[The child at the end of his life, how do the parents live, how to help them?].
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Men's health problems are rooted in early socialization, which inhibits self-care and help-seeking behavior. This article explores the impact of male socialization, as well as developmental challenges that undermine the health of boys and male adolescents. Maladaptive coping strategies used by young males are outlined. The author describes what young males need for maintaining emotional connections with themselves and others. Practical strategies are offered for how physicians may promote the emotional health of today's boys and male adolescents.
Answering the telephone is an important first contact with the dental office. The voice tone, inflection and other non-verbal aspects of the person answering all have a profound impact on how the caller perceives the dental office. Suggestions are presented which are designed to avoid communication problems and to project a positive professional image to a caller. Audio clips are included to demonstrate variations in telephone technique to assist the reader in the development of a telephone answering protocol that reflects a desirable image for the office staff and for the dental practice.
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OBJECTIVE: Current guidelines recommend use of written action plans and peak flow monitoring as key components of asthma care. Our study assesses whether written action plans, with or without peak flow monitoring, have an independent effect on outcomes when used as a component of asthma self-management. STUDY DESIGN: This was a systematic review of published studies. Two independent reviewers followed a prospective protocol for study selection and data abstraction. Outcome data were synthesized qualitatively; they were not appropriate for quantitative meta-analysis. Our comprehensive literature search used MEDLINE, EMBASE, the Cochrane Library, and a hand search of recent bibliographies. The search was limited to full-length, peer-reviewed articles with abstracts in English. The studies were randomized controlled trials that compared the outcomes of an asthma self-management intervention with and without the use a written action plan. The primary outcomes of interest are utilization measures, such as hospitalizations and ER visits. Other outcomes of interest include measures of symptom control and lung function. POPULATION: There were 1501 evaluable patients with asthma; 1410 adults and 91 children. OUTCOMES MEASURED: We measured the frequency of waiting and examination room companions, the reasons for accompaniment, the influence on the encounter, and the overall helpfulness of the companion as assessed by patients and companions. We also determined the physicianamprsquos assessment of the companionamprsquos influence, helpfulness, and behavior during the encounter. RESULTS: Nine randomized controlled trials enrolling a total of 1501 patients met selection criteria. The majority of comparisons in these studies do not demonstrate improved outcomes associated with a written action plan. There are notable methodologic limitations: studies reporting negative findings lack sufficient power, and studies reporting positive findings demonstrate systematic bias. CONCLUSIONS: Although written action plans are widely used, there is insufficient evidence to determine whether their use, with or without peak flow monitoring, improves outcomes.
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