The health needs of the majority versus the health needs of the individual: The reorganization of medical education in Colombia

The challenge of excellence in community health services has been taken up by medical educators in Colombia. Confronted with a nation where the primary indicators of disease mortality and morbidity (cardiovascular disease and infant mortality) were characteristic of First and Third World patterns, respectively, the Ministry of Health and La Asociacion Colombiana de Facultades de Medicina (ASCOFAME), representatives of institutions of medical education, have collaborated to conduct a needs assessment of the country's health needs and devised an implementation plan designed to better address the needs of the majority of that nation's people.As a model, the Colombian reorganization of medical education is an example which could be emulated by the U.S. where policy makers are struggling with troublesome questions of cost, equity and quality.     

Depressed mood and environmental mastery as potential pathways linking family relationship quality and disease self-management for African Americans with hypertension

African Americans are at significantly greater risk of hypertension and worse cardiovascular outcomes than other racialized groups, yet hypertension intervention effects remain limited. Thus, it is necessary to understand the potential mechanisms whereby interventions may be more effectively targeted to improve health. Supported by prior research evidence and guided by the Biobehavioral Family Model, this study examined associations between family relationship quality, psychological wellbeing, and self-management behaviors for African Americans with hypertension. Data were pooled from three Midlife Development in the U.S. projects, resulting in a sample of 317 African Americans (63.4% female, M_age = 53.32) with self-reported high blood pressure in the past 12 months. We tested four cross-sectional multiple mediator models, with depressed mood and environmental mastery mediating associations between family strain and exercise, smoking, problematic alcohol use, and stress-eating. Environmental mastery mediated the association between greater family strain and decreased odds of achieving recommended exercise levels; greater odds of reporting problematic alcohol use; and greater stress-eating. Though family strain was associated with depressed mood in each model, this variable did not serve as an indirect pathway to self-management behaviors. Family strain, and the potential pathway identified via environmental mastery, may be a meaningful predictor of disease self-management for African Americans with hypertension. Longitudinal studies are needed to examine directionality and to support intervention trials for improving self-management and hypertension outcomes.     

Value-based adoption of augmented reality: A study on the influence on online purchase intention in retail

The increasing use of digital technology-based retail services provides new opportunities for digital marketing. In this paper, we investigate how augmented reality (AR) technology can be leveraged as part of the firm's strategy. We explore the online purchase intention through AR smart glasses (ARSG), considering consumers' value assessment through a cost–benefit analysis and the influence of technical, experiential and social AR value drivers. We develop an augmented value-based adoption model addressing four main objectives: (1) Evaluate the effect of the perceived value of ARSG, (2) Evaluate the effect of immersion (experiential dimension), (3) Evaluate the effect of AR devices and technical complexity (technical dimension) and (4) Evaluate the importance of subjective norms (social dimension) on the online purchase intention through AR technology. Based on an ESIC Tech Lab experiment with two types of ARSG from market leaders and AR retail apps, the study uses survey data from 253 participants. The results suggest that the technical dimension has an ambiguous effect, with tech-complexity enhancing directly the perceived value of ARSG for online purchase while reducing the net value of consumers' economic cost–benefit analysis. We find strong evidence that the experiential and social AR dimensions (in the form of immersion and subjective norm) have a significant positive influence on consumers' purchase intention online, which are better predictors than the pure economic cost–benefit assessment (through usefulness and difficulty). Furthermore, the technical innovativeness of consumers is found to increase directly the online purchase intention through ARSG.     

Reciprocal relationships between personality traits and psychological well-being

This study used an American sample collected over a period of approximately 2 decades (at 3 time points) to examine the temporal relationships between psychological well-being and personality traits (i.e., neuroticism, extraversion, agreeableness, conscientiousness, and openness to experience). The random-intercept cross-lagged panel model was used to separate between-person and within-person sources of variation. Between-person correlations were comparable to those of previous studies. New insights were gained at the within-person level. There were reciprocal relationships between psychological well-being and openness and extraversion, suggesting the joint development of plasticity-related traits and well-being over time. The relationships between psychological well-being and conscientiousness and agreeableness were unidirectional, with psychological well-being preceding these traits. Despite a strong between-person association between neuroticism and psychological well-being, the two were not related at the within-person level.     

Social support from weak ties: Insight from the literature on minimal social interactions

When people face difficult life events, such as cancer or bereavement, they fare better when they receive support. These “experiencers” are likely to seek and receive support from a wide range of people, from close others to acquaintances. Indeed, the social support literature has long acknowledged the value of having a diverse support network. Research suggests that experiencers often perceive “weak ties” (i.e., acquaintances) as sources of support, and that experiencers sometimes prefer to get support from weak ties rather than strong ties. Providing support can be challenging for all kinds of supporters, however weak ties may be more likely than strong ties to allow worries about their inability to provide effective support to stop them from providing any support at all, thus depriving experiencers of opportunities for additional support. In this paper, we focus on the fact that often the provision of support occurs via a social interaction. We draw on the social psychology literature on minimal social interactions to suggest reasons why potential weak tie supporters might doubt their ability to provide effective support, and to generate advice to encourage potential supporters to reach out. Finally, we suggest future areas of research, with the ultimate goal of helping to expand the support that is available for people experiencing difficult life events.     

The elderly and high technology medicine: A case for individualized,autonomous allocation

The issues involved in decision making about the aggressiveness of future medical care for older persons are explored. They are related to population trends, the heterogeneity of older persons and a variety of factors involved in individual preferences. Case studies are presented to illustrate these points, as well as a review of pertinent literature. The argument is offered that, considering these many factors, a system of flexible, individualized care by informed patient preference, is more rational than the rationing of technological services by age.     

驾驶员心理品质检测中的杆型人形图法

在汽车驾驶员心理品质检测研究中,我们根据数学中的多变量图分析方法,并汲取简笔画的优点,用19个人形图变量代表检测所得的17种心理品质数据,来具体、形象地再现每个驾驶员心理品质变量的整体关系。这对于检测结果的分类或进行系统化分析具有重要的实用意义。     

A survey of reimbursement for cystic fibrosis carrier testing

To assess the current status of reimbursement for cystic fibrosis (CF) carrier testing, we surveyed individuals tested in the Mid-Atlantic region. Results show that CF testing was covered by insurance in part or in full for greater than 50% of respondents. The test was nearly always covered when performed during pregnancy because of a positive family history, but it was also covered for more than 50% of pregnant respondents with a negative family history. There were no significant differences in coverage by type of insurance. Many respondents needed to supply additional information about the testing to their insurance company before a coverage decision could be made. Before population-based CF screening programs are initiated, more data are needed on insurance reimbursement for testing, especially when performed pre-conceptually.     

Child and adolescent services research at the national institute of mental health: Research opportunities in an emerging field

This article describes an important new area of research on services for children and adolescents with mental disorders at the National Institute of Mental Health, the parameters of mental health services research for youth, and the opportunities that are available for grant-funded investigations in this area.