Evaluating graduate programs in bioethics: what measures should we use?
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Bioethics↗
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Results for “Communication Programs”
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[Shared decision making (SDM) with chronic pain patients. The patient as a partner in the medical decision making process].
Fibromyalgia syndrome (FMS) is an exemplary condition of chronic widespread pain that is difficult to control and often leads to frustration and resignation on the part of both the patient and the doctor. Shared decision making (SDM) could be a means to facilitate doctor-patient interaction and might therefore influence therapeutic decisions taken. We conducted a prospective study to evaluate the effects of SDM with FMS patients. We developed a communication train-ing program for physicians and a computer-based information tool on FMS for patients. The study included 133 FMS patients. Intervention group I (IG I) was treated by communication-trained doctors and had access to a computer-based information tool on FMS,intervention group II (IG II) was treated by standard doctors and received the information tool, and the control group (CG) was treated by standard doctors and got no additional information. All three groups we-re offered the same evidence-based treatment options for FMS. Patients of the IGs were more willing to become involved in exercise, to enroll in integrated group therapy for FMS patients (IGTF), and to take analgesics. Patients of the CG preferred anti-depressants. More patients from IG II and CG opted for relaxation techniques. Patients in IG I and IG II choose significantly more therapeutic options than patients in the CG. SDM is one means to increase FMS patients' readiness for treatment. Especially the element of providing sufficient medical information seems to account for this effect. The readiness to enroll in physical activities, to take analgesics, and to participate in psychotherapeutic elements was most likely to be raised through SDM.
Adult↗
Communication in intensive care settings: the challenge of futility disputes.
In intensive care settings, suboptimal communication can erode family trust and fuel so-called "futility" disputes. Presenting a teaching case used by >225 hospitals participating in the Decisions Near the End-of-Life program, we identify critical communication challenges and opportunities. We emphasize that good communication requires not only clear and sensitive language but also clinician self-awareness, psychological insight, and an institutional culture that promotes good communication with families. The article concludes with two examples of steps institutions can take to foster good communication between families and healthcare professionals.
Aged↗
A cardiovascular health education program for rural schools.
Public understanding of cardiovascular disease (CVD) risk factors and primary prevention has increased, due in part to community prevention efforts. However, many segments of society are difficult to reach. Such groups still need public education to acquire the knowledge that can lead to behavior change. Community intervention programs in rural areas face the challenge of disseminating health information to widely scattered populations isolated by difficult terrain and weather, and restricted by the sparsity of channels for mass communication. School health promotion programs, because of the special role schools play in rural communities, can help reach rural populations. During a five-year period, the Otsego-Schoharie Healthy Heart Program, a state-funded community intervention program, provided presentations to 18% of the combined total population of two rural counties through its school-based component. It also helped promote other program initiatives by establishing linkages in the community. Schools provide an effective channel for health promotion efforts to reach rural populations.
Adolescent↗
Internet Technology in Magnetic Resonance: A Common Gateway Interface Program for the World-Wide Web NMR Spectrometer
A custom-written Common Gateway Interface (CGI) program for remote control of an NMR spectrometer using a World Wide Web browser has been described. The program, running on a UNIX workstation, uses multiple processes to handle concurrent tasks of interacting with the user and with the spectrometer. The program's parent process communicates with the browser and sends out commands to the spectrometer; the child process is mainly responsible for data acquisition. Communication between the processes is via the shared memory mechanism. The WWW pages that have been developed for the system make use of the frames feature of web browsers. The CGI program provides an intuitive user interface to the NMR spectrometer, making, in effect, a complex system an easy-to-use Web appliance. Copyright 1998 Academic Press.
Journal Article↗
Humanities in surgery, a life threatening situation: communicating the diagnosis.
Surgeons should be able to communicate emotion-laden information to patients effectively. In most medical schools, there is an implicit assumption that students will learn communication skills through observation of appropriate role models. Young physicians often feel ill prepared to convey such information with sensitivity and understanding. University of Massachusetts Medical School's curriculum includes a program that addresses the communication skills involved in surgical practice and the ethical issues they raise. Videotaped vignettes of doctor-patient interactions culled from dramatic and documentary sources are viewed and discussed with students in small groups. These highly evocative vignettes are of live and role played doctor-patient encounters. The elements of communication are analyzed, as are psychosocial, existential, legal and ethical issues.
Communication↗
Selecting, implementing, and evaluating teen pregnancy prevention interventions: lessons from the CDC's Community Coalition Partnership Programs for the Prevention of Teen Pregnancy.
PURPOSE: To summarize 13 communities' experiences with selecting, implementing, and evaluating teen pregnancy prevention interventions within the CDC Community Coalition Partnership Programs for the Prevention of Teen Pregnancy. The study focuses on decision-making processes and barriers encountered in five categories of interventions: reproductive health services, reproductive health education, parent-child communication, male involvement, and programs for pregnant and parenting teens. METHODS: Telephone interviews were conducted with program directors, lead evaluators, and community coalition chairpersons in each of the 13 communities. The descriptive analysis explored factors that influenced community decisions to develop or not to develop interventions. These factors were analyzed by type of intervention. RESULTS: Each community implemented an average of six interventions and operated them with a variety of funding sources. Interventions were selected on the basis of need, and the community needs and assets assessment process was "very important" for most reported interventions. Decision-making was influenced most often by project staff, the coalition, or related work groups. Teens were infrequently viewed as primary decision-makers in the selection of interventions. Communities with family planning services as hub agencies were more likely to address reproductive services and reproductive health education. Communities with child advocacy or youth-serving agencies were more likely to focus on other intervention categories. About two-thirds of the interventions were evaluated by either process or outcome measures, or by both. CONCLUSIONS: This study highlights important lessons learned that should be considered in examinations of the overall effectiveness of this community coalition approach to the prevention of teen pregnancy.
Adolescent↗
Implementing security and access control mechanisms for an electronic healthcare record.
Personal Electronic Health Records (EHR) have recently been published as one means to support patient empowerment and patient control over their personal health record. The functionality of such an EHR may vary from a simple web-based interface for interactive data entry and data review up to a much more powerful system additionally supporting electronic data/document communication between clinical information systems of primary care practitioners or hospitals and even reminder based support for the empowered citizen, to actively take care of his health, based on relevant disease management programs. Since storage and communication of data in an EHR comprises sensible personal health data, each of those functions need specific security and access management requirements to be considered and implemented. In this article the most critical requirements for these aspects will be classified and respective mechanisms to provide secure data storage and communication as well as flexible access management functions will be presented.
Computer Security↗
The drug resistance strategies intervention: program effects on substance use.
This study evaluates the Drug Resistance Strategies (DRS) project, a culturally grounded, communication-based substance use prevention program implemented in 35 middle schools in Phoenix, Arizona. The intervention consisted of 10 lessons taught by the classroom teacher that imparted the knowledge, motivation, and skills needed to resist drug offers. The evaluation used growth modeling to analyze significant differences in average postintervention substance use (alcohol, cigarettes, and marijuana) and growth of use over the course of the study. The study involved 6,298 seventh graders (65% Mexican/Mexican American) who responded to at least 1 of 4 questionnaires (1 pretest and 3 follow-up measures). When compared to a control group, the DRS intervention appeared to significantly limit the increase in the number of students reporting recent substance use, especially alcohol and marijuana use. The multicultural version of the curriculum proved most broadly effective, followed by the version targeting Mexican American youth. The development of a culturally grounded prevention curriculum for Mexican American youth expands the population being served by interventions. Moreover, the success of the multicultural curriculum version, which has the broadest application, provides particular promise, and the article demonstrates how a growth modeling approach can be used to evaluate a communication-based intervention by analyzing changes over time rather than differences between the pretest and posttest scores.
Adolescent↗
Health education lessons learned: the H.A.P.I. Kids Program.
Challenges exist for effective health communication and health education within diverse populations of the United States. This article addresses the development process for educational materials and lessons learned from the Healthy Asian and Pacific Islander (H.A.P.I.) Kids Program, a vaccination demonstration project funded by the Centers for Disease Control and Prevention to promote catch-up hepatitis B vaccination for older American Asian and Pacific Islander children. Simplicity and a common message were incorporated in multiple strategies to disseminate information to a diverse population. Community representatives from the Cambodian, Hmong, Filipino, Lao, and Vietnamese communities were instrumental in the material development process, which included needs assessment, design, and translation. By making the target community part of the development process, important health messages can be disseminated effectively, carrying great impact to an otherwise hard-to-reach community.
Adult↗
Southern Health Board--advanced telematic/telemedicine in healthcare services in the south west of Ireland.
The Southern Health Board has been involved in Telematic Healthcare services for the past number of years. Our involvement in a number of EU funded projects has given us extensive experience and expertise in this area. The primary focus of our telematic applications is optimising health services delivery with a particular emphasis towards people who are isolated due to social and physical boundaries and limitations. Our main projects are: NIVEMES (Network of Integrated Vertical Medical Services) includes the exchange of medical information between urban centres and isolated communities including those at sea, rural, elderly and disabled persons. RISE (Remote Information Services for the Elderly) focuses on the enhanced healthcare services of the elderly and disabled through the use of telemedical applications. HEALTHLINE To strengthen the successful outcome of Telehealth implementation by specific projects in the EU by providing the expert Training and Information dissemination services to providers, beneficiaries and the general public, using the Telehealth systems and infrastructure applied by those projects. KATE (Killarney & Telecom Eireann) the SHB in conjunction with the Information Age Town Project in Killarney are working towards benefiting the local community through the innovative use of Information and Communication Technologies. TASTE (Technology Assessment in Telemedicine) An EU funded trans-national initiative aimed at developing a methodology for assessing medical technology, particularly in the area of Neurosurgery. FECV (Forward Emergency Control Vehicle) An European Space Agency project through which we are developing an advance communications vehicle for major emergence/event management through Satellite linkage to SHB systems.
Computer Communication Networks↗
Japanese attitudes towards foreign languages.
The purpose of this study is to clarify Japanese attitudes towards foreign languages based on the kinds and changes of TV and radio programs that aired on the Japanese national broadcasting station (NHK) between 1955 and 2000. Foreign language programs are classified into three groups according to their content: 1) cultivation, 2) education, or 3) communication. For Japanese people, foreign languages are the measures of intelligence and intellect. Studying a foreign language is considered a sign of intelligence whether or not it is used for actual communication. The number of foreign language programs has increased tremendously since 1965 in part because the global economy has brought many countries in such close contact. Since 1990, programs for the purpose of communication have increased because of the necessity to communicate with foreign people. Japanese attitudes towards studying foreign languages have been changing gradually from an intellectual purpose to a communication purpose.
Anthropology, Cultural↗
Health communication takes on new dimensions at CDC.
Actions by the Centers for Disease Control and Prevention (CDC) to integrate health communication into overall prevention programs as a means of influencing individual behavior to reduce risks to health are described. These actions include a set of 5-year goals for the Agency; a proposal to establish an Office of Health Communication to provide leadership and support for accomplishing the goals; and establishment of a working group to create the proposed Office of Health Communication and to develop a framework for accomplishing the goals. Fundamental to the policy was development of a definition of health communication as the Agency would practice it. Steps taken to reach this definition are outlined as well as the 10 steps adopted as a framework for health communication. The article concludes with a statement describing communication as a part of CDC's overall mission. The hope is that the ultimate accomplishment will be increased awareness among Americans of the importance of good health and their ability to achieve it.
Centers for Disease Control and Prevention, U.S.↗
The diversity of case management models.
Case management is experiencing rapid growth and evolutionary transition. This article explores the diversity and richness of case management models found in practice. Interdisciplinary communication in case management programs can be facilitated by an awareness of discipline-specific definitions and models. A categorization of models is described as a device to stimulate multidisciplinary case management collaboration.
Case Management↗
Role of the pediatrician in patient education.
Although most pediatricians agree on the importance of teaching parents and children about health care, they may not succeed in patient education because of a lack of the requisite communication skills, inadequate printed materials to augment personal involvement, a tendency to substitute such materials for personal involvement, and inadequate compensation. Physician recognition of an obligation to teach is a requisite for effective education. Adjustment of current practices is essential: use of educational materials must be systematically incorporated; educational efforts must make effective use of time and be cost-effective. Information should be readily understood, parents given an opportunity to ask questions, and effectiveness of the education evaluated. Pediatricians must have a constant source of supplementary material to use in patient education. Videotapes and interactive computer programs should be considered for more effective communication. Residency programs must teach future pediatricians how to educate parents and children.
Child↗
Software systems to control sensitivity studies of Monte Carlo simulation models.
Studies of the sensitivity of Monte Carlo models to changes in the values of their features involve repetitive simulations. Subsequent displays and analyses express variation in simulated outcomes as a function of change in location in multidimensional feature space and provide feedback via inputs for future simulations. A software system has been designed to control execution of the interacting programs required, reducing the need for human intervention. Assumptions about the goals and operation of the system as a whole are isolated within a program which executes component packages using interprogram control and communication mechanisms. The latter allow component programs to operate independently of the sources of data or the execution environment: they may be used separately, or in software systems, such as for sensitivity analysis of a Monte Carlo epidemic model. The methodology contributes to modularity at the level of executable programs and to the plausibility and efficiency of sensitivity studies.
Computer Simulation↗
Giving bad news compassionately: a 2-hour medical school educational program.
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Communication↗
Health care and Puerto Ricans: a consultation and educational program.
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Communication Barriers↗