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Reactivity in self-recording: obtrusiveness of recording procedure and peer comments.

Reactivity refers to behavior change that occurs during self-recording without specific programming of consequences. We analyzed the effects of obtrusiveness of recording procedure and peer comments on reactivity to self-recording. Three first-grade students in Experiment 1 completed math questions during a 5-min work period. When we gave the children recording devices and told them to try to complete more questions than the highest number they had previously completed, math performance increased, as did the number of verbalizations about it. Two children showed more reactivity when they used the more obtrusive recording device. Because the increase in math performance corresponded closely to increases in peer comments, we manipulated peer comments directly in Experiment 2. Four second-grade students completed a math task and an alphabet task. Three of the students showed increased math performance during periods when peer comments occurred compared to periods when peer comments did not occur. Although the data from the math task suggested that peer comments can enhance reactivity, we did not observe this relationship with the alphabet task. These results suggest that the conditions necessary to produce desirable results through self-recording are complex and contextually specific.

Auditory Perception

[Development and evaluation of the comment aid system for therapeutic drug monitoring. I. Application to valproate].

A comment aid system for therapeutic drug monitoring (TDM), which produces the primary comment on the dosage regimen of valproate, was developed. This system produces consulting comments with a fuzzy theory, by using the dosage regimen of valproate, pharmacokinetic parameters estimated by the Bayesian method, and therapeutic effect and toxicity of anticonvulsants evaluated by the physician. For nearly 90% in 42 cases, comments of the system were agreeable comparing with the notes of TDM technologists. There are a few disagreements between this system and experts, mainly because the system does not use enough information about combination therapy with other anticonvulsants. Developed comment aid system shows some clinical and educational utility, and suggests significance and possibility of more useful and al around TDM expert system. Then this system might be available as a prototype of the TDM expert system.

Adolescent

The patient comment card: a system to gather customer feedback.

Continuous patient feedback can give important information to hospitals about the quality of care they provide. The Patient Comment Card (PCC), a brief form that can be used to gather open-ended comments from patients and to measure quality, was developed during a two-year period and was extensively evaluated in a series of three pilot tests involving more than 2,000 patients discharged from five hospitals. Evaluation results demonstrate that the questionnaire elicits useful comments from patients and can generate statistically reliable scores and valid quality measures. However, in a field trial in four hospitals, low response rates (15%-27%) reflected, first, lack of follow-up of non-respondents, and second, the fact that most of the PCC quality scores were upwardly biased; these inflated scores were likely to reflect the low response rate. Tools such as the PCC should be used judiciously, given the possible abuses and misinterpretations of hospital quality scores.

Bias

Patients' comments on psychiatric inpatient treatment experiences: patient-therapist relationships and their implications for treatment outcome.

Only few researchers pay systematic attention to what patients may have to say about their treatment experience during psychiatric hospitalization. This study not only delineates the various therapeutic aspects of an open psychiatric inpatient unit based on the patients' comments, but also attempts to correlate the data with the objective outcome of treatment rated clinically by the therapists and independently by the author. Positive patient-therapist relationship has been found to be the most significant factor correlated closely with the treatment outcome. The correlation may support the relevance of the patients' comments regarding subjectively perceived therapeutic benefits vs. objective actual benefits.

Adolescent

Fundamental comments on cell polarography according to Velazquez and Rosado.

Some fundamental comments are made on cell polarography according to Velázquez and Rosado (Fertil Steril 23:562, 1972). The results which they have obtained cannot be reliable because fundamental mistakes are made against the principles of the electroanalytic techniques used. We comment upon the conductometry, the amperometric titrations, and the alternating-current polarography as carried out by Velázquez and Rosado.

Electrophysiology

General practitioners' comments on video recorded consultations as an aid to understanding the doctor-patient relationship.

The aim of this study was to describe, understand and interpret physicians' experiences of consultations. Forty-six consultations were videotaped in four primary health care centres. Twelve general practitioners and 46 patients participated. Afterwards the patients and the physicians (on different occasions) commented on the recorded consultations. The comments were analysed from an inductive as well as a hypothetical-deductive model. The analyses agreed well with each other. The result demonstrated that the physicians often had difficulties understanding the patient, that they did not really know how to handle the conversation and felt that they did not really understand the context. The perceived relation to the patient was mainly related to the patients' ability to give adequate information. It is concluded that a key factor in communication is the difficulty which the physician has in understanding what the patient in fact wants-the failure to be on the same wavelength so that the message from the patient can be received.

Adult

Patients comment on video-recorded consultations--the "good" GP and the "bad".

The aim of this study was to describe and understand patients' positive and negative experiences of General Practitioners (GPs). Forty-six consultations were videotaped in four primary health care centres in Sweden. Afterwards the patients commented on the recorded consultations. The comments were categorized and analyzed using an exploratory qualitative approach. An image of the "good" GP emerged that had two major characteristics: that of being a caring human; an individual who listens, understands, and is concerned. At the same time, the good GP acts like an ordinary person and treats the patient as an equal. The personal relationship with the GP also influenced the choice and course of medical interventions. For the patient, the manner in which an intervention is seen is linked to whether the GPs treats the patient with respect or not. A typical experience of a "bad" GP was that the GP appeared unreachable as a person. An example is when the patient feels that the GP was not taking his or her symptoms seriously. Another characteristic of the bad GP is failure to communicate to the patient his or her standpoint on issues raised during consultations.

Adult

Constancy of individual exponents for inspired lung volume: a comment on Harver (1987).

In this paper we made two brief commentaries on Harver's (1987) experiment. The first comment is an observation on the growing area of respiratory psychophysics for which we prefer the name Behavioral Physiology. In the second comment it is suggested that the stable individual differences in the exponent of the psychophysical power law reported by Harver may be an artifact of the psychophysical method employed: category production.

Arousal

Comparison of patients' and doctors' comments on video-recorded consultations.

To compare patient and doctor views of the consultation process, 46 consultations were videotaped in four primary health care centres. Twelve general practitioners and 46 patients participated. Later, the patients and the doctors (on different occasions) spontaneously commented on the recorded consultations. Qualitative methods were used for the analysis. The patients seemed to have a perspective oriented towards relationships, while the doctors were more oriented towards medical tasks. There was an association of power between the parties that implies a relationship of mutual dependency. The doctors depended on the patients to obtain the information they needed about the symptoms to be able to fulfil their professional task. The patients depended on the doctor to get their important needs satisfied; everything from a particular medicine to being treated as a human being. The major differences in the comments by the patients and the doctors reflected their different roles and the asymmetry in the relationship.

Adult

Case comment: Moore v. Regents of the University of California.

The increasing use of human tissues in medical research has spawned a host of ethical and legal debates. Legal analysis in this area has almost exclusively focused on the question of property rights in both the tissues used in research and in the resulting products. One illustrative case is Moore v. Regents of the University of California, in which a patient sued his doctor for conversion of his spleen which had been removed for therapeutic purposes. The doctor later used the spleen to develop a patented and profitable cell-line. This Comment examines and rejects the property law approach to this issue. Instead, this Comment proposes two legislative changes which would 1) eliminate any trade in human tissues and 2) require doctors to inform their patients of any research interest in proposed medical procedures. These proposals resolve the problem presented in Moore, and avoid the misleading, and inevitably unanswerable, question of property rights.

Humans

A comment on the preparation of liposomes from and on the beta in equilibrium alpha acyl chain melting behaviour of rough mutant lipopolysaccharide.

We would like to comment on the investigations of Vaara, M., Plachy, W.Z. and Nikaido, H. (Vaara, M. et al. (1990) Biochim. Biophys. Acta 1024, 152-158) on the partitioning of hydrophobic probes in lipopolysaccharide bilayers. These authors reported that they did not succeed in preparing closed vesicles (liposomes) from rough mutant lipopolysaccharide. We describe the conditions under which lipopolysaccharide liposomes are formed most readily. We, furthermore, summarize data which strongly support the existence of thermotropic phase transitions of lipopolysaccharides (with transition temperatures lying in the range of 30-36 degrees C) contradictory to Vaara et al. who argue that such transitions are artefacts. Exemplary measurements of the beta in equilibrium alpha acyl chain melting for lipopolysaccharide from Escherichia coli deep rough mutant (strain F515) as compared to synthetic and natural phospholipids are presented using fluorescence spectroscopy, Fourier-transform infrared spectroscopy and differential scanning calorimetry. These results unequivocally prove the necessity to perform experiments at 37 degrees C for a determination of the outer membrane permeability under physiological conditions.

Hot Temperature

Help for the gatekeepers: comment and summation on the admission process.

The author comments on articles that discuss the roles of demographic variables, qualitative variables, and the interview in making sound selection for medical school admission; analyze the effectiveness of traditional predictors in selecting successful students; and examine the predictors that best identify minority students likely to succeed in medical training. Together, the articles review the literature, analyze the findings, and recommend sound practices and areas of future research germane to selecting students. The discussions highlight the predictor role, initial importance, and relatively short half-life of academic criteria in physicians' total careers, and emphasize that academic predictors must be complemented by other factors in the applicant's background. Because selection for medical school leads in almost all cases to eventual practice as a physician, the admission decision has far-reaching impact. Those concerned with the admission process should use the distilled information in these articles to improve the assessment of applicants and the selection process.

Achievement

Comments on the objective analysis of motivation and psychotherapy.

There are several important issues raised in the paper by Cattell and in the comments upon it: the empirical status of the Cattell factors; the experimental verification of factors; difficulties with confirmatory analysis and the value of P-analysis. The relevance of these points is explicated in this paper.

Awareness

Comments on "Earphones in Audiometry" [Zwislocki et al., J. Acoust. Soc. Am. 83, 1688-1689 (1988)].

The Zwislocki et al. ["Earphones in Audiometry," J. Acoust. Soc. Am. 83, 1688-1689 (1988)] Letter to the Editor states that insert earphones have some unresolved technical problems, such as limited frequency response, limited dynamic range and power handling capability, intersubject variability, and hygiene safety. In evaluating circumaural earphones, Zwislocki et al. say that the lack of a standard coupler disqualifies them for audiometry. Since this letter carries the weight of a CHABA committee recommendation, these issues are commented on herein. Section I was written primarily by Mead Killion and Sec. II primarily by Edgar Villchur. For brevity throughout, the authors of the Zwislocki et al. letter will be referred to as "the authors."

Audiometry

Comments on "the Rorschach M response: a return to its roots".

These comments address three interrelated issues posed in Kramer's article concerning Rorschach's definition of the M response and the criteria for M that is applied in the Comprehensive System, the possibility that M may be overscored by the criteria for the Comprehensive System, and the issue of whether the Rorschach is amenable to quantification and empirical scrutiny. Kramer has oversimplified and misconstrued statements by Rorschach, Beck, and Bohm; in reality, the criterion for the scoring of M responses in the Comprehensive System differs very little, if at all, from that suggested by Rorschach. The accumulated history of the test seems to confirm that it is amenable to quantification and empirical scrutiny.

Humans