Building a Virtual Environment for Diabetes Self-Management Education and Support

The authors developed an immersive diabetes community to provide diabetes self-management education and support for adults with type 2 diabetes. In this article the authors describe the procedures used to develop this virtual environment (VE). Second Life Impacts Diabetes Education & Self-Management (SLIDES), the VE for our diabetes community was built in Second Life. Social Cognitive Theory, behavioral principles and key aspects of virtual environments related to usability were applied in the development in this VE. Collaboration between researchers, clinicians and information technology (IT) specialists occurred throughout the development process. An interactive community was successfully built and utilized to provide diabetes self-management education and support. VEs for health applications may be innovative and enticing, yet it must be kept in mind that there are substantial effort, expertise, and usability factors that must be considered in the development of these environments for health care consumers.

Research management team (RMT): a model for research support services at Duke University

Collecting and managing data for clinical and translational research presents significant challenges for clinical and translational researchers, many of whom lack needed access to data management expertise, methods, and tools. At many institutions, funding constraints result in differential levels of research informatics support among investigators. In addition, the lack of widely shared models and ontologies for clinical research informatics and health information technology hampers the accurate assessment of investigators' needs and complicates the efficient allocation of crucial resources for research projects, ultimately affecting the quality and reliability of research. In this paper, we present a model for providing flexible, cost-efficient institutional support for clinical and translational research data management and informatics, the research management team, and describe our initial experiences with deploying this model at our institution.

Prenatal consultation with a neonatologist prior to preterm delivery

OBJECTIVE

Evaluate the usefulness of prenatal consultation with a neonatologist before preterm birth.

STUDY DESIGN

A questionnaire was administered to mothers 1 week before home discharge of their preterm infant in a single regional level III neonatal intensive care unit.

RESULTS

Sixty-seven mothers completed the questionnaire; 84% indicated the consult was useful and 71% were comforted by the consult. However, mothers < 30 weeks' gestation were less likely to be comforted after the consult compared to those > or = 30 weeks. Most frequently, mothers indicated that they were provided with too little detail about retinopathy of prematurity and intraventricular hemorrhage.

CONCLUSIONS

Most mothers delivering a preterm infant describe the prenatal consultation with a neonatologist as useful. The majority of mothers are comforted by the information presented.

Physician early intervention referral as a function of child age and level of developmental delay

A 2 x 2 factorial design was used to examine the effects of child age (20 and 40 months) and level of developmental delay (mild and severe) on requests for consultations and referrals. Significant main effects for age and level of delay were found. Requests for education and psychological consultations were in the low to moderate range, and one fourth of the respondents were not likely to make a school referral. Implications for future research and continuing medical education were discussed.

Effects of child age and level of developmental delay on family practice physicians' diagnostic impressions

A 2 x 2 factorial design was used to examine the effects of child age (20 and 40 months) and level of developmental delay (mild and severe) on identification of developmental disorders by 155 family practice physicians. Results provide preliminary evidence that level of delay influences identification of developmental delay, with mild delay less likely to be detected. Implications in light of federal legislation as well as directions for future research were discussed.

Effects of Labels of Infant Health and Gender on Parent Ratings of a Preterm Infant

This study extends previous investigations of prematurity prejudice by manipulating labels of infant health status and infant gender in a 2 x 2 factorial design. Eighty-eight parents of young children born prematurely viewed a videotape of a preterm infant on an apnea monitor and then completed ratings of premature infant behavior, attractiveness, general health, and caregiving. Analyses of variance yielded significant results only on the General Health scale with a significant main effect for infant health. The health status bias did not globally influence all perceptions. Implications for clinical practice are discussed, and future research directions are outlined.

A study of the immunosuppressive properties of Sch 24937

Sch 24937 (6-bromo-5-chloro-2-1[(methylsulfonyl) acetyl] 3-(2-pyridyl indole) was previously shown to be an immunosuppressant with potent inhibitory effects on B lymphocyte mediated immune responses. The present investigation was primarily designed to compare the immunopharmacological profile of Sch 24937 with that of cyclosporin A (CSA) a well-known immunosuppressive drug that has selective effects on T-lymphocyte-mediated immune responses. The results show that while the immunosuppressive activity of CSA in vitro is superior to that of Sch 24937, in general the latter agent is a more potent inhibitor of immune responses in vivo. The activity of Sch 24937 in rat models of adjuvant arthritis and experimental allergic encephalomyelitis is also described. While Sch 24937 exhibits the type of immunopharmacological profile that is likely to yield a good therapeutic effect in the treatment of immune-mediated chronic inflammatory diseases, hepatotoxicity associated with the compound precludes its development for the treatment of non-life threatening human autoimmune conditions.

Simulation procedures for teaching independent menstrual care to mentally retarded persons

Four mentally retarded adolescent females participated in a program for assessment and training of independent menstrual care skills. Three task analyses served as the basis for instruction: (a) menstrual stain on underwear, (b) menstrual stain on a sanitary pad, and (c) menstrual stain on both sanitary pad and underwear. During individual training sessions, subjects were taught to perform correct sequences via simulation training with a small doll, in which a trainer utilized instructions, praise, modeling, and corrective feedback. Three types of assessment probes were conducted prior to training, upon completion of specified mastery criteria, and during post-training follow-up sessions. Doll probes assessed performance with the toy doll, self-probes assessed naturalistic performance but under conditions of simulated menstruation, and in vivo probes assessed performance during actual menstruation. Results of a multiple baseline analysis indicated that subjects emitted few correct responses during baseline probes, but showed consistent improvements that corresponded to the introduction of training. Generalization to untrained skills was noted with all subjects. Follow-up assessments indicated maintenance of skills for periods up to 30 weeks following termination of training.

Loss of calmodulin activity in cardiac sarcoplasmic reticulum after ischemia

Experiments were designed to evaluate whether cardiac ischemia affected the subcellular distribution of calmodulin activity. Major cellular fractions (nuclei, mitochondria, sarcoplasmic reticulum and cytosol) were isolated from globally ischemic hearts by differential centrifugation. Ischemia did not affect calmodulin activity in cell fractions other than sarcoplasmic reticulum, which showed a consistent and complete loss of activity. This site-specific loss of calmodulin activity may be one mechanism by which ischemia induces contractile dysfunction.

A logical and empirical analysis of current practice in classifying students as handicapped

The major criterion for classification systems is that students said to evidence any specific handicapping condition must demonstrate at least one universal and one specific characteristic. We conducted two investigations, using the category “learning disabilities” as an example, to examine the extent to which this criterion is met. In the first study, we demonstrated that 85% of 248 3rd-, 5th-, and 12th- grade students identified as normal could be classified as learning disabled. In a second investigation, we contrasted low-achieving students enrolled in regular fourth-grade classes with students labeled as learning disabled (LD). Analysis of these data indicated that 88% of the low-achieving sample could be identified as LD and that 4% of the LD sample did not meet any of the criteria for classification as LD. We found no specific characteristics that differentiated the groups.

Implications for classification practices in general and for serving students who are failing in school are discussed.