Evaluation of "Life with Diabetes" Patient Education Booklets

Evaluation of written patient education materials is a necessary part of pro viding education to pa tients with diabetes. Evaluation, however, is useful only if the needs of both those who use the materials (patients) and those who recommend and distribute the materials (health care professionals) are considered. Eight booklets in the "Life with Diabetes" patient educa tion series (developed by the Michigan Diabetes Research and Training Center) were evaluated by both health professionals and patients. Twenty-eight to 37 health professionals including nurses, dieti tians, and physicians evaluated each booklet. Their comments were used to revise and im prove the booklets before publication (formative or process evaluation).Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/69005/2/10.1177_014572178601200113.pd

Confrontation and politeness strategies in physician-patient interactions

The therapeutic sucess of physician-patient interactions depends in large part on how physicians interpret and respond to patients' implicit and explicit messages. Using a hypothetical vignette, in which a patient refuses to comply with a recommended therapeutic regimen, we found that first-year medical students with no classroom training in medical interviewing implicity recognized that the situation called for face preserving or polite linguistic behavior. Ninety percent of them used culturally sanctioned politeness forms to repair the conversational breakdown depicted in the vignette. They responded to this clinical scenario, however, with linguistic behaviors borrowed from their everyday interactions, some of which were culturally appropriate, but not necessarily therapeutic. We suggest that students can learn to adapt their culturally appropriate behaviors and engage in therapeutic communication as physicians if they are given the necessary conceptual tools. We discuss how Brown and Levinson's theories of politeness and strategic language usage can (1) provide a framework for interpreting communication in general and physician-patient interaction in particular, (2) illuminate some of the problems inherent in doctor-patient encounters, and (3) be used prescriptively for teaching students and health professionals how to avoid some communication difficulties.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/27511/1/0000555.pd

Physical Activity Training for Functional Mobility in Older Persons

The effectiveness of low-intensity physical activity for improving functional ability and psycho logical well-being in chronically impaired older individuals was demonstrated in a pilot study. Participants who completed 6 weeks of structured low-intensity exercise (N = 77) improved in the time and number of steps required to walk a measured course, in self-assessments of mobility and flexibility, and in three measures of well-being. Those who continued to exercise in a peer-led program (n = 32) maintained improvements in mobility and optimism after 18 weeks.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68101/2/10.1177_073346489501400401.pd

The importance of race in medical student performance of an AIDS risk assessment interview with simulated patients

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75349/1/j.1365-2923.2000.00455.x.pd

Evaluating medical students' patient interviewing skills: A biopsychosocial model

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/26843/1/0000403.pd

Interpreting behavioral, biomedical, and psychological relationships in chronic disease from 2 x 2 tables using correlation,

Correlations of 0.3 and 0.4 in psychological studies in chronic illness (e.g. diabetes) have been criticized as having little clinical importance. The present article suggests that correlation coefficients be interpreted as binomial effect size displays (BESD) as a means of gleaning the clinical importance of a given correlation coefficient. The BESD is easily understood, computed, and applied to research in chronic disease. An illustration is provided in which a r of 0.2 is shown to correspond to a BESD in which the success rate is improved from 40 to 60%. Using BESD to interpret the meaningfulness of relationships, correlations as low as 0.2 may have clinical importance.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/26429/1/0000517.pd

Measuring specialty indecision among career-decided students

Increasing numbers of career-decided students in professional and graduate schools have difficulty choosing a specialty. To begin to examine this problem, a measure of specialty indecision was devised by changing the Career Decision Scale items to deal with specialty indecision rather than career indecision. The scale was then administered to 567 medical students along with measures of vocational development and exploratory behavior. Initial evaluation of the psychometric properties of the Specialty Indecision Scale indicate that it is internally consistent, relates more to specialty choice than to career choice, and inversely relates to both vocational development and exploratory behavior. A factor analysis of the scale items extracted four factors that reflect cognitive, conative, criterion, and implementation restraints on the decision-making process. The Specialty Indecision Scale seems to be useful for diagnostic and research purposes in the study and treatment of specialty indecision.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/25480/1/0000020.pd

Evaluation of a joint Bioinformatics and Medical Informatics international course in Peru

Background: New technologies that emerge at the interface of computational and biomedical science could drive new advances in global health, therefore more training in technology is needed among health care workers. To assess the potential for informatics training using an approach designed to foster interaction at this interface, the University of Washington and the Universidad Peruana Cayetano Heredia developed and assessed a one-week course that included a new Bioinformatics (BIO) track along with an established Medical/Public Health Informatics track (MI) for participants in Peru. Methods: We assessed the background of the participants, and measured the knowledge gained by track-specific (MI or BIO) 30-minute pre- and post-tests. Participants' attitudes were evaluated both by daily evaluations and by an end-course evaluation. Results: Forty-three participants enrolled in the course - 20 in the MI track and 23 in the BIO track. Of 20 questions, the mean % score for the MI track increased from 49.7 pre-test (standard deviation or SD = 17.0) to 59.7 (SD = 15.2) for the post-test (P = 0.002, n = 18). The BIO track mean score increased from 33.6 pre-test to 51.2 post-test (P less than 0.001, n = 21). Most comments (76%) about any aspect of the course were positive. The main perceived strength of the course was the quality of the speakers, and the main perceived weakness was the short duration of the course. Overall, the course acceptability was very good to excellent with a rating of 4.1 (scale 1-5), and the usefulness of the course was rated as very good. Most participants (62.9%) expressed a positive opinion about having had the BIO and MI tracks come together for some of the lectures. Conclusion: Pre- and post-test results and the positive evaluations by the participants indicate that this first joint Bioinformatics and Medical/Public Health Informatics (MI and BIO) course was a success.The University of Washington AMAUTA Global Training in Health Informatics, a Fogarty International Center/NIH funded grant (5D43TW007551), and the AMAUTA Research Practica Program, a Puget Sound Partners for Global Health-funded grant

What's in a copy?

ABSTRACTI will answer the question “What’s in a copy?” by considering three sets of related issues: the importance of copies in academia; in cultural life; and in the economic world. In academia the current capability of making copies is challenging pedagogical practices and the trust of its members, plagiarism being the most immediate problem. The notion of authorship is also undergoing changes provoked by a proliferation of authors and new possibilities opened up by cyberspace. In cultural life, imitation and mimesis have long been fundamental engines of socialization. Our enhanced capacity of copying problematizes, with new intensity, the relationships between homogeneity and heterogeneity, between the genuine and the spurious. In the economic world, the digital era is threatening some of the fundamental tenets of capitalism, especially of its variant called the “knowledge society”, regarding the control of intellectual property rights. The gap between normativity and social practices is widening. The many dilemmas and tensions identified in the text are understood as symptoms of two major characteristics of the current times: hyperfetishism and hyperanimism. ________________________________________________________________________________ RESUMOResponderei à pergunta “O que existe em uma cópia?” considerando três conjuntos de questões relacionadas: a importância das cópias na academia, na vida cultural, no mundo econômico. Na academia a presente capacidade de fazer cópias está desafiando práticas pedagógicas e a confiança dos seus membros, o plágio sendo o problema mais imediato. A noção de autoria também está sofrendo mudanças provocadas por uma proliferação de autores e novas possibilidades abertas pelo ciberespaço. Na vida cultural, a imitação e a mimese de há muito são importantes motores de socialização. A nossa capacidade ampliada de fazer cópias problematiza, com nova intensidade, as relações entre homogeneidade e heterogeneidade, entre o genuíno e o espúrio. No mundo econômico, a era digital ameaça algumas das premissas fundamentais do capitalismo, especialmente da sua variante “sociedade do conhecimento”, no tocante aos direitos de propriedade intelectual. Cresce a distância entre normatividade e práticas sociais. Os muitos dilemas e tensões identificados no texto são compreendidos como sintomas de duas grandes características do presente: o hiperfetichismo e o hiperanimismo

Publication trends in the medical informatics literature: 20 years of "Medical Informatics" in MeSH

<p>Abstract</p> <p>Background</p> <p>The purpose of this study is to identify publication output, and research areas, as well as descriptively and quantitatively characterize the field of medical informatics through publication trend analysis over a twenty year period (1987–2006).</p> <p>Methods</p> <p>A bibliometric analysis of medical informatics citations indexed in Medline was performed using publication trends, journal frequency, impact factors, MeSH term frequencies and characteristics of citations.</p> <p>Results</p> <p>There were 77,023 medical informatics articles published during this 20 year period in 4,644 unique journals. The average annual article publication growth rate was 12%. The 50 identified medical informatics MeSH terms are rarely assigned together to the same document and are almost exclusively paired with a non-medical informatics MeSH term, suggesting a strong interdisciplinary trend. Trends in citations, journals, and MeSH categories of medical informatics output for the 20-year period are summarized. Average impact factor scores and weighted average impact factor scores increased over the 20-year period with two notable growth periods.</p> <p>Conclusion</p> <p>There is a steadily growing presence and increasing visibility of medical informatics literature over the years. Patterns in research output that seem to characterize the historic trends and current components of the field of medical informatics suggest it may be a maturing discipline, and highlight specific journals in which the medical informatics literature appears most frequently, including general medical journals as well as informatics-specific journals.</p