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The impossible interview with the man of the neuron doctrine. Interview by Edward G Jones.

This paper follows the form of that by Mazzarello that precedes it (Mazzarello, 2006) and presents an imaginary interview with Santiago Ramón y Cajal in December 1906. A few days earlier Cajal had been awarded the Nobel Prize for Physiology or Medicine, an award that he shared equally with Professor Camillo Golgi. Golgi had been recognized for his work as a pioneer into investigations of the nervous system, primarily on account of his discovery of the "black reaction" of silver chromate impregnation of whole nerve cells and their processes. Cajal had been recognized for his implementation of that method and for laying with it the foundations of what was to become modern neuroanatomical science. Paradoxically, the two awardees had been led by their researches to diametrically opposed views of the organization of the nervous system. Golgi believed in a continuous network of axons that formed the basis of all the integrative properties of the nervous system, while Cajal had provided the information that led to the formulation of the neuron doctrine that saw the nervous system as being made up of chains of discontinuous cells joined by polarized functional contacts that we now call synapses. The paper takes the form of an interview with Professor Cajal in the Grand Hotel Stockholm. His responses to questions posed by the imaginary interviewer are all taken from Cajal's own writings.

Anatomy↗

The impossible interview with the man of the hidden biological structures. Interview by Paolo Mazzarello.

This paper presents an "impossible interview" to Professor Camillo Golgi, placed in time in December 1906. The Italian Professor Golgi from Pavia has been awarded the Nobel Prize for Physiology or Medicine ex aequo with the Spanish anatomist Santiago Ramón y Cajal. Both scientists have obtained the award for their work on the anatomy of the nervous system. However, they have opposite views on the mechanisms underlying nervous functions. Golgi believes that the axons stained by his "black reaction" form a continuous anatomical or functional network along which nervous impulses propagate. Ramón y Cajal is the paladin of the neuron theory, a hypothesis questioned by Golgi in his Nobel lecture of Tuesday, December 11. After the ceremony, an independent journalist has interviewed Professor Golgi in the Grand Hotel in Stockholm. Excerpts about his education, his main scientific discoveries, and his personal life are here given (reconstructing the "impossible interview" on the basis of Golgi's original writings).

Anatomy↗

Audio computerized self-report interview use in prenatal clinics: audio computer-assisted self interview with touch screen to detect alcohol consumption in pregnant women: application of a new technology to an old problem.

Computer interviewing to obtain sensitive information is not a new concept. However, concerns about the acceptance of computers in disadvantaged populations with potentially low literacy led us to combine audio- and touch-screen technologies with an audio computerized self-report interview to obtain information about alcohol use. This study evaluated acceptance and ease of use by a disadvantaged population of pregnant women in the District of Columbia. Patients attending an initial visit at prenatal clinics answered questions anonymously about their consumption of alcoholic beverages and other personal information. The questionnaire was programmed on a laptop computer. The computer administered the recorded questions via earphones, as well as displayed them on the screen, and patients answered by touching the computer screen. Results were immediately available. A total of 507 women were interviewed, who were primarily African American, non-Hispanic, and never married. Nearly 24% did not complete a high school education, 43% were unemployed, and 30% received public assistance. Most of the women (59%) used computers occasionally (a few days a month) or never. Nearly all patients (96%) reported that the computer was not difficult to use, and approximately 90% liked answering the questions by computer. The study demonstrates that using computers to screen for alcohol use in disadvantaged pregnant populations is feasible and acceptable to the patients.

Adolescent↗

The World Health Organisation. Interview with the director general. Interview by Fiona Godlee.

Dr Hiroshi Nakajima was elected director general of WHO in 1988. Born in Japan, he trained as a psychiatrist before joining WHO in 1973. He was WHO's regional director for the Western Pacific from 1979 to 1988. His term of office has been marked by criticism of his management style and allegations of misuse of WHO's funds. I spoke to him at WHO's headquarters in Geneva in July. I have presented the interview in the form of questions and answers. It would be misleading, however, not to make clear that in doing so I have transcribed conversation which was at times extremely difficult to follow. I feel that it is important to emphasise this in the context of an interview with an international leader, one of whose primary tasks must be to communicate his views on health to people across the world. The interviews gave me first hand experience of the difficulties in communication that staff, diplomats, and others, including Japanese leaders, have consistently commented on since Dr Nakajima took office.

Global Health↗

Audio computer assisted self interview and face to face interview modes in assessing response bias among STD clinic patients.

BACKGROUND: Audio computer assisted self interview (ACASI) may minimise social desirability bias in the ascertainment of sensitive behaviours. The aim of this study was to describe the difference in reporting risk behaviour in ACASI compared to a face to face interview (FFI) among public sexually transmitted diseases (STD) clinic attendees. STUDY DESIGN: Randomly selected patients attending a public STD clinic in Baltimore, Maryland, sequentially took an ACASI formatted risk behaviour assessment followed by an FFI conducted by a single clinician, with both interview modalities surveying sexual and drug use behaviours. Binary responses were compared using the sign test, and categorical responses were compared using the Wilcoxon signed rank test to account for repeated measures. RESULTS: 671 (52% men, mean age 30 years, 95% African American) of 795 clinic attendees screened consented to participate. Subjects affirmed sensitive sexual behaviours such as same sex contact (p = 0.012), receptive rectal sexual exposure (p < 0.001), orogenital contact (p < 0.001), and a greater number of sex partners in the past month (p < 0.001) more frequently with ACASI than with an FFI. However, there were no differences in participant responses to questions on use of illicit drugs or needle sharing. CONCLUSIONS: Among STD clinic patients, reporting of sensitive sexual risk behaviours to clinicians was much more susceptible to social desirability bias than was reporting of illegal drug use behaviours. In STD clinics where screening of sexual risk is an essential component of STD prevention, the use of ACASI may be a more reliable assessment method than traditional FFI.

Adult↗

The parent interview for child symptoms: a situation-specific clinical research interview for attention-deficit hyperactivity and related disorders.

OBJECTIVE: To describe the properties of a semistructured research interview of parents designed to evaluate attention-deficit hyperactivity disorder (ADHD) and related psychopathology. METHOD: We examined interrater reliability in 48 videotaped interviews randomly selected from a large clinic sample. We examined convergence of the Parent Interview for Child Symptoms (PICS) and Conners' Parent Rating Scale (CPRS) scores in 594 clinic-referred cases and 26 control subjects, comparing the groups generated by cross-tabulation on measures of intelligence, academic achievement, and inhibitory control. RESULTS: Intraclass correlation coefficients for symptom scores of ADHD, oppositional defiant disorder (ODD), and conduct disorder (CD) were excellent. We found good reliability for diagnoses of ADHD (e = 0.73) and CD (kappa = 0.73) and excellent reliability for the diagnosis of ODD (kappa = 0.80). Two-thirds of cases were classified similarly on the PICS and the CPRS. Greater impairment in inhibitory control was observed in cases identified as ADHD by the PICS, compared with those identified by the CPRS-ADHD index. CONCLUSIONS: The PICS displays good reliability and validity, indicating that a balance between clinical applicability and reliability can be achieved in the development of clinical research instruments.

Adolescent↗

Comparison of aboriginal and nonaboriginal applicants for admissions on the Multiple Mini-Interview using aboriginal and nonaboriginal interviewers.

BACKGROUND: Achievement on grade point average and Medical College Admissions Test contribute as unintentional barriers to advancement of underrepresented minorities. So long as noncognitive measures mimic random number generators, they merely perpetuate such discrepancies. As reliable noncognitive measures are developed, it is crucial to ensure immunity from bias, enabling them to better dilute unintended discrimination of cognitive measures. PURPOSE: The Multiple Mini-Interview (MMI) is a recently developed, reliable (overall reliability = .70), noncognitive measure used for assessment of medical school applicants. Our purpose in this study was to evaluate whether any suggestion of bias existed in application of the MMI in its assessment of aboriginal medical school applicants. METHODS: In this study of the MMI (overall reliability = .70), each of 5 self-declared aboriginal applicants and 7 general-pool applicants experienced the same 11 vetted interview stations with the same 6 aboriginal raters and 5 nonaboriginal raters. RESULTS: The Interviewer Type x Interviewee Type interaction was nonsignificant, p > .7. CONCLUSION: Based on the results of this study, it is recommended that MMI stations be vetted by aboriginally sensitive personnel, but neither aboriginal-specific rater training nor aboriginal rater assignment is required to ensure a level playing field for the assessment of applicants' personal qualities.

Canada↗

Comparison of DSM-III-R symptoms for alcohol dependence between patient self-report and clinician interview or the Structured Clinical Interview for DSM-III-R.

This study sought to determine which Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised (DSM-III-R), symptoms of alcohol dependence were most sensitive to under-reporting by 78 inpatients from alcohol treatment programs. We hypothesized that patients would be more reluctant to report social/behavioral symptoms (lost time, hazardous behavior or major role interference, and reduced activities) than psychological or physiological symptoms. Patient endorsement of symptoms on a self-administered diagnostic questionnaire was compared with parallel items on the Structured Clinical Interview for DSM-III-R (SCID) and clinician interview. Bias and Prevalence Adjusted Kappas for individual symptom agreement ranged from -.02 to .87. Subjects endorsed fewer symptoms per category than either the SCID or clinician interview. Using a Student-Newman-Kuels post-hoc analysis at the p < .05 level, we found that mean agreement for the social/behavioral category was significantly lower than mean agreement for the other categories.

Adult↗

Effects of seating positions on heart rates, state anxiety, and estimated interview duration in interview situations.

This study examined the effects of three seating positions, face-to-face, side-by-side, at right-angles, on participants' heart rates, anxiety, and estimated duration of interview. The subjects were 84 students in a women's junior college who were divided into two groups, classmates and nonclassmates. The experiment used the three seating positions in each of the two groups during the interviews. Heart rates, anxiety scores, and estimated duration of interview were measured. There was a significant effect in different seating positions on the heart rates among the participants. The results suggest that the face-to-face seating produces increased arousal compared to the side-by-side and right-angled seating positions. However, this arousal seems to be more important among classmates than nonclassmates. The results and implications are discussed.

Adolescent↗

Interviewing older adults: increasing the credibility of interview data.

1. Contextual data obtained through open-ended interviewing allows the nurse to individualize the nursing care plan and can maximize the nurse's problem solving skills. 2. The interviewer who obtains credible data obtains believable data which accurately portrays the situation from the subject's point of view. 3. Interviewing techniques which can increase self-esteem in the older adult are: nonjudgmental wording of questions; providing positive reinforcement; giving the individual control; matching gender; allowing time; adapting to hearing and vision impairments; and adapting to reading deficits.

Aged↗

The automated interview versus the personal interview. Do patient responses to preoperative health questions differ?

Laboratory testing of presurgical patients has been shown to be excessive, thereby increasing costs, reducing resources for other health care uses, and increasing risks to both patients and physicians. As one step toward reducing the number of unnecessary preoperative tests ordered, we used an automated method to aid preoperative assessment of 239 patients in Chicago and in Winnipeg. The "HealthQuiz," a small hand-held device containing a computer chip and video screen, uses a decision tree to ask a minimum of 60 health-related questions (the patient's response to certain questions determines the number of questions presented). The device then generates a summary printout of patient answers, the health areas needing further attention, and the laboratory tests most likely to uncover clinically important abnormalities in that patient. HealthQuiz responses are intended to aid the physician and not to replace the personal interview. As an aid, the automated interview highlights possible problem areas for in-depth pursuit by the physician. The need for nonselective batteries of tests is eliminated because recommendations for tests are based on specific elements of a patient's history. To be effective, responses to the HealthQuiz should be the same as responses to similar questions asked by a physician. We tested that premise in this study. Patient's answers to the HealthQuiz were compared with their responses to a randomly selected set of the same questions in a personal interview. Ninety-seven percent of the response pairs were identical, and most of the 3% that differed involved changes from "not sure" replies to the HealthQuiz. Laboratory tests suggested by responses to the two methods of questioning did not differ.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

The interviewer's "presenting problems" in the initial interview.

Complex countertransference responses that contribute to the interviewer's presenting problems in the initial interview with a patient are related to: the clinician's preinterview fantasies, the interviewee's empirical reality, and the patient as experienced creatively. Presenting problems may be an unavoidable component of clinical contact, but when the interviewer responds to them with psychological-mindedness, they can contribute to realistic assessment and positive case disposition.

Countertransference↗

[Decisions of the physician in a psychoanalytic interview. Patient characteristics in the initial psychodiagnostic interview].

The focus of our investigation is the question which criteria of the first psychodiagnostic dialogue are associated with the decision of a physician to make a psychoanalytic interview. 51 patients have been investigated who had contacted the out-patient department of the Psychosomatic Hospital at the Central Institute of Mental Health in Mannheim. Patients who have been provided with a psychoanalytic interview by the therapist have been estimated as having a greater motivation for psychotherapy and they seemed more likely to consider their complaints as being psychologically caused. Younger patients have been regarded as having a greater motivation for psychotherapy than older ones and they could more likely attribute their complaints to psychologic causes, especially if they are females and belong to the middle social stratum. Furthermore, those patients who had been decided by the therapist to undergo a psychoanalytic interview more than the other group of patients showed a pattern of values which was similar to that of the therapists.

Adult↗

HCMR interviews physician administrator leaders. Interview by Michael J. Enright.

This interview departs from HCMR's usual format, interviewing several leaders in health care administration for their ideas on current economic pressures, the impact of competition and joint ventures, attitudes toward equity and capital formation, and competition between the interest of clinical medicine and the cost of care. The physician administrators interviewed hold senior administrative positions: Charles Edwards, President and Chief Executive Officer of Scripps Clinic and Research Foundation; Robert A. Henry, President and Chief Executive Officer of Swedish-American Corporation; William S. Kiser, Chairman of the Board of Governors at Cleveland Clinic Foundation; W. Eugene Mayberry, Chairman of the Board of Governors at Mayo Clinic; and Ronald P. Kaufman, Vice-President for Medical Affairs of George Washington University Hospital. All are members of the Board of Regents or Fellows of the American College of Physician Executives.

Economic Competition↗

Comparison between reports of care obtained by postdischarge telephone interview and predischarge personal interview.

The question of when to survey patients is the subject of ongoing debate because of the rising interest in monitoring quality from the consumer's perspective. This study of 772 randomly assigned patients from 17 hospitals compared results from predischarge in-person interviews (HI) and postdischarge telephone interviews (PHTI) for differences in participation rates, respondents' characteristics, and reports of quality most affected by nursing. The methods were equally costly. The results suggest that hospital interviews may enhance response rates of some vulnerable patient groups without jeopardizing the results.

Aged↗

Assessing borderline personality disorder with self-report, clinical interview, or semistructured interview.

The authors compared three methods of assessing borderline personality disorders. Test-retest reliability for the self-report Personality Diagnostic Questionnaire was adequate and compared favorably with the interrater reliability of the DSM-III-oriented clinical interview and the semistructured research interview. The overall prevalence of personality disorders scored on the questionnaire was similar to that generated by the clinical interview. The specificity and sensitivity of the questionnaire for the diagnosis of borderline personality disorder were slightly higher than 60%, which suggests that it may be a useful and economical instrument for identifying patients with borderline personality disorder.

Adolescent↗

Diagnosing comorbid psychiatric disorders in substance abusers: validity of the Spanish versions of the Psychiatric Research Interview for Substance and Mental Disorders and the Structured Clinical Interview for DSM-IV.

OBJECTIVE: The authors' goal was to assess the validity of DSM-IV diagnoses obtained with the Spanish versions of the Psychiatric Research Interview for Substance and Mental Disorders (PRISM) and the Structured Clinical Interview for DSM-IV (SCID) compared with the longitudinal, expert, all data (LEAD) procedure in a group of substance abusers. METHOD: A total of 105 substance abusers recruited at a drug abuse treatment center in Barcelona, Spain, were assessed. The PRISM and SCID were administered blindly by independent research interviewers. LEAD diagnoses were made by two senior psychiatrists who were blind to PRISM and SCID diagnoses. The kappa statistic was used to measure concordance between the LEAD procedure and the PRISM and SCID. RESULTS: Affective and anxiety disorders were diagnosed more frequently by the PRISM and SCID than by the LEAD procedure. Use of the PRISM resulted in more diagnoses of substance-induced depression, and use of the SCID resulted in more diagnoses of primary major depression than the LEAD procedure. Kappas between the LEAD procedure and the PRISM in current major depression, past substance-induced depression, and borderline personality disorder were better than those obtained between the LEAD procedure and the SCID. The concordance among the three methods for diagnoses of current dependence disorders was good or excellent for alcohol, anxiolytic, cocaine, and heroin dependence and fair for cannabis dependence. Abuse diagnoses showed poor concordance. CONCLUSIONS: Using the LEAD procedure as a "gold standard," the authors conclude that the Spanish version of the PRISM seems to be a better instrument than the Spanish version of the SCID for diagnosing major depression and borderline personality disorders in substance abusers.

Comorbidity↗

Understanding experience through Gadamerian hermeneutics: an interview with Brian Phillips. Interview by Pamela Wood & Lynne Giddings.

Hermeneutic approaches to research focus on understanding and interpretation of experience but differ in process and emphasis. Gadamerian hermeneutics concentrates on expanding horizons of understanding through dialogue, between people or between a researcher and texts, in which taken-for-granted assumptions are examined and opinions willingly put at risk. This article is the fourteenth in a series of articles based on interviews with nursing and midwifery researchers, designed to offer the beginning researcher a first-hand account of the experience of using particular methodologies. It considers a Gadamerian hermeneutic research approach as interpreted by Brian Phillips (RN, PhD) in interview. Brian is Research Fellow in the Graduate School of Nursing and Midwifery at Victoria University of Wellington. For his PhD research Brian used Gadamerian hermeneutics to interpret four men's experiences of suicidality and the ideas of masculinity that might have shaped their understandings.

Attitude of Health Personnel↗