Increased Mortality of Patients With Childhood-Onset Inflammatory Bowel Diseases,Compared With the General Population

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Withdrawing versus not offering cardiopulmonary resuscitation: Is there a difference?

Conflict between substitute decision makers (SDMs) and health care providers in the intensive care unit is commonly related to goals of treatment at the end of life. Based on recent court decisions, even medical consensus that ongoing treatment is not clinically indicated cannot justify withdrawal of mechanical ventilation without consent from the SDM. Cardiopulmonary resuscitation (CPR), similar to mechanical ventilation, is a life-sustaining therapy that can result in disagreement between SDMs and clinicians. In contrast to mechanical ventilation, in cases for which CPR is judged by the medical team to not be clinically indicated, there is no explicit or case law in Canada that dictates that withholding/not offering of CPR requires the consent of SDMs. In such cases, physicians can ethically and legally not offer CPR, even against SDM or patient wishes. To ensure that nonclinically indicated CPR is not inappropriately performed, hospitals should consider developing ‘scope of treatment’ forms that make it clear that even if CPR is desired, the individual components of resuscitation to be offered, if any, will be dictated by the medical team’s clinical assessment.     

高校单亲大学生绝望感及其影响因素

目的:探究单亲大学生绝望感水平以及单亲大学生绝望感与生活事件、功能性失调态度的关系,针对于单亲大学生的心理干预提供依据。方法:采取分层随机整群抽样方法,在山东省12所高校内采用BECK绝望量表(BHS)、青少年生活事件量表、功能失调态度量表对991名普通大学生进行问卷调查,用SPSS 21.0对数据进行分析。结果:单亲大学生在对未来的期待因子上得分与非单亲大学生具有明显差异(t=2.21,P0.05);单亲男性大学生在青少年生活事件的寻求赞许(t=2.69,P0.05)和认知哲学(t=2.37,P0.05)因子上得分与单亲女性大学生有明显差异;生活事件和绝望感相关(r=0.60,P0.01),绝望感与功能性失调态度相关(r=0.56,P0.01);脆弱性、完美化、健康适应、吸引和排斥、认知哲学、丧失对单亲大学生绝望感有62%的预测作用。结论:加强对单亲大学生的关注,尤其是单亲男性大学生,要引导其改变认知和构建方式以减少其绝望,预防心理和行为问题。     

Effect of polymerization temperature on the properties of autopolymerizing resin

Statement of problem

The polymerization conditions of an autopolymerizing resin affect its physical properties, and at chairside, 3 different methods are commonly used: cooling in cold water, warming in warm water, and heating in hot water. However, the effects of polymerization temperature on the physicomechanical properties of autopolymerizing resin are unclear.

Intervisit Management of Patients With Diabetes: Synchronized Phone Calls

The US health care model continues to struggle with providing chronic disease management. Innovation focusing on improving care delivery systems to bridge this gap will be necessary to improve chronic care in the United States. This quality improvement project focused on patients with type 2 diabetes. This innovation was designed to change patient and provider engagement in follow-up care by providing a protected synchronous time in the form of a scheduled phone call to work on glycemic goals through improving patient’s diabetes self-management techniques and, when appropriate, medication titration. A standardized tool (the Diabetes Treatment Satisfaction Questionnaire) was used to assess patient satisfaction with this intervention.     

Economic growth and health progress in England and Wales: 160 years of a changing relation

Using data for England and Wales during the years 1840-2000, a negative relation is found between economic growth--measured by the rate of growth of gross domestic product (GDP)--and health progress--as indexed by the annual increase in life expectancy at birth (LEB). That is, the lower is the rate of growth of the economy, the greater is the annual increase in LEB for both males and females. This effect is much stronger, however, in 1900-1950 than in 1950-2000, and is very weak in the 19th century. It appears basically at lag zero, though some short-lag effects of the same negative sign are found. In the other direction of causality, there are very small effects of the change in LEB on economic growth. These results add to an emerging consensus that in the context of long-term declining trends, mortality oscillates procyclically during the business cycle, declining faster in recessions. Therefore, LEB increases faster during recessions than during expansions. The investigation also shows how the relation between economic growth and health progress changed in England and Wales during the study period. No evidence of cointegration between income--as indexed by GDP or GDP per capita--and health--as indexed by LEB--is found.