Monthly Archives: August 2012

syllabus – understanding and interpreting human studies

Understanding and Interpreting Human Studies
INTD 381

Textbook:
Gehlbach, Stephen H. Interpreting the Medical Literature, McGraw-Hill, Amherst, Mass 2006.

There will be a Sakai site on Web4Students associated with this course, and you must be able to access it. Articles will be put up on the site for you to read online or download. It will be enable interaction for project selection.

Class times and schedule:
Class meets from 9:30 to 12:30

Course Summary: Studying people using scientific tools can actually help us and those around us to change behavior wisely and adjust our attitudes to better agree with the way the world operates. This course will introduce some of the key principles in the design of human studies primarily through reading and analyzing studies others have done. It is a challenge to study people. People are unfortunately – or fortunately – “messy”! By reading and interpreting studies of humans, we can make better decisions for ourselves and those we care about. To do that well, we need to know the limitations of the conclusions we can reach given the data presented. This course also addresses the ethical reasons to do research, and ethical concerns both in doing research and interpreting it. There will also be an opportunity to practice designing human research.

Goals:
This is an introductory course – we will work towards the following goals:
1) Be able to read a scientific paper on a human study, especially a medical study, and
a. identify key issues in study design
b. identify some fatal flaws
c. identify some of what you can and cannot conclude from the study
2) Through the reading of papers on human studies be able to identify some of the key factors involved in clinical and human research so that you can:
a. Begin to apply the results – personally and professionally
b. Design human research yourself or with others.
3) Identify some of the key ethical issues in doing human studies and presented when reading about the research of others
4) Apply the results of some specific research studies studied in class to your own life in practical ways.

Class attendance and participation is crucial
Missing even a single class is a real problem in this course. You are getting 3 hours credit for this course, so missing one class is like missing a week of class in the normal semester. Assignment materials will be handed out, and presentations and discussions cannot be made up easily. If you do miss a class it is your responsibility to obtain notes from someone in the class. The text is not a substitute for class participation.

Assignments:
a) Assigned reading. Keep notes on assigned reading. Keeping up with assigned reading is very important and it may also be evaluated by pop quiz or individualized class discussion assessment.
b) Specific project assignments. Make sure these are completed in accordance with the instructions, and submitted on time. Late assignments will not get full credit, and are a real problem as class discussion of assignment material happens the day it is due.
c) You are expected to spend substantive time outside class reading assigned materials and working on projects. The more you put into this course, the more you will get out of it.

Project Assignments:
The following are preliminary descriptions of these assignments. These will be presented in more detail, and possibly refined, as the class develops.

1) Project one
a. Summary – What was the central study question? Explain for the non-expert
b. Terms for Project one: Use these terms to examine the study
* Confounding
* Types of study: More important to describe the architecture of it than to name: Cross sectional, Intervention – (Experimental),Retrospective (Case control – or comparative sample),Variations, Prospective (followup or longitudinal)
* Definitions
* Measurement
* Classifications
* Outcomes
* Selection issues – Bias? Sample? Random?
c. What are the implications for action of this study? What limits keep it from being helpful for action? Discuss strengths and limitations.

2) Second project: Design a study
Think of a question you would like to answer about humans – be specific and clear
Design a study to answer that question.
What kind of study will work best: intervention, cross-sectional, retrospective, prospective, combo
What measures will you use… for each of the variables
How reliable are your measures?
Is there any way to make them more reliable?
How do they connect to the construct of interest- so they enable your study to be useful
How will you “control” the study so that you investigate your question, and not something else?
How will you select your sample?
Think about the various issues we have discussed to date in study design and incorporate them into your study plan.
This assignment will be critiqued by your peers in class.
You will also hand in a hard copy.

3) Final project:
I would suggest that you pick this published study early on in the class, and be collecting your info all along on it.
Take a question that you are interested in answering about human beings that might have practical application to your life or those you care about. Pick something specific.
Pick one original study on the topic in a peer-reviewed medical or social science journal.
Describe the study: Type, selection, measurements, likelihood of having false positive or false negative results…see Gehlbach readings and class notes for prompts for various additional points.
Use what you learned from feedback from project one to improve this project write-up. This project should be in more depth, as you will now know more.
Given the results, what would you advise regarding action and why?
Look at various problems in the study that limits what you can conclude?
Class presentation and hard copy to hand in.
Weighting of assignments:
There will be no final exam in this course
30% Project 1
30% Project 2
40% Project 3

 

using the dses to improve patient care

Using the Daily Spiritual Experience Scale to Improve Patient Care. Psychiatry Conference: Sympozion National al ARSP cu Participare Internationala. Lynn Underwood. Sponsored invitation to speak. Targu Mures, Romania. 31 May – 3 June, 2012.

Abstract:

Spiritual and religious issues and values can influence how people cope with disease, make decisions, and behave in ways that affect their health. Spiritual and religious attitudes help to shape how people view the world and what they consider important. They can provide resources for patients to draw on. These may be particularly salient for them in the midst of mental illness, chronic disease, addiction, times of medical crisis, and at end-of-life.  It is often challenging to communicate with patients about religious and spiritual values and issues without running headlong into beliefs that may polarize conversation and empathic understanding, and limit the caregiver’s capacity to attend to patient needs and desires.

The Daily Spiritual Experiences Scale (DSES) is a 16-item psychometrically validated scale that measures the frequency of ordinary experiences such as awe, compassionate love, mercy, divine closeness, sense of spiritual support, gratitude, and deep inner peace in daily life ( www.dsescale.org ).  The DSES was constructed based on extensive qualitative research in multiple cultures, religions and secular settings.  It has been used in over 100 published studies, answered by many thousands of people, put on longitudinal health studies, and translated into over 20 languages.  It is linked to outcomes such as less addictive behaviors, better mood, improved relationships, decreased hospital stays, positive health behaviors, and diminished burnout.  It has been used extensively in medicine, psychiatry, psychology and social work research.   It functions well for people from various major religious backgrounds as well as for those who call themselves spiritual but not religious.  It does not reduce the spiritual to vague positive features, rather it allows for the kinds of experiences that encompass religious and spiritual depth. It is not only a potential mediating variable but also a measure of a significant component of quality of life for many.

This presentation will discuss ways in which the scale can be used in health-care settings to enhance the caregivers’ capacity to communicate with the patient and to help those who are ill to mobilize their own spiritual and religious resources to better cope with illness.  Another use of the scale is as a self-exploration tool for caregivers themselves using a structured method to enhance self-understanding and their ability to communicate with others different from themselves.  Scores have predicted less burnout in a large hospital system in Hong Kong, as well as in a study of those in the US working in palliative care.

In addition to describing its use in research, and how spiritual experience interacts with biology, this presentation will describe how this psychometrically validated set of 16 questions can be used as a clinical tool to improve patient care.

Return to “Recent and Current Presentations”

enhancing spiritual connection through poetry in a secular context

Enhancing Spiritual Connection through Poetry in a Secular Context. Lynn Underwood. University College London. Institute for Advanced Study, Senate House, June 29, 2012.

Abstract:

Poetry can open the mind to better grasp the complexity of the divine, the holy, and help make connections in down-to-earth ways, integrated into daily life.  The language of poetry and the use of metaphor and apparent paradox can expand our conceptual understanding.  The concreteness of poetry can also help ground this in the substance of our days.  This paper will give examples of specific poetry from Seamus Heaney, Billy Collins, Rainer Maria Rilke, R.S. Thomas, Jessica Powers and others, and point to specifically religious poetry from a variety of faith traditions, describing how they have been useful in the classroom for enriching capacity for sense of communication with the divine for those from specific faith traditions and those who call themselves “spiritual but not religious.”  Poetry provides words that can open doorways without reducing the spiritual to a meaningless common denominator – leading instead to the depths and richness of religious traditions.

Poetry can help those of faith and those not comfortable in a religious tradition to enhance sense of connection with God and become increasingly aware of that connection in daily life. It can bridge traditions and beliefs and has been used effectively by the author of this paper in a variety of secular college classroom settings and in small group work.  Approaching poetry in a contemplative rather than analytic way facilitates this engagement, and journaling encourages direct encounter with the poems themselves in written conversation.  Structured group discussion of personal responses to the poems can also provide mutual illumination of contexts and invitation.

Return to “Recent and Current Presentations”

enhancing communication and understanding in health care

Enhancing Communication and Understanding in Health Care, October 20, 2012, American Society for Bioethics and Humanities, Lynn Underwood, Washington D.C.
Spiritual and religious issues and values often influence how people cope with disease, make decisions, and behave in ways that affect their health. These may be particularly salient for them in chronic disease, mental health, addiction, times of medical crisis, and at end-of-life. It is often challenging to communicate with patients about religious and spiritual values and issues of importance without running headlong into beliefs that may polarize conversation and empathic understanding, and limit the caregiver’s capacity to attend to patient needs and desires.

Abstract:

The Daily Spiritual Experiences Scale (DSES) is a 16-item psychometrically validated scale that measures the frequency of ordinary experiences such as awe, compassionate love, mercy, divine closeness, sense of spiritual support, gratitude, and deep inner peace in daily life (www.dsescale.org). The DSES was constructed based on extensive qualitative research in multiple cultures. It has been used in over 100 published studies, included in the General Social Survey and longitudinal health studies, and translated into over 20 languages. It is linked to outcomes such as less addictive behaviors, better mood, decreased hospital stays, positive health behaviors, and diminished burnout. It has been used extensively in medicine, psychiatry, psychology and social work research. It functions well for people from various major religious backgrounds as well as for those who call themselves spiritual but not religious, and atheists. It does not reduce the spiritual to vague positive features, rather it allows for the kinds of experiences that encompass religious and spiritual depth. It is not only a potential mediating variable but also a measure of a significant component of quality of life for many.
This presentation will discuss ways in which the scale can be used in secular health-care settings to enhance the caregiver’s capacity to communicate with the patient and to help those who are ill to mobilize their own spiritual and religious resources to better cope with illness. Another use of the scale is as a self-exploration tool for caregivers themselves using a structured method to enhance self-understanding and their ability to communicate with others different from themselves. Scores have predicted less burnout in a large hospital system in Hong Kong, as well as in a study of those working in palliative care. This presentation will describe how this psychometrically validated set of 16 questions can be used.

Return to “Recent and Current Presentations”

compassionate love publications by lynn underwood

The Science of Compassionate Love: Research, Theory, and Applications. Fehr. B. Sprecher, S, Underwood, LG, eds. Oxford England, Malden Mass: Wiley-Blackwell. 2009.

Altruism and Altruistic Love: Science, Philosophy, and Religion in Dialogue Post, SG, Underwood, LG, Schloss, JP, Hurlbut, WB, eds., Oxford University Press, 2002.

Articles/Chapters:

“Interviews with Trappist Monks as a Contribution to Research Methodology in the Investigation of Compassionate Love.” Underwood LG Journal for the Theory of Social Behavior, 35:3 (September, 2005), 285-302.

“Altruistic Love – Compassionate Love”. Underwood, L. In Harry T. Reis & Susan Sprecher (Eds.), Encyclopedia of Human Relationships. Thousand Oaks, CA: Sage. (2009)

“Chapter 1: Compassionate love: A framework for research” Underwood, Lynn G. in Fehr, Sprecher and Underwood The Science of Compassionate Love: Theory Research and Applications, Blackwell. Wiley- Blackwell. Malden Massachusetts, Oxford, England 2009.

“Giving of Self for the Good of the Other: Science Research on Compassionate Love and Spirituality” Underwood, Lynn G. in The Love that Does Justice, Edwards, Michael and Post Stephen (eds), Cleveland, Ohio 2008, p 133-138.

“Compassionate Love,” in Post, Stephen G. ed. 2004. Encyclopedia of Bioethics, 3rd edition. New York: Macmillan Reference USA, 483-488.

“The Human Experience of Compassionate Love: Conceptual Mapping and Data from Selected Studies”, in Post, SG, Underwood, LG, Schloss, JP, Hurlbut, WB, eds. Altruism and Altruistic Love: Science, Philosophy, and Religion in Dialogue, 2002. New York City: Oxford University Press. 72-88.

“Concluding Summary and Future Research Needs on Altruism and Altruistic Love,” with Post, SG in ibid. 3-12, 379-386.