No abstract

In this randomized controlled trial marginal intervention effects for the improvement of communication skills and only partial changes in patient satisfaction scores from pre to post training were shown. However, physicians with poorer performance at the beginning showed greater improvements, suggesting that competence levels were already relatively high at the beginning of the study. Also, formation of communication training groups should be based on specific skill deficits rather than being implemented unspecifically for an entire team of physicians.

PFM activity during reflex latency response time intervals during coughing was significantly higher than at rest, which suggests PFM pre-activity and reflex activity during coughing. Although we standardized coughing, EMG variables for PFM activity showed poor reliability [good to excellent ICC(3,k) and fair to excellent ICC(3,1) but high SEM and MD]. Therefore, coughing is expected to be heterogeneous, with low reliability, in clinical test situations. Potential crosstalk from other muscles involved in coughing could limit the interpretation of our results.

Exposure to extreme stress is known to have immediate as well as long‐term effects on sleep. There is some evidence that adverse childhood experiences as well can increase the vulnerability of sleep to stress in the long term. In order to validate these assumptions, 39 healthy female undergraduate students were exposed to a video stress induction procedure before bedtime. Self‐reports and actigraphic measures were collected through a period of three baseline nights and the test night. Participants' self‐reports of the subsequent night's sleep were significantly associated with the degree to which they reported that the stress inducing film had triggered own stressful memories of their past. This finding supports the assumption that early stress history can increase an individual's vulnerability of sleep to stress, in particularly when actual stressors lead to the reactivation of stressful memories. Yet, actigraphic measures did not corroborate this subjective impression of sleep impairment. Copyright © 2010 John Wiley & Sons, Ltd.