Managed care in dentistry. Interview by Phillip Bonner

The proliferation of human melanoma cells in vitro during the first 3 days after irradiation and/or hyperthermia was followed by two-parameter flow cytometry combining cell cycle analysis on the basis of DNA content with Ki-67 antibody labeling. It was found that cells arrested or delayed in the S and G2 phases of the cell cycle were Ki-67-positive in spite of the antigen's very short half-life. Thus Ki-67 staining failed to reflect those changes in cell proliferation which typically occur in the course of a fractionated radiotherapy as well as those expected in the case of hyperthermia or a combined treatment.     

On Erik Erikson's Berkeley resignation.

Comments on J. R. Hopkin's (See record 83-12717) obituary of Erik Erikson, who failed to provide any reasons for Erikson's resignation from Berkeley in 1950. Erikson's resignation came during the era of Senator Joe MacCarthy's political persecutions when many states forced their teachers and professors to sign "loyalty oaths" as a condition of their further employment. Erikson refused to comply, choosing instead to resign. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Computer-assisted intervention improves patient-centered diabetes care by increasing autonomy support.

Objective: To determine if a patient-centered, computer-assisted diabetes care intervention increased perceived autonomy support, perceived competence (from self-determination theory), and if these constructs mediated the effect of the intervention on ADA/NCQA recommended diabetes care outcomes. Design: A randomized controlled trial of 866 adult type 2 diabetes patients in heterogeneous primary care settings in Colorado. Main Outcome Measures: Perceived autonomy support, perceived competence, patient satisfaction, glycemic control (HbA1c), ratio of total to HDL cholesterol, diabetes distress, and depressive symptoms. Results: The computer-assisted intervention increased patient perception of autonomy support relative to a computer-based control condition ( p = .05). Change in perceived competence partially mediated the effects of increased autonomy support on the change in lipids, diabetes distress, and depressive symptoms. The construct of autonomy support was found to be separate from that of patient satisfaction. Conclusions: A patient-centered, computer-assisted intervention was effective in improving diabetes self-management outcomes, in part, because it increased patients' perception that their autonomy was supported which changed perceived competence. These findings support the self-determination model for health behavior change and the chronic care model and support the further study of the use of these technologies to motivate patients to improve their health outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Outcomes: essential information for clinical decision support: an interview with Ellen B. White. Interview by Melinda L. Orlando

There is an increasing demand for outcomes data from both purchasers of health care and providers. This is especially true for the managed behavioral health care industry. Patients are more educated about health care and active in treatment decisions. Patient-reported outcomes data, clinical information, and functional status are components of the clinical decision support system. This article describes, in interview format, an outcomes measurement system for clinical decision support.