Personality variables as moderators between hassles and subjective indications of distress

The research was designed to investigate the moderating effect of some personality traits on subjective distress caused by daily hassles. The traits were internal locus of control, repression, ego strength, and barrier (as studied and defined by S. Fisher). The last two variables were negatively correlated both with the somatic and emotional distress indications and with the frequency of hassles reportED; internal locus of control showed an inverse relationship only with frequency of hassles. The hypothesis is formulated that ego strength and barrier are personality factors influencing not only the outcomes of coping (ie the stress response), but also event appraisal.     

基于OKR理念的医院核心工作指标体系建设及应用

以三级公立医院绩效考核及院长绩效考核为指导,结合医院实际情况,构建医院核心工作指标体系。运用目标与关键成果法管理理念,从医院的发展目标和核心问题出发,通过流程优化、任务分解、全员参与,聚焦有挑战性的目标,从而实现管理模式转变。认为核心工作指标体系可赋能医院绩效管理,充分发挥绩效考核在医院管理中的“指挥棒”作用。     

Predictive accuracy of a health risk appraisal program using mortality risk age in 116,927 Korean men

Health risk appraisal (HRA) is a tool for determining health risk factors and motivating individuals to maintain a healthy lifestyle. We performed this study to describe the HRA algorithm and evaluate the accuracy of an HRA program for 10-yr mortality prediction in Korean men. We used data derived from periodic health examinations of 116,927 male public officials and school personnel aged 20 or older. Risk age and the difference between risk age and calendar age were calculated. We obtained the hazard ratio (HR) of 10-yr mortality according to the calculated age difference. Of the 116,927 subjects, 1,900 (1.6%) died during the 10 yr after the 1992 medical examinations. The HR of 10-yr mortality increased significantly with age difference. Compared with the HR in the reference group (age difference below 2 yr), the HR in the group with a 2- to 6-yr age difference was 1.20 (95% confidence interval [CI]: 1.05 to 1.38) and HR in the group with more than 7-yr age difference was 1.35 (95% CI: 1.14 to 1.75). Risk age is a relatively good predictor of 10-yr mortality in Korean men and may be useful in identifying high-risk middle-aged men for health interventions.     

The accuracy of diagnostic tests for adenoid hypertrophy: A systematic review

BackgroundAdenoid hypertrophy may cause sleep-disordered breathing and altered craniofacial growth. The authors conducted a study to gauge the accuracy of alternative tests compared with nasoendoscopy (reference standard) for screening adenoid hypertrophy.MethodsThe authors conducted a systematic review that included searches of electronic databases, hand searches of bibliographies of relevant articles and gray literature searches. They included all articles in which an alternative test was compared with nasoendoscopy in children with suspected nasal or nasopharyngeal airway obstruction.ResultsThe authors identified seven articles that were of poor to good quality. They identified the following alternative tests: multirow detector computed tomography (sensitivity, 92 percent; specificity, 97 percent), videofluoroscopy (sensitivity, 100 percent; specificity, 90 percent), rhinomanometry with decongestant (sensitivity, 83 percent; specificity, 83 percent) and clinical examination (sensitivity, 22 percent; specificity, 88 percent). Lateral cephalograms tended to have good to fair sensitivity (typically 61-75 percent) and poor specificity (41-55 percent) when adenoid size was evaluated but excellent to good specificity when airway patency was evaluated (68-96 percent).ConclusionsNo ideal tool exists for dentists to screen adenoid hypertrophy, owing to access constraints, radiation concerns and suboptimal diagnostic accuracy. Research is needed to identify a low-risk, easily acceptable, highly valid diagnostic screening tool.Practical ImplicationsAlthough lateral cephalograms (which have good to fair sensitivity) and a thorough medical history (which has good specificity) are imperfect individually, when they are used together, they can compensate for each other's weaknesses. This combined approach is the best tool available to dentists for screening adenoid hypertrophy.     

全科医师临床沟通能力的培养模式与评估机制

临床沟通能力成为全球医学教育七大最低基本要求之一。本文强调了沟通能力在全科医疗服务中的重要性,指出全科教育的薄弱环节,并探讨了临床沟通能力的培养模式及考评机制。     

Pre-operative appraisal of cochlear implant results by means of electrical promontory stimulation: Preliminary report

Summary A test procedure based on the patient's understanding of acoustic material is presented. The score obtained in this test showed a highly significant correlation with the postoperative score evaluated by independent examiners 4 weeks after stimulator adjustment.     

Stress, appraisal, and coping: a comparison of HIV-infected women in the pre-HAART and HAART eras

BACKGROUND: It has been widely suggested that highly active antiretroviral therapy (HAART) has improved the psychosocial aspects of living with HIV/AIDS. METHOD: A sample of 79 women living with HIV/AIDS in the pre-HAART era (1994-1996) were compared with a matched sample of 79 women with HIV/AIDS from the HAART era (2000-2003) on measures of stress, illness appraisals, and coping strategies. RESULTS: Contrary to expectations, HIV-infected women in the HAART era were significantly more likely than women in the pre-HAART era to report health-related stress, to report stress from stigma and disclosure, to view HIV as having caused them harm, to report that their health is due to chance, and to report more use of maladaptive forms of coping (e.g., escape-avoidant coping). CONCLUSION: Although HAART may have extended survival for many HIV-infected individuals, they have not resulted in equivalent psychosocial improvements. Thus, efforts are needed to address the psychosocial difficulties that HIV-infected women in the HAART era continue to experience.     

Argument-based medical ethics: a formal tool for critically appraising the normative medical ethics literature

Although there are critical appraisal tools for other genres of the medical literature, there currently is no formal tool for physicians to use in their critical appraisal of the normative medical ethics literature. We present a formal assessment tool for the critical appraisal of the normative medical ethics literature that incorporates the intellectual standards of argument-based medical ethics and evidence-based medicine. We draw on the intellectual standards of argument-based ethics, ethical analysis and argument, and the literature on evidence-based medicine. The tool involves 4 questions about normative medical ethics papers: (1) Does the article address a focused ethics question? (2) Are the arguments that support the results of the article valid? (3) What are the results? (4) Will the results help me in clinical practice? Obstetrician-gynecologists can use this tool to appraise the normative literature of ethics in obstetrics and gynecology formally.