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The Use of Pro-Ana Blogs for Online Social Support

EATING DISORDERS 2013年第5期21卷 408-422页

作者： Tong, Stephanie Tom Heinemann-Lafave, Daria Jeon, Jehoon Kolodziej-Smith, Renata Warshay, Nathaniel Wayne State Univ Dept Commun Detroit MI 48201 USA

The aim of this research was to document the content on pro-ana blogs and to uncover how the unique socio-technical features of blogs (interactivity, self-disclosure, masspersonal communication) facilitate social support among members. A final sample of 48 pro-ana blogs provided 624 individual units for coding. Results indicate that prevalent forms of social support were emotional support, esteem support, and informational support. A new category, reciprocal self-disclosure, was also revealed to be quite frequent. Blogs are spaces where social support is sought and communicated among members of the pro-ana network. Interpretation of blog communication and implications for treatment and research are discussed.

关键词： EATING disorders COMMUNICATION CONTENT analysis (Communication) INTERNET RESEARCH methodology SAMPLING (Statistics) SELF-disclosure SELF-perception SOCIAL networks STATISTICS WORLD Wide Web BLOGS SOCIAL support medical coding PSYCHOLOGICAL aspects

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Medicare Mandate for Claims-Based Functional Data Collection: An Opportunity to Advance Care, or a Regulatory Burden?

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PHYSICAL THERAPY 2013年第5期93卷 587-588页

作者： Resnik, Linda Brown Univ Dept Hlth Serv Policy & Practice Providence RI 02912 USA

The author reflects on the implementation of Medicare's mandate for claims-based functional data collection. She states that the mandate is applicable to physical therapy, occupational therapy, and speech-language pathology providers and that American Physical Therapy Association (APTA) has circulated educational information to help them apply the requirements. The author also discusses the shortcomings of the mandated requirements.

关键词： OUTCOME assessment (medical care) METHODOLOGY LIFE skills MEDICARE PHYSICAL therapy services ACQUISITION of data medical coding

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Supporting students in self-regulation: Use of formative feedback and portfolios in a problem-based learning setting

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medical TEACHER 2013年第8期35卷 655-660页

作者： Dannefer, Elaine F. Prayson, Richard A. Cleveland Clin Lerner Coll Med Cleveland OH 44106 USA Case Western Reserve Univ Cleveland OH 44106 USA

Background: The widely recognized need for students to self-regulate their behavior and learning extends to the multiple dimensions of professionalism. Aim: This study examines the extent to which students self-regulate professionalism behaviors related to work habits and interpersonal skills in a PBL setting. Methods: Formative feedback on works habits and interpersonal skills provided by peers and tutors to a Year 1 cohort (n = 32) over the course of a year-long PBL experience (5 blocks) was examined for comments on targeted areas for improvement (TAFIs) and observed improvements. We examined congruence between PBL feedback and students' self-reported TAFIs and behavioral improvements in their assessment portfolios. Results: Both PBL peer and faculty feedback and portfolio self-assessments targeted Interpersonal Skills TAFIs more frequently than Work Habit-related issues. TAFIs were more frequently identified midway in PBL blocks versus the end. Students reported TAFIs in their portfolio essays, citing feedback from both peers and tutors, and provided evidence of improved performance over time. Conclusions: Students utilized external formative feedback to document their portfolio self-assessment in a system designed to support self-regulation of PBL professionalism-related behaviors. A decrease in TAFIs identified at the end of PBL blocks suggests students made use of mid-block feedback to self-regulate behaviors.

关键词： INTERPROFESSIONAL relations medical students PROBLEM-based learning SELF-evaluation SELF-management (Psychology) STUDENTS STUDENTS -- Rating of SUPERVISION of employees EMPLOYMENT portfolios PROFESSIONALISM medical coding

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Comparative effectiveness of instructional design features in simulation-based education: Systematic review and meta-analysis

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medical TEACHER 2013年第1期35卷 E844-E875页

作者： Cook, David A. Hamstra, Stanley J. Brydges, Ryan Zendejas, Benjamin Szostek, Jason H. Wang, Amy T. Erwin, Patricia J. Hatala, Rose Mayo Clin & Mayo Fdn Mayo Med Sch Off Educ Res Rochester MN 55905 USA Mayo Clin Coll Med Div Gen Internal Med Dept Med Rochester MN 55905 USA Mayo Clin Coll Med Dept Surg Rochester MN 55905 USA Univ Ottawa Fac Med Acad Innovat Med Educ Ottawa ON Canada Univ Toronto Dept Med Toronto ON Canada Univ British Columbia Dept Med Vancouver BC Canada

Background: Although technology-enhanced simulation is increasingly used in health professions education, features of effective simulation-based instructional design remain uncertain. Aims: Evaluate the effectiveness of instructional design features through a systematic review of studies comparing different simulation-based interventions. Methods: We systematically searched MEDLINE, EMBASE, CINAHL, ERIC, PsycINFO, Scopus, key journals, and previous review bibliographies through May 2011. We included original research studies that compared one simulation intervention with another and involved health professions learners. Working in duplicate, we evaluated study quality and abstracted information on learners, outcomes, and instructional design features. We pooled results using random effects meta-analysis. Results: From a pool of 10 903 articles we identified 289 eligible studies enrolling 18 971 trainees, including 208 randomized trials. Inconsistency was usually large (I-2 > 50%). For skills outcomes, pooled effect sizes (positive numbers favoring the instructional design feature) were 0.68 for range of difficulty (20 studies;p < 0.001), 0.68 for repetitive practice (7 studies;p = 0.06), 0.66 for distributed practice (6 studies;p = 0.03), 0.65 for interactivity (89 studies;p < 0.001), 0.62 for multiple learning strategies (70 studies;p < 0.001), 0.52 for individualized learning (59 studies;p < 0.001), 0.45 for mastery learning (3 studies;p = 0.57), 0.44 for feedback (80 studies;p < 0.001), 0.34 for longer time (23 studies;p = 0.005), 0.20 for clinical variation (16 studies;p = 0.24), and -0.22 for group training (8 studies;p = 0.09). Conclusions: These results confirm quantitatively the effectiveness of several instructional design features in simulation-based education.

关键词： CINAHL (Information retrieval system) COMPUTER simulation ERIC (Information retrieval system) INFORMATION storage & retrieval systems -- Medicine INFORMATION storage & retrieval systems -- Psychology MEDICINE -- Study & teaching MEDLINE META-analysis RESEARCH -- Finance STATISTICS UNIVERSITIES & colleges -- Graduate work SYSTEMATIC reviews (medical research) EFFECT sizes (Statistics) INTER-observer reliability DATA analysis -- Software medical coding

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A review of longitudinal community and hospital placements in medical education: BEME Guide No. 26

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medical TEACHER 2013年第8期35卷 E1340-E1364页

作者： Thistlethwaite, J. E. Bartle, Emma Chong, Amy Ai Ling Dick, Marie-Louise King, David Mahoney, Sarah Papinczak, Tracey Tucker, George Univ Queensland Ctr Med Educ Res & Scholarship Herston Qld 4006 Australia Univ Queensland Sch Med Herston Qld 4006 Australia Flinders Univ S Australia Adelaide SA Australia Univ Queensland Fac Engn Architecture & Informat Technol Herston Qld 4006 Australia Univ Queensland Rural Clin Sch Herston Qld 4006 Australia

Background: Traditionally, clinical learning for medical students consists of short-term and opportunistic encounters with primarily acute-care patients, supervised by an array of clinician preceptors. In response to educational concerns, some medical schools have developed longitudinal placements rather than short-term rotations. Many of these longitudinal placements are also integrated across the core clinical disciplines, are commonly termed longitudinal integrated clerkships (LICs) and often situated in rural locations. This review aimed to explore, analyse and synthesise evidence relating to the effectiveness of longitudinal placements, for medical students in particular to determine which aspects are most critical to successful outcomes. Method: Extensive search of the literature resulted in 1679 papers and abstracts being considered, with 53 papers ultimately being included for review. The review group coded these 53 papers according to standard BEME review guidelines. Specific information extracted included: data relating to effectiveness, the location of the study, number of students involved, format, length and description of placement, the learning outcomes, research design, the impact level for evaluation and the main evaluation methods and findings. We applied a realist approach to consider what works well for whom and under what circumstances. Findings: The early LICs were all community-based immersion programs, situated in general practice and predominantly in rural settings. More recent LIC innovations were situated in tertiary-level specialist ambulatory care in urban settings. Not all placements were integrated across medical disciplines but were longitudinal in relation to location, patient base and/or supervision. Twenty-four papers focussed on one of four programs from different viewpoints. Most evaluations were student opinion (survey, interview, focus group) and/or student assessment results. Placements varied from one half day per week for si

关键词： MEDICINE -- Study & teaching CINAHL (Information retrieval system) CLINICAL medicine HEALTH occupations students INFORMATION storage & retrieval systems -- Medicine INTERNSHIP programs LONGITUDINAL method medical personnel & patient MEDLINE ONLINE information services SCHOOL environment SYSTEMATIC reviews (medical research) INTER-observer reliability PATIENT-centered care medical coding SOCIETIES, etc.

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Development of ACLEEM questionnaire, an instrument measuring residents' educational environment in postgraduate ambulatory setting

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medical TEACHER 2013年第1期35卷 E838-E843页

作者： Riquelme, Arnoldo Padilla, Oslando Herrera, Cristian Olivos, Trinidad Antonio Roman, Jose Sarfatis, Alberto Solis, Nancy Pizarro, Margarita Torres, Patricio Roff, Sue Pontificia Univ Catolica Chile Dept Gastroenterol Sch Med Santiago Chile Pontificia Univ Catolica Chile Ctr Med Educ Sch Med Santiago Chile Pontificia Univ Catolica Chile Dept Publ Hlth Santiago Chile Pontificia Univ Catolica Chile Sch Med Unit Hlth Policy & Syst Res Evidence Based Healthcare Programme Santiago Chile Pontificia Univ Catolica Chile Dept Psychiat Santiago Chile Pontificia Univ Catolica Chile Student Support & Mental Hlth Programme Postgrad Residency Programmes Santiago Chile Univ Alberto Hurtado Fac Psychol Santiago Chile Univ Dundee Dundee DD1 4HN Scotland

Background: Students' perceptions of their educational environment (EE) have been studied in undergraduate and postgraduate curricula. Postgraduate EE has been measured in hospital settings. However, there are no instruments available to measure the EE in postgraduate ambulatory settings. Aim: The aim of this study was to develop the "Ambulatory Care Learning Education Environment Measure" (ACLEEM). Methods: A mixed methodology was used including three stages: (1) Grounded theory (focus groups);(2) Delphi technique to identify consensus;and (3) Pilot study. Results: Three quota samples of approximately 60 stakeholders were formed, one as Focus Groups and two as Delphi panels. Eight focus groups were carried out including 58 residents (Latin-American Spanish speakers). The results were analysed and 173 items were offered to a National Delphi panel (61 residents and teachers). They reduced in two rounds the number of important items to 54. The 54-item questionnaire was then piloted with 63 residents and refined to the final version of the ACLEEM with 50 items and three domains. Conclusions: The 50-item inventory is a valid instrument to measure the EE in postgraduate ambulatory setting in Chile. Large-scale administration of the ACLEEM questionnaire to evaluate its construct validity and reliability are the next steps to test the psychometric properties of the instrument.

关键词： QUESTIONNAIRES EVALUATION HOSPITAL medical staff EDUCATION CLINICS DELPHI method EXPERIMENTAL design FOCUS groups GROUNDED theory HEALTH facilities RESEARCH -- Methodology PSYCHOMETRICS RELIABILITY (Personality trait) RESEARCH -- Finance SCALE analysis (Psychology) PILOT projects MULTITRAIT multimethod techniques RESEARCH methodology evaluation DATA analysis -- Software medical coding

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Postdischarge Transitional Care Management: A Reimbursable Service in 2013

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JOURNAL OF THE AMERICAN GERIATRICS SOCIETY 2013年第4期61卷 665-666页

作者： Ota, Ken S. Beutler, David S. Loli, Akil I. Banner Good Samaritan Med Ctr Dept Transit Care Med Phoenix AZ USA Banner Good Samaritan Med Ctr Cardiol Fellowship Program Phoenix AZ USA

A letter to the editor is presented which is concerned with the postdischarge transitional care management of patients discharged from an inpatient setting.

关键词： CONTINUUM of care METHODOLOGY HEALTH insurance reimbursement DISCHARGE planning medical coding

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Health Concept and Health Promotion Process Among Korean Migrant Women

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HEALTH CARE FOR WOMEN INTERNATIONAL 2013年第8期34卷 628-650页

作者： Cha, Chiyoung Ewha Womans Univ Div Nursing Sci Coll Hlth Sci Seoul 120750 South Korea

My purpose in this study was to explore the concepts of health and the health promotion process among Korean women who migrated to North America for their children's education. Interviews and surveys were analyzed using a grounded theory analysis and descriptive statistics. Women in this study established their health concept and health promotion process in accordance to their socially constructed mother role. The women established unique meanings of health and developed an altruistic motivation to be healthy that allowed them to actively pursue health promotion despite their traditional care provider roles.

关键词： GROUNDED theory HEALTH promotion HEALTH status indicators INTERVIEWING KOREANS RESEARCH -- Methodology MOTHERHOOD MOTIVATION (Psychology) NOMADS QUESTIONNAIRES SCALE analysis (Psychology) SURVEYS TRANSLATIONS WOMEN DATA analysis DATA analysis -- Software medical coding DESCRIPTIVE statistics

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Infants Show Ratio-dependent Number Discrimination Regardless of Set Size

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INFANCY 2013年第6期18卷 927-941页

作者： Starr, Ariel Libertus, Melissa E. Brannon, Elizabeth M. Duke Univ Ctr Cognit Neurosci Durham NC 27708 USA Duke Univ Durham NC 27708 USA Johns Hopkins Univ Baltimore MD 21218 USA

Evidence for approximate number system (ANS) representations in infancy is robust but has typically only been found when infants are presented with arrays of four or more elements. In addition, several studies have found that infants fail to discriminate between small numbers when continuous variables such as surface area and contour length are controlled. These findings suggest that under some circumstances, infants fail to recruit either the ANS or object file representations for small sets. Here, we used a numerical change detection paradigm to assess 6-month-old infants' ability to represent small values. In Experiment 1, infants were tested with 1 versus 3, 1 versus 2, and 2 versus 3 dots. Infants successfully discriminated 1 versus 3 and 1 versus 2, but failed with 2 versus 3. In Experiment 2, we tested whether infants could compare small and large values with a 2 versus 4 condition. Across both experiments, infants' performance exhibited ratio dependence, the hallmark of the ANS. Our results indicate that infants can attend to the purely numerical attributes of small sets and that the numerical change detection paradigm accesses ANS representations in infancy regardless of set size.

关键词： ANALYSIS of variance AUDIOVISUAL materials COGNITION in children RESEARCH -- Finance STATISTICS T-test (Statistics) DATA analysis TASK performance INTER-observer reliability medical coding

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Matroniya: The Lived Experiences of Rural Auxiliary Midwives in Koutiala, Mali

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HEALTH CARE FOR WOMEN INTERNATIONAL 2013年第6期34卷 482-498页

作者： Warren, Nicole Norr, Kathleen F. Keeney, Gwen Brumbaugh Johns Hopkins Univ Dept Community Publ Hlth Nursing Sch Nursing Baltimore MD 21210 USA Univ Illinois Coll Nursing Dept Women Children & Family Hlth Sci Chicago IL USA

Our team explored the lived experiences of rural auxiliary midwives, or matrones, in Mali. Since matrones attend more births than all other health workers combined, they are critical to efforts to reduce maternal mortality. Currently, their experiences are not well understood. This study used interpretive phenomenology to describe the experiences of seven matrones. We suggest that matrones provide a vital connection between traditional approaches to birth and the biomedical services offered by the formal health sector. Matrones' unique role as both health professionals and rural women creates challenges and opportunities that affect their effectiveness and personal lives.

关键词： EXPERIENCE INTERVIEWING PHENOMENOLOGY MIDWIVES RURAL conditions SOUND recordings QUALITATIVE research THEMATIC analysis DATA analysis -- Software medical coding

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