Daily incorporation of low-GI carbohydrates in meal planning can be an effective diabetes self-management strategy for glycemic control and weight management. The documented responses to the subjects' conceptual and practical knowledge of the GI confirm their acceptance of this approach as a permanent behavioral lifestyle change and not a "diet." The positive results of this study attest to what worked for these subjects, inviting diabetes educators to consider offering low-GI dietary advice to their diabetes patients.

adults, the BMI data showed 53% men and 70% women were in the healthy range, 40% men and 21% women were undernourished, and 7% men and 9% women were mildly overweight. The MUAC cutoff point of ≤ 22.5 cm which corresponds to BMI <18.5 kg/m², the WHO cutoff reference for undernutrition, indicated 87% men and 72% women had both normal muscle mass and subcutaneous fat levels and 13% men and 28% women were undernourished. The TSF figures, also based on WHO ranges, indicated 88% men and 96% women had depleted fat stores and 12% men and 4% women had normal fat stores. Body Mass Index showed strong positive correlations with MUAC (r = 0.75, N = 62, p < 0.001) and with TSF (r = 0.58, N = 62, p < 0.001). The supplemental food likely played a positive role in the healthy weight status (BMI) and normal muscle mass and subcutaneous fat levels (MUAC) of the majority of participants (62%, 80% respectively) but not in their depleted fat stores status (TSF). These findings culminated in recommendations that adroitly targeted newly identified nutritional concerns. Increasing dietary variety, especially meat, fish, vegetables and fruits, and increasing the quantity and nutrient density of a nutritional powder made from stoneground peanuts, soya beans, maize, and millet were two new dietary strategies immediately implemented at the conclusion of the study. Positive TSF trends would support the effectiveness of TVAT's food delivery program to improve this crucial nutritional parameter for this population.

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Purpose The purpose of this pilot study was 2-fold. The first was to investigate the conceptual relationship between previously validated methodologies. The second was to establish a linkage between medical education research and current neurocognitive science that accounts for knowledge organization during the clinical reasoning process. Methods Transcripts of Think Aloud interviews conducted after an objective structured clinical examination (n = 12) were coded and analyzed into 3 clinical reasoning competencies (semantic, diagnostic, and knowledge network organization). Correlational analyses were conducted to establish relationships between the 2 methodologies. Analyses of variance examined group differences. Results Significant correlations with large effect sizes were found between semantic, diagnostic, and knowledge network organization variables. Analysis of variance results approach significant difference in the knowledge network organization between weak versus strong diagnosticians. Conclusions Knowledge network organization measurement can be used to discern differences in clinical reasoning and may offer explanations for the variation in health professionals' diagnostic performance.

Background: Several instruments intend to measure clinical reasoning capability, yet we lack evidence contextualizing their scores. The authors compared three clinical reasoning instruments [Clinical Reasoning Task (CRT), Patient Note Scoring rubric (PNS), and Summary Statement Assessment Rubric (SSAR)] using Messick's convergent validity framework in pre-clinical medical students. Scores were compared to a validated clinical reasoning instrument, Clinical Data Interpretation (CDI). Method: Authors administered CDI and the first clinical case to 235 students. Sixteen randomly selected students (four from each CDI quartile) wrote a note on a second clinical case. Each note was scored with CRT, PNS, and SSAR. Final scores were compared to CDI. Results: CDI scores did not significantly correlate with any other instrument. A large, significant correlation between PNS and CRT was seen (r = 0.71; p = 0.002). Conclusions: None of the tested instruments outperformed the others when using CDI as a standard measure of clinical reasoning. Differing strengths of association between clinical reasoning instruments suggest they each measure different components of the clinical reasoning construct. The large correlation between CRT and PNS scoring suggests areas of novice clinical reasoning capability, which may not be yet captured in CDI or SSAR, which are weighted toward knowledge synthesis and hypothesis testing.

AbstractObjectivesExplicit education on diagnostic reasoning is underrepresented relative to the burden of diagnostic errors. Medical educators report curricular time is a major barrier to implementing new curricula. The authors propose using concise student-identified educational opportunities -- differential diagnosis and summary statement writing -- to justify curriculum development in diagnostic reasoning.MethodsEighteen clerkship and 235 preclinical medical students participated in a 1 h computerized case presentation and facilitated discussion. Students were surveyed on their attitudes toward the case.ResultsAll 18 (100% response) clerkship students and 121 of the 235 preclinical students completed the survey. Students felt the module was effective and relevant. They proposed medical schools consider longitudinal computerized case presentations as an educational strategy.ConclusionsA computerized case presentation is a concise instructional strategy to teach critical points in diagnosis to clerkship and preclinical medical students.

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