Perceived personal immunity to the consequences of drinking alcohol: The relationship between behavior and perception

Heavy drinkers, moderate drinkers, light drinkers, and nondrinkers were asked to rate a variety of negative health and social consequences of using alcohol. Subjects made probability ratings for fictional others who were heavy, moderate, or light drinkers or nondrinkers. Subjects also made probability ratings for themselves as hypothetical heavy, moderate, or light drinkers or nondrinkers and for themselves actually. A pattern of perceived personal immunity was found across groups. Subjects rated fictional others and themselves as hypothetical drinkers to be more likely to experience negative consequences than their actual selves. All groups of subjects (heavy, moderate, and light drinkers and abstainers) rated their actual chances of experiencing negative consequences to be approximately equal. In contrast, heavy drinkers saw the effects of drinking for other heavy drinkers as less likely than did subjects who had light or abstinent drinking patterns who rated fictional heavy drinkers. These findings suggest that individuals who drink more tend to deny the potential harm that may result from alcohol consumption. Short-term social consequences were viewed as most likely to occur. Long-term consequences were perceived as least likely to occur.This research was supported in part by grant 1-R01-AA06201 from the National Institute on Alcohol Abuse and Alcoholism.     

Personal Infant Feeding Experiences of Postpartum Nurses Affect How They Provide Breastfeeding Support

Objective

To describe the experiences of postpartum nurses when feeding their own infants and explore how these experiences influence the breastfeeding support they provide to new mothers.

Combined body plethysmographic, spirometric and flow volume reference values for male and female children aged 6 to 16 years obtained from “hospital normals”

Vital capacity (VC) and its subdivisions (IC and ERV), total lung capacity (TLC), residual volume (RV), peak expiratory flow (PEF), forced vital capacity (FVC), forced expiratory volume in one second (FEV₁), maximum flow volume curve (MEF₇₅, MEF₅₀, MEF₂₅, MMEF, FEF_75–85), airway resistance (R_tot, R_eff) and the thoracic gas volume at resting expiratory position (FRC) were measured in 187 girls and 213 boys (hospital normals) aged 6 to 16 years. The measurements were carried out consecutively on the same subjects in the morning using a volume-constant plethysmograph (MasterLab, E. Jaeger; programs: body plethysmography, spirometry and flow volume). Using multiple regression analysis the best fitting curves for the prediction of normal values for boys and girls were selected. Analyses of covariance were performed to compare the adjusted means of the spirometric and body plethysmographic variables of the male and female subjects. As expected, we found higher static and dynamic (FVC, FEV₁, PEF) lung volumes in boys than in girls relating to height. The flows (MMEF, MEF₅₀, MEF₂₅, FEF_75–85) were significantly lower in the male than in the female subjects of the same age justifying separate prediction equations, but the same equation for both genders may be used for the resistance variables R_tot and R_eff. Our results are compared with those of previous studies. Conclusion Lung volumes and flows differ significantly between girls and boys calling for separate reference values for female and male subjects of the same age. Received: 21 August 2000 and in revised form: 20 December 2000 / Accepted: 22 December 2000     

Daily music exposure dose and hearing problems using personal listening devices in adolescents and young adults: A systematic review

Objective: This systematic review aimed to explore the evidence on whether the preferred listening levels (PLLs) and durations of music listening through personal listening devices (PLDs) in adolescents and young adults exceed the current recommended 100% daily noise dose; together with the impact on hearing and possible influential factors of such listening behaviours. Design: A systematic search was conducted using multiple online bibliographic databases. Study sample: The 26 studies were included on the basis of the inclusion and exclusion criteria. Results: The results showed that up to 58.2% of participants exceeded the 100% daily noise dose, particularly in the presence of background noise. Significantly positive correlations were found among background noise levels and mean PLLs, as well as the proportion of participants exceeding the 100% daily noise dose. Moreover, significantly worse hearing thresholds were found in PLD users using audiometry, and significantly poor results in otoacoustic emission (OAE), even in the participants with self-reported ‘normal hearing’. Conclusion: It is crucial to develop appropriate standards and safe recommendations for daily music exposure dose in future studies. Providing an essential guide and effective education to adolescents and young adults will help raise awareness, increase knowledge, and consequently change attitudes and listening habits.     

健康成年人咽部吞咽功能客观参数的测量

目的 通过吞咽动力学研究了解并初步建立成年国人咽部吞咽功能相关参数的客观数值.方法 对年龄20～60岁的男女各40例健康成人志愿者进行X线动态吞咽造影检查并录像,然后通过图像分析测量软件Avidemux 2.5及Image J计算测量在吞咽过程中与咽部吞咽功能密切相关的客观参数,如舌骨的最大移动距离、钡剂通过咽腔的时间、咽腔的收缩率及食管入口的最大开放程度.结果 在80例志愿者中,舌骨的最大移动平均距离(x±s,下同)为(1.91 ±0.48) cm,钡剂通过咽腔的时间为(0.82±0.15)s,咽腔的缩窄率为94.9％±3.41％,食管入口的最大开放程度为(0.91 ±0.05)cm.进一步分组分析发现,男性舌骨的最大移动距离(2.04±0.46)cm,明显大于女性(1.78 ±0.47)cm,差异具有统计学意义(t=2.44,P=0.017),但男女之间及男女不同年龄组之间钡剂通过咽腔的时间、咽腔收缩率及食管入口的最大开放程度差异均无统计学意义(P值均＞0.05).结论 本研究初步建立了成年国人咽部吞咽功能相关参数的客观数值,为更进一步地客观评估咽部吞咽障碍提供了研究基础.     

Evaluation of the adequacy of Hadlock’s reference chart for identification of fetuses with growth restriction

Objective: This study aimed to verify whether Hadlock’s reference values for fetal weight identify fetuses below the 10th percentile in our population correctly.

Methods: The fitness of the Hadlock reference range to our study population was tested by assessment of Z scores. We evaluated differences between the reference weight ranges proposed in our study and those recommended by Hadlock.

Results: Z scores for Hadlock reference values were non-normally distributed. The difference between the 50th percentile fetal weight proposed by our study model and that proposed by Hadlock was ≤1% at GAs ≥22 weeks and 2–3% at 19–21 weeks. For the 90th percentile level, the maximum difference at GAs ≥17 weeks was 1.5%. For the 10th percentile level, the differences were 2–4% in the third trimester, reaching 8% in week 20 and 13% at a GA of 14 weeks.

Conclusions: The weight reference ranges of this study virtually overlap with the Hadlock ranges. We believe that only at lower gestational ages in the second trimester might some FGR diagnoses be missed in the population study with Hadlock’s reference.     

新生儿先天性肾上腺皮质增生症筛查分析

目的探讨新生儿先天性肾上腺皮质增生症（CAH）筛查情况,为CAH的早期筛查、确诊和治疗提供依据。方法选择柳州市新生儿疾病筛查中心2010年9月至2012年12月进行CAH筛查的新生儿,采用时间分辨荧光免疫分析方法检测滤纸片17．羟孕酮（17-OHP）浓度,通过数据分析确立实验室筛查的切值。结果研究期间共筛查46592例新生儿,初筛阳性304例,确诊1例CAH。同一胎龄组中17-OHP浓度随体重增加而降低,同一体重组中早产儿17-OHP浓度大于足月儿,差异均有统计学意义（P〈0．05）。3327例早产儿97．5^th和99^th分位数值分别为40．1nmol／L和57．3nmoL／L,体重〈2500g早产儿切值定为40．0nmo]／L,体重≥2500g定为30．0nmol／L;足月儿中,体重〈2500g者97．5^th和99^th分位数值分别为20．9nmol／L和27．5nmol／L,体重2500～4000g 97．5^th和99^th分位数值分别为16．8nmol／L和21．1nmol／L,但初筛17-OHP浓度分布显示99．8％的新生儿筛查结果分布在O．0～30．0nmol／L,所以,足月儿无论体重大小17-OHP实验室筛查切值均定为30．0nmoL／L。结论确立17．OHP筛查切值,规范实验室管理,具有临床意义。     

Implementation,participation and satisfaction rates of a web-based decision support tool for patients with metastatic colorectal cancer

ObjectiveTo examine implementation and patients’ and providers’ participation and satisfaction of a newly developed decision support tool (DST) for patients with metastatic colorectal cancer (mCRC) in palliative setting.MethodsOur DST consisted of a consultation sheet and web-based tailored information for mCRC treatment options. We conducted an implementation trajectory in 11 Dutch hospitals and evaluated implementation, participation and satisfaction rates.ResultsImplementation rates fluctuated between 3 and 72 handed out (median:23) consultation sheets per hospital with patients’ login rates between 36% and 83% (median:57%). The majority of patients (68%) had (intermediate)-high participation scores. The median time spent using the DST was 38 min (IQR:18–56) and was highest for questions concerning patients’ perspective (5 min). Seventy-six% of patients were (very) satisfied. The provider DST rating was 7.8 (scale 1–10) and participation ranged between 25 and 100%. Remaining implementation thresholds included providers’ treatment preferences, resistance against shared decision-making and (over)confidence in shared decision-making concepts already in use.ConclusionWe implemented a DST with sufficient patient and oncologist satisfaction and high patient participation, but participation differed considerably between hospitals suggesting unequal adoption of our tool.Practice implicationsRequirements for structural implementation are to overcome remaining thresholds and increase awareness for additional decision support.     

Personal networks,social media,and community cohesion in the strategies of peace‐building agents in Colombia to counteract the segregation of displaced populations

As part of the “Colombian Peace Process,” victim assistance programs, actions for the reincorporation into civilian life of ex‐combatants, and demobilized persons of the armed conflict have been developed as well as innovative instances of intervention in cases of posttraumatic stress. In this study, we surveyed 143 community leaders from the Department of Atlántico (Colombia), participants in a program for capacity building in rehabilitation and mediation strategies. With a mixed design in which we combine the analysis of personal networks, psychometric scales, and qualitative interviews, we describe the use that community mediators make of their personal skills, their personal network, and social media in their actions to confront social trauma and promote coexistence in the local community. The results show a significant relationship between the density of personal networks and the psychological sense of community. Paradoxically, the high social cohesion of the communities of people displaced by political violence seems to pose objective difficulties in reducing trauma. In the discussion, we indicate that the sociogeographic segregation derived from housing policies becomes an obstacle to the effective functioning of the coexistence and reintegration programs of victims and demobilized persons of the armed conflict. In this context, social media such as Facebook, Twitter, and WhatsApp are little used by community mediators in the development of their activities, which they perceive as reinforcing largely the dynamics of segregation of the displaced population.     

Pulmonary tuberculosis

We present a case of previously undiagnosed and unsuspected pulmonary tuberculosis (TB) identified on post mortem histology. The presentation of TB in the mortuary is reviewed and we present the key learning points regarding dealing with this infection in the post mortem patient.Trainees should appreciate that although a rare occurrence, pulmonary TB may go undiagnosed until after death, and given its ability to survive in the post mortem patient, the use of personal protective equipment is paramount.