Patient-centered care in telemedicine - An experimental-design study.

BACKGROUND: Patients using telemedicine expect health providers to meet their expectations and are concerned about losing interpersonal contact. Studies on tailoring telemedicine to patient expectations are scant. This experimental design starts to close the gap in the state-of-the-art testing of patient expectations of communication with healthcare providers in telemedicine based on the patient-centered approach. The study was conducted from June 2021 through September 2021. METHODS: The convenience sample comprised 677 students, 298 females and 379 males, ages 18 to 64 who are all patients of one of four national health funds in Israel, using telemedicine. We used a conjoint-based experimental design. Each respondent evaluated a unique set of 24 vignettes of messages. The dependent variable was patient expectations of communication with healthcare providers in Telemedicine. The independent variables were four acknowledged categories of patient expectations of provider-patient communication. RESULTS: Coefficients for the total panel suggest no significant differences. Applying mathematical clustering, three mindsets emerged. A Post-hoc ANOVA test indicated that the mindsets are significantly different. Members of Mindset 1 expect the provider to walk them through the change process. Members of Mindset 2 expect healthcare providers to refer them to a reliable source of information to enhance their healthcare literacy. Members of Mindset 3 expect respect, both in non-verbal conduct and for their time. We developed a prediction tool enabling to identify the mindset-belonging of each patient in the population to a mindset in the sample. CONCLUSIONS: Findings call healthcare providers to communicate with patients via telemedicine based on mindset-tailored messages rather than based on socio-demographics for optimum patient-centered communication. Using the prediction tool, providers may identify the mindset-belonging of each patient. To enhance patient-centered care via telemedicine, providers are called upon to meet expectations by using mindset-tailored communication that structures the communication with greater specificity enhancing patient-centered care.

Sugar sweetness and pleasantness: evidence for different psychological laws.

Sweetness and the pleasantness of sweetness of sucrose solutions and sweetened food conform to different functions. Sweetness rises with concentration, whereas pleasantness first rises and then decreases. The breakpoint appears to occur at a constant sweetness (that is, constant sensory) level.

Cross-cultural differences in simple taste preferences.

A population of Indian laborers who show high preferences for sour and bitter tastes has been studied. Their judgments of taste intensity and pleasantness of sweet and salty stimuli are in accord with European population estimates, which suggests that dietary history may alter preferences for simple taste stimuli without affecting the gustatory system.

Sodium channel polypeptides in central nervous systems of various insects identified with site directed antibodies.

Immunoprecipitation, radiophosphorylation and SDS-PAGE autoradiography enable the characterization of sodium channel polypeptides in the central nervous system of insects belonging to four phylogenetically distinct orders: grasshoppers, cockroaches, flies and moth larvae. It has been shown that the insect sodium channels: (1) Are recognized by the previously described (Gordon et al. (1988) Biochemistry 27, 7032-7038) site directed antibodies corresponding to a highly conserved segment linking the homologous domains III and IV in the vertebrate sodium channel alpha subunits. (2) Serve as substrates for phosphorylation by cAMP-dependent protein kinase. (3) Are devoid of disulfide linkage to smaller subunits unlike sodium channels in vertebrate brain. (4) Are glycoproteins as shown in the grasshopper by the decrease of apparent molecular weight following endoglycosidase F treatment and specific binding to the lectins concanavalin A and wheat germ agglutinin. (5) Reveal a diversity with regard to their (a) apparent molecular masses which range from 240 to 280 kDa and (b) V8 proteinase digestion phosphopeptides indicating either differences in the positioning of the enzymatic cleavage and/or phosphorylation sites. These results provide the first evidence for structural diversity of sodium channel subtypes among various insect orders and are compared to their mammalian counterparts.

The methylation state of the proviruses in avian sarcoma virus transformed chick and rat cells.

The endogenous viruses in the avian cells are not completely methylated, nor are the Schmidt-Ruppin RSV-D (SRD) proviruses in the infected cells completely unmethylated. Avian sarcoma proviruses integrated in rat transformed cloned cells are heavily methylated. In these cells, a region in the 3' end of the env gene is unmethylated in all the src-containing proviruses but not in the transformed defective (td) proviruses. A possible role for the hypomethylation of the 3' end of the env region is proposed.

Sensory characteristics of foods: new evaluation techniques.

New product development requires the integration of sensory attributes including product taste, texture, and appearance with consumer attitudes and health biases. Both sensory and attitudinal variables determine food preferences, product purchase and food consumption. This review paper describes novel mathematical procedures that allow for study of real foods rather than model systems. Application of the Response Surface Method (RSM) to sensory evaluation of salted snacks is described.

Effects of long-term administration of buspirone and diazepam on driver steering control.

The effects of buspirone, diazepam, and placebo on tracking control were investigated over a nine-day period, using three groups of subjects, each with eight females and eight males. Subjects were tested using an interactive, computer-based driving simulator on days one, eight, and nine of the treatment period. On day nine, subjects received alcohol with their drug treatment. Measures of steering control were derived from car-driver transfer functions. Tracking performance was also measured. Diazepam was found to adversely affect steering control measures in comparison with placebo. This was true both after doses on the first as well as the eighth day of treatment. Thus, there was no evidence of behavioral tolerance to diazepam. In contrast, buspirone was not found to have any adverse effects on steering control; in fact, some evidence of improved tracking control was found. When alcohol was added to each treatment on the ninth day, differences between the drug treatment groups were less pronounced but in the same direction as on the first and eighth days.

Isolation of juvenile hormone esterase and its partial cDNA clone from the beetle, Tenebrio molitor.

Juvenile hormone esterase (JHE) plays an essential role in insect development. It is partially responsible for the clearance of juvenile hormone (JH) which regulates various aspects of insect development and reproduction. Because of its role in regulating JH titer, this enzyme has been targeted for development of biologically-based insecticides. JHE was partially purified from the beetle, Tenebrio molitor, using a transition state analog as the affinity ligand. Two forms of JHE were characterized by activity analysis, isoelectric focusing, two-dimensional SDS-PAGE and N-terminal sequence analysis. The esterase is associated with two proteins of sizes 71 and 150 kDa, both of which are active on JH III. A partial cDNA clone for the enzyme was isolated based on the sequence of N-terminal and internal peptides. Its sequence indicates that JHE from T. molitor and Heliothis virescens may have a common origin.

Effects of chronically administered buspirone and diazepam on driving-related skills performance.

The effects on driving skills of buspirone and diazepam, singly and in combination with alcohol, were examined. Three groups of 16 subjects each (8 men and 8 women) received either 20 mg of buspirone, 15 mg of diazepam, or placebo daily for 9 days. On day 9, they also received alcohol (men, 0.85 g/kg; women, 0.72 g/kg). On days 1, 8, and 9, subjects were tested on a driving simulator and given four sessions of divided attention tasks examining tracking and visual search performance. Extensive evidence of performance impairment associated with diazepam contrasted with improved performance under chronic buspirone treatment. Alcohol effects were additive.

A comparison of the effects of trazodone and amitriptyline on skills performance by geriatric subjects.

Fifteen healthy adults, aged 60 years and older, participated in a double-blind, crossover study of trazodone in comparison with amitriptyline and placebo. A battery of laboratory tests was used to measure drug effects on information processing, attention, and visual-motor skills. Amitriptyline 50 mg impaired vigilance and tracking performance and increased drowsiness. Trazodone 100 mg impaired only the most difficult tracking task. This study demonstrates that cognition and performance are less adversely affected in geriatric subjects by trazodone than by amitriptyline beginning 90 minutes after a single-dosage trial.