Can Contextualization Increase Understanding During Man-Machine Communication? A Theory-Driven Study

The Internet offers unlimited possibilities for finding health information. However, the user is often faced with the problem of understanding it. Contextualization has a role to play in enhancing the user’s comprehension. We report on a study which addresses this issue, using a theoretical model of communication whose central theme is that of context. A randomized controlled experimental design was chosen, using as a test-bed the website SeniorGezond we had previously developed. The study was composed of a pre-test, the intervention with the website and a post-test. Participants (n=40) were randomly assigned to exposure or no exposure to contextualization with the website. Results show that contextualization increases understanding for non-knowledgeable users. Furthermore, the participant’s cognitive style was found to be a significant factor on understanding. We also found that participants bring their own contexts such as social context and psychological context to support their understanding

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Contexts for collaboration in healthcare education

In recent years, the drive towards cost-effectiveness and efficiency, coupled with radical changes in healthcare education, have resulted in an increased need for collaboration, both at the interpersonal and institutional levels. Such collaborations were once regarded primarily as pragmatic ventures. Increasingly, however, there are reports of these collaborations yielding tangible benefits, both in terms of curriculum innovation and reconceptualization of the educational process. This paper draws upon some recent examples from the literature to examine the nature of collaborative partnerships in healthcare education. In particular, it discusses the development of collaborative practices and identifies diverse contexts (such as the sharing of resources and the integration of computer technologies in the curriculum) in which these practices evolve. This paper brings to the front changes that are triggered by collaborative initiatives, and highlights lessons learned for successful collaborations

Modelling medical diagnostic processes

2 volsAvailable from British Library Document Supply Centre- DSC:DX93816 / BLDSC - British Library Document Supply CentreSIGLEGBUnited Kingdo

Easing Internet access of health information for elderly users

Elderly users are increasingly becoming active consumers of Internet technologies. Developing websites dedicated to this user group presents several design issues (such as that of 'design for all', participatory design, patient empowerment and cognitive usability assessment methods). SeniorGezond is a health information resource currently under development. It aims to support elderly users in their search and access of appropriate information in the area of fall incidences. The current development of SeniorGezond provides a useful illustration on how design issues can be addressed and applied in a practical setting. Copyright © 2004 Sage Publications