Robert A. Diseker

An Analysis of Empathy in Medical Students Before and Following Clinical Experience.

The nature and direction of changes in empathy as measured by Hogans empathy scale was explored over time (1975, 1976, and 1979) for medical students in the class of 1979 at the Bowman Gray School of Medicine. Results indicated that empathy scores declined slightly over time, correlated negatively with Medical College Admission Test scores, and were unrelated to academic performance or performance on Part I or Part II examinations of the National Board of Medical Examiners.

Noncompliance in screening follow-up among family planning clinic patients with cervical dysplasia.

This investigation estimated the extent of noncompliance with follow-up to screening for cervical dysplasia at a public health family planning clinic. Available data also permitted examination of the relationship between selected background characteristics and compliance with follow-up. Noncompliance was defined as failure to respond to notification of an abnormal cervical smear (Class III, IV, or V) by failing either to make a follow-up appointment or to keep such an appointment after it was made. The sample consisted of 177 women with abnormal cervical smears who were screened at the Forsyth County Family Planning Clinic between January 1, 1980, and June 30, 1981. Information on the womens compliance with the request for follow-up was obtained from a file specifically kept for this purpose by the clinic nurse. Background characteristics were obtained by reviewing clinic records. Results indicated that approximately 17% of the sample was noncompliant. Noncompliant patients were more likely to be unmarried, less educated, younger, and to have fewer total health problems than women who returned for follow-up. Logistic regression analysis revealed that the number of health problems and educational attainment were the most important predictors of noncompliance.

Racial differences in knowledge of cancer: A pilot study

The present study examined the reported sources of information on cancer and the level of cancer knowledge for a sample of black and white adults. Black respondents had significantly less knowledge and the relationship between race and cancer knowledge persisted even when controlling for education, sex, and age. Possible reasons for the observed difference include (a) the tendency for blacks to obtain information on cancer from television and radio, while whites rely more on printed materials, (b) differences in the quality of education received by black and white adults, and (c) a possible lack of motivation on the part of black respondents to acquire knowledge of cancer due to lower access to medical care. Intervention programs designed to provide all blacks with information about cancer should take into account the preferred sources of information, and should be oriented toward reducing the barriers to taking action related to prevention and early detection as well as increasing perceptions of the benefits of taking such action.

The relationship between weight-height indices and the triceps skinfold measure among children age 5 to 12.

This study examines several weight for height indices--Quetelets index W/H2, W/H, and Rohrers index W/H3--for their appropriateness in estimating adiposity among young children. Data were obtained for a sample of 1,668 children age 5-12 residing in Forsyth County, North Carolina. Although W/H2 was found to be the most useful of these indices, the results suggest that no index, including the tricep skinfold measure, can be considered completely satisfactory in estimating adiposity among children.

Knowledge of diabetes and glaucoma in a rural North Carolina community

Effective use of time, money, and personnel in the delivery of health care services to rural areas requires baseline information on the target population with respect to the problem being addressed. Prior to the initiation of an educational program on diabetes and glaucoma, the Public Health Department of Davie County, North Carolina, conducted a survey of county residents to determine knowledge, attitudes, and practices concerning these illnesses. The goals of the survey were to determine (1) basic knowledge with respect to the nature of each illness, symptoms, and high-risk groups, (2) the stigma attached to each illness, and (3) health practices in terms of previous tests for diabetes and glaucoma and whether or not the respondents know where to go for such tests. Information was obtained through a telephone survey of randomly sampled households in Davie County. Results of the survey indicated that the level of knowledge for both diabetes and glaucoma is particularly low with respect to identification of high-risk groups and symptoms, and approximately one-quarter of all respondents felt there was some stigma attached to diabetes and glaucoma. The lowest levels of knowledge were observed in the youngest and oldest respondents, males, the unmarried, and those with low levels of educational attainment. The differences in knowledge by age, marital status, and sex were found to be partially a function of differing levels of educational attainment. These data have provided information useful in the selection of content areas for the programs and in the identification of target populations for special emphasis.

Relative importance of variables in determination of practice location: A pilot study

Abstract Variables influencing practice location were independently weighted in importance by 22 practitioners and 48 residents. Among practitioners the four most important variables in rank order were: (1) availability of adequate hospital facilities, (2) acceptability of location to spouse, (3) availability of practice coverage, and (4) openness and receptivity of medical community. Among residents the four most important were: (1) availability of practice coverage, (2) availability of adequate hospital facilities, (3) acceptability of location to spouse, and (4) geographic location. “Openness and receptivity of medical community” is established as an important new variable with slightly higher value in smaller communities. Practitioners and residents included the same eight items in their 11 top rankings and there was complete agreement in ranking of the six least important items. Similarity of the groups suggests that perception of importance of variables influencing practice location is independent of experience and/or time.

Weight-for-height indices as measures of adiposity in children

This study examines the weight-for-height index q = w/h lambda where the parameter lambda is chosen to maximize the correlation of q with triceps skinfold thickness, and thus provide an indirect measure of adiposity. Using a sample of 1668 children ages 5-12 years, we estimate lambda by an iterative procedure in each age/sex category. We find that lambda does not vary simply across the age/sex categories, and that the correlation of q and skinfold thickness is never more than marginally greater than that of the Quetelet index w/h2. We indicate that almost identical properties will be evidenced by the more general two-parameter index w alpha/h beta. Our conclusion is that there is no weight-for-height index generally useful as an indirect measure of adiposity in children.

A Comparison of Height, Weight, and Triceps Skinfold Thickness of Children Ages 5-12 in Michigan (1978), Forsyth County North Carolina (1978), and HANES I (1971-1974)

Height, weight, and triceps skinfold measurements were made on 1,668 Forsyth County, North Carolina students ages 5-12 during 1978. These data were compared to a representative sample of Michigan children taken during the same year and to their United States counterparts in HANES I (1971-74). The North Carolina children more closely resembled their US counterparts than did the Michigan group, casting doubt on the secular trend toward heavier children suggested by the Michigan researchers. (Am J Public Health 1982; 72:730-733.)

The autonomy loss index: measuring autonomy lost by hospital administrators through participation in joint programs with other organizations.

Abstract Joint Programs and shared services are increasingly being promoted as an optimal means of rationalizing the health care system. A neglected consequence of joint programs is the administrative tradeoff of autonomy for resources. Administrators identified autonomy as important in five areas of joint programs. Each of these areas was then represented in statements concerning actual conditions of program participation. Administrators judged the degree of autonomy they would have under each condition, yielding a weight for each. When summed, the individual weights attached to all of the conditions found in a specific joint activity would form an index of autonomy lost.