Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

Managing intercultural conflict effectively

In this volume, Ting-Toomey and Oetzel accomplish two objectives: to explain the culture-based situational conflict model, including the relationship among conflict, ethnicity, and culture; and, second, integrate theory and practice in the discussion of interpersonal conflict in culture, ethnic, and gender contexts. While the book is theoretically directed, it is also a down-to-earth practical book that contains ample examples, conflict dialogues, and critical incidents. Managing Intercultural Conflict Effectively helps to illustrate the complexity of intercultural conflict interactions and readers will gain a broad yet integrative perspective in assessing intercultural conflict situations. The book is a multidisciplinary text that draws from the research work of a variety of disciplines such as cross-cultural psychology, social psychology, sociology, marital and family studies, international management, and communication

Culture and interpersonal communication/ Gudykunst

277 hal.: 23 cm

Culture and interpersonal communication/ Gudykunst

277 hal.: 23 cm

The Sage Handbook of Conflict Communication: Integrating Theory, Research, and Practice

Qin Zhang is a contributing author (with John G. Oetzel, Bibiana Arcos, Phola Mabizela, and Michael Weinman), Historical, Political, and Spiritual Factors of Conflict: Understanding Conflict Perspectives and Communication in the Muslim World, China, Colombia, and South Africa, pp. 549-574. Book description: The SAGE Handbook of Conflict Communication: Integrating Theory, Research, and Practice is the first resource to synthesize key theories, research, and practices of conflict communication in a variety of contexts. Editors John Oetzel and Stella Ting-Toomey, as well as expert researchers in the field, emphasize constructive conflict management from a communication perspective which places primacy in the message as the focus of conflict research and practice.https://digitalcommons.fairfield.edu/communications-books/1013/thumbnail.jp