A model of suicidal behavior in posttraumatic stress disorder (PTSD): The mediating role of defeat and entrapment

The aim of this study was to examine whether depression, hopelessness and perceptions of defeat and entrapment mediated the effects of posttraumatic stress disorder (PTSD) symptoms on suicidal behavior. Participants were 73 individuals (mean age=29.2, S.D.=10.9, 79.5% female) diagnosed with current or lifetime PTSD who reported at least one PTSD symptom in the past month. Participants completed a series of self-report measures assessing depression, hopelessness and perceptions of defeat and entrapment. The Clinician Administrated Posttraumatic Scale for DSM-IV was administered to assess the presence and severity of PTSD symptoms. The results of Structural Equation Modeling supported a model whereby perceptions of defeat and entrapment fully mediated the effects of PTSD symptom severity upon suicidal behavior. The finding that perceptions of defeat and entrapment mediate the relationship between PTSD symptom severity and suicidal behavior was replicated in a subgroup of participants (n=50) who met the full criteria for a current PTSD diagnosis. The results support a recent theoretical model of suicide (The Schematic Appraisal Model of Suicide) which argues that perceptions of defeat and entrapment have a key role in the development of suicidal behaviors. We discuss the clinical implications of the findings.     

Measurement of health literacy in patients with cardiovascular diseases: A systematic review

BackgroundWhile many instruments have been developed, validated, and used to assess health literacy skills, their use and appropriateness among patients with cardiovascular diseases (CVDs) are not widely studied.ObjectiveTo identify, appraise, and synthesize available health literacy assessment instruments used in patients with CVDs.MethodsElectronic databases were searched for studies that used validated measures to assess health literacy in patients with CVDs. Included studies were assessed for risk of bias and the identified instruments were evaluated based on their psychometric properties. Data were synthesized using a narrative approach.ResultsForty-three studies were included in the review, of which 20 were cross-sectional studies and 12 were randomized controlled trials. Eleven health literacy assessment instruments were identified, of which only one was disease-specific. The Abbreviated version of the Test of Functional Health Literacy in Adults (S-TOFHLA) (n = 19) and the Rapid Estimate of Adult Literacy in Medicine (REALM) (n = 13) were found to be the most commonly used instruments to assess health literacy in CVDs.ConclusionsThe S-TOFHLA and the REALM are the most widely used instruments to evaluate health literacy in CVD population. More CVD-specific health literacy screening instruments are warranted. Assessment of health literacy should be a standard of care in patients with CVDs and effective interventions should be developed to improve the impact of limited health literacy on health outcomes in this population.     

总额限定下医院绩效考核体系的构建与探讨

由于松江区已实行收支两条线管理以及绩效工资政策,医院原先三维度考核办法已不再适合新形势的要求.通过借鉴其它医院经验及结合医院实际,构建了一个既不突破核定总额又能体现医务人员劳动价值,涵盖量、质的绩效考核体系,希望为松江卫生综合改革及其它实施收支两条线管理的地区提供借鉴.     

Temporal dynamics of event‐related potentials related to goal conduciveness and power appraisals

The Component Process Model hypothesizes that appraisal—the mechanism that elicits and differentiates emotion—is processed sequentially. It predicts that the goal conduciveness check (motivational valence evaluation) is evaluated before the power check (evaluation of the degree of power to act on events). To test this prediction, we recorded event‐related potentials (ERPs) during a gambling task in response to feedback that simultaneously presented the goal conduciveness (outcome: win, loss, or break‐even) and the power check (options to act on the outcome) information. In line with the sequence hypothesis, mean amplitudes of subsequent ERPs were differentially modulated by the appraisal information. The feedback‐related negativity was sensitive to the goal conduciveness check, and the P300 yielded main effects of both appraisal checks. Results suggest that neural evaluative processes associated with appraisal processing are sequential.     

Clinical practice guidelines for treating headache with Traditional Chinese Medicine: quality assessment with the appraisal of guidelines for research and evaluation II instrument

OBJECTIVE

To critically appraise the methodological quality of clinical practice guidelines for headache produced over the last two decades, including those covering specific interventions using Traditional Chinese Medicine.

责任护士职责落实情况考核在优质护理中的应用

目的：探讨责任护士职责落实情况考核在优质护理中的应用效果。方法：利用本院病区分为东西两翼的优势,将2013年1-6月到西翼区心血管内科住院的600例患者设为观察组,在东翼区五官科住院的600例患者设为对照组,两组均采用护士管床及流动护士站床边工作制的护理模式,观察组每天由综合控制班对分管床位的责任护士工作职责落实情况进行考核,对照组未进行考核。比较两组患者对护理服务的满意度、按时服药到口率、3d完成辅助检查率。结果：观察组对护理服务的满意度、按时服药到口率、3d完成辅助检查率均明显高于对照组,差异有统计学意义（P〈0．05）。结论：责任护士职责落实情况考核能明显提高护理服务质量,提高护士的执行力,同时提高患者对护理工作的满意度,有效促进护患关系的良性发展,值得临床推广应用。     

我院医学计量管理模式的探讨

本文结合目前医院计量管理工作中存在的实际问题,介绍了医院计量管理的复杂性和面临的困难,提出了我院计量管理的实施措施,希望与同行共同探讨。     

动脉血氧分压在尘肺劳动能力鉴定中的地位

通过４１５例Ⅰ期煤工尘肺（ＣＷＰ）的动脉血氧分压（ＰａＯ２）和肺功能测定资料分析，提示在常规通气功能及肺容量测定基础上加测ＰａＯ２，将能提高８．４０％阳性检出率（占总阳性检出率的２２．０５％），因此认为，ＰａＯ２在尘肺劳动能力鉴定中占有一定的重要地位。