reliability of the ADLIMS subscales met the requirements of a measure to be used in general research such as in the investigation of correlates among groups of medical students, they did not meet the higher requirements of a measure to be used to identify or predict individuals with pathological learning styles.     

Role of EDRF in the Regulation of Shear Rate in Large Coronary Arteries in Conscious Dogs

To determine whether dilation of large coronary arteries normalizes shear during increased flow following brief occlusion, six dogs were instrumented to measure aortic and left ventricular pressures, left circumflex coronary artery external diameter, and coronary blood flow. The coronary artery was occluded for 15 or 30 s. Data were obtained before and after blockade of EDRF synthesis with nitro-L-arginine. Internal coronary artery diameter and wall shear were calculated on a moment-to-moment basis and the area under the flow curve was measured. Peak flow and shear rate were unaffected by NLA or by the occlusion duration. Flow curve area increased with the duration of occlusion. Internal and external diameters increased significantly for 15 s occlusions before NLA (by 4 ± 1% in external diameter and by 11 ± 4% in internal diameter) and for 30 s occlusions before NLA (by 5 ± 1% in external diameter and by 14 ± 5% in internal diameter) but not after NLA. Adenosine infusions of 0.05, 0.10, 0.50, and 1.0 μmol/kg/min were also used to dilate the coronary arteries. With each infusion, flow, shear and diameter were allowed to reach steady state. Steady state shear was reduced only slightly and did not approach the baseline state. We conclude that increased shear rate causes an increase in coronary artery diameter which is EDRF dependent. Increased coronary artery diameter during reactive hyperemia and adenosine infusions did not normalize wall shear.     

Human factors in firefighting: ergonomic-, cardiopulmonary-, and psychogenic stress-related issues

Summary There are many issues in firefighting that involve human factors and cardiopulmonary conditioning. Population-based mortality and disability surveillance studies suggest a relatively small but significant excess of disability but not mortality from nonmalignant cardiovascular disease for fire fighters. More targeted cohort and case-control studies do not support such an excess and instead suggest a strong healthy worker effect. Pulmonary function among fire fighters has been extensively studied, with contradictory findings. Extreme exposures and long-term exposure in combination with cigarette smoking may be risk factors for respiratory disorders and accelerated decline in airflow. It appears likely that individual fire fighters who show early signs of illness are often selectively transferred out of active firefighting positions. Despite exposure to substances such as carbon monoxide that may predispose to cardiovascular mortality and morbidity, excesses are not consistently shown in mortality studies. Clinical studies of individual fire fighters do suggest an elevated risk for myocardial ischemia. The ergonomic demands of firefighting are extreme at peak activity because of high energy costs for activities such as climbing aerial ladders, the positive heat balance from endogenous and absorbed environmental heat, and encumbrance by bulky but necessary protective equipment. The psychological stresses of firefighting include long periods of relative inactivity punctuated by highly stressful alarms and extremely stressful situations such as rescues, as reflected in physiological and biochemical indicators. Fire fighters are at risk for depression and posttraumatic stress disorder, although morale overall is generally much higher than in comparable occupations. Women firefighter candidates as a group perform less well on selection test simulating the demands of active firefighting, but some individual women perform very well.