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101.
Evidence suggests that attachment styles may influence subclinical psychosis phenotypes (schizotypy) and affective disorders and may play a part in the association between psychosis and childhood adversity. However, the role of attachment in the initial stages of psychosis remains poorly understood. Our main aim was to describe and compare attachment styles in 60 individuals at ultra high risk for psychosis (UHR) and a matched sample of 60 healthy volunteers (HV). The HV had lower anxious and avoidant attachment scores than the UHR individuals (p < .001). Sixty-nine percentage of the UHR group had more than one DSM-IV diagnosis, mainly affective and anxiety disorders. The UHR group experienced more trauma (p < .001) and more mood and anxiety symptoms (p < .001). Interestingly, in our UHR group, only schizotypy paranoia was correlated with insecure attachment. In the HV group, depression, anxiety, schizotypy paranoia, and social anxiety were correlated with insecure attachment. This difference and some discrepancies with previous studies involving UHR suggest that individuals at UHR may compose a heterogeneous group; some experience significant mood and/or anxiety symptoms that may not be explained by specific attachment styles. Nonetheless, measuring attachment in UHR individuals could help maximize therapeutic relationships to enhance recovery.  相似文献   
102.
We tested the hypothesis that a sense of responsibility drives group representatives' decisions to be more risk averse compared with decisions made by individuals. The hypothesis was supported when the monetary considerations (i.e., payoff inequality and the magnitude effect) were controlled for in the potential gain domain as well as in the potential loss domain. Evidence showed that this is because the group representatives were concerned about how they would view themselves (e.g., guilt and self‐blame) and also how they would be viewed by others (i.e., to avoid being blamed and looked down upon by others). This study provided new insights into understanding group representatives' decision making under risk. Copyright © 2017 John Wiley & Sons, Ltd.  相似文献   
103.
The mandated public availability of individual hospital's audit data for children's heart surgery in the UK creates a challenging scenario for communicating these complex and sensitive data to diverse audiences. On the basis of this scenario, we conducted three experiments with the aim of understanding how best to help lay people understand these data and the practical goal of improving the public presentation of these data. The experiments compared different outcome measures for displaying the survival rate (percentage scale versus the ratio of the predicted/observed rates) and presentation formats (individual hospital versus all hospitals shown) for outcomes data presented relative to prediction intervals generated by a risk model that adjusts for case mix. Our data highlight how easily inappropriate comparisons can influence evaluations of complex data: for instance, both a survival ratio of 1 and the presence of other hospitals seemingly provided reference points that resulted in inappropriately harsh evaluations of some hospitals. By drawing on evaluability theory, we demonstrate how to enhance people's understanding of these complex data while also discouraging inappropriate comparisons, which has implications for communicating risk and uncertainty and for choice architecture design in a range of contexts. Copyright © 2018 John Wiley & Sons, Ltd.  相似文献   
104.
Objective: Here, we develop an integrative account of the roles of emotion in decision-making. In Part I, we illustrate how emotional inputs into decisions may rely on physiological signals from emotions experienced while making the decision, and we review evidence suggesting that the failure to represent the emotional meaning of options can often reduce decision quality. We propose that health-related decrements in the ability to generate emotional reactions lead people to inaccurately represent emotional responses and compromise decisions, particularly about risk. Part II explores complex decisions in which choice options involve trade-offs between positive and negative attributes. We first review evidence showing that difficult trade-off decisions generate negative affect and physiological arousal. Next, we propose that medical decision-making will be linked to short- and long-term stress and health outcomes.

Conclusion: In sum, this article proposes and reviews initial evidence supporting the effective use and management of emotional inputs as important to both clinical and non-clinical populations. Our approach will contribute to the understanding of patient-centred emotional decision-making and will inform medical decision aids.  相似文献   
105.
Despite vaccines' consistently demonstrated effectiveness, vaccination rates remain suboptimal due to vaccine refusal. Low vaccination rates are particularly problematic for individuals who cannot be vaccinated for medical reasons and thus must rely on herd immunity (i.e., protection of vulnerable individuals due to the high rate of vaccination of other—often socially distant—individuals). The current study uses a novel decision‐making task to examine how three variables impacted participants' highest acceptable probability of side effects to their children: 1) the severity of the side effects their children experience, 2) the social distance to the beneficiary of the vaccination, and 3) the probability that the vaccine will prevent disease for that designated beneficiary. Participants' willingness to risk potential side effects of vaccination systematically decreased as the 1) effectiveness of the vaccination decreased, 2) the beneficiary of the vaccination became more socially distant, and 3) the severity of side effects increased. These data were well‐described by behavioral economic models used to examine the discounting of other health behavior.  相似文献   
106.
Objective: It has been suggested that randomised controlled trials (RCTs) of health behaviour change (HBC) interventions are less rigorously designed than – for example– drug trials. This study presents an approach to clarifying whether this is due to poor trial design, incomplete trial reporting and/or the inappropriateness of commonly applied risk of bias assessment criteria.

Design: First, a framework of key sources of bias and common strategies for reducing bias risk is developed based on a literature review. Second, we describe the design of a multi-site RCT evaluating the cost-effectiveness of an HIV-treatment adherence intervention (case study). The choices made by the multidisciplinary team trying to minimise the risk of bias are compared against the risk of bias framework.

Main outcome measures: Implementation of common strategies for reducing the risk of bias in the case study; alternative or additional strategies applied; a justification for each deviation from the risk of bias framework.

Results: Most of the common strategies for reducing the risk of bias could be implemented. Alternative strategies were developed for minimising the risk of performance bias and contamination. Several additional, domain-specific risk of bias strategies were implemented.

Conclusions: The literature provides useful guidance for reducing the risk of bias in HBC trials. Yet, the case study suggests that HBC trial designers may face specific challenges that require alternative/additional measures for reducing the risk of bias. Using the risk of bias justification table (RATIONALE) could lead to better-designed HBC trials, more comprehensive trial reports and the data necessary for evaluating the appropriateness of commonly applied risk of bias assessment criteria to HBC trials.  相似文献   
107.
108.
Using a cross-sectional design, this study surveyed 144 students on campus who are service members and veterans to determine whether posttraumatic stress (PTS) symptoms are significantly correlated with demographic factors (e.g., age, race and marital status), risk factors (e.g., military branch and combat exposure), and resources (e.g., social support and religiosity). The results confirm previous findings on correlates of PTS symptoms, provide new information about service members on campus that are at a greater risk for PTS and highlight resources that are associated with reduced PTS symptoms. These findings not only give institutions of higher learning insight into identifying specific demographics that are at a greater risk for PTS symptoms on college campuses, but also point to ways of supporting student service members/veterans by accurately targeting existing resources to the most affected populations.  相似文献   
109.
脉压的大小是反映动脉粥样硬化的一个指标,因此,脉压增宽可以预测心脑血管疾病的发生,脉压预测的脑血管疾病危险的价值大于收缩压和舒张压,并有助于解释以往研究中舒张压与病死率关系不一致的现象。  相似文献   
110.
回顾了该研究的思路,指出进行这样的研究,关键是建立一个有代表性的监测系统,针对同一监测人群,开展综合监测,发展规范的现场工作程序,确保获得高质量数据。建立标准的、动态的人口库、出生、死亡和危险因素个案库,是完成这项研究的前提,世界卫生组织专家称这是中国人在流行病学监测中的天才创新。  相似文献   
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