EFFECTS OF INFORMATION DISPLAY ON THE CONSTRUCTION OF CLINICIAN MENTAL MODELS

Objective: To determine how a clinician’s background knowledge, their tasks, and displays of information interact to affect the clinician’s mental model. Design: Repeated Measure Nested Experimental Design Population, Sample, Setting: Populations were gastrointestinal/internal medicine physicians and nurses within the greater Houston area. A purposeful sample of 24 physicians and 24 nurses were studied in 2003. Methods: Subjects were randomized to two different displays of two different mock medical records; one that contained highlighted patient information and one that contained non-highlighted patient information. They were asked to read and summarize their understanding of the patients aloud. Propositional analysis was used to understand their comprehension of the patients. Findings: Different mental models were found between physicians and nurses given the same display of information. The information they shared was very minor compared to the variance in their mental models. There was additionally more variance within the nursing mental models than the physician mental models given different displays of the same information. Statistically, there was no interaction effect between the display of information and clinician type. Only clinician type could account for the differences in the clinician comprehension and thus their mental models of the cases. Conclusion: The factors that may explain the variance within and between the clinician models are clinician type, and only in the nursing group, the use of highlighting

The Relevance of the Southern Ocean to the Development of a Global Regime for Marine Areas beyond National Jurisdiction—An Uncommon Commons

The Southern Ocean\u27s areas beyond national jurisdiction (ABNJ) are uncommon in a number of ways. This article first discusses features of the Southern Ocean\u27s uncommonness that may be relevant to the relationship between the Antarctic Treaty System (ATS) and the development of the international legally binding instrument on the conservation and sustainable use of marine biological diversity of ABNJ under United Nations General Assembly Resolution 69/292 (ILBI). Second, the article considers the potential relationship between the ILBI and the ATS. Third, the article discusses the current approach of the ATS to governance of the Southern Ocean\u27s ABNJ by focusing on two particular topics which are to be included in the development of the ILBI. The topics discussed are measures (such as area-based management, including marine protected areas) and marine genetic resources

Exchanges in a Virtual Environment for Diabetes Self-Management Education and Support: Social Network Analysis.

BACKGROUND: Diabetes remains a major health problem in the United States, affecting an estimated 10.5% of the population. Diabetes self-management interventions improve diabetes knowledge, self-management behaviors, and clinical outcomes. Widespread internet connectivity facilitates the use of eHealth interventions, which positively impacts knowledge, social support, and clinical and behavioral outcomes. In particular, diabetes interventions based on virtual environments have the potential to improve diabetes self-efficacy and support, while being highly feasible and usable. However, little is known about the patterns of social interactions and support taking place within type 2 diabetes-specific virtual communities. OBJECTIVE: The objective of this study was to examine social support exchanges from a type 2 diabetes self-management education and support intervention that was delivered via a virtual environment. METHODS: Data comprised virtual environment-mediated synchronous interactions among participants and between participants and providers from an intervention for type 2 diabetes self-management education and support. Network data derived from such social interactions were used to create networks to analyze patterns of social support exchange with the lens of social network analysis. Additionally, network correlations were used to explore associations between social support networks. RESULTS: The findings revealed structural differences between support networks, as well as key network characteristics of supportive interactions facilitated by the intervention. Emotional and appraisal support networks are the larger, most centralized, and most active networks, suggesting that virtual communities can be good sources for these types of support. In addition, appraisal and instrumental support networks are more connected, suggesting that members of virtual communities are more likely to engage in larger group interactions where these types of support can be exchanged. Lastly, network correlations suggest that participants who exchange emotional support are likely to exchange appraisal or instrumental support, and participants who exchange appraisal support are likely to exchange instrumental support. CONCLUSIONS: Social interaction patterns from disease-specific virtual environments can be studied using a social network analysis approach to better understand the exchange of social support. Network data can provide valuable insights into the design of novel and effective eHealth interventions given the unique opportunity virtual environments have facilitating realistic environments that are effective and sustainable, where social interactions can be leveraged to achieve diverse health goals

Consistency of Reported Barriers for Colorectal Cancer Screening Among Adults Who Have Never Been Screened

Morbidity and mortality from colorectal cancer can be decreased by addressing patient barriers to colorectal cancer screening; especially among adults who have never been screened. Assessing changes in barriers over time may help practitioners better tailor interventions to address patient barriers. We assessed among adults ages 50 -75 who have never been screened for colorectal cancer (CRC) which barriers predict prospective screening. A sample of 560 adults who had never been screened, recruited from Growth for Knowledge’s online panel, completed a baseline and a six-month follow-up survey. Both surveys assessed screening barriers after an online intervention that involved conveying tailored comparative risk estimates and message framing. Among those who did not get screened, we examined the consistency between reported barriers at baseline and at six-month follow-up. At baseline, participants identified 27 barriers; some reported no barriers. Among those never screened (n = 362), there was a significant increase from baseline to follow-up in five barriers: ‘time/too busy’, ‘no symptoms’, ‘in good health’, ‘no motivation’, and ‘hadn’t thought about it’. Reporting ‘no barriers’ at baseline was a significant predictor of being screened at follow-up (OR = 3.67, 95% CI = 1.44-9.30, p \u3c .007). Among people who have never been screened, interventions should focus on addressing the most consistently reported barriers (i.e., ‘time/too busy’, and on improving knowledge and beliefs about who should be screened and when, as well as attitudes toward screening, to design more efficacious and tailored interventions

Can prospective usability evaluation predict data errors?

Increasing amounts of clinical research data are collected by manual data entry into electronic source systems and directly from research subjects. For this manual entered source data, common methods of data cleaning such as post-entry identification and resolution of discrepancies and double data entry are not feasible. However data accuracy rates achieved without these mechanisms may be higher than desired for a particular research use. We evaluated a heuristic usability method for utility as a tool to independently and prospectively identify data collection form questions associated with data errors. The method evaluated had a promising sensitivity of 64% and a specificity of 67%. The method was used as described in the literature for usability with no further adaptations or specialization for predicting data errors. We conclude that usability evaluation methodology should be further investigated for use in data quality assurance

Galactic Globular and Open Clusters in the Sloan Digital Sky Survey. I. Crowded Field Photometry and Cluster Fiducial Sequences in ugriz

We present photometry for globular and open cluster stars observed with the Sloan Digital Sky Survey (SDSS). In order to exploit over 100 million stellar objects with r < 22.5 mag observed by SDSS, we need to understand the characteristics of stars in the SDSS ugriz filters. While star clusters provide important calibration samples for stellar colors, the regions close to globular clusters, where the fraction of field stars is smallest, are too crowded for the standard SDSS photometric pipeline to process. To complement the SDSS imaging survey, we reduce the SDSS imaging data for crowded cluster fields using the DAOPHOT/ALLFRAME suite of programs and present photometry for 17 globular clusters and 3 open clusters in a SDSS value-added catalog. Our photometry and cluster fiducial sequences are on the native SDSS 2.5-meter ugriz photometric system, and the fiducial sequences can be directly applied to the SDSS photometry without relying upon any transformations. Model photometry for red giant branch and main-sequence stars obtained by Girardi et al. cannot be matched simultaneously to fiducial sequences; their colors differ by ~0.02-0.05 mag. Good agreement (< ~0.02 mag in colors) is found with Clem et al. empirical fiducial sequences in u'g'r'i'z' when using the transformation equations in Tucker et al.Comment: 30 pages, 25 figures. Accepted for publication in ApJS. Version with high resolution figures available at http://www.astronomy.ohio-state.edu/~deokkeun/AnJohnson.pd