Specific and individuated death reflection fosters identity integration

Identity integration is the process wherein a person assimilates multiple or conflicting identities (e.g., beliefs, values, needs) into a coherent, unified self-concept. Three experiments examined whether contemplating mortality in a specific and individuated manner (i.e., via the death reflection manipulation) facilitated outcomes indicative of identity integration. Participants in the death reflection condition (vs. control conditions) considered positive and negative life experiences as equally important in shaping their current identity (Experiment 1), regarded self-serving values and other-serving values as equally important life principles (Experiment 2), and were equally motivated to pursue growth-oriented and security-oriented needs (Experiment 3). Death reflection motivates individuals to integrate conflicting aspects of their identity into a coherent self-concept. Given that identity integration is associated with higher well-being, the findings have implications for understanding the psychological benefits of existential contemplation

Confiabilidade do diagnóstico final de dengue na epidemia 2001-2002 no Município do Rio de Janeiro, Brasil Reliability of the final dengue diagnosis in the epidemic occurring in Rio de Janeiro, Brazil, 2001-2002

Este estudo analisou a confiabilidade do diagnóstico final das 155.242 notificações de dengue da epidemia 2001-2002 no Município do Rio de Janeiro, fornecidas pela Secretaria Municipal de Saúde do Rio de Janeiro, por meio do Sistema de Informação de Agravos de Notificação (SINAN). O diagnóstico final possui como opções de preenchimento: dengue clássico, febre hemorrágica do dengue, descartado, inconclusivo e ignorado. Foi construída uma rotina em Epi Info para comparar o diagnóstico final digitado no SINAN com os critérios do Ministério da Saúde (MS), agrupando os casos como dengue clássico, dengue hemorrágico, descartado e inconclusivo (inclui ignorado). O diagnóstico final mostrou 52,4% dengue clássico, 0,6% dengue hemorrágico, 0,9% descartado e 46% de inconclusivo e ignorado, sendo que 78% de dengue clássico, 69% de dengue hemorrágico e 21,1% dos descartados preencheram os critérios do MS. A confiabilidade do diagnóstico final digitado foi em geral satisfatória (kappa = 0,681; IC95%: 0,685-0,677), porém baixa para os óbitos (kappa = 0,152; IC95%: 0,046-0,258). Considerando-se o volume da epidemia, o diagnóstico final de dengue clássico e dengue hemorrágico foi satisfatório, porém a alta proporção de casos ignorados e inconclusivos e a baixa qualidade da informação nos óbitos limitam o uso do SINAN nesse contexto.<br>This study analyzed the reliability of the final diagnosis in the 155,242 dengue reports during the 2001-2002 epidemic in the city of Rio de Janeiro, Brazil, using the official information system on communicable diseases (SINAN). The system allows the following options for the final diagnosis: classic dengue, dengue hemorrhagic fever, discarded, inconclusive, and unknown. We built a classification routine in Epi Info to compare the final diagnosis from SINAN with Ministry of Health criteria. According to the final diagnosis, the case breakdown was: 52.4% classic dengue; 0.6% dengue hemorrhagic fever; 0.9% discarded; 46% inconclusive and unknown. The revised diagnosis showed that 78% of classic dengue, 69% of dengue hemorrhagic fever, and 21.1% of discarded cases met the classification criteria. Although the reliability of the SINAN final diagnosis was generally satisfactory (kappa = 0.681; 95%CI: 0.685-0.677), it was worse for fatal cases (kappa = 0.152; 95%CI: 0.046-0.258). Considering the epidemic's magnitude, the final diagnosis of classic dengue and dengue hemorrhagic fever was satisfactory, but the high proportion of inconclusive or unknown cases and the poor quality of information for fatal cases limit the usefulness of SINAN in this context