Biomedical subjects

W K Davis

Publications and source records attributed to W K Davis.

60 records · Page 4Linked to original sources

PubMedDate not supplied

Psychosocial correlates of survival in diabetes.

The goal of this research was to quantify the relationships between patient survival and a set of explanatory variables in a randomly selected sample of community-based patients with non-insulin-dependent diabetes mellitus (NIDDM). The sample included 343 patients with NIDDM initially entered into the study in 1981-1982 and reexamined in 1985-1986. Mortality data were collected on reexamination in 1985 and updated from death-certificate data through 1 January 1986. The data collected from the patients included demographic and clinical variables, psychosocial variables related to diabetes, measures of physiologic control, hospitalization, and mortality. The Cox proportional-hazards model was used to compute a hazard rate for each individual and to determine risk covariates. The results indicated that the variables most associated with the risk of mortality were patient age, social impact of diabetes, renal function, complexity of diet regimen, and history of smoking. Two of these variables (social impact and complexity of diet regimen) were obtained from the Diabetes Educational Profile completed by all patients on entry to the study. The five predictor variables were more closely related to mortality than diabetes control as measured by HbA1, previous hospital admissions, previous heart attacks, and other physiologic measures frequently used as outcome measures. The only physiologic predictor was renal function.

Adult↗

PubMedDate not supplied

Factors affecting the educational diagnosis of diabetic patients.

An accurate determination of the educational needs of diabetic patients is based on a wide range of patient characteristics. In the development of an assessment instrument to determine the educational needs of patients, the relative importance of numerous patient characteristics was determined. A questionnaire was mailed to 1518 health professionals who are either members of the American Association of Diabetes Educators or community health nurses in the state of Michigan. Analyses of the responses to this questionnaire have provided information regarding the knowledge, psychosocial, and demographic characteristics of patients, which are thought to be important in an educational diagnosis. Questions to measure these identified characteristics will be incorporated into an instrument that will assess the educational needs of diabetic patients.

Community Health Nursing↗

PubMedDate not supplied

The validation of a diabetes patient knowledge test.

Diabetes knowledge tests, used in conjunction with measures of patient attitudes and behaviors, can provide a useful basis for assessing educational needs and designing appropriate instructional experiences. Accurate decisions require instruments that measure patient knowledge of diabetes and its management with high reliability and validity. Data obtained from more than 950 administrations of two parallel forms of a Diabetes Patient Knowledge Test have provided documentation of patient knowledge levels, insight into the effectiveness of educational programs, and support for ongoing program revisions. These data have also allowed study of the psychometric properties of the test instruments, including factor structure, reliability, and validity. Each test form has an overall reliability of 0.89 and the forms are of equal difficulty. Five subcomponents (factors) labeled "Carbohydrates," "Blood Sugar," "Basics," "Food Exchanges," and "Insulin Administration" are measured in the tests. Evidence of content, construct, concurrent, and discriminant validity has been demonstrated.

Blood Glucose↗

PubMedDate not supplied

Evaluating the costs and benefits of outpatient diabetes education and nutrition counseling.

The Board of Directors of the American Diabetes Association (ADA) recently endorsed a resolution recommending third-party payment for outpatient education and nutritional counseling. One of the major rationales for the statement was that education and nutritional counseling will lead to reductions in health care costs. This article critically reviews the 13 studies cited in support of the ADA Policy Statement. Among these studies, only 2 compared a treated group with a control group. Both of the studies with control groups failed to randomly assign patients to treatment condition. Only 4 of the studies showed an accounting of program costs. Upon close inspection, it appears that some of the programs actually increased, rather than decreased, health care expenditures. Attrition from programs was reported in only a minority of cases, and was large when reported. The effect of the programs upon diabetes control was inconsistent across studies. It is suggested that the rationale for education and nutritional services be based on improved health status. In addition, the execution of a systematic experimental study to evaluate these services is urged.

Cost-Benefit Analysis↗

PubMedDate not supplied

Assessing medical and dental students' knowledge of preventive medicine.

This cross-sectional study examined medical and dental students' knowledge of preventive medicine. The purpose of the study was to assess the knowledge of preventive medicine--both epidemiological and clinical--that students demonstrate as they enter medical and dental school and acquire during training. The results of a two-group (medical versus dental school) by three-time (first-, second-, and third-year level) analysis of variance of students' mean examination scores showed significant main effects for school (F = 28.3, P less than .001) and training level (F = 24.5, P less than .001), and a significant school-by-training level interaction (F = 13.9, P less than .001). Medical students at higher training levels demonstrated greater knowledge of preventive medicine. In contrast, there were no significant differences by year of training among the dental students on the total test or on the epidemiological or clinical subscales. Both the dental and medical students demonstrated greater knowledge of clinical applications than of epidemiological foundations (t = 4.21, P less than .01). Dental students performed better than medical students on items that focused on diseases and risk factors that manifest symptoms more likely to be observed in dentistry than in general medical practice. The findings underscore the need to demonstrate practice relevance when teaching preventive medicine.

Analysis of Variance↗

PubMedDate not supplied

[18F]2-fluoro-2-deoxyglucose-positron emission tomography correlation of gadolinium-enhanced MR imaging of central nervous system neoplasia.

PURPOSE: To correlate the findings of gadolinium-diethylenetriaminepentaacetic acid (Gd-DTPA)-enhanced MR imaging with positron emission tomography (PET) in the evaluation of central nervous system neoplasia. MATERIALS AND METHODS: Thirty-six lesions identified on noncontrast MR in 35 patients with biopsy-proved intracranial tumors were imaged with both T1-weighted Gd-DTPA MR at 1.5 T and [18F]2-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET). Eighteen women and 17 men with a mean age of 47.1 years (range 22-72) were studied. The degrees of Gd-DTPA enhancement and FDG uptake were rated separately, and then all scans were reviewed together. FDG uptake was graded 1-5. RESULTS: Of the 35 lesions rated, 30 had Gd-DTPA enhancement and 28 of these were hypermetabolic (FDG accumulation greater than white matter) on PET (93% concordance). Twenty-six of 32 neoplastic lesions had Gd-DTPA enhancement. Twenty-four of these enhancing tumors were hypermetabolic. Only one lesion was completely missed on PET but identified on routine spin echo MR. CONCLUSION: Gd-DTPA MR and FDG-PET are complementary and there is a high concordance of Gd-DTPA-enhancing tumours displaying FDG hypermetabolism. Although FDG hypermetabolism and Gd-DTPA enhancement are usually suggestive of high-grade malignancy, anaplastic astrocytomas may not enhance with Gd-DTPA and can be hypometabolic. In addition, benign intracranial tumors (two cases of meningioma) and radiation necrosis can be associated with both FDG uptake and Gd-DTPA enhancement.

Adult↗