Background:The database of the German programme for quality in healthcare including data of every hospitalised patient with community-acquired pneumonia (CAP) during a 2-year period (n = 388 406 patients in 2005 and 2006) was analysed.Methods:End points of the analysis were: (1) incidence; (2) outcome; (3) performance of the CRB-65 (C, mental confusion; R, respiratory rate ⩾30/min; B, systolic blood pressure <90 mm Hg or diastolic blood pressure ⩽60 mm Hg; 65, age ⩾65 years) score in predicting death; and (4) lack of ventilatory support as a possible indicator of treatment restrictions. The CRB-65 score was calculated, resulting in three risk classes (RCs).Results:The incidence of hospitalised CAP was 2.75 and 2.96 per 1000 inhabitants/year in 2005 and 2006, respectively, higher for males (3.21 vs 2.52), and strongly age related, with an incidence of 7.65 per 1000 inhabitants/year in patients aged ⩾60 years over 2 years. Mortality (13.72% and 14.44%) was higher than reported in previous studies. The CRB-65 RCs accurately predicted death in a three-class pattern (mortality 2.40% in CRB-65 RC 1, 13.43% in CRB-65 RC 2 and 34.39% in CRB-65 RC 3). The first days after admission were consistently associated with the highest risk of death throughout all risk classes. Only a minority of patients who died had received mechanical ventilation during hospitalisation (15.74%).Conclusions:Hospitalised CAP basically is a condition of the elderly associated with a higher mortality than previously reported. It bears a considerable risk of early mortality, even in low risk patients. CRB-65 is a simple and powerful tool for the assessment of CAP severity. Hospitalised CAP is a frequent terminal event in chronic debilitated patients, and a limitation of treatment escalation is frequently applied.

Not living up to one's ideal self has been shown to coincide with decreased self-esteem. In the present paper, this notion is applied to the differentiation between people with independent versus interdependent self-construal. We suggest that the ideal self of independents differs in two respects from the one of interdependents: with respect to its contents (autonomous versus social self-knowledge) and with respect to the degree of context-dependency of the encoded knowledge (context-independent versus context-dependent self-knowledge). In three studies, via a priming we either manipulated contents or degree of context-dependency of what participants considered themselves to actually be like. On both explicit and implicit measures, participants with independent construal indicated higher self-esteem after priming of autonomous and context-independent knowledge than after priming of social and context-dependent knowledge. The opposite pattern was observed in participants with interdependent construal. Results suggest that independent and interdependent construals mirror different ideals which are applied as a comparison standard when evaluating the self. Past research has shown that self-esteem is dependent on the extent to which what a person wants to be, corresponds with what that person considers he or she actually is. For instance, in a study by Moretti and Higgins (1990), students were asked to generate attributes they believed they actually possessed and attributes they ideally wished or hoped to possess. In a second step, participants had to indicate the extent to which they believed they possessed or wished they possessed each attribute. Results showed that self-esteem was the higher the smaller the deviation between what the persons considered themselves to actually be like and what they wanted to be like. Many other studies have since provided additional support for the notion that self-esteem is the outcome of a comparison between actual self-views and standards, goals, or ideals which the person holds for his or her self (e.g.

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Zusammenfassung: Wenn eine Person bei der Beurteilung eines sozialen Stimulus einen verzerrenden Kontexteinfluß vermutet, kann sie ihr Urteil in der dem angenommenen Einfluß entgegengesetzten Richtung an die Kontextinformation assimilieren bzw. von dieser kontrastieren. Im vorliegenden Papier wird diese Annahme auf den speziellen Fall selbstbezogener Urteile angewendet. Hier sollte die Wahrscheinlichkeit, mit der eine Person zu korrigieren versucht, von ihrer Selbstdefinition abhängig sein. Personen mit independenter Selbstdefinition sollten Kontexteinflüsse auf selbstbezogene Urteile für verzerrend halten und ihnen entgegensteuern. Personen mit interdependenter Selbstdefinition sollten hingegen Kontextinformationen für eine angemessene Grundlage zur Bildung selbstbezogener Urteile halten und entsprechend Assimilationseffekte produzieren. In den beiden berichteten Studien zeigte sich erwartungsgemäß, daß Personen mit interdependenter Selbstdefinition sich in selbstbezogenen Urteilen von einem Priming selbstbezogenen Wissens leiten ließen, während Personen mit independenter Selbstdefinition keine Primingeffekte oder Kontrasteffekte produzierten.

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