[Comment on the contribution by U. Beiteke et al. Adjuvant therapy of primary malignant melanoma with natural human interferon-beta. First comment].
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Humans↗
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[Comment on the contribution by U. Beiteke et al. Adjuvant therapy of primary malignant melanoma with natural human interferon-beta. Second comment].
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Humans↗
Letter: Comment on comments about reading.
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Adolescent↗
Elevator talk: observational study of inappropriate comments in a public space.
OBJECTIVES: We conducted a study to determine the type and frequency of inappropriate comments made by hospital employees while riding hospital elevators. METHODS: Four observers rode in elevators at five hospitals, listening for any comments made by hospital employees that might be deemed inappropriate. All potentially inappropriate comments were reviewed by the research team and were classified as inappropriate if they met at least one of the following criteria: violated patient confidentiality, raised concerns about the speaker's ability or desire to provide high-quality patient care, raised concerns about poor quality of care in the hospital (by persons other than the speaker), or contained derogatory remarks about patients or their families. RESULTS: We observed 259 one-way elevator trips offering opportunity for conversation. We overheard a total of 39 inappropriate comments, which took place on 36 rides (13.9% of the trips). The most frequent comments (18) were violations of patients confidentiality. Next most frequent (10 comments) were unprofessional remarks in which clinicians talked about themselves in ways that raised questions about their ability or desire to provide high-quality patient care. Other comments included derogatory statements about the general quality of hospital care (8) and derogatory remarks about patients (5). Physicians were involved in 15 of the comments, nurses in 10, and other hospital employees in the remainder. CONCLUSION: Inappropriate comments took place with disturbing frequency in the elevator rides we sampled. These comments did not exclusively involve violations of patient confidentiality, but encompassed a range of discussions that health care employees must be careful to avoid.
Confidentiality↗
The redundancy of student comments and numerical ratings in evaluations of teaching.
Student evaluation of teaching effectiveness is widely used in undergraduate institutions as one element of determining overall faculty effectiveness. The evaluation format typically consists of (1) a number of questions the student answers by indicating a numerical rating and (2) an open-ended section for written comments. Some faculty members believe that the numerical ratings are not taken seriously by the students, and that the written comments impose greater accountability on the part of students. On the other hand, numerical ratings are necessary to minimize the fear that unfavorable written comments will be taken out of context in promotion decisions. Tabulation of numerical ratings is essential if a computerized data base for faculty evaluation is to be established. This study was designed to examine the relationship between student's numerically based ratings and written comments by evaluating allied health instructors using a standard, schoolwide evaluation form. Written comments were categorized according to a five-point scale and compared to mean values obtained from numerical ratings. Twenty-two faculty and 1,311 student evaluations were included. Significant positive correlations were found between the numerical student ratings and the written comments. The highest correlations were between student comments and two items related to overall teaching effectiveness. Students who evaluated instructors at either extreme on the spectrum of effectiveness were most likely to include written comments. Based on the consistency of numerical ratings and written comments we recommend that only the numerical ratings be used as part of the promotion and tenure decision-making process.(ABSTRACT TRUNCATED AT 250 WORDS)
Allied Health Personnel↗
PDA comments: SUPAC-IR, ICH Q1C, FDA draft guideline. Parenteral Drug Association.
Following are comments prepared by PDA on three draft regulatory documents all relating to stability for post-approval changes, new dosage forms and related issues. The comments on SUPAC-IR and ICH Q1C were submitted to FDA on February 10, 1995. The comments on the December 12, 1994 draft guideline were submitted on March 10, 1995. The documents have different sources and content, however, there is some overlap between the three. Readers may wish to peruse the table attached to the March 10, 1995 PDA comments for a graphic analysis of the contents of the three documents. Readers are cautioned that these comments are based on draft proposals by FDA and/or the International Conference on Harmonization. More recent drafts may be available. Copies of all three documents are available from PDA (SUPAC-IR: Document #FDA 79; ICH Q1C: #FDA 93; December 12, 1994 guideline: #FDA 77). See the PDA Letter or contact the PDA staff for additional information. Further clarifying comments can be found in the January, March and April 1995 issues of the PDA Letter. Staff contact is James Lyda. PDA expresses thanks to the working group which drafted the comments on very short notice: Raymond Shaw, Jr. Ph.D., Merck (now of Wyeth-Ayerst) (Chair); Robert Barraza, Burroughs Wellcome; Fred Gustafson, Abbott; Paulette Kosmoski, and Russel Madsen and James Lyda, PDA.
Dosage Forms↗
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↗
[Effects of stress comments on autonomic measures during the performance of a task (author's transl)].
The present study examined the effects of stressful comments on autonomic measures during the performance of a task. Thirty subjects were assigned at random to the stress condition (S group) and to the nonstress condition (NS group). Negative and stressful comments were given to the S group. Positive and comfortable comments were given to the NS group after the performance. The results showed that heart rates were much higher during the performance than during the adaptation and the rest period, although they were not affected by the negative comments. Vasoconstriction was significantly larger in the S group than in the NS group. In conclusion, vasoconstriction was more sensitive to the stressful comments than heart rate was.
Adolescent↗
User comments on a clinical event monitor.
Columbia-Presbyterian Medical Center's health care providers have access to alerts and interpretations generated by an Arden Syntax-based clinical event monitor. They have the opportunity to send comments to the clinical information services staff. Over a period of 26 months, they sent 126 comments. The comments were analyzed using the critical incident technique, resulting in a hierarchy of categories that summarizes user concerns. The majority of comments (65) indicated that the messages were actually (8) or at least potentially useful (57). A minority (28) indicated that they were unhelpful (27) or actually harmful (1). Another group (27) made suggestions or asked questions. The comments have been very helpful for the maintenance of Medical Logic Modules (MLMs) and the clinical event monitor itself.
Academic Medical Centers↗
The effect of non-factual post-training negative comment on the recall of verbal information.
Healthy human volunteers were asked to study a 250-word account of the 1954 World Football Cup and submitted to a questionnaire on the verbally learned material 48 h later. The subjects were divided into 7 groups. One received no treatment between text and questionnaire. The others were shown either a brief laudatory or derogatory comment on the World Cup 0, 3, or 6 h after having read the text. The comment contained no facts relevant to the text. Subjects exposed to the derogatory comment 0 or 3 h after having studied the text performed much worse in the questionnaire than any of the other groups. Performance in another, unrelated, general knowledge memory test was not affected by reading the World Cup text or subsequent comments. Thus post-event non-factual information was able to affect recall of verbally acquired factual material even if presented 3 h later; the effect does not seem to be explicable by a general performance deficit, and may be due to integration of information acquired during and after the event into one single experience.
Adult↗
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↗
[The effects of information relevance to speaker vs. hearer on the use of comment expressions and interrogative sentences in the Japanese language].
This study examined how the relevance of information to the speaker and the hearer affected the use of comments and interrogative sentences. Subjects read scenarios and rated the necessity of an expression (Experiment 1) or the naturalness of expressions (Experiment 2) in each of the situations. Experiment 1 investigated the use of comments, which preceded the information, to show the speaker's uncertainty about the information contents (subjects: 138 undergraduates). The less the information was relevant to the speaker and/or the more it was relevant to the hearer, the more the comments were judged to be necessary. Experiment 2 investigated the use of interrogative sentences, declarative sentences, and declarative sentences + a sentence final particle 'ne' (subjects: 96 undergraduates). Interrogative sentences were judged to be the most natural in the conditions where the information was relevant to the hearer and not to the speaker, whereas declarative sentences were judged to be the most natural where the information was relevant to the speaker and not to the hearer. Declarative sentences + 'ne' showed intermediate patterns of use between interrogative sentences and declarative sentences.
Adult↗
Legislative comment: nursing home patients' rights in Massachusetts: current protection and recommendations for improvement.
Several Massachusetts laws, including the recently enacted Patients' Bill of Rights, protect the rights of nursing home patients. Although these laws address many of the problems that such patients face, they do not adequately meet all of the unique needs of this vulnerable group. This Comment discusses safeguards afforded by current Massachusetts law that are particularly important for nursing home patients, and recommends improvements that would secure more adequate protection for their rights. The Comment also analyzes some of Massachusetts law's shortcomings in implementation and enforcement, in forum selection and in limitations on standing, and suggests improvements in these areas. Finally, the Comment proposes the enactment of a comprehensive Bill of Rights for Nursing Home Patients in order to address their unique needs more adequately, and to eliminate the duplicative, vague, and confusing provisions contained in current law.
Aged↗
Patient comments concerning psychiatric hospitalization.
During the past decade increasing attention has been paid to consumer assessment of mental health services. This study summarizes and interprets the comments made by 1457 adults and 474 adolescents concerning their inpatient care at a large private psychiatric hospital. Although adult and adolescent comments evidenced many similarities, adolescents tended to give a greater number of responses and to be more critical of hospitalization than were adults. Comparisons with previous research also supported findings that individual therapy is the most highly valued treatment modality, while food, finances, and living conditions are the most commonly criticized aspects of psychiatric hospitalization.
Adolescent↗
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↗