Wechsler Adult Intelligence Scale-III profile in the early stages of Alzheimer's disease: performance in subtests sensitive to and resistant to normal decline with ageing.

PubMed

Matsuda, Osamu; Saito, Masahiko; Kato, Mayumi; Azami, Hiroki; Shido, Emi

2015-03-01

This study examined the significance of age-related subtest scores from the Japanese version of the Wechsler Adult Intelligence Scale-III in patients in the early stages of Alzheimer's disease (AD). The subjects of this study included 58 elderly Japanese persons classified into two groups: AD group (n = 29) and control group (n = 29). These groups did not differ in age, years of education, gender ratio, Hasegawa's Dementia Scale-Revised score, or Full-Scale IQ score. No subject scored below the cut-off point on Hasegawa's Dementia Scale-Revised, a frequently used dementia screen test in Japan. At the index score level, General Ability Index scores were the only scores that differed significantly between the groups, with the AD group scoring significantly lower than the control group (P < 0.05, Hedges' g = 0.54). At the subtest level, information scores were the only scores that differed significantly between the groups, with the AD group significantly lower than the control group (P < 0.01, Hedges' g = 0.74). The General Ability Index is a composite score that deducts components of working memory and processing speed, which are sensitive to decline with normal ageing, from the Full-Scale IQ. It also served as a subtest measuring crystallized intelligence, especially of acquired knowledge of general and factual information. Therefore, the results of this study seem to suggest that Wechsler Adult Intelligence Scale-III profile of very early AD may be characterized by weak performance on subtests normally resistant to decline with ageing. © 2014 The Authors. Psychogeriatrics © 2014 Japanese Psychogeriatric Society.

Low motor performance scores among overweight children: poor coordination or morphological constraints?

PubMed

Chivers, Paola; Larkin, Dawne; Rose, Elizabeth; Beilin, Lawrence; Hands, Beth

2013-10-01

This study examined whether lower motor performance scores can be full attributed to poor coordination, or whether weight related morphological constraints may also affect motor performance. Data for 666 children and adolescents from the longitudinal Western Australian Pregnancy Cohort (Raine) Study were grouped into normal weight, overweight and obese categories based on the International Obesity Task Force cut points. Participants completed the 10-item McCarron Assessment of Neuromuscular Development (MAND) at the 10 and 14 year follow-up. The prevalence of overweight and obese participants classified with mild or moderate motor difficulties was not different from the normal weight group at 10 years (χ2 = 5.8 p = .215), but higher at 14 years (χ2 = 11.3 p = .023). There were no significant differences in overall motor performance scores between weight status groups at 10 years, but at 14 years, the normal weight group achieved better scores than the obese group (p<.05). For specific items, the normal weight group consistently scored higher than the overweight and obese groups on the jump task at 10 (p<.001) and 14 (p<.01)years but lower on the hand strength task at both ages (p<.01). Our findings raise the question as to whether some test items commonly used for assessing motor competence are appropriate for an increasingly overweight and obese population. Copyright © 2013 Elsevier B.V. All rights reserved.

Comparison of Cognitive Orientation to daily Occupational Performance and conventional occupational therapy on occupational performance in individuals with stroke: A randomized controlled trial.

PubMed

Ahn, Si-Nae; Yoo, Eun-Young; Jung, Min-Ye; Park, Hae-Yean; Lee, Ji-Yeon; Choi, Yoo-Im

2017-01-01

Cognitive Orientation to daily Occupational Performance (CO-OP) approach based on cognitive strategy in occupational therapy. To investigate the effects of CO-OP approach on occupational performance in individuals with hemiparetic stroke. This study was designed as a 5-week, randomized, single-blind. Forty-three participants who had a diagnosis of first stroke were enrolled in this study. The participants were randomly assigned to the experimental group (n = 20) or the control group (n = 23). The experimental group conducted CO-OP approach while the control group conducted conventional occupational therapy based on occupational performance components. This study measured Canadian Occupational Performance Measure (COPM) and Performance Quality Rating Scale (PQRS). Outcome measurements were performed at baseline and post-intervention. After training, the scores of COPM and PQRS in trained task were significantly higher for the score in the experimental group than the control group. In addition, the non-trained task was significantly higher for the score in the experimental group than the control group in COPM and the PQRS. This study suggests that the CO-OP approach is beneficial effects on the occupational performance to improvement in individuals with hemiparetic stroke, and have positive effects on generalization and transfer of acquired skills.

Visualization Improves Supraclavicular Access to the Subclavian Vein in a Mixed Reality Simulator.

PubMed

Sappenfield, Joshua Warren; Smith, William Brit; Cooper, Lou Ann; Lizdas, David; Gonsalves, Drew B; Gravenstein, Nikolaus; Lampotang, Samsun; Robinson, Albert R

2018-07-01

We investigated whether visual augmentation (3D, real-time, color visualization) of a procedural simulator improved performance during training in the supraclavicular approach to the subclavian vein, not as widely known or used as its infraclavicular counterpart. To train anesthesiology residents to access a central vein, a mixed reality simulator with emulated ultrasound imaging was created using an anatomically authentic, 3D-printed, physical mannequin based on a computed tomographic scan of an actual human. The simulator has a corresponding 3D virtual model of the neck and upper chest anatomy. Hand-held instruments such as a needle, an ultrasound probe, and a virtual camera controller are directly manipulated by the trainee and tracked and recorded with submillimeter resolution via miniature, 6 degrees of freedom magnetic sensors. After Institutional Review Board approval, 69 anesthesiology residents and faculty were enrolled and received scripted instructions on how to perform subclavian venous access using the supraclavicular approach based on anatomic landmarks. The volunteers were randomized into 2 cohorts. The first used real-time 3D visualization concurrently with trial 1, but not during trial 2. The second did not use real-time 3D visualization concurrently with trial 1 or 2. However, after trial 2, they observed a 3D visualization playback of trial 2 before performing trial 3 without visualization. An automated scoring system based on time, success, and errors/complications generated objective performance scores. Nonparametric statistical methods were used to compare the scores between subsequent trials, differences between groups (real-time visualization versus no visualization versus delayed visualization), and improvement in scores between trials within groups. Although the real-time visualization group demonstrated significantly better performance than the delayed visualization group on trial 1 (P = .01), there was no difference in gain scores, between performance on the first trial and performance on the final trial, that were dependent on group (P = .13). In the delayed visualization group, the difference in performance between trial 1 and trial 2 was not significant (P = .09); reviewing performance on trial 2 before trial 3 resulted in improved performance when compared to trial 1 (P < .0001). There was no significant difference in median scores (P = .13) between the real-time visualization and delayed visualization groups for the last trial after both groups had received visualization. Participants reported a significant improvement in confidence in performing supraclavicular access to the subclavian vein. Standard deviations of scores, a measure of performance variability, decreased in the delayed visualization group after viewing the visualization. Real-time visual augmentation (3D visualization) in the mixed reality simulator improved performance during supraclavicular access to the subclavian vein. No difference was seen in the final trial of the group that received real-time visualization compared to the group that had delayed visualization playback of their prior attempt. Training with the mixed reality simulator improved participant confidence in performing an unfamiliar technique.

High velocity missile-related colorectal injuries: In-theatre application of injury scores and their effects on ostomy rates.

PubMed

Kaymak, Şahin; Ünlü, Aytekin; Harlak, Ali; Ersöz, Nail; Şenocak, Rahman; Coşkun, Ali Kağan; Zeybek, Nazif; Lapsekili, Emin; Kozak, Orhan

2016-03-01

Treatment of colorectal injuries (CRIs) remains a significant cause of morbidity and mortality. The aim of the present study was to analyze treatment trends of Turkish surgeons and effects of the American Association for the Surgery of Trauma (AAST), Injury Severity (ISS), and Penetrating Abdominal Trauma Index (PATI) scoring systems on decision-making processes and clinical outcomes. Data regarding high velocity missile (HVM)-related CRIs were retrospectively gathered. Four patient groups were included: Group 1 (stoma), Group 2 (no stoma in primary surgery), Group 2a (conversion to stoma in secondary surgery), and Group 2b (remaining Group 2 patients). Groups 1, 2, 2a, and 2b included 39 (66%), 20 (34%), 6 (30%), and 14 (70%) casualties, respectively. Ostomies were performed in casualties with significantly higher AAST scores (p<0.001). However, PATI and ISS scores were not decisive factors in the performance of ostomy (p=0.61; p=0.28, respectively). Ostomy rates of civilian and military surgeons were 62% and 68%, respectively (p=0.47). Receiver operating characteristic (ROC) analysis showed that AAST score was a more accurate guide for performing ostomy, with sensitivity and specificity rates of 80% and 92.9%, respectively. Clinical significance of diversion in HVM-related CRIs remains. Stomas were associated with lower complication rates and significantly higher AAST colon/rectum injury scores.

Effectiveness of autogenic training in improving motor performances in Parkinson's disease.

PubMed

Ajimsha, M S; Majeed, Nisar A; Chinnavan, Elanchezhian; Thulasyammal, Ramiah Pillai

2014-06-01

Relaxation training can be an important adjunct in reducing symptoms associated with Parkinson's disease (PD). Autogenic Training (AT) is a simple, easily administered and inexpensive technique for retraining the mind and the body to be able to relax. AT uses visual imagery and body awareness to promote a state of deep relaxation. To investigate whether AT when used as an adjunct to Physiotherapy (PT) improves motor performances in PD in comparison with a control group receiving PT alone. Randomized, controlled, single blinded trial. Movement Disorder Clinic and Department of Physiotherapy, Sree Chithira Thirunal Institute of Medical Sciences and Technology in Trivandrum, Kerala, India. Patients with PD of grade 2 or 3 of Hoehn & Yahr (H&Y) scale (N = 66). AT group or control group. The techniques were administered by Physiotherapists trained in AT and consisted of 40 sessions per patient over 8 weeks. Motor score subscale of Unified Parkinson's Disease Rating Scale (UPDRS) was used to measure the motor performances. The primary outcome measure was the difference in Motor score subscale of UPDRS scores between Week 1 (pretest score), Week 8 (posttest score), and follow-up at Week 12 after randomization. The simple main effects analysis showed that the AT group performed better than the control group in weeks 8 and 12 (P < .005). Patients in the AT and control groups reported a 51.78% and 35.24% improvement, respectively, in their motor performances in Week 8 compared with that in Week 1, which persisted, in the follow-up (Week 12) as 30.82% in the AT group and 21.42% in the control group. This study provides evidence that AT when used as an adjunct to PT is more effective than PT alone in improving motor performances in PD patients. Copyright © 2014 Elsevier Ltd. All rights reserved.

Assessment of three risk evaluation systems for patients aged ≥70 in East China: performance of SinoSCORE, EuroSCORE II and the STS risk evaluation system.

PubMed

Shan, Lingtong; Ge, Wen; Pu, Yiwei; Cheng, Hong; Cang, Zhengqiang; Zhang, Xing; Li, Qifan; Xu, Anyang; Wang, Qi; Gu, Chang; Zhang, Yangyang

2018-01-01

To assess and compare the predictive ability of three risk evaluation systems (SinoSCORE, EuroSCORE II and the STS risk evaluation system) in patients aged ≥70, and who underwent coronary artery bypass grafting (CABG) in East China. Three risk evaluation systems were applied to 1,946 consecutive patients who underwent isolated CABG from January 2004 to September 2016 in two hospitals. Patients were divided into two subsets according to their age: elderly group (age ≥70) with a younger group (age <70) used for comparison. The outcome of interest in this study was in-hospital mortality. The entire cohort and subsets of patients were analyzed. The calibration and discrimination in total and in subsets were assessed by the Hosmer-Lemeshow and the C statistics respectively. Institutional overall mortality was 2.52%. The expected mortality rates of SinoSCORE, EuroSCORE II and the STS risk evaluation system were 0.78(0.64)%, 1.43(1.14)% and 0.78(0.77)%, respectively. SinoSCORE achieved the best discrimination (the area under the receiver operating characteristic curve (AUC) = 0.829), followed by the STS risk evaluation system (AUC = 0.790) and EuroSCORE II (AUC = 0.769) in the entire cohort. In the elderly group, the observed mortality rate was 4.82% while it was 1.38% in the younger group. SinoSCORE (AUC = .829) also achieved the best discrimination in the elderly group, followed by the STS risk evaluation system (AUC = .730) and EuroSCORE II (AUC = 0.640) while all three risk evaluation systems all had good performances in the younger group. SinoSCORE, EuroSCORE II and the STS risk evaluation system all achieved positive calibrations in the entire cohort and subsets. The performance of the three risk evaluation systems was not ideal in the entire cohort. In the elderly group, SinoSCORE appeared to achieve better predictive efficiency than EuroSCORE II and the STS risk evaluation system.

The use of autologous adult, allogenic juvenile, and combined juvenile-adult cartilage fragments for the repair of chondral defects.

PubMed

Bonasia, Davide Edoardo; Martin, James A; Marmotti, Antonio; Kurriger, Gail L; Lehman, Abigail D; Rossi, Roberto; Amendola, Annunziato

2016-12-01

The goal of the study was to evaluate the repair of chondral lesions treated with combined autologous adult/allogenic juvenile cartilage fragments, compared with isolated adult and isolated juvenile cartilage fragments. Fifty-eight adult (>16 week old) and five juvenile (<6 week old) New Zealand White female rabbits were used. A large osteochondral defect was created in the center of the femoral trochlea of adult rabbits. The rabbits were divided in four groups: Group 1 = untreated defects (controls); Group 2 = adult cartilage fragments; Group 3 = juvenile cartilage fragments; and Group 4 = adult + juvenile cartilage fragments. Killings were performed at 3 and 6 months. The defects were evaluated with ICRS macroscopic score, modified O'Driscoll score, and Collagen type II immunostaining. At 3 months, Group 4 performed better than Group 1, in terms of modified O'Driscoll score (p = 0.001) and Collagen type II immunostaining (p = 0.015). At 6 months, Group 4 showed higher modified O'Driscoll score (p = 0.003) and Collagen type II immunostaining score (p < 0.001) than Group 1. Histologically, also Group 3 performed better than Group 1 (p = 0.03), and Group 4 performed better than Group 2 (p = 0.004). Mixing adult and juvenile cartilage fragments improved cartilage repair in a rabbit model. In the clinical setting, a new "one-stage" procedure combining the two cartilage sources can be hypothesized, with the advantages of improved chondral repair and large defect coverage, because of the use of an off-the-shelf juvenile allograft. Further studies on larger animals and clinical trials are required to confirm these results.

Cold aortic flush and chest compressions enable good neurologic outcome after 15 mins of ventricular fibrillation in cardiac arrest in pigs.

PubMed

Janata, Andreas; Weihs, Wolfgang; Schratter, Alexandra; Bayegan, Keywan; Holzer, Michael; Frossard, Martin; Sipos, Wolfgang; Springler, Gregor; Schmidt, Peter; Sterz, Fritz; Losert, Udo M; Laggner, Anton N; Kochanek, Patrick M; Behringer, Wilhelm

2010-08-01

The induction of deep cerebral hypothermia via ice-cold saline aortic flush during prolonged ventricular fibrillation cardiac arrest, followed by hypothermic stasis and delayed resuscitation (emergency preservation and resuscitation), improved neurologic outcome after cardiac arrest in pigs, as compared to conventional resuscitation. We hypothesized that emergency preservation and resuscitation with chest compressions would further improve outcome in the same model. Prospective experimental study. University research laboratory. : Twenty-four female, large, white breed pigs (27-37 kg). Fifteen minutes of ventricular fibrillation cardiac arrest were followed by 20 mins of resuscitation with chest compressions (control, n = 8), deep cerebral hypothermia via 200 mL/kg 4 degrees C saline aortic flush and hypothermic stasis (emergency preservation and resuscitation, n = 8), and emergency preservation and resuscitation combined with chest compressions (emergency preservation and resuscitation plus chest compressions, n = 8). At 35 mins after cardiac arrest, cardiopulmonary bypass was initiated, followed by defibrillation. Mild hypothermia was continued for 20 hrs. Pigs were evaluated after 9 days using a neurologic deficit (neurologic deficit score: 100% = brain dead; 0%-10% = normal) and an overall performance category score (overall performance category score: 1 = normal; 2 = slightly handicapped; 3 = severely handicapped; 4 = comatose; 5 = dead/brain dead). Brain temperature decreased from 38.5 degrees C to 15.3 degrees C +/- 3.3 degrees C in the emergency preservation and resuscitation group, and to 11.3 degrees C +/- 1.2 degrees C in the emergency preservation and resuscitation plus chest compressions group. In the control group, restoration of spontaneous circulation was achieved in four out of eight pigs, and one survived to 9 days. In the emergency preservation and resuscitation group, restoration of spontaneous circulation was achieved in seven out of eight pigs and five survived; in the emergency preservation and resuscitation plus chest compressions group, all had restoration of spontaneous circulation and seven survived (restoration of spontaneous circulation, p = .08). Neurologic outcome for (median and interquartile range) the control group included overall performance category score of 3, neurologic deficit score of 45%; for the emergency preservation and resuscitation group, overall performance category score was 3 (2-5) and neurologic deficit score was 45% (36; 50) and in the emergency preservation and resuscitation plus chest compressions group, overall performance category score was 2 (1-3) and neurologic deficit score was 13% (5; 21) (overall performance category score, p = .04; neurologic deficit score emergency preservation and resuscitation vs. emergency preservation and resuscitation plus chest compressions, p = .003). Emergency preservation and resuscitation by deep cerebral hypothermia combined with chest compressions during prolonged cardiac arrest in pigs are feasible and improve neurologic outcome.

Effect of height on motor coordination in college students participating in a dancesport program.

PubMed

Li, Xiaoxin; Wang, Huazhuo; Yang, Yaohua; Qi, Chunying; Wang, Fei; Jin, Man

2015-03-01

Athlete screening tools combine measures of physical performance and morphometric parameters unique to each sport. Given the increasing competitiveness of dancesport, we designed the present quasi-experimental study to analyze the relationship between body height and motor coordination in college students. Six hundred eighty-six students were randomly selected to participate in a dancing sport program that consisted of 16 weeks (32 hrs) of training. The program included an assessment of basic skills (rhythm, movement specificity, intensity, expressive force, and action coherence) and skills related to a doubles dance routine. Male and female students were divided into four single-sex groups based on their heights (each group had a 5-cm range), and the average scores for each performance indicator were analyzed. A one-way ANOVA revealed significant differences in performance scores for each indicator of basic skills and double routine skills between the different height groups. Male in the 175-179 cm group and female students in the 165-169 cm group had the best performance scores on each indicator, while the shortest students had the worst performance scores. The height of students participating in sport dancing training had an impact on dancesport performance and motor coordination, counter to the traditional belief that shorter people have better coordination.

Development and validation of a composite scoring system for robot-assisted surgical training--the Robotic Skills Assessment Score.

PubMed

Chowriappa, Ashirwad J; Shi, Yi; Raza, Syed Johar; Ahmed, Kamran; Stegemann, Andrew; Wilding, Gregory; Kaouk, Jihad; Peabody, James O; Menon, Mani; Hassett, James M; Kesavadas, Thenkurussi; Guru, Khurshid A

2013-12-01

A standardized scoring system does not exist in virtual reality-based assessment metrics to describe safe and crucial surgical skills in robot-assisted surgery. This study aims to develop an assessment score along with its construct validation. All subjects performed key tasks on previously validated Fundamental Skills of Robotic Surgery curriculum, which were recorded, and metrics were stored. After an expert consensus for the purpose of content validation (Delphi), critical safety determining procedural steps were identified from the Fundamental Skills of Robotic Surgery curriculum and a hierarchical task decomposition of multiple parameters using a variety of metrics was used to develop Robotic Skills Assessment Score (RSA-Score). Robotic Skills Assessment mainly focuses on safety in operative field, critical error, economy, bimanual dexterity, and time. Following, the RSA-Score was further evaluated for construct validation and feasibility. Spearman correlation tests performed between tasks using the RSA-Scores indicate no cross correlation. Wilcoxon rank sum tests were performed between the two groups. The proposed RSA-Score was evaluated on non-robotic surgeons (n = 15) and on expert-robotic surgeons (n = 12). The expert group demonstrated significantly better performance on all four tasks in comparison to the novice group. Validation of the RSA-Score in this study was carried out on the Robotic Surgical Simulator. The RSA-Score is a valid scoring system that could be incorporated in any virtual reality-based surgical simulator to achieve standardized assessment of fundamental surgical tents during robot-assisted surgery. Copyright © 2013 Elsevier Inc. All rights reserved.

The Gachon University Ureteral Narrowing score: A comprehensive standardized system for predicting necessity of ureteral dilatation to treat proximal ureteral calculi.

PubMed

Lee, Seung Kyu; Kim, Tae Beom; Ko, Kwang-Pil; Kim, Chang Hee; Kim, Kwang Taek; Chung, Kyung Jin; Kim, Khae Hawn; Jung, Han; Yoon, Sang Jin; Oh, Jin Kyu

2016-07-01

For treating proximal ureteral calculi, treatment decision has been known still difficult to choose ureteroscopic lithotripsy (URS) or shockwave lithotripsy. The aims of our study are to identify the possible predictors for necessity of URS and to propose the Gachon University Ureteral Narrowing scoring system (GUUN score) as a helpful predictor. We evaluated 83 consecutive patients who underwent semirigid URS due to proximal ureteral calculi between April 2011 and February 2014 by a single surgeon. We reviewed patient characteristics and pre- and postoperative parameters and surgical records. We divided the patients into 2 groups (group 1, nondilation group; group 2, dilation group) according to whether or not balloon dilation was performed. A stepwise logistic regression was performed to identify the factors that predict dilatation. Receiver operating characteristic (ROC) curves were plotted and areas under the ROC curve (AUC) were calculated to GUUN score. Mean patients' age and their stone size were 48.53±12.90 years and 7.79±2.57 cm, respectively. Significantly smaller stone size (p=0.009), lower stone density (p=0.005), and lower ureteral density differences between ureteral narrowing level and far distal ureter (UD) (p<0.001) were observed in group 1 (n=34) than in group 2 (n=49). GUUN score consists of age, stone size and UD (AUC, 0.938). Overall stone-free clearance rate was 85.5%. We suggest that the GUUN score is an excellent scoring system to predict the necessity of ureteral dilatation for decision making whether or not to perform surgical manipulation.

Effect of Computer-Assisted Learning on Students' Dental Anatomy Waxing Performance.

PubMed

Kwon, So Ran; Hernández, Marcela; Blanchette, Derek R; Lam, Matthew T; Gratton, David G; Aquilino, Steven A

2015-09-01

The aim of this study was to evaluate the impact of computer-assisted learning on first-year dental students' waxing abilities and self-evaluation skills. Additionally, this study sought to determine how well digital evaluation software performed compared to faculty grading with respect to students' technical scores on a practical competency examination. First-year students at one U.S. dental school were assigned to one of three groups: control (n=40), E4D Compare (n=20), and Sirona prepCheck (n=19). Students in the control group were taught by traditional teaching methodologies, and the technology-assisted groups received both traditional training and supplementary feedback from the corresponding digital system. Five outcomes were measured: visual assessment score, self-evaluation score, and digital assessment scores at 0.25 mm, 0.30 mm, and 0.35 mm tolerance. The scores from visual assessment and self-evaluation were examined for differences among groups using the Kruskal-Wallis test. Correlation between the visual assessment and digital scores was measured using Pearson and Spearman rank correlation coefficients. At completion of the course, students were asked to complete a survey on the use of these digital technologies. All 79 students in the first-year class participated in the study, for a 100% response rate. The results showed that the visual assessment and self-evaluation scores did not differ among groups (p>0.05). Overall correlations between visual and digital assessment scores were modest though statistically significant (5% level of significance). Analysis of survey responses completed by students in the technology groups showed that profiles for the two groups were similar and not favorable towards digital technology. The study concluded that technology-assisted training did not affect these students' waxing performance or self-evaluation skills and that visual scores given by faculty and digital assessment scores correlated moderately.

Does theory of mind performance differ in children with early-onset and regressive autism?

PubMed

Matthews, Nicole L; Goldberg, Wendy A; Lukowski, Angela F; Osann, Kathryn; Abdullah, Maryam M; Ly, Agnes R; Thorsen, Kara; Spence, M Anne

2012-01-01

A deficit in theory of mind (ToM), or the ability to infer the mental states of others, has been implicated as one of the major characteristics of Autism Spectrum Disorder (ASD); however, little attention has been devoted to possible differences in ToM ability within ASD. The current study examined ToM performance in children with early-onset autism and regressive autism in comparison to typically developing children. Results indicated that children in the regressive autism group performed significantly better than the early-onset autism group on the non-verbal appearance-reality task. Additionally, Fisher's exact tests indicated a pattern of lowest scores in the early-onset group and highest scores in the typically developing group, whereas the regressive autism group tended to score in between the early-onset and typically developing groups. The apparent heterogeneity in ToM performance within ASD could account for the lack of universality in ToM ability found in previous studies. © 2011 Blackwell Publishing Ltd.

HEART score performance in Asian and Caucasian patients presenting to the emergency department with suspected acute coronary syndrome.

PubMed

de Hoog, Vince C; Lim, Swee Han; Bank, Ingrid Em; Gijsberts, Crystel M; Ibrahim, Irwani B; Kuan, Win Sen; Ooi, Shirley Bs; Chua, Terrance Sj; Tai, E Shyong; Gao, Fei; Pasterkamp, Gerard; den Ruijter, Hester M; Doevendans, Pieter A; Wildbergh, Thierry X; Mosterd, Arend; Richards, A Mark; de Kleijn, Dominique Pv; Timmers, Leo

2017-03-01

The HEART score is a simple and effective tool to predict short-term major adverse cardiovascular events in patients suspected of acute coronary syndrome. Patients are assigned to three risk categories using History, ECG, Age, Risk factors and Troponin (HEART). The purpose is early rule out and discharge is considered safe for patients in the low risk category. Its performance in patients of Asian ethnicity is unknown. We evaluated the performance of the HEART score in patients of Caucasian, Chinese, Indian and Malay ethnicity. The HEART score was assessed retrospectively in 3456 patients presenting to the emergency department with suspected acute coronary syndrome (1791 Caucasians, 1059 Chinese, 344 Indians, 262 Malays), assigning them into three risk categories. The incidence of major adverse cardiovascular events within six weeks after presentation was similar between the ethnic groups. A smaller proportion of Caucasians was in the low risk category compared with Asians (Caucasians 35.8%, Chinese 43.5%, Indians 45.3%, Malays 44.7%, p<0.001). The negative predictive value of a low HEART score was comparable across the ethnic groups, but lower than previously reported (Caucasians 95.3%, Chinese 95.0%, Indians 96.2%, Malays 96.6%). Also the c-statistic for the HEART score was not significantly different between the groups. These results show that the overall performance of the HEART score is equal among Caucasian and Asian ethnic groups. The event rate in the low risk group, however, was higher than reported in previous studies, which queries the safety of early discharge of patients in the low risk category.

Estimation of premorbid general fluid intelligence using traditional Chinese reading performance in Taiwanese samples.

PubMed

Chen, Ying-Jen; Ho, Meng-Yang; Chen, Kwan-Ju; Hsu, Chia-Fen; Ryu, Shan-Jin

2009-08-01

The aims of the present study were to (i) investigate if traditional Chinese word reading ability can be used for estimating premorbid general intelligence; and (ii) to provide multiple regression equations for estimating premorbid performance on Raven's Standard Progressive Matrices (RSPM), using age, years of education and Chinese Graded Word Reading Test (CGWRT) scores as predictor variables. Four hundred and twenty-six healthy volunteers (201 male, 225 female), aged 16-93 years (mean +/- SD, 41.92 +/- 18.19 years) undertook the tests individually under supervised conditions. Seventy percent of subjects were randomly allocated to the derivation group (n = 296), and the rest to the validation group (n = 130). RSPM score was positively correlated with CGWRT score and years of education. RSPM and CGWRT scores and years of education were also inversely correlated with age, but the declining trend for RSPM performance against age was steeper than that for CGWRT performance. Separate multiple regression equations were derived for estimating RSPM scores using different combinations of age, years of education, and CGWRT score for both groups. The multiple regression coefficient of each equation ranged from 0.71 to 0.80 with the standard error of estimate between 7 and 8 RSPM points. When fitting the data of one group to the equations derived from its counterpart group, the cross-validation multiple regression coefficients ranged from 0.71 to 0.79. There were no significant differences in the 'predicted-obtained' RSPM discrepancies between any equations. The regression equations derived in the present study may provide a basis for estimating premorbid RSPM performance.

The efficiency of different irrigation solutions and techniques for the removal of triple antibiotic paste from simulated immature root canals.

PubMed

Ustun, Y; Düzgün, S; Aslan, T; Aktı, A

2018-03-01

The purpose of this study was to evaluate the efficiencies of different irrigation protocols in the removal of triple antibiotic paste (TAP) from root canals. A total of 127 extracted human maxillary incisor teeth were prepared. Then, root-end resection of 3 mm was accomplished to simulate immature apex model. The root canals were filled with TAP, after 21 days, randomly divided into nine groups according to irrigation systems and solutions (n = 13). Conventional irrigation (CI) groups - Group 1: Root canal irrigation was performed with CI by Peracetic acid (PAA) solution, Group 2: Root canal irrigation was performed with CI by etidronic acid 1-hydroxyethylidene-1, 1-bisphosphonate (HEBP) + sodium hypochlorite (NaOCl) solution, Group 3: Root canal irrigation was performed with CI by ethylenediaminetetraacetic acid (EDTA)/NaOCl solutions. Vibringe system groups - Group 4: Root canal irrigation was performed with Vibringe system by PAA solution, Group 5: Root canal irrigation was performed with Vibringe system by HEBP + NaOCl solution, Group 6: Root canal irrigation was performed with Vibringe system by EDTA/NaOCl solution. EndoVac system groups - Group 7: Root canal irrigation was performed with EndoVac system by PAA solution, Group 8: Root canal irrigation was performed with EndoVac system by HEBP + NaOCl solution, Group 9: Root canal irrigation was performed with EndoVac system by EDTA/NaOCl solution. Control Group: (n = 0). Samples were sectioned vertically, and the amount of remaining medicament was scored for each root half and data were statistically analyzed. Among the irrigation systems, CI groups showed the highest scores at both apical and coronal parts (P < 0.05). In comparisons among the solutions, at the apical part, PAA groups showed the highest scores (P < 0.05). At the coronal part, EDTA + NaOCl groups showed the lowest score values (P < 0.05). The use of irrigation systems improved the removal of TAP from the simulated immature root canals. Also, as an irrigation solution EDTA gives more promising results than PAA and HEBP solutions.

Does Ultrasound-Enhanced Instruction of Musculoskeletal Anatomy Improve Physical Examination Skills of First-Year Medical Students?

PubMed

Walrod, Bryant J; Schroeder, Allison; Conroy, Mark J; Boucher, Laura C; Bockbrader, Marcia; Way, David P; McCamey, Kendra L; Hartz, Clinton A; Jonesco, Michael A; Bahner, David P

2018-01-01

Ultrasound imaging is commonly used to teach basic anatomy to medical students. The purpose of this study was to determine whether learning musculoskeletal anatomy with ultrasound improved performance on medical students' musculoskeletal physical examination skills. Twenty-seven first-year medical students were randomly assigned to 1 of 2 instructional groups: either shoulder or knee. Both groups received a lecture followed by hands-on ultrasound scanning on live human models of the assigned joint. After instruction, students were assessed on their ability to accurately palpate 4 anatomic landmarks: the acromioclavicular joint, the proximal long-head biceps tendon, and the medial and lateral joint lines of the knee. Performance scores were based on both accuracy and time. A total physical examination performance score was derived for each joint. Scores for instructional groups were compared by a 2-way analysis of variance with 1 repeated measure. Significant findings were further analyzed with post hoc tests. All students performed significantly better on the knee examination, irrespective of instructional group (F = 14.9; df = 1.25; P = .001). Moreover, the shoulder instruction group performed significantly better than the knee group on the overall assessment (t = -3.0; df = 25; P < .01). Post hoc analyses revealed that differences in group performance were due to the shoulder group's higher scores on palpation of the biceps tendon (t = -2.8; df = 25; P = .01), a soft tissue landmark. Both groups performed similarly on palpation of all other anatomic structures. The use of ultrasound appears to provide an educational advantage when learning musculoskeletal physical examination of soft tissue landmarks. © 2017 by the American Institute of Ultrasound in Medicine.

[Equating scores using bridging stations on the clinical performance examination].

PubMed

Yoo, Dong-Mi; Han, Jae-Jin

2013-06-01

This study examined the use of the Tucker linear equating method in producing an individual student's score in 3 groups with bridging stations over 3 consecutive days of the clinical performance examination (CPX) and compared the differences in scoring patterns by bridging number. Data were drawn from 88 examinees from 3 different CPX groups-DAY1, DAY2, and DAY3-each of which comprised of 6 stations. Each group had 3 common stations, and each group had 2 or 3 stations that differed from other groups. DAY1 and DAY3 were equated to DAY2. Equated mean scores and standard deviations were compared with the originals. DAY1 and DAY3 were equated again, and the differences in scores (equated score-raw score) were compared between the 3 sets of equated scores. By equating to DAY2, DAY1 decreased in mean score from 58.188 to 56.549 and in standard deviation from 4.991 to 5.046, and DAY3 fell in mean score from 58.351 to 58.057 and in standard deviation from 5.546 to 5.856, which demonstrates that the scores of examinees in DAY1 and DAY2 were accentuated after use of the equation. The patterns in score differences between the equated sets to DAY1, DAY2, and DAY3 yielded information on the soundness of the equating results from individual and overall comparisons. To generate equated scores between 3 groups on 3 consecutive days of the CPX, we applied the Tucker linear equating method. We also present a method of equating reciprocal days to the anchoring day as much as bridging stations.

Lifetime Occupation and Late-Life Cognitive Performance Among Women.

PubMed

Ribeiro, Pricila Cristina Correa; Lourenço, Roberto Alves

2015-01-01

We examined whether women who had regular jobs throughout life performed better cognitively than older adult housewives. Linear regression was used to compare global cognitive performance scores of housewives (G1) and women exposed to work of low (G2) and high (G3) complexity. The sample comprised 477 older adult Brazilian women, 430 (90.4%) of whom had performed lifelong jobs. In work with data, the G2 group's cognitive performance scores were 1.73 points higher (p =.03), and the G3 group scored 1.76 points (p =.02) higher, than the G1. In work with things and with people, the G3 scored, respectively, 2.04 (p <.01) and 2.21 (p <.01) cognitive test points higher than the G1. Based on our findings we suggest occupation of greater complexity is associated with better cognitive performance in women later in life.

Effect of protected research time on ABSITE scores during general surgery residency.

PubMed

Orkin, Bruce A; Poirier, Jennifer; Kowal-Vern, Areta; Chan, Edie; Ohara, Karen; Mendoza, Brian

2018-02-01

Objective - To determine whether residents with one or more years of dedicated research time (Research Residents, RR) improved their ABSITE scores compared to those without (Non-Research Residents, N-RR). A retrospective review of general surgery residents' ABSITE scores from 1995 to 2016 was performed. RR were compared to N-RR. Additional analysis of At Risk (AR) v Not At Risk residents (NAR) (35th percentile as PGY1-2) was also performed. Cohort - 147 residents (34 RR and 113 N-RR). There were no differences in initial ABSITE scores (p = 0.47). By definition, the AR group had lower scores than NAR. Overall, post-research RR v PGY-4 N-RR scores did not differ (p = 0.84). Only the AR residents improved their scores (p = 0.0009 v NAR p = 0.42), regardless of research group (p = 0.70). Protected research time did not improve residents' ABSITE scores, regardless of initial scores. At Risk residents improved regardless of research group status. Copyright © 2017 Elsevier Inc. All rights reserved.

Evaluating the complementary roles of an SJT and academic assessment for entry into clinical practice.

PubMed

Cousans, Fran; Patterson, Fiona; Edwards, Helena; Walker, Kim; McLachlan, John C; Good, David

2017-05-01

Although there is extensive evidence confirming the predictive validity of situational judgement tests (SJTs) in medical education, there remains a shortage of evidence for their predictive validity for performance of postgraduate trainees in their first role in clinical practice. Moreover, to date few researchers have empirically examined the complementary roles of academic and non-academic selection methods in predicting in-role performance. This is an important area of enquiry as despite it being common practice to use both types of methods within a selection system, there is currently no evidence that this approach translates into increased predictive validity of the selection system as a whole, over that achieved by the use of a single selection method. In this preliminary study, the majority of the range of scores achieved by successful applicants to the UK Foundation Programme provided a unique opportunity to address both of these areas of enquiry. Sampling targeted high (>80th percentile) and low (<20th percentile) scorers on the SJT. Supervisors rated 391 trainees' in-role performance, and incidence of remedial action was collected. SJT and academic performance scores correlated with supervisor ratings (r = .31 and .28, respectively). The relationship was stronger between the SJT and in-role performance for the low scoring group (r = .33, high scoring group r = .11), and between academic performance and in-role performance for the high scoring group (r = .29, low scoring group r = .11). Trainees with low SJT scores were almost five times more likely to receive remedial action. Results indicate that an SJT for entry into trainee physicians' first role in clinical practice has good predictive validity of supervisor-rated performance and incidence of remedial action. In addition, an SJT and a measure of academic performance appeared to be complementary to each other. These initial findings suggest that SJTs may be more predictive at the lower end of a scoring distribution, and academic attainment more predictive at the higher end.

The impact of hearing loss on language performance in older adults with different stages of cognitive function

PubMed Central

Lodeiro-Fernández, Leire; Lorenzo-López, Laura; Maseda, Ana; Núñez-Naveira, Laura; Rodríguez-Villamil, José Luis; Millán-Calenti, José Carlos

2015-01-01

Purpose The possible relationship between audiometric hearing thresholds and cognitive performance on language tests was analyzed in a cross-sectional cohort of older adults aged ≥65 years (N=98) with different degrees of cognitive impairment. Materials and methods Participants were distributed into two groups according to Reisberg’s Global Deterioration Scale (GDS): a normal/predementia group (GDS scores 1–3) and a moderate/moderately severe dementia group (GDS scores 4 and 5). Hearing loss (pure-tone audiometry) and receptive and production-based language function (Verbal Fluency Test, Boston Naming Test, and Token Test) were assessed. Results Results showed that the dementia group achieved significantly lower scores than the predementia group in all language tests. A moderate negative correlation between hearing loss and verbal comprehension (r=−0.298; P<0.003) was observed in the predementia group (r=−0.363; P<0.007). However, no significant relationship between hearing loss and verbal fluency and naming scores was observed, regardless of cognitive impairment. Conclusion In the predementia group, reduced hearing level partially explains comprehension performance but not language production. In the dementia group, hearing loss cannot be considered as an explanatory factor of poor receptive and production-based language performance. These results are suggestive of cognitive rather than simply auditory problems to explain the language impairment in the elderly. PMID:25914528

The Effects of Phonological Short-Term Memory and Speech Perception on Spoken Sentence Comprehension in Children: Simulating Deficits in an Experimental Design.

PubMed

Higgins, Meaghan C; Penney, Sarah B; Robertson, Erin K

2017-10-01

The roles of phonological short-term memory (pSTM) and speech perception in spoken sentence comprehension were examined in an experimental design. Deficits in pSTM and speech perception were simulated through task demands while typically-developing children (N [Formula: see text] 71) completed a sentence-picture matching task. Children performed the control, simulated pSTM deficit, simulated speech perception deficit, or simulated double deficit condition. On long sentences, the double deficit group had lower scores than the control and speech perception deficit groups, and the pSTM deficit group had lower scores than the control group and marginally lower scores than the speech perception deficit group. The pSTM and speech perception groups performed similarly to groups with real deficits in these areas, who completed the control condition. Overall, scores were lowest on noncanonical long sentences. Results show pSTM has a greater effect than speech perception on sentence comprehension, at least in the tasks employed here.

The use and evaluation of study guides with middle school students1

PubMed Central

Farnum, Marlene; Brigham, Thomas A.

1978-01-01

Two experiments were conducted with 24 fifth-grade students participating. In the first experiment, quiz performance with study guides was compared to quiz performance without study guides. The group whose students received study guides always scored higher than the group who did not receive study guides. Experiment II assessed the feasibility of students scoring their own study guides. The reliability of student scoring was found to be 93% over all study guides and there were no significant differences between “self-scored” and “teacher-scored” groups on the weekly quizzes. PMID:16795579

Twelve-Week Exercise Influences Memory Complaint but not Memory Performance in Older Adults: A Randomized Controlled Study.

PubMed

Iuliano, Enzo; Fiorilli, Giovanni; Aquino, Giovanna; Di Costanzo, Alfonso; Calcagno, Giuseppe; di Cagno, Alessandra

2017-10-01

This study aimed to evaluate the effects of different types of exercise on memory performance and memory complaint after a 12-week intervention. Eighty community-dwelling volunteers, aged 66.96 ± 11.73 years, were randomly divided into four groups: resistance, cardiovascular, postural, and control groups (20 participants for each group). All participants were tested for their cognitive functions before and after their respective 12-week intervention using Rey memory words test, Prose memory test, and Memory Complaint Questionnaire (MAC-Q). Statistical analysis showed that the three experimental groups significantly improved MAC-Q scores in comparison with the control group (p < .05). The variation of MAC-Q scores and the variations of Rey and Prose memory tests scores were not correlated. These results indicate that the 12-week interventions exclusively influenced memory complaint but not memory performance. Further investigations are needed to understand the relation between memory complaint and memory performance, and the factors that can influence this relationship.

Do attitudes toward exercise vary with differences in mobility and disability status? - a study among low-income seniors.

PubMed

Bean, Jonathan F; Bailey, Allison; Kiely, Dan K; Leveille, Suzanne G

2007-08-15

To examine attitudes toward exercise among a vulnerable aged population characterized by low socioeconomic status, poor functional status and lack of available therapeutic exercise resources. This cross-sectional survey among public low-income housing residents (n = 94), aged > 70 years utilizes these assessments: Physician-based Assessment & Counseling for Exercise (PACE) scale, exercise self-efficacy score, Short Physical Performance Battery (SPPB), Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) scales. Readiness to exercise differed significantly (p < 0.001) across physical performance levels, and ADL and IADL groups. Exercise self-efficacy also differed significantly (p < 0.001) across performance levels. The highest performance level (score 7 - 12) had a significantly (p < 0.05) higher self-efficacy score (x=7.0+/-2.8) than the medium performance level (score 4 - 6) (x=5.3+/-2.8) and the lowest performance level (0 - 3) (x=4.3+/-2.5) groups. Exercise self-efficacy also differed significantly (p < 0.001) across ADL and IADL groups. However, interest in home-based or class-based exercise participation was high among all groups. More than 70% of subjects reported interest with no significant difference noted among groups. Attitudes toward exercise are significantly associated with observed physical function and self-reported disability among vulnerable older adults living in public low-income housing.

Predicting preference-based SF-6D index scores from the SF-8 health survey.

PubMed

Wang, P; Fu, A Z; Wee, H L; Lee, J; Tai, E S; Thumboo, J; Luo, N

2013-09-01

To develop and test functions for predicting the preference-based SF-6D index scores from the SF-8 health survey. This study was a secondary analysis of data collected in a population health survey in which respondents (n = 7,529) completed both the SF-36 and the SF-8 questionnaires. We examined seven ordinary least-square estimators for their performance in predicting SF-6D scores from the SF-8 at both the individual and the group levels. In general, all functions performed similarly well in predicting SF-6D scores, and the predictions at the group level were better than predictions at the individual level. At the individual level, 42.5-51.5% of prediction errors were smaller than the minimally important difference (MID) of the SF-6D scores, depending on the function specifications, while almost all prediction errors of the tested functions were smaller than the MID of SF-6D at the group level. At both individual and group levels, the tested functions predicted lower than actual scores at the higher end of the SF-6D scale. Our study developed functions to generate preference-based SF-6D index scores from the SF-8 health survey, the first of its kind. Further research is needed to evaluate the performance and validity of the prediction functions.

Effects of script-based role play in cardiopulmonary resuscitation team training.

PubMed

Chung, Sung Phil; Cho, Junho; Park, Yoo Seok; Kang, Hyung Goo; Kim, Chan Woong; Song, Keun Jeong; Lim, Hoon; Cho, Gyu Chong

2011-08-01

The purpose of this study is to compare the cardiopulmonary resuscitation (CPR) team dynamics and performance between a conventional simulation training group and a script-based training group. This was a prospective randomised controlled trial of educational intervention for CPR team training. Fourteen teams, each consisting of five members, were recruited. The conventional group (C) received training using a didactic lecture and simulation with debriefing, while the script group (S) received training using a resuscitation script. The team activity was evaluated with checklists both before and after 1 week of training. The videotaped simulated resuscitation events were compared in terms of team dynamics and performance aspects. Both groups showed significantly higher leadership scores after training (C: 58.2 ± 9.2 vs. 67.2 ± 9.5, p=0.007; S: 57.9 ± 8.1 vs. 65.4 ± 12.1, p=0.034). However, there were no significant improvements in performance scores in either group after training. There were no differences in the score improvement after training between the two groups in dynamics (C: 9.1 ± 12.6 vs. S: 7.4 ± 13.7, p=0.715), performance (C: 5.5 ± 11.4 vs. S: 4.7 ± 9.6, p=0.838) and total scores (C: 14.6 ± 20.1 vs. S: 12.2 ± 19.5, p=0.726). Script-based CPR team training resulted in comparable improvements in team dynamics scores compared with conventional simulation training. Resuscitation scripts may be used as an adjunct for CPR team training.

Selection and study performance: comparing three admission processes within one medical school.

PubMed

Schripsema, Nienke R; van Trigt, Anke M; Borleffs, Jan C C; Cohen-Schotanus, Janke

2014-12-01

This study was conducted to: (i) analyse whether students admitted to one medical school based on top pre-university grades, a voluntary multifaceted selection process, or lottery, respectively, differed in study performance; (ii) examine whether students who were accepted in the multifaceted selection process outperformed their rejected peers, and (iii) analyse whether participation in the multifaceted selection procedure was related to performance. We examined knowledge test and professionalism scores, study progress and dropout in three cohorts of medical students admitted to the University of Groningen, the Netherlands in 2009, 2010 and 2011 (n = 1055). We divided the lottery-admitted group into, respectively, students who had not participated and students who had been rejected in the multifaceted selection process. We used ancova modelling, logistic regression and Bonferroni post hoc multiple-comparison tests and controlled for gender and cohort. The top pre-university grade group achieved higher knowledge test scores and more Year 1 course credits than all other groups (p < 0.05). This group received the highest possible professionalism score more often than the lottery-admitted group that had not participated in the multifaceted selection process (p < 0.05). The group of students accepted in the multifaceted selection process obtained higher written test scores than the lottery-admitted group that had not participated (p < 0.05) and achieved the highest possible professionalism score more often than both lottery-admitted groups. The lottery-admitted group that had not participated in the multifaceted selection process earned fewer Year 1 and 2 course credits than all other groups (p < 0.05). Dropout rates differed among the groups (p < 0.05), but correction for multiple comparisons rendered all pairwise differences non-significant. A top pre-university grade point average was the best predictor of performance. For so-called non-academic performance, the multifaceted selection process was efficient in identifying applicants with suitable skills. Participation in the multifaceted selection procedure seems to be predictive of higher performance. Further research is needed to assess whether our results are generalisable to other medical schools. © 2014 John Wiley & Sons Ltd.

Business Statistics: A Comparison of Student Performance in Three Learning Modes

ERIC Educational Resources Information Center

Simmons, Gerald R.

2014-01-01

The purpose of this study was to compare the performance of three teaching modes and age groups of business statistics sections in terms of course exam scores. The research questions were formulated to determine the performance of the students within each teaching mode, to compare each mode in terms of exam scores, and to compare exam scores by…

Comparing the functional performance of children and youths with autism, developmental disabilities, and no disability using the revised pediatric evaluation of disability inventory item banks.

PubMed

Kao, Ying-Chia; Kramer, Jessica M; Liljenquist, Kendra; Tian, Feng; Coster, Wendy J

2012-01-01

OBJECTIVE. We compared the functional performance of children with autism spectrum disorders (ASD), intellectual and developmental disabilities (IDD), and without disabilities using the revised Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT) Social/Cognitive, Daily Activities, and Responsibility domains. METHOD. A nationally representative sample of parents of children ages 0-21 without disabilities (n = 2,205), with ASD (n = 108), or with IDD (n = 150) completed an online survey. We obtained predicted PEDI-CAT scaled scores for three reference ages (5, 10, 15) from a modified analysis of covariance model and compared each group's scores using contrasts of the regression parameters. RESULTS. We found no significant differences between the ASD and IDD groups. The group with ASD demonstrated significantly lower performance than the group without disabilities across the three domains at ages 10 and 15. CONCLUSION. Scores on the PEDI-CAT differentiated the group with ASD from the group without disabilities. Children with ASD and IDD did not demonstrate different performance profiles. Copyright © 2012 by the American Occupational Therapy Association, Inc.

Spectral Entropy Can Predict Changes of Working Memory Performance Reduced by Short-Time Training in the Delayed-Match-to-Sample Task

PubMed Central

Tian, Yin; Zhang, Huiling; Xu, Wei; Zhang, Haiyong; Yang, Li; Zheng, Shuxing; Shi, Yupan

2017-01-01

Spectral entropy, which was generated by applying the Shannon entropy concept to the power distribution of the Fourier-transformed electroencephalograph (EEG), was utilized to measure the uniformity of power spectral density underlying EEG when subjects performed the working memory tasks twice, i.e., before and after training. According to Signed Residual Time (SRT) scores based on response speed and accuracy trade-off, 20 subjects were divided into two groups, namely high-performance and low-performance groups, to undertake working memory (WM) tasks. We found that spectral entropy derived from the retention period of WM on channel FC4 exhibited a high correlation with SRT scores. To this end, spectral entropy was used in support vector machine classifier with linear kernel to differentiate these two groups. Receiver operating characteristics analysis and leave-one out cross-validation (LOOCV) demonstrated that the averaged classification accuracy (CA) was 90.0 and 92.5% for intra-session and inter-session, respectively, indicating that spectral entropy could be used to distinguish these two different WM performance groups successfully. Furthermore, the support vector regression prediction model with radial basis function kernel and the root-mean-square error of prediction revealed that spectral entropy could be utilized to predict SRT scores on individual WM performance. After testing the changes in SRT scores and spectral entropy for each subject by short-time training, we found that 16 in 20 subjects’ SRT scores were clearly promoted after training and 15 in 20 subjects’ SRT scores showed consistent changes with spectral entropy before and after training. The findings revealed that spectral entropy could be a promising indicator to predict individual’s WM changes by training and further provide a novel application about WM for brain–computer interfaces. PMID:28912701

Clinical competency evaluation of Brazilian chiropractic interns

PubMed Central

Facchinato, Ana Paula A.; Benedicto, Camila C.; Mora, Aline G.; Cabral, Dayane M.C.; Fagundes, Djalma J.

2015-01-01

Objective This study compares the results of an objective structured clinical examination (OSCE) between 2 groups of students before an internship and after 6 months of clinical practice in an internship. Methods Seventy-two students participated, with 36 students in each cohort. The OSCEs were performed in the simulation laboratory before the participants' clinical practice internship and after 6 months of the internship. Students were tested in 9 stations for clinical skills and knowledge. The same procedures were repeated for both cohorts. The t test was used for unpaired parametric samples and Fisher's exact test was used for comparison of proportions. Results There was no difference in the mean final score between the 2 groups (p = .34 for test 1; p = .08 for test 2). The performance of the students in group 1 was not significantly different when performed before and after 6 months of clinical practice, but in group 2 there was a significant decrease in the average score after 6 months of clinical practice. Conclusions There was no difference in the cumulative average score for the 2 groups before and after 6 months of clinical practice in the internship. There were differences within the cohorts, however, with a significant decrease in the average score in group 2. Issues pertaining to test standardization and student motivation for test 2 may have influenced the scores. PMID:25588200

Comparison of virtual patient simulation with mannequin-based simulation for improving clinical performances in assessing and managing clinical deterioration: randomized controlled trial.

PubMed

Liaw, Sok Ying; Chan, Sally Wai-Chi; Chen, Fun-Gee; Hooi, Shing Chuan; Siau, Chiang

2014-09-17

Virtual patient simulation has grown substantially in health care education. A virtual patient simulation was developed as a refresher training course to reinforce nursing clinical performance in assessing and managing deteriorating patients. The objective of this study was to describe the development of the virtual patient simulation and evaluate its efficacy, by comparing with a conventional mannequin-based simulation, for improving the nursing students' performances in assessing and managing patients with clinical deterioration. A randomized controlled study was conducted with 57 third-year nursing students who were recruited through email. After a baseline evaluation of all participants' clinical performance in a simulated environment, the experimental group received a 2-hour fully automated virtual patient simulation while the control group received 2-hour facilitator-led mannequin-based simulation training. All participants were then re-tested one day (first posttest) and 2.5 months (second posttest) after the intervention. The participants from the experimental group completed a survey to evaluate their learning experiences with the newly developed virtual patient simulation. Compared to their baseline scores, both experimental and control groups demonstrated significant improvements (P<.001) in first and second post-test scores. While the experimental group had significantly lower (P<.05) second post-test scores compared with the first post-test scores, no significant difference (P=.94) was found between these two scores for the control group. The scores between groups did not differ significantly over time (P=.17). The virtual patient simulation was rated positively. A virtual patient simulation for a refreshing training course on assessing and managing clinical deterioration was developed. Although the randomized controlled study did not show that the virtual patient simulation was superior to mannequin-based simulation, both simulations have demonstrated to be effective refresher learning strategies for improving nursing students' clinical performance. Given the greater resource requirements of mannequin-based simulation, the virtual patient simulation provides a more promising alternative learning strategy to mitigate the decay of clinical performance over time.

Virtual reality cataract surgery training: learning curves and concurrent validity.

PubMed

Selvander, Madeleine; Åsman, Peter

2012-08-01

To investigate initial learning curves on a virtual reality (VR) eye surgery simulator and whether achieved skills are transferable between tasks. Thirty-five medical students were randomized to complete ten iterations on either the VR Caspulorhexis module (group A) or the Cataract navigation training module (group B) and then two iterations on the other module. Learning curves were compared between groups. The second Capsulorhexis video was saved and evaluated with the performance rating tool Objective Structured Assessment of Cataract Surgical Skill (OSACSS). The students' stereoacuity was examined. Both groups demonstrated significant improvements in performance over the 10 iterations: group A for all parameters analysed including score (p < 0.0001), time (p < 0.0001) and corneal damage (p = 0.0003), group B for time (p < 0.0001), corneal damage (p < 0.0001) but not for score (p = 0.752). Training on one module did not improve performance on the other. Capsulorhexis score correlated significantly with evaluation of the videos using the OSACSS performance rating tool. For stereoacuity < and ≥120 seconds of arc, sum of both modules' second iteration score was 73.5 and 41.0, respectively (p = 0.062). An initial rapid improvement in performance on a simulator with repeated practice was shown. For capsulorhexis, 10 iterations with only simulator feedback are not enough to reach a plateau for overall score. Skills transfer between modules was not found suggesting benefits from training on both modules. Stereoacuity may be of importance in the recruitment and training of new cataract surgeons. Additional studies are needed to investigate this further. Concurrent validity was found for Capsulorhexis module. © 2010 The Authors. Acta Ophthalmologica © 2010 Acta Ophthalmologica Scandinavica Foundation.

The effects of using high-fidelity simulators and standardized patients on the thorax, lung, and cardiac examination skills of undergraduate nursing students.

PubMed

Tuzer, Hilal; Dinc, Leyla; Elcin, Melih

2016-10-01

Existing research literature indicates that the use of various simulation techniques in the training of physical examination skills develops students' cognitive and psychomotor abilities in a realistic learning environment while improving patient safety. The study aimed to compare the effects of the use of a high-fidelity simulator and standardized patients on the knowledge and skills of students conducting thorax-lungs and cardiac examinations, and to explore the students' views and learning experiences. A mixed-method explanatory sequential design. The study was conducted in the Simulation Laboratory of a Nursing School, the Training Center at the Faculty of Medicine, and in the inpatient clinics of the Education and Research Hospital. Fifty-two fourth-year nursing students. Students were randomly assigned to Group I and Group II. The students in Group 1 attended the thorax-lungs and cardiac examination training using a high-fidelity simulator, while the students in Group 2 using standardized patients. After the training sessions, all students practiced their skills on real patients in the clinical setting under the supervision of the investigator. Knowledge and performance scores of all students increased following the simulation activities; however, the students that worked with standardized patients achieved significantly higher knowledge scores than those that worked with the high-fidelity simulator; however, there was no significant difference in performance scores between the groups. The mean performance scores of students on real patients were significantly higher compared to the post-simulation assessment scores (p<0.001). Results of this study revealed that use of standardized patients was more effective than the use of a high-fidelity simulator in increasing the knowledge scores of students on thorax-lungs and cardiac examinations; however, practice on real patients increased performance scores of all students without any significant difference in two groups. Copyright © 2016 Elsevier Ltd. All rights reserved.

Fine-motor skills testing and prediction of endovascular performance.

PubMed

Bech, Bo; Lönn, Lars; Schroeder, Torben V; Ringsted, Charlotte

2013-12-01

Performing endovascular procedures requires good control of fine-motor digital movements and hand-eye coordination. Objective assessment of such skills is difficult. Trainees acquire control of catheter/wire movements at various paces. However, little is known to what extent talent plays for novice candidates at entry to practice. To study the association between performance in a novel aptitude test of fine-motor skills and performance in simulated procedures. The test was based on manual course-tracking using a proprietary hand-operated roller-bar device coupled to a personal computer with monitor view rotation. A total of 40 test repetitions were conducted separately with each hand. Test scores were correlated with simulator performance. Group A (n = 14), clinicians with various levels of endovascular experience, performed a simulated procedure of contralateral iliac artery stenting. Group B (n = 19), medical students, performed 10 repetitions of crossing a challenging aortic bifurcation in a simulator. The test score differed markedly between the individuals in both groups, in particular with the non-dominant hand. Group A: the test score with the non-dominant hand correlated significantly with simulator performance assessed with the global rating scale SAVE (R = -0.69, P = 0.007). There was no association observed from performances with the dominant hand. Group B: there was no significant association between the test score and endovascular skills acquisition neither with the dominant nor with the non-dominant hand. Clinicians with increasing levels of endovascular technical experience had developed good fine-motor control of the non-dominant hand, in particular, that was associated with good procedural performance in the simulator. The aptitude test did not predict endovascular skills acquisition among medical students, thus, cannot be suggested for selection of novice candidates. Procedural experience and practice probably supplant the influence of innate abilities (talent) over time.

Comparison of short- to medium-term results of Coonrad-Morrey elbow replacement in patients with rheumatoid arthritis versus patients after elbow injuries

PubMed Central

Szyluk, Karol; Widuchowski, Wojciech; Jasiński, Andrzej; Koczy, Bogdan; Widuchowski, Jerzy

2013-01-01

Background The aim of this study was to assess the utility of the Coonrad-Morrey elbow prosthesis in patients with severe elbow dysfunction secondary to rheumatoid arthritis (RA) or post-traumatic elbow dysfunction. Material/Methods The study involved 35 patients followed up for a mean of 36 months. The patients were divided into those with RA (Group I) and those with post-traumatic elbow dysfunction (Group II). Treatment outcomes were evaluated according to the Mayo Elbow Performance Score (MEPS) and the Disabilities of the Arm, Shoulder and Hand Score (Quick DASH). Results According to the MEPS, there were 20 (57.15%) excellent, 12 (34.3%) good, 1 (2.85%) fair, and 2 (5.7%) poor outcomes. The mean post-operative Quick-DASH score for the entire study group was 37.73 points. In subgroup analysis, the MEPS-based evaluation revealed: 14 (70%) excellent, 5 (25%) good, and 1 (5%) satisfactory outcome in Group I, versus 6 (40%) excellent, 7 (46.7%) good, and 2 (13.3%) poor outcomes in Group II. The mean Quick Dash scores were 78.64 points in Group I and 76.36 points in Group II. The final MEPS scores in Group I (p=0.000018) and Group II (p=0.00065) were most markedly influenced by reduction in elbow pain and improvement in the ability to perform activities of daily living (ADL): p=0.000018 in Group I and p=0.000713 in Group II. Conclusions The treatment outcomes confirm the utility of arthroplasty for severe elbow dysfunctions; they were most strongly influenced by pain reduction and improved ability to perform activities of daily living. PMID:23291737

Individualized deliberate practice on a virtual reality simulator improves technical performance of surgical novices in the operating room: a randomized controlled trial.

PubMed

Palter, Vanessa N; Grantcharov, Teodor P

2014-03-01

The purpose of this study was to investigate whether individualized deliberate practice on a virtual reality (VR) simulator results in improved technical performance in the operating room. Training on VR simulators has been shown to improve technical performance in the operating room (OR). Currently described VR curricula consist of trainees practicing the same tasks until expert proficiency is reached. It has yet to be investigated whether the individualized deliberate practice, where curricula tasks vary depending on prior levels of technical proficiency, would translate into the OR. This single-blinded prospective trial randomized 16 novice surgical residents to a deliberate practice (DP) group and a conventional residency training group. Both groups performed a laparoscopic cholecystectomy in the OR that was video-recorded. Technical performance of DP group residents in the OR was assessed using 3 validated assessment tools. A score of less than 60% on any component of the assessment tool resulted in the trainee practicing a specific task on the VR simulator. The DP group practiced on the simulator as per their individualized schedule. Both groups then performed another laparoscopic cholecystectomy. A blinded expert assessed the OR recordings using a validated global rating scale. Although both groups had similar technical abilities preintervention [DP: median score, 13.5 (9.3-15.0); control: median score, 14.5 (9.3-17.8); P = 0.45], the DP residents had a superior technical performance postintervention [DP: median score, 17.0 (15.3-18.5); control: median score, 12.5 (7.5-14.0); P = 0.03]. Of 8 DP residents, 6 practiced 5 basic VR tasks (median 1 trial to pass), and 7 of 8 practiced 2 advanced tasks (median 4 trials to pass). A curriculum of deliberate individualized practice on a VR simulator improves technical performance in the OR. This has implications to greatly improve the feasibility of implementing simulation-based curricula in residency training programs, rather then having them being limited to research protocols.

Academic performance in adolescence after inguinal hernia repair in infancy: a nationwide cohort study.

PubMed

Hansen, Tom G; Pedersen, Jacob K; Henneberg, Steen W; Pedersen, Dorthe A; Murray, Jeffrey C; Morton, Neil S; Christensen, Kaare

2011-05-01

Although animal studies have indicated that general anesthetics may result in widespread apoptotic neurodegeneration and neurocognitive impairment in the developing brain, results from human studies are scarce. We investigated the association between exposure to surgery and anesthesia for inguinal hernia repair in infancy and subsequent academic performance. Using Danish birth cohorts from 1986-1990, we compared the academic performance of all children who had undergone inguinal hernia repair in infancy to a randomly selected, age-matched 5% population sample. Primary analysis compared average test scores at ninth grade adjusting for sex, birth weight, and paternal and maternal age and education. Secondary analysis compared the proportions of children not attaining test scores between the two groups. From 1986-1990 in Denmark, 2,689 children underwent inguinal hernia repair in infancy. A randomly selected, age-matched 5% population sample consists of 14,575 individuals. Although the exposure group performed worse than the control group (average score 0.26 lower; 95% CI, 0.21-0.31), after adjusting for known confounders, no statistically significant difference (-0.04; 95% CI, -0.09 to 0.01) between the exposure and control groups could be demonstrated. However, the odds ratio for test score nonattainment associated with inguinal hernia repair was 1.18 (95% CI, 1.04-1.35). Excluding from analyses children with other congenital malformations, the difference in mean test scores remained nearly unchanged (0.05; 95% CI, 0.00-0.11). In addition, the increased proportion of test score nonattainment within the exposure group was attenuated (odds ratio = 1.13; 95% CI, 0.98-1.31). In the ethnically and socioeconomically homogeneous Danish population, we found no evidence that a single, relatively brief anesthetic exposure in connection with hernia repair in infancy reduced academic performance at age 15 or 16 yr after adjusting for known confounding factors. However, the higher test score nonattainment rate among the hernia group could suggest that a subgroup of these children are developmentally disadvantaged compared with the background population.

Performance of brain-damaged and non-brain-damaged institutionalized children on the Minnesota Percepto-Diagnostic Test.

PubMed

Holland, J M; Fuller, G B; Barth, C E

1982-01-01

Examined the performance of 64 children on the Minnesota Percepto-Diagnostic test (MPD) who were diagnosed as either Brain-Damaged (BD) or emotionally impaired Non-Brain-Damaged (NBD). There were 31 children in the NBD group and 33 in the BD group. The MPD T-score and Actuarial Table significantly differentiated between the two groups. Seventy-four percent of the combined BD-NBD groups were identified correctly. Additional discriminant analysis on this sample yielded combined BD-NBD groups classification rates that ranged from 77% with the MPD variables Separation of Circle-Diamond (SPCD), Distortion of Circle-Diamond (DCD) and Distortion of Dots (DD) to 83% with the WISC-R three IQ scores plus the MPD T-score, SPCD and DD. The MPD T-score and Actuarial Table (MPD Two-Step Diagnosis) appeared to generalize to other populations more readily than discriminant analysis formulae, which tend to be sensitive to the samples from which they are derived.

Initial construct validity evidence of a virtual human application for competency assessment in breaking bad news to a cancer patient.

PubMed

Guetterman, Timothy C; Kron, Frederick W; Campbell, Toby C; Scerbo, Mark W; Zelenski, Amy B; Cleary, James F; Fetters, Michael D

2017-01-01

Despite interest in using virtual humans (VHs) for assessing health care communication, evidence of validity is limited. We evaluated the validity of a VH application, MPathic-VR, for assessing performance-based competence in breaking bad news (BBN) to a VH patient. We used a two-group quasi-experimental design, with residents participating in a 3-hour seminar on BBN. Group A (n=15) completed the VH simulation before and after the seminar, and Group B (n=12) completed the VH simulation only after the BBN seminar to avoid the possibility that testing alone affected performance. Pre- and postseminar differences for Group A were analyzed with a paired t -test, and comparisons between Groups A and B were analyzed with an independent t -test. Compared to the preseminar result, Group A's postseminar scores improved significantly, indicating that the VH program was sensitive to differences in assessing performance-based competence in BBN. Postseminar scores of Group A and Group B were not significantly different, indicating that both groups performed similarly on the VH program. Improved pre-post scores demonstrate acquisition of skills in BBN to a VH patient. Pretest sensitization did not appear to influence posttest assessment. These results provide initial construct validity evidence that the VH program is effective for assessing BBN performance-based communication competence.

Initial construct validity evidence of a virtual human application for competency assessment in breaking bad news to a cancer patient

PubMed Central

Guetterman, Timothy C; Kron, Frederick W; Campbell, Toby C; Scerbo, Mark W; Zelenski, Amy B; Cleary, James F; Fetters, Michael D

2017-01-01

Background Despite interest in using virtual humans (VHs) for assessing health care communication, evidence of validity is limited. We evaluated the validity of a VH application, MPathic-VR, for assessing performance-based competence in breaking bad news (BBN) to a VH patient. Methods We used a two-group quasi-experimental design, with residents participating in a 3-hour seminar on BBN. Group A (n=15) completed the VH simulation before and after the seminar, and Group B (n=12) completed the VH simulation only after the BBN seminar to avoid the possibility that testing alone affected performance. Pre- and postseminar differences for Group A were analyzed with a paired t-test, and comparisons between Groups A and B were analyzed with an independent t-test. Results Compared to the preseminar result, Group A’s postseminar scores improved significantly, indicating that the VH program was sensitive to differences in assessing performance-based competence in BBN. Postseminar scores of Group A and Group B were not significantly different, indicating that both groups performed similarly on the VH program. Conclusion Improved pre–post scores demonstrate acquisition of skills in BBN to a VH patient. Pretest sensitization did not appear to influence posttest assessment. These results provide initial construct validity evidence that the VH program is effective for assessing BBN performance-based communication competence. PMID:28794664

Performance of crossbred calves with dietary supplementation of garlic extract.

PubMed

Ghosh, S; Mehla, R K; Sirohi, S K; Tomar, S K

2011-08-01

Twelve crossbred calves (Holstein cross) in their pre-ruminant stage were used to study the effect of garlic extract feeding on their performance and they were randomly allotted into treatment and control groups in equal number. Performance was evaluated by measuring average body weight (BW) gain, feed intake [dry matter (DM); total digestible nutrient (TDN) and crude protein (CP)], feed conversion efficiency (DM, TDN and CP), fecal score and fecal coliform count. Diets were same for both groups. In addition, treatment group received garlic extract supplementation at 250 mg/kg BW/day/calf. BW measured weekly, feed intake measured twice daily, proximate analysis of feeds and fodders analysed weekly, fecal scores monitored daily and fecal coliform count done weekly. There was a significant (p < 0.01) increase in mean BW gain and feed intake and a significant (p < 0.01) decrease in severity of scours as measured by fecal score in the treatment group compared to the control group. The results suggest that garlic extract can be supplemented to the calves for better performance. © 2010 Blackwell Verlag GmbH.

Matching weights to simultaneously compare three treatment groups: Comparison to three-way matching

PubMed Central

Yoshida, Kazuki; Hernández-Díaz, Sonia; Solomon, Daniel H.; Jackson, John W.; Gagne, Joshua J.; Glynn, Robert J.; Franklin, Jessica M.

2017-01-01

BACKGROUND Propensity score matching is a commonly used tool. However, its use in settings with more than two treatment groups has been less frequent. We examined the performance of a recently developed propensity score weighting method in the three treatment group setting. METHODS The matching weight method is an extension of inverse probability of treatment weighting (IPTW) that reweights both exposed and unexposed groups to emulate a propensity score matched population. Matching weights can generalize to multiple treatment groups. The performance of matching weights in the three-group setting was compared via simulation to three-way 1:1:1 propensity score matching and IPTW. We also applied these methods to an empirical example that compared the safety of three analgesics. RESULTS Matching weights had similar bias, but better mean squared error (MSE) compared to three-way matching in all scenarios. The benefits were more pronounced in scenarios with a rare outcome, unequally sized treatment groups, or poor covariate overlap. IPTW’s performance was highly dependent on covariate overlap. In the empirical example, matching weights achieved the best balance for 24 out of 35 covariates. Hazard ratios were numerically similar to matching. However, the confidence intervals were narrower for matching weights. CONCLUSIONS Matching weights demonstrated improved performance over three-way matching in terms of MSE, particularly in simulation scenarios where finding matched subjects was difficult. Given its natural extension to settings with even more than three groups, we recommend matching weights for comparing outcomes across multiple treatment groups, particularly in settings with rare outcomes or unequal exposure distributions. PMID:28151746

Animation-assisted CPRII program as a reminder tool in achieving effective one-person-CPR performance.

PubMed

Choa, Minhong; Cho, Junho; Choi, Young Hwan; Kim, Seungho; Sung, Ji Min; Chung, Hyun Soo

2009-06-01

The objective of this study is to compare the skill retention of two groups of lay persons, six months after their last CPR training. The intervention group was provided with animation-assisted CPRII (AA-CPRII) instruction on their cellular phones, and the control group had nothing but what they learned from their previous training. This study was a single blind randomized controlled trial. The participants' last CPR trainings were held at least six months ago. We revised our CPR animation for on-site CPR instruction content emphasizing importance of chest compression. Participants were randomized into two groups, the AA-CPRII group (n=42) and the control group (n=38). Both groups performed three cycles of CPR and their performances were video recorded. These video clips were assessed by three evaluators using a checklist. The psychomotor skills were evaluated using the ResusciAnne SkillReporter. Using the 30-point scoring checklist, the AA-CPRII group had a significantly better score compared to the control group (p<0.001). Psychomotor skills evaluated with the AA-CPRII group demonstrated better performance in hand positioning (p=0.025), compression depth (p=0.035) and compression rate (p<0.001) than the control group. The AA-CPRII group resulted in better checklist scores, including chest compression rate, depth and hand positioning. Animation-assisted CPR could be used as a reminder tool in achieving effective one-person-CPR performance. By installing the CPR instruction on cellular phones and having taught them CPR with it during the training enabled participants to perform better CPR.

Improving Reading Performance through Hypnosis.

ERIC Educational Resources Information Center

Fillmer, H. Thompson; And Others

1981-01-01

Describes a study investigating the effects of group hypnosis on the reading performance of university students in a reading and writing center. Discusses study procedures and presents data on pretest scores and gains in vocabulary and comprehension scores. Concludes that regular use of self-hypnosis significantly improved performance. (DMM)

The effect of dietary garlic supplementation on body weight gain, feed intake, feed conversion efficiency, faecal score, faecal coliform count and feeding cost in crossbred dairy calves.

PubMed

Ghosh, Sudipta; Mehla, Ram K; Sirohi, S K; Roy, Biswajit

2010-06-01

Thirty-six crossbred calves (Holstein cross) of 5 days of age were used to study the effect of garlic extract feeding on their performance up to the age of 2 months (pre-ruminant stage). They were randomly allotted into treatment and control groups (18 numbers in each group). Performance was evaluated by measuring average body weight (BW) gain, feed intake (dry matter (DM), total digestible nutrient (TDN) and crude protein (CP)), feed conversion efficiency (FCE; DM, TDN and CP), faecal score, faecal coliform count and feeding cost. Diets were the same for the both groups. In addition, treatment group received garlic extract supplementation at 250 mg/kg BW per day per calf. Body weight measured weekly, feed intake measured twice daily, proximate analysis of feeds and fodders analysed weekly, faecal scores monitored daily and faecal coliform count done weekly. There was significant increase in average body weight gain, feed intake and FCE and significant decrease in severity of scours as measured by faecal score and faecal coliform count in the treatment group compared to the control group (P < 0.01). Feed cost per kilogramme BW gain was significantly lower in the treatment group compared to control group (P < 0.01). The results suggest that garlic extract can be supplemented to the calves for better performance.

Correlation between safety climate and contractor safety assessment programs in construction

PubMed Central

Sparer, EH1; Murphy, LA; Taylor, KM; Dennerlein, Jt

2015-01-01

Background Contractor safety assessment programs (CSAPs) measure safety performance by integrating multiple data sources together; however, the relationship between these measures of safety performance and safety climate within the construction industry is unknown. Methods 401 construction workers employed by 68 companies on 26 sites and 11 safety managers employed by 11 companies completed brief surveys containing a nine-item safety climate scale developed for the construction industry. CSAP scores from ConstructSecure, Inc., an online CSAP database, classified these 68 companies as high or low scorers, with the median score of the sample population as the threshold. Spearman rank correlations evaluated the association between the CSAP score and the safety climate score at the individual level, as well as with various grouping methodologies. In addition, Spearman correlations evaluated the comparison between manager-assessed safety climate and worker-assessed safety climate. Results There were no statistically significant differences between safety climate scores reported by workers in the high and low CSAP groups. There were, at best, weak correlations between workers’ safety climate scores and the company CSAP scores, with marginal statistical significance with two groupings of the data. There were also no significant differences between the manager-assessed safety climate and the worker-assessed safety climate scores. Conclusions A CSAP safety performance score does not appear to capture safety climate, as measured in this study. The nature of safety climate in construction is complex, which may be reflective of the challenges in measuring safety climate within this industry. PMID:24038403

Effects of losartan on experimental varicocele-induced testicular germ cell apoptosis.

PubMed

Bolat, D; Oltulu, F; Uysal, A; Kose, T; Gunlusoy, B; Yigitturk, G; Turk, N S; Turan, T

2016-09-01

To investigate the potential protective effects of losartan on varicocele-induced germ cell apoptosis, 24 adult male Sprague Dawley rats were divided into three groups: a sham operation was performed in SHAM group, and experimental left varicocele was created in VAR and VAR + LOS groups. Additionally, in VAR + LOS group, losartan was administered for 30 days starting on the day of surgery. At the end of 30 days, all animals were sacrificed and left orchiectomy was performed. Testicular injury and spermatogenesis were evaluated according to Johnsen scoring system. To assess the nitrosative stress, immunohistochemical staining for endothelial nitric oxide synthase was used and evaluated by H-score and apoptotic index (AI) of germ cells was analysed by TUNEL method. A significant decrease in the mean Johnsen score (JS) was observed in VAR group compared with SHAM (p < .001). The mean H-score and AI were significantly higher in VAR group compared with SHAM (p < .001). After losartan administration, mean JS was significantly increased (p < .001) and mean H-score and AI were significantly decreased compared with VAR group (p < .001 and .01, respectively). Findings of this suggest that losartan acts as a potent protective agent against varicocele-induced germ cell apoptosis. © 2016 Blackwell Verlag GmbH.

Admission interview scores are associated with clinical performance in an undergraduate physiotherapy course: an observational study.

PubMed

Edgar, Susan; Mercer, Annette; Hamer, Peter

2014-12-01

The purpose of this study was to determine if there is an association between admission interview score and subsequent academic and clinical performance, in a four-year undergraduate physiotherapy course. Retrospective observational study. 141 physiotherapy students enrolled in two entry year groups. Individual student performance in all course units, practical examinations, clinical placements as well as year level and overall Grade Point Average. Predictor variables included admission interview scores, admission academic scores and demographic data (gender, age and entry level). Interview score demonstrated a significant association with performance in three of six clinical placements through the course. This association was stronger than for any other admission criterion although effect sizes were small to moderate. Further, it was the only admission score to have a significant association with overall Clinical Grade Point Average for the two year groups analysed (r=0.322). By contrast, academic scores on entry showed significant associations with all year level Grade Point Averages except Year 4, the clinical year. This is the first study to review the predictive validity of an admission interview for entry into a physiotherapy course in Australia. The results show that performance in this admission interview is associated with overall performance in clinical placements through the course, while academic admission scoring is not. These findings suggest that there is a role for both academic and non-academic selection processes for entry into physiotherapy. Copyright © 2014 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Conventional En Masse Repair Versus Separate Double-Layer Double-Row Repair for the Treatment of Delaminated Rotator Cuff Tears.

PubMed

Kim, Yang-Soo; Lee, Hyo-Jin; Jin, Hong-Ki; Kim, Sung-Eun; Lee, Jin-Woo

2016-05-01

The rotator cuff tendon is known to exert a shear force between the superficial and deep layers. Owing to this characteristic, separate repair of delaminated rotator cuff tears has been introduced for the restoration of the physiological biomechanics of the rotator cuff. However, whether conventional en masse repair or separate repair is superior is controversial in terms of outcomes. To compare clinical outcomes between conventional en masse repair and separate double-layer double-row repair for the treatment of delaminated rotator cuff tears. Randomized controlled study; Level of evidence, 2. Between August 2007 and March 2014, a total of 82 patients who underwent arthroscopic rotator cuff repair of a delaminated tear were enrolled and randomized into 2 groups. In group 1 (n = 48), arthroscopic conventional en masse repair was performed. In group 2 (n = 34), separate double-layer double-row repair was performed. The American Shoulder and Elbow Surgeons score, Constant score, Simple Shoulder Test score, and visual analog scale (VAS) score for pain and range of motion (ROM) were assessed before surgery; at 3, 6, and 12 months after surgery; and at the last follow-up visit. Magnetic resonance imaging (MRI) was performed at 12 months postoperatively to examine the retear rate and pattern. There was no significant difference between groups in the preoperative demographic data, including patient age, sex, symptom duration, tear size, and functional scores (P > .05). The mean follow-up period was 25.9 ± 1.2 months. Significant improvements in functional and pain scores were observed in both groups at the last follow-up visit. However, no significant differences in functional scores and ROM were found between the 2 groups at each time point, except that group 2 had significantly lower VAS pain scores (P < .05) at 3, 6, and 12 months postoperatively. Eight (17%) of 48 patients in group 1 and 6 (18%) of 34 patients in group 2 showed retears on MRI at 12-month follow-up (P > .05). Both conventional en masse repair and separate double-layer double-row repair were effective in improving clinical outcomes in the treatment of delaminated rotator cuff tears. Lower pain scores were seen in patients who underwent separate double-layer double-row repair. © 2016 The Author(s).

Neuropsychological test scores, academic performance, and developmental disorders in Spanish-speaking children.

PubMed

Rosselli, M; Ardila, A; Bateman, J R; Guzmán, M

2001-01-01

Limited information is currently available about performance of Spanish-speaking children on different neuropsychological tests. This study was designed to (a) analyze the effects of age and sex on different neuropsychological test scores of a randomly selected sample of Spanish-speaking children, (b) analyze the value of neuropsychological test scores for predicting school performance, and (c) describe the neuropsychological profile of Spanish-speaking children with learning disabilities (LD). Two hundred ninety (141 boys, 149 girls) 6- to 11-year-old children were selected from a school in Bogotá, Colombia. Three age groups were distinguished: 6- to 7-, 8- to 9-, and 10- to 11-year-olds. Performance was measured utilizing the following neuropsychological tests: Seashore Rhythm Test, Finger Tapping Test (FTT), Grooved Pegboard Test, Children's Category Test (CCT), California Verbal Learning Test-Children's Version (CVLT-C), Benton Visual Retention Test (BVRT), and Bateria Woodcock Psicoeducativa en Español (Woodcock, 1982). Normative scores were calculated. Age effect was significant for most of the test scores. A significant sex effect was observed for 3 test scores. Intercorrelations were performed between neuropsychological test scores and academic areas (science, mathematics, Spanish, social studies, and music). In a post hoc analysis, children presenting very low scores on the reading, writing, and arithmetic achievement scales of the Woodcock battery were identified in the sample, and their neuropsychological test scores were compared with a matched normal group. Finally, a comparison was made between Colombian and American norms.

Applying a 2D based CAD scheme for detecting micro-calcification clusters using digital breast tomosynthesis images: an assessment

NASA Astrophysics Data System (ADS)

Park, Sang Cheol; Zheng, Bin; Wang, Xiao-Hui; Gur, David

2008-03-01

Digital breast tomosynthesis (DBT) has emerged as a promising imaging modality for screening mammography. However, visually detecting micro-calcification clusters depicted on DBT images is a difficult task. Computer-aided detection (CAD) schemes for detecting micro-calcification clusters depicted on mammograms can achieve high performance and the use of CAD results can assist radiologists in detecting subtle micro-calcification clusters. In this study, we compared the performance of an available 2D based CAD scheme with one that includes a new grouping and scoring method when applied to both projection and reconstructed DBT images. We selected a dataset involving 96 DBT examinations acquired on 45 women. Each DBT image set included 11 low dose projection images and a varying number of reconstructed image slices ranging from 18 to 87. In this dataset 20 true-positive micro-calcification clusters were visually detected on the projection images and 40 were visually detected on the reconstructed images, respectively. We first applied the CAD scheme that was previously developed in our laboratory to the DBT dataset. We then tested a new grouping method that defines an independent cluster by grouping the same cluster detected on different projection or reconstructed images. We then compared four scoring methods to assess the CAD performance. The maximum sensitivity level observed for the different grouping and scoring methods were 70% and 88% for the projection and reconstructed images with a maximum false-positive rate of 4.0 and 15.9 per examination, respectively. This preliminary study demonstrates that (1) among the maximum, the minimum or the average CAD generated scores, using the maximum score of the grouped cluster regions achieved the highest performance level, (2) the histogram based scoring method is reasonably effective in reducing false-positive detections on the projection images but the overall CAD sensitivity is lower due to lower signal-to-noise ratio, and (3) CAD achieved higher sensitivity and higher false-positive rate (per examination) on the reconstructed images. We concluded that without changing the detection threshold or performing pre-filtering to possibly increase detection sensitivity, current CAD schemes developed and optimized for 2D mammograms perform relatively poorly and need to be re-optimized using DBT datasets and new grouping and scoring methods need to be incorporated into the schemes if these are to be used on the DBT examinations.

Informal Peer Interaction and Practice Type as Predictors of Physician Performance on Maintenance of Certification Examinations.

PubMed

Valentine, Melissa A; Barsade, Sigal; Edmondson, Amy C; Gal, Amit; Rhodes, Robert

2014-06-01

Physicians can demonstrate mastery of the knowledge that supports continued clinical competence by passing a maintenance of certification examination (MOCEX). Performance depends on professional learning and development, which may be enhanced by informal routine interactions with colleagues. Some physicians, such as those in solo practice, may have less opportunity for peer interaction, thus negatively influencing their examination performance. To determine the relationship among level of peer interaction, group and solo practice, and MOCEX performance. Longitudinal cohort study of 568 surgeons taking the 2008 MOCEX. Survey responses reporting the level of physicians' peer interactions and their practice type were related to MOCEX scores, controlling for initial qualifying examination scores, practice type, and personal characteristics. Solo practice and amount of peer interaction. Scores on the MOCEX and pass-fail status. Of the 568 surgeons in the study sample, 557 (98.1%) passed the examination. Higher levels of peer interaction were associated with a higher score (β = 0.91 [95% CI, 0.31-1.52]) and higher likelihood of passing the examination (odds ratio, 2.58 [1.08-6.16]). Physicians in solo (vs group) practice had fewer peer interactions (β = -0.49 [95% CI, -0.64 to -0.33), received lower scores (β = -1.82 [-2.94 to -0.82]), and were less likely to pass the examination (odds ratio, 0.22 [0.06-0.77]). Level of peer interaction moderated the relationship between solo practice and MOCEX score; solo practitioners with high levels of peer interaction achieved an MOCEX performance on a par with that of group practitioners. Physicians in solo practice had poorer MOCEX performance. However, solo practitioners who reported high levels of peer interaction performed as well as those in group practice. Peer interaction is important for professional learning and quality of care.

Influence of dietary supplementation of prebiotics (mannanoligosaccharide) on the performance of crossbred calves.

PubMed

Ghosh, Sudipta; Mehla, Ram Kumar

2012-03-01

Thirty-six Holstein cross calves 5 days of age in their preruminant stage were used to study the effect of feeding prebiotic (mannanoligosaccharide) on their performance up to the age of 2 months. Treatment and control groups consisted of 18 calves each. Treatment group was supplemented with 4 g prebiotic (mannanoligosaccharide)/calf/day. Performance was evaluated by measuring average body weight (BW) gain, feed intake [dry matter (DM), total digestible nutrient (TDN) and crude protein(CP)], feed conversion efficiency (DM, TDN, and CP), fecal score, fecal coliform count and feeding cost. Body weight measured weekly, feed intake measured twice daily, proximate analysis of feeds and fodders analyzed weekly, fecal score monitored daily and fecal coliform count done weekly. There was a significant increase in average body weight gain, feed intake and feed conversion efficiency; and a significant decrease in severity of scours as measured by fecal score and fecal coliform count in the treatment group compared with control group (P < 0.01). Feed cost/kg BW gain was significantly lower in the treatment group compared to control group (P < 0.01). The results suggest that prebiotic (mannanoligosaccharide) can be supplemented to the calves for better performance.

[Relationship between unipedal stance test score and center of pressure velocity in elderly].

PubMed

Rodrigo Antonio, Guzmán; Rony, Silvestre; Francisco Aniceto, Rodríguez; David Andrés, Arriagada; Pablo Andrés, Ortega

2011-01-01

Frequent falls are one of the most important health problems in the elderly population. The unipedal stance test (UPST), asses postural stability and is used in fall risk measures. Despite this, there is little information about its relationship with posturographic parameters (PP) that characterizes postural stability. Center of pressure velocity (CoPV) is one of the best PP that describes postural stability. The aim of this study was to analyze the relation between UST score and CoPV in elderly population. A sample of 38 healthy elderly subjects where divided in two groups according to their UPST score, low performance (LP, n=11) and high performance (HP, n=27). The correlation between UPST score and COP mean velocity (CoPmV), recorded from a posturographic test, was analyzed between both groups. An inverse correlation between UPST score and CoPmV was found in both groups. However, this was higher in the LP group (r=-0.69, P=.02) compared to the HP (r=-0.39, P=.04). Based on the results of this investigation, it may be concluded that the achievement on UPST has an inverse relationship with CoPmV, especially in subjects with low performance in the UPST. Copyright © 2010 SEGG. Published by Elsevier Espana. All rights reserved.

Functional Outcome Trajectories After Out-of-Hospital Pediatric Cardiac Arrest.

PubMed

Silverstein, Faye S; Slomine, Beth S; Christensen, James; Holubkov, Richard; Page, Kent; Dean, J Michael; Moler, Frank W

2016-12-01

To analyze functional performance measures collected prospectively during the conduct of a clinical trial that enrolled children (up to age 18 yr old), resuscitated after out-of-hospital cardiac arrest, who were at high risk of poor outcomes. Children with Glasgow Motor Scale score less than 5, within 6 hours of resuscitation, were enrolled in a clinical trial that compared two targeted temperature management interventions (THAPCA-OH, NCT00878644). The primary outcome, 12-month survival with Vineland Adaptive Behavior Scale, second edition, score greater or equal to 70, did not differ between groups. Thirty-eight North American PICUs. Two hundred ninety-five children were enrolled; 270 of 295 had baseline Vineland Adaptive Behavior Scale, second edition, scores greater or equal to 70; 87 of 270 survived 1 year. Targeted temperatures were 33.0°C and 36.8°C for hypothermia and normothermia groups. Baseline measures included Vineland Adaptive Behavior Scale, second edition, Pediatric Cerebral Performance Category, and Pediatric Overall Performance Category. Pediatric Cerebral Performance Category and Pediatric Overall Performance Category were rescored at hospital discharges; all three were scored at 3 and 12 months. In survivors with baseline Vineland Adaptive Behavior Scale, second edition scores greater or equal to 70, we evaluated relationships of hospital discharge Pediatric Cerebral Performance Category with 3- and 12-month scores and between 3- and 12-month Vineland Adaptive Behavior Scale, second edition, scores. Hospital discharge Pediatric Cerebral Performance Category scores strongly predicted 3- and 12-month Pediatric Cerebral Performance Category (r = 0.82 and 0.79; p < 0.0001) and Vineland Adaptive Behavior Scale, second edition, scores (r = -0.81 and -0.77; p < 0.0001). Three-month Vineland Adaptive Behavior Scale, second edition, scores strongly predicted 12-month performance (r = 0.95; p < 0.0001). Hypothermia treatment did not alter these relationships. In comatose children, with Glasgow Motor Scale score less than 5 in the initial hours after out-of-hospital cardiac arrest resuscitation, function scores at hospital discharge and at 3 months predicted 12-month performance well in the majority of survivors.

PREDICTIVE MEASURES OF A RESIDENT'S PERFORMANCE ON WRITTEN ORTHOPAEDIC BOARD SCORES

PubMed Central

Dyrstad, Bradley W; Pope, David; Milbrandt, Joseph C; Beck, Ryan T; Weinhoeft, Anita L.; Idusuyi, Osaretin B

2011-01-01

Objective Residency programs are continually attempting to predict the performance of both current and potential residents. Previous studies have supported the use of USMLE Steps 1 and 2 as predictors of Orthopaedic In-Training Examination (OITE) and eventual American Board of Orthopaedic Surgery success, while others show no significant correlation. A strong performance on OITE examinations does correlate with strong residency performance, and some believe OITE scores are good predictors of future written board success. The current study was designed to examine potential differences in resident assessment measures and their predictive value for written boards. Design/Methods A retrospective review of resident performance data was performed for the past 10 years. Personalized information was removed by the residency coordinator. USMLE Step 1, USMLE Step 2, Orthopaedic In-Training Examination (from first to fifth years of training), and written orthopaedic specialty board scores were collected. Subsequently, the residents were separated into two groups, those scoring above the 35th percentile on written boards and those scoring below. Data were analyzed using correlation and regression analyses to compare and contrast the scores across all tests. Results A significant difference was seen between the groups in regard to USMLE scores for both Step 1 and 2. Also, a significant difference was found between OITE scores for both the second and fifth years. Positive correlations were found for USMLE Step 1, Step 2, OITE 2 and OITE 5 when compared to performance on written boards. One resident initially failed written boards, but passed on the second attempt This resident consistently scored in the 20th and 30th percentiles on the in-training examinations. Conclusions USMLE Step 1 and 2 scores along with OITE scores are helpful in gauging an orthopaedic resident’s performance on written boards. Lower USMLE scores along with consistently low OITE scores likely identify residents at risk of failing their written boards. Close monitoring of the annual OITE scores is recommended and may be useful to identify struggling residents. Future work involving multiple institutions is warranted and would ensure applicability of our findings to other orthopedic residency programs. PMID:22096449

Admission characteristics and academic performance of podiatric and osteopathic medical students at Des Moines University.

PubMed

Yoho, Robert M; Vardaxis, Vassilios; Comstock, Kathryn

2010-01-01

Podiatric and osteopathic medical students at Des Moines University take the same basic science medical curriculum. The first course students complete is medical biochemistry. The final common course is the second-year medical pharmacology course. Attrition typically occurs between these academic offerings. We sought to compare admissions data, retention rates, and academic performance between these two groups of medical students for the classes of 2008 to 2011. Average admission scores, performance scores for the biochemistry and medical pharmacology courses, and retention rates for the 2008 to 2011 classes were obtained from the registrar and enrollment offices. One-way analysis of variance was used to compare the scores of the two cohorts. Linear regression was used to identify changes across time. The DO students showed significantly better performance than the DPM students in matriculating overall and science grade point averages, total Medical College Admissions Test scores, retention rates, and the medical biochemistry course (P < .01). There was no difference in the performance of the student groups in the medical pharmacology course. The DPM student scores across the four classes increased for both academic courses, whereas the DO student scores remained at the same level for medical biochemistry, at a rate of 0.74% per year (R(2) = 0.50), and pharmacology, at a rate of 0.90% per year (R(2) = 0.49). Admissions data and initial academic performance of osteopathic medical students were higher than those of podiatric medical students. Once attrition occurred in year 1, the difference in academic performance between these groups of students was no longer statistically significant, and students in both medical programs at that time in the curriculum are equally academically qualified.

Effects of Social Network Exposure on Nutritional Learning: Development of an Online Educational Platform.

PubMed

Dagan, Noa; Beskin, Daniel; Brezis, Mayer; Reis, Ben Y

2015-10-05

Social networking sites (SNSs) such as Facebook have the potential to enhance online public health interventions, in part, as they provide social exposure and reinforcement. The objective of the study was to evaluate whether social exposure provided by SNSs enhances the effects of online public health interventions. As a sample intervention, we developed Food Hero, an online platform for nutritional education in which players feed a virtual character according to their own nutritional needs and complete a set of virtual sport challenges. The platform was developed in 2 versions: a "private version" in which a user can see only his or her own score, and a "social version" in which a user can see other players' scores, including preexisting Facebook friends. We assessed changes in participants' nutritional knowledge using 4 quiz scores and 3 menu-assembly scores. Monitoring feeding and exercising attempts assessed engagement with the platform. The 2 versions of the platform were randomly assigned between a study group (30 members receiving the social version) and a control group (33 members, private version). The study group's performance on the quizzes gradually increased over time, relative to that of the control group, becoming significantly higher by the fourth quiz (P=.02). Furthermore, the study group's menu-assembly scores improved over time compared to the first score, whereas the control group's performance deteriorated. Study group members spent an average of 3:40 minutes assembling each menu compared to 2:50 minutes in the control group, and performed an average of 1.58 daily sport challenges, compared to 1.21 in the control group (P=.03). This work focused on isolating the SNSs' social effects in order to help guide future online interventions. Our results indicate that the social exposure provided by SNSs is associated with increased engagement and learning in an online nutritional educational platform.

Clock face drawing test performance in children with ADHD.

PubMed

Ghanizadeh, Ahmad; Safavi, Salar; Berk, Michael

2013-01-01

The utility and discriminatory pattern of the clock face drawing test in ADHD is unclear. This study therefore compared Clock Face Drawing test performance in children with ADHD and controls. 95 school children with ADHD and 191 other children were matched for gender ratio and age. ADHD symptoms severities were assessed using DSM-IV ADHD checklist and their intellectual functioning was assessed. The participants completed three clock-drawing tasks, and the following four functions were assessed: Contour score, Numbers score, Hands setting score, and Center score. All the subscales scores of the three clock drawing tests of the ADHD group were lower than that of the control group. In ADHD children, inattention and hyperactivity/ impulsivity scores were not related to free drawn clock test scores. When pre-drawn contour test was performed, inattentiveness score was statistically associated with Number score while none of the other variables of age, gender, intellectual functioning, and hand use preference were associated with that kind of score. In pre-drawn clock, no association of ADHD symptoms with any CDT subscales found significant. In addition, more errors are observed with free drawn clock and Pre-drawn contour than pre-drawn clock. Putting Numbers and Hands setting are more sensitive measures to screen ADHD than Contour and Center drawing. Test performance, except Hands setting, may have already reached a developmental plateau. It is probable that Hand setting deficit in children with ADHD may not decrease from age 8 to 14 years. Performance of children with ADHD is associated with complexity of CDT.

The Relationships between Online Game Player Biogenetic Traits, Playing Time, and the Genre of the Game Being Played.

PubMed

Kim, Jun Won; Han, Doug Hyun; Park, Doo Byung; Min, Kyung Joon; Na, Churl; Won, Su Kyung; Park, Ga Na

2010-03-01

Psychobiological traits may be associated with excessive Internet use. This study assessed the relationships between biogenetic traits, the amount of time spent in online game playing, and the genre of the online game being played. Five hundred sixty five students who enjoyed one of the four types of games included in this study were recruited. The types of games examined included role playing games (RPG), real-time strategy games (RTS), first person shooting games (FPS), and sports games. Behavioral patterns of game play, academic performance, and player biogenetic characteristics were assessed. The amount of time that the participants spent playing online games was significantly greater on weekends than on weekdays. On weekends, the types of games with the largest numbers of participants who played games for more than three hours were ranked as follows: RPG and FPS, RTS, and sports games. The Young's Internet Addiction Scale (YIAS)score for the RPG group was the highest among the groups of the four types of game players. The time that participants spent playing games on weekdays was negatively associated with academic performance, especially for the RPG and FPS groups. Compared with the other groups, the RPG and RTS groups had higher novelty seeking (NS) scores and self-directedness (SD) scores, respectively. Additionally, the sports game group had higher reward dependency scores than the other groups. These results suggest that RPGs may have specific factors that are attractive to latent game addicts with higher NS scores. Additionally, excessive playing of online games is related to impaired academic performance.

The Relationships between Online Game Player Biogenetic Traits, Playing Time, and the Genre of the Game Being Played

PubMed Central

Kim, Jun Won; Park, Doo Byung; Min, Kyung Joon; Na, Churl; Won, Su Kyung; Park, Ga Na

2010-01-01

Objective Psychobiological traits may be associated with excessive Internet use. This study assessed the relationships between biogenetic traits, the amount of time spent in online game playing, and the genre of the online game being played. Methods Five hundred sixty five students who enjoyed one of the four types of games included in this study were recruited. The types of games examined included role playing games (RPG), real-time strategy games (RTS), first person shooting games (FPS), and sports games. Behavioral patterns of game play, academic performance, and player biogenetic characteristics were assessed. Results The amount of time that the participants spent playing online games was significantly greater on weekends than on weekdays. On weekends, the types of games with the largest numbers of participants who played games for more than three hours were ranked as follows: RPG and FPS, RTS, and sports games. The Young's Internet Addiction Scale (YIAS)score for the RPG group was the highest among the groups of the four types of game players. The time that participants spent playing games on weekdays was negatively associated with academic performance, especially for the RPG and FPS groups. Compared with the other groups, the RPG and RTS groups had higher novelty seeking (NS) scores and self-directedness (SD) scores, respectively. Additionally, the sports game group had higher reward dependency scores than the other groups. Conclusion These results suggest that RPGs may have specific factors that are attractive to latent game addicts with higher NS scores. Additionally, excessive playing of online games is related to impaired academic performance. PMID:20396428

Long-term effect of early-life stress from earthquake exposure on working memory in adulthood.

PubMed

Li, Na; Wang, Yumei; Zhao, Xiaochuan; Gao, Yuanyuan; Song, Mei; Yu, Lulu; Wang, Lan; Li, Ning; Chen, Qianqian; Li, Yunpeng; Cai, Jiajia; Wang, Xueyi

2015-01-01

The present study aimed to investigate the long-term effect of 1976 Tangshan earthquake exposure in early life on performance of working memory in adulthood. A total of 907 study subjects born and raised in Tangshan were enrolled in this study. They were divided into three groups according to the dates of birth: infant exposure (3-12 months, n=274), prenatal exposure (n=269), and no exposure (born at least 1 year after the earthquake, n=364). The prenatal group was further divided into first, second, and third trimester subgroups based on the timing of exposure during pregnancy. Hopkins Verbal Learning Test-Revised and Brief Visuospatial Memory Test-Revised (BVMT-R) were used to measure the performance of working memory. Unconditional logistic regression analysis was used to analyze the influential factors for impaired working memory. The Hopkins Verbal Learning Test-Revised scores did not show significant difference across the three groups. Compared with no exposure group, the BVMT-R scores were slightly lower in the prenatal exposure group and markedly decreased in the infant exposure group. When the BVMT-R scores were analyzed in three subgroups, the results showed that the subjects whose mothers were exposed to earthquake in the second and third trimesters of pregnancy had significantly lower BVMT-R scores compared with those in the first trimester. Education level and early-life earthquake exposure were identified as independent risk factors for reduced performance of visuospatial memory indicated by lower BVMT-R scores. Infant exposure to earthquake-related stress impairs visuospatial memory in adulthood. Fetuses in the middle and late stages of development are more vulnerable to stress-induced damage that consequently results in impaired visuospatial memory. Education and early-life trauma can also influence the performance of working memory in adulthood.

Cognitive Profile of Intellectually Gifted Adults: Analyzing the Wechsler Adult Intelligence Scale.

PubMed

Lang, Margherita; Matta, Michael; Parolin, Laura; Morrone, Cristina; Pezzuti, Lina

2017-09-01

The Wechsler Adult Intelligence Scale (WAIS) has been used extensively to study intellectual abilities of special groups. Here, we report the results of an intellectually gifted group on the WAIS-IV. Gifted individuals are people who obtained scores equal to or greater than 2 standard deviations above the mean on an intelligence test. Hence, the current study aims first, to examine mean group performance data of gifted individuals on the WAIS-IV; second, to revalidate the pattern of performance identified in this special group in previous studies (i.e., verbal skills higher than all other abilities); third, to compare scatter measures across intellectual domains with a matched comparison group. A total of 130 gifted individuals (79 males) were administered the full battery and their performance was compared with a matched comparison group. Analyses revealed that gifted group displayed higher scores in all intellectual domains. Contrary to expectations, they showed the highest scores in perceptual reasoning tasks. A multivariate approach revealed that this ability was statistically different from all other domains within the gifted group. Moreover, gifted individuals showed higher discrepancies across intellectual domains than average-intelligence people. Findings have important practical implications to detect intellectual giftedness in adulthood.

Improving performance of Zambia Defence Force antiretroviral therapy providers: evaluation of a standards-based approach

PubMed Central

Kim, Young Mi; Banda, Joseph; Kanjipite, Webby; Sarkar, Supriya; Bazant, Eva; Hiner, Cyndi; Tholandi, Maya; Reinhardt, Stephanie; Njobvu, Panganani Dalisani; Kols, Adrienne; Benavides, Bruno

2013-01-01

ABSTRACT Background: The Zambia Defence Force (ZDF) has applied the Standards-Based Management and Recognition (SBM-R®) approach, which uses detailed performance standards, at some health facilities to improve HIV-related services offered to military personnel and surrounding civilian communities. This study examines the effectiveness of the SBM-R approach in improving facility readiness and provider performance at ZDF facilities. Methods: We collected data on facility readiness and provider performance before and after the 2010–2012 intervention at 4 intervention sites selected for their relatively poor performance and 4 comparison sites. Assessors observed whether each facility met 16 readiness standards and whether providers met 9 performance standards during consultations with 354 returning antiretroviral therapy (ART) clients. We then calculated the percentages of criteria achieved for each readiness and performance standard and conducted bivariate and multivariate analyses of provider performance data. Results: Facilities' ART readiness scores exceeded 80% before the intervention at both intervention and comparison sites. At endline, scores improved on 4 facility readiness standards in the intervention group but on only 1 standard in the comparison group. Multivariate analysis found that the overall provider performance score increased significantly in the intervention group (from 58% to 84%; P<.01) but not in the comparison group (from 62% to 70%). The before-and-after improvement in scores was significantly greater among intervention sites than among comparison sites for 2 standards—initial assessment of the client's condition and nutrition counseling. Conclusion: The standards-based approach, which involved intensive and mutually reinforcing intervention activities, showed modest improvements in some aspects of providers' performance during ART consultations. Further research is needed to determine whether improvements in provider performance affect client outcomes such as adherence to ART. PMID:25276534

ASKing the kids: how children view their abilities after perinatal stroke.

PubMed

Barkat-Masih, Monica; Saha, Chandan; Golomb, Meredith R

2011-01-01

A total of 19 children with a history of perinatal stroke were asked how they saw their own motor abilities and disabilities using the Activities Scale for Kids (ASK) performance and capability questionnaires. The median ASK performance score was significantly lower (86.7) than the median ASK capability score (93.4; P = .03), suggesting children felt they were not doing everything they were capable of doing. Performance and capability total scores were not associated with gender or stroke type; lower performance and capability scores were associated with cerebral palsy. Within groups, performance scores were significantly lower than capability scores in girls (P = .02), children with presumed perinatal stroke (P = .02), children with unilateral stroke (P = .02), and children with large versus small branch unilateral middle cerebral artery stroke (P = .03). Further work is needed to understand why these children's performance does not match perceived capability.

Ground Reaction Force Differences in the Countermovement Jump in Girls with Different Levels of Performance

ERIC Educational Resources Information Center

Floría, Pablo; Harrison, Andrew J.

2013-01-01

Purpose: The aim of this study was to ascertain the biomechanical differences between better and poorer performers of the vertical jump in a homogeneous group of children. Method: Twenty-four girls were divided into low-scoring (LOW; M [subscript age] = 6.3 ± 0.8 years) and high-scoring (HIGH; M [subscript age] = 6.6 ± 0.8 years) groups based on…

Eccentric exercises for the management of tendinopathy of the main body of the Achilles tendon with or without the AirHeel Brace. A randomized controlled trial. A: effects on pain and microcirculation.

PubMed

Knobloch, Karsten; Schreibmueller, Louisa; Longo, Umile Giuseppe; Vogt, Peter M

2008-01-01

To compare eccentric training and the combination of eccentric training with the AirHeel Brace for the management of tendinopathy of the main body of the Achilles tendon. We recruited 116 subjects with unilateral tendinopathy of the main body of the Achilles tendon, who were randomized in two groups. Group A performed a regimen of daily eccentric training associated with the AirHeel Brace (Donjoy Orthopedics, Vista, CA, USA). Group B performed the same eccentric training without the AirHeel Brace. Tendon microcirculatory mapping was performed using combined Laser-Doppler and spectrophotometry. Pre- and post-operative FAOS score and VAS score were used to evaluate the patients. The FAOS score and the VAS score showed significant improvements from pre-operative to post-operative values in both groups (A 5.1 +/- 2 vs. 2.9 +/- 2.4, 43% reduction and B: 5.4 +/- 2.1 vs. 3.6 +/- 2.4, 33% reduction, both p = 0.0001). There were no statistically significant differences in FAOS score and VAS score when comparing the two groups after the end of the intervention. In Group A, tendon oxygen saturation in the main body of the Achilles tendon showed significant increase from pre- to post-management values (68 +/- 12 vs.74 +/- 8%, p = 0.003). Post-capillary venous filling pressures showed significant reduction from pre- to post-intervention values. Eccentric training, associated or not with the AirHeel Brace, produces the same effect in patients with tendinopathy of the main body of the Achilles tendon. The combination of eccentric training with the AirHeel Brace can optimize tendon microcirculation, but these micro-circulator advantages do not translate into superior clinical performance when compared with eccentric training alone.

FUNCTIONAL PERFORMANCE AND KNEE LAXITY IN NORMAL INDIVIDUALS AND IN INDIVIDUALS SUBMITTED TO ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

PubMed Central

de Vasconcelos, Rodrigo Antunes; Bevilaqua-Grossi, Débora; Shimano, Antonio Carlos; Jansen Paccola, Cleber Antonio; Salvini, Tânia Fátima; Prado, Christiane Lanatovits; Mello Junior, Wilson A.

2015-01-01

The aim of this study was to analyze the correlation between deficits in the isokinetic peak torque of the knee extensors and flexors with hop tests, postoperative knee laxity and functional scores in normal and ACL- reconstructed subjects with patellar tendon and hamstring tendon autografts. Methods: Sixty male subjects were enrolled and subdivided into three groups: Twenty subjects without knee injuries (GC group) and two groups of 20 subjects submitted to ACL reconstruction with patellar tendon (GTP group) and hamstrings autograft (GTF group). Results: The results showed significant correlation between knee extensors peak torque and performance in the hop tests for GTF and GC groups. There are no significantly correlations between post op knee laxity and Lysholm score compared with the hop tests and peak torque deficits. Concerning the differences between groups, the GTP group showed greater peak torque deficits in knee extensors, worst Lysholm scores and higher percentage of individuals with lower limb symmetry index (ISM) < 90% in both hop tests when compared to the other two groups. Conclusion: It is not recommendable to use only one measurement instrument for the functional evaluation of ACL-reconstructed patients, because significant correlation between peak torque, subject's functional score, knee laxity and hop tests were not observed in all groups. PMID:26998464

Use of condensed videos in a flipped classroom for pharmaceutical calculations: Student perceptions and academic performance.

PubMed

Gloudeman, Mark W; Shah-Manek, Bijal; Wong, Terri H; Vo, Christina; Ip, Eric J

2018-02-01

The flipped teaching method was implemented through a series of multiple condensed videos for pharmaceutical calculations with student perceptions and academic performance assessed post-intervention. Student perceptions from the intervention group were assessed via an online survey. Pharmaceutical exam scores of the intervention group were compared to the control group. The intervention group spent a greater amount of class time on active learning. The majority of students (68.2%) thought that the flipped teaching method was more effective to learn pharmaceutical calculations than the traditional method. The mean exam scores of the intervention group were not significantly different than the control group (80.5 ± 15.8% vs 77.8 ± 16.8%; p = 0.253). Previous studies on the flipped teaching method have shown mixed results in regards to student perceptions and exam scores, where either student satisfaction increased or exam scores improved, but rarely both. The flipped teaching method was rated favorably by a majority of students. The flipped teaching method resulted in similar outcomes in pharmaceutical calculations exam scores, and it appears to be an acceptable and effective option to deliver pharmaceutical calculations in a Doctor of Pharmacy program. Copyright © 2017 Elsevier Inc. All rights reserved.

Imperfect practice makes perfect: error management training improves transfer of learning.

PubMed

Dyre, Liv; Tabor, Ann; Ringsted, Charlotte; Tolsgaard, Martin G

2017-02-01

Traditionally, trainees are instructed to practise with as few errors as possible during simulation-based training. However, transfer of learning may improve if trainees are encouraged to commit errors. The aim of this study was to assess the effects of error management instructions compared with error avoidance instructions during simulation-based ultrasound training. Medical students (n = 60) with no prior ultrasound experience were randomised to error management training (EMT) (n = 32) or error avoidance training (EAT) (n = 28). The EMT group was instructed to deliberately make errors during training. The EAT group was instructed to follow the simulator instructions and to commit as few errors as possible. Training consisted of 3 hours of simulation-based ultrasound training focusing on fetal weight estimation. Simulation-based tests were administered before and after training. Transfer tests were performed on real patients 7-10 days after the completion of training. Primary outcomes were transfer test performance scores and diagnostic accuracy. Secondary outcomes included performance scores and diagnostic accuracy during the simulation-based pre- and post-tests. A total of 56 participants completed the study. On the transfer test, EMT group participants attained higher performance scores (mean score: 67.7%, 95% confidence interval [CI]: 62.4-72.9%) than EAT group members (mean score: 51.7%, 95% CI: 45.8-57.6%) (p < 0.001; Cohen's d = 1.1, 95% CI: 0.5-1.7). There was a moderate improvement in diagnostic accuracy in the EMT group compared with the EAT group (16.7%, 95% CI: 10.2-23.3% weight deviation versus 26.6%, 95% CI: 16.5-36.7% weight deviation [p = 0.082; Cohen's d = 0.46, 95% CI: -0.06 to 1.0]). No significant interaction effects between group and performance improvements between the pre- and post-tests were found in either performance scores (p = 0.25) or diagnostic accuracy (p = 0.09). The provision of error management instructions during simulation-based training improves the transfer of learning to the clinical setting compared with error avoidance instructions. Rather than teaching to avoid errors, the use of errors for learning should be explored further in medical education theory and practice. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Norms and Performance Standards for Work Sample Scores.

ERIC Educational Resources Information Center

Wisconsin Univ. - Stout, Menomonie. Dept. of Rehabilitation and Manpower Services. Materials Development Center.

Work samples are commonly used to aid in the assessment of a client's potential for functioning in various competitive occupations. To determine an individual's position relative to a particular reference group the most commonly used norms are those based on scores of other clients who have performed a specific work sample, and performance scores…

Correlation between safety climate and contractor safety assessment programs in construction.

PubMed

Sparer, Emily H; Murphy, Lauren A; Taylor, Kathryn M; Dennerlein, Jack T

2013-12-01

Contractor safety assessment programs (CSAPs) measure safety performance by integrating multiple data sources together; however, the relationship between these measures of safety performance and safety climate within the construction industry is unknown. Four hundred and one construction workers employed by 68 companies on 26 sites and 11 safety managers employed by 11 companies completed brief surveys containing a nine-item safety climate scale developed for the construction industry. CSAP scores from ConstructSecure, Inc., an online CSAP database, classified these 68 companies as high or low scorers, with the median score of the sample population as the threshold. Spearman rank correlations evaluated the association between the CSAP score and the safety climate score at the individual level, as well as with various grouping methodologies. In addition, Spearman correlations evaluated the comparison between manager-assessed safety climate and worker-assessed safety climate. There were no statistically significant differences between safety climate scores reported by workers in the high and low CSAP groups. There were, at best, weak correlations between workers' safety climate scores and the company CSAP scores, with marginal statistical significance with two groupings of the data. There were also no significant differences between the manager-assessed safety climate and the worker-assessed safety climate scores. A CSAP safety performance score does not appear to capture safety climate, as measured in this study. The nature of safety climate in construction is complex, which may be reflective of the challenges in measuring safety climate within this industry. Am. J. Ind. Med. 56:1463-1472, 2013. © 2013 Wiley Periodicals, Inc. © 2013 Wiley Periodicals, Inc.

Learning curves and impact of previous operative experience on performance on a virtual reality simulator to test laparoscopic surgical skills.

PubMed

Grantcharov, Teodor P; Bardram, Linda; Funch-Jensen, Peter; Rosenberg, Jacob

2003-02-01

The study was carried out to analyze the learning rate for laparoscopic skills on a virtual reality training system and to establish whether the simulator was able to differentiate between surgeons with different laparoscopic experience. Forty-one surgeons were divided into three groups according to their experience in laparoscopic surgery: masters (group 1, performed more than 100 cholecystectomies), intermediates (group 2, between 15 and 80 cholecystectomies), and beginners (group 3, fewer than 10 cholecystectomies) were included in the study. The participants were tested on the Minimally Invasive Surgical Trainer-Virtual Reality (MIST-VR) 10 consecutive times within a 1-month period. Assessment of laparoscopic skills included time, errors, and economy of hand movement, measured by the simulator. The learning curves regarding time reached plateau after the second repetition for group 1, the fifth repetition for group 2, and the seventh repetition for group 3 (Friedman's tests P <0.05). Experienced surgeons did not improve their error or economy of movement scores (Friedman's tests, P >0.2) indicating the absence of a learning curve for these parameters. Group 2 error scores reached plateau after the first repetition, and group 3 after the fifth repetition. Group 2 improved their economy of movement score up to the third repetition and group 3 up to the sixth repetition (Friedman's tests, P <0.05). Experienced surgeons (group 1) demonstrated best performance parameters, followed by group 2 and group 3 (Mann-Whitney test P <0.05). Different learning curves existed for surgeons with different laparoscopic background. The familiarization rate on the simulator was proportional to the operative experience of the surgeons. Experienced surgeons demonstrated best laparoscopic performance on the simulator, followed by those with intermediate experience and the beginners. These differences indicate that the scoring system of MIST-VR is sensitive and specific to measuring skills relevant for laparoscopic surgery.

Theory of mind performance using a story comprehension task in bipolar mania compared to schizophrenia and healthy controls.

PubMed

Rossell, Susan L; Van Rheenen, Tamsyn E

2013-01-01

Theory of mind (ToM) refers to the ability to understand the mental state of self and others. There is limited research into this topic in bipolar disorder (BD), with no previous study examining ToM in a BD group within a psychotic manic phase. Twenty-eight psychotic manic BD patients were compared with 30 schizophrenia (SCZ) patients and 29 healthy controls (HC). Participants performed a ToM story comprehension task that compared ToM stories and non-ToM stories (which we relabelled non-ToM "semantic" stories). Performance was examined by answering comprehension questions. Both patient groups were equally impaired on their scores for ToM stories (scores BD = 10/24, SCZ = 9/24, HC = 14/24, p < .001). Interestingly, both patient groups showed reduced performance on non-ToM semantic stories (scores BD = 12/24, SCZ = 9/24, HC = 15/24, p < .001); SCZ showed a larger deficit. Reduced ToM performance was correlated with delusion severity in the BD group only. ToM performance was impaired in BD patients experiencing psychotic symptoms. Patient performance was also impaired on the control condition (i.e., non-ToM semantic stories) supporting an additional deficit in semantic processing.

Effects of anatomical variation on trainee performance in a virtual reality temporal bone surgery simulator.

PubMed

Piromchai, P; Ioannou, I; Wijewickrema, S; Kasemsiri, P; Lodge, J; Kennedy, G; O'Leary, S

2017-01-01

To investigate the importance of anatomical variation in acquiring skills in virtual reality cochlear implant surgery. Eleven otolaryngology residents participated in this study. They were randomly allocated to practice cochlear implant surgery on the same specimen or on different specimens for four weeks. They were then tested on two new specimens, one standard and one challenging. Videos of their performance were de-identified and reviewed independently, by two blinded consultant otolaryngologists, using a validated assessment scale. The scores were compared between groups. On the standard specimen, the round window preparation score was 2.7 ± 0.4 for the experimental group and 1.7 ± 0.6 for the control group (p = 0.01). On the challenging specimen, instrument handling and facial nerve preservation scores of the experimental group were 3.0 ± 0.4 and 3.5 ± 0.7 respectively, while the control group received scores of 2.1 ± 0.8 and 2.4 ± 0.9 respectively (p < 0.05). Training on temporal bones with differing anatomies is beneficial in the development of expertise.

Temperament and character traits in patients with conversion disorder and their relations with dissociation.

PubMed

Sarisoy, Gökhan; Kaçar, Ö Mer Faruk; Öztürk, Arif; Yilman, Tuba; Mor, Sema; Özturan, Deniz Deniz; Yazici, Neslihan; Gümüş, Kübra

2015-12-01

The purpose of this study was to investigate temperament and character traits in patients with conversion disorder and the relation of these traits with dissociative symptoms. Sixty patients (60) diagnosed with conversion disorder according to DSM-IV-TR and 60 healthy volunteers were included in the study. All participants' temperament and character traits were determined using Cloninger's Temperament and Character Inventory (TCI). Patients with conversion disorder were divided into two subgroups using the Dissociative Experiences Scale (DES), dissociative (n=30, 50%) and non-dissociative (n=30, 50%). The two conversion disorder subgroups were compared with the control group in terms of temperament and character traits. Correlation analysis was also performed between TCI and DES scores in the entire conversion group. Novelty seeking (NS) scores were lower in both the dissociative and non-dissociative groups compared to the control group. Harm avoidance (HA) scores were higher in the dissociative group than in the control group. Reward dependence (RD) scores were lower in the dissociative group than in the non-dissociative and control group. Self-directedness (SD) scores were lower in the dissociative group than in the control group. Self-transcendence (ST) scores were higher in the dissociative group than in the non-dissociative group. DES scores were negatively correlated with RD and SD scores in the entire conversion group and positively correlated with ST scores. Low NS temperament traits may be associated with conversion disorder. High HA and low RD temperament traits and low SD and high ST character traits may be associated with pathological dissociation in patients with conversion disorder.

37: COMPARISON OF TWO METHODS: TBL-BASED AND LECTURE-BASED LEARNING IN NURSING CARE OF PATIENTS WITH DIABETES IN NURSING STUDENTS

PubMed Central

Khodaveisi, Masoud; Qaderian, Khosro; Oshvandi, Khodayar; Soltanian, Ali Reza; Vardanjani, Mehdi molavi

2017-01-01

Background and aims learning plays an important role in developing nursing skills and right care-taking. The Present study aims to evaluate two learning methods based on team –based learning and lecture-based learning in learning care-taking of patients with diabetes in nursing students. Method In this quasi-experimental study, 64 students in term 4 in nursing college of Bukan and Miandoab were included in the study based on knowledge and performance questionnaire including 15 questions based on knowledge and 5 questions based on performance on care-taking in patients with diabetes were used as data collection tool whose reliability was confirmed by cronbach alpha (r=0.83) by the researcher. To compare the mean score of knowledge and performance in each group in pre-test step and post-test step, pair –t test and to compare mean of scores in two groups of control and intervention, the independent t- test was used. Results There was not significant statistical difference between two groups in pre terms of knowledge and performance score (p=0.784). There was significant difference between the mean of knowledge scores and diabetes performance in the post-test in the team-based learning group and lecture-based learning group (p=0.001). There was significant difference between the mean score of knowledge of diabetes care in pre-test and post-test in base learning groups (p=0.001). Conclusion In both methods team-based and lecture-based learning approaches resulted in improvement in learning in students, but the rate of learning in the team-based learning approach is greater compared to that of lecture-based learning and it is recommended that this method be used as a higher education method in the education of students.

Selective peripheral nerve resection for treatment of persistent pain around the knee joint after total knee arthroplasty.

PubMed

Zhong, Guangjun; Liang, Zhu; Kan, Jiang; Muheremu, Aikeremujiang

2018-01-01

Objective This study was performed to determine the efficacy of selective peripheral nerve resection for treatment of persistent neuropathic pain after total knee arthroplasty (TKA). Methods Patients who underwent TKA in our department from January 2013 to July 2016 and experienced persistent pain around the knee joint after TKA were retrospectively included in the current study. Sixty patients were divided into experimental and control groups according the treatment they received. The treatment effect was evaluated by the Hospital for Special Surgery (HSS) knee score and visual analog scale (VAS) pain score preoperatively and at 1, 2, 3, 6, and 12 months postoperatively. Results The HSS knee scores were higher in both groups after than before the treatment, and HSS knee scores were significantly higher in the experimental group than in the control group. The VAS pain scores were lower in both groups after than before the treatment, and VAS pain scores were significantly lower in the experimental group than in the control group. Conclusions Selective peripheral nerve resection is an effective treatment method for persistent neuropathic pain after TKA.

The Use of Hypnosis in Improving Reading Performance.

ERIC Educational Resources Information Center

Fillmer, H. Thompson; And Others

1983-01-01

Describes a study investigating the effects of group hypnosis on the reading improvement of university students. Finds marginally significant improvement in total vocabulary and comprehension scores and greatest improvement in students with initially low reading scores. Sees group hypnosis as an efficient and economically feasible instructional…

Comparison of fresh-frozen cadaver and high-fidelity virtual reality simulator as methods of laparoscopic training.

PubMed

Sharma, Mitesh; Horgan, Alan

2012-08-01

The aim of this study was to compare fresh-frozen cadavers (FFC) with a high-fidelity virtual reality simulator (VRS) as training tools in minimal access surgery for complex and relatively simple procedures. A prospective comparative face validity study between FFC and VRS (LAP Mentor(™)) was performed. Surgeons were recruited to perform tasks on both FFC and VRS appropriately paired to their experience level. Group A (senior) performed a laparoscopic sigmoid colectomy, Group B (intermediate) performed a laparoscopic incisional hernia repair, and Group C (junior) performed basic laparoscopic tasks (BLT) (camera manipulation, hand-eye coordination, tissue dissection and hand-transferring skills). Each subject completed a 5-point Likert-type questionnaire rating the training modalities in nine domains. Data were analysed using nonparametric tests. Forty-five surgeons were recruited to participate (15 per skill group). Median scores for subjects in Group A were significantly higher for evaluation of FFC in all nine domains compared to VRS (p < 0.01). Group B scored FFC significantly better (p < 0.05) in all domains except task replication (p = 0.06). Group C scored FFC significantly better (p < 0.01) in eight domains but not on performance feedback (p = 0.09). When compared across groups, juniors accepted VRS as a training model more than did intermediate and senior groups on most domains (p < 0.01) except team work. Fresh-frozen cadaver is perceived as a significantly overall better model for laparoscopic training than the high-fidelity VRS by all training grades, irrespective of the complexity of the operative procedure performed. VRS is still useful when training junior trainees in BLT.

The standardized live patient and mechanical patient models--their roles in trauma teaching.

PubMed

Ali, Jameel; Al Ahmadi, Khalid; Williams, Jack Ivan; Cherry, Robert Allen

2009-01-01

We have previously demonstrated improved medical student performance using standardized live patient models in the Trauma Evaluation and Management (TEAM) program. The trauma manikin has also been offered as an option for teaching trauma skills in this program. In this study, we compare performance using both models. Final year medical students were randomly assigned to three groups: group I (n = 22) with neither model, group II (n = 24) with patient model, and group III (n = 24) with mechanical model using the same clinical scenario. All students completed pre-TEAM and post-TEAM multiple choice question (MCQ) exams and an evaluation questionnaire scoring five items on a scale of 1 to 5 with 5 being the highest. The items were objectives were met, knowledge improved, skills improved, overall satisfaction, and course should be mandatory. Students (groups II and III) then switched models, rating preferences in six categories: more challenging, more interesting, more dynamic, more enjoyable learning, more realistic, and overall better model. Scores were analyzed by ANOVA with p < 0.05 being considered statistically significant. All groups had similar scores (means % +/- SD)in the pretest (group I - 50.8 +/- 7.4, group II - 51.3 +/- 6.4, group III - 51.1 +/- 6.6). All groups improved their post-test scores but groups II and III scored higher than group I with no difference in scores between groups II and III (group I - 77.5 +/- 3.8, group II - 84.8 +/- 3.6, group III - 86.3 +/- 3.2). The percent of students scoring 5 in the questionnaire are as follows: objectives met - 100% for all groups; knowledge improved: group I - 91%, group II - 96%, group III - 92%; skills improved: group I - 9%, group II - 83%, group III - 96%; overall satisfaction: group I - 91%, group II - 92%, group III - 92%; should be mandatory: group I - 32%, group II - 96%, group III - 100%. Student preferences (48 students) are as follows: the mechanical model was more challenging (44 of 48); more interesting (40 of 48); more dynamic (46 of 48); more enjoyable (48 of 48); more realistic (32/48), and better overall model (42 of 48). Using the TEAM program, we have demonstrated that improvement in knowledge and skills are equally enhanced by using mechanical or patient models in trauma teaching. However, students overwhelmingly preferred the mechanical model.

Efficacy of Glutamate Modulators in Tic Suppression: A Double-Blind, Randomized Control Trial of D-serine and Riluzole in Tourette Syndrome.

PubMed

Lemmon, Monica E; Grados, Marco; Kline, Tina; Thompson, Carol B; Ali, Syed F; Singer, Harvey S

2015-06-01

It has been hypothesized that glutamatergic transmission may be altered in Tourette syndrome. In this study, we explored the efficacy of a glutamate agonist (D-serine) and antagonist (riluzole) as tic-suppressing agents in children with Tourette syndrome. We performed a parallel three-arm, 8-week, double-blind, randomized placebo-controlled treatment study in children with Tourette syndrome. Each child received 6 weeks of treatment with D-serine (maximum dose 30 mg/kg/day), riluzole (maximum dose 200 mg/day), or placebo, followed by a 2-week taper. The primary outcome measure was effective tic suppression as determined by the differences in the Yale Global Tic Severity Scale score; specifically, the total tic score and the combined score (total tic score + global impairment) between treatment arms after 6 weeks of treatment. Mann-Whitney U tests were performed to analyze differences between each group and the placebo group. Twenty-four patients (males = 21, ages 9-18) enrolled in the study; one patient dropped out before completion. Combined Yale Global Tic Severity Scale score and total tic scores improved in all groups. The 6-week mean percent improvement of the riluzole (n = 10), D-serine (n = 9), and placebo (n = 5) groups in the combined Yale Global Tic Severity Scale score were 43.7, 39.5, and 30.2 and for total tic scores were 38.0, 25.0, and 34.0, respectively. There were no significant differences in Yale Global Tic Severity Scale score or total tic score, respectively, between the riluzole and placebo (P = 0.35, 0.85) or D-serine and placebo (P = 0.50, 0.69) groups. Tics diminished by comparable percentages in the riluzole, D-serine, and placebo groups. These preliminary data suggest that D-serine and riluzole are not effective in tic suppression. Copyright © 2015 Elsevier Inc. All rights reserved.

Effect of teaching mathematics using GeoGebra on students' with dissimilar spatial visualisation

NASA Astrophysics Data System (ADS)

Bakar, Kamariah Abu; Ayub, Ahmad Fauzi Mohd; Tarmizi, Rohani Ahmad; Luan, Wong Su

2015-10-01

This study examined the effects of GeoGebra on mathematics performance of students with different spatial visualization. A qusai-experimental, pretest-posttest control group design was conducted. A total of 71 students from two intact groups were involved in the study. They were in two groups and each group was randonly assigned to the experimental group (36 students) and control group (35 students). A spatial visual test to identify students with high or low visualization, and a mathematics performance pre-test were administered at the initial stage of this study. A post-test was administered after 12 weeks of treatment using GeoGebra. Analyses of Covarion (ANCOVA) was used to adjust for the pre-test score. Findings showed that the group with access to GeoGebra achieved significantly better test scores in the posttest as compared to the group which followed the traditional teaching method. A two-way ANCOVA used to analyse the effect of students' spatial visualization on post-test performance showed that there was no effect. The results from this study suggested that using GeoGebra had helped the students to score better in the posttest. However, there is no significance difference on mathematics performances on students with difference types of spatial visualisastion. This study indicates that GeoGebra is useful in enhancing the teaching and learning of mathematics.

The Bay Area Verbal Learning Test (BAVLT): Normative Data and the Effects of Repeated Testing, Simulated Malingering, and Traumatic Brain Injury

PubMed Central

Woods, David L.; Wyma, John M.; Herron, Timothy J.; Yund, E. William

2017-01-01

Verbal learning tests (VLTs) are widely used to evaluate memory deficits in neuropsychiatric and developmental disorders. However, their validity has been called into question by studies showing significant differences in VLT scores obtained by different examiners. Here we describe the computerized Bay Area Verbal Learning Test (BAVLT), which minimizes inter-examiner differences by incorporating digital list presentation and automated scoring. In the 10-min BAVLT, a 12-word list is presented on three acquisition trials, followed by a distractor list, immediate recall of the first list, and, after a 30-min delay, delayed recall and recognition. In Experiment 1, we analyzed the performance of 195 participants ranging in age from 18 to 82 years. Acquisition trials showed strong primacy and recency effects, with scores improving over repetitions, particularly for mid-list words. Inter-word intervals (IWIs) increased with successive words recalled. Omnibus scores (summed over all trials except recognition) were influenced by age, education, and sex (women outperformed men). In Experiment 2, we examined BAVLT test-retest reliability in 29 participants tested with different word lists at weekly intervals. High intraclass correlation coefficients were seen for omnibus and acquisition scores, IWIs, and a categorization index reflecting semantic reorganization. Experiment 3 examined the performance of Experiment 2 participants when feigning symptoms of traumatic brain injury. Although 37% of simulated malingerers showed abnormal (p < 0.05) omnibus z-scores, z-score cutoffs were ineffective in discriminating abnormal malingerers from control participants with abnormal scores. In contrast, four malingering indices (recognition scores, primacy/recency effects, learning rate across acquisition trials, and IWIs) discriminated the two groups with 80% sensitivity and 80% specificity. Experiment 4 examined the performance of a small group of patients with mild or severe TBI. Overall, both patient groups performed within the normal range, although significant performance deficits were seen in some patients. The BAVLT improves the speed and replicability of verbal learning assessments while providing comprehensive measures of retrieval timing, semantic organization, and primacy/recency effects that clarify the nature of performance. PMID:28127280

Effects of Didactic Instruction and Test-Enhanced Learning in a Nursing Review Course.

PubMed

Tu, Yu-Ching; Lin, Yi-Jung; Lee, Jonathan W; Fan, Lir-Wan

2017-11-01

Determining the most effective approach for students' successful academic performance and achievement on the national licensure examination for RNs is important to nursing education and practice. A quasi-experimental design was used to compare didactic instruction and test-enhanced learning among nursing students divided into two fundamental nursing review courses in their final semester. Students in each course were subdivided into low-, intermediate-, and high-score groups based on their first examination scores. Mixed model of repeated measure and two-way analysis of variance were applied to evaluate students' academic results and both teaching approaches. Intermediate-scoring students' performances improved more through didactic instruction, whereas low-scoring students' performances improved more through test-enhanced learning. Each method had differing effects on individual subgroups within the different performance level groups of their classes, which points to the importance of considering both the didactic and test-enhanced learning approaches. [J Nurs Educ. 2017;56(11):683-687.]. Copyright 2017, SLACK Incorporated.

Functional Outcome Trajectories after Out-of Hospital Pediatric Cardiac Arrest

PubMed Central

Silverstein, Faye S; Slomine, Beth; Christensen, James; Holubkov, Richard; Page, Kent; Dean, J. Michael; Moler, Frank

2016-01-01

Objective To analyze functional performance measures collected prospectively during the conduct of a clinical trial that enrolled children (up to age 18 years), resuscitated after out-of-hospital cardiac arrest, who were at high risk for poor outcomes. Design Children with Glasgow Motor Scales <5, within 6 hours of resuscitation, were enrolled in a clinical trial that compared two targeted temperature management interventions (THAPCA-OH, NCT00878644). The primary outcome, 12-month survival with Vineland Adaptive Behavior Scales, second edition (VABS-II) score ≥70, did not differ between groups. Setting 38 North American pediatric ICU’s. Participants 295 children were enrolled; 270/295 had baseline VABS-II scores ≥70; 87/270 survived one year. Interventions Targeted temperatures were 33.0°C and 36.8°C for hypothermia and normothermia groups. Measurements and Main Results Baseline measures included VABS-II, Pediatric Cerebral Performance Category(PCPC), and Pediatric Overall Performance Category (POPC). PCPC and POPC were rescored at hospital discharges; all three were scored at 3 and 12 months. In survivors with baseline VABS-II scores ≥70, we evaluated relationships of hospital discharge PCPC with 3 and 12 month scores, and between 3 and 12 month VABS-II scores. Hospital discharge PCPC scores strongly predicted 3 and 12 month PCPC (r=0.82,0.79; p<0.0001) and VABS-II scores (r=−0.81,−0.77; p<0.0001) Three month VABS-II scores strongly predicted 12 month performance (r=0.95, p<0.0001). Hypothermia treatment did not alter these relationships. Conclusions In comatose children, with Glasgow Motor Scales <5 in the initial hours after out-of-hospital cardiac arrest resuscitation, function scores at hospital discharge and at 3 months predicted 12-month performance well in the majority of survivors. PMID:27509385

Informal Peer-Assisted Learning Groups Did Not Lead to Better Performance of Saudi Dental Students.

PubMed

AbdelSalam, Maha; El Tantawi, Maha; Al-Ansari, Asim; AlAgl, Adel; Al-Harbi, Fahad

2017-01-01

To describe peer-assisted learning (PAL) groups formed by dental undergraduate students in a biomedical course and to investigate the association of individual and group characteristics with academic performance. In 2015, 92 fourth-year students (43 males and 49 females) in the College of Dentistry, University of Dammam, Saudi Arabia, were invited to form PAL groups to study a unit of a biomedical course. An examination was used to assess their knowledge after 2 weeks. In addition, a questionnaire and social network analysis were used to investigate (1) individual student attributes: gender, role, subject matter knowledge, grade in previous year, teaming with friends, previous communication with teammates, and content discussion, and (2) group attributes: group teacher's previous grade, number of colleagues with whom a student connected, teaming with friends, similarity of teammates' previous grades, and teacher having higher previous grades than other teammates. Regression analysis was used to assess the association of examination scores with individual and group attributes. The response rate was 80.4% (74 students: 36 males and 38 females). Students who previously scored grades A and B had higher examination scores than students with grades C/less (regression coefficient = 18.50 and 13.39) within the groups. Higher scores were not associated with working in groups including friends only (regression coefficient = 1.17) or when all students had similar previous grades (regression coefficient = 0.85). Students with previous high grades benefited to a greater extent from working in PAL groups. Similarity of teammates in PAL groups was not associated with better scores. © 2017 S. Karger AG, Basel.

Semantic deficits in Spanish-English bilingual children with language impairment.

PubMed

Sheng, Li; Peña, Elizabeth D; Bedore, Lisa M; Fiestas, Christine E

2012-02-01

To examine the nature and extent of semantic deficits in bilingual children with language impairment (LI). Thirty-seven Spanish-English bilingual children with LI (ranging from age 7;0 [years;months] to 9;10) and 37 typically developing (TD) age-matched peers generated 3 associations to 12 pairs of translation equivalents in English and Spanish. Responses were coded as paradigmatic (e.g., dinner-lunch, cena-desayuno [dinner-breakfast]), syntagmatic (e.g., delicious-pizza, delicioso-frijoles [delicious-beans]), and errors (e.g., wearing-where, vestirse-mal [to get dressed-bad]). A semantic depth score was derived in each language and conceptually by combining children's performance in both languages. The LI group achieved significantly lower semantic depth scores than the TD group after controlling for group differences in vocabulary size. Children showed higher conceptual scores than single-language scores. Both groups showed decreases in semantic depth scores across multiple elicitations. Analyses of individual performances indicated that semantic deficits (1 SD below the TD mean semantic depth score) were manifested in 65% of the children with LI and in 14% of the TD children. School-age bilingual children with and without LI demonstrated spreading activation of semantic networks. Consistent with the literature on monolingual children with LI, sparsely linked semantic networks characterize a considerable proportion of bilingual children with LI.

The Relationship Between ACGME Duty Hour Requirements and Performance on the American Board of Emergency Medicine Qualifying Examination.

PubMed

Counselman, Francis L; Kowalenko, Terry; Marco, Catherine A; Joldersma, Kevin B; Korte, Robert C; Reisdorff, Earl J

2016-10-01

In 2003, the Accreditation Council for Graduate Medical Education (ACGME) instituted requirements that limited the number of hours residents could spend on duty, and in 2011, it revised these requirements. This study explored whether the implementation of the 2003 and 2011 duty hour limits was associated with a change in emergency medicine residents' performance on the American Board of Emergency Medicine (ABEM) Qualifying Examination (QE). Beginning with the 1999 QE and ending with the 2014 QE, candidates for whom all training occurred without duty hour requirements (Group A), candidates under the first set of duty hour requirements (Group C), and candidates under the second set of duty hour requirements (Group E) were compared. Comparisons included mean scores and pass rates. In Group A, 5690 candidates completed the examination, with a mean score of 82.8 and a 90.2% pass rate. In Group C, 8333 candidates had a mean score of 82.4 and a 90.5% pass rate. In Group E, there were 1269 candidates, with a mean score of 82.5 and an 89.4% pass rate. There was a small but statistically significant decrease in the mean scores (0.04, P  < .001) after implementation of the first duty hour requirements, but this difference did not occur after implementation of the 2011 standards. There was no difference among pass rates for any of the study groups (χ 2  = 1.68, P  = .43). We did not identify an association between the 2003 and 2011 ACGME duty hour requirements and performance of test takers on the ABEM QE.

Evaluating Equating Accuracy and Assumptions for Groups that Differ in Performance

ERIC Educational Resources Information Center

Powers, Sonya; Kolen, Michael J.

2014-01-01

Accurate equating results are essential when comparing examinee scores across exam forms. Previous research indicates that equating results may not be accurate when group differences are large. This study compared the equating results of frequency estimation, chained equipercentile, item response theory (IRT) true-score, and IRT observed-score…

A multinational randomised study comparing didactic lectures with case scenario in a severe sepsis medical simulation course.

PubMed

Li, Chih-Huang; Kuan, Win-Sen; Mahadevan, Malcolm; Daniel-Underwood, Lynda; Chiu, Te-Fa; Nguyen, H Bryant

2012-07-01

Medical simulation has been used to teach critical illness in a variety of settings. This study examined the effect of didactic lectures compared with simulated case scenario in a medical simulation course on the early management of severe sepsis. A prospective multicentre randomised study was performed enrolling resident physicians in emergency medicine from four hospitals in Asia. Participants were randomly assigned to a course that included didactic lectures followed by a skills workshop and simulated case scenario (lecture-first) or to a course that included a skills workshop and simulated case scenario followed by didactic lectures (simulation-first). A pre-test was given to the participants at the beginning of the course, post-test 1 was given after the didactic lectures or simulated case scenario depending on the study group assignment, then a final post-test 2 was given at the end of the course. Performance on the simulated case scenario was evaluated with a performance task checklist. 98 participants were enrolled in the study. Post-test 2 scores were significantly higher than pre-test scores in all participants (80.8 ± 12.0% vs 65.4 ± 12.2%, p<0.01). There was no difference in pre-test scores between the two study groups. The lecture-first group had significantly higher post-test 1 scores than the simulation-first group (78.8 ± 10.6% vs 71.6 ± 12.6%, p<0.01). There was no difference in post-test 2 scores between the two groups. The simulated case scenario task performance completion was 90.8% (95% CI 86.6% to 95.0%) in the lecture-first group compared with 83.8% (95% CI 79.5% to 88.1%) in the simulation-first group (p=0.02). A medical simulation course can improve resident physician knowledge in the early management of severe sepsis. Such a course should include a comprehensive curriculum that includes didactic lectures followed by simulation experience.

A Direct Comparison of Real-World and Virtual Navigation Performance in Chronic Stroke Patients.

PubMed

Claessen, Michiel H G; Visser-Meily, Johanna M A; de Rooij, Nicolien K; Postma, Albert; van der Ham, Ineke J M

2016-04-01

An increasing number of studies have presented evidence that various patient groups with acquired brain injury suffer from navigation problems in daily life. This skill is, however, scarcely addressed in current clinical neuropsychological practice and suitable diagnostic instruments are lacking. Real-world navigation tests are limited by geographical location and associated with practical constraints. It was, therefore, investigated whether virtual navigation might serve as a useful alternative. To investigate the convergent validity of virtual navigation testing, performance on the Virtual Tubingen test was compared to that on an analogous real-world navigation test in 68 chronic stroke patients. The same eight subtasks, addressing route and survey knowledge aspects, were assessed in both tests. In addition, navigation performance of stroke patients was compared to that of 44 healthy controls. A correlation analysis showed moderate overlap (r = .535) between composite scores of overall real-world and virtual navigation performance in stroke patients. Route knowledge composite scores correlated somewhat stronger (r = .523) than survey knowledge composite scores (r = .442). When comparing group performances, patients obtained lower scores than controls on seven subtasks. Whereas the real-world test was found to be easier than its virtual counterpart, no significant interaction-effects were found between group and environment. Given moderate overlap of the total scores between the two navigation tests, we conclude that virtual testing of navigation ability is a valid alternative to navigation tests that rely on real-world route exposure.

Learning physics: A comparative analysis between instructional design methods

NASA Astrophysics Data System (ADS)

Mathew, Easow

The purpose of this research was to determine if there were differences in academic performance between students who participated in traditional versus collaborative problem-based learning (PBL) instructional design approaches to physics curricula. This study utilized a quantitative quasi-experimental design methodology to determine the significance of differences in pre- and posttest introductory physics exam performance between students who participated in traditional (i.e., control group) versus collaborative problem solving (PBL) instructional design (i.e., experimental group) approaches to physics curricula over a college semester in 2008. There were 42 student participants (N = 42) enrolled in an introductory physics course at the research site in the Spring 2008 semester who agreed to participate in this study after reading and signing informed consent documents. A total of 22 participants were assigned to the experimental group (n = 22) who participated in a PBL based teaching methodology along with traditional lecture methods. The other 20 students were assigned to the control group (n = 20) who participated in the traditional lecture teaching methodology. Both the courses were taught by experienced professors who have qualifications at the doctoral level. The results indicated statistically significant differences (p < .01) in academic performance between students who participated in traditional (i.e., lower physics posttest scores and lower differences between pre- and posttest scores) versus collaborative (i.e., higher physics posttest scores, and higher differences between pre- and posttest scores) instructional design approaches to physics curricula. Despite some slight differences in control group and experimental group demographic characteristics (gender, ethnicity, and age) there were statistically significant (p = .04) differences between female average academic improvement which was much higher than male average academic improvement (˜63%) in the control group which may indicate that traditional teaching methods are more effective in females, whereas there was no significant difference noted in the experimental group between male and female participants. There was a statistically significant and negative relationship (r = -.61, p = .01) between age and physics pretest scores in the control group. No statistical analyses yielded significantly different average academic performance values in either group as delineated by ethnicity.

Retrospective Analysis of an Ongoing Group-Based Modified Constraint-Induced Movement Therapy Program for Children with Acquired Brain Injury.

PubMed

Komar, Alyssa; Ashley, Kelsey; Hanna, Kelly; Lavallee, Julia; Woodhouse, Janet; Bernstein, Janet; Andres, Matthew; Reed, Nick

2016-01-01

A pretest-posttest retrospective design was used to evaluate the impact of a group-based modified constraint-induced movement therapy (mCIMT) program on upper extremity function and occupational performance. 20 children ages 3 to 18 years with hemiplegia following an acquired brain injury participated in a 2-week group mCIMT program. Upper extremity function was measured with the Assisting Hand Assessment (AHA) and subtests from the Quality of Upper Extremity Skills Test (QUEST). Occupational performance and satisfaction were assessed using the Canadian Occupational Performance Measure (COPM). Data were analyzed using a Wilcoxon signed-ranks test. Group-based analysis revealed upper extremity function and occupational performance attained statistically significant improvements from pre- to postintervention on all outcome measures (AHA: Z = -3.63, p = <.001; QUEST Grasps: Z = -3.10, p = .002; QUEST Dissociated Movement: Z = -2.51, p = .012; COPM Performance: Z = -3.64, p = <.001; COPM Satisfaction: Z = -3.64, p = <.001). Across individuals, clinically significant improvements were found in 65% of participants' AHA scores. 80% of COPM Performance scores and 70% of COPM Satisfaction scores demonstrated clinically significant improvements in at least one identified goal. This study is an initial step in evaluating and providing preliminary evidence supporting the effectiveness of a group-based mCIMT program for children with hemiplegia following an acquired brain injury.

Detecting Intervention Effects in a Cluster-Randomized Design Using Multilevel Structural Equation Modeling for Binary Responses

PubMed Central

Cho, Sun-Joo; Preacher, Kristopher J.; Bottge, Brian A.

2015-01-01

Multilevel modeling (MLM) is frequently used to detect group differences, such as an intervention effect in a pre-test–post-test cluster-randomized design. Group differences on the post-test scores are detected by controlling for pre-test scores as a proxy variable for unobserved factors that predict future attributes. The pre-test and post-test scores that are most often used in MLM are summed item responses (or total scores). In prior research, there have been concerns regarding measurement error in the use of total scores in using MLM. To correct for measurement error in the covariate and outcome, a theoretical justification for the use of multilevel structural equation modeling (MSEM) has been established. However, MSEM for binary responses has not been widely applied to detect intervention effects (group differences) in intervention studies. In this article, the use of MSEM for intervention studies is demonstrated and the performance of MSEM is evaluated via a simulation study. Furthermore, the consequences of using MLM instead of MSEM are shown in detecting group differences. Results of the simulation study showed that MSEM performed adequately as the number of clusters, cluster size, and intraclass correlation increased and outperformed MLM for the detection of group differences. PMID:29881032

Detecting Intervention Effects in a Cluster-Randomized Design Using Multilevel Structural Equation Modeling for Binary Responses.

PubMed

Cho, Sun-Joo; Preacher, Kristopher J; Bottge, Brian A

2015-11-01

Multilevel modeling (MLM) is frequently used to detect group differences, such as an intervention effect in a pre-test-post-test cluster-randomized design. Group differences on the post-test scores are detected by controlling for pre-test scores as a proxy variable for unobserved factors that predict future attributes. The pre-test and post-test scores that are most often used in MLM are summed item responses (or total scores). In prior research, there have been concerns regarding measurement error in the use of total scores in using MLM. To correct for measurement error in the covariate and outcome, a theoretical justification for the use of multilevel structural equation modeling (MSEM) has been established. However, MSEM for binary responses has not been widely applied to detect intervention effects (group differences) in intervention studies. In this article, the use of MSEM for intervention studies is demonstrated and the performance of MSEM is evaluated via a simulation study. Furthermore, the consequences of using MLM instead of MSEM are shown in detecting group differences. Results of the simulation study showed that MSEM performed adequately as the number of clusters, cluster size, and intraclass correlation increased and outperformed MLM for the detection of group differences.

Are WISC IQ scores in children with mathematical learning disabilities underestimated? The influence of a specialized intervention on test performance.

PubMed

Lambert, Katharina; Spinath, Birgit

2018-01-01

Intelligence measures play a pivotal role in the diagnosis of mathematical learning disabilities (MLD). Probably as a result of math-related material in IQ tests, children with MLD often display reduced IQ scores. However, it remains unclear whether the effects of math remediation extend to IQ scores. The present study investigated the impact of a special remediation program compared to a control group receiving private tutoring (PT) on the WISC IQ scores of children with MLD. We included N=45 MLD children (7-12 years) in a study with a pre- and post-test control group design. Children received remediation for two years on average. The analyses revealed significantly greater improvements in the experimental group on the Full-Scale IQ, and the Verbal Comprehension, Perceptual Reasoning, and Working Memory indices, but not Processing Speed, compared to the PT group. Children in the experimental group showed an average WISC IQ gain of more than ten points. Results indicate that the WISC IQ scores of MLD children might be underestimated and that an effective math intervention can improve WISC IQ test performance. Taking limitations into account, we discuss the use of IQ measures more generally for defining MLD in research and practice. Copyright © 2017 Elsevier Ltd. All rights reserved.

Comparison of Static and Dynamic Balance in Female Collegiate Soccer, Basketball, and Gymnastics Athletes

PubMed Central

Bressel, Eadric; Yonker, Joshua C; Kras, John; Heath, Edward M

2007-01-01

Context: How athletes from different sports perform on balance tests is not well understood. When prescribing balance exercises to athletes in different sports, it may be important to recognize performance variations. Objective: To compare static and dynamic balance among collegiate athletes competing or training in soccer, basketball, and gymnastics. Design: A quasi-experimental, between-groups design. Independent variables included limb (dominant and nondominant) and sport played. Setting: A university athletic training facility. Patients or Other Participants: Thirty-four female volunteers who competed in National Collegiate Athletic Association Division I soccer (n = 11), basketball (n = 11), or gymnastics (n = 12). Intervention(s): To assess static balance, participants performed 3 stance variations (double leg, single leg, and tandem leg) on 2 surfaces (stiff and compliant). For assessment of dynamic balance, participants performed multidirectional maximal single-leg reaches from a unilateral base of support. Main Outcome Measure(s): Errors from the Balance Error Scoring System and normalized leg reach distances from the Star Excursion Balance Test were used to assess static and dynamic balance, respectively. Results: Balance Error Scoring System error scores for the gymnastics group were 55% lower than for the basketball group (P = .01), and Star Excursion Balance Test scores were 7% higher in the soccer group than the basketball group (P = .04). Conclusions: Gymnasts and soccer players did not differ in terms of static and dynamic balance. In contrast, basketball players displayed inferior static balance compared with gymnasts and inferior dynamic balance compared with soccer players. PMID:17597942

Improved performance in CAPRI round 37 using LZerD docking and template-based modeling with combined scoring functions.

PubMed

Peterson, Lenna X; Shin, Woong-Hee; Kim, Hyungrae; Kihara, Daisuke

2018-03-01

We report our group's performance for protein-protein complex structure prediction and scoring in Round 37 of the Critical Assessment of PRediction of Interactions (CAPRI), an objective assessment of protein-protein complex modeling. We demonstrated noticeable improvement in both prediction and scoring compared to previous rounds of CAPRI, with our human predictor group near the top of the rankings and our server scorer group at the top. This is the first time in CAPRI that a server has been the top scorer group. To predict protein-protein complex structures, we used both multi-chain template-based modeling (TBM) and our protein-protein docking program, LZerD. LZerD represents protein surfaces using 3D Zernike descriptors (3DZD), which are based on a mathematical series expansion of a 3D function. Because 3DZD are a soft representation of the protein surface, LZerD is tolerant to small conformational changes, making it well suited to docking unbound and TBM structures. The key to our improved performance in CAPRI Round 37 was to combine multi-chain TBM and docking. As opposed to our previous strategy of performing docking for all target complexes, we used TBM when multi-chain templates were available and docking otherwise. We also describe the combination of multiple scoring functions used by our server scorer group, which achieved the top rank for the scorer phase. © 2017 Wiley Periodicals, Inc.

MRI-based score helps in assessing the severity and in follow-up of pediatric patients with perianal Crohn disease.

PubMed

Kulkarni, Sakil; Gomara, Roberto; Reeves-Garcia, Jesse; Hernandez, Erick; Restrepo, Ricardo

2014-02-01

The radiologic healing of perianal fistulizing Crohn disease (PfCD) lags behind the clinical healing. Contrast-enhanced pelvic magnetic resonance imaging (MRI) is the radiologic study of choice used to diagnose PfCD in children. The aim was to study whether the various MRI-based radiologic parameters and score can help in staging and follow-up of patients with PfCD. We performed a retrospective chart review of children with PfCD who underwent contrast-enhanced MRI of the pelvis. The demographic profile, clinical status, and laboratory data of the patients at the time of each MRI examination were noted. Based on the clinical status of the patient at the time of MRI examinations, the MRIs were classified into 3 groups: severe disease, mild-to-moderate disease, and asymptomatic. Each MRI examination was reviewed by a radiologist, who was blinded to the clinical status of the patient. Of the radiologic parameters, the number of fistulas, the complexity of fistulas, and the number of abscesses were significantly lower in the asymptomatic group compared with the mild-to-moderate and severe disease groups. The Van Assche MRI-based score was significantly lower in the asymptomatic group compared with the mild-to-moderate disease (P = 0.01) and the severe disease group (P = 0.002). The percentage increase in fistula activity after gadolinium administration was significantly lower in the asymptomatic group compared with the mild-to-moderate disease (P = 0.026) and severe disease (P = 0.019) groups. The MRI-based scores were significantly higher in the MRI examinations performed at diagnosis compared with those that were performed while the patients were receiving the treatment (P = 0.017). The Van Assche MRI score and the percentage increase in fistula activity after gadolinium administration help in assessing the severity perianal Crohn disease. The Van Assche MRI score may be helpful in documenting healing during therapy of perianal Crohn disease.

Organizational strategy influence on visual memory performance after stroke: cortical/subcortical and left/right hemisphere contrasts.

PubMed

Lange, G; Waked, W; Kirshblum, S; DeLuca, J

2000-01-01

To examine how organizational strategy at encoding influences visual memory performance in stroke patients. Case control study. Postacute rehabilitation hospital. Stroke patients with right hemisphere damage (n = 20) versus left hemisphere damage (n = 15), and stroke patients with cortical damage (n = 11) versus subcortical damage (n = 19). Organizational strategy scores, recall performance on the Rey-Osterrieth Complex Figure (ROCF). Results demonstrated significantly greater organizational impairment and less accurate copy performance (i.e., encoding of visuospatial information on the ROCF) in the right compared to the left hemisphere group, and in the cortical relative to the subcortical group. Organizational strategy and copy accuracy scores were significantly related to each other. The absolute amount of immediate and delayed recall was significantly associated with poor organizational strategy scores. However, relative to the amount of visual information originally encoded, memory performances did not differ between groups. These findings suggest that visual memory impairments after stroke may be caused by a lack of organizational strategy affecting information encoding, rather than an impairment in memory storage or retrieval.

Improved neurocognitive test performance in both arms of the SMART study: impact of practice effect

PubMed Central

Grund, Birgit; Wright, Edwina J.; Brew, Bruce J.; Price, Richard W.; Roediger, Mollie P.; Bain, Margaret P.; Hoy, Jennifer F.; Shlay, Judith C.; Vjecha, Michael J.; Robertson, Kevin R.

2013-01-01

We evaluated factors associated with improvement in neurocognitive performance in 258 HIV-infected adults with baseline CD4 lymphocyte counts above 350 cells/mm3 randomized to intermittent, CD4-guided antiretroviral therapy (ART) (128 participants) versus continuous therapy (130) in the Neurology substudy of the Strategies for Management of Antiretroviral Therapy trial. Participants were enrolled in Australia, North America, Brazil, and Thailand, and neurocognitive performance was assessed by a five-test battery at baseline and month 6. The primary outcome was change in the quantitative neurocognitive performance z score (QNPZ-5), the average of the z scores of the five tests. Associations of the 6-month change in test scores with ART use, CD4 cell counts, HIV RNA levels, and other factors were determined using multiple regression models. At baseline, median age was 40 years, median CD4 cell count was 513 cells/mm3, 88 % had plasma HIV RNA ≤400 copies/mL, and mean QNPZ-5 was −0.68. Neurocognitive performance improved in both treatment groups by 6 months; QNPZ-5 scores increased by 0.20 and 0.13 in the intermittent and continuous ART groups, respectively (both P<0.001 for increase and P=0.26 for difference). ART was used on average for 3.6 and 5.9 out of the 6 months in the intermittent and continuous ART groups, respectively, but the increase in neurocognitive test scores could not be explained by ART use, changes in CD4, or plasma HIV RNA, which suggests a practice effect. The impact of a practice effect after 6 months emphasizes the need for a control group in HIV studies that measure intervention effects using neurocognitive tests similar to ours. PMID:23943468

Selfish play increases during high-stakes NBA games and is rewarded with more lucrative contracts.

PubMed

Uhlmann, Eric Luis; Barnes, Christopher M

2014-01-01

High-stakes team competitions can present a social dilemma in which participants must choose between concentrating on their personal performance and assisting teammates as a means of achieving group objectives. We find that despite the seemingly strong group incentive to win the NBA title, cooperative play actually diminishes during playoff games, negatively affecting team performance. Thus team cooperation decreases in the very high stakes contexts in which it is most important to perform well together. Highlighting the mixed incentives that underlie selfish play, personal scoring is rewarded with more lucrative future contracts, whereas assisting teammates to score is associated with reduced pay due to lost opportunities for personal scoring. A combination of misaligned incentives and psychological biases in performance evaluation bring out the "I" in "team" when cooperation is most critical.

Selfish Play Increases during High-Stakes NBA Games and Is Rewarded with More Lucrative Contracts

PubMed Central

Uhlmann, Eric Luis; Barnes, Christopher M.

2014-01-01

High-stakes team competitions can present a social dilemma in which participants must choose between concentrating on their personal performance and assisting teammates as a means of achieving group objectives. We find that despite the seemingly strong group incentive to win the NBA title, cooperative play actually diminishes during playoff games, negatively affecting team performance. Thus team cooperation decreases in the very high stakes contexts in which it is most important to perform well together. Highlighting the mixed incentives that underlie selfish play, personal scoring is rewarded with more lucrative future contracts, whereas assisting teammates to score is associated with reduced pay due to lost opportunities for personal scoring. A combination of misaligned incentives and psychological biases in performance evaluation bring out the “I” in “team” when cooperation is most critical. PMID:24763384

Peer video review and feedback improve performance in basic surgical skills.

PubMed

Vaughn, Carolyn J; Kim, Edward; O'Sullivan, Patricia; Huang, Emily; Lin, Matthew Y C; Wyles, Susannah; Palmer, Barnard J A; Pierce, Jonathan L; Chern, Hueylan

2016-02-01

Incorporation of home-video assessments allows flexibility in feedback but requires faculty time. Peer feedback (PF) may provide additional benefits while avoiding these constraints. Twenty-four surgical interns completed a 12-week skills curriculum with home-video assignments focused on knot tying and suturing. Interns were randomized into 2 groups: PF or faculty feedback (FF). Peers and faculty provided feedback on home videos with checklists, global rating, and comments. Learners' skills were assessed at baseline, during, and at the conclusion of the curriculum. Performance of the 2 groups as rated by experts was compared. FF and PF were compared. Both groups improved from baseline, and the highest rated scores were seen on their home-video assessments. The PF group performed better at the final assessment than the FF group (effect size, .84). When using a checklist, there was no significant difference between scores given by peers and faculty. The PF group performed better at the final assessment, suggesting reviewing and analyzing another's performance may improve one's own performance. With checklists as guidance, peers can serve as raters comparable to faculty. Copyright © 2016 Elsevier Inc. All rights reserved.

Financial Capacity Following Traumatic Brain Injury: A Six-Month Longitudinal Study

PubMed Central

Dreer, Laura E.; DeVivo, Michael J.; Novack, Thomas A.; Marson, Daniel C.

2015-01-01

Objective To longitudinally investigate financial capacity (FC) following traumatic brain injury (TBI). Design Longitudinal study comparing FC in cognitively healthy adults and persons with moderate to severe TBI at time of acute hospitalization (Time 1) and at six months post injury (Time 2). Setting Inpatient brain injury rehabilitation unit. Participants Twenty healthy adult controls and 24 adult persons with moderate to severe TBI. Main Outcome Measures Participants were administered the Financial Capacity Instrument (FCI-9), a standardized instrument that measures performance on eighteen financial tasks, nine domains, and two global scores. Between and within group differences were examined for each FCI-9 domain and global scores. Using control group referenced cut scores, participants with TBI were also assigned an impairment rating (intact, marginal, or impaired) on each domain and global score. Results At Time 1, participants with TBI performed significantly below controls on the majority of financial variables tested. At Time 2, participants with TBI demonstrated within group improvement on both simple and complex financial skills, but continued to perform below adult controls on complex financial skills and both global scores. Group by time interactions were significant for five domains and both global scores. At Time 1, high percentages of participants with TBI were assigned either ‘marginal’ or ‘impaired’ ratings on the domains and global scores, with significant percentage increases of ‘intact’ ratings at Time 2. Conclusions Immediately following acute injury, persons with moderate to severe TBI show global impairment of FC. Findings indicate improvement of both simple and complex financial skills over a six month period, but continued impairment on more complex financial skills. Future studies should examine loss and recovery of FC following TBI over longer time periods and a wider range of injury severity. PMID:22369113

Determinants of sport-specific postural control strategy and balance performance of amateur rugby players.

PubMed

Chow, Gary C C; Fong, Shirley S M; Chung, Joanne W Y; Chung, Louisa M Y; Ma, Ada W W; Macfarlane, Duncan J

2016-11-01

Postural control strategy and balance performance of rugby players are important yet under-examined issues. This study aimed to examine the differences in balance strategy and balance performance between amateur rugby players and non-players, and to explore training- and injury-related factors that may affect rugby players' balance outcomes. Cross-sectional and exploratory study. Forty-five amateur rugby players and 41 healthy active individuals participated in the study. Balance performance and balance strategies were assessed using the sensory organization test (SOT) of the Smart Equitest computerized dynamic posturography machine. Rugby training history and injury history were solicited from the participants. The SOT strategy scores were 1.99-54.90% lower in the rugby group than in the control group (p<0.05), and the equilibrium scores were 1.06-14.29% lower in the rugby group than in the control group (p<0.05). After accounting for age, sex and body mass index, only length of rugby training (in years) was independently associated with the SOT condition 6 strategy score, explaining 15.7% of its variance (p=0.006). There was no association between SOT condition 6 strategy/equilibrium scores and injury history among the rugby players (p>0.05). Amateur rugby players demonstrated inferior balance strategy and balance performance compared to their non-training counterparts. Their suboptimal balance strategy was associated with insufficient training experience but not with history of injury. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

CrossFit athletes exhibit high symmetry of fundamental movement patterns. A cross-sectional study

PubMed Central

Tafuri, Silvio; Notarnicola, Angela; Monno, Antonello; Ferretti, Francesco; Moretti, Biagio

2016-01-01

Summary Background even if CrossFit training programs accounted actually more than 7500 gyms affiliated in the USA and more than 2000 in Europe and involved today more than 1 million of people, actually there were not several studies about the effect of the CrossFit on the health and sport performance. The aim of these research was to evaluate the performance in 7 fundamental movement patterns using a standardized methods, the Functional Movement Screen (FMS). Methods we enrolled three groups of athletes (age 17–40 years; >6 months of training programs): CrossFitters, body builders and professional weightlifters. FMS test was performed to all people enrolled. Scores of FMS test was examined comparing three groups. Results no differences in the three groups were showed in the mean score values of each test and in total score, except for shoulder mobility test (higher among CrossFitters) and trunk stability push-up test (higher among weightlifter). Agreement between the test performed on the two sides was higher in CrossFit groups for hurdle step (93.2%), in line lung (86%), rotary stability test (95.3%) and shoulder mobility (90.7%; p<0.001). Conclusions CrossFitters seem to have a high level of concordance in the scores achieved in bilateral test. CrossFit seems to produce marked symmetry in some fundamental movements compared to weightlifting and bodybuilding. PMID:27331045

CrossFit athletes exhibit high symmetry of fundamental movement patterns. A cross-sectional study.

PubMed

Tafuri, Silvio; Notarnicola, Angela; Monno, Antonello; Ferretti, Francesco; Moretti, Biagio

2016-01-01

even if CrossFit training programs accounted actually more than 7500 gyms affiliated in the USA and more than 2000 in Europe and involved today more than 1 million of people, actually there were not several studies about the effect of the CrossFit on the health and sport performance. The aim of these research was to evaluate the performance in 7 fundamental movement patterns using a standardized methods, the Functional Movement Screen (FMS). we enrolled three groups of athletes (age 17-40 years; >6 months of training programs): CrossFitters, body builders and professional weightlifters. FMS test was performed to all people enrolled. Scores of FMS test was examined comparing three groups. no differences in the three groups were showed in the mean score values of each test and in total score, except for shoulder mobility test (higher among CrossFitters) and trunk stability push-up test (higher among weightlifter). Agreement between the test performed on the two sides was higher in CrossFit groups for hurdle step (93.2%), in line lung (86%), rotary stability test (95.3%) and shoulder mobility (90.7%; p<0.001). CrossFitters seem to have a high level of concordance in the scores achieved in bilateral test. CrossFit seems to produce marked symmetry in some fundamental movements compared to weightlifting and bodybuilding.

A new survival score for patients with brain metastases who received whole-brain radiotherapy (WBRT) alone.

PubMed

Rades, Dirk; Dziggel, Liesa; Nagy, Viorica; Segedin, Barbara; Lohynska, Radka; Veninga, Theo; Khoa, Mai T; Trang, Ngo T; Schild, Steven E

2013-07-01

Survival scores for patients with brain metastasis exist. However, the treatment regimens used to create these scores were heterogeneous. This study aimed to develop and validate a survival score in homogeneously treated patients. Eight-hundred-and-eighty-two patients receiving 10 × 3Gy of WBRT alone were randomly assigned to a test group (N=441) or a validation group (N=441). In the multivariate analysis of the test group, age, performance status, extracranial metastasis, and systemic treatment prior to WBRT were independent predictors of survival. The score for each factor was determined by dividing the 6-month survival rate (in %) by 10. Scores were summed and total scores ranged from 6 to 19 points. Patients were divided into four prognostic groups. The 6-month survival rates were 4% for 6-9 points, 29% for 10-14 points, 62% for 15-17 points, and 93% for 17-18 points (p<0.001) in the test group. The survival rates were 3%, 28%, 54% and 96%, respectively (p<0.001) in the validation group. Since the 6-month survival rates in the validation group were very similar to the test group, this new score (WBRT-30) appears valid and reproducible. It can help making treatment choices and stratifying patients in future trials. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Cognitive Function in a Randomized Trial of Evolocumab.

PubMed

Giugliano, Robert P; Mach, François; Zavitz, Kenton; Kurtz, Christopher; Im, Kyungah; Kanevsky, Estella; Schneider, Jingjing; Wang, Huei; Keech, Anthony; Pedersen, Terje R; Sabatine, Marc S; Sever, Peter S; Robinson, Jennifer G; Honarpour, Narimon; Wasserman, Scott M; Ott, Brian R

2017-08-17

Background Findings from clinical trials of proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors have led to concern that these drugs or the low levels of low-density lipoprotein (LDL) cholesterol that result from their use are associated with cognitive deficits. Methods In a subgroup of patients from a randomized, placebo-controlled trial of evolocumab added to statin therapy, we prospectively assessed cognitive function using the Cambridge Neuropsychological Test Automated Battery. The primary end point was the score on the spatial working memory strategy index of executive function (scores range from 4 to 28, with lower scores indicating a more efficient use of strategy and planning). Secondary end points were the scores for working memory (scores range from 0 to 279, with lower scores indicating fewer errors), episodic memory (scores range from 0 to 70, with lower scores indicating fewer errors), and psychomotor speed (scores range from 100 to 5100 msec, with faster times representing better performance). Assessments of cognitive function were performed at baseline, week 24, yearly, and at the end of the trial. The primary analysis was a noninferiority comparison of the mean change from baseline in the score on the spatial working memory strategy index of executive function between the patients who received evolocumab and those who received placebo; the noninferiority margin was set at 20% of the standard deviation of the score in the placebo group. Results A total of 1204 patients were followed for a median of 19 months; the mean (±SD) change from baseline over time in the raw score for the spatial working memory strategy index of executive function (primary end point) was -0.21±2.62 in the evolocumab group and -0.29±2.81 in the placebo group (P<0.001 for noninferiority; P=0.85 for superiority). There were no significant between-group differences in the secondary end points of scores for working memory (change in raw score, -0.52 in the evolocumab group and -0.93 in the placebo group), episodic memory (change in raw score, -1.53 and -1.53, respectively), or psychomotor speed (change in raw score, 5.2 msec and 0.9 msec, respectively). In an exploratory analysis, there were no associations between LDL cholesterol levels and cognitive changes. Conclusions In a randomized trial involving patients who received either evolocumab or placebo in addition to statin therapy, no significant between-group difference in cognitive function was observed over a median of 19 months. (Funded by Amgen; EBBINGHAUS ClinicalTrials.gov number, NCT02207634 .).

Efficacy of gait trainer as an adjunct to traditional physical therapy on walking performance in hemiparetic cerebral palsied children: a randomized controlled trial.

PubMed

Gharib, Nevein Mm; El-Maksoud, Gehan M Abd; Rezk-Allah, Soheir S

2011-10-01

To assess the effects of additional gait trainer assisted walking exercises on walking performance in children with hemiparetic cerebral palsy. A randomized controlled study. Paediatric physical therapy outpatient clinic. Thirty spastic hemiparetic cerebral palsied children of both sexes (10-13 years - 19 girls and 11 boys). Children were randomly assigned into two equal groups; experimental and control groups. Participants in both groups received a traditional physical therapy exercise programme. Those in the experimental group received additional gait trainer based walking exercises which aimed to improve walking performance. Treatment was provided three times per week for three successive months. Children received baseline and post-treatment assessments using Biodex Gait Trainer 2 assessment device to evaluate gait parameters including: average step length, walking speed, time on each foot (% of gait cycle) and ambulation index. Children in the experimental group showed a significant improvement as compared with those in the control group. The ambulation index was 75.53±7.36 (11.93 ± 2.89 change score) for the experimental group and 66.06 ± 5.48 (2.13 ± 4.43 change score) for the control group (t = 3.99 and P = 0.0001). Time of support for the affected side was 42.4 ± 3.37 (7 ± 2.20 change score) for the experimental group and 38.06 ± 4.63 (3.33 ± 6.25 change score) for the control group (t = 2.92 and P = 0.007). Also, there was a significant improvement in step length and walking speed in both groups. Gait trainer combined with traditional physiotherapy increase the chance of improving gait performance in children with spastic hemiparetic cerebral palsy.

Functional brain organization of working memory in adolescents varies in relation to family income and academic achievement.

PubMed

Finn, Amy S; Minas, Jennifer E; Leonard, Julia A; Mackey, Allyson P; Salvatore, John; Goetz, Calvin; West, Martin R; Gabrieli, Christopher F O; Gabrieli, John D E

2017-09-01

Working memory (WM) capacity reflects executive functions associated with performance on a wide range of cognitive tasks and education outcomes, including mathematics achievement, and is associated with dorsolateral prefrontal and parietal cortices. Here we asked if family income is associated with variation in the functional brain organization of WM capacity among adolescents, and whether that variation is associated with performance on a statewide test of academic achievement in mathematics. Participants were classified into higher-income and lower-income groups based on family income, and performed a WM task with a parametric manipulation of WM load (N-back task) during functional magnetic resonance imaging (fMRI). Behaviorally, the higher-income group had greater WM capacity and higher mathematics achievement scores. Neurally, the higher-income group showed greater activation as a function of WM load in bilateral prefrontal, parietal, and other regions, although the lower-income group exhibited greater activation at the lowest load. Both groups exhibited positive correlations between parietal activations and mathematics achievement scores, but only the higher-income group exhibited a positive correlation between prefrontal activations and mathematics scores. Most of these findings were maintained when higher- and lower-income groups were matched on WM task performance or nonverbal IQ. Findings indicate that the functional neural architecture of WM varies with family income and is associated with education measures of mathematics achievement. © 2016 John Wiley & Sons Ltd.

Twelve-Year Follow-Up of Navigated Computer-Assisted Versus Conventional Total Knee Arthroplasty: A Prospective Randomized Comparative Trial.

PubMed

Cip, Johannes; Obwegeser, Florian; Benesch, Thomas; Bach, Christian; Ruckenstuhl, Paul; Martin, Arno

2018-05-01

Navigated computer-assisted total knee arthroplasty (TKA) was introduced to expedite long-term survival based on improved postoperative implantation accuracy. However, long-term outcome data after 10 years or more are rare, even available meta-analyses show controversial study results. In a prospective randomized trial, 100 conventional TKAs (group CONV) were compared with 100 computer-assisted TKAs (group NAV) after a mean follow-up of 12 years postoperatively. A long-leg weight-bearing X-ray was performed for measuring mechanical axis of the limb, lateral distal femoral angle, and medial proximal tibial angle. Tibial slope, patella alpha angle, and radiolucent lines were also observed. Clinical investigation included evaluation of 4 different scores: Insall Knee Score, Western Ontario and MacMaster University Index score, Hospital for Special Surgery Knee Score, and visual analog scale. Based on a follow-up rate of at least 75%, no difference in TKA survival was found 12 years postoperatively: 91.5% in group CONV vs 98.2% in group NAV (P = .181). Since 5-year follow-up, no additional TKA revision had been performed in both groups. Group CONV showed a nonsignificant higher inaccuracy of neutral lower limb axis (1.8° ± 1.4°) compared to group NAV (1.6° ± 1.7°, P = .700). All X-ray assessments were not significant different within both study groups (P ≥ .068). Clinical examination showed no differences in evaluations (P ≥ .204). All collected outcome score results were similar (P ≥ .222). Twelve years postoperatively, no differences were found in terms of long-term survival, implantation accuracy, clinical outcome or score results. Copyright © 2017 Elsevier Inc. All rights reserved.

A comparative evaluation of oral hygiene using Braille and audio instructions among institutionalized visually impaired children aged between 6 years and 20 years: A 3-monthfollow-up study.

PubMed

Mahantesha, Taranatha; Nara, Asha; Kumari, Parveen Reddy; Halemani, Praveen Kumar Nugadoni; Buddiga, Vinutna; Mythri, Sarpangala

2015-12-01

The aim of this study is to compare the oral hygiene status among institutionalized visually impaired children of age between 6 and 20 years given with Braille and audio instructions in Raichur city of Karnataka. A total of 50 children aged between 6 to 20 years were included in this study from a residential school for visually impaired children. These children were randomly divided into two equal groups. One group was given oral hygiene instructions by audio recordings and another written in Braille and were instructed to practice the same. After three months time the oral hygiene status and dental caries experience was recorded and compared using patient performance index. Statistical analysis was done by student paired t test and multiple comparison by Tukey's HSD (honest significant difference) test. The mean PHP (Patient Hygiene Performance) score of group A at baseline was 3.88 compared to 3.90 of group B. At 7 days PHP score of group A and group B was 3.42 and 3.45 respectively. At 3 month PHP score of group A and group B was 2.47 and 2.86 respectively. Even though over a period of time the mean score of PHP index reduced the score comparison between the 2 groups were statistically non significant. In group A the mean difference of PHP score between baseline and 7 days was 0.46, between baseline and 3 months it was 1.40. The PHP score between 7 days and 3 months was 0.94. All the above values were statistically significant. Effective dental health education method has to be instituted for visually impaired children. The present study shows improvement of oral health status in both the study population by decrease in the mean plaque score. Hence continuous motivation and reinforcement in the form of Braille and audio instruction is beneficial to achieve good oral hygiene levels in visually impaired children.

The Effects of Material and Task Variations on a Brief Cognitive Learning Strategies Training Program

DTIC Science & Technology

1980-08-01

EFFECTS OF MATERIAL AND TASK VARIATIONS ON A BRIEF COGNITIVE LEARNING STRATEGIES TRAINING PROGRAM Introduction As scholastic achievement scores continue to...variance of the test scores revealed no significant dif- ferences among the three treatment conditions on any of the tests. Although these results...tentative because of the group performance patterns. On the first (easier) passage, group means indicated nearly perfect scores for all three of the

Implementation of internet training on posture reform of computer users in iran.

PubMed

Keykhaie, Zohreh; Zareban, Iraj; Shahrakipoor, Mahnaz; Hormozi, Maryam; Sharifi-Rad, Javad; Masoudi, Gholamreza; Rahimi, Fatemeh

2014-12-01

Musculoskeletal disorders are of common problems among computer (PC) users. Training of posture reform plays a significant role in the prevention of the emergence, progression and complications of these diseases. The present research was performed to study the effect of the Internet training on the posture reform of the Internet users working in two Iranian universities including Sistan and Baluchestan University and Islamic Azad University of Zahedan in 2014. This study was a quasi-experimental intervention with control group and conducted in two Iranian universities including Sistan and Baluchestan University and Islamic Azad University of Zahedan. The study was done on 160 PC users in the two groups of intervention (80 people) and control (80 people). Training PowerPoint was sent to the intervention group through the Internet and a post test was given to them after 45 days. Statistical software of SPSS 19 and statistical tests of Kolmogrov, t-test, Fisher Exact test, and correlation coefficient were used for data analysis. After the training, the mean scores of knowledge, attitude, performance and self-efficacy in the intervention group were 24.21 ± 1.34, 38.36 ± 2.89, 7.59 ± 1.16, and 45.06 ± 4.11, respectively (P <0.001). The mean scores of knowledge in the intervention group 5.45±2.81 and in the control group 1.20 ± 1.07 showed a significant change. Mean scores of attitude in the intervention group 3.60 ± 3.59 and in the control group 0.48± 1.03 showed a significant change as well. Mean scores of self-efficacy in the intervention group 14.83 ± 4.67 and in the control group 0.88 ± 1.93 indicated a significant change and mean scores of performance in the intervention group 5.28 ± 1.24 and in the control group 0.62 ± 0.73 indicated a significant change (P <0.001). The results of the study showed that training through the Internet had a significant impact on the posture reform of the PC users. According to the findings observed, there was a significant relationship between the scores of self-efficacy-performance after training. Therefore, based on the findings of the study, it is suggested that Internet training to increase self-efficacy approach in the successive periods can be effective to reform the postures of PC users.

Bilateral hip arthroscopy under the same anesthetic for patients with symptomatic bilateral femoroacetabular impingement: 1-year outcomes.

PubMed

Mei-Dan, Omer; McConkey, Mark O; Knudsen, Joshua S; Brick, Matthew J

2014-01-01

The purpose of this study was to investigate whether, in patients with bilateral symptomatic femoroacetabular impingement, bilateral surgery under 1 anesthetic is safe and efficacious and allows a rapid return of function compared with staged procedures. Three groups were evaluated: in group 1 both hips were treated simultaneously, in group 2 both hips were treated in a staged fashion, and in group 3 a single hip was addressed. The outcome measures were anesthesia and surgical times; time in the hospital; visual analog scale score for pain on postoperative days 1, 3, 7, and 30; analgesic use; and time until the patient could bike, drive, perform office work, perform gym activities, run, and return to play. Midterm evaluation was performed with the Non-Arthritic Hip Score and Western Ontario and McMaster Universities Osteoarthritis Index score at 6 and 12 months postoperatively. We enrolled 76 patients (122 hips) in this study. There were 42 male and 34 female patients. The mean age was 33 years (range, 14 to 50 years), and the mean body mass index was 24 (range, 18 to 35). Group 1 comprised 26 patients (52 hips, 16 male and 10 female patients). Group 2 comprised 20 patients (40 hips, 13 male and 7 female patients), with a mean time between surgeries of 14.56 weeks. Group 3 comprised 33 patients (30 hips, 13 male and 17 female patients). No preoperative differences were found between the groups. The surgical and anesthesia times in group 1 were significantly longer than those in groups 2 and 3. We found no significant differences in postoperative visual analog scale scores, analgesic use, or length of hospital stay. Group 1 required more time before patients were able to ride a stationary bicycle (14.7 days in group 1, 7.8 days in group 2, and 8.5 days in group 3; P < .05). We found no differences between the groups regarding when patients returned to driving, performing office work, or reporting a normal gait. Each group had significant improvements in the Western Ontario and McMaster Universities Osteoarthritis Index and Non-Arthritic Hip Score at 6 and 12 months compared with preoperatively (P < .05). No significant differences in outcome scores were found in the 3 groups before surgery and at 6 or 12 months after surgery. Simultaneous femoroacetabular impingement surgery does not lead to higher rates of complications, postoperative pain, analgesic use, or side effects. The return to daily activities is similar to a single-hip procedure with the advantage of a single rehabilitation. Level III, retrospective comparative study. Copyright © 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Frequency doubling technique perimetry and spectral domain optical coherence tomography in patients with early glaucoma.

PubMed

Horn, F K; Mardin, C Y; Bendschneider, D; Jünemann, A G; Adler, W; Tornow, R P

2011-01-01

To assess the combined diagnostic power of frequency-doubling technique (FDT)-perimetry and retinal nerve fibre layer (RNFL) thickness measurements with spectral domain optical coherence tomography (SDOCT). The study included 330 experienced participants in five age-related groups: 77 'preperimetric' open-angle glaucoma (OAG) patients, 52 'early' OAG, 50 'moderate' OAG, 54 ocular hypertensive patients, and 97 healthy subjects. For glaucoma assessment in all subjects conventional perimetry, evaluation of fundus photographs, FDT-perimetry and RNFL thickness measurement with SDOCT was done. Glaucomatous visual field defects were classified using the Glaucoma Staging System. FDT evaluation used a published method with casewise calculation of an 'FDT-score', including all missed localized probability levels. SDOCT evaluation used mean RNFL thickness and a new individual SDOCT-score considering normal confidence limits in 32 sectors of a peripapillary circular scan. To examine the joined value of both methods a combined score was introduced. Significance of the difference between Receiver-operating-characteristic (ROC) curves was calculated for a specificity of 96%. Sensitivity in the preperimetric glaucoma group was 44% for SDOCT-score, 25% for FDT-score, and 44% for combined score, in the early glaucoma group 83, 81, and 89%, respectively, and in the moderate glaucoma group 94, 94, and 98%, respectively, all at a specificity of 96%. ROC performance of the newly developed combined score is significantly above single ROC curves of FDT-score in preperimetric and early OAG and above RNFL thickness in moderate OAG. Combination of function and morphology by using the FDT-score and the SDOCT-score performs equal or even better than each single method alone.

Frequency doubling technique perimetry and spectral domain optical coherence tomography in patients with early glaucoma

PubMed Central

Horn, F K; Mardin, C Y; Bendschneider, D; Jünemann, A G; Adler, W; Tornow, R P

2011-01-01

Purpose To assess the combined diagnostic power of frequency-doubling technique (FDT)-perimetry and retinal nerve fibre layer (RNFL) thickness measurements with spectral domain optical coherence tomography (SDOCT). Methods The study included 330 experienced participants in five age-related groups: 77 ‘preperimetric' open-angle glaucoma (OAG) patients, 52 ‘early' OAG, 50 ‘moderate' OAG, 54 ocular hypertensivepatients, and 97 healthy subjects. For glaucoma assessment in all subjects conventional perimetry, evaluation of fundus photographs, FDT-perimetry and RNFL thickness measurement with SDOCT was done. Glaucomatous visual field defects were classified using the Glaucoma Staging System. FDT evaluation used a published method with casewise calculation of an ‘FDT-score', including all missed localized probability levels. SDOCT evaluation used mean RNFL thickness and a new individual SDOCT-score considering normal confidence limits in 32 sectors of a peripapillary circular scan. To examine the joined value of both methods a combined score was introduced. Significance of the difference between Receiver-operating-characteristic (ROC) curves was calculated for a specificity of 96%. Results Sensitivity in the preperimetric glaucoma group was 44% for SDOCT-score, 25% for FDT-score, and 44% for combined score, in the early glaucoma group 83, 81, and 89%, respectively, and in the moderate glaucoma group 94, 94, and 98%, respectively, all at a specificity of 96%. ROC performance of the newly developed combined score is significantly above single ROC curves of FDT-score in preperimetric and early OAG and above RNFL thickness in moderate OAG. Conclusion Combination of function and morphology by using the FDT-score and the SDOCT-score performs equal or even better than each single method alone. PMID:21102494

[Cognitive markers to discriminate between mild cognitive impairment and normal ageing].

PubMed

Rodríguez Rodríguez, Nely; Juncos-Rabadán, Onésimo; Facal Mayo, David

2008-01-01

mild cognitive impairment (MCI) has been characterized as a transitional stage between normal ageing and dementia. The aim of the present study was to examine differences between normal ageing and MCI in the performance of several cognitive tests. These differences might serve as differential markers. we performed a longitudinal study (24 months) with two evaluations at 12-monthly intervals using the CAMCOG-R and a verbal learning test [test de aprendizaje verbal España-Complutense (TAVEC)]. The sample was composed of 25 persons aged more than 50 years old (five men and 20 women), distributed into two groups: the control group and the MCI group. To assign persons to either of the two groups, Petersen's MCI criteria were applied to Mini-Mental State Examination (MMSE) scores. repeated measures ANOVA (2 groups x 2 assessment) showed significant differences between the MCI and control group in the CAMCOG-R scores in orientation, language, memory, abstract thinking, executive function and global score and in the TAVEC scores for immediate recall and short- and long-term free and clued recall. No significant differences were found between the first and second assessment or in the interaction group assessment. the results of the present study confirm that the CAMCOG-R and the TAVEC effectively discriminate between normal ageing and MCI and can be used complementarily.

Outcome Comparison Between in Situ Repair Versus Tear Completion Repair for Partial Thickness Rotator Cuff Tears.

PubMed

Kim, Yang-Soo; Lee, Hyo-Jin; Bae, Sung-Ho; Jin, Hyonki; Song, Hyun Seok

2015-11-01

To compare the clinical outcomes of arthroscopic in situ repair with the tear completion repair technique for partial-thickness rotator cuff tears (PT-RCTs). We prospectively enrolled 100 cases with articular-sided and bursal-sided PT-RCTs exceeding 50% of tendon thickness and allocated them randomly. An in situ repair was performed in group 1 (n = 50). Completion of the remaining cuff tissue and repair were performed in group 2 (n = 50). The medial row was knotted as transosseous repair (suture-bridge technique) in all cases. American Shoulder Elbow Society (ASES) score, Constant shoulder (CS) score, Simple shoulder (SS) score, and Korean shoulder (KS) score, and visual analog scale (VAS) for pain and range of motion were assessed at 3, 6, and 12 months and at the last visit. Repaired tendon integrity was determined at 6 to 12 months by magnetic resonance imaging. Eight cases were lost to follow-up. Ultimately, 92 cases were analyzed. The average follow-up was 19.1 months (range, 12 to 42 months). Significant improvements in the VAS for pain and functional outcomes were observed in both groups postoperatively (P = .001 for VAS; P < .001 for ASES score; P < .001 for CS score; P = .001 for SS score; P<.001 for KS score). No significant difference in the clinical results was observed at any time between the groups. No difference of retear rate on articular-sided PT-RCT was observed between the groups (P = .34). Retears on the bursal-sided PT-RCT were more frequent in group 2 (P = .02). Arthroscopic repair of PT-RCT exceeding 50% of the thickness provided functional improvements and pain relief regardless of the repair technique. The retear rate for bursal-sided PT-RCT was higher in group 2, although the retear rate for the articular-sided PT-RCT was not different. Level II, prospective comparative study. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Assessment of driving-related performance in chronic whiplash using an advanced driving simulator.

PubMed

Takasaki, Hiroshi; Treleaven, Julia; Johnston, Venerina; Rakotonirainy, Andry; Haines, Andrew; Jull, Gwendolen

2013-11-01

Driving is often nominated as problematic by individuals with chronic whiplash associated disorders (WAD), yet driving-related performance has not been evaluated objectively. The purpose of this study was to test driving-related performance in persons with chronic WAD against healthy controls of similar age, gender and driving experience to determine if driving-related performance in the WAD group was sufficiently impaired to recommend fitness to drive assessment. Driving-related performance was assessed using an advanced driving simulator during three driving scenarios; freeway, residential and a central business district (CBD). Total driving duration was approximately 15min. Five driving tasks which could cause a collision (critical events) were included in the scenarios. In addition, the effect of divided attention (identify red dots projected onto side or rear view mirrors) was assessed three times in each scenario. Driving performance was measured using the simulator performance index (SPI) which is calculated from 12 measures. z-Scores for all SPI measures were calculated for each WAD subject based on mean values of the control subjects. The z-scores were then averaged for the WAD group. A z-score of ≤-2 indicated a driving failing grade in the simulator. The number of collisions over the five critical events was compared between the WAD and control groups as was reaction time and missed response ratio in identifying the red dots. Seventeen WAD and 26 control subjects commenced the driving assessment. Demographic data were comparable between the groups. All subjects completed the freeway scenario but four withdrew during the residential and eight during the CBD scenario because of motion sickness. All scenarios were completed by 14 WAD and 17 control subjects. Mean z-scores for the SPI over the three scenarios was statistically lower in the WAD group (-0.3±0.3; P<0.05) but the score was not below the cut-off point for safe driving. There were no differences in the reaction time and missed response ratio in divided attention tasks between the groups (All P>0.05). Assessment of driving in an advanced driving simulator for approximately 15min revealed that driving-related performance in chronic WAD was not sufficiently impaired to recommend the need for fitness to drive assessment. Copyright © 2013 Elsevier Ltd. All rights reserved.

Landing Error Scoring System Differences Between Single-Sport and Multi-Sport Female High School-Aged Athletes.

PubMed

Beese, Mark E; Joy, Elizabeth; Switzler, Craig L; Hicks-Little, Charlie A

2015-08-01

Single-sport specialization (SSS) is becoming more prevalent in youth athletes. Deficits in functional movement have been shown to predispose athletes to injury. It is unclear whether a link exists between SSS and the development of functional movement deficits that predispose SSS athletes to an increased risk of knee injury. To determine whether functional movement deficits exist in SSS athletes compared with multi-sport (M-S) athletes. Cross-sectional study. Soccer practice fields. A total of 40 (21 SSS [age = 15.05 ± 1.2 years], 19 M-S [age = 15.32 ± 1.2 years]) female high school athlete volunteers were recruited through local soccer clubs. All SSS athletes played soccer. Participants were grouped into 2 categories: SSS and M-S. All participants completed 3 trials of the standard Landing Error Scoring System (LESS) jump-landing task. They performed a double-legged jump from a 30-cm platform, landing on a rubber mat at a distance of half their body height. Upon landing, participants immediately performed a maximal vertical jump. Values were assigned to each trial using the LESS scoring criteria. We averaged the 3 scored trials and then used a Mann-Whitney U test to test for differences between groups. Participant scores from the jump-landing assessment for each group were also placed into the 4 defined LESS categories for group comparison using a Pearson χ(2) test. The α level was set a priori at .05. Mean scores were 6.84 ± 1.81 for the SSS group and 6.07 ± 1.93 for the M-S group. We observed no differences between groups (z = -1.44, P = .15). A Pearson χ(2) analysis revealed that the proportions of athletes classified as having excellent, good, moderate, or poor LESS scores were not different between the SSS and M-S groups ([Formula: see text] = 1.999, P = .57). Participation in soccer alone compared with multiple sports did not affect LESS scores in adolescent female soccer players. However, the LESS scores indicated that most female adolescent athletes may be at an increased risk for knee injury, regardless of the number of sports played.

The Model for End-stage Liver Disease score is potentially a useful predictor of hyperkalemia occurrence among hospitalized angiotensin receptor blocker users.

PubMed

Sheen, S S; Park, R W; Yoon, D; Shin, G-T; Kim, H; Park, I-W

2015-02-01

Angiotensin receptor blockers (ARBs) are medications commonly used for treating conditions such as hypertension. However, ARBs are frequently associated with hyperkalemia, a potentially critical adverse event, in high-risk patients. Although both the liver and the kidney are major elimination routes of ARBs, the relationship between hepatorenal function and ARB-related hyperkalemia has not yet been investigated. The purpose of this study was to evaluate the risk of hyperkalemia, in terms of various hepatorenal functions, for hospitalized patients newly initiated on ARB treatment. We evaluated ARB-related hyperkalemia in a cohort of 5530 hospitalized patients, who had not previously used ARBs, between 12 April 2004 and 31 May 2012. Hepatorenal function was assessed by the Model for End-stage Liver Disease (MELD) score. Hyperkalemia risk was assessed by hepatorenal function, risks were categorized into the four MELD scoring groups, and the groups were compared with one another. The MELD score was significantly different between the hyperkalemic and non-hyperkalemic groups (independent t-test, P < 0.001). The MELD score 10-14, 15-19 and ≥ 20 groups showed higher risks of hyperkalemia than the lowest MELD score group {log-rank test, P < 0.001; multiple Cox proportional hazard model, hazard ratios 1.478 (P = 0.003), 2.285 (P < 0.001) and 3.024 (P < 0.001), respectively}. The MELD score showed a stronger predictive performance for hyperkalemia than either serum creatinine or estimated glomerular filtration rate alone. Furthermore, the MELD score showed good predictive performance for ARB-related hyperkalemia among hospitalized patients. The clinical implications and reasons for these findings merit future investigation. © 2014 John Wiley & Sons Ltd.

Obesity Has Minimal Impact on Short-Term Functional Scores After Reverse Shoulder Arthroplasty for Rotator Cuff Tear Arthropathy.

PubMed

Morris, Brent J; Haigler, Richard E; Cochran, John M; Laughlin, Mitzi S; Elkousy, Hussein A; Gartsman, Gary M; Edwards, T Bradley

2016-01-01

The potential adverse effect of body mass index (BMI) on shoulder function scores after reverse shoulder arthroplasty (RSA) has not been investigated. We conducted a study to examine outcomes of RSA performed for rotator cuff tear arthropathy (RCTA) across BMI categories (normal weight, overweight, obese). We hypothesized that, compared with normal-weight patients, obese patients would have worse shoulder function scores, worse mobility, and more complications. Using a prospective shoulder arthroplasty registry, we identified 77 primary RSAs performed for RCTA with minimum 2-year follow-up. Thirty-four patients had normal weight (BMI <25 kg/m2), 21 were overweight (BMI 25-30 kg/m2), and 22 were obese (BMI >30 kg/m2). Shoulder function scores, mobility, and satisfaction were evaluated before surgery and at final follow-up. The 3 BMI groups were not significantly different on demographic factors, preoperative shoulder function scores, or preoperative mobility (P > .05). For each group, shoulder function scores and mobility significantly improved between the preoperative and final follow-up assessments (P < .001). Patient satisfaction was similar between groups (P = .967). Improved shoulder function scores, mobility, and patient satisfaction can be expected after RSA for RCTA in patients regardless of BMI.

Confirmed clinical efficacy of Actovegin in elderly patients with organic brain syndrome.

PubMed

Kanowski, S; Kinzler, E; Lehmann, E; Schweizer, A; Kuntz, G

1995-07-01

A double-blind randomized clinical trial was performed comparing the therapeutic effects of Actovegin versus placebo in elderly patients with organic brain syndrome. In addition to the necessary basic internal medicine therapy, 40 geriatric patients received dialy intravenous infusions of 250 ml Actovegin 20% p.i., and 20 patients received 250 ml 0.9% saline solution as placebo over a period of four weeks. Of the patient sample, 58% were hospitalized for simple dementia (ICD-9: 290.0) and 42% due to senile dementia with depressive or paranoid symptoms (ICD-9: 290.2). Based on the Syndrome Short Test (SKT) and the Sandoz Clinical Assessment Geriatric Scale (SCAG) score, the patients suffered from mild to moderate dementia. The therapeutic effect on the total SCAG score and the Clinical Global Impression (CGI) were the primary study variables. The scores for the SCAG subscales and the SKT score served as secondary variables. The mean total SCAG score in the drug group decreased from 56.3 at the start of therapy to 36.3 points at the end of therapy, and in the placebo group the total score went from 61.2 to 52.0 (p < 0.01). The CGI showed that with Actovegin, 70% of the patients experienced "distinct improvement" or "improvement" compared to only 35% with such results in the placebo group. The SCAG subscales and the total SKT score also demonstrated the superior effects of Actovegin compared to placebo. Moreover, the therapy group treated with Actovegin showed greater improvements in social behavior and mental performance than did the placebo group.(ABSTRACT TRUNCATED AT 250 WORDS)

Towards Virtual FLS: Development of a Peg Transfer Simulator

PubMed Central

Arikatla, Venkata S; Ahn, Woojin; Sankaranarayanan, Ganesh; De, Suvranu

2014-01-01

Background Peg transfer is one of five tasks in the Fundamentals of Laparoscopic Surgery (FLS), program. We report the development and validation of a Virtual Basic Laparoscopic Skill Trainer-Peg Transfer (VBLaST-PT©) simulator for automatic real-time scoring and objective quantification of performance. Methods We have introduced new techniques in order to allow bi-manual manipulation of pegs and automatic scoring/evaluation while maintaining high quality of simulation. We performed a preliminary face and construct validation study with 22 subjects divided into two groups: experts (PGY 4–5, fellow and practicing surgeons) and novice (PGY 1–3). Results Face validation shows high scores for all the aspects of the simulation. A two-tailed Mann-Whitney U-test scores showed significant difference between the two groups on completion time (p=0.003), FLS score (p=0.002) and the VBLaST-PT© score (p=0.006). Conclusions VBLaST-PT© is a high quality virtual simulator that showed both face and construct validity. PMID:24030904

Design and Validation of an Open-Source, Partial Task Trainer for Endonasal Neuro-Endoscopic Skills Development: Indian Experience.

PubMed

Singh, Ramandeep; Baby, Britty; Damodaran, Natesan; Srivastav, Vinkle; Suri, Ashish; Banerjee, Subhashis; Kumar, Subodh; Kalra, Prem; Prasad, Sanjiva; Paul, Kolin; Anand, Sneh; Kumar, Sanjeev; Dhiman, Varun; Ben-Israel, David; Kapoor, Kulwant Singh

2016-02-01

Box trainers are ideal simulators, given they are inexpensive, accessible, and use appropriate fidelity. The development and validation of an open-source, partial task simulator that teaches the fundamental skills necessary for endonasal skull-base neuro-endoscopic surgery. We defined the Neuro-Endo-Trainer (NET) SkullBase-Task-GraspPickPlace with an activity area by analyzing the computed tomography scans of 15 adult patients with sellar suprasellar parasellar tumors. Four groups of participants (Group E, n = 4: expert neuroendoscopists; Group N, n =19: novice neurosurgeons; Group R, n = 11: neurosurgery residents with multiple iterations; and Group T, n = 27: neurosurgery residents with single iteration) performed grasp, pick, and place tasks using NET and were graded on task completion time and skills assessment scale score. Group E had lower task completion times and greater skills assessment scale scores than both Group N and R (P ≤ 0.03, 0.001). The performance of Groups N and R was found to be equivalent; in self-assessing neuro-endoscopic skill, the participants in these groups were found to have equally low pretraining scores (4/10) with significant improvement shown after NET simulation (6, 7 respectively). Angled scopes resulted in decreased scores with tilted plates compared with straight plates (30° P ≤ 0.04, 45° P ≤ 0.001). With tilted plates, decreased scores were observed when we compared the 0° with 45° endoscope (right, P ≤ 0.008; left, P ≤ 0.002). The NET, a face and construct valid open-source partial task neuroendoscopic trainer, was designed. Presimulation novice neurosurgeons and neurosurgical residents were described as having insufficient skills and preparation to practice neuro-endoscopy. Plate tilt and endoscope angle were shown to be important factors in participant performance. The NET was found to be a useful partial-task trainer for skill building in neuro-endoscopy. Copyright © 2016 Elsevier Inc. All rights reserved.

Construct validity and expert benchmarking of the haptic virtual reality dental simulator.

PubMed

Suebnukarn, Siriwan; Chaisombat, Monthalee; Kongpunwijit, Thanapohn; Rhienmora, Phattanapon

2014-10-01

The aim of this study was to demonstrate construct validation of the haptic virtual reality (VR) dental simulator and to define expert benchmarking criteria for skills assessment. Thirty-four self-selected participants (fourteen novices, fourteen intermediates, and six experts in endodontics) at one dental school performed ten repetitions of three mode tasks of endodontic cavity preparation: easy (mandibular premolar with one canal), medium (maxillary premolar with two canals), and hard (mandibular molar with three canals). The virtual instrument's path length was registered by the simulator. The outcomes were assessed by an expert. The error scores in easy and medium modes accurately distinguished the experts from novices and intermediates at the onset of training, when there was a significant difference between groups (ANOVA, p<0.05). The trend was consistent until trial 5. From trial 6 on, the three groups achieved similar scores. No significant difference was found between groups at the end of training. Error score analysis was not able to distinguish any group at the hard level of training. Instrument path length showed a difference in performance according to groups at the onset of training (ANOVA, p<0.05). This study established construct validity for the haptic VR dental simulator by demonstrating its discriminant capabilities between that of experts and non-experts. The experts' error scores and path length were used to define benchmarking criteria for optimal performance.

Are you SURE?

PubMed Central

Légaré, France; Kearing, Stephen; Clay, Kate; Gagnon, Susie; D’Amours, Denis; Rousseau, Michel; O’Connor, Annette

2010-01-01

ABSTRACT OBJECTIVE To assess the reliability and validity of the 4-item SURE (Sure of myself; Understand information; Risk-benefit ratio; Encouragement) screening test for decisional conflict in patients. DESIGN Cross-sectional study. SETTING Four family medicine groups in Quebec and 1 rural academic medical centre in New Hampshire. PARTICIPANTS One hundred twenty-three French-speaking pregnant women considering prenatal screening for Down syndrome and 1474 English-speaking patients referred to watch condition-specific video decision aids. MAIN OUTCOME MEASURES Cronbach α was used to assess the reliability of SURE. A factorial analysis was performed to assess its unidimensionality. The Pearson correlation coefficient was computed between SURE and the Decisional Conflict Scale to assess concurrent validation. A t test procedure comparing the SURE scores of patients who had made decisions with the scores of those who had not was used to assess construct validation. RESULTS Among the 123 French-speaking pregnant women, 105 (85%) scored 4 out of 4 (no decisional conflict); 10 (8%) scored 3 (≤ 3 indicates decisional conflict); 7 (6%) scored 2; and 1 (1%) scored 1. Among the 1474 English-speaking treatment-option patients, 981 (67%) scored 4 out of 4; 272 (18%) scored 3; 147 (10%) scored 2; 54 (4%) scored 1; and 20 (1%) scored 0. The reliability of SURE was moderate (Cronbach α of 0.54 in French-speaking pregnant women and 0.65 in treatment-option patients). In the group of pregnant women, 2 factors accounted for 72% of the variance. In the treatment-option group, 1 factor accounted for 49% of the variance. In the group of pregnant women, SURE correlated negatively with the Decisional Conflict Scale (r = −0.46; P < .0001); and in the group of treatment-option patients, it discriminated between those who had made a choice for a treatment and those who had not (P < .0001). CONCLUSION The SURE screening test shows promise for screening for decisional conflict in both French- and English-speaking patients; however, future studies should assess its performance in a broader group of patients. PMID:20705870

Naming Speed of Adolescents and Young Adults with Attention Deficit Hyperactivity Disorder: Differences in Alphanumeric Versus Color/Object Naming.

PubMed

Whipple, Brittany D; Nelson, Jason M

2016-02-01

This study investigated the performance of adolescents and young adults with Attention Deficit Hyperactivity Disorder (ADHD), Reading Disorder (RD), and ADHD/RD on measures of alphanumeric and nonalphanumeric naming speed and the relationship between naming speed and academic achievement. The sample (N = 203) included students aged 17-28 years diagnosed with ADHD (n = 83), RD (n = 71), or ADHD/RD (n = 49). Individuals with ADHD performed significantly faster on measures of alphanumeric naming compared with RD and comorbid groups and, within group, demonstrated significantly quicker naming of letters/digits compared with colors/objects. Both alphanumeric rapid naming scores and processing speed scores variably predicted academic achievement scores across groups, whereas nonalphanumeric rapid naming only predicted reading comprehension scores within the ADHD group. Results support findings that older individuals with ADHD show relative weakness in rapid naming of objects and colors. Implications of these findings in regard to assessment of older individuals for ADHD are discussed. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Neurocognitive performance and symptom profiles of Spanish-speaking Hispanic athletes on the ImPACT test.

PubMed

Ott, Summer; Schatz, Philip; Solomon, Gary; Ryan, Joseph J

2014-03-01

This study documented baseline neurocognitive performance of 23,815 athletes on the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) test. Specifically, 9,733 Hispanic, Spanish-speaking athletes who completed the ImPACT test in English and 2,087 Hispanic, Spanish-speaking athletes who completed the test in Spanish were compared with 11,955 English-speaking athletes who completed the test in English. Athletes were assigned to age groups (13-15, 16-18). Results revealed a significant effect of language group (p < .001; partial η(2) = 0.06) and age (p < .001; partial η(2) = 0.01) on test performance. Younger athletes performed more poorly than older athletes, and Spanish-speaking athletes completing the test in Spanish scored more poorly than Spanish-speaking and English-speaking athletes completing the test in English, on all Composite scores and Total Symptom scores. Spanish-speaking athletes completing the test in English also performed more poorly than English-speaking athletes completing the test in English on three Composite scores. These differences in performance and reported symptoms highlight the need for caution in interpreting ImPACT test data for Hispanic Americans.

External Validation of Risk Scores for Major Bleeding in a Population-Based Cohort of Transient Ischemic Attack and Ischemic Stroke Patients.

PubMed

Hilkens, Nina A; Li, Linxin; Rothwell, Peter M; Algra, Ale; Greving, Jacoba P

2018-03-01

The S 2 TOP-BLEED score may help to identify patients at high risk of bleeding on antiplatelet drugs after a transient ischemic attack or ischemic stroke. The score was derived on trial populations, and its performance in a real-world setting is unknown. We aimed to externally validate the S 2 TOP-BLEED score for major bleeding in a population-based cohort and to compare its performance with other risk scores for bleeding. We studied risk of bleeding in 2072 patients with a transient ischemic attack or ischemic stroke on antiplatelet agents in the population-based OXVASC (Oxford Vascular Study) according to 3 scores: S 2 TOP-BLEED, REACH, and Intracranial-B 2 LEED 3 S. Performance was assessed with C statistics and calibration plots. During 8302 patient-years of follow-up, 117 patients had a major bleed. The S 2 TOP-BLEED score showed a C statistic of 0.69 (95% confidence interval [CI], 0.64-0.73) and accurate calibration for 3-year risk of major bleeding. The S 2 TOP-BLEED score was much more predictive of fatal bleeding than nonmajor bleeding (C statistics 0.77; 95% CI, 0.69-0.85 and 0.50; 95% CI, 0.44-0.58). The REACH score had a C statistic of 0.63 (95% CI, 0.58-0.69) for major bleeding and the Intracranial-B 2 LEED 3 S score a C statistic of 0.60 (95% CI, 0.51-0.70) for intracranial bleeding. The ratio of ischemic events versus bleeds decreased across risk groups of bleeding from 6.6:1 in the low-risk group to 1.8:1 in the high-risk group. The S 2 TOP-BLEED score shows modest performance in a population-based cohort of patients with a transient ischemic attack or ischemic stroke. Although bleeding risks were associated with risks of ischemic events, risk stratification may still be useful to identify a subgroup of patients at particularly high risk of bleeding, in whom preventive measures are indicated. © 2018 The Authors.

Evaluation of Problem- and Simulator-Based Learning in Lumbar Puncture in Adult Neurology Residency Training.

PubMed

Sun, Chenjing; Qi, Xiaokun

2018-01-01

Lumbar puncture (LP) is an essential part of adult neurology residency training. Technologic as well as nontechnologic training is needed. However, current assessment tools mostly focus on the technologic aspects of LP. We propose a training method-problem- and simulator-based learning (PSBL)-in LP residency training to develop overall skills of neurology residents. We enrolled 60 neurology postgraduate-year-1 residents from our standardized residents training center and randomly divided them into 2 groups: traditional teaching group and PSBL group. After training, we assessed the extent that the residents were ready to perform LP and tracked successful LPs performed by the residents. We then asked residents to complete questionnaires about the training models. Performance scores and the results of questionnaires were compared between the 2 groups. Students and faculty concluded that PSBL provided a more effective learning experience than the traditional teaching model. Although no statistical difference was found in the pretest, posttest, and improvement rate scores between the 2 groups, based on questionnaire scores and number of successful LPs after training, the PSBL group showed a statistically significant improvement compared with the traditional group. Findings indicated that nontechnical elements, such as planning before the procedure and controlling uncertainties during the procedure, are more crucial than technical elements. Compared with traditional teaching model, PSBL for LP training can develop overall surgical skills, including technical and nontechnical elements, improving performance. Residents in the PSBL group were more confident and effective in performing LP. Copyright © 2017 Elsevier Inc. All rights reserved.

Self-reported study habits for enhancing medical students’ performance in the National Medical Unified Examination

PubMed Central

Idris, Amr; Al Saadi, Tareq; Edris, Basel; Sawaf, Bisher; Zakaria, Mhd. Ismael; Alkhatib, Mahmoud; Turk, Tarek

2016-01-01

Background: The National Medical Unified Examination (NMUE) is currently required for graduation, joining postgraduate medical training, and practicing medicine in Syria. Objective: To investigate self-reported study habits that correlate with high performance on the NMUE. Methods: First through 3rd year residents at the three main hospitals in Damascus, Syria, were asked to complete a retrospective cross-sectional survey investigating their study habits and previous scores. Results: Significantly higher score was associated with >15 study h/day and allocating 1–40% of study time for practicing questions. Mean NMUE score was not significantly different in relation to preparation months for examination or for those who reported spending all their time studying alone compared with spending any amount of time in a group setting. Scores of 231–240 on the Syrian scientific high school exam correlated with significantly higher NMUE performance compared with fewer scores, except scores of 221–230. For every 10 point increase in medical school cumulative grades, the NMUE score increased 3.6 (95% confidence interval 2.5–4.8). Conclusion: The NMUE score was significantly affected by hours spent studying per day, number of practice questions completed, percentage of study time allocated for doing questions, Syrian scientific high school exam scores, and the cumulative medical school class grades. It was not significantly affected by preparation months or studying in a group setting. More studies are needed to further describe and investigate the factors that might affect performance in the NMUE. PMID:27144140

Evaluation of motor and cognitive development among infants exposed to HIV.

PubMed

da Silva, Kaitiana Martins; de Sá, Cristina Dos Santos Cardoso; Carvalho, Raquel

2017-02-01

This study of a prospective and cross-sectional nature compared the motor and cognitive development of HIV-exposed and unexposed infants in their first 18months of age. 40 infants exposed to HIV and antiretroviral therapy (Experimental Group - EG) and 40 unexposed infants (Control Group - CG) participated in the study. They were divided into four age groups of 4, 8, 12 and 18months old, with 10 infants from EG and 10 from CG in each group. The infants were evaluated once on motor and cognitive development by the Bayley Scale of Infant and Toddler Development. Performance category grading and comparisons among scaled score, composite score and percentile rank were held. There was significant group effect for scores in motor and cognitive domains showing lower scores for EG regardless of age. In comparison to the CG, the EG presented lower scores for cognitive domain at 8 and 18months. In the performance categories, all infants were classified at or above the average for motor and cognitive development, except of one EG-18month old infant classified as borderline for motor development. Infants exposed to HIV and antiretroviral therapy own adequate cognitive and motor development in the first 18months. However, the lower scores found, particularly on the 8th and 18th month for cognitive development, may indicate future problems, highlighting the need for systematic follow-up of this population. Copyright © 2017 Elsevier B.V. All rights reserved.

[Needs assessment for developing teaching competencies of medical educators].

PubMed

Si, Jihyun

2015-09-01

This study conducted a needs assessment for developing teaching competencies of medical educators by assessing their perceived ability to perform teaching competencies as well as their perceived importance of these competencies. Additionally, this study examined whether there were any differences in needs assessments scores among three faculty groups. Hundred and eighteen professors from Dong-A University College of Medicine were surveyed, and the data from 44 professors who answered all the questions were analyzed using IBM SPSS 21. The needs assessment tool measured participants' perceived ability to perform teaching competencies and perceived importance of these competencies. The Borich formula was used to calculate needs assessment scores. The most urgent needs for faculty development were identified for the teaching competencies of "diagnosis and reflection," followed by "test and feedback," and "facilitation." Additionally, two, out of 51, items with the highest needs assessment scores were "developing a thorough course syllabus" and "introducing students to the course syllabus on the first day of class." The assistant professor group scored significantly higher on educational needs related to "facilitation," "affection and concern for students," and "respect for diversity" competencies than the professor group. Furthermore, the educational needs scores for all the teaching competencies except "diagnosis and reflection," "global mindset," and "instructional management" were higher for the assistant professor group than the other two faculty groups. Thus, the educational needs assessment scores obtained in this study can be used as criteria for designing and developing faculty development programs for medical educators.

Visual-motor integration performance in children with severe specific language impairment.

PubMed

Nicola, K; Watter, P

2016-09-01

This study investigated (1) the visual-motor integration (VMI) performance of children with severe specific language impairment (SLI), and any effect of age, gender, socio-economic status and concomitant speech impairment; and (2) the relationship between language and VMI performance. It is hypothesized that children with severe SLI would present with VMI problems irrespective of gender and socio-economic status; however, VMI deficits will be more pronounced in younger children and those with concomitant speech impairment. Furthermore, it is hypothesized that there will be a relationship between VMI and language performance, particularly in receptive scores. Children enrolled between 2000 and 2008 in a school dedicated to children with severe speech-language impairments were included, if they met the criteria for severe SLI with or without concomitant speech impairment which was verified by a government organization. Results from all initial standardized language and VMI assessments found during a retrospective review of chart files were included. The final study group included 100 children (males = 76), from 4 to 14 years of age with mean language scores at least 2SD below the mean. For VMI performance, 52% of the children scored below -1SD, with 25% of the total group scoring more than 1.5SD below the mean. Age, gender and the addition of a speech impairment did not impact on VMI performance; however, children living in disadvantaged suburbs scored significantly better than children residing in advantaged suburbs. Receptive language scores of the Clinical Evaluation of Language Fundamentals was the only score associated with and able to predict VMI performance. A small subgroup of children with severe SLI will also have poor VMI skills. The best predictor of poor VMI is receptive language scores on the Clinical Evaluation of Language Fundamentals. Children with poor receptive language performance may benefit from VMI assessment and multidisciplinary management. © 2016 John Wiley & Sons Ltd.

Ultrasound Mediated Microbubbles Destruction Augmented Sonolysis: An In Vitro and In Vivo Study.

PubMed

Cui, Hai; Zhu, Qiong; Gao, Yunhua; Xia, Hongmei; Tan, Kaibin; He, Ying; Liu, Zheng; Xu, Yali

2017-01-01

This study was aimed at exploring ultrasound mediated microbubbles destruction (UMMD) assisted sonolysis in both the in vitro and in vivo clots. Therapeutic ultrasound (TUS) and lipid microbubbles (MBs) were used in whole blood clots and divided into the control, TUS group, and TUS + MB group. Thrombolytic rates and microscopy were performed. Color Doppler flow imaging (CDFI) and angiography were performed to evaluate the recanalization rates and flow scores in femoral arterial thrombus (FAT) in rabbits. FAT were dyed with H&E. The average thrombolytic ratios of TUS + MB group were significantly higher than those of TUS group and the control group (both P < 0.05). Clots had different pathological changes. Recanalization rates and flow scores in TUS + MB group were significantly higher than the control and TUS group. Flow scores and recanalization ratios were grade 0 in 0% of the control group, grade I in 25% of TUS group, and grade II or higher in 87.5% of TUS + MB group after 30 min sonolysis. Both the in vitro and in vivo sonolysis can be significantly augmented by the introduction of MBs without thrombolytic agents, which might be induced by the enhanced cavitation via UMMD.

Biases and power for groups comparison on subjective health measurements.

PubMed

Hamel, Jean-François; Hardouin, Jean-Benoit; Le Neel, Tanguy; Kubis, Gildas; Roquelaure, Yves; Sébille, Véronique

2012-01-01

Subjective health measurements are increasingly used in clinical research, particularly for patient groups comparisons. Two main types of analytical strategies can be used for such data: so-called classical test theory (CTT), relying on observed scores and models coming from Item Response Theory (IRT) relying on a response model relating the items responses to a latent parameter, often called latent trait. Whether IRT or CTT would be the most appropriate method to compare two independent groups of patients on a patient reported outcomes measurement remains unknown and was investigated using simulations. For CTT-based analyses, groups comparison was performed using t-test on the scores. For IRT-based analyses, several methods were compared, according to whether the Rasch model was considered with random effects or with fixed effects, and the group effect was included as a covariate or not. Individual latent traits values were estimated using either a deterministic method or by stochastic approaches. Latent traits were then compared with a t-test. Finally, a two-steps method was performed to compare the latent trait distributions, and a Wald test was performed to test the group effect in the Rasch model including group covariates. The only unbiased IRT-based method was the group covariate Wald's test, performed on the random effects Rasch model. This model displayed the highest observed power, which was similar to the power using the score t-test. These results need to be extended to the case frequently encountered in practice where data are missing and possibly informative.

Correlation of probability scores of placenta accreta on magnetic resonance imaging with hemorrhagic morbidity.

PubMed

Lim, Grace; Horowitz, Jeanne M; Berggruen, Senta; Ernst, Linda M; Linn, Rebecca L; Hewlett, Bradley; Kim, Jennifer; Chalifoux, Laurie A; McCarthy, Robert J

2016-11-01

To evaluate the hypothesis that assigning grades to magnetic resonance imaging (MRI) findings of suspected placenta accreta will correlate with hemorrhagic outcomes. We chose a single-center, retrospective, observational design. Nulliparous or multiparous women who had antenatal placental MRI performed at a tertiary level academic hospital were included. Cases with antenatal placental MRI were included and compared with cases without MRI performed. Two radiologists assigned a probability score for accreta to each study. Estimated blood loss and transfusion requirements were compared among groups by the Kruskal-Wallis H test. Thirty-five cases had placental MRI performed. MRI performance was associated with higher blood loss compared with the non-MRI group (2600 [1400-4500]mL vs 900[600-1500]mL, P<.001). There was no difference in estimated blood loss (P=.31) or transfusion (P=.57) among the MRI probability groups. In cases of suspected placenta accreta, probability scores for antenatal placental MRI may not be associated with increasing degrees of hemorrhage. Continued research is warranted to determine the effectiveness of assigning probability scores for antenatal accreta imaging studies, combined with clinical indices of suspicion, in assisting with antenatal multidisciplinary team planning for operative management of this morbid condition. Copyright © 2016 Elsevier Inc. All rights reserved.

[Case-control study on polymer polylactic acid absorbable medical film for preventing acromion adhesion after arthroscopic rotator cuff repair].

PubMed

Lin, Wei; Xu, Huan; Xing, Hai-Lin; Zheng, Rong-Zong; Ying, Jin-He

2018-03-25

To study effect of shoulder joint function after rotator cuff repair of polylactic acid absorbable membrane. From September 2015 to December 2016, 50 patients diagnosed with rotator cuff tear were selected and divided into treatment group and control group. There were 25 patients in control group, including 12 males and 13 females, with an average age of (48.7±3.5) years old, who received simple arthroscopic rotator cuff repair. There were 25 patients in treatment group, including 11 males and 14 females, with an average age of(49.2±4.1) years old, who performed arthroscopic rotator cuff repair with implanting polylactic acid absorbable membraneon shoulder of rotator cuff. Preoperative and postoperative VAS score, ASES score and UCLA score were recorded and compared between two groups. At 6 months after operation, preoperative VAS score in control group was 5.48±1.12, and decreased as 1.28±0.84 after operation; ASES score before operation was 52.24±4.64, and improved to 86.92±3.20 after operation;preoperative UCLA score improved from 14.36±1.89 before operation to 30.72±1.28 after operation. In treatment group, VAS score decreased from 5.36±1.32 before operation to 1.40±0.71 after operation;preoperative ASES score was 51.04±4.09, and improved to 88.96±2.79 after operation; UCLA score improved from 15.12±1.81 before operation to 32.12±1.33 after operation. There was no significant difference in VAS score between two groups, and ASES score, UCLA score in treatment group was obviously better than control group. Application of polylactic acid absorbable medical membrane could obviously improve shoulder function, and effectively prevent acromion adhesion after arthroscopic rotator cuff repair. Copyright© 2018 by the China Journal of Orthopaedics and Traumatology Press.

Face and content validation of a virtual reality temporal bone simulator.

PubMed

Arora, Asit; Khemani, Sam; Tolley, Neil; Singh, Arvind; Budge, James; Varela, David A Diaz Voss; Francis, Howard W; Darzi, Ara; Bhatti, Nasir I

2012-03-01

To validate the VOXEL-MAN TempoSurg simulator for temporal bone dissection. Prospective international study. Otolaryngology departments of 2 academic health care institutions in the United Kingdom and United States. Eighty-five subjects were recruited consisting of an experienced and referent group. Participants performed a standardized familiarization session and temporal bone dissection task. Realism, training effectiveness, and global impressions were evaluated across 21 domains using a 5-point Likert-type scale. A score of 4 was the minimum threshold for acceptability. The experienced group comprised 25 otolaryngology trainers who had performed 150 mastoid operations. The referent group comprised 60 trainees (mean otolaryngology experience of 2.9 years). Familiarization took longer in the experienced group (P = .01). User-friendliness was positively rated (mean score 4.1). Seventy percent of participants rated anatomical appearance as acceptable. Trainers rated drill ergonomics worse than did trainees (P = .01). Simulation temporal bone training scored highly (mean score 4.3). Surgical anatomy, drill navigation, and hand-eye coordination accounted for this. Trainees were more likely to recommend temporal bone simulation to a colleague than were trainers (P = .01). Transferability of skills to the operating room was undecided (mean score 3.5). Realism of the VOXEL-MAN virtual reality temporal bone simulator is suboptimal in its current version. Nonetheless, it represents a useful adjunct to existing training methods and is particularly beneficial for novice surgeons before performing cadaveric temporal bone dissection. Improvements in realism, specifically drill ergonomics and visual-spatial perception during deeper temporal bone dissection, are warranted.

Older medical students' performances at McGill University.

PubMed

Feil, D; Kristian, M; Mitchell, N

1998-01-01

To compare admission data and academic performances of medical students younger and older than 25, and to qualify older students' experiences and perceptions in medical school. The authors reviewed 1988-1991 data for applications to the McGill University Faculty of Medicine. Data included GPAs and MCAT scores, as well as ratings for reference letters, autobiographical statements, and interviews. For those same years, the authors measured students' academic performances in the preclinical and clinical years. The authors compared the data by students' age: "younger" students, aged 17 to 24; and "older" students, aged 25 and above. All enrolled students took the Derogatis Stress Profile, and the older students participated in focus groups. The older applicants had lower GPAs and MCAT scores, but higher interview and reference letter ratings. For older accepted students, basic science course scores were lower than those of younger students, but clinical scores did not differ significantly between the groups. The two groups had similar stress levels, although older students tested lower in driven behavior, relaxation potential, attitude posture, and hostility. In focus groups, the older students spoke of learning style differences, loss of social support, and loss of professional identity. Different scores in admission criteria suggest that McGill uses different standards to select older medical students. Older students admitted under different criteria, however, do just as well as do younger students by their clinical years. A broad-based study of admission criteria and outcomes for the older student population is warranted.

Collateral Flow and White Matter Disease in Patients with Internal Carotid Artery Occlusion.

PubMed

Ishikawa, Mami; Sugawara, Hitoshi; Nagai, Mutsumi; Kusaka, Gen; Tanaka, Yuichi; Naritaka, Heiji

2017-01-01

When an internal carotid artery (ICA) occludes, a patient may develop cerebral infarction (CI). We investigated whether CI caused by ICA occlusion (ICAO) is associated with collateral flow through the anterior and posterior communicating arteries (ACoA and PCoA). In 100 patients with ICAO, we investigated CI and white matter disease by performing an MRI and the anatomy of the ACoA and PCoA were investigated by performing magnetic resonance angiography. All patients were divided into the symptomatic CI group or the no-CI group. The collateral flow pathway was estimated by the anterior cerebral artery (ACA)-PCoA score and the collateral flow volume after ICAO was estimated by the middle cerebral artery (MCA) flow score, based on how well the MCA was visualized. Of 100 patients with ICAO, the symptomatic CI group included 36 patients. ACA-PCoA score and white matter disease grades were significantly higher in the CI group (indicating poor collateral flow). More than 80% of patients with an ACA-PCoA score of 4 (poor collateral) experienced symptomatic CI. Thirty-one symptomatic CI patients (86%) had an MCA flow score of 1 or 2 (decreased MCA flow). The ACA-PCoA score and white matter disease grade may suggest an increased risk of CI following ICAO. © 2016 S. Karger AG, Basel.

Floor Effect of PROMIS Depression CAT Associated With Hasty Completion in Orthopaedic Surgery Patients.

PubMed

Guattery, Jason M; Dardas, Agnes Z; Kelly, Michael; Chamberlain, Aaron; McAndrew, Christopher; Calfee, Ryan P

2018-04-01

The Patient Reported Outcomes Measurement Information System (PROMIS) was developed to provide valid, reliable, and standardized measures to gather patient-reported outcomes for many health domains, including depression, independent of patient condition. Most studies confirming the performance of these measures were conducted with a consented, volunteer study population for testing. Using a study population that has undergone the process of informed consent may be differentiated from the validation group because they are educated specifically as to the purpose of the questions and they will not have answers recorded in their permanent health record. (1) When given as part of routine practice to an orthopaedic population, do PROMIS Physical Function and Depression item banks produce score distributions different than those produced by the populations used to calibrate and validate the item banks? (2) Does the presence of a nonnormal distribution in the PROMIS Depression scores in a clinical population reflect a deliberately hasty answering of questions by patients? (3) Are patients who are reporting minimal depressive symptoms by scoring the minimum score on the PROMIS Depression Computer Adaptive Testing (CAT) distinct from other patients according to demographic data or their scores on other PROMIS assessments? Univariate descriptive statistics and graphic histograms were used to describe the frequency distribution of scores for the Physical Function and Depression item banks for all orthopaedic patients 18 years or older who had an outpatient visit between June 2015 and December 2016. The study population was then broken into two groups based on whether they indicated a lack of depressive symptoms and scored the minimum score (34.2) on the Depression CAT assessment (Floor Group) or not (Standard Group). The distribution of Physical Function CAT scores was compared between the two groups. Finally, a time-per-question value was calculated for both the Physical Function and Depression CATs and was compared between assessments within each group as well as between the two groups. Bivariate statistics compared the demographic data between the two groups. Physical Function CAT scores in musculoskeletal patients were normally distributed like the distribution calibration population; however, the score distribution of the Depression CAT in musculoskeletal patients was nonnormal with a spike in the floor score. After excluding the floor spike, the distribution of the Depression CAT scores was not different from the population control group. Patients who scored the floor score on the Depression CAT took slightly less time per question for Physical Function CAT when compared with other musculoskeletal patients (floor patients: 11 ± 9 seconds; normally distributed patients: 12 ± 10 seconds; mean difference: 1 second [0.8-1.1]; p < 0.001 but not clinically relevant). They spent a substantially shorter amount of time per question on the Depression CAT (Floor Group: 4 ± 3 seconds; Standard Group: 7 ± 7 seconds; mean difference: 3 [2.9-3.2]; p < 0.001). Patients who scored the minimum score on the PROMIS Depression CAT were younger than other patients (Floor Group: 50 ± 18 SD; Standard Group: 55 ± 16 SD; mean difference: 4.5 [4.2-4.7]; p < 0.001) with a larger percentage of men (Floor Group: 48.8%; Standard Group 40.0%; odds ratio 0.6 [0.6-0.7]; p < 0.001) and minor differences in racial breakdown (Floor Group: white 85.2%, black 11.9%, other 0.03%; Standard Group: white 83.9%, black 13.7%, other 0.02%). In an orthopaedic surgery population that is given PROMIS CAT as part of routine practice, the Physical Function item bank had a normal performance, but there is a group of patients who hastily complete Depression questions producing a strong floor effect and calling into question the validity of those floor scores that indicate minimal depression. Level II, diagnostic study.

Epilepsy in patients with primary brain tumors: The impact on mood, cognition, and HRQOL.

PubMed

Rahman, Z; Wong, C H; Dexter, M; Olsson, G; Wong, M; Gebsky, V; Nahar, N; Wood, A; Byth, K; King, M; Bleasel, A B

2015-07-01

A primary brain tumor (PBT) is often a fatal disease of the nervous system and has a serious impact on health-related quality of life (HRQOL). Presence of epilepsy and adverse reactions from tumor and epilepsy treatments may cause additional decline in HRQOL. We aimed to study the impact of epileptic seizures on cognition, mood, and HRQOL in patients with brain tumor-related epilepsy. Patients were grouped on an ordinal scale according to epilepsy burden from none to severe based on the presence of epileptic seizures and seizure frequency: L1, no epilepsy; L2, with epilepsy, seizure-free in the last 6 months with antiepileptic drugs; and L3, with epilepsy, at least one seizure in the last 6 months with AEDs. Health-related quality of life was measured by Functional Assessment of Cancer Therapy-Brain (FACT-Br) and Quality of Life in Epilepsy-31 (QOLIE-31) tools, cognition by the Montreal Cognitive Assessment (MoCA) tool and Frontal Assessment Battery (FAB), mood by the Hospital Anxiety and Depression Scale (HADS), activities of daily living (ADLs) by the Barthel Index (BI), and performance status by the Karnofsky Performance Status (KPS) scale in patients with primary brain tumors at least one month following neurosurgery with or without radiotherapy and chemotherapy. Eighty-one patients with a diagnosis of primary brain tumors were recruited. Sixty-eight percent of patients were diagnosed with primary brain tumor-related epilepsy, 50.61% patients had cognitive impairment, 33% had abnormal scores in the anxiety scale, and 34% had abnormal scores in the depression scale. There were no statistically significant differences in these scores among L1, L2, and L3 groups. There were statistically significant differences in duration of disease and KPS and BI scores between L1 and L3 groups. The L3 group has significantly longer duration of disease and scored low in both the BI and KPS scale when compared to the L1 group. All patients with primary brain tumors scored significantly low in FACT-Br 'physical well-being' (PWB) and 'emotional well-being' (EWB) and high in 'social well-being' (SWB) when compared to healthy controls. When scores of each group were individually compared to healthy controls, the L3 group showed the lowest scores in PWB, EWB, and 'functional well-being'. In SWB, L1 and L2 groups showed statistically significantly high scores when compared to normative data. The QOLIE-31 applied to groups with epilepsy showed statistically significantly lower scores in the L3 group when compared to the L2 group in 'cognitive' and 'social functioning' domains. On multivariate analysis, both poor performance status and frequency of seizures were found to be independent risk factors for poor HRQOL when FACT-Br mean scores were compared. Level of seizures was found to be an independent risk factor for poor HRQOL when QOLIE-31 scores were compared between L2 and L3 groups. Presence of brain tumors could be attributed to cognitive impairment irrespective of the presence of epilepsy in our cohort. High seizure burden is an independent risk factor for poor HRQOL in patients with primary brain tumors. The QOLIE-31 is a more sensitive tool than the FACT-Br because of the presence of a seizure-related questionnaire. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

Entecavir treatment does not eliminate the risk of hepatocellular carcinoma in chronic hepatitis B: limited role for risk scores in Caucasians.

PubMed

Arends, Pauline; Sonneveld, Milan J; Zoutendijk, Roeland; Carey, Ivana; Brown, Ashley; Fasano, Massimo; Mutimer, David; Deterding, Katja; Reijnders, Jurriën G P; Oo, Ye; Petersen, Jörg; van Bömmel, Florian; de Knegt, Robert J; Santantonio, Teresa; Berg, Thomas; Welzel, Tania M; Wedemeyer, Heiner; Buti, Maria; Pradat, Pierre; Zoulim, Fabien; Hansen, Bettina; Janssen, Harry L A

2015-08-01

Hepatocellular carcinoma (HCC) risk-scores may predict HCC in Asian entecavir (ETV)-treated patients. We aimed to study risk factors and performance of risk scores during ETV treatment in an ethnically diverse Western population. We studied all HBV monoinfected patients treated with ETV from 11 European referral centres within the VIRGIL Network. A total of 744 patients were included; 42% Caucasian, 29% Asian, 19% other, 10% unknown. At baseline, 164 patients (22%) had cirrhosis. During a median follow-up of 167 (IQR 82-212) weeks, 14 patients developed HCC of whom nine (64%) had cirrhosis at baseline. The 5-year cumulative incidence rate of HCC was 2.1% for non-cirrhotic and 10.9% for cirrhotic patients (p<0.001). HCC incidence was higher in older patients (p<0.001) and patients with lower baseline platelet counts (p=0.02). Twelve patients who developed HCC achieved virologic response (HBV DNA <80 IU/mL) before HCC. At baseline, higher CU-HCC and GAG-HCC, but not REACH-B scores were associated with development of HCC. Discriminatory performance of HCC risk scores was low, with sensitivity ranging from 18% to 73%, and c-statistics from 0.71 to 0.85. Performance was further reduced in Caucasians with c-statistics from 0.54 to 0.74. Predicted risk of HCC based on risk-scores declined during ETV therapy (all p<0.001), but predictive performances after 1 year were comparable to those at baseline. Cumulative incidence of HCC is low in patients treated with ETV, but ETV does not eliminate the risk of HCC. Discriminatory performance of HCC risk scores was limited, particularly in Caucasians, at baseline and during therapy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The impact of outpatient clinical teaching on students' academic performance in obstetrics and gynecology.

PubMed

Hassan, Bahaeldin A; Elfaki, Omer A; Khan, Muhammed A

2017-01-01

Clinical teaching at outpatient settings is an essential part of undergraduate medical students' training. The increasing number of students in many medical schools and short hospital stays makes inpatient teaching alone insufficient to provide students with the required clinical skills. To make up this shortfall, outpatient clinical teaching has been implemented by our Department of Obstetrics and Gynecology, King Khalid University, KSA, throughout the academic year 2015-2016. The aim of this study was to evaluate the impact of clinical teaching at outpatient settings on the academic performance of our students. In this comparative retrospective study, the effects of outpatient clinical teaching of obstetrics and gynecology on the academic performance of student was assessed through an objective structured clinical examination (OSCE). During their course on obstetrics and gynecology, 58 students had their clinical teaching both at inpatient and outpatient settings and constituted "study group". The remaining 52 students had clinical teaching only at inpatient settings and were considered "control group". Students in both groups sat for OSCE at the end of week 8 of the gynecology course. Students in both groups sat for OSCE at the end of week 8 of the gynecology course. Four stations were used for assessment: obstetric history, gynecological history, obstetric physical examination of pregnant women, and gynecological procedure station. Twenty marks were allocated for each station giving a total score of 80. The OSCE scores for study group were compared with those of the control group using Student's t -test; p < 0.05 was considered statistically significant. The total mean OSCE score was statistically significantly higher in the study group (62.36 vs. 47.94, p < 0.001). The study group participants showed significantly higher scores in the gynecological procedure station (16.74 vs. 11.62, p < 0.0001) and obstetric examination station (16.72 vs. 10.79, p < 0.0001). Clinical teaching at outpatient settings leads to an improvement in students' performance in OSCE. There is evidence of remarkable improvement in the mastery of clinical skills as manifested in the students' scores in physical examination and procedures stations. These results will encourage us to have clinical teaching in other disciplines at outpatient settings.

Feasibility of peer assessment and clinical audit to self-regulate the quality of physiotherapy services: a mixed methods study.

PubMed

Maas, Marjo J M; Nijhuis-van der Sanden, Maria W G; Driehuis, Femke; Heerkens, Yvonne F; van der Vleuten, Cees P M; van der Wees, Philip J

2017-02-10

To evaluate the feasibility of a quality improvement programme aimed to enhance the client-centeredness, effectiveness and transparency of physiotherapy services by addressing three feasibility domains: (1) acceptability of the programme design, (2) appropriateness of the implementation strategy and (3) impact on quality improvement. Mixed methods study. 64 physiotherapists working in primary care, organised in a network of communities of practice in the Netherlands. The programme contained: (1) two cycles of online self-assessment and peer assessment (PA) of clinical performance using client records and video-recordings of client communication followed by face-to-face group discussions, and (2) clinical audit assessing organisational performance. Assessment was based on predefined performance indicators which could be scored on a 5-point Likert scale. Discussions addressed performance standards and scoring differences. All feasibility domains were evaluated qualitatively with two focus groups and 10 in-depth interviews. In addition, we evaluated the impact on quality improvement quantitatively by comparing self-assessment and PA scores in cycles 1 and 2. We identified critical success features relevant to programme development and implementation, such as clarifying expectations at baseline, training in PA skills, prolonged engagement with video-assessment and competent group coaches. Self-reported impact on quality improvement included awareness of clinical and organisational performance, improved evidence-based practice and client-centeredness and increased motivation to self-direct quality improvement. Differences between self-scores and peer scores on performance indicators were not significant. Between cycles 1 and 2, scores for record keeping showed significant improvement, however not for client communication. This study demonstrated that bottom-up initiatives to improve healthcare quality can be effective. The results justify ongoing evaluation to inform nationwide implementation when the critical success features are addressed. Further research is necessary to explore the sustainability of the results and the impact on client outcomes in a full-scale study. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

An anatomically sound surgical simulation model for myringotomy and tympanostomy tube insertion.

PubMed

Hong, Paul; Webb, Amanda N; Corsten, Gerard; Balderston, Janet; Haworth, Rebecca; Ritchie, Krista; Massoud, Emad

2014-03-01

Myringotomy and tympanostomy tube insertion (MT) is a common surgical procedure. Although surgical simulation has proven to be an effective training tool, an anatomically sound simulation model for MT is lacking. We developed such a model and assessed its impact on the operating room performance of senior medical students. Prospective randomized trial. A randomized single-blind controlled study of simulation training with the MT model versus no simulation training. Each participant was randomized to either the simulation model group or control group, after performing an initial MT procedure. Within two weeks of the first procedure, the students performed a second MT. All procedures were performed on real patients and rated with a Global Rating Scale by two attending otolaryngologists. Time to complete the MT was also recorded. Twenty-four senior medical students were enrolled. Control and intervention groups did not differ at baseline on their Global Rating Scale score or time to complete the MT procedure. Following simulation training, the study group received significantly higher scores (P=.005) and performed the MT procedure in significantly less time (P=.034). The control group did not improve their performance scores (P>.05) or the time to complete the procedure (P>.05). Our surgical simulation model shows promise for being a valuable teaching tool for MT for senior medical students. Such anatomically appropriate physical simulators may benefit teaching of junior trainees. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Is performance on the Wechsler test of adult reading affected by traumatic brain injury?

PubMed

Mathias, J L; Bowden, S C; Bigler, E D; Rosenfeld, J V

2007-11-01

The validity of the National Adult Reading Test (NART) as a predictor of premorbid IQ when used with patients who have sustained a traumatic brain injury (TBI) has been questioned in recent years. This study examined whether performance on the Wechsler Test of Adult Reading (WTAR) is similarly affected by TBI in the first year after an injury. The WTAR scores of participants who had sustained a mild TBI (N=82), moderate TBI (N=73), severe TBI (N=61) or an orthopaedic injury (N=95) were compared (cross-sectional study). A subset of 21 mild TBI, 31 moderate TBI, 26 severe TBI and 21 control group participants were additionally reassessed 6 months later to assess the impact of recovery on WTAR scores (longitudinal study). The severe TBI group had significantly lower scores on the WTAR than the mild TBI, moderate TBI and control groups in the cross-sectional study, despite being matched demographically. The findings from the longitudinal study revealed a significant group difference and a small improvement in performance over time but the interaction between group and time was not significant, suggesting that the improvements in WTAR performance over time were not restricted to more severely injured individuals whose performance was temporarily suppressed. These findings suggest that reading performance may be affected by severe TBI and that the WTAR may underestimate premorbid IQ when used in this context, which may cause clinicians to underestimate the cognitive deficits experienced by these patients.

Influences of Resistance Training on Physical Function in Older, Obese Men and Women With Sarcopenia.

PubMed

Stoever, Katja; Heber, Anke; Eichberg, Sabine; Brixius, Klara

Sarcopenic obesity is associated with disability, gait problems, and falls. Activities of daily living such as walking and climbing stairs are physically difficult or impossible for the individual with severe obesity. These aspects also limit participation in recreational activities or exercise programs. However, good muscle function is crucial to maintain functional independence. The objective of this study was to investigate the influence of resistance training on physical function in older, obese persons with sarcopenia. The study was conducted in a pre-test/post-test design with 2 intervention groups. The participants were physically inactive and obese older adults (≥65 years, BMI ≥ 30 kg/m), without severe diseases. They were divided into a group with sarcopenia (SAR, n = 28) and a group with no or presarcopenia (NSAR, n = 20). The intervention consisted of progressive resistance training, undertaken twice a week for 16 weeks, increasing to 80% to 85% of maximum strength with 3 sets of 8 to 12 repetitions. Sarcopenia was assessed using the Short Physical Performance Battery (SPPB), hand-grip strength, and skeletal muscle mass index (SMI). In addition, the modified Physical Performance Test (PPT) and the Functional Reach Test were used for determining physical function. After training, participants in the SAR group were able to significantly increase their performance in hand-grip strength (by 9%), gait speed (by 5%), SPPB score (by 13%), and modified PPT score (by 11%). In SPPB and modified PPT, they could reach the values of the NSAR group's baseline performance. The NSAR group participants were also able to improve their already good performance at baseline in the 2 tests of physical function after training (SPPB score by 10%, modified PPT score by 7%). However, the participants of both groups could not increase the results of the SMI and the Functional Reach Test. The participants of both groups improved their physical performance in several parameters after training. The results also showed that older, obese adults with sarcopenia benefitted from resistance training. The increase in muscle function can support them having a life with functional independence, and this can help reduce the risk of disability and falls.

Are all hands-on activities equally effective? Effect of using plastic models, organ dissections, and virtual dissections on student learning and perceptions.

PubMed

Lombardi, Sara A; Hicks, Reimi E; Thompson, Katerina V; Marbach-Ad, Gili

2014-03-01

This study investigated the impact of three commonly used cardiovascular model-assisted activities on student learning and student attitudes and perspectives about science. College students enrolled in a Human Anatomy and Physiology course were randomly assigned to one of three experimental groups (organ dissections, virtual dissections, or plastic models). Each group received a 15-min lecture followed by a 45-min activity with one of the treatments. Immediately after the lesson and then 2 mo later, students were tested on anatomy and physiology knowledge and completed an attitude survey. Students who used plastic models achieved significantly higher overall scores on both the initial and followup exams than students who performed organ or virtual dissections. On the initial exam, students in the plastic model and organ dissection treatments scored higher on anatomy questions than students who performed virtual dissections. Students in the plastic model group scored higher than students who performed organ dissections on physiology questions. On the followup exam, when asked anatomy questions, students in the plastic model group scored higher than dissection students and virtual dissection students. On attitude surveys, organ dissections had higher perceived value and were requested for inclusion in curricula twice as often as any other activity. Students who performed organ dissections were more likely than the other treatment groups to agree with the statement that "science is fun," suggesting that organ dissections may promote positive attitudes toward science. The findings of this study provide evidence for the importance of multiple types of hands-on activities in anatomy laboratory courses.

Usefulness of a mobile phone with video telephony in identifying the correct landmark for performing needle thoracocentesis.

PubMed

You, J S; Park, S; Chung, S P; Park, J W

2009-03-01

A needle thoracocentesis should be performed with maximal safety and optimal efficacy in mind. Mobile video telephony (VT) could be used to facilitate instructions for the accurate performance of needle thoracocentesis in an emergency setting. This new communication method will increase the accuracy of identifying the relevant anatomical site during the decompression technique. A prospective randomised manikin study was performed to investigate the effectiveness of using VT as a method of instruction for the identification of anatomical landmarks during the performance of needle thoracocentesis. The overall success rate was significantly higher in the VT group which performed needle thoracocentesis under the guidance of VT than in the non-VT group who performed the procedure without VT-aided instruction. The instrument difficulty score and procedure satisfaction score were significantly lower in the VT group than in the non-VT group. Identification of the correct anatomical landmark for needle thoracocentesis can be performed with instructions provided via VT because a dispatcher can monitor every step and provide correct instructions. This new technology will improve critical care medicine.

Do racial and ethnic group differences in performance on the MCAT exam reflect test bias?

PubMed

Davis, Dwight; Dorsey, J Kevin; Franks, Ronald D; Sackett, Paul R; Searcy, Cynthia A; Zhao, Xiaohui

2013-05-01

The Medical College Admission Test (MCAT) is a standardized examination that assesses fundamental knowledge of scientific concepts, critical reasoning ability, and written communication skills. Medical school admission officers use MCAT scores, along with other measures of academic preparation and personal attributes, to select the applicants they consider the most likely to succeed in medical school. In 2008-2011, the committee charged with conducting a comprehensive review of the MCAT exam examined four issues: (1) whether racial and ethnic groups differ in mean MCAT scores, (2) whether any score differences are due to test bias, (3) how group differences may be explained, and (4) whether the MCAT exam is a barrier to medical school admission for black or Latino applicants. This analysis showed that black and Latino examinees' mean MCAT scores are lower than white examinees', mirroring differences on other standardized admission tests and in the average undergraduate grades of medical school applicants. However, there was no evidence that the MCAT exam is biased against black and Latino applicants as determined by their subsequent performance on selected medical school performance indicators. Among other factors which could contribute to mean differences in MCAT performance, whites, blacks, and Latinos interested in medicine differ with respect to parents' education and income. Admission data indicate that admission committees accept majority and minority applicants at similar rates, which suggests that medical students are selected on the basis of a combination of attributes and competencies rather than on MCAT scores alone.

The Effects of Occupational Therapy and Psychosocial Interventions on Interpersonal Functioning and Personal and Social Performance Levels of Corresponding Patients.

PubMed

Çakmak, Soner; Süt, Hüzün; Öztürk, Sibel; Tamam, Lut; Bal, Ufuk

2016-09-01

In this study, we aimed to investigate the effects of occupational therapy and psychosocial interventions on the interpersonal functioning and individual and social performance levels of corresponding patients under the heading of psychosocial treatment approaches in psychiatry clinics as well as the attitudes of the patients in regard to those interventions. In 2013, out of psychotic (schizophrenia, bipolar disorder/mania) and nonpsychotic (depression, obsessive compulsive disorder, alcohol dependence) inpatients in our clinic, 48 patients who participated in occupational activities were included in the study group and 43 patients who did not participate in these activities were included in the control group. We prepared and implemented a 3-item questionnaire constructed by our team, which probed the patients' thoughts on these occupational activities. The Interpersonal Functioning Scale (IFS) and Personal and Social Performance Scale (PSP) were applied to both groups on hospital admission and discharge; variations in scale scores were evaluated on par with sociodemographic variables, and the study and control groups were compared. In total, 91% of the study group provided positive feedback regarding the aforementioned interventions. When comparing the study and control groups, the IFS variance score of the study group did not show a significant difference with respect to that of the control group. A statistically significant difference (p<0.0001) was observed in the PSP scores. Evaluation of the PSP of the occupational activities, focusing on sociodemographics and diagnostic labels, revealed a significant improvement in nonpsychotic patients (p=0.002) compared with psychotic patients, in females (p=0.001) compared with males, in unemployed patients (p=0.0001) compared with employed patients, in single patients (p=0.002) compared with married patients, in less-educated patients (p=0.004) compared with high school graduates, and in patients younger than 45 years (p=0.002) compared with those older than 45 years. The findings of our study showed coherence with the literature regarding similar studies conducted on psychotic subgroups. The results demonstrated significantly positive repercussions, specifically in the treatment of nonpsychotic patients; both groups benefited from occupational activities, as shown by improvements in all psychiatric inpatients' PSP scores in comparison with scores of the control group. We concluded that the recruitment of psychosocial treatment approaches enhanced personal and social performance in the patient groups, thereby leading to additional clinical benefits.

Pretests or advance organizers for Web-based allergy-immunology medical education? A randomized controlled trial.

PubMed

Rank, Matthew A; Volcheck, Gerald W; Swagger, Timothy; Cook, David A

2012-01-01

Web-based modules may facilitate instruction on core topics in allergy and immunology (AI). Pretests (PTs) have been shown to improve learning in Web-based courses, but their effectiveness in comparison with advance organizers (AOs) is unknown. We performed a randomized controlled trial of a Web-based educational intervention for teaching the practical aspects of allergen immunotherapy (AIT). AI Fellows-in-Training were randomly assigned to receive the introduction to the modules in an AO outline (AO group) or as PT questions (PT group). The primary outcome was the difference in posttest scores between groups. The secondary outcome was the difference in PT and posttest scores in the PT group. Thirty participants in the AO group and 35 in the PT group completed the modules and the posttest. The mean (SD) posttest score for the AO group was 74% (14%) compared with 73% (9%) for the PT group, a mean difference of -1% (95% CI, -7%, 5%; p = 0.67). A multivariate analysis controlling for year-in-training and total time spent on the modules revealed virtually identical results. The mean (SD) PT score for the PT group increased from 49 (10%) to 73% (9%), a mean difference of 24% (95% CI, 19%, 28%; p < 0.0001). Introducing Web-based allergy education with PT questions or an AO resulted in similar posttest scores. Posttest scores in the PT group improved significantly compared with PT scores.

Validity of Peer Evaluation for Team-Based Learning in a Dental School in Japan.

PubMed

Nishigawa, Keisuke; Hayama, Rika; Omoto, Katsuhiro; Okura, Kazuo; Tajima, Toyoko; Suzuki, Yoshitaka; Hosoki, Maki; Ueda, Mayu; Inoue, Miho; Rodis, Omar Marianito Maningo; Matsuka, Yoshizo

2017-12-01

The aim of this study was to determine the validity of peer evaluation for team-based learning (TBL) classes in dental education in comparison with the term-end examination records and TBL class scores. Examination and TBL class records of 256 third- and fourth-year dental students in six fixed prosthodontics courses from 2013 to 2015 in one dental school in Japan were investigated. Results of the term-end examination during those courses, individual readiness assurance test (IRAT), group readiness assurance test (GRAT), group assignment projects (GAP), and peer evaluation of group members in TBL classes were collected. Significant positive correlations were found between all combinations of peer evaluation, IRAT, and term-end examination. Individual scores also showed a positive correlation with group score (total of GRAT and GAP). From the investigation of the correlations in the six courses, significant positive correlations between peer evaluation and individual score were found in four of the six courses. In this study, peer evaluation seemed to be a valid index for learning performance in TBL classes. To verify the effectiveness of peer evaluation, all students have to realize the significance of scoring the team member's performance. Clear criteria and detailed instruction for appropriate evaluation are also required.

Language and theory of mind in autism spectrum disorder: the relationship between complement syntax and false belief task performance.

PubMed

Lind, Sophie E; Bowler, Dermot M

2009-06-01

This study aimed to test the hypothesis that children with autism spectrum disorder (ASD) use their knowledge of complement syntax as a means of "hacking out" solutions to false belief tasks, despite lacking a representational theory of mind (ToM). Participants completed a "memory for complements" task, a measure of receptive vocabulary, and traditional location change and unexpected contents false belief tasks. Consistent with predictions, the correlation between complement syntax score and location change task performance was significantly stronger within the ASD group than within the comparison group. However, contrary to predictions, complement syntax score was not significantly correlated with unexpected contents task performance within either group. Possible explanations for this pattern of results are considered.

Seating Arrangement, Group Composition and Competition-driven Interaction: Effects on Students' Performance in Physics

DOE Office of Scientific and Technical Information (OSTI.GOV)

Roxas, R. M.; Monterola, C.; Carreon-Monterola, S. L.

2010-07-28

We probe the effect of seating arrangement, group composition and group-based competition on students' performance in Physics using a teaching technique adopted from Mazur's peer instruction method. Ninety eight lectures, involving 2339 students, were conducted across nine learning institutions from February 2006 to June 2009. All the lectures were interspersed with student interaction opportunities (SIO), in which students work in groups to discuss and answer concept tests. Two individual assessments were administered before and after the SIO. The ratio of the post-assessment score to the pre-assessment score and the Hake factor were calculated to establish the improvement in student performance.more » Using actual assessment results and neural network (NN) modeling, an optimal seating arrangement for a class was determined based on student seating location. The NN model also provided a quantifiable method for sectioning students. Lastly, the study revealed that competition-driven interactions increase within-group cooperation and lead to higher improvement on the students' performance.« less

Performance and Return to Sport After Nonoperative Treatment of Clavicle Fractures in National Football League Players.

PubMed

Jack, Robert A; Sochacki, Kyle R; Navarro, Sergio M; McCulloch, Patrick C; Lintner, David M; Harris, Joshua D

2017-09-01

Clavicle fractures are often seen in contact sports. The purpose of this study was to determine (1) return-to-sport (RTS) rate of National Football League (NFL) players following nonoperative treatment of clavicle fractures, (2) posttreatment career length and games per season, (3) pre- and posttreatment performance, and (4) posttreatment performance compared with control players matched by position, age, years of experience, and performance. Public records were used to identify NFL players who underwent nonoperative treatment of clavicle fractures. Demographic and performance data were collected for each player. Matched controls (position, age, experience, and performance) were identified. Control and case performance scores were calculated using a standardized scoring system. Return to sport was defined as playing a minimum of 1 game after treatment. Comparisons between the 2 groups and pre- and posttreatment time points were made using paired-samples Student's t tests. Thirty players (32 fractures) were analyzed. Two players fractured their contralateral clavicle. Of the players analyzed, 96.9% were able to RTS at a mean of 244.6±119.6 days. Eight players (27.6%) returned within the same season as their injury. Overall 1-year survival rate posttreatment was 93.5%. Players with nonoperative treatment had career lengths similar to those of controls (P>.05). No significant (P>.05) differences existed in demographic, performance, or games per season data between position groups for cases and matched controls pretreatment and preindex and in posttreatment compared with pretreatment performance scores. Wide receivers played fewer games per season (P=.043) following treatment. No position group had significantly worse posttreatment performance scores when compared with postindex matched controls. [Orthopedics. 2017; 40(5):e836-e843.]. Copyright 2017, SLACK Incorporated.

Clinical, functional, and radiographic outcomes following total knee arthroplasty with patient-specific instrumentation, computer-assisted surgery, and manual instrumentation: a short-term follow-up study.

PubMed

Yaffe, Mark; Luo, Michael; Goyal, Nitin; Chan, Philip; Patel, Anay; Cayo, Max; Stulberg, S David

2014-09-01

The purpose of this study was to evaluate clinical, functional, and radiographic outcomes following total knee arthroplasty (TKA) performed with patient-specific instrumentation (PSI), computer-assisted surgery (CAS), and manual instruments at short-term follow-up. 122 TKAs were performed by a single surgeon: 42 with PSI, 38 with CAS, and 40 with manual instrumentation. Preoperative, 1-month, and 6-month clinical and functional outcomes were measured using the Knee Society scoring system (knee score, function score, range of motion, and pain score). Improvements in clinical and functional outcomes from the preoperative to postoperative period were analyzed. Preoperative and postoperative radiographs were measured to evaluate limb and component alignment. Preoperative, 1-month postoperative, and 6-month postoperative knee scores, function scores, range of motion, and pain scores were highest in the PSI group compared to CAS and manual instrumentation. At 6-month follow-up, PSI TKA was associated with a statistically significant improvement in functional score when compared to manual TKA. Otherwise, there were no statistically significant differences in improvements among PSI, CAS, and manual TKA groups. The higher preoperative scores in the PSI group limits the ability to draw definitive conclusions from the raw postoperative scores, but analyzing the changes in scores revealed that PSI was associated with a statistically significant improvement in Knee Society Functional score at 6-month post-TKA as compared to CAS or manual TKA. This may be attributable to improvements in component rotation and positioning, improved component size accuracy, or other factors that are not discernible on plain radiograph.

Dengue score as a diagnostic predictor for pleural effusion and/or ascites: external validation and clinical application.

PubMed

Suwarto, Suhendro; Hidayat, Mohammad Jauharsyah; Widjaya, Bing

2018-02-23

The Dengue Score is a model for predicting pleural effusion and/or ascites and uses the hematocrit (Hct), albumin concentration, platelet count and aspartate aminotransferase (AST) ratio as independent variables. As this metric has not been validated, we conducted a study to validate the Dengue Score and assess its clinical application. A retrospective study was performed at a private hospital in Jakarta, Indonesia. Patients with dengue infection hospitalized from January 2011 through March 2016 were included. The Dengue Score was calculated using four parameters: Hct increase≥15.1%, serum albumin≤3.49 mg/dL, platelet count≤49,500/μL and AST ratio ≥ 2.51. Each parameter was scored as 1 if present and 0 if absent. To validate the Dengue Score, goodness-of-fit was used to assess calibration, and the area under the receiver operating characteristic curve (AROC) was used to assess discrimination. Associations between clinical parameters and Dengue Score groups were determined by bivariate analysis. A total of 207 patients were included in this study. The calibration of the Dengue Score was acceptable (Hosmer-Lemeshow test, p = 0.11), and the score's discriminative ability was good (AROC = 0.88 (95% CI: 0.83-0.92)). At a cutoff of ≥2, the Dengue Score had a positive predictive value (PPV) of 79.03% and a negative predictive value (NPV) of 90.36% for the diagnostic prediction of pleural effusion and/or ascites. Compared with the Dengue Score ≤ 1 group, the Dengue Score = 2 group was significantly associated with hemoconcentration> 20% (p = 0.029), severe thrombocytopenia (p = 0.029), and increased length of hospital stay (p = 0.003). Compared with the Dengue Score = 2 group, the Dengue Score ≥ 3 group was significantly associated with hemoconcentration> 20% (p = 0.001), severe thrombocytopenia (p = 0.024), severe dengue (p = 0.039), and increased length of hospital stay (p = 0.011). The Dengue Score performed well and can be used in daily practice to help clinicians identify patients who have plasma leakage associated with severe dengue.

Feasibility of peer assessment and clinical audit to self-regulate the quality of physiotherapy services: a mixed methods study

PubMed Central

Nijhuis-van der Sanden, Maria W G; Driehuis, Femke; Heerkens, Yvonne F; van der Vleuten, Cees P M; van der Wees, Philip J

2017-01-01

Objectives To evaluate the feasibility of a quality improvement programme aimed to enhance the client-centeredness, effectiveness and transparency of physiotherapy services by addressing three feasibility domains: (1) acceptability of the programme design, (2) appropriateness of the implementation strategy and (3) impact on quality improvement. Design Mixed methods study. Participants and setting 64 physiotherapists working in primary care, organised in a network of communities of practice in the Netherlands. Methods The programme contained: (1) two cycles of online self-assessment and peer assessment (PA) of clinical performance using client records and video-recordings of client communication followed by face-to-face group discussions, and (2) clinical audit assessing organisational performance. Assessment was based on predefined performance indicators which could be scored on a 5-point Likert scale. Discussions addressed performance standards and scoring differences. All feasibility domains were evaluated qualitatively with two focus groups and 10 in-depth interviews. In addition, we evaluated the impact on quality improvement quantitatively by comparing self-assessment and PA scores in cycles 1 and 2. Results We identified critical success features relevant to programme development and implementation, such as clarifying expectations at baseline, training in PA skills, prolonged engagement with video-assessment and competent group coaches. Self-reported impact on quality improvement included awareness of clinical and organisational performance, improved evidence-based practice and client-centeredness and increased motivation to self-direct quality improvement. Differences between self-scores and peer scores on performance indicators were not significant. Between cycles 1 and 2, scores for record keeping showed significant improvement, however not for client communication. Conclusions This study demonstrated that bottom-up initiatives to improve healthcare quality can be effective. The results justify ongoing evaluation to inform nationwide implementation when the critical success features are addressed. Further research is necessary to explore the sustainability of the results and the impact on client outcomes in a full-scale study. PMID:28188156

Effect of Group Setting on Gross Motor Performance in Children 3-5 Years Old with Motor Delays.

PubMed

Fay, Deanne; Wilkinson, Tawna; Wagoner, Michelle; Brooks, Danna; Quinn, Lauren; Turnell, Andrea

2017-02-01

The purpose of this study was to evaluate differences in gross motor performance of children 3-5 years of age with motor delays when assessed individually compared to assessment in a group setting among peers with typical development (TD). Twenty children with motor delays and 42 children with TD were recruited from a preschool program. A within-subject repeated measures design was used; each child with delay was tested both in an individual setting and in a group setting with two to four peers with TD. Testing sessions were completed 4-8 days apart. Ten different motor skills from the Peabody Developmental Motor Scales-2 were administered. Performance of each item was videotaped and scored by a blinded researcher. Overall gross motor performance was significantly different (p < .05) between the two settings, with 14 of 20 children demonstrating better performance in the group setting. In particular, children performed better on locomotion items (p < .05). The higher scores for locomotion in the group setting may be due to the influence of competition, motivation, or modeling. Assessing a child in a group setting is recommended as part of the evaluation process.

An effective repetitive training schedule to achieve skill proficiency using a novel robotic virtual reality simulator.

PubMed

Kang, Sung Gu; Ryu, Byung Ju; Yang, Kyung Sook; Ko, Young Hwii; Cho, Seok; Kang, Seok Ho; Patel, Vipul R; Cheon, Jun

2015-01-01

A robotic virtual reality simulator (Mimic dV-Trainer) can be a useful training method for the da Vinci surgical system. Herein, we investigate several repetitive training schedules and determine which is the most effective. A total of 30 medical students were enrolled and were divided into 3 groups according to the training schedule. Group 1 performed the task 1 hour daily for 4 consecutive days, group II performed the task on once per week for 1 hour for 4 consecutive weeks, and group III performed the task for 4 consecutive hours in 1 day. The effects of training were investigated by analyzing the number of repetitions and the time required to complete the "Tube 2" simulation task when the learning curve plateau was reached. The point at which participants reached a stable score was evaluated using the cumulative sum control graph. The average time to complete the task at the learning curve plateau was 150.3 seconds in group I, 171.9 seconds in group II, and 188.5 seconds in group III. The number of task repetitions required to reach the learning curve plateau was 45 repetitions in group I, 36 repetitions in group II, and 39 repetitions in group III. Therefore, there was continuous improvement in the time required to perform the task after 40 repetitions in group I only. There was a significant correlation between improvement in each trial interval and attempt, and the correlation coefficient (0.924) in group I was higher than that in group II (0.899) and group III (0.838). Daily 1-hour practice sessions performed for 4 consecutive days resulted in the best final score, continuous score improvement, and effective training while minimizing fatigue. This repetition schedule can be used for effectively training novices in future. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Neurofeedback training improves attention and working memory performance.

PubMed

Wang, Jinn-Rong; Hsieh, Shulan

2013-12-01

The present study aimed to investigate the effectiveness of the frontal-midline theta (fmθ) activity uptraining protocol on attention and working memory performance of older and younger participants. Thirty-two participants were recruited. Participants within each age group were randomly assigned to either the neurofeedback training (fmθ uptraining) group or the sham-neurofeedback training group. There was a significant improvement in orienting scores in the older neurofeedback training group. In addition, there was a significant improvement in conflict scores in both the older and young neurofeedback training groups. However, alerting scores failed to increase. In addition, the fmθ training was found to improve working memory function in the older participants. The results further showed that fmθ training can modulate resting EEG for both neurofeedback groups. Our study demonstrated that fmθ uptraining improved attention and working memory performance and theta activity in the resting state for normal aging adults. In addition, younger participants also benefited from the present protocol in terms of improving their executive function. The current findings contribute to a better understanding of the mechanisms underlying neurofeedback training in cognitive function, and suggest that the fmθ uptraining protocol is an effective intervention program for cognitive aging. Copyright © 2013 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Comparison of two extracorporeal shock wave therapy techniques for the treatment of painful subcalcaneal spur. A randomized controlled study.

PubMed

Tornese, Davide; Mattei, Enrico; Lucchesi, Giampaolo; Bandi, Marco; Ricci, Gabriele; Melegati, Gianluca

2008-09-01

To describe and compare two extracorporeal shock wave therapy techniques for the treatment of painful subcalcaneal spur. Random assignment to two groups of treatment with two and eight months follow-up. The data were collected in outpatients. Forty-five subjects with a history of at least six months of heel pain were studied. Each subject received a three-session ultrasound-guided extracorporeal shock wave therapy (performed weekly). Perpendicular technique was used in group A (n=22, mean age 59.3 +/- 12 years) and tangential technique was used in group B (n= 23, mean age 58.8 +/- 12.3 years). Mayo Clinical Scoring System was used to evaluate each subject before the treatment and at two and eight months follow-up. Mayo Clinical Scoring System pretreatment scores were homogeneous between the groups (group A 55.2 +/-18.7; group B 53.5 +/- 20; P>0.05). In both groups there was a significant (P<0.05) increase in the Mayo Clinical Scoring System score at two months (group A 83.9 +/- 13.7; group B 80 +/- 15,8) and eight months (group A 90 +/- 10.5; group B 90.2 +/-8.7) follow-up. No significant differences were obtained comparing the Mayo Clinical Scoring System scores of the two groups at two and eight months follow-up. There was no difference between the two techniques of using extracorporeal shock wave therapy. The tangential technique was found to be better tolerated as regards treatment-induced pain, allowing higher energy dosages to be used.

A comparison of hands-on inquiry instruction to lectureinstruction with special needs high school biology students

NASA Astrophysics Data System (ADS)

Jensen-Ruopp, Helga Spitko

A comparison of hands-on inquiry instruction with lecture instruction was presented to 134 Patterns and Process Biology students. Students participated in seven biology lessons that were selected from Biology Survey of Living Things (1992). A pre and post paper and pencil assessment was used as the data collecting instrument. The treatment group was taught using hands-on inquiry strategies while the non-treatment group was taught in the lecture method of instruction. The team teaching model was used as the mode of presentation to the treatment group and the non-treatment group. Achievement levels using specific criterion; novice (0% to 50%), developing proficiency (51% to 69%), accomplished (70% to 84) and exceptional or mastery level (85% to 100%) were used as a guideline to tabulate the results of the pre and post assessment. Rubric tabulation was done to interpret the testing results. The raw data was plotted using percentage change in test score totals versus reading level score by gender as well as percentage change in test score totals versus auditory vocabulary score by gender. Box Whisker plot comparative descriptive of individual pre and post test scores for the treatment and non-treatment group was performed. Analysis of covariance (ANCOVA) using MINITAB Statistical Software version 14.11 was run on data of the seven lessons, as well as on gender (male results individual and combined, and female results individual and combined) results. Normal Probability Plots for total scores as well as individual test scores were performed. The results suggest that hands-on inquiry based instruction when presented to special needs students including; at-risk; English as a second language limited, English proficiency and special education inclusive students' learning may enhance individual student achievement.

Clinical and structural outcomes after arthroscopic repair of full-thickness rotator cuff tears with and without platelet-rich product supplementation: a meta-analysis and meta-regression.

PubMed

Warth, Ryan J; Dornan, Grant J; James, Evan W; Horan, Marilee P; Millett, Peter J

2015-02-01

The purpose of this study was to perform a systematic review, meta-analysis, and meta-regression of all Level I and Level II studies comparing the clinical or structural outcomes, or both, after rotator cuff repair with and without platelet-rich product (PRP) supplementation. A literature search of the PubMed and EMBASE databases was performed to identify all Level I or II studies comparing the clinical or structural outcomes, or both, after arthroscopic repair of full-thickness rotator cuff tears with (PRP+ group) and without (PRP- group) PRP supplementation. Data included outcome scores (American Shoulder and Elbow Surgeons [ASES], University of California Los Angeles [UCLA], Constant, Simple Shoulder Test [SST] and visual analog scale [VAS] scores) and retears diagnosed with imaging studies. Meta-analyses compared preoperative, postoperative, and gain in outcome scores and relative risk ratios for retears. Meta-regression compared the effect of PRP treatment on outcome scores and retear rates according to 6 covariates. Minimum effect sizes that were detectable with 80% power were also calculated for each study. Eleven studies were included in this review and a maximum of 8 studies were used for meta-analyses according to data availability. There were no statistically significant differences between the PRP+ and PRP- groups for overall outcome scores or retear rates (P > .05). Overall gain in the Constant score was decreased when liquid PRP was injected over the tendon surface compared with PRP application at the tendon-bone interface (-6.88 points v +0.78 points, respectively; P = .046); however, this difference did not reach the previously reported minimum clinically important difference (MCID) for Constant scores. When the initial tear size was greater than 3 cm in anterior-posterior length, the PRP+ group exhibited decreased retear rates after double-row repairs when compared with the PRP- group (25.9% v 57.1%, respectively; P = .046). Sensitivity power analyses revealed that most included studies were only powered to detect large differences in outcome scores between groups. There were no statistically significant differences in overall gain in outcome scores or retear rates between treatment groups. Gain in Constant scores was significantly increased when PRPs were applied at the tendon-bone interface when compared with application over the top of the repaired tendon. Retear rates were significantly decreased when PRPs were used for the treatment of tears greater than 3 cm in anterior-posterior length using a double-row technique. Most of the included studies were only powered to detect large differences in outcome scores between treatment groups. In addition, an increased risk for selection, performance, and attrition biases was found. Level II, meta-analysis of Level I and Level II studies. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

[Effects of on education program for nurses on the use of restraints].

PubMed

Yeo, Jeong Min; Park, Myong Hwa

2006-06-01

This study was conducted to verify the effects of an education program of restraints use on nurses' knowledge, attitude and nursing performance related to restraints use. A quasi experimental study with a pre and post non-equivalent design was used. The subjects were nurses who met the selection criteria and worked in intensive care units of two university hospitals located at K-city, Gyeongbuk. Twenty nurses in A hospital were designated as the experimental group and 20 nurses in B hospital as the control group. The first hypothesis which assumed that the experimental group would have higher scores of knowledge than the control group was supported(F=62.66, p=0.000). The second hypothesis which assumed that the experimental group would have lower scores of attitude toward using restraints than the control group was supported(F=23.77, p=0.000). The third hypothesis which assumed that the experimental group would have higher scores of nursing performance than the control group was supported(F=3.28, p=0.032). An education program for nurses' on the use of restraints needs to be introduced to decrease inappropriate use of restraints.

The Contributions of Memory and Vocabulary to Non-Verbal Ability Scores in Adolescents with Intellectual Disability

PubMed Central

Mungkhetklang, Chantanee; Bavin, Edith L.; Crewther, Sheila G.; Goharpey, Nahal; Parsons, Carl

2016-01-01

It is usually assumed that performance on non-verbal intelligence tests reflects visual cognitive processing and that aspects of working memory (WM) will be involved. However, the unique contribution of memory to non-verbal scores is not clear, nor is the unique contribution of vocabulary. Thus, we aimed to investigate these contributions. Non-verbal test scores for 17 individuals with intellectual disability (ID) and 39 children with typical development (TD) of similar mental age were compared to determine the unique contribution of visual and verbal short-term memory (STM) and WM and the additional variance contributed by vocabulary scores. No significant group differences were found in the non-verbal test scores or receptive vocabulary scores, but there was a significant difference in expressive vocabulary. Regression analyses indicate that for the TD group STM and WM (both visual and verbal) contributed similar variance to the non-verbal scores. For the ID group, visual STM and verbal WM contributed most of the variance to the non-verbal test scores. The addition of vocabulary scores to the model contributed greater variance for both groups. More unique variance was contributed by vocabulary than memory for the TD group, whereas for the ID group memory contributed more than vocabulary. Visual and auditory memory and vocabulary contributed significantly to solving visual non-verbal problems for both the TD group and the ID group. However, for each group, there were different weightings of these variables. Our findings indicate that for individuals with TD, vocabulary is the major factor in solving non-verbal problems, not memory, whereas for adolescents with ID, visual STM, and verbal WM are more influential than vocabulary, suggesting different pathways to achieve solutions to non-verbal problems. PMID:28082922

The US7 score is sensitive to change in a large cohort of patients with rheumatoid arthritis over 12 months of therapy

PubMed Central

Backhaus, Tina M; Ohrndorf, Sarah; Kellner, Herbert; Strunk, Johannes; Hartung, Wolfgang; Sattler, Horst; Iking-Konert, Christof; Burmester, Gerd R; Schmidt, Wolfgang A; Backhaus, Marina

2013-01-01

Purpose To determine the sensitivity to change of the US7 score among RA patients under various therapies and to analyze the effect of each therapeutic option over 1 year. To estimate predictors for development of destructive bone changes. Methods Musculoskeletal ultrasound (US7 score), DAS28, CRP and ESR were performed in 432 RA patients at baseline and after 3, 6 and 12 months. The cohort was divided into four sub-groups: first-line DMARDs (Group 1; 27.3%), therapy switch: DMARDs to second DMARDs (Group 2; 25.0%), first-line biologic after DMARDs therapy (Group 3; 35.4%) and therapy change from biologic to second biologic (Group 4; 12.3%). Results The US7 synovitis and tenosynovitis sum scores in grey-scale (GSUS) and power Doppler ultrasound (PDUS) as well as ESR, CRP decreased significantly (p<0.05) after 12 months in group 1 to 3. Group 1+2 also illustrated a significant change of DAS28 after 1 year (p<0.001). Only in Group 4, the US7 erosion sum score decreased significantly from 4.3 to 3.6 (p=0.008) after 1 year. Predictors capable of forecasting US erosions after one year were: higher score of US7 synovitis (p<0.001), of US7 erosions in GSUS (p<0.001), as well as of DAS28 (p<0.001) at baseline. Conclusions The comparable developments of the US7 score with clinical and laboratory data illustrates its potential to reflect therapeutic response. Therefore, the novel US7 score is sensitive to change. Patients who switched from one biologic to another exhibited a significant decline in erosions after 12 months, while the erosions scores in the other groups were stable. PMID:22956596

Primary Arthrodesis versus Open Reduction and Internal Fixation for Low-Energy Lisfranc Injuries in a Young Athletic Population.

PubMed

Cochran, Grant; Renninger, Christopher; Tompane, Trevor; Bellamy, Joseph; Kuhn, Kevin

2017-09-01

There are 2 Level I studies comparing open reduction and internal fixation (ORIF) and primary arthrodesis (PA) in high-energy Lisfranc injuries. There are no studies comparing ORIF and PA in young athletic patients with low-energy injuries. All operatively managed low-energy Lisfranc injuries sustained by active duty military personnel at a single institution were identified from 2010 to 2015. The injury pattern, method of treatment, and complications were reviewed. Implant removal rates, fitness test scores, return to military duty rates, and Foot and Ankle Ability Measure (FAAM) scores were compared. Thirty-two patients were identified with the average age of 28 years. PA was performed in 14 patients with ORIF in 18. The PA group returned to full duty at an average of 4.5 months whereas the ORIF group returned at an average of 6.7 months ( P = .0066). The PA group ran their fitness test an average of 9 seconds per mile slower than their preoperative average whereas the ORIF group ran it an average of 39 seconds slower per mile ( P = .032). There were no differences between the 2 groups in the FAAM scores at an average of 35 months. Implant removal was performed in 15 (83%) in the ORIF group and 2 (14%) in the PA group ( P = .005). Low-energy Lisfranc injuries treated with primary arthrodesis had a lower implant removal rate, an earlier return to full military activity, and better fitness test scores after 1 year, but there was no difference in FAAM scores after 3 years. Level III, comparative cohort study.

"The effects of family-centered physiotherapy on the cognitive and motor performance in premature infants".

PubMed

Elbasan, Bulent; Kocyigit, Murat Fatih; Soysal-Acar, A Sebnem; Atalay, Yıldız; Gucuyener, Kivilcim

2017-11-01

The aim of this study is to investigate the effects of family centered physiotherapy according to the neurodevelopmental treatment (NDT) principles on mental and motor performance in premature infants. A total of 156 infant, ≥24/36 week+6days gestational age included in the study. All the infants were diagnosed by a child neurologist and referred to psychology and physiotherapy department for their neurodevelopmental assessment and treatment. Bayley Scale of Infant II (BSI-II) was used for neurodevelopmental assessment and Alberta Infant Motor Scale (AIMS) was used for assessing their motor performance. Seventy-eight of the infants were in the study group and 76 were recruited as age matched controls according to the classification of their gestational age. Family centered physiotherapy according to the neurodevelopmental treatment principles was used as an intervention and all the mothers are trained accordingly. Cognitive Development Scores and Motor Development Scores of Bayley II were recorded for the 3., 6., 9., and 12 months respectively. Between the 3. and 12. month of gestational age, within-groups measurements in both Cognitive Development Scores (p<0.001) and Motor Development Scores (p<0.001) were significantly increased. However, the improvements in both Cognitive Development Scores (p=0.059) and Motor Development Scores (p=0.334) between the groups was not different. Family centered physiotherapy with NDT principles may not be enough to improve motor and cognitive performance in preterm infants at the first year of age. For supporting the motor and cognitive development of the preterm infants other intervention modalities also should be considered. Copyright © 2017 Elsevier Inc. All rights reserved.

Glasgow Prognostic Score is superior to ECOG PS as a prognostic factor in patients with gastric cancer with peritoneal seeding.

PubMed

Yuan, Shu-Qiang; Nie, Run-Cong; Chen, Yong-Ming; Qiu, Hai-Bo; Li, Xiao-Ping; Chen, Xiao-Jiang; Xu, Li-Pu; Yang, Li-Fang; Sun, Xiao-Wei; Li, Yuan-Fang; Zhou, Zhi-Wei; Chen, Shi; Chen, Ying-Bo

2018-04-01

The Glasgow Prognostic Score (GPS) has been shown to be associated with survival rates in patients with advanced cancer. The present study aimed to compare the GPS with the Eastern Cooperative Oncology Group Performance Status (ECOG PS) in patients with gastric cancer with peritoneal seeding. For the investigation, a total of 384 gastric patients with peritoneal metastasis were retrospectively analyzed. Patients with elevated C-reactive protein (CRP; >10 mg/l) and hypoalbuminemia (<35 mg/l) were assigned a score of 2. Patients were assigned a score of 1 if presenting with only one of these abnormalities, and a score of 0 if neither of these abnormalities were present. The clinicopathologic characteristics and clinical outcomes of patients with peritoneal seeding were analyzed. The results showed that the median overall survival (OS) of patients in the GPS 0 group was longer, compared with that in the GPS 1 and GPS 2 groups (15.50, vs. 10.07 and 7.97 months, respectively; P<0.001). No significant difference was found between the median OS of patients with a good performance status (ECOG <2) and those with a poor (ECOG ≥2) performance status (13.67, vs. 11.80 months; P=0.076). In the subgroup analysis, the median OS in the GPS 0 group was significantly longer, compared with that in the GPS 1 and GPS 2 groups, for the patients receiving palliative chemotherapy and patients without palliative chemotherapy. Multivariate survival analysis demonstrated that CA19-9, palliative gastrectomy, first-line chemotherapy and GPS were the prognostic factors predicting OS. In conclusion, the GPS was superior to the subjective assessment of ECOG PS as a prognostic factor in predicting the outcome of gastric cancer with peritoneal seeding.

Tablet computer enhanced training improves internal medicine exam performance.

PubMed

Baumgart, Daniel C; Wende, Ilja; Grittner, Ulrike

2017-01-01

Traditional teaching concepts in medical education do not take full advantage of current information technology. We aimed to objectively determine the impact of Tablet PC enhanced training on learning experience and MKSAP® (medical knowledge self-assessment program) exam performance. In this single center, prospective, controlled study final year medical students and medical residents doing an inpatient service rotation were alternatingly assigned to either the active test (Tablet PC with custom multimedia education software package) or traditional education (control) group, respectively. All completed an extensive questionnaire to collect their socio-demographic data, evaluate educational status, computer affinity and skills, problem solving, eLearning knowledge and self-rated medical knowledge. Both groups were MKSAP® tested at the beginning and the end of their rotation. The MKSAP® score at the final exam was the primary endpoint. Data of 55 (tablet n = 24, controls n = 31) male 36.4%, median age 28 years, 65.5% students, were evaluable. The mean MKSAP® score improved in the tablet PC (score Δ + 8 SD: 11), but not the control group (score Δ- 7, SD: 11), respectively. After adjustment for baseline score and confounders the Tablet PC group showed on average 11% better MKSAP® test results compared to the control group (p<0.001). The most commonly used resources for medical problem solving were journal articles looked up on PubMed or Google®, and books. Our study provides evidence, that tablet computer based integrated training and clinical practice enhances medical education and exam performance. Larger, multicenter trials are required to independently validate our data. Residency and fellowship directors are encouraged to consider adding portable computer devices, multimedia content and introduce blended learning to their respective training programs.

Tablet computer enhanced training improves internal medicine exam performance

PubMed Central

Wende, Ilja; Grittner, Ulrike

2017-01-01

Background Traditional teaching concepts in medical education do not take full advantage of current information technology. We aimed to objectively determine the impact of Tablet PC enhanced training on learning experience and MKSAP® (medical knowledge self-assessment program) exam performance. Methods In this single center, prospective, controlled study final year medical students and medical residents doing an inpatient service rotation were alternatingly assigned to either the active test (Tablet PC with custom multimedia education software package) or traditional education (control) group, respectively. All completed an extensive questionnaire to collect their socio-demographic data, evaluate educational status, computer affinity and skills, problem solving, eLearning knowledge and self-rated medical knowledge. Both groups were MKSAP® tested at the beginning and the end of their rotation. The MKSAP® score at the final exam was the primary endpoint. Results Data of 55 (tablet n = 24, controls n = 31) male 36.4%, median age 28 years, 65.5% students, were evaluable. The mean MKSAP® score improved in the tablet PC (score Δ + 8 SD: 11), but not the control group (score Δ- 7, SD: 11), respectively. After adjustment for baseline score and confounders the Tablet PC group showed on average 11% better MKSAP® test results compared to the control group (p<0.001). The most commonly used resources for medical problem solving were journal articles looked up on PubMed or Google®, and books. Conclusions Our study provides evidence, that tablet computer based integrated training and clinical practice enhances medical education and exam performance. Larger, multicenter trials are required to independently validate our data. Residency and fellowship directors are encouraged to consider adding portable computer devices, multimedia content and introduce blended learning to their respective training programs. PMID:28369063

"Alarm-corrected" ergonomic armrest use could improve learning curves of novices on robotic simulator.

PubMed

Yang, Kun; Perez, Manuela; Hossu, Gabriela; Hubert, Nicolas; Perrenot, Cyril; Hubert, Jacques

2017-01-01

In robotic surgery, the professional ergonomic habit of using an armrest reduces operator fatigue and increases the precision of motion. We designed and validated a pressure surveillance system (PSS) based on force sensors to investigate armrest use. The objective was to evaluate whether adding an alarm to the PSS system could shorten ergonomic training and improve performance. Twenty robot and simulator-naïve participants were recruited and randomized in two groups (A and B). The PSS was installed on a robotic simulator, the dV-Trainer, to detect contact with the armrest. The Group A members completed three tasks on the dV-Trainer without the alarm, making 15 attempts at each task. The Group B members practiced the first two tasks with the alarm and then completed the final tasks without the alarm. The simulator provided an overall score reflecting the trainees' performance. We used the new concept of an "armrest load" score to describe the ergonomic habit of using the armrest. Group B had a significantly higher performance score (p < 0.001) and armrest load score (p < 0.001) than Group A from the fifth attempt of the first task to the end of the experiment. Based on the conditioned reflex effect, the alarm associated with the PSS rectified ergonomic errors and accelerated professional ergonomic habit acquisition. The combination of the PSS and alarm is effective in significantly shortening the learning curve in the robotic training process.

The Relationship of Laboratory Performance Ratings, Information Achievement and Pencil-Paper Performance Test Scores in College-Level Electricity.

ERIC Educational Resources Information Center

Francis, Charles E.

In this study, a pencil paper performance test (PPPT) was developed and administered to an experimental group of 46 students and a control group of 48 students to determine: (1) the difference between laboratory performance and the successful completion of a laboratory course in electricity, (2) the relationship between laboratory performance as…

Serious game training improves performance in combat life-saving interventions.

PubMed

Planchon, Jerome; Vacher, Anthony; Comblet, Jeremy; Rabatel, Eric; Darses, Françoise; Mignon, Alexandre; Pasquier, Pierre

2018-01-01

In modern warfare, almost 25% of combat-related deaths are considered preventable if life-saving interventions are performed. Therefore, Tactical Combat Casualty Care (TCCC) training for soldiers is a major challenge. In 2014, the French Military Medical Service supported the development of 3D-SC1 ® , a serious game designed for the French TCCC program, entitled Sauvetage au Combat de niveau 1 (SC1). Our study aimed to evaluate the impact on performance of additional training with 3D-SC1 ® . The study assessed the performance of soldiers randomly assigned to one of two groups, before (measure 1) and after (measure 2) receiving additional training. This training involved either 3D-SC1 ® (Intervention group), or a DVD (Control group). The principal measure was the individual performance (on a 16-point scale), assessed by two investigators during a hands-on simulation. First, the mean performance score was compared between the two measures for Intervention and Control groups using a two-tailed paired t-test. Second, a multivariable linear regression was used to determine the difference in the impacts of 3D-SC1 ® and DVD training, and the order of presentation of the two scenarios, on the mean change from baseline in performance scores. A total of 96 subjects were evaluated: seven could not be followed-up, while 50 were randomly allocated to the Intervention group, and 39 to the Control group. Between measure 1 and measure 2, the mean (SD) performance score increased from 9.9 (3.13) to 14.1 (1.23), and from 9.4 (2.97) to 12.5 (1.83), for the Intervention group and Control group, respectively (p<0.0001). The adjusted mean difference in performance scores between 3D-SC1 ® and DVD training was 1.1 (95% confidence interval -0.3, 2.5) (p=0.14). Overall, the study found that supplementing SC1 training with either 3D-SC1 ® or DVD improved performance, assessed by a hands-on simulation. However, our analysis did not find a statistically significant difference between the effects of these two training tools. 3D-SC1 ® could be an efficient and pedagogical tool to train soldiers in life-saving interventions. In the current context of terrorist threat, a specifically-adapted version of 3D-SC1 ® may be a cost-effective and engaging way to train a large civilian public. Copyright © 2017 Elsevier Ltd. All rights reserved.

Administration Modifications on the WISC-R Performance Scale with Different Categories of Deaf Children.

ERIC Educational Resources Information Center

Sullivan, Patricia M.

1982-01-01

Two studies investigated the effects of administration modifications on subtest scaled scores of the Wechsler-Intelligence Scale for Children-Revised (WISC-R). Performance scale rated different groups of 57 severely/profoundly hearing-impaired children. Total communication was found to result in higher scores on all subtests in the genetic and…

Enamel Hypomineralization in Children With Clefts and the Relationship to Treatment: A Cross-sectional Retrospective Study.

PubMed

Allam, Eman; Ghoneima, Ahmed; Tholpady, Sunil S; Kula, Katherine

2018-06-19

The aim of this study was to determine whether molar incisor hypomineralization (MIH) is greater in patients with cleft lip and palate (CLP) who underwent primary alveolar grafting (PAG) as compared with CLP waiting for secondary alveolar grafting (SAG) and with controls. A retrospective analysis of intraoral photographs of 13 CLP patients who underwent a PAG, 28 CLP prior to SAG, and 60 controls without CLP was performed. Mantel-Haenszel χ tests were used to compare the 3 groups for differences in MIH scores, and Wilcoxon rank sum tests were used to compare the groups for differences in average MIH scores. A 5% significance level was used for all tests. Molar incisor hypomineralization scores were significantly higher for the PAG and SAG groups compared with the control group (P < 0.001). The PAG group had significantly higher incisor MIH (P = 0.016) compared with the SAG group. Molar incisor hypomineralization average scores were significantly higher for the 2 graft groups compared with the controls (P < 0.0001). The PAG group had significantly higher average MIH score and average MIH score for incisors compared with the SAG group (P = 0.03). Cleft lip and palate patients have significantly greater MIH compared with controls, and CLP patients with PAGs have significantly greater MIH in the incisor region compared with CLP patients with SAGs, indicating that subjects with PAGs have more severely affected dentition.

Effect of video-game experience and position of flight stick controller on simulated-flight performance.

PubMed

Cho, Bo-Keun; Aghazadeh, Fereydoun; Al-Qaisi, Saif

2012-01-01

The purpose of this study was to determine the effects of video-game experience and flight-stick position on flying performance. The study divided participants into 2 groups; center- and side-stick groups, which were further divided into high and low level of video-game experience subgroups. The experiment consisted of 7 sessions of simulated flying, and in the last session, the flight stick controller was switched to the other position. Flight performance was measured in terms of the deviation of heading, altitude, and airspeed from their respective requirements. Participants with high experience in video games performed significantly better (p < .001) than the low-experienced group. Also, participants performed significantly better (p < .001) with the center-stick than the side-stick. When the side-stick controller was switched to the center-stick position, performance scores continued to increase (0.78 %). However, after switching from a center- to a side-stick controller, performance scores decreased (4.8%).

Key performance indicators score (KPIs-score) based on clinical and laboratorial parameters can establish benchmarks for internal quality control in an ART program.

PubMed

Franco, José G; Petersen, Claudia G; Mauri, Ana L; Vagnini, Laura D; Renzi, Adriana; Petersen, Bruna; Mattila, M C; Comar, Vanessa A; Ricci, Juliana; Dieamant, Felipe; Oliveira, João Batista A; Baruffi, Ricardo L R

2017-06-01

KPIs have been employed for internal quality control (IQC) in ART. However, clinical KPIs (C-KPIs) such as age, AMH and number of oocytes collected are never added to laboratory KPIs (L-KPIs), such as fertilization rate and morphological quality of the embryos for analysis, even though the final endpoint is the evaluation of clinical pregnancy rates. This paper analyzed if a KPIs-score strategy with clinical and laboratorial parameters could be used to establish benchmarks for IQC in ART cycles. In this prospective cohort study, 280 patients (36.4±4.3years) underwent ART. The total KPIs-score was obtained by the analysis of age, AMH (AMH Gen II ELISA/pre-mixing modified, Beckman Coulter Inc.), number of metaphase-II oocytes, fertilization rates and morphological quality of the embryonic lot. The total KPIs-score (C-KPIs+L-KPIs) was correlated with the presence or absence of clinical pregnancy. The relationship between the C-KPIs and L-KPIs scores was analyzed to establish quality standards, to increase the performance of clinical and laboratorial processes in ART. The logistic regression model (LRM), with respect to pregnancy and total KPIs-score (280 patients/102 clinical pregnancies), yielded an odds ratio of 1.24 (95%CI = 1.16-1.32). There was also a significant difference (p<0.0001) with respect to the total KPIs-score mean value between the group of patients with clinical pregnancies (total KPIs-score=20.4±3.7) and the group without clinical pregnancies (total KPIs-score=15.9±5). Clinical pregnancy probabilities (CPP) can be obtained using the LRM (prediction key) with the total KPIs-score as a predictor variable. The mean C-KPIs and L-KPIs scores obtained in the pregnancy group were 11.9±2.9 and 8.5±1.7, respectively. Routinely, in all cases where the C-KPIs score was ≥9, after the procedure, the L-KPIs score obtained was ≤6, a revision of the laboratory procedure was performed to assess quality standards. This total KPIs-score could set up benchmarks for clinical pregnancy. Moreover, IQC can use C-KPIs and L-KPIs scores to detect problems in the clinical-laboratorial interface.

Cheating in OSCEs: The Impact of Simulated Security Breaches on OSCE Performance.

PubMed

Gotzmann, Andrea; De Champlain, André; Homayra, Fahmida; Fotheringham, Alexa; de Vries, Ingrid; Forgie, Melissa; Pugh, Debra

2017-01-01

Construct: Valid score interpretation is important for constructs in performance assessments such as objective structured clinical examinations (OSCEs). An OSCE is a type of performance assessment in which a series of standardized patients interact with the student or candidate who is scored by either the standardized patient or a physician examiner. In high-stakes examinations, test security is an important issue. Students accessing unauthorized test materials can create an unfair advantage and lead to examination scores that do not reflect students' true ability level. The purpose of this study was to assess the impact of various simulated security breaches on OSCE scores. Seventy-six 3rd-year medical students participated in an 8-station OSCE and were randomized to either a control group or to 1 of 2 experimental conditions simulating test security breaches: station topic (i.e., providing a list of station topics prior to the examination) or egregious security breach (i.e., providing detailed content information prior to the examination). Overall total scores were compared for the 3 groups using both a one-way between-subjects analysis of variance and a repeated measure analysis of variance to compare the checklist, rating scales, and oral question subscores across the three conditions. Overall total scores were highest for the egregious security breach condition (81.8%), followed by the station topic condition (73.6%), and they were lowest for the control group (67.4%). This trend was also found with checklist subscores only (79.1%, 64.9%, and 60.3%, respectively for the security breach, station topic, and control conditions). Rating scale subscores were higher for both the station topic and egregious security breach conditions compared to the control group (82.6%, 83.1%, and 77.6%, respectively). Oral question subscores were significantly higher for the egregious security breach condition (88.8%) followed by the station topic condition (64.3%), and they were the lowest for the control group (48.6%). This simulation of different OSCE security breaches demonstrated that student performance is greatly advantaged by having prior access to test materials. This has important implications for medical educators as they develop policies and procedures regarding the safeguarding and reuse of test content.

Biases and Power for Groups Comparison on Subjective Health Measurements

PubMed Central

Hamel, Jean-François; Hardouin, Jean-Benoit; Le Neel, Tanguy; Kubis, Gildas; Roquelaure, Yves; Sébille, Véronique

2012-01-01

Subjective health measurements are increasingly used in clinical research, particularly for patient groups comparisons. Two main types of analytical strategies can be used for such data: so-called classical test theory (CTT), relying on observed scores and models coming from Item Response Theory (IRT) relying on a response model relating the items responses to a latent parameter, often called latent trait. Whether IRT or CTT would be the most appropriate method to compare two independent groups of patients on a patient reported outcomes measurement remains unknown and was investigated using simulations. For CTT-based analyses, groups comparison was performed using t-test on the scores. For IRT-based analyses, several methods were compared, according to whether the Rasch model was considered with random effects or with fixed effects, and the group effect was included as a covariate or not. Individual latent traits values were estimated using either a deterministic method or by stochastic approaches. Latent traits were then compared with a t-test. Finally, a two-steps method was performed to compare the latent trait distributions, and a Wald test was performed to test the group effect in the Rasch model including group covariates. The only unbiased IRT-based method was the group covariate Wald’s test, performed on the random effects Rasch model. This model displayed the highest observed power, which was similar to the power using the score t-test. These results need to be extended to the case frequently encountered in practice where data are missing and possibly informative. PMID:23115620

The Combination of Preoperative Bone Marrow Lesions and Partial-Thickness Cartilage Loss Did Not Result in Inferior Outcomes After Medial Unicompartmental Knee Arthroplasty.

PubMed

Berend, Keith R; Lombardi, Adolph V; Jacobs, Cale A

2017-10-01

The purpose of this study is to compare patient-reported outcomes and revision rates between medial unicompartmental knee arthroplasty (UKA) patients based on the presence of medial bone marrow lesions (BMLs) and/or partial- vs full-thickness cartilage loss. BMLs were graded on preoperative magnetic resonance imaging (MRI) findings from 174 UKAs performed between 2009 and 2013 using the MRI Osteoarthritis Knee Score criteria by a single evaluator blinded to the patient's outcome. A second evaluator blinded to the MRI findings and postoperative outcomes assessed medial joint space present on both weight-bearing and valgus stress radiographs. Preoperative and postoperative Knee Society Knee Scores, Pain Scores, and Function Scores were then compared between 4 groups of patients: patients with BML with either partial- or full-thickness cartilage loss, and patients without BML with either partial- or full-thickness cartilage loss. In total, 152 of 174 (87%) patients had minimum 2-year follow-up. One patient in the no BML/full-thickness loss group was converted to total knee arthroplasty secondary to arthrofibrosis; however, there were no statistical differences in revision rate between the 4 groups as no other revisions were performed (P = .61). Similarly, preoperative and postoperative Knee Society Knee Scores, Pain Scores, and Function Scores did not differ between groups, nor did postoperative University of California, Los Angeles activity scores. Medial tibial BMLs were not associated with inferior outcomes, either in patients with partial- or full-thickness cartilage loss. Although the current results do not allow for the presence of preoperative BML to be considered an indication for UKA, these results definitively support that BMLs are not a contraindication for medial UKA. Copyright © 2017 Elsevier Inc. All rights reserved.

Integrating physical examination and trunk anatomy; a new course for second year medical students.

PubMed

Adibi, Iman; Hasani, Nasibeh; Ashoorioun, Vahid; Sadrearhami, Shohreh; Monajemi, Ali Reza

2007-11-01

The aim of this study was to determine the effect of an integrated course of physical examination and trunk anatomy on second year medical students' attitude and knowledge of anatomy. Thirty nine second year medical students attended a physical examination course (5 small group sessions) related to topics in trunk anatomy (2004/05). Students in control group attended routine anatomy lectures and problem based learning discussions relevant to their physiology course. Routine final anatomy exam (65 multiple choices questions) was performed. Attitude toward course impacts in intervention group were assessed by a likert questionnaire (18 items). A T-test was performed to compare anatomy scores. The Intervention group had higher score exam anatomy (46.6 +/- 6.3) than others (41.4 +/- 6.0, p = 0.04). The mean score of attitude questionnaire was 3.48 (SD = 0.8). In conclusion teaching physical examinations integrated with trunk anatomy improves students' knowledge and motivated them in learning anatomy.

Personality correlates of study difficulty and academic performance in university students. I. The Middlesex Hospital Questionnaire and Dynamic Personality Inventory.

PubMed

Stringer, P; Crown, S; Lucas, C J; Supramanium, S

1977-09-01

The personality correlates of study difficulty and academic performance in university students have been measured in terms of psychiatric symptomatology and premorbid characteristics. The UCLSQ, MHQ and DPI were administered to two groups of male and female students presenting at an health centre: one (n = 72) of patients seeking psychological help, the other (n = 73) a control group. Significant differences between the two groups were formed on the MHQ, confirming previous results; and these were supplemented by differences on the DPI. Motivational and psychoneurotic components of study difficulty were significantly related to MHQ scores in both groups. DPI scores were more closely related to study difficulty in the patients than controls; and served particularly to characterize their sylbism and work satisfaction. The DPI added to the picture of a subgroup of students observed both in an earlier and the present study: academically successful patients scoring high on phobic anxiety.

Activity Pacing Self-Management in Chronic Fatigue Syndrome: A Randomized Controlled Trial

PubMed Central

van Eupen, Inge; Meirte, Jill; Van Cauwenbergh, Deborah; Moorkens, Greta; Meeus, Mira; Nijs, Jo

2015-01-01

OBJECTIVE. The objective of this study was to evaluate the effectiveness of an activity pacing self-management (APSM) intervention in improving performance of daily life activities in women with chronic fatigue syndrome (CFS). METHOD. A total of 33 women with CFS (age 41.1 ± 11.2 yr) were randomly allocated to APSM (experimental group; n = 16) or relaxation (control group; n = 17). Main outcome measures included the Canadian Occupational Performance Measure (COPM; primary) and Checklist Individual Strength (CIS). RESULTS. COPM scores changed significantly over time in both groups (p = .03). The change in Satisfaction scores showed a significant difference in favor only of APSM (effect size = 0.74 [0.11, 1.4]). CIS scores decreased significantly in the experimental group only (p < .01). CONCLUSION. APSM was found to be feasible and effective in optimizing participation in desired daily life activities in women with CFS. Replication in a larger sample with long-term follow-up is required. PMID:26356665

Impact of movie-based simulation training, with or without conventional verbal demonstration on observed OSPE scores in medical undergraduates: a double control study.

PubMed

Malik, Samina; Zaheer, Reema; Bilal, Muhammad

2013-01-01

Movie-based simulation training may be useful in delivering the preclinical observed OSPE curriculum, minimising the need of subjects/patients: however, a double-control trial needs to be performed and optimal timing and duration of training is yet to be defined. Likewise, gender-based response and students' feedback has to be assessed. The objective of this study was to compare the movie-based and traditional verbal demonstration teaching methodologies. Second-year medical undergraduates (n = 90) of Avicenna Medical College were randomised to movie-based simulation training (group B, n = 30), traditional verbal training alone (group C, n=30), and a combination (group A, n = 30). The scores were marked by observers using a standardised key and were compared for performance at 2 observed OSPE stations. Group B and A performed significantly better than group C on station 1 and 2. Gender factor did not seem to influence the score. A total of 99% students reported that combination of the 2 teaching modes is the best option. They believed it offers more clear understanding with interest (61%), long term memory (21%), use of both senses; seeing & hearing (10%) & better focus of attention (3%). Even half an hour of movie-based simulation training with traditional instructor-based training may improve student performance significantly, and the students prefer a combination of the both.

Animal source foods have a positive impact on the primary school test scores of Kenyan schoolchildren in a cluster-randomised, controlled feeding intervention trial.

PubMed

Hulett, Judie L; Weiss, Robert E; Bwibo, Nimrod O; Galal, Osman M; Drorbaugh, Natalie; Neumann, Charlotte G

2014-03-14

Micronutrient deficiencies and suboptimal energy intake are widespread in rural Kenya, with detrimental effects on child growth and development. Sporadic school feeding programmes rarely include animal source foods (ASF). In the present study, a cluster-randomised feeding trial was undertaken to determine the impact of snacks containing ASF on district-wide, end-term standardised school test scores and nutrient intake. A total of twelve primary schools were randomly assigned to one of three isoenergetic feeding groups (a local plant-based stew (githeri) with meat, githeri plus whole milk or githeri with added oil) or a control group receiving no intervention feeding. After the initial term that served as baseline, children were fed at school for five consecutive terms over two school years from 1999 to 2001. Longitudinal analysis was used controlling for average energy intake, school attendance, and baseline socio-economic status, age, sex and maternal literacy. Children in the Meat group showed significantly greater improvements in test scores than those in all the other groups, and the Milk group showed significantly greater improvements in test scores than the Plain Githeri (githeri+oil) and Control groups. Compared with the Control group, the Meat group showed significant improvements in test scores in Arithmetic, English, Kiembu, Kiswahili and Geography. The Milk group showed significant improvements compared with the Control group in test scores in English, Kiswahili, Geography and Science. Folate, Fe, available Fe, energy per body weight, vitamin B₁₂, Zn and riboflavin intake were significant contributors to the change in test scores. The greater improvements in test scores of children receiving ASF indicate improved academic performance, which can result in greater academic achievement.

The effect of fertility stress on endometrial and subendometrial blood flow among infertile women.

PubMed

Dong, Yuezhi; Cai, Yanna; Zhang, Yu; Xing, Yurong; Sun, Yingpu

2017-03-04

To investigate the effect of fertility stress on endometrial and subendometrial blood flow among infertile women. This case-control study was conducted in The First Affiliated Hospital of Zhengzhou University. The fertility problem inventory (FPI) was adopted to evaluate fertility stress. Three-dimensional power Doppler ultrasonography (3D PD-US) was performed during the proliferative phase of the menstrual cycle (days 5-11) to measure endometrial thickness, pattern, endometrial and subendometrial volume (V), the vascularization index (VI), the flow index (FI) and the vascularization-FI (VFI) index. Then, 300 infertile women were separated into two groups (high-score group and low-score group) based on total FPI scores and 80 healthy women were selected as controls. No differences were found among all three groups with regard to general characteristics, endometrial thickness, pattern, endometrial and subendometrial V, VI and VFI. The endometrial and subendometrial FIs associated with different stress levels significantly differed among the three groups (F = 33.95, P < 0.001; F = 44.79, P < 0.001, respectively). The endometrial and subendometrial FIs in the control group were significantly higher than those in the high-score group and low-score groups. The endometrial and subendometrial FIs in the low-score group were significantly higher than those in the high-score group. The total FPI score was closely related to the endometrial and subendometrial FIs (r = -0.304, P < 0.001; r = -0.407, P < 0.001, respectively). Fertility stress was associated with endometrial and subendometrial flow index. Whether fertility stress might affect pregnancy outcome by reducing endometrial and subendometrial blood flow requires further research.

Comparison of Chevron and Distal Oblique Osteotomy for Bunion Correction.

PubMed

Scharer, Brandon M; DeVries, J George

2016-01-01

The chevron osteotomy is a standard procedure by which bunions are corrected. One of us routinely performs a distal oblique osteotomy, which, to the best of our knowledge, has not been described for the correction of bunion deformities. The purpose of the present study was to compare the short- and medium-term results of the distal oblique and chevron osteotomies for bunion correction. We performed a retrospective clinical and radiographic comparison of patients who had undergone a distal oblique or chevron osteotomy for the correction of bunion deformity. In addition, a prospective patient satisfaction survey was undertaken. A total of 55 patients were included in the present study and were treated from January 2012 to November 2014. Of the 55 patients, 27 (49.2%) were in the chevron group and 28 (50.8%) in the distal oblique group. Radiographically, no statistically significant difference was found between the 2 groups with respect to postoperative first intermetatarsal angle (p < .0001) and hallux valgus angle (p < .0001), but a greater change was found in the intermetatarsal angle in the distal oblique group (p = .467). Prospective patient satisfaction scores were available for 33 patients (60%), 16 (29%) in the chevron group and 17 (31%) in the distal oblique group. When converting the satisfaction score to a numerical score, the chevron group scored 3.3 ± 1.1 and the distal oblique group scored 3.2 ± 0.8 (p = .812). We found that the distal oblique osteotomy used in the present study is simple and reliable and showed radiographic correction and patient satisfaction equivalent to those in the chevron osteotomy. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

The association between neuropsychological scores and ethnicity, language, and acculturation variables in a large patient population.

PubMed

Boone, Kyle Brauer; Victor, Tara L; Wen, Johnny; Razani, Jill; Pontón, Marcel

2007-03-01

The relationship between ethnicity and cognitive test performance was examined in a sample of 161 patients referred for evaluation at a public hospital-affiliated neuropsychology clinic; 83 patients were Caucasian (non-Hispanic), 31 were African-American, 30 were Hispanic, and 17 were Asian. Significant group differences were present on some measures of language (Boston Naming Test), attention (Digit Span ACSS), constructional ability (Rey-Osterrieth [RO] copy), nonverbal processing speed (Trails A), and executive skills (Wisconsin Card Sorting Test [WCST]). Comparison of those who spoke English as a first language (or who learned English concurrently with a second language) versus those who spoke English as a second language (ESL) revealed significantly higher performance in the non-ESL group for Digit Span, Boston Naming Test, and FAS, and a higher score in the ESL group for RO copy. Boston Naming Test scores were significantly related to years educated in the United States; Boston Naming Test and Digit Span scores were significantly correlated with age at which conversational English was first learned and number of years in the United States; and finally, FAS scores were also significantly related to number of years in the United States. These findings are consistent with data from published literature on ethnic differences and the effects of acculturation on cognitive test performance in nonpatients, and also indicate that these observations are not attenuated by the presence of psychiatric or neurologic illness. The results further caution that normative data derived on Caucasian samples may not be appropriate for use with other ethnic groups.

Objective structured assessment of technical skills evaluation of theoretical compared with hands-on training of shoulder dystocia management: a randomized controlled trial.

PubMed

Buerkle, Bernd; Pueth, Julia; Hefler, Lukas A; Tempfer-Bentz, Eva-Katrin; Tempfer, Clemens B

2012-10-01

To compare the skills of performing a shoulder dystocia management algorithm after hands-on training compared with demonstration. We randomized medical students to a 30-minute hands-on (group 1) and a 30-minute demonstration (group 2) training session teaching a standardized shoulder dystocia management scheme on a pelvic training model. Participants were tested with a 22-item Objective Structured Assessment of Technical Skills scoring system after training and 72 hours thereafter. Objective Structured Assessment of Technical Skills scores were the primary outcome. Performance time, self-assessment, confidence, and global rating scale were the secondary outcomes. Statistics were performed using Mann-Whitney U test, χ test, and multiple linear regression analysis. Two hundred three participants were randomized. Objective Structured Assessment of Technical Skills scores were significantly higher in group 1 (n=103) compared with group 2 (n=100) (17.95±3.14 compared with 15.67±3.18, respectively; P<.001). The secondary outcomes global rating scale (GRS; 10.94±2.71 compared with 8.57±2.61, respectively; P<.001), self-assessment (3.15±0.94 compared with 2.72±1.01; P=.002), and confidence (3.72±0.98 compared with 3.34±0.90, respectively; P=.005), but not performance time (3:19±0:48 minutes compared with 3:31±1:05 minutes; P=.1), were also significantly different, favoring group 1. After 72 hours, Objective Structured Assessment of Technical Skills scores were still significantly higher in group 1 (n=67) compared with group 2 (n=60) (18.17±2.76 compared with 14.98±3.03, respectively; P<.001) as were GRS (10.80±2.62 compared with 8.15±2.59; P<.001) and self assessment (SA; 3.44±0.87 compared with 2.95±0.94; P=.003). In a multiple linear regression analysis, group assignment (group 1 compared with 2; P<.001) and sex (P=.002) independently influenced Objective Structured Assessment of Technical Skills scores. Hands-on training helps to achieve a significant improvement of shoulder dystocia management on a pelvic training model. www.ClinicalTrials.gov, NCT01618565. I.

Maintenance of Wakefulness Test scores and driving performance in sleep disorder patients and controls.

PubMed

Philip, Pierre; Chaufton, Cyril; Taillard, Jacques; Sagaspe, Patricia; Léger, Damien; Raimondi, Monika; Vakulin, Andrew; Capelli, Aurore

2013-08-01

Sleepiness at the wheel is a risk factor for traffic accidents. Past studies have demonstrated the validity of the Maintenance of Wakefulness Test (MWT) scores as a predictor of driving impairment in untreated patients with obstructive sleep apnea syndrome (OSAS), but there is limited information on the validity of the maintenance of wakefulness test by MWT in predicting driving impairment in patients with hypersomnias of central origin (narcolepsy or idiopathic hypersomnia). The aim of this study was to compare the MWT scores with driving performance in sleep disorder patients and controls. 19 patients suffering from hypersomnias of central origin (9 narcoleptics and 10 idiopathic hypersomnia), 17 OSAS patients and 14 healthy controls performed a MWT (4×40-minute trials) and a 40-minute driving session on a real car driving simulator. Participants were divided into 4 groups defined by their MWT sleep latency scores. The groups were pathological (sleep latency 0-19 min), intermediate (20-33 min), alert (34-40 min) and control (>34 min). The main driving performance outcome was the number of inappropriate line crossings (ILCs) during the 40 minute drive test. Patients with pathological MWT sleep latency scores (0-19 min) displayed statistically significantly more ILC than patients from the intermediate, alert and control groups (F (3, 46)=7.47, p<0.001). Pathological sleep latencies on the MWT predicted driving impairment in patients suffering from hypersomnias of central origin as well as in OSAS patients. MWT is an objective measure of daytime sleepiness that appears to be useful in estimating the driving performance in sleepy patients. Copyright © 2013 Elsevier B.V. All rights reserved.

Concordance between Subjective and Objective Memory Impairment in Volunteer Subjects.

PubMed

Alegret, Montserrat; Rodríguez, Octavio; Espinosa, Ana; Ortega, Gemma; Sanabria, Angela; Valero, Sergi; Hernández, Isabel; Rosende-Roca, Maitée; Vargas, Liliana; Abdelnour, Carla; Mauleón, Ana; Gailhajanet, Anna; Martín, Elvira; Tárraga, Lluís; Rentz, Dorene M; Amariglio, Rebecca E; Ruíz, Agustín; Boada, Mercè

2015-01-01

Subjective memory impairment (SMI) refers to subjective awareness of initial memory decline undetectable with existing standardized cognitive tests. The Face Name Associative Memory Exam (FNAME) was created to detect memory deficits in individuals with preclinical Alzheimer's disease (AD). We reported normative data of a Spanish version of FNAME (S-FNAME) in cognitively normal (CN) Spanish-speaking subjects >49. To determine whether higher SMI [a modification of Memory Failures Everyday (MFE-30)] was related to worse memory performance (S-FNAME) or associated with greater affective symptoms in subjects >49; and whether MFE-30 and FNAME were able to discriminate between CN and mild cognitive impairment (MCI) subjects. 317 subjects (CN = 196, MCI = 121) were included in the analysis because they attended the annual "Open House Initiative" at Memory Clinic Fundació ACE, were >49 years, literate, received S-FNAME, MFE-30, and Hospital Anxiety and Depression Scale, had Mini-Mental State Examination scores ≥27, and returned to complete a comprehensive diagnostic assessment. MFE-30 scores were associated with affective symptoms but not with S-FNAME performance. S-FNAME scores were related to performance on memory variables of NBACE (neuropsychological battery used in Fundació ACE). Although the MCI group showed significantly higher MFE-30 and worse S-FNAME scores than the CN group, their discriminability values were similar (Sensitivity: 49.6 versus 52.9; Specificity: 85.1 versus 83.6, respectively). SMI was more related to depressive symptoms than to S-FNAME memory performance; and S-FNAME scores were related to other episodic memory test performances, but neither to affective symptoms nor to SMI. MFE-30 and S-FNAME are not optimal for discriminating between CN and MCI groups. Longitudinal follow-up will determine if lower S-FNAME and higher SMI are related to increased risk of AD.

A randomized comparison of video demonstration versus hands-on training of medical students for vacuum delivery using Objective Structured Assessment of Technical Skills (OSATS).

PubMed

Hilal, Ziad; Kumpernatz, Anne K; Rezniczek, Günther A; Cetin, Cem; Tempfer-Bentz, Eva-Katrin; Tempfer, Clemens B

2017-03-01

To compare medical students' skills for vaginal operative delivery by vacuum extraction (VE) after hands-on training versus video demonstration. We randomized medical students to an expert demonstration (group 1) or a hands-on (group 2) training using a standardized VE algorithm on a pelvic training model. Students were tested with a 40-item Objective Structured Assessment of Technical Skills (OSATS) scoring system after training and 4 days later. OSATS scores were the primary outcome. Performance time, self-assessment, confidence, and global rating scale were secondary outcomes. We assessed the constructive validity of OSATS in this VE model comparing metric scores of experts and students. In all, 137 students were randomized. OSATS scores were higher in group 2 (n = 63) compared with group 1 (n = 74) (32.89 ± 6.39 vs 27.51 ± 10.27, respectively; P < 0.0001). Global rating scale (1.49 ± 0.76 vs 2.33 ± 0.94, respectively; P < 0.0001), confidence (2.22 ± 0.75 vs 3.26 ± 0.94, respectively; P = 0.04), self-assessment (2.03 ± 0.62 vs 2.51 ± 0.77, respectively; P < 0.0001), and performance time (38.81 ± 11.58 seconds vs 47.23 ± 17.35 seconds, respectively; P = 0.001) also favored group 2. After 4 days, this effect persisted with OSATS scores still being significantly higher in group 2 (30.00 ± 6.50 vs 25.59 ± 6.09, respectively; P = 0.001). The assessed OSATS scores showed constructive validity. In a multiple linear regression analysis, group assignment independently influenced OSATS scores, whereas sex, handedness, sports activities, and type of curriculum were not independently associated with OSATS scores. Hands-on training is superior to video demonstration for teaching VE on a pelvic model.

A randomized comparison of video demonstration versus hands-on training of medical students for vacuum delivery using Objective Structured Assessment of Technical Skills (OSATS)

PubMed Central

Hilal, Ziad; Kumpernatz, Anne K.; Rezniczek, Günther A.; Cetin, Cem; Tempfer-Bentz, Eva-Katrin; Tempfer, Clemens B.

2017-01-01

Abstract Background: To compare medical students’ skills for vaginal operative delivery by vacuum extraction (VE) after hands-on training versus video demonstration. Methods: We randomized medical students to an expert demonstration (group 1) or a hands-on (group 2) training using a standardized VE algorithm on a pelvic training model. Students were tested with a 40-item Objective Structured Assessment of Technical Skills (OSATS) scoring system after training and 4 days later. OSATS scores were the primary outcome. Performance time, self-assessment, confidence, and global rating scale were secondary outcomes. We assessed the constructive validity of OSATS in this VE model comparing metric scores of experts and students. Results: In all, 137 students were randomized. OSATS scores were higher in group 2 (n = 63) compared with group 1 (n = 74) (32.89 ± 6.39 vs 27.51 ± 10.27, respectively; P < 0.0001). Global rating scale (1.49 ± 0.76 vs 2.33 ± 0.94, respectively; P < 0.0001), confidence (2.22 ± 0.75 vs 3.26 ± 0.94, respectively; P = 0.04), self-assessment (2.03 ± 0.62 vs 2.51 ± 0.77, respectively; P < 0.0001), and performance time (38.81 ± 11.58 seconds vs 47.23 ± 17.35 seconds, respectively; P = 0.001) also favored group 2. After 4 days, this effect persisted with OSATS scores still being significantly higher in group 2 (30.00 ± 6.50 vs 25.59 ± 6.09, respectively; P = 0.001). The assessed OSATS scores showed constructive validity. In a multiple linear regression analysis, group assignment independently influenced OSATS scores, whereas sex, handedness, sports activities, and type of curriculum were not independently associated with OSATS scores. Conclusions: Hands-on training is superior to video demonstration for teaching VE on a pelvic model. PMID:28296771

Virtual reality does not meet expectations in a pilot study on multimodal laparoscopic surgery training.

PubMed

Nickel, Felix; Bintintan, Vasile V; Gehrig, Tobias; Kenngott, Hannes G; Fischer, Lars; Gutt, Carsten N; Müller-Stich, Beat P

2013-05-01

The purpose of the present study was to determine the value of virtual reality (VR) training for a multimodality training program of basic laparoscopic surgery. Participants in a two-day multimodality training for laparoscopic surgery used box trainers, live animal training, and cadaveric training on the pulsating organ perfusion (POP) trainer in a structured and standardized training program. The participants were divided into two groups. The VR group (n = 13) also practiced with VR training during the program, whereas the control group (n = 14) did not use VR training. The training modalities were assessed using questionnaires with a five-point Likert scale after the program. Concerning VR training, members of the control group assessed their expectations, whereas the VR group assessed the actual experience of using it. Skills performance was evaluated with five standardized test tasks in a live porcine model before (pre-test) and after (post-test) the training program. Laparoscopic skills were measured by task completion time and a general performance score for each task. Baseline tests were compared with laparoscopic experience of all participants for construct validity of the skills test. The expected benefit from VR training of the control group was higher than the experienced benefit of the VR group. Box and POP training received better ratings from the VR group than from the control group for some purposes. Both groups improved their skill parameters significantly from pre-training to post-training tests [score +17 % (P < 0.01), time -29 % (P < 0.01)]. No significant difference was found between the two groups for laparoscopic skills improvement except for the score in the instrument coordination task. Construct validity of the skills test was significant for both time and score. At its current level of performance, VR training does not meet expectations. No additional benefit was observed from VR training in our multimodality training program.

Teaching binocular indirect ophthalmoscopy to novice residents using an augmented reality simulator.

PubMed

Rai, Amandeep S; Rai, Amrit S; Mavrikakis, Emmanouil; Lam, Wai Ching

2017-10-01

To compare the traditional teaching approach of binocular indirect ophthalmoscopy (BIO) to the EyeSI augmented reality (AR) BIO simulator. Prospective randomized control trial. 28 post-graduate year one (PGY1) ophthalmology residents. Residents were recruited at the 2012 Toronto Ophthalmology Residents Introductory Course (TORIC). 15 were randomized to conventional teaching (Group 1), and 13 to augmented reality simulator training (Group 2). 3 vitreoretinal fellows were enrolled to serve as experts. Evaluations were completed on the simulator, with 3 tasks, and outcome measures were total raw score, total time elapsed, and performance. Following conventional training, Group 1 residents were outperformed by vitreoretinal fellows with respect to all 3 outcome measures. Following AR training, Group 2 residents demonstrated superior total scores and performance compared to Group 1 residents. Once the Group 1 residents also completed the AR BIO training, there was a significant improvement compared to their baseline scores, and were now on par with Group 2 residents. This study provides construct validity for the EyeSI AR BIO simulator and demonstrates that it may be superior to conventional BIO teaching for novice ophthalmology residents. Copyright © 2017 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

Decision-making in obesity without eating disorders: a systematic review and meta-analysis of Iowa gambling task performances.

PubMed

Rotge, J-Y; Poitou, C; Fossati, P; Aron-Wisnewsky, J; Oppert, J-M

2017-08-01

There is evidence that obesity is associated with impairments in executive functions, such as deficits in decision-making, planning or problem solving, which might interfere with weight loss in obese individuals. We performed a systematic review and meta-analysis of decision-making abilities, as measured with the Iowa gambling task (IGT), in obesity without eating disorders. A systematic search was conducted to identify studies comparing IGT performances between groups of obese patients without eating disorders and groups of healthy control groups. The standardized mean differences were calculated for the total IGT scores and for the course of IGT scores. Meta-regression analyses were performed to explore the influence of clinical variables on standardized mean differences. Total IGT scores were significantly lower in obese patients compared with normal-weight healthy controls. IGT performances did not differ between groups for the first trials of the task. Significant effect sizes for the last trials of the task were subjected to a high degree of heterogeneity. Risky decision-making is impaired in obesity. The clinical importance of non-food-related decision-making impairments remains to be assessed especially in terms of consequences in daily life or the achievement of weight loss. This meta-analysis has been registered in the Prospero database (CRD42016037533). © 2017 World Obesity Federation.

Retention of movement pattern changes after a lower extremity injury prevention program is affected by program duration.

PubMed

Padua, Darin A; DiStefano, Lindsay J; Marshall, Stephen W; Beutler, Anthony I; de la Motte, Sarah J; DiStefano, Michael J

2012-02-01

Changes in movement patterns have been repeatedly observed immediately after completing a lower extremity injury prevention program. However, it is not known if movement pattern changes are maintained after discontinuing the training program. The ability to maintain movement pattern changes after training has ceased may be influenced by the program's duration. The authors hypothesized that among individuals who completed either a 3-month or 9-month training program and who demonstrated immediate movement pattern changes, only those who completed the 9-month training program would maintain movement pattern changes after a 3-month period of no longer performing the exercises. Cohort study; Level of evidence, 2. A total of 140 youth soccer athletes from 15 separate teams volunteered to participate. Athletes' movement patterns were assessed using the Landing Error Scoring System (LESS) at pretest, posttest, and 3 months after ceasing the program (retention test). Eighty-four of the original 140 participants demonstrated improvements in their LESS scores between pretest and posttest (change in LESS score >0) and were included in the final analyses for this study (n = 84; 20 boys and 64 girls; mean age, 14 ± 2 years; age range, 11-17 years). Teams performed 3-month (short-duration group) and 9-month (extended-duration group) injury prevention programs. The exercises performed were identical for both groups. Teams performed the programs as part of their normal warm-up routine. Although both groups improved their total LESS scores from pretest to posttest, only the extended-duration training group retained their improvements 3 months after ceasing the injury prevention program (F(2,137) = 3.38; P = .04). Results suggest that training duration may be an important factor to consider when designing injury prevention programs that facilitate long-term changes in movement control.

Training students with patient actors improves communication: a pilot study.

PubMed

Anderson, Heather A; Young, Jack; Marrelli, Danica; Black, Rudolph; Lambreghts, Kimberly; Twa, Michael D

2014-01-01

Effective patient communication is correlated with better health outcomes and patient satisfaction, but is challenging to train, particularly with difficult clinical scenarios such as loss of sight. In this pilot study, we evaluated the use of simulated patient encounters with actors to train optometric students. Students were recorded during encounters with actors and assigned to an enrichment group performing five interactions with instructor feedback (n = 6) or a no-enrichment group performing two interactions without feedback (n = 4). Student performance on first and last encounters was scored with (1) subjective rating of performance change using a visual analog scale (anchors: much worse/much better), (2) yes/no response: Would you recommend this doctor to a friend/relative?, and (3) average score on questions from the American Board of Internal Medicine (ABIM) assessment of doctor communication skills. Three clinical instructors, masked to student group assignments and the order of patient encounters they viewed, provided scores in addition to self-evaluation by students and patient-actors. Using the visual analog scale, students who received enrichment were rated more improved than the no-enrichment group by masked examiners (+18 vs. -11% p = 0.04) and self-evaluation (+79 vs. +27% p = 0.009), but not by actors (+31 vs. +43%). The proportion of students recommended significantly increased following enrichment for masked examiners (61% vs. 94%; p < 0.001), but not actors (100 vs. 83%). Average ABIM assessment scores were not significantly different by any rating group: masked instructors, actors, or self-ratings. The findings of this study suggest five simulated patient encounters with feedback result in measurable improvement in student-patient communication skills as rated by masked examiners.

A Randomized Controlled Trial of Team-Based Learning Versus Lectures with Break-Out Groups on Knowledge Retention.

PubMed

Thrall, Grace C; Coverdale, John H; Benjamin, Sophiya; Wiggins, Anna; Lane, Christianne Joy; Pato, Michele T

2016-10-01

This goal of this study was to evaluate the efficacy of team-based learning (TBL) on knowledge retention compared to traditional lectures with small break-out group discussion (teaching as usual (TAU)) using a randomized controlled trial. This randomized controlled trial was conducted during a daylong conference for psychiatric educators on attention-deficit hyperactivity disorder and the research literacy topic of efficacy versus effectiveness trials. Learners (n = 115) were randomized with concealed allocation to either TBL or TAU. Knowledge was measured prior to the intervention, immediately afterward, and 2 months later via multiple-choice tests. Participants were necessarily unblinded. Data enterers, data analysts, and investigators were blinded to group assignment in data analysis. Per-protocol analyses of test scores were performed using change in knowledge from baseline. The primary endpoint was test scores at 2 months. At baseline, there were no statistically significant differences between groups in pre-test knowledge. At immediate post-test, both TBL and TAU groups showed improved knowledge scores compared with their baseline scores. The TBL group performed better statistically on the immediate post-test than the TAU group (Cohen's d = 0.73; p < 0.001), although the differences in knowledge scores were not educationally meaningful, averaging just one additional test question correct (out of 15). On the 2-month remote post-test, there were no group differences in knowledge retention among the 42 % of participants who returned the 2-month test. Both TBL and TAU learners acquired new knowledge at the end of the intervention and retained knowledge over 2 months. At the end of the intervention day and after 2 months, knowledge test scores were not meaningfully different between TBL and TAU completers. In conclusion, this study failed to demonstrate the superiority of TBL over TAU on the primary outcome of knowledge retention at 2 months post-intervention.

Event-Related-Potential (ERP) Correlates of Performance Monitoring in Adults With Attention-Deficit Hyperactivity Disorder (ADHD)

PubMed Central

Marquardt, Lynn; Eichele, Heike; Lundervold, Astri J.; Haavik, Jan; Eichele, Tom

2018-01-01

Introduction: Attention-deficit hyperactivity disorder (ADHD) is one of the most frequent neurodevelopmental disorders in children and tends to persist into adulthood. Evidence from neuropsychological, neuroimaging, and electrophysiological studies indicates that alterations of error processing are core symptoms in children and adolescents with ADHD. To test whether adults with ADHD show persisting deficits and compensatory processes, we investigated performance monitoring during stimulus-evaluation and response-selection, with a focus on errors, as well as within-group correlations with symptom scores. Methods: Fifty-five participants (27 ADHD and 28 controls) aged 19–55 years performed a modified flanker task during EEG recording with 64 electrodes, and the ADHD and control groups were compared on measures of behavioral task performance, event-related potentials of performance monitoring (N2, P3), and error processing (ERN, Pe). Adult ADHD Self-Report Scale (ASRS) was used to assess ADHD symptom load. Results: Adults with ADHD showed higher error rates in incompatible trials, and these error rates correlated positively with the ASRS scores. Also, we observed lower P3 amplitudes in incompatible trials, which were inversely correlated with symptom load in the ADHD group. Adults with ADHD also displayed reduced error-related ERN and Pe amplitudes. There were no significant differences in reaction time (RT) and RT variability between the two groups. Conclusion: Our findings show deviations of electrophysiological measures, suggesting reduced effortful engagement of attentional and error-monitoring processes in adults with ADHD. Associations between ADHD symptom scores, event-related potential amplitudes, and poorer task performance in the ADHD group further support this notion. PMID:29706908

Prediction of cardiovascular risk in rheumatoid arthritis: performance of original and adapted SCORE algorithms.

PubMed

Arts, E E A; Popa, C D; Den Broeder, A A; Donders, R; Sandoo, A; Toms, T; Rollefstad, S; Ikdahl, E; Semb, A G; Kitas, G D; Van Riel, P L C M; Fransen, J

2016-04-01

Predictive performance of cardiovascular disease (CVD) risk calculators appears suboptimal in rheumatoid arthritis (RA). A disease-specific CVD risk algorithm may improve CVD risk prediction in RA. The objectives of this study are to adapt the Systematic COronary Risk Evaluation (SCORE) algorithm with determinants of CVD risk in RA and to assess the accuracy of CVD risk prediction calculated with the adapted SCORE algorithm. Data from the Nijmegen early RA inception cohort were used. The primary outcome was first CVD events. The SCORE algorithm was recalibrated by reweighing included traditional CVD risk factors and adapted by adding other potential predictors of CVD. Predictive performance of the recalibrated and adapted SCORE algorithms was assessed and the adapted SCORE was externally validated. Of the 1016 included patients with RA, 103 patients experienced a CVD event. Discriminatory ability was comparable across the original, recalibrated and adapted SCORE algorithms. The Hosmer-Lemeshow test results indicated that all three algorithms provided poor model fit (p<0.05) for the Nijmegen and external validation cohort. The adapted SCORE algorithm mainly improves CVD risk estimation in non-event cases and does not show a clear advantage in reclassifying patients with RA who develop CVD (event cases) into more appropriate risk groups. This study demonstrates for the first time that adaptations of the SCORE algorithm do not provide sufficient improvement in risk prediction of future CVD in RA to serve as an appropriate alternative to the original SCORE. Risk assessment using the original SCORE algorithm may underestimate CVD risk in patients with RA. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Simulator training and non-technical factors improve laparoscopic performance among OBGYN trainees.

PubMed

Ahlborg, Liv; Hedman, Leif; Nisell, Henry; Felländer-Tsai, Li; Enochsson, Lars

2013-10-01

To investigate how simulator training and non-technical factors affect laparoscopic performance among residents in obstetrics and gynecology. In this prospective study, trainees were randomized into three groups. The first group was allocated to proficiency-based training in the LapSimGyn(®) virtual reality simulator. The second group received additional structured mentorship during subsequent laparoscopies. The third group served as control group. At baseline an operation was performed and visuospatial ability, flow and self-efficacy were assessed. All groups subsequently performed three tubal occlusions. Self-efficacy and flow were assessed before and/or after each operation. Simulator training was conducted at the Center for Advanced Medical Simulation and Training, Karolinska University Hospital. Sterilizations were performed at each trainee's home clinic. Twenty-eight trainees/residents from 21 hospitals in Sweden were included. Visuospatial ability was tested by the Mental Rotation Test-A. Flow and self-efficacy were assessed by validated scales and questionnaires. Laparoscopic performance was measured as the duration of surgery. Visuospatial ability, self-efficacy and flow were correlated to the laparoscopic performance using Spearman's correlations. Differences between groups were analyzed by the Mann-Whitney U-test. No differences across groups were detected at baseline. Self-efficacy scores before and flow scores after the third operation were significantly higher in the trained groups. Duration of surgery was significantly shorter in the trained groups. Flow and self-efficacy correlate positively with laparoscopic performance. Simulator training and non-technical factors appear to improve the laparoscopic performance among trainees/residents in obstetrics and gynecology. © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

Adherence to the Mediterranean diet and academic performance in youth: the UP&DOWN study.

PubMed

Esteban-Cornejo, Irene; Izquierdo-Gomez, Rocio; Gómez-Martínez, Sonia; Padilla-Moledo, Carmen; Castro-Piñero, Jose; Marcos, Ascensión; Veiga, Oscar L

2016-04-01

To examine the association between adherence to the Mediterranean diet and academic performance in children and adolescents. This is a cross-sectional study conducted with 1371 youth aged 12.04 ± 2.50 years (685 girls) in Spain during 2011-2012. Adherence to the Mediterranean diet was assessed using the KIDMED index (Mediterranean Diet Quality Index in children and adolescents), which includes 16 questions on specific dietary patterns. Levels of adherence were classified into three groups: poor adherence (0-3), average adherence (4-7), and good adherence (8-12). Academic performance was assessed through school records using four indicators: math, language, an average of math and language, and grade point average score. Adherence to the Mediterranean diet was related to academic performance (β ranging from 0.107 to 0.148; all P < 0.001) after adjusting for confounders. The group of good adherence to the Mediterranean diet had significantly higher scores in all of the academic indicators compared with the poor group (ranging from +0.429 to 0.464; all P ≤ 0.001); as well as the group of average adherence to the Mediterranean diet had significantly higher scores in all of the academic indicators compared with the poor group (ranging from +0.292 to 0.344; all P ≤ 0.06). There were no differences between the groups of good and average adherence to the Mediterranean diet. Adherence to the Mediterranean diet may have a beneficial influence on academic performance in youth. Importantly, the benefits of adherence to the Mediterranean diet on academic performance may be stronger as youth adhered to the optimal Mediterranean diet levels.

A score card for upper GI endoscopy: Evaluation of interobserver variability in examiners with various levels of experience.

PubMed

Neumann, M; Friedl, S; Meining, A; Egger, K; Heldwein, W; Rey, J F; Hochberger, J; Classen, M; Hohenberger, W; Rösch, T

2002-10-01

In most European countries, training in GI endoscopy has largely been based on hands-on acquisition of experience in patients rather than on a structured training programme. With the development of training models systematic hands-on training in a variety of diagnostic and therapeutic endoscopy techniques was achieved. Little, however, is known about methods of objectively assessing trainees' performance. We therefore developed an assessment 'score card' for upper GI endoscopy and tested it in endoscopists with various levels of experience. The aim of the study was therefore to assess interobserver variations in the evaluation of trainees. On the basis of textbook and expert opinions a consensus group of eight experienced endoscopists developed a score card for diagnostic upper GI endoscopy with biopsy. The score card includes an assessment of the single steps of the procedure as well as of the times needed to complete each step. This score card was then evaluated in a further conference including ten experts who blindly assessed videotapes of 15 endoscopists performing upper GI endoscopy in a training bio-simulation model (the 'Erlangen Endo-Trainer'). On the basis of their previous experience (i. e. the number of endoscopies performed) these 15 endoscopists were classified into four groups: very experienced, experienced, having some experience and inexperienced. Interobserver variability (IOV) was tested for the various score card parameters (Kendall's rank-correlation coefficient 0.0-0.5 poor, 0.5-1.0 good agreement). In addition, the correlation between the score card assessment and the examiners' experience levels was analysed. Despite poor IOV results for all the parameters tested (Kendall coefficient < 0.3), the assessment parameters correlated well when the examiners' different experience levels were taken into account (correlation coefficient 0.59-0.89, p < 0.05). The score card parameters were suitable for differentiating between the four groups of examiners with different levels of endoscopic experience. As expected with scores involving subjective assessment of performance, the variability between reviewers was substantial. Nevertheless, the assessment score was capable of distinguishing reliably between different experience levels in terms of a good individual observer consistency. The score card can therefore be used to document both training status and progress during endoscopy training courses using bio-simulation models, and this might be able to provide improved quality assurance in GI endoscopy training.

Human and Server Docking Prediction for CAPRI Round 30–35 Using LZerD with Combined Scoring Functions

PubMed Central

Peterson, Lenna X.; Kim, Hyungrae; Esquivel-Rodriguez, Juan; Roy, Amitava; Han, Xusi; Shin, Woong-Hee; Zhang, Jian; Terashi, Genki; Lee, Matt; Kihara, Daisuke

2016-01-01

We report the performance of protein-protein docking predictions by our group for recent rounds of the Critical Assessment of Prediction of Interactions (CAPRI), a community-wide assessment of state-of-the-art docking methods. Our prediction procedure uses a protein-protein docking program named LZerD developed in our group. LZerD represents a protein surface with 3D Zernike descriptors (3DZD), which are based on a mathematical series expansion of a 3D function. The appropriate soft representation of protein surface with 3DZD makes the method more tolerant to conformational change of proteins upon docking, which adds an advantage for unbound docking. Docking was guided by interface residue prediction performed with BindML and cons-PPISP as well as literature information when available. The generated docking models were ranked by a combination of scoring functions, including PRESCO, which evaluates the native-likeness of residues’ spatial environments in structure models. First, we discuss the overall performance of our group in the CAPRI prediction rounds and investigate the reasons for unsuccessful cases. Then, we examine the performance of several knowledge-based scoring functions and their combinations for ranking docking models. It was found that the quality of a pool of docking models generated by LZerD, i.e. whether or not the pool includes near-native models, can be predicted by the correlation of multiple scores. Although the current analysis used docking models generated by LZerD, findings on scoring functions are expected to be universally applicable to other docking methods. PMID:27654025

Performance evaluation of Al-Zahra academic medical center based on Iran balanced scorecard model.

PubMed

Raeisi, Ahmad Reza; Yarmohammadian, Mohammad Hossein; Bakhsh, Roghayeh Mohammadi; Gangi, Hamid

2012-01-01

Growth and development in any country's national health system, without an efficient evaluation system, lacks the basic concepts and tools necessary for fulfilling the system's goals. The balanced scorecard (BSC) is a technique widely used to measure the performance of an organization. The basic core of the BSC is guided by the organization's vision and strategies, which are the bases for the formation of four perspectives of BSC. The goal of this research is the performance evaluation of Al-Zahra Academic Medical Center in Isfahan University of Medical Sciences, based on Iran BSC model. This is a combination (quantitative-qualitative) research which was done at Al-Zahra Academic Medical Center in Isfahan University of Medical Sciences in 2011. The research populations were hospital managers at different levels. Sampling method was purposive sampling in which the key informed personnel participated in determining the performance indicators of hospital as the BSC team members in focused discussion groups. After determining the conceptual elements in focused discussion groups, the performance objectives (targets) and indicators of hospital were determined and sorted in perspectives by the group discussion participants. Following that, the performance indicators were calculated by the experts according to the predetermined objectives; then, the score of each indicator and the mean score of each perspective were calculated. Research findings included development of the organizational mission, vision, values, objectives, and strategies. The strategies agreed upon by the participants in the focus discussion group included five strategies, which were customer satisfaction, continuous quality improvement, development of human resources, supporting innovation, expansion of services and improving the productivity. Research participants also agreed upon four perspectives for the Al-Zahra hospital BSC. In the patients and community perspective (customer), two objectives and three indicators were agreed upon, with a mean score of 75.9%. In the internal process perspective, 4 objectives and 14 indicators were agreed upon, with a mean score of 79.37%. In the learning and growth perspective, four objectives and eight indicators were agreed upon, with a mean score of 81.11%. Finally, in the financial perspective, two objectives and five indicators were agreed upon, with a mean score of 67.15%. One way to create demand for hospital services is performance evaluation by paying close attention to all BSC perspectives, especially the non-financial perspectives such as customers and internal processes perspectives. In this study, the BSC showed the differences in performance level of the organization in different perspectives, which would assist the hospital managers improve their performance indicators. The learning and growth perspective obtained the highest score, and the financial perspective obtained the least score. Since the learning and growth perspective acts as a base for all other perspectives and they depend on it, hospitals must continuously improve the service processes and the quality of services by educating staff and updating their policies and procedures. This can increase customer satisfaction and productivity and finally improve the BSC in financial perspective.

Management of symphysis pubis dysfunction during pregnancy using exercise and pelvic support belts.

PubMed

Depledge, Jill; McNair, Peter J; Keal-Smith, Cheryl; Williams, Maynard

2005-12-01

Symphysis pubis pain is a significant problem for some pregnant women. The purpose of this study was to investigate the effects of exercise, advice, and pelvic support belts on the management of symphysis pubis dysfunction during pregnancy. Ninety pregnant women with symphysis pubis dysfunction were randomly assigned to 3 treatment groups. A randomized masked prospective experimental clinical trial was conducted. Specific muscle strengthening exercises and advice concerning appropriate methods for performing activities of daily living were given to the 3 groups, and 2 of the groups were given either a rigid pelvic support belt or a nonrigid pelvic support belt. The dependent variables, which were measured before and after the intervention, were a Roland-Morris Questionnaire score, a Patient-Specific Functional Scale score, and a pain score (101-point numerical rating score). After the intervention, there was a significant reduction in the Roland-Morris Questionnaire score, the Patient-Specific Functional Scale score, and the average and worst pain scores in all groups. With the exception of average pain, there were no significant differences between groups for the other measures. The findings indicate that the use of either a rigid or a nonrigid pelvic support belt did not add to the effects provided by exercise and advice.

Behavioral Executive Functions Among Adolescents With Mathematics Difficulties.

PubMed

Holm, Marja E; Aunio, Pirjo; Björn, Piia M; Klenberg, Liisa; Korhonen, Johan; Hannula, Markku S

2017-07-01

This study investigates behavioral executive functions (EFs) in the mathematics classroom context among adolescents with different mathematics performance levels. The EF problems were assessed by teachers using a behavioral rating inventory. Using cutoff scores on a standardized mathematics assessment, groups with mathematics difficulties (MD; n = 124), low mathematics performance (LA; n = 140), and average or higher scores (AC; n = 355) were identified. Results showed that the MD group had more problems with distractibility, directing attention, shifting attention, initiative, execution of action, planning, and evaluation than the LA group, whereas the differences in hyperactivity, impulsivity, and sustaining attention were not significant. Compared to the AC group, the MD group showed more problems with all behavioral EFs except hyperactivity and impulsivity, while the LA group showed more problems only with shifting attention. Male adolescents showed more behavioral EF problems than female adolescents, but this gender difference was negligible within the MD group. The practical implications of the results are discussed.

Providing Hospitalized Patients With an Educational Booklet Increases the Quality of Colonoscopy Bowel Preparation.

PubMed

Ergen, William F; Pasricha, Trisha; Hubbard, Francie J; Higginbotham, Tina; Givens, Tonya; Slaughter, James C; Obstein, Keith L

2016-06-01

Inadequate bowel preparation is a problem frequently encountered by gastroenterologists who perform colonoscopies on hospitalized patients. A method is needed to increase the quality of bowel preparation in inpatients. An educational booklet has been shown to increase the overall quality of bowel preparation for outpatients. We performed a prospective study to evaluate the effects of an educational booklet on the quality of bowel preparation in a group of hospitalized patients. We performed a randomized, single-blind, controlled trial of all inpatients at a tertiary care medical center scheduled for inpatient colonoscopy from October 2013 through March 2014. They were randomly assigned to groups that were (n = 45) or were not (controls, n = 40) given the booklet before bowel preparation the evening before their colonoscopy. All patients received a standard bowel preparation (clear liquid diet the day before the procedure, followed by split-dose GoLYTELY). At the colonoscopy, the Boston Bowel preparation scale (BBPS) was used to assess bowel preparation. The primary outcome measure was adequate bowel preparation (a total BBPS score ≥6 with all segment scores ≥2). Secondary outcomes assessed included total BBPS score, BBPS segment score, and a total BBPS score of 0. There were no differences between the groups in age, race, sex, body mass index, history of colonoscopy, history of polyps, or time of colonoscopy. Twenty-eight patients who received the booklet (62%) and 14 who did not (35%) had an adequate bowel preparation (P = .012). The number needed to treat to attain adequate bowel preparation was 4. After adjusting for age and history of prior colonoscopies, the odds of achieving an adequate bowel preparation and a higher total BBPS score after receipt of the booklet were 3.14 (95% confidence interval, 1.29-7.83) and 2.27 (95% confidence interval, 1.05-4.88), respectively. Three patients in the booklet group and 9 in the no-booklet group had a BBPS score of 0 (P = .036). The mean BBPS segment score was greater for the booklet group than the no-booklet group (right colon, P = .097; transverse colon, P = .023; left colon, P = .045). In a randomized controlled trial, we found that providing hospitalized patients with an educational booklet on colonoscopy preparation increases the odds of a quality bowel preparation more than 2-fold. Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.

Evaluation of a Jugular Venipuncture Alpaca Model to Teach the Technique of Blood Sampling in Adult Alpacas.

PubMed

Rousseau, Marjolaine; Beauchamp, Guy; Nichols, Sylvain

The effectiveness of teaching aids in veterinary medical education is not often assessed rigorously. The objective in the present study was to evaluate the effectiveness of a commercially available jugular venipuncture alpaca model as a complementary tool to teach veterinary students how to perform venipuncture in adult alpacas. We hypothesized that practicing on the model would allow veterinary students to draw blood in alpacas more rapidly with fewer attempts than students without previous practice on the model. Thirty-six third-year veterinary students were enrolled and randomly allocated to the model (group M; n=18) or the control group (group C; n=18). The venipuncture technique was taught to all students on day 0. Students in group M practiced on the model on day 2. On day 5, an evaluator blinded to group allocation evaluated the students' venipuncture skills during a practical examination using live alpacas. Success was defined as the aspiration of a 6-ml sample of blood. Measured outcomes included number of attempts required to achieve success (success score), total procedural time, and overall qualitative score. Success scores, total procedural time, and overall scores did not differ between groups. Use of restless alpacas reduced performance. The jugular venipuncture alpaca model failed to improve jugular venipuncture skills in this student population. Lack of movement represents a significant weakness of this training model.

Do Pilates-based exercises following total knee arthroplasty improve postural control and quality of life?

PubMed

Karaman, Aysenur; Yuksel, Inci; Kinikli, Gizem Irem; Caglar, Omur

2017-04-01

The aim of this prospective, randomized, controlled study was to investigate the effects of the addition of Pilates-based exercises to standard exercise programs performed after total knee arthroplasty on quality of life and balance. Forty-six volunteers were divided into two groups. The control group (n = 17) was assigned a standard exercise program after discharge; the study group (n = 17) was assigned Pilates-based exercises along with the standard exercise program. We carried out clinical evaluations of all patients on the day of discharge and after the completion of the 6-week exercise program. We also recorded sociodemographic data, Berg Balance test scores, and Short Form-36 (SF-36) health-related quality of life measurements. When we compared the differences between pre- and post-treatment balance scores of the groups, we found a significant change in favor of the Pilates-based exercise group (13.64 ± 1.45; p < 0.01). The changes in the pre- and post-treatment SF-36 scores of the Pilates-based exercises group were found to be significant in terms of physical function (p = 0.001), physical role restriction (p = 0.01), and physical component score (p = 0.001). Pilates-based exercises performed along with standard exercise programs were more effective for improving balance and quality of life than standard exercise programs alone.

Is relatively young age within a school year a risk factor for mental health problems and poor school performance? A population-based cross-sectional study of adolescents in Oslo, Norway.

PubMed

Lien, Lars; Tambs, Kristian; Oppedal, Brit; Heyerdahl, Sonja; Bjertness, Espen

2005-10-05

Several studies have shown that children who are relatively young within a school year are at greater risk for poorer school performance compared with their older peers. One study also reported that relative age within a school year is an independent risk factor for emotional and behavioral problems. The objective of this study was to test the hypothesis that relatively younger adolescents in the multiethnic population of Oslo have poorer school performance and more mental health problems than their relatively older classmates within the same school year. This population-based cross-sectional study included all 10th-grade pupils enrolled in 2000 and 2001 in the city of Oslo. The participation rate was 88%. Of the 6,752 pupils in the study sample, 25% had a non-Norwegian background. Mental health problems were quantified using the abbreviated versions of Symptom Check List-25 (SCL-10) and the Strength and Difficulties Questionnaire (SDQ). Information on school performances and mental health problems were self-reported. We controlled for confounding factors including parental educational level, social support, gender, and ethnicity. The youngest one-third of pupils had significantly lower average school grades than the middle one-third and oldest one-third of their classmates (p < 0.001). Of the mental health problems identified in the questionnaires, the groups differed only on peer problems; the youngest one-third reported significantly more problems than the middle and oldest groups (p < 0.05). Age within a school year and gender showed significant interactions with total SDQ score, SDQ peer problems score, SDQ pro social score, and SCL-10 score. After stratifying for gender, the peer problem scores differed significantly between age groups only among boys. The SCL-10 score was significant, but only in girls and in the opposite direction to that expected, with the oldest pupils having significantly higher scores than the other two groups (p < 0.05). In adolescents from a multicultural city in Norway, relative age within a school year significantly influenced academic performance. In contrast to data from Great Britain, relative age within a school year was not an important risk factor for mental health problems in adolescents in Oslo.

Does familiarity with computers affect computerized neuropsychological test performance?

PubMed

Iverson, Grant L; Brooks, Brian L; Ashton, V Lynn; Johnson, Lynda G; Gualtieri, C Thomas

2009-07-01

The purpose of this study was to determine whether self-reported computer familiarity is related to performance on computerized neurocognitive testing. Participants were 130 healthy adults who self-reported whether their computer use was "some" (n = 65) or "frequent" (n = 65). The two groups were individually matched on age, education, sex, and race. All completed the CNS Vital Signs (Gualtieri & Johnson, 2006b) computerized neurocognitive battery. There were significant differences on 6 of the 23 scores, including scores derived from the Symbol-Digit Coding Test, Stroop Test, and the Shifting Attention Test. The two groups were also significantly different on the Psychomotor Speed (Cohen's d = 0.37), Reaction Time (d = 0.68), Complex Attention (d = 0.40), and Cognitive Flexibility (d = 0.64) domain scores. People with "frequent" computer use performed better than people with "some" computer use on some tests requiring rapid visual scanning and keyboard work.

Longitudinal patterns of semantic and episodic memory in frontotemporal lobar degeneration and Alzheimer's disease.

PubMed

Xie, Sharon X; Libon, David J; Wang, Xingmei; Massimo, Lauren; Moore, Peachie; Vesely, Luisa; Khan, Alea; Chatterjee, Anjan; Coslett, H Branch; Hurtig, Howard I; Liang, Tsao-Wei; Grossman, Murray

2010-03-01

The longitudinal assessment of episodic and semantic memory was obtained from 236 patients diagnosed with Alzheimer's disease (AD, n = 128) and with frontotemporal lobar degeneration (FTLD, n = 108), including patients with a social comportment/dysexecutive (SOC/EXEC) disorder, progressive nonfluent aphasia (PNFA), semantic dementia (SemD), and corticobasal syndrome (CBS). At the initial assessment, AD patients obtained a lower score on the delayed free recall test than other patients. Longitudinal analyses for delayed free recall found converging performance, with all patients reaching the same level of impairment as AD patients. On the initial evaluation for delayed recognition, AD patients also obtained lower scores than other groups. Longitudinal analyses for delayed recognition test performance found that AD patients consistently produced lower scores than other groups and no convergence between AD and other dementia groups was seen. For semantic memory, there were no initial between-group differences. However, longitudinal analyses for semantic memory revealed group differences over illness duration, with worse performance for SemD versus AD, PNFA, SOC/EXEC, and CBS patients. These data suggest the presence of specific longitudinal patterns of impairment for episodic and semantic memory in AD and FTLD patients suggesting that all forms of dementia do not necessarily converge into a single phenotype.

Is semantic verbal fluency impairment explained by executive function deficits in schizophrenia?

PubMed

Berberian, Arthur A; Moraes, Giovanna V; Gadelha, Ary; Brietzke, Elisa; Fonseca, Ana O; Scarpato, Bruno S; Vicente, Marcella O; Seabra, Alessandra G; Bressan, Rodrigo A; Lacerda, Acioly L

2016-04-19

To investigate if verbal fluency impairment in schizophrenia reflects executive function deficits or results from degraded semantic store or inefficient search and retrieval strategies. Two groups were compared: 141 individuals with schizophrenia and 119 healthy age and education-matched controls. Both groups performed semantic and phonetic verbal fluency tasks. Performance was evaluated using three scores, based on 1) number of words generated; 2) number of clustered/related words; and 3) switching score. A fourth performance score based on the number of clusters was also measured. SZ individuals produced fewer words than controls. After controlling for the total number of words produced, a difference was observed between the groups in the number of cluster-related words generated in the semantic task. In both groups, the number of words generated in the semantic task was higher than that generated in the phonemic task, although a significant group vs. fluency type interaction showed that subjects with schizophrenia had disproportionate semantic fluency impairment. Working memory was positively associated with increased production of words within clusters and inversely correlated with switching. Semantic fluency impairment may be attributed to an inability (resulting from reduced cognitive control) to distinguish target signal from competing noise and to maintain cues for production of memory probes.

Pharmacy Students’ Performance and Perceptions in a Flipped Teaching Pilot on Cardiac Arrhythmias

PubMed Central

Ip, Eric J.; Lopes, Ingrid; Rajagopalan, Vanishree

2014-01-01

Objective. To implement the flipped teaching method in a 3-class pilot on cardiac arrhythmias and to assess the impact of the intervention on academic performance and student perceptions. Design. An intervention group of 101 first-year pharmacy students, who took the class with the flipped teaching method, were supplied with prerecorded lectures prior to their 3 classes (1 class in each of the following subjects: basic sciences, pharmacology, and therapeutics) on cardiac arrhythmias. Class time was focused on active-learning and case-based exercises. Students then took a final examination that included questions on cardiac arrhythmias. The examination scores of the intervention group were compared to scores of the Spring 2011 control group of 105 first-year students who took the class with traditional teaching methods. An online survey was conducted to assess student feedback from the intervention group. Assessment. The mean examination scores of the intervention group were significantly higher than the mean examination scores of the control group for the cardiac arrhythmia classes in pharmacology (with 89.6 ± 2.0% vs 56.8 ± 2.2%, respectively) and therapeutics (89.2 ± 1.4% vs 73.7 ± 2.1%, respectively). The survey indicated higher student satisfaction for flipped classes with highly rated learning objectives, recordings, and in-class activities. Conclusion. Use of the flipped teaching method in a 3-class pilot on cardiac arrhythmias improved examination scores for 2 of the 3 classes (pharmacology and therapeutics). Student satisfaction was influenced by the quality of the learning objectives, prerecorded lectures, and inclass active-learning activities. PMID:25657372

Virtual reality training improves da Vinci performance: a prospective trial.

PubMed

Cho, Jae Sung; Hahn, Koo Yong; Kwak, Jung Myun; Kim, Jin; Baek, Se Jin; Shin, Jae Won; Kim, Seon Hahn

2013-12-01

The DV-Trainer™ (a virtual reality [VR] simulator) (Mimic Technologies, Inc., Seattle, WA) is one of several different robotic surgical training methods. We designed a prospective study to determine whether VR training could improve da Vinci(®) Surgical System (Intuitive Surgical, Inc., Sunnyvale, CA) performance. Surgeons (n=12) were enrolled using a randomized protocol. Groups 1 (VR training) and 2 (control) participated in VR and da Vinci exercises. Participants' time and moving distance were combined to determine a composite score: VR index=1000/(time×moving distance). The da Vinci exercises included needle control and suturing. Procedure time and error were measured. A composite index (DV index) was computed and used to measure da Vinci competency. After the initial trial with both the VR and da Vinci exercises, only Group 1 was trained with the VR simulator following our institutional curriculum for 3 weeks. All members of both groups then participated in the second trial of the VR and da Vinci exercises and were scored in the same way as in the initial trial. In the initial trial, there was no difference in the VR index (Group 1 versus Group 2, 8.9 ± 3.3 versus 9.4 ± 3.7; P=.832) and the DV index (Group 1 versus Group 2, 3.85 ± 0.73 versus 3.66 ± 0.65; P=.584) scores between the two groups. At the second time point, Group 1 showed increased VR index scores in comparison with Group 2 (19.3 ± 4.5 versus 9.7 ± 4.1, respectively; P=.001) and improved da Vinci performance skills as measured by the DV index (5.80 ± 1.13 versus 4.05 ± 1.03, respectively; P=.028) and by suturing time (7.1 ± 1.54 minutes versus 10.55 ± 1.93 minutes, respectively; P=.018). We found that VR simulator training can improve da Vinci performance. VR practice can result in an early plateau in the learning curve for robotic practice under controlled circumstances.

Arthroscopic removal of intraosseous and intratendinous deposits in calcifying tendinitis of the rotator cuff.

PubMed

Seyahi, Aksel; Demirhan, Mehmet

2009-06-01

The purpose of this study was to evaluate the surgical outcome of arthroscopic removal of intraosseous deposits in calcifying tendinitis of the rotator cuff. We studied the results of arthroscopic treatment in 30 shoulders in 28 patients with calcifying tendinitis (mean age, 48.3 years; age range, 26 to 83 years), with a mean follow-up of 38 months. According to the localization of calcification, the patients were divided into 2 groups: those with pure tendinous/soft-tissue involvement (n = 25) (group I) and those with tendinous/soft-tissue and osseous involvement (n = 5) (group II). After routine tendon debridement, debridement and curettage of the bone lesion were also performed in patients with bone involvement. Clinical outcome was evaluated by use of the pain score on a visual analog scale and the Constant score, and a special inquiry was used for self-assessment. The pain scores and functional Constant scores improved significantly after the operation in both groups (P = .043 for pain score and P = .0001 for Constant score in group I and P = .042 for pain score and P = .0001 for Constant score in group II). The median Constant score increased from 42 (range, 22 to 65) preoperatively to 100 (range, 80 to 100) postoperatively in group I and from 40 (range, 25 to 55) to 100 (range, 85 to 100) in group II. The mean pain score was 6.5 +/- 1.4 (range, 4 to 9) before treatment and 0.2 +/- 0.5 (range, 0 to 2) at follow-up in group I, and it was 6.2 +/- 1.48 (range, 4 to 8) and 0.4 +/- 0.55 (range, 0 to 1), respectively, in group II. There was no significant difference between the 2 groups in terms of the final Constant (P = .85) and pain scores (P = .26). Arthroscopic removal of intraosseous and intratendinous deposits to treat calcifying tendinitis with osseous involvement seems to be as safe and effective a treatment method as the arthroscopic removal of intratendinous deposits in cases of tendinous involvement only. Level IV, therapeutic case series.

A comparison between caudal block versus splash block for postoperative analgesia following inguinal herniorrhaphy in children

PubMed Central

Cheon, Jun Kong; Hwang, Kan Taeck; Choi, Bo Yoon

2011-01-01

Background We wanted to determine the postoperative analgesic efficacy of preincisional caudal epidural block versus instillation (splash block) following inguinal herniorrhaphy in children. Methods Thirty children (age range: 1-7 years) who were scheduled to undergo inguinal herniorrhaphy were divided into 2 groups: the caudal block group and the splash block group with 15 children in each group. Tracheal intubation was performed. Fifteen children received caudal block with 1.0 ml/kg of 0.25% ropivacaine (Group 1). Caudal block was performed using the loss of resistance method via the sacral hiatus. Fifteen children in Group 2 received local instillation (splash block) in the surgical site with up to 0.4 ml/kg of 0.25% ropivacaine. The patients were observed for 90 minutes in the postanesthesia care unit and then they were transferred to the ward. The pain scores were taken 4 times. We assessed pain using the Faces pain scores. Results There were no significant differences between the groups regarding the pain scores at 10, 30 and 60 minutes upon entering the postanesthesia care unit. The pain scores of Group 1 were slightly lower at the last evaluation point when compared to that of Group 2. One patient in Group 1 required supplemental postoperative intravenous (IV) tramadol, while all the other patients in both groups did not require supplemental IV tramadol. The intraoperative requirement for sevoflurane was decreased in Group 1 as compared to that of Group 2. There were no major complications related to either type of block. Conclusions We conclude that a splash block can have a similar analgesic effect as that of a caudal block for the postoperative herniorrhaphy pain of children. PMID:21602975

A comparison between caudal block versus splash block for postoperative analgesia following inguinal herniorrhaphy in children.

PubMed

Cheon, Jun Kong; Park, Cheon Hee; Hwang, Kan Taeck; Choi, Bo Yoon

2011-04-01

We wanted to determine the postoperative analgesic efficacy of preincisional caudal epidural block versus instillation (splash block) following inguinal herniorrhaphy in children. THIRTY CHILDREN (AGE RANGE: 1-7 years) who were scheduled to undergo inguinal herniorrhaphy were divided into 2 groups: the caudal block group and the splash block group with 15 children in each group. Tracheal intubation was performed. Fifteen children received caudal block with 1.0 ml/kg of 0.25% ropivacaine (Group 1). Caudal block was performed using the loss of resistance method via the sacral hiatus. Fifteen children in Group 2 received local instillation (splash block) in the surgical site with up to 0.4 ml/kg of 0.25% ropivacaine. The patients were observed for 90 minutes in the postanesthesia care unit and then they were transferred to the ward. The pain scores were taken 4 times. We assessed pain using the Faces pain scores. There were no significant differences between the groups regarding the pain scores at 10, 30 and 60 minutes upon entering the postanesthesia care unit. The pain scores of Group 1 were slightly lower at the last evaluation point when compared to that of Group 2. One patient in Group 1 required supplemental postoperative intravenous (IV) tramadol, while all the other patients in both groups did not require supplemental IV tramadol. The intraoperative requirement for sevoflurane was decreased in Group 1 as compared to that of Group 2. There were no major complications related to either type of block. We conclude that a splash block can have a similar analgesic effect as that of a caudal block for the postoperative herniorrhaphy pain of children.

A clinical measure of DNA methylation predicts outcome in de novo acute myeloid leukemia

PubMed Central

Luskin, Marlise R.; Gimotty, Phyllis A.; Smith, Catherine; Loren, Alison W.; Figueroa, Maria E.; Harrison, Jenna; Sun, Zhuoxin; Tallman, Martin S.; Paietta, Elisabeth M.; Litzow, Mark R.; Melnick, Ari M.; Levine, Ross L.; Fernandez, Hugo F.; Luger, Selina M.; Master, Stephen R.; Wertheim, Gerald B.W.

2016-01-01

BACKGROUND. Variable response to chemotherapy in acute myeloid leukemia (AML) represents a major treatment challenge. Clinical and genetic features incompletely predict outcome. The value of clinical epigenetic assays for risk classification has not been extensively explored. We assess the prognostic implications of a clinical assay for multilocus DNA methylation on adult patients with de novo AML. METHODS. We performed multilocus DNA methylation assessment using xMELP on samples and calculated a methylation statistic (M-score) for 166 patients from UPENN with de novo AML who received induction chemotherapy. The association of M-score with complete remission (CR) and overall survival (OS) was evaluated. The optimal M-score cut-point for identifying groups with differing survival was used to define a binary M-score classifier. This classifier was validated in an independent cohort of 383 patients from the Eastern Cooperative Oncology Group Trial 1900 (E1900; NCT00049517). RESULTS. A higher mean M-score was associated with death and failure to achieve CR. Multivariable analysis confirmed that a higher M-score was associated with death (P = 0.011) and failure to achieve CR (P = 0.034). Median survival was 26.6 months versus 10.6 months for low and high M-score groups. The ability of the M-score to perform as a classifier was confirmed in patients ≤ 60 years with intermediate cytogenetics and patients who achieved CR, as well as in the E1900 validation cohort. CONCLUSION. The M-score represents a valid binary prognostic classifier for patients with de novo AML. The xMELP assay and associated M-score can be used for prognosis and should be further investigated for clinical decision making in AML patients. PMID:27446991

Associations between cortical thickness and general intelligence in children, adolescents and young adults

PubMed Central

Menary, Kyle; Collins, Paul F.; Porter, James N.; Muetzel, Ryan; Olson, Elizabeth A.; Kumar, Vipin; Steinbach, Michael; Lim, Kelvin O.; Luciana, Monica

2013-01-01

Neuroimaging research indicates that human intellectual ability is related to brain structure including the thickness of the cerebral cortex. Most studies indicate that general intelligence is positively associated with cortical thickness in areas of association cortex distributed throughout both brain hemispheres. In this study, we performed a cortical thickness mapping analysis on data from 182 healthy typically developing males and females ages 9 to 24 years to identify correlates of general intelligence (g) scores. To determine if these correlates also mediate associations of specific cognitive abilities with cortical thickness, we regressed specific cognitive test scores on g scores and analyzed the residuals with respect to cortical thickness. The effect of age on the association between cortical thickness and intelligence was examined. We found a widely distributed pattern of positive associations between cortical thickness and g scores, as derived from the first unrotated principal factor of a factor analysis of Wechsler Abbreviated Scale of Intelligence (WASI) subtest scores. After WASI specific cognitive subtest scores were regressed on g factor scores, the residual score variances did not correlate significantly with cortical thickness in the full sample with age covaried. When participants were grouped at the age median, significant positive associations of cortical thickness were obtained in the older group for g-residualized scores on Block Design (a measure of visual-motor integrative processing) while significant negative associations of cortical thickness were observed in the younger group for g-residualized Vocabulary scores. These results regarding correlates of general intelligence are concordant with the existing literature, while the findings from younger versus older subgroups have implications for future research on brain structural correlates of specific cognitive abilities, as well as the cognitive domain specificity of behavioral performance correlates of normative gray matter thinning during adolescence. PMID:24744452

Comparison of traditional diabetes risk scores and HbA1c to predict type 2 diabetes mellitus in a population based cohort study.

PubMed

Krabbe, Christine Emma Maria; Schipf, Sabine; Ittermann, Till; Dörr, Marcus; Nauck, Matthias; Chenot, Jean-François; Markus, Marcello Ricardo Paulista; Völzke, Henry

2017-11-01

Compare performances of diabetes risk scores and glycated hemoglobin (HbA1c) to estimate the risk of incident type 2 diabetes mellitus (T2DM) in Northeast Germany. We studied 2916 subjects (20 to 81years) from the Study of Health in Pomerania (SHIP) in a 5-year follow-up period. Diabetes risk scores included the Cooperative Health Research in the Region of Augsburg (KORA) base model, the Danish diabetes risk score and the Data from the Epidemiological Study on the Insulin Resistance syndrome (D.E.S.I.R) clinical risk score. We assessed the performance of each of the diabetes risk scores and the HbA1c for 5-year risk of T2DM by the area under the receiver-operating characteristic curve (AUC) and calibration plots. In SHIP, the incidence of T2DM was 5.4% (n=157) in the 5-year follow-up period. Diabetes risk scores and HbA1c achieved AUCs ranging from 0.76 for the D.E.S.I.R. clinical risk score to 0.82 for the KORA base model. For diabetes risk scores, the discriminative ability was lower for the age group 55 to 74years. For HbA1c, the discriminative ability also decreased for the group 55 to 74years while it was stable in the age group 30 to 64years old. All diabetes risk scores and the HbA1c showed a good prediction for the risk of T2DM in SHIP. Which model or biomarker should be used is driven by its context of use, e.g. the practicability, implementation of interventions and availability of measurement. Copyright © 2017 Elsevier Inc. All rights reserved.

The effectiveness of training with an emergency department simulator on medical student performance in a simulated disaster.

PubMed

Franc-Law, Jeffrey Michael; Ingrassia, Pier Luigi; Ragazzoni, Luca; Della Corte, Francesco

2010-01-01

Training in practical aspects of disaster medicine is often impossible, and simulation may offer an educational opportunity superior to traditional didactic methods. We sought to determine whether exposure to an electronic simulation tool would improve the ability of medical students to manage a simulated disaster. We stratified 22 students by year of education and randomly assigned 50% from each category to form the intervention group, with the remaining 50% forming the control group. Both groups received the same didactic training sessions. The intervention group received additional disaster medicine training on a patient simulator (disastermed.ca), and the control group spent equal time on the simulator in a nondisaster setting. We compared markers of patient flow during a simulated disaster, including mean differences in time and number of patients to reach triage, bed assignment, patient assessment and disposition. In addition, we compared triage accuracy and scores on a structured command-and-control instrument. We collected data on the students' evaluations of the course for secondary purposes. Participants in the intervention group triaged their patients more quickly than participants in the control group (mean difference 43 s, 99.5% confidence interval [CI] 12 to 75 s). The score of performance indicators on a standardized scale was also significantly higher in the intervention group (18/18) when compared with the control group (8/18) (p < 0.001). All students indicated that they preferred the simulation-based curriculum to a lecture-based curriculum. When asked to rate the exercise overall, both groups gave a median score of 8 on a 10-point modified Likert scale. Participation in an electronic disaster simulation using the disastermed.ca software package appears to increase the speed at which medical students triage simulated patients and increase their score on a structured command-and-control performance indicator instrument. Participants indicated that the simulation-based curriculum in disaster medicine is preferable to a lecture-based curriculum. Overall student satisfaction with the simulation-based curriculum was high.

Sub-classification of Advanced-Stage Hepatocellular Carcinoma: A Cohort Study Including 612 Patients Treated with Sorafenib.

PubMed

Yoo, Jeong-Ju; Chung, Goh Eun; Lee, Jeong-Hoon; Nam, Joon Yeul; Chang, Young; Lee, Jeong Min; Lee, Dong Ho; Kim, Hwi Young; Cho, Eun Ju; Yu, Su Jong; Kim, Yoon Jun; Yoon, Jung-Hwan

2018-04-01

Advanced hepatocellular carcinoma (HCC) is associated with various clinical conditions including major vessel invasion, metastasis, and poor performance status. The aim of this study was to establish a prognostic scoring system and to propose a sub-classification of the Barcelona-Clinic Liver Cancer (BCLC) stage C. This retrospective study included consecutive patientswho received sorafenib for BCLC stage C HCC at a single tertiary hospital in Korea. A Cox proportional hazard model was used to develop a scoring system, and internal validationwas performed by a 5-fold cross-validation. The performance of the model in predicting risk was assessed by the area under the curve and the Hosmer-Lemeshow test. A total of 612 BCLC stage C HCC patients were sub- classified into strata depending on their performance status. Five independent prognostic factors (Child-Pugh score, α-fetoprotein, tumor type, extrahepatic metastasis, and portal vein invasion) were identified and used in the prognostic scoring system. This scoring system showed good discrimination (area under the receiver operating characteristic curve, 0.734 to 0.818) and calibration functions (both p < 0.05 by the Hosmer-Lemeshow test at 1 month and 12 months, respectively). The differences in survival among the different risk groups classified by the total score were significant (p < 0.001 by the log-rank test in both the Eastern Cooperative Oncology Group 0 and 1 strata). The heterogeneity of patientswith BCLC stage C HCC requires sub-classification of advanced HCC. A prognostic scoring system with five independent factors is useful in predicting the survival of patients with BCLC stage C HCC.

Surgical management of congenital heart disease: contribution of the Aristotle complexity score to planning and budgeting in the German diagnosis-related groups system.

PubMed

Sinzobahamvya, Nicodème; Photiadis, Joachim; Kopp, Thorsten; Arenz, Claudia; Haun, Christoph; Schindler, Ehrenfried; Hraska, Viktor; Asfour, Boulos

2012-01-01

Planning and budgeting for congenital heart surgery depend primarily on how closely reimbursement matches costs and on the number and complexity of the surgical procedures. Aristotle complexity scores for the year 2010 were correlated with hospital costs and with reimbursement according to the German diagnosis-related groups (DRG) system. Unit surgical performance was estimated as surgical performance (complexity score × hospital survival) times the number of primary procedures. This study investigated how this performance evolved during years 2006 to 2010. Hospital costs and reimbursements correlated highly with Aristotle comprehensive complexity levels (Spearman r = 1). Mean costs and reimbursement reached 35,050 ± 32,665 and 31,283 ± 34,732, respectively, for an underfunding of 10.7%. Basic and comprehensive unit surgical performances were respectively 3036 ± 1009 and 3891 ± 1591 points in 2006. Both performances increased in sigmoid fashion to reach 3883 ± 1344 and 5335 ± 1314 points, respectively, in 2010. Top performances would be achieved in year 2011, and extrapolated costs would comprise about 19,434,094.92 (95% confidence interval, 11,961,491.22-22,495,764.42). The current underfunding of congenital heart surgery needs correction. The Aristotle score can help to adjust reimbursement according to complexity of procedures. Unit surgical performance allows accurate budgeting in the current German DRG system.

Ethnicity and Sex Distinctions in Patterns of Aptitude Factor Scores in a Sample of Urban High School Seniors

ERIC Educational Resources Information Center

Hennessy, James J.; Merrifield, Philip R.

1978-01-01

Three aptitude factor scores for each of 2,985 college bound urban high school seniors were used to compare patterns and levels of performance by sex and ethnic group membership. Significant differences in levels of performance between Blacks, Hispanics, Caucasian Jewish, and Caucasian Gentile were found on factors labeled Verbal, Reasoning, and…

The Relationship between SAT Scores and Retention to the Third Year: 2006 Cohort. Statistical Report

ERIC Educational Resources Information Center

Mattern, Krista D.; Patterson, Brian F.

2010-01-01

Results show that SAT performance is related to third year retention rates. Even after controlling for student and institutional characteristics, returners had higher SAT total scores than non-returners, and the performance gap is not due to differences in the demographic makeup of the two groups. Furthermore, while differences in retention can be…

Assessing English Language Learners' Oral Performance: A Comparison of Monologue, Interview, and Group Oral Test

ERIC Educational Resources Information Center

Ahmadi, Alireza; Sadeghi, Elham

2016-01-01

In the present study we investigated the effect of test format on oral performance in terms of test scores and discourse features (accuracy, fluency, and complexity). Moreover, we explored how the scores obtained on different test formats relate to such features. To this end, 23 Iranian EFL learners participated in three test formats of monologue,…

White Matter Changes and Confrontation Naming in Retired Aging National Football League Athletes.

PubMed

Strain, Jeremy F; Didehbani, Nyaz; Spence, Jeffrey; Conover, Heather; Bartz, Elizabeth K; Mansinghani, Sethesh; Jeroudi, Myrtle K; Rao, Neena K; Fields, Lindy M; Kraut, Michael A; Cullum, C Munro; Hart, John; Womack, Kyle B

2017-01-15

Using diffusion tensor imaging (DTI), we assessed the relationship of white matter integrity and performance on the Boston Naming Test (BNT) in a group of retired professional football players and a control group. We examined correlations between fractional anisotropy (FA) and mean diffusivity (MD) with BNT T-scores in an unbiased voxelwise analysis processed with tract-based spatial statistics (TBSS). We also analyzed the DTI data by grouping voxels together as white matter tracts and testing each tract's association with BNT T-scores. Significant voxelwise correlations between FA and BNT performance were only seen in the retired football players (p < 0.02). Two tracts had mean FA values that significantly correlated with BNT performance: forceps minor and forceps major. White matter integrity is important for distributed cognitive processes, and disruption correlates with diminished performance in athletes exposed to concussive and subconcussive brain injuries, but not in controls without such exposure.

Antisaccade performance of 1,273 men: effects of schizotypy, anxiety, and depression.

PubMed

Smyrnis, Nikolaos; Evdokimidis, Ioannis; Stefanis, Nicholas C; Avramopoulos, Dimitrios; Constantinidis, Theodoros S; Stavropoulos, Alexios; Stefanis, Costas N

2003-08-01

A total of 1,273 conscripts of the Greek Air Force performed antisaccades and completed self-reporting questionnaires measuring schizotypy and current state-dependent psychopathology. Only 1.0% of variability in antisaccade performance indices was related to psychometric scores in the population and could be attributed more to current state-dependent symptoms such as anxiety rather than to schizotypy. In contrast, a specific increase of error rate and response latency variability and a high correlation of these 2 variables was observed in a group with very high schizotypy scores. This effect was independent of anxiety and depression, suggesting that a specific group of psychosis-prone individuals has a characteristic deviance in antisaccade performance that is not present in the general population.

Urban Latino children's physical activity levels and performance in interactive dance video games: effects of goal difficulty and goal specificity.

PubMed

Gao, Zan; Podlog, Leslie

2012-10-01

To examine the effects of different levels of goal specificity and difficulty on Latino children's performance and physical activity (PA) levels in an after-school program incorporating an interactive dance program (Dance Dance Revolution [DDR]; Konami Corporation). Comparison study. Rose Park Elementary School, Salt Lake City, Utah. Ninety-eight Latino children in the first through sixth grades, aged 7 to 13 years. After the pretest, the participants were randomly assigned into 1 of the following 3 goal-setting conditions: (1) easy, (2) difficult, and (3) best effort (hereinafter referred to as do-your-best goal). Participants' PA levels were measured using piezoelectric pedometers, and steps per minute were used as the outcome variable. Participants' total points for their dance on television screens were retrieved as their performance scores. These outcome variables were assessed again 8 weeks later (posttest score). The multivariate analysis of covariance yielded a significant main effect for the goal-setting condition. Follow-up tests revealed that children who set specific (easy or difficult) goals had significantly greater increased PA levels (mean scores, 10.34 for easy and 22.45 for difficult) and DDR performance (0.011 for easy and 0.67 for difficult) than those in the do-your-best group (0.83 for PA and 0.17 for performance). In addition, children's increased PA levels in the difficult-goal group were significantly higher than those in the easy-goal group. The easy- and difficult-goal groups show a significant improvement on DDR performance. The difficult- goal group also displays the highest improvement on PA levels. Strategies to enhance children's DDR performance and PA levels are discussed in relation to the extant goal-setting literature.

A pectin-honey hydrogel prevents postoperative intraperitoneal adhesions in a rat model.

PubMed

Giusto, Gessica; Vercelli, Cristina; Iussich, Selina; Audisio, Andrea; Morello, Emanuela; Odore, Rosangela; Gandini, Marco

2017-02-17

Adhesions are a common postoperative surgical complication. Liquid honey has been used intraperitoneally to reduce the incidence of these adhesions. However, solid barriers are considered more effective than liquids in decreasing postoperative intra-abdominal adhesion formation; therefore, a new pectin-honey hydrogel (PHH) was produced and its effectiveness was evaluated in a rat cecal abrasion model. Standardized cecal/peritoneal abrasion was performed through laparotomy in 48 adult Sprague-Dawley rats to induce peritoneal adhesion formation. Rats were randomly assigned to a control (C) and treatment (T) group. In group T, PHHs were placed between the injured peritoneum and cecum. Animals were euthanized on day 15 after surgery. Adhesions were evaluated macroscopically and adhesion scores were recorded and compared between the two groups. Inflammation, fibrosis, and neovascularization were histologically graded and compared between the groups. In group C, 17 of 24 (70.8%) animals developed adhesions between the cecum and peritoneum, while in group T only 5 of 24 (20.8%) did (p = 0.0012). In group C, one rat had an adhesion score of 3, sixteen had scores of 2, and seven rats had scores of 0. In group T, four rats had adhesion scores of 2, one rat had an adhesion score of 1 and nineteen have score 0 (p = 0.0003). Significantly lower grades of inflammation, fibrosis, and neovascularization were seen in group T (p = 0.006, p = 0.001, p = 0.002, respectively). PHH is a novel absorbable barrier that is effective in preventing intra-abdominal adhesions in a cecal abrasion model in rats.

Comparison of National Board of Chiropractic Examiners part I examination scores between tutors and tutees at a chiropractic college

PubMed Central

Kenya, Amilliah W.; Hart, John F.; Vuyiya, Charles K.

2016-01-01

Objective: This study compared National Board of Chiropractic Examiners part I test scores between students who did and did not serve as tutors on the subject matter. Methods: Students who had a prior grade point average of 3.45 or above on a 4.0 scale just before taking part I of the board exams were eligible to participate. A 2-sample t-test was used to ascertain the difference in the mean scores on part I between the tutor group (n = 28) and nontutor (n = 29) group. Results: Scores were higher in all subjects for the tutor group compared to the nontutor group and the differences were statistically significant (p < .01) with large effect sizes. Conclusion: The tutors in this study performed better on part I of the board examination compared to nontutors, suggesting that tutoring results in an academic benefit for tutors themselves. PMID:26998665

The management of acute appendicitis in liver transplant patients: How effective is the Alvarado score?

PubMed

Ince, Volkan; Barut, Bora; Ozdemir, Fatih; Ersan, Veysel; Kutluturk, Koray; Gonultas, Fatih; Onur, Asim; Isik, Burak; Kutlu, Ramazan; Yilmaz, Sezai

2017-01-01

The incidence of acute appendicitis after liver transplantation (LT) is extremely low, reported to be 0.09% to 0.49%, but the efficacy of the Alvarado score in this patient group has not been studied. This study was an investigation of the clinical management of patients who developed acute appendicitis after LT and the usefulness of the Alvarado score in the diagnosis. The study was performed using the data of 7 patients treated for acute appendicitis who were among 1990 patients who underwent LT between March 2002 and July 2017. The Alvarado score of the patients was calculated and reliability was analyzed. In this study, the incidence of acute appendicitis in LT patients was 0.35%. All of the patients were in the adult age group; 86% were male. The mean age was 46.4±10.7 years and the timeframe for the development of appendicitis after transplantation was a median of 12 months (range: 4-101 months). The median Alvarado score was 7 (range: 5-9). All of the patients had an Alvarado score above 5 and 71% had a score of 7 or more. Acute appendicitis is very rare in LT patients. As with non-transplant patients, Alvarado scoring can be safely performed in LT patients.

The management of acute appendicitis in liver transplant patients: How effective is the Alvarado score?

PubMed Central

Ince, Volkan; Barut, Bora; Ozdemir, Fatih; Ersan, Veysel; Kutluturk, Koray; Gonultas, Fatih; Onur, Asim; Isik, Burak; Kutlu, Ramazan; Yilmaz, Sezai

2017-01-01

OBJECTIVE: The incidence of acute appendicitis after liver transplantation (LT) is extremely low, reported to be 0.09% to 0.49%, but the efficacy of the Alvarado score in this patient group has not been studied. This study was an investigation of the clinical management of patients who developed acute appendicitis after LT and the usefulness of the Alvarado score in the diagnosis. METHODS: The study was performed using the data of 7 patients treated for acute appendicitis who were among 1990 patients who underwent LT between March 2002 and July 2017. The Alvarado score of the patients was calculated and reliability was analyzed. RESULTS: In this study, the incidence of acute appendicitis in LT patients was 0.35%. All of the patients were in the adult age group; 86% were male. The mean age was 46.4±10.7 years and the timeframe for the development of appendicitis after transplantation was a median of 12 months (range: 4-101 months). The median Alvarado score was 7 (range: 5-9). All of the patients had an Alvarado score above 5 and 71% had a score of 7 or more. CONCLUSION: Acute appendicitis is very rare in LT patients. As with non-transplant patients, Alvarado scoring can be safely performed in LT patients. PMID:29270576

Evaluation of an educational intervention for farming families to protect their children from pesticide exposure.

PubMed

Farahat, T M; Farahat, F M; Michael, A A

2009-01-01

A culturally appropriate educational intervention was developed and directed towards farming families in Menoufia governorate, Egypt, to improve their knowledge and practices in protecting their children from exposure to pesticides. Parents were randomly assigned to either a lecture or videotape training group. Ability to recall information or improve practices among parents was evaluated in 3 sessions: pretraining and 2 weeks and 1 month after training. Knowledge and practice scores after training of younger and more educated participants were significantly higher than older, less educated participants. Knowledge and practice performance of the videotape group was better than the lecture group and in both groups the improvement of knowledge scores after training was significantly higher than that of practice scores.

Score Reporting in Teacher Certification Testing: A Review, Design, and Interview/Focus Group Study

ERIC Educational Resources Information Center

Klesch, Heather S.

2010-01-01

The reporting of scores on educational tests is at times misunderstood, misinterpreted, and potentially confusing to examinees and other stakeholders who may need to interpret test scores. In reporting test results to examinees, there is a need for clarity in the message communicated. As pressure rises for students to demonstrate performance at a…

Relationship between relaxation by guided imagery and performance of working memory.

PubMed

Hudetz, J A; Hudetz, A G; Klayman, J

2000-02-01

This study tested the hypothesis that relaxation by guided imagery improves working-memory performance of healthy participants. 30 volunteers (both sexes, ages 17-56 years) were randomly assigned to one of three groups and administered the WAIS-III Letter-Number Sequencing Test before and after 10-min. treatment with guided imagery or popular music. The control group received no treatment. Groups' test scores were not different before treatment. The mean increased after relaxation by guided imagery but not after music or no treatment. This result supports the hypothesis that working-memory scores on the test are enhanced by guided imagery and implies that human information processing may be enhanced by prior relaxation.

Prospective Randomized Controlled Study on the Efficacy of Multimedia Informed Consent for Patients Scheduled to Undergo Green-Light High-Performance System Photoselective Vaporization of the Prostate

PubMed Central

Ham, Dong Yeub; Choi, Woo Suk; Song, Sang Hoon; Ahn, Young-Joon; Park, Hyoung Keun; Kim, Hyeong Gon

2016-01-01

Purpose The aim of this study was to evaluate the efficacy of a multimedia informed consent (IC) presentation on the understanding and satisfaction of patients who were scheduled to receive 120-W green-light high-performance system photoselective vaporization of the prostate (HPS-PVP). Materials and Methods A multimedia IC (M-IC) presentation for HPS-PVP was developed. Forty men with benign prostatic hyperplasia who were scheduled to undergo HPS-PVP were prospectively randomized to a conventional written IC group (W-IC group, n=20) or the M-IC group (n=20). The allocated IC was obtained by one certified urologist, followed by a 15-question test (maximum score, 15) to evaluate objective understanding, and questionnaires on subjective understanding (range, 0~10) and satisfaction (range, 0~10) using a visual analogue scale. Results Demographic characteristics, including age and the highest level of education, did not significantly differ between the two groups. No significant differences were found in scores reflecting the objective understanding of HPS-PVP (9.9±2.3 vs. 10.6±2.8, p=0.332) or in subjective understanding scores (7.5±2.1 vs. 8.6±1.7, p=0.122); however, the M-IC group showed higher satisfaction scores than the W-IC group (7.4±1.7 vs. 8.4±1.5, p=0.033). After adjusting for age and educational level, the M-IC group still had significantly higher satisfaction scores. Conclusions M-IC did not enhance the objective knowledge of patients regarding this surgical procedure. However, it improved the satisfaction of patients with the IC process itself. PMID:27169129

Influence of videogames and musical instruments on performances at a simulator for robotic surgery.

PubMed

Moglia, Andrea; Perrone, Vittorio; Ferrari, Vincenzo; Morelli, Luca; Boggi, Ugo; Ferrari, Mauro; Mosca, Franco; Cuschieri, Alfred

2017-06-01

To assess if exposure to videogames, musical instrument playing, or both influence the psychomotor skills level, assessed by a virtual reality simulator for robot-assisted surgery (RAS). A cohort of 57 medical students were recruited: playing musical instruments (group 1), videogames (group 2), both (group 3), and no activity (group 4); all students executed four exercises on a virtual simulator for RAS. Subjects from group 3 achieved the best performances on overall score: 527.09 ± 130.54 vs. 493.73 ± 108.88 (group 2), 472.72 ± 85.31 (group 1), and 403.13 ± 99.83 (group 4). Statistically significant differences (p < .05) between group 3 and group 4 were found for overall score (p = .009) and for time of completion (p = .044). As regards experience with the piano, subjects from group 3 outperformed those from group 1 on overall score (496.98 ± 122.71 vs. 470.25 ± 92.31), but without statistically significant difference (p = .646). The present study suggests that the level of psychomotor skills in subjects exposed to both musical instrument playing and videogames is higher than that in those practicing either one alone. The effect of videogames appears negligible in individuals playing the piano.

The Impact of Computer and Mathematics Software Usage on Performance of School Leavers in the Western Cape Province of South Africa: A Comparative Analysis

ERIC Educational Resources Information Center

Smith, Garth Spencer; Hardman, Joanne

2014-01-01

In this study the impact of computer immersion on performance of school leavers Senior Certificate mathematics scores was investigated across 31 schools in the EMDC East education district of Cape Town, South Africa by comparing performance between two groups: a control and an experimental group. The experimental group (14 high schools) had access…

Visual distraction alone for the improvement of colonoscopy-related pain and satisfaction.

PubMed

Umezawa, Shotaro; Higurashi, Takuma; Uchiyama, Shiori; Sakai, Eiji; Ohkubo, Hidenori; Endo, Hiroki; Nonaka, Takashi; Nakajima, Atsushi

2015-04-21

To evaluate the effect of a relaxing visual distraction alone on patient pain, anxiety, and satisfaction during colonoscopy. This study was designed as an endoscopist-blinded randomized controlled trial with 60 consecutively enrolled patients who underwent elective colonoscopy at Yokohama City University Hospital, Japan. Patients were randomly assigned to two groups: group 1 watched a silent movie using a head-mounted display, while group 2 only wore the display. All of the colonoscopies were performed without sedation. We examined pain, anxiety, and the satisfaction of patients before and after the procedure using questionnaires that included the Visual Analog Scale. Patients were also asked whether they would be willing to use the same method for a repeat procedure. A total of 60 patients were allocated to two groups. Two patients assigned to group 1 and one patient assigned to group 2 were excluded after the randomization. Twenty-eight patients in group 1 and 29 patients in group 2 were entered into the final analysis. The groups were similar in terms of gender, age, history of prior colonoscopy, and pre-procedural anxiety score. The two groups were comparable in terms of the cecal insertion rate, the time to reach the cecum, the time needed for the total procedure, and vital signs. The median anxiety score during the colonoscopy did not differ significantly between the two groups (median scores, 20 vs 24). The median pain score during the procedure was lower in group 1, but the difference was not significant (median scores, 24.5 vs 42). The patients in group 1 reported significantly higher median post-procedural satisfaction levels, compared with the patients in group 2 (median scores, 89 vs 72, P = 0.04). Nearly three-quarters of the patients in group 1 wished to use the same method for repeat procedures, and the difference in rates between the two groups was statistically significant (75.0% vs 48.3%, P = 0.04). Patients with greater levels of anxiety before the procedure tended to feel a painful sensation. Among patients with a pre-procedural anxiety score of 50 or higher, the anxiety score during the procedure was significantly lower in the group that received the visual distraction (median scores, 20 vs 68, P = 0.05); the pain score during the colonoscopy was also lower (median scores, 23 vs 57, P = 0.04). No adverse effects arising from the visual distraction were recognized. Visual distraction alone improves satisfaction in patients undergoing colonoscopy and decreases anxiety and pain during the procedure among patients with a high pre-procedural anxiety score.

Impact of shift work on sleep and daytime performance among health care professionals.

PubMed

Alshahrani, Sultan M; Baqays, Abdulsalam A; Alenazi, Abdelelah A; AlAngari, Abdulaziz M; AlHadi, Ahmad N

2017-08-01

To evaluate sleep quality and daytime sleepiness in health care professionals who are performing shift work. Methods: This cross-sectional study was conducted on 510 health care professionals at Prince Sultan Military Medical City and King Khalid University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia between December 2015 and April 2016. Data were collected using the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS). Participants were divided into 2 groups: shift workers and non-shift workers. Results: We compared both groups regarding the effect of shift work on the total score of PSQI and ESS. We found that the PSQI global score (p less than 0.001) and the total ESS score (p=0.003) were significantly higher in shift work health care professionals.  Conclusion: Shift work among health care professionals is associated with poor sleep quality but not excessive daytime sleepiness. Health care professionals performing shift work have PSQI and ESS scores slightly higher than non-shift work health professionals.

Short-duration virtual reality simulation training positively impacts performance during laparoscopic colectomy in animal model: results of a single-blinded randomized trial : VR warm-up for laparoscopic colectomy.

PubMed

Araujo, Sergio E A; Delaney, Conor P; Seid, Victor E; Imperiale, Antonio R; Bertoncini, Alexandre B; Nahas, Sergio C; Cecconello, Ivan

2014-09-01

Several studies have demonstrated skills transfer after virtual reality (VR) simulation training in laparoscopic surgery. However, the impact of VR simulation training on transfer of skills related to laparoscopic colectomy remains not investigated. The present study aimed at determining the impact of VR simulation warm-up on performance during laparoscopic colectomy in the porcine model. Fourteen residents naive to laparoscopic colectomy as surgeons were randomly assigned in block to two groups. Seven trainees completed a 2-h VR simulator training in the laparoscopic sigmoid colectomy module (study group). The remaining seven surgeons (control group) underwent no intervention. On the same day, all participants performed a sigmoid colectomy with anastomosis on a pig. All operations were video recorded. Two board-certified expert colorectal surgeons independently assessed performance during the colectomy on the swine. Examiners were blinded to group assignment. The two examiners used a previously validated clinical instrument specific to laparoscopic colectomy. The primary outcome was the generic and specific skills score values. Surgeons undergoing short-duration training on the VR simulator performed significantly better during laparoscopic colectomy on the pig regarding general and specific technical skills evaluation. The average score of generic skills was 17.2 (16.5-18) for the control group and 20.1 (16.5-22) for the study group (p = 0.002). The specific skills average score for the control group was 20.2 (19-21.5) and 24.2 (21-27.5) for the study group (p = 0.001). There was acceptable concordance (Kendall's W) regarding the video assessment of generic (W = 0.78) and specific skills (W = 0.84) between the two examiners. A single short-duration VR simulator practice positively impacted surgeons' generic and specific skills performance required to accomplish laparoscopic colectomy in the swine model.

A Randomized Controlled Trial to Compare e-Feedback Versus "Standard" Face-to-Face Verbal Feedback to Improve the Acquisition of Procedural Skill.

PubMed

Al-Jundi, Wissam; Elsharif, Mohamed; Anderson, Melanie; Chan, Phillip; Beard, Jonathan; Nawaz, Shah

Constructive feedback plays an important role in learning during surgical training. Standard feedback is usually given verbally following direct observation of the procedure by a trained assessor. However, such feedback requires the physical presence of expert faculty members who are usually busy and time-constrained by clinical commitments. We aim to evaluate electronic feedback (e-feedback) after video observation of surgical suturing in comparison with standard face-to-face verbal feedback. A prospective, blinded, randomized controlled trial comparing e-feedback with standard verbal feedback was carried out in February 2015 using a validated pro formas for assessment. The study participants were 38 undergraduate medical students from the University of Sheffield, UK. They were recorded on video performing the procedural skill, completed a self-evaluation form, and received e-feedback on the same day (group 1); observed directly by an assessor, invited to provide verbal self-reflection, and then received standard verbal feedback (group 2). In both groups, the feedback was provided after performing the procedure. The participants returned 2 days later and performed the same skill again. Poststudy questionnaire was used to assess the acceptability of each feedback among the participants. Overall, 19 students in group 1 and 18 students in group 2 completed the study. Although there was a significant improvement in the overall mean score on the second performance of the task for all participants (first performance mean 11.59, second performance mean 15.95; p ≤ 0.0001), there was no difference in the overall mean improvement score between group 1 and group 2 (4.74 and 3.94, respectively; p = 0.49). The mean overall scores for the e-feedback group at baseline recorded by 2 independent investigators showed good agreement (mean overall scores of 12.84 and 11.89; Cronbach α = 0.86). Poststudy questionnaire demonstrated that both e-feedback and standard verbal feedback achieved high mean Likert grades as recorded by the participants (4.42 [range: 2-5] and 4.71 [range: 4-5], respectively; p = 0.274). e-Feedback after watching a video recording appears to be acceptable and is not quantitatively different than standard feedback in improving suturing skills among novice trainees. Video assessment of procedural skills is reliable. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

East meets West: the influence of racial, ethnic and cultural risk factors on cardiac surgical risk model performance.

PubMed

Soo-Hoo, Sarah; Nemeth, Samantha; Baser, Onur; Argenziano, Michael; Kurlansky, Paul

2018-01-01

To explore the impact of racial and ethnic diversity on the performance of cardiac surgical risk models, the Chinese SinoSCORE was compared with the Society of Thoracic Surgeons (STS) risk model in a diverse American population. The SinoSCORE risk model was applied to 13 969 consecutive coronary artery bypass surgery patients from twelve American institutions. SinoSCORE risk factors were entered into a logistic regression to create a 'derived' SinoSCORE whose performance was compared with that of the STS risk model. Observed mortality was 1.51% (66% of that predicted by STS model). The SinoSCORE 'low-risk' group had a mortality of 0.15%±0.04%, while the medium-risk and high-risk groups had mortalities of 0.35%±0.06% and 2.13%±0.14%, respectively. The derived SinoSCORE model had a relatively good discrimination (area under of the curve (AUC)=0.785) compared with that of the STS risk score (AUC=0.811; P=0.18 comparing the two). However, specific factors that were significant in the original SinoSCORE but that lacked significance in our derived model included body mass index, preoperative atrial fibrillation and chronic obstructive pulmonary disease. SinoSCORE demonstrated limited discrimination when applied to an American population. The derived SinoSCORE had a discrimination comparable with that of the STS, suggesting underlying similarities of physiological substrate undergoing surgery. However, differential influence of various risk factors suggests that there may be varying degrees of importance and interactions between risk factors. Clinicians should exercise caution when applying risk models across varying populations due to potential differences that racial, ethnic and geographic factors may play in cardiac disease and surgical outcomes.

Comparison of actigraphy immobility rules with polysomnographic sleep onset latency in children and adolescents.

PubMed

Meltzer, Lisa J; Walsh, Colleen M; Peightal, Ashley A

2015-12-01

While actigraphy has gained popularity in pediatric sleep research, questions remain about the validity of actigraphy as an estimate of sleep-wake patterns. In particular, there is little consistency in the field in terms of scoring rules used to determine sleep onset latency. The purpose of this study was to evaluate different criteria of immobility as a measure of sleep onset latency in children and adolescents. Ninety-five youth (ages 3-17 years, 46 % male) wore both the Ambulatory Monitoring Inc. Motionlogger Sleep Watch (AMI) and the Philips Respironics Mini-Mitter Actiwatch-2 (PRMM) during overnight polysomnography in a pediatric sleep lab. We examined different sleep onset latency scoring rules (3, 5, 10, 15, and 20 min of immobility) using different algorithms (Sadeh and Cole-Kripke) and sensitivity settings (low, medium, high) for the devices. Comparisons were also made across age groups (preschoolers, school-aged, adolescents) and sleep disordered breathing status (no obstructive sleep apnea [OSA], mild OSA, clinically significant OSA). For the AMI device, shorter scoring rules performed best for children and longer scoring rules were better for adolescents, with shorter scoring rules best across sleep disordered breathing groups. For the PRMM device, medium to longer scoring rules performed best across age and sleep disordered breathing groups. Researchers are encouraged to determine the scoring rule that best fits their population of interest. Future studies are needed with larger samples of children and adolescents to further validate actigraphic immobility as a proxy for sleep onset latency.

Diagnostic performance of T lymphocyte subpopulations in assessment of liver fibrosis stages in hepatitis C virus patients: simple noninvasive score.

PubMed

Toson, El-Shatat A; Shiha, Gamal E; El-Mezayen, Hatem A; El-Sharkawy, Aml M

2016-08-01

Evaluation of liver fibrosis in patients infected with hepatitis C virus is highly useful for the diagnosis of the disease as well as therapeutic decision. Our aim was to develop and validate a simple noninvasive score for liver fibrosis staging in chronic hepatitis C (CHC) patients and compare its performance against three published simple noninvasive indexes. CHC patients were divided into two groups: an estimated group (n=70) and a validated group (n=52). Liver fibrosis was tested in biopsies using the Metavair score system. CD4 and CD8 count/percentage were assayed by fluorescence-activated cell sorting analysis. The multivariate discriminant analysis selects a function on the basis of absolute values of five biochemical markers: immune fibrosis index (IFI); score=3.07+3.06×CD4/CD8+0.02×α-fetoprotein (U/l)-0.07×alanine aminotransferase ratio-0.005×platelet count (10/l)-1.4×albumin (g/dl). The IFI score produced areas under curve of 0.949, 0.947, and 0.806 for differentiation of all patient categories [significant fibrosis (F2-F4), advanced fibrosis (F3-F4), and cirrhosis (F4)]. The IFI score, a novel noninvasive test, can be used easily for the prediction of liver fibrosis stage in CHC patients. Our score was more efficient than aspartate aminotransferase to platelet ratio index, fibrosis index, and fibroQ and more suitable for use in Egyptian hepatitis C virus patients.

Effectiveness of a Wheelchair Skills Training Program for Powered Wheelchair Users: A Randomized Controlled Trial

PubMed Central

Kirby, R. Lee; Miller, William C.; Routhier, Francois; Demers, Louise; Mihailidis, Alex; Polgar, Jan Miller; Rushton, Paula W.; Titus, Laura; Smith, Cher; McAllister, Mike; Theriault, Chris; Thompson, Kara; Sawatzky, Bonita

2015-01-01

Objectives To test the hypothesis that powered wheelchair users who receive the Wheelchair Skills Training Program (WSTP) improve their wheelchair skills in comparison with a Control group that receives standard care. Our secondary objectives were to assess goal achievement, satisfaction with training, retention, injury rate, confidence with wheelchair use and participation. Design Randomized controlled trial (RCT). Setting Rehabilitation centers and communities. Participants 116 powered wheelchair users. Intervention Five 30-minute WSTP training sessions. Main Outcome Measures Assessments were done at baseline (T1), post-training (T2) and 3 months post-training (T3) using the Wheelchair Skills Test Questionnaire (WST-Q 4.1), Goal Attainment Score (GAS), Satisfaction Questionnaire, Injury Rate, Wheelchair Use Confidence Scale for Power Wheelchair Users (WheelCon) and Life Space Assessment (LSA). Results There was no significant T2-T1 difference between the groups for WST-Q capacity scores (p = 0.600) but the difference for WST-Q performance scores was significant (p = 0.016) with a relative (T2/T1 x 100%) improvement of the median score for the Intervention group of 10.8%. The mean (SD) GAS for the Intervention group after training was 92.8% (11.4) and satisfaction with training was high. The WST-Q gain was not retained at T3. There was no clinically significant difference between the groups in injury rate and no statistically significant differences in WheelCon or LSA scores at T3. Conclusions Powered wheelchair users who receive formal wheelchair skills training demonstrate modest transient post-training improvements in their WST-Q performance scores, they have substantial improvements on individualized goals and they are positive about training. PMID:26232684

Comparison of occipitocervical and atlantoaxial fusion in treatment of unstable Jefferson fractures.

PubMed

Hu, Yong; Yuan, Zhen-Shan; Kepler, Christopher K; Dong, Wei-Xin; Sun, Xiao-Yang; Zhang, Jiao

2017-01-01

Controversy exists regarding the management of unstable Jefferson fractures, with some surgeons performing reduction and immobilization of the patient in a halo vest and others performing open reduction and internal fixation. This study compares the clinical and radiological outcome parameters between posterior atlantoaxial fusion (AAF) and occipitocervical fusion (OCF) constructs in the treatment of the unstable atlas fracture. 68 consecutive patients with unstable Jefferson fractures treated by AAF or OCF between October 2004 and March 2011 were included in this retrospective evaluation from institutional databases. The authors reviewed medical records and original images. The patients were divided into two surgical groups treated with either AAF ( n = 48, F/M 30:18) and OCF ( n = 20, F/M 13:7) fusion. Blood loss, operative time, Japanese Orthopaedic Association (JOA) score, visual analog scale (VAS) score, atlanto-dens interval, lateral mass displacement, complications, and the bone fusion rates were recorded. Five patients with incomplete paralysis (7.4%) demonstrated postoperative improvement by more than 1 grade on the American Spinal Injury Association impairment scale. The JOA score of the AAF group improved from 12.5 ± 3.6 preoperatively to 15.7 ± 2.3 postoperatively, while the JOA score of the OCF group improved from 11.2 ± 3.3 preoperatively to 14.8 ± 4.2 postoperatively. The VAS score of AAF group decreased from 4.8 ± 1.5 preoperatively to 1.0 ± 0.4 postoperatively, the VAS score of the OCF group decreased from 5.4 ± 2.2 preoperatively to 1.3 ± 0.9 postoperatively. The OCF or AAF combined with short-term external immobilization can establish the upper cervical stability and prevent further spinal cord injury and nerve function damage.

A Comparison of Presentation Levels to Maximize Word Recognition Scores

PubMed Central

Guthrie, Leslie A.; Mackersie, Carol L.

2010-01-01

Background While testing suprathreshold word recognition at multiple levels is considered best practice, studies on practice patterns do not suggest that this is common practice. Audiologists often test at a presentation level intended to maximize recognition scores, but methods for selecting this level are not well established for a wide range of hearing losses. Purpose To determine the presentation level methods that resulted in maximum suprathreshold phoneme-recognition scores while avoiding loudness discomfort. Research Design Performance-intensity functions were obtained for 40 participants with sensorineural hearing loss using the Computer-Assisted Speech Perception Assessment. Participants had either gradually sloping (mild, moderate, moderately severe/severe) or steeply sloping losses. Performance-intensity functions were obtained at presentation levels ranging from 10 dB above the SRT to 5 dB below the UCL (uncomfortable level). In addition, categorical loudness ratings were obtained across a range of intensities using speech stimuli. Scores obtained at UCL – 5 dB (maximum level below loudness discomfort) were compared to four alternative presentation-level methods. The alternative presentation-level methods included sensation level (SL; 2 kHz reference, SRT reference), a fixed-level (95 dB SPL) method, and the most comfortable loudness level (MCL). For the SL methods, scores used in the analysis were selected separately for the SRT and 2 kHz references based on several criteria. The general goal was to choose levels that represented asymptotic performance while avoiding loudness discomfort. The selection of SLs varied across the range of hearing losses. Results Scores obtained using the different presentation-level methods were compared to scores obtained using UCL – 5 dB. For the mild hearing loss group, the mean phoneme scores were similar for all presentation levels. For the moderately severe/severe group, the highest mean score was obtained using UCL - 5 dB. For the moderate and steeply sloping groups, the mean scores obtained using 2 kHz SL were equivalent to UCL - 5 dB, whereas scores obtained using the SRT SL were significantly lower than those obtained using UCL - 5 dB. The mean scores corresponding to MCL and 95 dB SPL were significantly lower than scores for UCL - 5 dB for the moderate and the moderately severe/severe group. Conclusions For participants with mild to moderate gradually sloping losses and for those with steeply sloping losses, the UCL – 5 dB and the 2 kHz SL methods resulted in the highest scores without exceeding listeners' UCLs. For participants with moderately severe/severe losses, the UCL - 5 dB method resulted in the highest phoneme recognition scores. PMID:19594086

Using a genetic/clinical risk score to stop smoking (GeTSS): randomised controlled trial.

PubMed

Nichols, John A A; Grob, Paul; Kite, Wendy; Williams, Peter; de Lusignan, Simon

2017-10-23

As genetic tests become cheaper, the possibility of their widespread availability must be considered. This study involves a risk score for lung cancer in smokers that is roughly 50% genetic (50% clinical criteria). The risk score has been shown to be effective as a smoking cessation motivator in hospital recruited subjects (not actively seeking cessation services). This was an RCT set in a United Kingdom National Health Service (NHS) smoking cessation clinic. Smokers were identified from medical records. Subjects that wanted to participate were randomised to a test group that was administered a gene-based risk test and given a lung cancer risk score, or a control group where no risk score was performed. Each group had 8 weeks of weekly smoking cessation sessions involving group therapy and advice on smoking cessation pharmacotherapy and follow-up at 6 months. The primary endpoint was smoking cessation at 6 months. Secondary outcomes included ranking of the risk score and other motivators. 67 subjects attended the smoking cessation clinic. The 6 months quit rates were 29.4%, (10/34; 95% CI 14.1-44.7%) for the test group and 42.9% (12/28; 95% CI 24.6-61.2%) for the controls. The difference is not significant. However, the quit rate for test group subjects with a "very high" risk score was 89% (8/9; 95% CI 68.4-100%) which was significant when compared with the control group (p = 0.023) and test group subjects with moderate risk scores had a 9.5% quit rate (2/21; 95% CI 2.7-28.9%) which was significantly lower than for above moderate risk score 61.5% (8/13; 95% CI 35.5-82.3; p = 0.03). Only the sub-group with the highest risk score showed an increased quit rate. Controls and test group subjects with a moderate risk score were relatively unlikely to have achieved and maintained non-smoker status at 6 months. ClinicalTrials.gov ID NCT01176383 (date of registration: 3 August 2010).

Female Sexual Function Before and After Bariatric Surgery: a Cross-Sectional Study and Review of Literature.

PubMed

Janik, Michał Robert; Bielecka, Ilona; Paśnik, Krzysztof; Kwiatkowski, Andrzej; Podgórska, Ludmiła

2015-08-01

The aims of the present study were to compare sexual quality of life and prevalence of female sexual dysfunction (FSD) after surgical weight loss with controls seeking bariatric surgery, and to perform a literature review. Female Sexual Function Index (FSFI) and Sexual Quality of Life-Female (SQoL-F) questionnaires were sent within 12-18 months postoperatively via e-mail to 153 women who had undergone weight loss surgery (postoperative group). The control group comprised of 23 women who were asked to complete the questionnaires during their preoperative evaluation (preoperative group). The total FSFI cutoff score for a diagnosis of FSD was ≤ 26.55. The median (Q1, Q3) FSFI score did not differ significantly between the preoperative (26.9 [24.3, 30.7]) and postoperative groups (26.9 [22.6, 30.0]). There was no difference in the prevalence of FSD between groups. However, median scores in FSFI domains of desire and arousal were significantly higher in the postoperative group. There were no differences in the other FSFI domains. The median SQoL-F was significantly higher in the postoperative group. The FSFI score did not predict the SQoL-F score. The prevalence of FSD was comparable in the two groups. The higher SQoL-F score in the postoperative group may be the result of an improvement in self-esteem, which in turn leads to greater interest in sex and more intense feelings of desire and arousal.

Motor competency and social communication skills in preschool children with autism spectrum disorder.

PubMed

Craig, Francesco; Lorenzo, Alessandro; Lucarelli, Elisabetta; Russo, Luigi; Fanizza, Isabella; Trabacca, Antonio

2018-06-01

This study aimed to investigate the association between motor competency and social communication in children with Autism Spectrum Disorder (ASD) compared with children with Intellectual Disabilities (ID) and typically developing (TD) children. Motor competency, ASD symptoms, and nonverbal Intelligent Quotient (IQ) were investigated through the following tests: Movement Assessment Battery for Children, second edition (MABC-2), Social Communication Questionnaire (SCQ), Autism Classification System of Functioning: Social Communication (ACSF:SC) and Leiter International Performances Scale Revised (Leiter-R). The ASD + ID and ID groups had lower MABC-2-manual dexterity mean scores, MABC-2-aiming and catching mean scores, MABC-2-static and dynamic balance mean scores and MABC-2-TTS compared with the TD group (P < 0.05). In addition, the ASD + ID group had lower MABC-2-aiming and catching mean scores compared with the ID group. In the ASD + ID group, we found a significant negative correlation (P < 0.001) between MABC-2-aiming and catching scores with SCQ scores, nonverbal IQ and ACSF:SC levels. Our findings provide new insight into the common neuropsychological mechanisms underlying social communication and motor deficits in ASD. Multiple deficits in motor functioning may be present in ASD and ID, however deficits involving the ability to integrate motor and social cues are somewhat specific to ASD. Autism Res 2018, 11: 893-902. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. This study highlighted the specificity of motor impairment in ASD comparing performances on a frequently used measure of motor impairment between clinical groups (ASD + ID and ID) and a non-clinical group. While previous research has suggested that multiple deficits in motor functioning may be present in ASD, our findings suggest that deficits in tasks involving the ability to integrate visual and motor cues (aiming and catching task) are somewhat specific to ASD. © 2018 International Society for Autism Research, Wiley Periodicals, Inc.

[Effects of temporal lobe epilepsy and idiopathic epilepsy on cognitive function and emotion in children].

PubMed

Yang, Xiao-Yan; Long, Li-Li; Xiao, Bo

2016-07-01

To investigate the effects of temporal lobe epilepsy and idiopathic epilepsy on cognitive function and emotion in children and the risk factors for cognitive impairment. A retrospective analysis was performed for the clinical data of 38 children with temporal lobe epilepsy and 40 children with idiopathic epilepsy. The controls were 42 healthy children. All subjects received the following neuropsychological tests: Montreal Cognitive Assessment (MoCA) scale, verbal fluency test, digit span test, block design test, Social Anxiety Scale for Children (SASC), and Depression Self-rating Scale for Children (DSRSC). Compared with the control group, the temporal lobe epilepsy and idiopathic epilepsy groups showed significantly lower scores of MoCA, verbal fluency, digit span, and block design (P<0.05) and significantly higher scores on SASC and DSRSC (P<0.05). Compared with the idiopathic epilepsy group, the temporal lobe epilepsy group showed significantly lower scores of MoCA, verbal fluency, digit span, and block design (P<0.05) and significantly higher scores on SASC and DSRSC (P<0.05). In the temporal lobe epilepsy group, MoCA score was negatively correlated with SASC score, DSRSC score, and seizure frequency (r=-0.571, -0.529, and -0.545 respectively; P<0.01). In the idiopathic epilepsy group, MoCA score was also negatively correlated with SASC score, DSRSC score, and seizure frequency (r=-0.542, -0.487, and -0.555 respectively; P<0.01). Children with temporal lobe epilepsy and idiopathic epilepsy show impaired whole cognition, verbal fluency, memory, and executive function and have anxiety and depression, which are more significant in children with temporal lobe epilepsy. High levels of anxiety, depression, and seizure frequency are risk factors for impaired cognitive function.

Isoflavones, calcium, vitamin D and inulin improve quality of life, sexual function, body composition and metabolic parameters in menopausal women: result from a prospective, randomized, placebo-controlled, parallel-group study.

PubMed

Vitale, Salvatore Giovanni; Caruso, Salvatore; Rapisarda, Agnese Maria Chiara; Cianci, Stefano; Cianci, Antonio

2018-03-01

Menopause results in metabolic changes that contribute to increase risk of cardiovascular diseases: increase in low density lipoprotein (LDL) and triglycerides and decrease in high density lipoprotein (HDL), weight gain are associated with a correspondent increase in incidence of hypertension and diabetes. The aim of this study was to evaluate the effect of a preparation of isoflavones, calcium vitamin D and inulin in menopausal women. We performed a prospective, randomized, placebo-controlled, parallel-group study. A total of 50 patients were randomized to receive either oral preparations of isoflavones (40 mg), calcium (500 mg) vitamin D (300 UI) and inulin (3 g) or placebo (control group). Pre- and post-treatment assessment of quality of life and sexual function were performed through Menopause-Specific Quality of Life Questionnaire (MENQOL) and Female Sexual Function Index (FSFI); evaluations of anthropometric indicators, body composition through bioelectrical impedance analyser, lumbar spine and proximal femur T-score and lipid profile were performed. After 12 months, a significant reduction in MENQOL vasomotor, physical and sexual domain scores ( p < 0.05) and a significant increase in all FSFI domain scores ( p < 0.05) were observed in treatment group. Laboratory tests showed significant increase in serum levels of HDL ( p < 0.05). No significant changes of lumbar spine and femur neck T-score ( p > 0.05) were found in the same group. According to our data analysis, isoflavones, calcium, vitamin D and inulin may exert favourable effects on menopausal symptoms and signs.

Reliable and valid assessment of point-of-care ultrasonography.

PubMed

Todsen, Tobias; Tolsgaard, Martin Grønnebæk; Olsen, Beth Härstedt; Henriksen, Birthe Merete; Hillingsø, Jens Georg; Konge, Lars; Jensen, Morten Lind; Ringsted, Charlotte

2015-02-01

To explore the reliability and validity of the Objective Structured Assessment of Ultrasound Skills (OSAUS) scale for point-of-care ultrasonography (POC US) performance. POC US is increasingly used by clinicians and is an essential part of the management of acute surgical conditions. However, the quality of performance is highly operator-dependent. Therefore, reliable and valid assessment of trainees' ultrasonography competence is needed to ensure patient safety. Twenty-four physicians, representing novices, intermediates, and experts in POC US, scanned 4 different surgical patient cases in a controlled set-up. All ultrasound examinations were video-recorded and assessed by 2 blinded radiologists using OSAUS. Reliability was examined using generalizability theory. Construct validity was examined by comparing performance scores between the groups and by correlating physicians' OSAUS scores with diagnostic accuracy. The generalizability coefficient was high (0.81) and a D-study demonstrated that 1 assessor and 5 cases would result in similar reliability. The construct validity of the OSAUS scale was supported by a significant difference in the mean scores between the novice group (17.0; SD 8.4) and the intermediate group (30.0; SD 10.1), P = 0.007, as well as between the intermediate group and the expert group (72.9; SD 4.4), P = 0.04, and by a high correlation between OSAUS scores and diagnostic accuracy (Spearman ρ correlation coefficient = 0.76; P < 0.001). This study demonstrates high reliability as well as evidence of construct validity of the OSAUS scale for assessment of POC US competence. Hence, the OSAUS scale may be suitable for both in-training as well as end-of-training assessment.

The characteristics of patients with uncertain/mild cognitive impairment on the Alzheimer disease assessment scale-cognitive subscale.

PubMed

Pyo, Geunyeong; Elble, Rodger J; Ala, Thomas; Markwell, Stephen J

2006-01-01

The performances of the uncertain/mild cognitive impairment (MCI) patients on the Alzheimer Disease Assessment Scale-Cognitive (ADAS-Cog) subscale were compared with those of normal controls, Alzheimer disease patients with CDR 0.5, and Alzheimer disease patients with CDR 1.0. The Uncertain/MCI group was significantly different from normal controls and Alzheimer disease CDR 0.5 or 1.0 groups on the ADAS-Cog except on a few non-memory subtests. Age was significantly correlated with total error score in the normal group, but there was no significant correlation between age and ADAS-Cog scores in the patient groups. Education was not significantly correlated with the ADAS-Cog scores in any group. Regardless of age and educational level, there were clear differences between the normal group and the Uncertain/MCI group, especially on the total error scores. We found that the total error score of the ADAS-Cog was the most reliable variable in detecting patients with mild cognitive impairment. The present study demonstrated that the ADAS-Cog is a promising tool for detecting and studying patients with mild cognitive impairment. The results also indicated that demographic variables such as age and education do not play a significant role in the diagnosis of mild cognitive impaired patients based on the ADAS-Cog scores.

Evaluation of the virtual mentor cataract training program.

PubMed

Henderson, Bonnie An; Kim, Jae Yong; Golnik, Karl C; Oetting, Thomas A; Lee, Andrew G; Volpe, Nicholas J; Aaron, Maria; Uhler, Tara A; Arnold, Anthony; Dunn, James P; Prajna, N Venkatesh; Lane, Anne Marie; Loewenstein, John I

2010-02-01

Evaluate the effectiveness of an interactive cognitive computer simulation for teaching the hydrodissection portion of cataract surgery compared with standard teaching and to assess the attitudes of residents about the teaching tools and their perceived confidence in the knowledge gained after using the tools. Case-control study. Residents at academic institutions. Prospective, multicenter, single-masked, controlled trial was performed in 7 academic departments of ophthalmology (Harvard Medical School/Massachusetts Eye and Ear Infirmary, University of Iowa, Emory University, University of Cincinnati, University of Pennsylvania/Scheie Eye Institute, Jefferson Medical College of Thomas Jefferson University/Wills Eye Institute, and the Aravind Eye Institute). All residents from these centers were asked to participate and were randomized into 2 groups. Group A (n = 30) served as the control and received traditional teaching materials; group B (n = 38) received a digital video disc of the Virtual Mentor program. This program is an interactive cognitive simulation, specifically designed to separate cognitive aspects (such as decision making and error recognition) from the motor aspects. Both groups took online anonymous pretests (n = 68) and posttests (n = 58), and answered satisfaction questionnaires (n = 53). Wilcoxon tests were completed to compare pretest and posttest scores between groups. Analysis of variance was performed to assess differences in mean scores between groups. Scores on pretests, posttests, and satisfaction questionnaires. There was no difference in the pretest scores between the 2 groups (P = 0.62). However, group B (Virtual Mentor [VM]) scored significantly higher on the posttest (P = 0.01). Mean difference between pretest and posttest scores were significantly better in the VM group than in the traditional learning group (P = 0.04). Questionnaire revealed that the VM program was "more fun" to use (24.1% vs 4.2%) and residents were more likely to use this type of program again compared with the likelihood of using the traditional tools (58.6% vs 4.2%). The VM, a cognitive computer simulation, augmented teaching of the hydrodissection step of phacoemulsification surgery compared with traditional teaching alone. The program was more enjoyable and more likely to be used repetitively by ophthalmology residents. Copyright (c) 2010 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Baseline neurocognitive testing in sports-related concussions: the importance of a prior night's sleep.

PubMed

McClure, D Jake; Zuckerman, Scott L; Kutscher, Scott J; Gregory, Andrew J; Solomon, Gary S

2014-02-01

The management of sports-related concussions (SRCs) utilizes serial neurocognitive assessments and self-reported symptom inventories to assess recovery and safety for return to play (RTP). Because postconcussive RTP goals include symptom resolution and a return to neurocognitive baseline levels, clinical decisions rest in part on understanding modifiers of this baseline. Several studies have reported age and sex to influence baseline neurocognitive performance, but few have assessed the potential effect of sleep. We chose to investigate the effect of reported sleep duration on baseline Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) performance and the number of patient-reported symptoms. We hypothesized that athletes receiving less sleep before baseline testing would perform worse on neurocognitive metrics and report more symptoms. Cross-sectional study; Level of evidence, 3. We retrospectively reviewed 3686 nonconcussed athletes (2371 male, 1315 female; 3305 high school, 381 college) with baseline symptom and ImPACT neurocognitive scores. Patients were stratified into 3 groups based on self-reported sleep duration the night before testing: (1) short, <7 hours; (2) intermediate, 7-9 hours; and (3) long, ≥9 hours. A multivariate analysis of covariance (MANCOVA) with an α level of .05 was used to assess the influence of sleep duration on baseline ImPACT performance. A univariate ANCOVA was performed to investigate the influence of sleep on total self-reported symptoms. When controlling for age and sex as covariates, the MANCOVA revealed significant group differences on ImPACT reaction time, verbal memory, and visual memory scores but not visual-motor (processing) speed scores. An ANCOVA also revealed significant group differences in total reported symptoms. For baseline symptoms and ImPACT scores, subsequent pairwise comparisons revealed these associations to be most significant when comparing the short and intermediate sleep groups. Our results indicate that athletes sleeping fewer than 7 hours before baseline testing perform worse on 3 of 4 ImPACT scores and report more symptoms. Because SRC management and RTP decisions hinge on the comparison with a reliable baseline evaluation, clinicians should consider sleep duration before baseline neurocognitive testing as a potential factor in the assessment of athletes' recovery.

Selective impairment of decision making under ambiguity in alexithymia.

PubMed

Zhang, Lei; Wang, Xue; Zhu, Yu; Li, Hongchen; Zhu, Chunyan; Yu, Fengqiong; Wang, Kai

2017-11-28

Alexithymia is characterised by difficulties identifying and describing emotions. Few studies have investigated how alexithymia influences decision-making under different conditions (ambiguity and risk). This study aimed to examine whether alexithymia contributes to impairment in decision-making. This study included 42 participants with high scores in the Chinese version of Toronto Alexithymia Scale (alexithymia group), and 44 matched subjects with low scores (control group). Decision-making was measured using the Iowa Gambling Task (IGT) and the Game of Dice Task (GDT). The main findings of this study revealed selective deficits in IGT performance for the alexithymia group, while GDT performance was unimpaired when compared with the control group. In IGT, total netscores were lower for the alexithymia group compared to the control group, particularly with regard to block 5. Moreover, the alexithymia individuals selected significantly more adverse cards than the controls, indicating significant decision-making impairments. Alexithymia selectively influences decision-making under ambiguity.

Do Knee Bracing and Delayed Weight Bearing Affect Mid-Term Functional Outcome after Anterior Cruciate Ligament Reconstruction?

PubMed

Di Miceli, Riccardo; Marambio, Carlotta Bustos; Zati, Alessandro; Monesi, Roberta; Benedetti, Maria Grazia

2017-12-01

Purpose  The aim of this study was to assess the effect of knee bracing and timing of full weight bearing after anterior cruciate ligament reconstruction (ACLR) on functional outcomes at mid-term follow-up. Methods  We performed a retrospective study on 41 patients with ACLR. Patients were divided in two groups: ACLR group, who received isolated ACL reconstruction and ACLR-OI group who received ACL reconstruction and adjunctive surgery. Information about age at surgery, bracing, full or progressive weight bearing permission after surgery were collected for the two groups. Subjective IKDC score was obtained at follow-up. Statistical analysis was performed to compare the two groups for IKDC score. Subgroup analysis was performed to assess the effect of postoperative regimen (knee bracing and weight bearing) on functional outcomes. Results  The mean age of patients was 30.8 ± 10.6 years. Mean IKDC score was 87.4 ± 13.9. The mean follow-up was 3.5 ± 1.8 years. Twenty-two (53.7%) patients underwent ACLR only, while 19 (46.3%) also received other interventions, such as meniscal repair and/or collateral ligament suture. Analysis of overall data showed no differences between the groups for IKDC score. Patients in the ACLR group exhibited a significantly better IKDC score when no brace and full weight bearing after 4 weeks from surgery was prescribed in comparison with patients who worn a brace and had delayed full weight bearing. No differences were found with respect to the use of brace and postoperative weight bearing regimen in the ACLR-OI group. Conclusion  Brace and delayed weight bearing after ACLR have a negative influence on long-term functional outcomes. Further research is required to explore possible differences in the patients operated on ACLR and other intervention with respect to the use of a brace and the timing of full weight bearing to identify optimal recovery strategies. Level of Evidence  Level III, retrospective observational study.

Student-led tutorials in problem-based learning: educational outcomes and students' perceptions.

PubMed

Kassab, Salah; Abu-Hijleh, Marwan F; Al-Shboul, Qasim; Hamdy, Hossam

2005-09-01

The aim of this study was to examine the effectiveness of using students as tutors in a problem-based learning (PBL) medical curriculum. Ninety-one third-year medical students were divided into ten tutorial groups. The groups were randomly allocated into student-led tutorials (SLT) (five groups, n = 44 students) and faculty-led tutorials (FLT) (five groups, n = 47 students). Outcome measurements included assessment of students' performance in tutorials individually and as a group, end-unit examinations scores, assessment of tutoring skills and identifying students' perceptions about peer tutoring. Student tutors were perceived better in providing feedback and in understanding the difficulties students face in tutorials. Tutorial atmosphere, decision-making and support for the group leader were better in SLT compared with FLT groups. Self-assessment of student performance in SLT was not different from FLT. Student scores in the written and practical examinations were comparable in both groups. However, SLT groups found difficulties in analysis of problems presented in the first tutorial session. We conclude that the impact of peer tutoring on student performance in tutorials, group dynamics, and student achievement in examinations is positive overall. However, student tutors require special training before adopting this approach in PBL programs.

A supplemental video teaching tool enhances splinting skills.

PubMed

Mehrpour, Saeed Reza; Aghamirsalim, Mohamadreza; Motamedi, Seyed Mohammad Kalantar; Ardeshir Larijani, Fatemeh; Sorbi, Reza

2013-02-01

The ability to apply casts and splints is a technical skill that requires practice and understanding of basic principles of musculoskeletal medicine. A video in which a given procedure is simulated on a dummy can represent reality under controlled conditions. A decrease in physician competency in musculoskeletal medicine is the result of educational deficiencies at the medical school level. We asked whether (1) a supplemental video educational program enhances performance of medical students' musculoskeletal clinical skills and (2) factors such as the proportion of orthopaedic professors to students, sex, age, and previous scores of medical students affected the clinical skills of medical students. We allocated 474 medical students into one of two groups: all participants received 90 minutes of lecture instruction on how to splint and cast but one group viewed the supplemental instructional video and the other did not. There were no differences in terms of sex, age, basic science exam scores, or grade point average of the groups. Thirteen specific skills in splinting an injured limb were evaluated. We recorded grade point averages. We developed a 10-point scoring system and graded each student on their splinting skills 6 months after the lectures. The medical students who watched the video had an average score of 7.6, whereas the control group's average score was 2.0. We observed a positive association between watching the educational video and clinical exam score. A higher professor-to-student ratio was associated with lower student Objective Structured Clinical Examination score. Our observations suggest a supplemental video instructional program improved the performance of musculoskeletal clinical skills in comparison to only a traditional lecture series.

NBME subject examination in surgery scores correlate with surgery clerkship clinical experience.

PubMed

Myers, Jonathan A; Vigneswaran, Yalini; Gabryszak, Beth; Fogg, Louis F; Francescatti, Amanda B; Golner, Christine; Bines, Steven D

2014-01-01

Most medical schools in the United States use the National Board of Medical Examiners Subject Examinations as a method of at least partial assessment of student performance, yet there is still uncertainty of how well these examination scores correlate with clinical proficiency. Thus, we investigated which factors in a surgery clerkship curriculum have a positive effect on academic achievement on the National Board of Medical Examiners Subject Examination in Surgery. A retrospective analysis of 83 third-year medical students at our institution with 4 unique clinical experiences on the general surgery clerkship for the 2007-2008 academic year was conducted. Records of the United States Medical Licensing Examination Step 1 scores, National Board of Medical Examiners Subject Examination in Surgery scores, and essay examination scores for the groups were compared using 1-way analysis of variance testing. Rush University Medical Center, Chicago IL, an academic institution and tertiary care center. Our data demonstrated National Board of Medical Examiners Subject Examination in Surgery scores from the group with the heavier clinical loads and least time for self-study were statistically higher than the group with lighter clinical services and higher rated self-study time (p = 0.036). However, there was no statistical difference of National Board of Medical Examiners Subject Examination in Surgery scores between the groups with equal clinical loads (p = 0.751). Students experiencing higher clinical volumes on surgical services, but less self-study time demonstrated statistically higher academic performance on objective evaluation, suggesting clinical experience may be of higher value than self-study and reading. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

The effectiveness of computer-assisted instruction in teaching nursing students about congenital heart disease.

PubMed

Rouse, D P

2000-01-01

This study compared the effectiveness of three instructional intervention strategies for teaching nursing students about congenital heart disease (CHD). They are: (1) computer-assisted instruction (CAI), (2) traditional class room lecture (TCL); and (3) the combination of CAI and TCL. The subjects were associate degree nursing (ADN) students enrolled in a pediatric nursing course at the University of Cincinnati Raymond Walters College. Differences between pre- and post-scores on a 20-item multiple choice test were analyzed by analysis of variance. There was a significant improvement in scores for all groups but no significant difference in improvement in scores between the CAI group and the TCL group. The CAI/TCL group showed significant improvement in scores compared with the other two groups. The researcher concluded that when teaching strategies are comparable, CAI is as effective as TCL. Used together, a significant improvement is seen in student performance than when either strategy is used alone.

Outcome following total knee arthroplasty in obese versus non-obese Asian patients.

PubMed

Goh, Graham Seow-Hng; Liow, Ming Han Lincoln; Mitra, Amit Kanta

2015-12-01

To compare the outcome following total knee arthroplasty (TKA) in obese and non-obese Asian patients. 27 obese patients were compared with 27 non-obese controls matched for age, gender, diagnosis (osteoarthritis), prosthesis, preoperative Knee Society knee and function scores, preoperative Oxford Knee Score, and follow-up duration. All TKAs were performed by a single surgeon. Patients were assessed at 6 months and 2 years for the range of motion, Knee Society knee and function scores, Oxford Knee Score, and Short Form-36 Health Survey (SF-36). The obese and non-obese groups did not differ significantly in pre- and post-operative variables: range of motion, Knee Society knee and function scores, Oxford Knee Score, and SF-36 score. Using revision as an end-point, implant survival was 100%. There were no intra- or post-operative complications in either group. Obese and non-obese Asian patients achieved a comparable outcome following TKA.

Modified Team-Based Learning in an Ophthalmology Clerkship in China

PubMed Central

Zhou, Yuxian; Ao, Yong; Xin, Wei; Jia, Yu; Yang, Ying; Cai, Yu; Xu, Chaochao; Yang, Yangfan; Lin, Haotian

2016-01-01

Objective Team-based learning (TBL) is an increasingly popular teaching method in medical education. However, TBL hasn’t been well-studied in the ophthalmology clerkship context. This study was to examine the impact of modified TBL in such context and to assess the student evaluations of TBL. Methods Ninety-nine students of an 8-year clinical medicine program from Zhongshan Ophthalmic Centre, Sun Yat-sen University, were randomly divided into four sequential units and assigned to six teams with the same faculty. The one-week ophthalmology clerkship module included traditional lectures, gross anatomy and a TBL module. The effects of the TBL module on student performance were measured by the Individual Readiness Assurance Test (IRAT), the Group Readiness Assurance Test (GRAT), the Group Application Problem (GAP) and final examination scores (FESs). Students’ evaluations of TBL were measured by a 16-item questionnaire. IRAT and GRAT scores were compared using a paired t-test. One-way analysis of variance (ANOVA) and subgroup analysis compared the effects among quartiles that were stratified by the Basic Ophthalmology Levels (BOLs). The BOLs were evaluated before the ophthalmology clerkship. Results In TBL classes, the GRAT scores were significantly higher than the IRAT scores in both the full example and the BOL-stratified groups. It highlighted the advantages of TBL compared to the individual learning. Quartile-stratified ANOVA comparisons showed significant differences at FES scores (P < 0.01). In terms to IRAT, GRAT and GAP scores, there was no significant result. Moreover, IRAT scores only significantly differed between the first and fourth groups. The FES scores of the first three groups are significantly higher than the fourth group. Gender-specific differences were significant in FES but not the IRAT. Overall, 57.65% of student respondents agreed that TBL was helpful. Male students tended to rate TBL higher than female students. Conclusion The application of modified TBL to the ophthalmology clerkship curriculum improved students’ performance and increased students’ engagement and satisfaction. TBL should be further optimized and developed to enhance the educational outcomes among multi-BOLs medical students. PMID:27100286

Docking and scoring protein complexes: CAPRI 3rd Edition.

PubMed

Lensink, Marc F; Méndez, Raúl; Wodak, Shoshana J

2007-12-01

The performance of methods for predicting protein-protein interactions at the atomic scale is assessed by evaluating blind predictions performed during 2005-2007 as part of Rounds 6-12 of the community-wide experiment on Critical Assessment of PRedicted Interactions (CAPRI). These Rounds also included a new scoring experiment, where a larger set of models contributed by the predictors was made available to groups developing scoring functions. These groups scored the uploaded set and submitted their own best models for assessment. The structures of nine protein complexes including one homodimer were used as targets. These targets represent biologically relevant interactions involved in gene expression, signal transduction, RNA, or protein processing and membrane maintenance. For all the targets except one, predictions started from the experimentally determined structures of the free (unbound) components or from models derived by homology, making it mandatory for docking methods to model the conformational changes that often accompany association. In total, 63 groups and eight automatic servers, a substantial increase from previous years, submitted docking predictions, of which 1994 were evaluated here. Fifteen groups submitted 305 models for five targets in the scoring experiment. Assessment of the predictions reveals that 31 different groups produced models of acceptable and medium accuracy-but only one high accuracy submission-for all the targets, except the homodimer. In the latter, none of the docking procedures reproduced the large conformational adjustment required for correct assembly, underscoring yet again that handling protein flexibility remains a major challenge. In the scoring experiment, a large fraction of the groups attained the set goal of singling out the correct association modes from incorrect solutions in the limited ensembles of contributed models. But in general they seemed unable to identify the best models, indicating that current scoring methods are probably not sensitive enough. With the increased focus on protein assemblies, in particular by structural genomics efforts, the growing community of CAPRI predictors is engaged more actively than ever in the development of better scoring functions and means of modeling conformational flexibility, which hold promise for much progress in the future. (c) 2007 Wiley-Liss, Inc.

Social cognition in bipolar disorder: Focus on emotional intelligence.

PubMed

Varo, C; Jimenez, E; Solé, B; Bonnín, C M; Torrent, C; Valls, E; Morilla, I; Lahera, G; Martínez-Arán, A; Vieta, E; Reinares, M

2017-08-01

The present study aims to characterize emotional intelligence (EI) variability in a sample of euthymic bipolar disorder (BD) patients through the Mayer- Salovey-Caruso Emotional Intelligence Test (MSCEIT). A total of 134 euthymic BD outpatients were recruited and divided into three groups according to the total Emotional Intelligence Quotient (EIQ) score of the MSCEIT, following a statistical criterion of scores 1.5SDs above/below the normative group mean, as follows: a low performance (LP) group (EIQ <85), a normal performance (NP) group (85≤EIQ≤115), and a high performance (HP) group (EIQ >115). Afterwards, main sociodemographic, clinical, functional and neurocognitive variables were compared between the groups. Three groups were identified: 1) LP group (n=16, 12%), 2) NP group (n=93, 69%) and 3) HP group (n=25, 19%). There were significant differences between the groups in premorbid intelligence quotient (IQ) (p=0.010), axis II comorbidity (p=0.008), subthreshold depressive symptoms (p=0.027), general functioning (p=0.013) and in four specific functional domains: autonomy, occupation, interpersonal relations and leisure time. Significant differences in neurocognitive performance were found between groups with the LP group showing the lowest attainments. The cross-sectional design of the study. Our results suggest that EI variability among BD patients, assessed through MSCEIT, is lower than expected. EI could be associated with premorbid IQ, subthreshold depressive symptoms, neurocognitive performance and general functioning. The identification of different profiles of SC may help guide specific interventions for distinct patient subgroups aimed at improving social cognition, neurocognitive performance and psychosocial functioning. Copyright © 2017 Elsevier B.V. All rights reserved.

Lameness scoring system for dairy cows using force plates and artificial intelligence.

PubMed

Ghotoorlar, S Mokaram; Ghamsari, S Mehdi; Nowrouzian, I; Ghotoorlar, S Mokaram; Ghidary, S Shiry

2012-02-04

Lameness scoring is a routine procedure in dairy industry to screen the herds for new cases of lameness. Subjective lameness scoring, which is the most popular lameness detection and screening method in dairy herds, has several limitations. They include low intra-observer and inter-observer agreement and the discrete nature of the scores which limits its usage in monitoring the lameness. The aim of this study is to develop an automated lameness scoring system comparable with conventional subjective lameness scoring by means of artificial neural networks. The system is composed of four balanced force plates installed in a hoof-trimming box. A group of 105 dairy cows was used for the study. Twenty-three features extracted from ground reaction force (GRF) data were used in a computer training process which was performed on 60 per cent of the data. The remaining 40 per cent of the data were used to test the trained system. Repeatability of the lameness scoring system was determined by GRF samples from 25 cows, captured at two different times from the same animals. The mean sd was 0.31 and the mean coefficient of variation was 14.55 per cent, which represents a high repeatability in comparison with subjective vision-based scoring methods. Although the highest sensitivity and specificity values were seen in locomotion score groups 1 and 4, the automatic lameness system was both sensitive and specific in all groups. The sensitivity and specificity were higher than 72 per cent in locomotion score groups 1 to 4, and it was 100 per cent specific and 50 per cent sensitive for group 5.

Neurobiological mechanisms associated with facial affect recognition deficits after traumatic brain injury.

PubMed

Neumann, Dawn; McDonald, Brenna C; West, John; Keiski, Michelle A; Wang, Yang

2016-06-01

The neurobiological mechanisms that underlie facial affect recognition deficits after traumatic brain injury (TBI) have not yet been identified. Using functional magnetic resonance imaging (fMRI), study aims were to 1) determine if there are differences in brain activation during facial affect processing in people with TBI who have facial affect recognition impairments (TBI-I) relative to people with TBI and healthy controls who do not have facial affect recognition impairments (TBI-N and HC, respectively); and 2) identify relationships between neural activity and facial affect recognition performance. A facial affect recognition screening task performed outside the scanner was used to determine group classification; TBI patients who performed greater than one standard deviation below normal performance scores were classified as TBI-I, while TBI patients with normal scores were classified as TBI-N. An fMRI facial recognition paradigm was then performed within the 3T environment. Results from 35 participants are reported (TBI-I = 11, TBI-N = 12, and HC = 12). For the fMRI task, TBI-I and TBI-N groups scored significantly lower than the HC group. Blood oxygenation level-dependent (BOLD) signals for facial affect recognition compared to a baseline condition of viewing a scrambled face, revealed lower neural activation in the right fusiform gyrus (FG) in the TBI-I group than the HC group. Right fusiform gyrus activity correlated with accuracy on the facial affect recognition tasks (both within and outside the scanner). Decreased FG activity suggests facial affect recognition deficits after TBI may be the result of impaired holistic face processing. Future directions and clinical implications are discussed.

A randomized controlled study of manikin simulator fidelity on neonatal resuscitation program learning outcomes.

PubMed

Curran, Vernon; Fleet, Lisa; White, Susan; Bessell, Clare; Deshpandey, Akhil; Drover, Anne; Hayward, Mark; Valcour, James

2015-03-01

The neonatal resuscitation program (NRP) has been developed to educate physicians and other health care providers about newborn resuscitation and has been shown to improve neonatal resuscitation skills. Simulation-based training is recommended as an effective modality for instructing neonatal resuscitation and both low and high-fidelity manikin simulators are used. There is limited research that has compared the effect of low and high-fidelity manikin simulators for NRP learning outcomes, and more specifically on teamwork performance and confidence. The purpose of this study was to examine the effect of using low versus high-fidelity manikin simulators in NRP instruction. A randomized posttest-only control group study design was conducted. Third year undergraduate medical students participated in NRP instruction and were assigned to an experimental group (high-fidelity manikin simulator) or control group (low-fidelity manikin simulator). Integrated skills station (megacode) performance, participant satisfaction, confidence and teamwork behaviour scores were compared between the study groups. Participants in the high-fidelity manikin simulator instructional group reported significantly higher total scores in overall satisfaction (p = 0.001) and confidence (p = 0.001). There were no significant differences in teamwork behaviour scores, as observed by two independent raters, nor differences on mandatory integrated skills station performance items at the p < 0.05 level. Medical students' reported greater satisfaction and confidence with high-fidelity manikin simulators, but did not demonstrate overall significantly improved teamwork or integrated skills station performance. Low and high-fidelity manikin simulators facilitate similar levels of objectively measured NRP outcomes for integrated skills station and teamwork performance.

Quantitative calcaneal ultrasound parameters and bone mineral density at final height in girls treated with depot gonadotrophin-releasing hormone agonist for central precocious puberty or idiopathic short stature.

PubMed

Kapteijns-van Kordelaar, Simone; Noordam, Kees; Otten, Barto; van den Bergh, Joop

2003-11-01

To evaluate the effect of gonadotrophin-releasing hormone (GnRH) agonist treatment on bone quality at final height, we studied girls with central precocious puberty (CPP) and with idiopathic short stature (ISS). A total of 25 Caucasian girls were included: group A (n=14) with idiopathic CPP (mean age at start 7.4 years) and group B (n=11) with ISS (mean age at start 11.7 years). Treatment duration was 3.8 and 1.7 years respectively. The quantitative ultrasound parameters (QUS) broadband ultrasound attenuation (BUA) and speed of sound (SOS) were measured at the calcaneus (UBIS 3000 device). Lumbar spine bone mineral density (BMD; L2-L4) was measured by dual energy X-ray absorptiometry (DXA) (Hologic QDR1000). Measurements were performed at final height and expressed as Z-scores corrected for bone age. Mean Z-scores of QUS parameters, areal BMD and volumetric BMD (BMDvol) were above -1 in both groups (group A: BUA Z-score -0.21, SOS Z-score -0.29, BMD Z-score 0.02, BMDvol Z-score 0.05, group B: BUA Z-score -0.93, SOS Z-score -0.40, BMD Z-score -0.86, BMDvol Z-score -0.68), although mean Z-scores of BUA and areal BMD in group B were significantly different from zero (P=0.03 and P=0.02 respectively). Mean Z-score BMDvol was not significantly different from zero (P=0.05), we found no significant difference between the groups for BMDvol (P=0.13). Although quantitative ultrasound parameters parameters and bone mineral density were normal in girls with central precocious puberty at final height after gonadotrophin-releasing hormone agonist treatment, mean Z-score for broadband ultrasound attenuation and areal bone mineral density were significantly different from zero and mean Z-score for volumetric bone mineral density was (just) not significantly different from zero in idiopathic short stature girls with normal puberty treated with gonadotrophin-releasing hormone agonists. Therefore we cannot say that this treatment is safe in these girls with regard to bone health.

New reference values for the Alberta Infant Motor Scale need to be established.

PubMed

Fleuren, K M W; Smit, L S; Stijnen, Th; Hartman, A

2007-03-01

The Alberta Infant Motor Scale (AIMS) is an infant developmental test, which can be used to evaluate motor performance from birth to independent walking. Between 1990 and 1992 Piper and Darrah determined reference values in a cohort in Canada. To our knowledge no study has been carried out to determine whether the Canadian data are representative for other countries. In the present study we aimed to establish whether the AIMS test needs new reference values for Dutch children. Motor performance of 100 Dutch children, aged 0-12 months, was measured using the AIMS test. The mean percentile score of the Dutch children was 28.8 (+/-22.9, range 1-85). The percentile scores of the group were significantly lower than scores of the Canadian norm population (p < 0.001), whereby 75% of the Dutch children scored below the 50th percentile. These lower scores were not be explained by sex, racial differences or congenital disorders and were seen in all age groups. We conclude that new reference values on the AIMS test for the age group of 0-12 months need to be established for Dutch children. It is recommended that the need for new normative data is also determined in all other European countries.

The novel EuroSCORE II algorithm predicts the hospital mortality of thoracic aortic surgery in 461 consecutive Japanese patients better than both the original additive and logistic EuroSCORE algorithms.

PubMed

Nishida, Takahiro; Sonoda, Hiromichi; Oishi, Yasuhisa; Tanoue, Yoshihisa; Nakashima, Atsuhiro; Shiokawa, Yuichi; Tominaga, Ryuji

2014-04-01

The European System for Cardiac Operative Risk Evaluation (EuroSCORE) II was developed to improve the overestimation of surgical risk associated with the original (additive and logistic) EuroSCOREs. The purpose of this study was to evaluate the significance of the EuroSCORE II by comparing its performance with that of the original EuroSCOREs in Japanese patients undergoing surgery on the thoracic aorta. We have calculated the predicted mortalities according to the additive EuroSCORE, logistic EuroSCORE and EuroSCORE II algorithms in 461 patients who underwent surgery on the thoracic aorta during a period of 20 years (1993-2013). The actual in-hospital mortality rates in the low- (additive EuroSCORE of 3-6), moderate- (7-11) and high-risk (≥11) groups (followed by overall mortality) were 1.3, 6.2 and 14.4% (7.2% overall), respectively. Among the three different risk groups, the expected mortality rates were 5.5 ± 0.6, 9.1 ± 0.7 and 13.5 ± 0.2% (9.5 ± 0.1% overall) by the additive EuroSCORE algorithm, 5.3 ± 0.1, 16 ± 0.4 and 42.4 ± 1.3% (19.9 ± 0.7% overall) by the logistic EuroSCORE algorithm and 1.6 ± 0.1, 5.2 ± 0.2 and 18.5 ± 1.3% (7.4 ± 0.4% overall) by the EuroSCORE II algorithm, indicating poor prediction (P < 0.0001) of the mortality in the high-risk group, especially by the logistic EuroSCORE. The areas under the receiver operating characteristic curves of the additive EuroSCORE, logistic EuroSCORE and EuroSCORE II algorithms were 0.6937, 0.7169 and 0.7697, respectively. Thus, the mortality expected by the EuroSCORE II more closely matched the actual mortality in all three risk groups. In contrast, the mortality expected by the logistic EuroSCORE overestimated the risks in the moderate- (P = 0.0002) and high-risk (P < 0.0001) patient groups. Although all of the original EuroSCOREs and EuroSCORE II appreciably predicted the surgical mortality for thoracic aortic surgery in Japanese patients, the EuroSCORE II best predicted the mortalities in all risk groups.

Cognitive decline and slower reaction time in elderly individuals with mild cognitive impairment.

PubMed

Chen, Ko-Chia; Weng, Chia-Ying; Hsiao, Sigmund; Tsao, Wen-Long; Koo, Malcolm

2017-11-01

The relationship between declining performance, as measured by changes in reaction time, and declining cognitive function has not been critically studied. The aim of the present study was to investigate the association between reaction time during a task and cognitive ability in elderly Taiwanese individuals. Patients aged 65 years or older with mild cognitive impairment (MCI) (n = 33) and Alzheimer's disease (n = 26) were recruited from the neurology clinic of a regional hospital in southern Taiwan. In addition, 28 healthy controls aged 65 years or older were recruited from the community. The cognitive performance of the study participants was assessed using the Cognitive Abilities Screening Instrument (CASI). A computer-administered simple reaction time (SRT) task and a flanker reaction time (FRT) task were administered to assess participants' cognitive function. A non-parametric Kruskal-Wallis test was performed to compare CASI scores, SRT, and FRT among the three groups. anova was also used to compare CASI scores, inverse-transformed SRT, and inverse-transformed FRT among the three groups, with adjustment for age and years of education. Additionally, Pearson's partial correlation coefficients were used to assess the association of CASI scores with inverse-transformed SRT, and inverse-transformed FRT within each of the three groups. Significant differences in CASI scores, SRT, and FRT were found between the Alzheimer's disease group and the other two groups, either with or without adjustment for age or education. The reaction time of patients with Alzheimer's disease was significantly slower than the other two groups. Moreover, significant correlation between CASI and FRT was found in patients with MCI. Altered performance in a speed task was observed in patients with MCI. The FRT task should further be explored for its role as a marker for cognitive decline in elderly individuals, particularly in those with MCI. © 2017 Japanese Psychogeriatric Society.

Designing and Evaluating an Interactive Multimedia Web-Based Simulation for Developing Nurses’ Competencies in Acute Nursing Care: Randomized Controlled Trial

PubMed Central

Wong, Lai Fun; Chan, Sally Wai-Chi; Ho, Jasmine Tze Yin; Mordiffi, Siti Zubaidah; Ang, Sophia Bee Leng; Goh, Poh Sun; Ang, Emily Neo Kim

2015-01-01

Background Web-based learning is becoming an increasingly important instructional tool in nursing education. Multimedia advancements offer the potential for creating authentic nursing activities for developing nursing competency in clinical practice. Objective This study aims to describe the design, development, and evaluation of an interactive multimedia Web-based simulation for developing nurses’ competencies in acute nursing care. Methods Authentic nursing activities were developed in a Web-based simulation using a variety of instructional strategies including animation video, multimedia instructional material, virtual patients, and online quizzes. A randomized controlled study was conducted on 67 registered nurses who were recruited from the general ward units of an acute care tertiary hospital. Following a baseline evaluation of all participants’ clinical performance in a simulated clinical setting, the experimental group received 3 hours of Web-based simulation and completed a survey to evaluate their perceptions of the program. All participants were re-tested for their clinical performances using a validated tool. Results The clinical performance posttest scores of the experimental group improved significantly (P<.001) from the pretest scores after the Web-based simulation. In addition, compared to the control group, the experimental group had significantly higher clinical performance posttest scores (P<.001) after controlling the pretest scores. The participants from the experimental group were satisfied with their learning experience and gave positive ratings for the quality of the Web-based simulation. Themes emerging from the comments about the most valuable aspects of the Web-based simulation include relevance to practice, instructional strategies, and fostering problem solving. Conclusions Engaging in authentic nursing activities using interactive multimedia Web-based simulation can enhance nurses’ competencies in acute care. Web-based simulations provide a promising educational tool in institutions where large groups of nurses need to be trained in acute nursing care and accessibility to repetitive training is essential for achieving long-term retention of clinical competency. PMID:25583029

Designing and evaluating an interactive multimedia Web-based simulation for developing nurses' competencies in acute nursing care: randomized controlled trial.

PubMed

Liaw, Sok Ying; Wong, Lai Fun; Chan, Sally Wai-Chi; Ho, Jasmine Tze Yin; Mordiffi, Siti Zubaidah; Ang, Sophia Bee Leng; Goh, Poh Sun; Ang, Emily Neo Kim

2015-01-12

Web-based learning is becoming an increasingly important instructional tool in nursing education. Multimedia advancements offer the potential for creating authentic nursing activities for developing nursing competency in clinical practice. This study aims to describe the design, development, and evaluation of an interactive multimedia Web-based simulation for developing nurses' competencies in acute nursing care. Authentic nursing activities were developed in a Web-based simulation using a variety of instructional strategies including animation video, multimedia instructional material, virtual patients, and online quizzes. A randomized controlled study was conducted on 67 registered nurses who were recruited from the general ward units of an acute care tertiary hospital. Following a baseline evaluation of all participants' clinical performance in a simulated clinical setting, the experimental group received 3 hours of Web-based simulation and completed a survey to evaluate their perceptions of the program. All participants were re-tested for their clinical performances using a validated tool. The clinical performance posttest scores of the experimental group improved significantly (P<.001) from the pretest scores after the Web-based simulation. In addition, compared to the control group, the experimental group had significantly higher clinical performance posttest scores (P<.001) after controlling the pretest scores. The participants from the experimental group were satisfied with their learning experience and gave positive ratings for the quality of the Web-based simulation. Themes emerging from the comments about the most valuable aspects of the Web-based simulation include relevance to practice, instructional strategies, and fostering problem solving. Engaging in authentic nursing activities using interactive multimedia Web-based simulation can enhance nurses' competencies in acute care. Web-based simulations provide a promising educational tool in institutions where large groups of nurses need to be trained in acute nursing care and accessibility to repetitive training is essential for achieving long-term retention of clinical competency.

Premedical special master’s programs increase USMLE STEP1 scores and improve residency placements

PubMed Central

Khuder, Sadik

2017-01-01

The effectiveness of Special Master’s Programs (SMPs) in benefiting a potential medical student’s career beyond admission into an MD-program is largely unknown. This study aims to evaluate the role of SMPs, if any, in affecting the performance and outcomes of students during their medical school career. This study analyzed anonymous surveys of students and residents from the University of Toledo. The data analysis is used to evaluate a student’s academic performance before, during and after medical school. Measured metrics included: MCAT Scores, undergraduate GPA, USMLE STEP 1 scores, participation in research, number of research publications, and residency placement. Of 500 people surveyed 164 medical students or residents responded. Based on their responses, the respondents were divided into traditional (non-SMP) and SMP groups. As anticipated, MCAT scores (SMP: 29.82 vs. traditional 31.10) are significantly (p<0.05) different between the two groups. Interestingly, there is no significant difference in USMLE STEP 1 scores (SMP: 232.7 vs. traditional: 233.8) and when normalized relative to MCAT scores, USMLE STEP 1 scores for SMP-students are significantly (p<0.05) higher than their traditional counterparts (p<0.05). Additionally, SMP-students did not outperform the traditional students with regards to research publications. But, they did demonstrate a significant (p<0.05) proclivity towards surgical residencies when compared to the traditional students. Overall, our results highlight that SMPs potentiate USMLE STEP 1 performance and competitive residency-placements for its students. PMID:29190691

Influence of compressive gear on powerlifting performance: role of blood flow restriction training.

PubMed

Godawa, Travis M; Credeur, Daniel P; Welsch, Michael A

2012-05-01

This study investigated the effects of powerlifting gear on training volume and performance, defined by the squat, bench press, and deadlift. Eighteen powerlifters (18-26 years) were randomized into either a group that trained and competed using compressive gear (CG) or without the gear (NON). Training volume, volume progression, and powerlifting performance were assessed before and after 10 weeks of training. Training volume increased in the first 4 weeks for both groups. Volume lifted for squat and the totals were greater in the CG. There was an increase in squat (19.05 ± 30.97 lb, p = 0.02), deadlift (19.05 ± 21.17 lb, p = 0.001), and the total score (44.00 ± 60.44 lb, p = 0.005) for both the groups. The improvements in squat (CG = 33.85 vs. NON = 5.74, p = 0.07) and totals (CG = 66.59 vs. NON = 23.67, p = 0.15) were greater in the CG. Both groups showed a significant and similar increase in the Wilks scores (+13.54 points, p = 0.03). There was a trend toward greater volume progression in those wearing CG during the initial stages of training. Both the groups significantly improved performance for the squat, and deadlift, and had higher totals, and Wilks scores, indicating significant strength gains. The greater magnitude of improvements in the squat and totals for the CG lifters suggests an ergogenic potential of training with powerlifting gear.

Neurocognitive functions and brain atrophy after proven neuroborreliosis: a case-control study.

PubMed

Schmidt, Holger; Djukic, Marija; Jung, Klaus; Holzgraefe, Manfred; Dechent, Peter; von Steinbüchel, Nicole; Blocher, Joachim; Eiffert, Helmut; Schmidt-Samoa, Carsten

2015-08-19

Patients often report neurocognitive difficulties after neuroborreliosis (NB). The frequency and extent of cognitive problems in European patients have been studied incompletely. Sixty patients received a neurological and neuropsychological work-up 6 months or longer after treatment for proven NB. Quality of life, psychiatric symptom load, and brain atrophy were measured. All results were compared with a group of 30 healthy control persons adapted for age, gender and education being serologically negative for Borrelia burgdorferi senso latu. A cognitive sum score and a global sum score including cognitive, psychological results and quality of life data was calculated for both groups. Patients after NB showed a lower (i.e. more impaired) score on the Scripps Neurological rating scale (SNRS), but the observed neurological deficits were generally mild (mean ± SD: 97.1 ± 4.7 vs. 99.1 ± 2.4, p = 0.02). The mean neuropsychological domain results of the NB group were all within the normal range. However, a lower performance was found for the frontal executive function z-values (mean ± SD -0.29 ± 0.60 vs. 0.09 ± 0.60; p = 0.0059) of NB patients. Comparing the global sum score (mean ± SD 11.3 ± 4.2 NB vs. 14.3 ± 2.9 control , p = 0.001) and the cognitive sum score of the NB group with those of the control group (mean ± SD -0.15 ± 0.42 NB vs. 0.08 ± 0.31 control , p = 0.0079), both differences were statistically different. The frequencies of impaired global sum scores and those of the pathological cognitive sum scores (p = 0.07) did not differ statistically. No significant differences were found for health-related quality of life (hrQoL), sleep, psychiatric symptom load, or brain atrophy. The mean cognitive functions of patients after proven NB were in the normal range. However, we were able to demonstrate a lower performance for the domain of frontal executive functions, for the mean cognitive sum score and the global sum score as a sign of subtle but measurable sequelae of neuroborreliosis. Brain atrophy is not a common consequence of neuroborreliosis.

Test-retest reliability and minimal detectable change scores for the timed "up & go" test, the six-minute walk test, and gait speed in people with Alzheimer disease.

PubMed

Ries, Julie D; Echternach, John L; Nof, Leah; Gagnon Blodgett, Michelle

2009-06-01

With the increasing incidence of Alzheimer disease (AD), determining the validity and reliability of outcome measures for people with this disease is necessary. The goals of this study were to assess test-retest reliability of data for the Timed "Up & Go" Test (TUG), the Six-Minute Walk Test (6MWT), and gait speed and to calculate minimal detectable change (MDC) scores for each outcome measure. Performance differences between groups with mild to moderate AD and moderately severe to severe AD (as determined by the Functional Assessment Staging [FAST] scale) were studied. This was a prospective, nonexperimental, descriptive methodological study. Background data collected for 51 people with AD included: use of an assistive device, Mini-Mental Status Examination scores, and FAST scale scores. Each participant engaged in 2 test sessions, separated by a 30- to 60-minute rest period, which included 2 TUG trials, 1 6MWT trial, and 2 gait speed trials using a computerized gait assessment system. A specific cuing protocol was followed to achieve optimal performance during test sessions. Test-retest reliability values for the TUG, the 6MWT, and gait speed were high for all participants together and for the mild to moderate AD and moderately severe to severe AD groups separately (intraclass correlation coefficients > or = .973); however, individual variability of performance also was high. Calculated MDC scores at the 90% confidence interval were: TUG=4.09 seconds, 6MWT=33.5 m (110 ft), and gait speed=9.4 cm/s. The 2 groups were significantly different in performance of clinical tests, with the participants who were more cognitively impaired being more physically and functionally impaired. A single researcher for data collection limited sample numbers and prohibited blinding to dementia level. The TUG, the 6MWT, and gait speed are reliable outcome measures for use with people with AD, recognizing that individual variability of performance is high. Minimal detectable change scores at the 90% confidence interval can be used to assess change in performance over time and the impact of treatment.

Collaborative Test Reviews: Student Performance

ERIC Educational Resources Information Center

Bhatia, Anuradha; Makela, Carole J.

2010-01-01

A group study method proved helpful in improving senior-level students' performance on unit tests through collaborative learning. Students of a History of Textiles course voluntarily attended study sessions to review course content and prepare for unit tests. The students who attended the group reviews scored better on tests than those who did…

PISA Mathematics and Reading Performance Differences of Mainstream European and Turkish Immigrant Students

ERIC Educational Resources Information Center

Arikan, Serkan; van de Vijver, Fons J. R.; Yagmur, Kutlay

2017-01-01

Lower reading and mathematics performance of Turkish immigrant students as compared to mainstream European students could reflect differential learning outcomes, differential socioeconomic backgrounds of the groups, differential mainstream language proficiency, and/or test bias. Using PISA reading and mathematics scores of these groups, we…

Low Vision Rehabilitation for Adult African Americans in Two Settings.

PubMed

Draper, Erin M; Feng, Rui; Appel, Sarah D; Graboyes, Marcy; Engle, Erin; Ciner, Elise B; Ellenberg, Jonas H; Stambolian, Dwight

2016-07-01

The Vision Rehabilitation for African Americans with Central Vision Impairment (VISRAC) study is a demonstration project evaluating how modifications in vision rehabilitation can improve the use of functional vision. Fifty-five African Americans 40 years of age and older with central vision impairment were randomly assigned to receive either clinic-based (CB) or home-based (HB) low vision rehabilitation services. Forty-eight subjects completed the study. The primary outcome was the change in functional vision in activities of daily living, as assessed with the Veteran's Administration Low-Vision Visual Function Questionnaire (VFQ-48). This included scores for overall visual ability and visual ability domains (reading, mobility, visual information processing, and visual motor skills). Each score was normalized into logit estimates by Rasch analysis. Linear regression models were used to compare the difference in the total score and each domain score between the two intervention groups. The significance level for each comparison was set at 0.05. Both CB and HB groups showed significant improvement in overall visual ability at the final visit compared with baseline. The CB group showed greater improvement than the HB group (mean of 1.28 vs. 0.87 logits change), though the group difference is not significant (p = 0.057). The CB group visual motor skills score showed significant improvement over the HB group score (mean of 3.30 vs. 1.34 logits change, p = 0.044). The differences in improvement of the reading and visual information processing scores were not significant (p = 0.054 and p = 0.509) between groups. Neither group had significant improvement in the mobility score, which was not part of the rehabilitation program. Vision rehabilitation is effective for this study population regardless of location. Possible reasons why the CB group performed better than the HB group include a number of psychosocial factors as well as the more standardized distraction-free work environment within the clinic setting.

The Arthroscopic Surgical Skill Evaluation Tool (ASSET).

PubMed

Koehler, Ryan J; Amsdell, Simon; Arendt, Elizabeth A; Bisson, Leslie J; Braman, Jonathan P; Bramen, Jonathan P; Butler, Aaron; Cosgarea, Andrew J; Harner, Christopher D; Garrett, William E; Olson, Tyson; Warme, Winston J; Nicandri, Gregg T

2013-06-01

Surgeries employing arthroscopic techniques are among the most commonly performed in orthopaedic clinical practice; however, valid and reliable methods of assessing the arthroscopic skill of orthopaedic surgeons are lacking. The Arthroscopic Surgery Skill Evaluation Tool (ASSET) will demonstrate content validity, concurrent criterion-oriented validity, and reliability when used to assess the technical ability of surgeons performing diagnostic knee arthroscopic surgery on cadaveric specimens. Cross-sectional study; Level of evidence, 3. Content validity was determined by a group of 7 experts using the Delphi method. Intra-articular performance of a right and left diagnostic knee arthroscopic procedure was recorded for 28 residents and 2 sports medicine fellowship-trained attending surgeons. Surgeon performance was assessed by 2 blinded raters using the ASSET. Concurrent criterion-oriented validity, interrater reliability, and test-retest reliability were evaluated. Content validity: The content development group identified 8 arthroscopic skill domains to evaluate using the ASSET. Concurrent criterion-oriented validity: Significant differences in the total ASSET score (P < .05) between novice, intermediate, and advanced experience groups were identified. Interrater reliability: The ASSET scores assigned by each rater were strongly correlated (r = 0.91, P < .01), and the intraclass correlation coefficient between raters for the total ASSET score was 0.90. Test-retest reliability: There was a significant correlation between ASSET scores for both procedures attempted by each surgeon (r = 0.79, P < .01). The ASSET appears to be a useful, valid, and reliable method for assessing surgeon performance of diagnostic knee arthroscopic surgery in cadaveric specimens. Studies are ongoing to determine its generalizability to other procedures as well as to the live operating room and other simulated environments.

Longitudinal Analysis of Music Education on Executive Functions in Primary School Children

PubMed Central

Jaschke, Artur C.; Honing, Henkjan; Scherder, Erik J. A.

2018-01-01

Background: Research on the effects of music education on cognitive abilities has generated increasing interest across the scientific community. Nonetheless, longitudinal studies investigating the effects of structured music education on cognitive sub-functions are still rare. Prime candidates for investigating a relationship between academic achievement and music education appear to be executive functions such as planning, working memory, and inhibition. Methods: One hundred and forty-seven primary school children, Mage = 6.4 years, SD = 0.65 were followed for 2.5 years. Participants were randomized into four groups: two music intervention groups, one active visual arts group, and a no arts control group. Neuropsychological tests assessed verbal intelligence and executive functions. Additionally, a national pupil monitor provided data on academic performance. Results: Children in the visual arts group perform better on visuospatial memory tasks as compared to the three other conditions. However, the test scores on inhibition, planning and verbal intelligence increased significantly in the two music groups over time as compared to the visual art and no arts controls. Mediation analysis with executive functions and verbal IQ as mediator for academic performance have shown a possible far transfer effect from executive sub-function to academic performance scores. Discussion: The present results indicate a positive influence of long-term music education on cognitive abilities such as inhibition and planning. Of note, following a two-and-a-half year long visual arts program significantly improves scores on a visuospatial memory task. All results combined, this study supports a far transfer effect from music education to academic achievement mediated by executive sub-functions. PMID:29541017

Longitudinal Analysis of Music Education on Executive Functions in Primary School Children.

PubMed

Jaschke, Artur C; Honing, Henkjan; Scherder, Erik J A

2018-01-01

Background: Research on the effects of music education on cognitive abilities has generated increasing interest across the scientific community. Nonetheless, longitudinal studies investigating the effects of structured music education on cognitive sub-functions are still rare. Prime candidates for investigating a relationship between academic achievement and music education appear to be executive functions such as planning, working memory, and inhibition. Methods: One hundred and forty-seven primary school children, M age = 6.4 years, SD = 0.65 were followed for 2.5 years. Participants were randomized into four groups: two music intervention groups, one active visual arts group, and a no arts control group. Neuropsychological tests assessed verbal intelligence and executive functions. Additionally, a national pupil monitor provided data on academic performance. Results: Children in the visual arts group perform better on visuospatial memory tasks as compared to the three other conditions. However, the test scores on inhibition, planning and verbal intelligence increased significantly in the two music groups over time as compared to the visual art and no arts controls. Mediation analysis with executive functions and verbal IQ as mediator for academic performance have shown a possible far transfer effect from executive sub-function to academic performance scores. Discussion: The present results indicate a positive influence of long-term music education on cognitive abilities such as inhibition and planning. Of note, following a two-and-a-half year long visual arts program significantly improves scores on a visuospatial memory task. All results combined, this study supports a far transfer effect from music education to academic achievement mediated by executive sub-functions.

Operational Consequences of Literacy Gap.

DTIC Science & Technology

1980-05-01

Comprehension Scores on the Safety and Sanitation Content 37 11. Statistics on Experimental Groups’ Performance by Sex and Content 37 12. Analysis of...Variance of Experimental Groups by Sex and Content 38 13. Mean Comprehension Scores Broken Down by Content, Subject RGL and Reading Time 39 14. Analysis...ratings along a scale of difficulty which parallels the school grade scale. Burkett (1975) and Klare (1963; 1974-1975) provide summaries of the extensive

A simple strategy to reduce stereotype threat for orthopedic residents.

PubMed

Gomez, Everlyne; Wright, James G

2014-04-01

Stereotype threat, defined as the predicament felt by people in either positive or negative learning experiences where they could conform to negative stereotypes associated with their own group membership, can interfere with learning. The purpose of this study was to determine if a simple orientation session could reduce stereotype threat for orthopedic residents. The intervention group received an orientation on 2 occasions focusing on their possible responses to perceived poor performance in teaching rounds and the operating room (OR). Participants completed a survey with 7 questions typical for stereotype threat evaluating responses to their experiences. The questions had 7 response options with a maximum total score of 49, where higher scores indicated greater degree of experiences typical of stereotype threat. Of the 84 eligible residents, 49 participated: 22 in the nonintervention and 27 in the intervention group. The overall scores were 29 and 29.4, and 26.2 and 25.8 in the nonintervention and intervention groups for their survey responses to perceived poor performance in teaching rounds (p = 0.85) and the OR (p = 0.84), respectively. Overall, responses typical of stereotype threat were greater for perceived poor performance at teaching rounds than in the OR (p = 0.001). Residents experience low self-esteem following perceived poor performance, particularly at rounds. A simple orientation designed to reduce stereotype threat was unsuccessful in reducing this threat overall. Future research will need to consider longer-term intervention as possible strategies to reduce perceived poor performance at teaching rounds and in the OR.

The impact of using standardized patients in psychiatric cases on the levels of motivation and perceived learning of the nursing students.

PubMed

Sarikoc, Gamze; Ozcan, Celale Tangul; Elcin, Melih

2017-04-01

The use of standardized patients is not very common in psychiatric nursing education and there has been no study conducted in Turkey. This study evaluated the impact of using standardized patients in psychiatric cases on the levels of motivation and perceived learning of the nursing students. This manuscript addressed the quantitative aspect of a doctoral thesis study in which both quantitative and qualitative methods were used. A pre-test and post-test were employed in the quantitative analysis in a randomized and controlled study design. The motivation scores, and interim and post-test scores for perceived learning were higher in the experimental group compared to pre-test scores and the scores of the control group. The students in the experimental group reported that they felt more competent about practical training in clinical psychiatry, as well as in performing interviews with patients having mental problems, and reported less anxiety about performing an interview when compared to students in the control group. It is considered that the inclusion of standardized patient methodology in the nursing education curriculum in order to improve the knowledge level and skills of students would be beneficial in the training of mental health nurses. Copyright © 2017 Elsevier Ltd. All rights reserved.

The impact of prematurity and maternal socioeconomic status and education level on achievement-test scores up to 8th grade.

PubMed

ElHassan, Nahed O; Bai, Shasha; Gibson, Neal; Holland, Greg; Robbins, James M; Kaiser, Jeffrey R

2018-01-01

The relative influence of prematurity vs. maternal social factors (socioeconomic status and education level) on academic performance has rarely been examined. To examine the impact of prematurity and maternal social factors on academic performance from 3rd through 8th grade. We conducted a retrospective cohort study of infants born in 1998 at the University of Arkansas for Medical Sciences. The study sample included 58 extremely low gestational age newborns (ELGANs, 23‒<28 weeks), 171 preterm (≥28‒<34 weeks), 228 late preterm (≥34‒<37 weeks), and 967 term ((≥37‒<42 weeks) infants. Neonatal and maternal variables were collected including maternal insurance status (proxy measure for socioeconomic status) and education level. The primary outcomes were literacy and mathematics achievement-test scores from 3rd through 8th grade. Linear mixed models were used to identify significant predictors of academic performance. All two-way interactions between grade level, gestational-age (GA) groups, and social factors were tested for statistical significance. Prematurity, social factors, gender, race, gravidity, and Apgar score at one minute were critical determinants of academic performance. Favorable social factors were associated with a significant increase in both literacy and mathematic scores, while prematurity was associated with a significant decrease in mathematic scores. Examination of GA categories and social factors interaction suggested that the impact of social factors on test scores was similar for all GA groups. Furthermore, the impact of social factors varied from grade to grade for literacy, while the influence of either GA groups or social factors was constant across grades for mathematics. For example, an ELGAN with favorable social factors had a predicted literacy score 104.1 (P <.001), 98.2 (P <.001), and 76.4 (P <.01) points higher than an otherwise similar disadvantaged term infant at grades 3, 5, and 8, respectively. The difference in their predicted mathematic scores was 33.4 points for all grades (P <.05). While there were significant deficits in academic performance for ELGANs compared to PT, LPT, and term infants, the deficit could be offset by higher SES and better-educated mothers. These favorable social factors were critical to a child's academic achievement. The role of socioeconomic factors should be incorporated in discussions on outcome with families of preterm infants.

Changes in balance in older adults based on use of physical therapy vs the Wii Fit gaming system: a preliminary study.

PubMed

Bateni, Hamid

2012-09-01

To determine the effectiveness of Wii Fit training on balance control in older adults compared with physical therapy training. Quasi-experimental design. Eight males and nine females aged 53 to 91 years. Participants were divided into three groups: one group received both physical therapy training and Wii Fit training (PW group), one group received Wii Fit training alone (WI group), and one group received physical therapy training alone (PT group). Training consisted of three sessions per week for 4 weeks. Berg Balance Scale (all groups) and Bubble Test (PW and WI groups) scores. Descriptive statistics, medians, interquartile ranges and 95% confidence intervals are reported to identify trends in balance control as a result of different types of training. All subjects showed improvement in the Berg Balance Scale and Bubble Test scores. The PT and PW groups tended to perform better than the WI group on the Berg Balance Scale following treatment. Although the differences in the Bubble Test score were not substantial between the PW and WI groups, the PW group performed slightly better than the WI group on the Berg Balance Scale. Wii Fit training appears to improve balance. However, physical therapy training on its own or in addition to Wii Fit training appears to improve balance to a greater extent than Wii Fit training alone. Copyright © 2011 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

The mortality risk score and the ADG score: two points-based scoring systems for the Johns Hopkins aggregated diagnosis groups to predict mortality in a general adult population cohort in Ontario, Canada.

PubMed

Austin, Peter C; Walraven, Carl van

2011-10-01

Logistic regression models that incorporated age, sex, and indicator variables for the Johns Hopkins' Aggregated Diagnosis Groups (ADGs) categories have been shown to accurately predict all-cause mortality in adults. To develop 2 different point-scoring systems using the ADGs. The Mortality Risk Score (MRS) collapses age, sex, and the ADGs to a single summary score that predicts the annual risk of all-cause death in adults. The ADG Score derives weights for the individual ADG diagnosis groups. : Retrospective cohort constructed using population-based administrative data. All 10,498,413 residents of Ontario, Canada, between the age of 20 and 100 years who were alive on their birthday in 2007, participated in this study. Participants were randomly divided into derivation and validation samples. : Death within 1 year. In the derivation cohort, the MRS ranged from -21 to 139 (median value 29, IQR 17 to 44). In the validation group, a logistic regression model with the MRS as the sole predictor significantly predicted the risk of 1-year mortality with a c-statistic of 0.917. A regression model with age, sex, and the ADG Score has similar performance. Both methods accurately predicted the risk of 1-year mortality across the 20 vigintiles of risk. The MRS combined values for a person's age, sex, and the John Hopkins ADGs to accurately predict 1-year mortality in adults. The ADG Score is a weighted score representing the presence or absence of the 32 ADG diagnosis groups. These scores will facilitate health services researchers conducting risk adjustment using administrative health care databases.

Human and server docking prediction for CAPRI round 30-35 using LZerD with combined scoring functions.

PubMed

Peterson, Lenna X; Kim, Hyungrae; Esquivel-Rodriguez, Juan; Roy, Amitava; Han, Xusi; Shin, Woong-Hee; Zhang, Jian; Terashi, Genki; Lee, Matt; Kihara, Daisuke

2017-03-01

We report the performance of protein-protein docking predictions by our group for recent rounds of the Critical Assessment of Prediction of Interactions (CAPRI), a community-wide assessment of state-of-the-art docking methods. Our prediction procedure uses a protein-protein docking program named LZerD developed in our group. LZerD represents a protein surface with 3D Zernike descriptors (3DZD), which are based on a mathematical series expansion of a 3D function. The appropriate soft representation of protein surface with 3DZD makes the method more tolerant to conformational change of proteins upon docking, which adds an advantage for unbound docking. Docking was guided by interface residue prediction performed with BindML and cons-PPISP as well as literature information when available. The generated docking models were ranked by a combination of scoring functions, including PRESCO, which evaluates the native-likeness of residues' spatial environments in structure models. First, we discuss the overall performance of our group in the CAPRI prediction rounds and investigate the reasons for unsuccessful cases. Then, we examine the performance of several knowledge-based scoring functions and their combinations for ranking docking models. It was found that the quality of a pool of docking models generated by LZerD, that is whether or not the pool includes near-native models, can be predicted by the correlation of multiple scores. Although the current analysis used docking models generated by LZerD, findings on scoring functions are expected to be universally applicable to other docking methods. Proteins 2017; 85:513-527. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Physician groups' use of data from patient experience surveys.

PubMed

Friedberg, Mark W; SteelFisher, Gillian K; Karp, Melinda; Schneider, Eric C

2011-05-01

In Massachusetts, physician groups' performance on validated surveys of patient experience has been publicly reported since 2006. Groups also receive detailed reports of their own performance, but little is known about how physician groups have responded to these reports. To examine whether and how physician groups are using patient experience data to improve patient care. During 2008, we conducted semi-structured interviews with the leaders of 72 participating physician groups (out of 117 groups receiving patient experience reports). Based on leaders' responses, we identified three levels of engagement with patient experience reporting: no efforts to improve (level 1), efforts to improve only the performance of low-scoring physicians or practice sites (level 2), and efforts to improve group-wide performance (level 3). Groups' level of engagement and specific efforts to improve patient care. Forty-four group leaders (61%) reported group-wide improvement efforts (level 3), 16 (22%) reported efforts to improve only the performance of low-scoring physicians or practice sites (level 2), and 12 (17%) reported no performance improvement efforts (level 1). Level 3 groups were more likely than others to have an integrated medical group organizational model (84% vs. 31% at level 2 and 33% at level 1; P < 0.005) and to employ the majority of their physicians (69% vs. 25% and 20%; P < 0.05). Among level 3 groups, the most common targets for improvement were access, communication with patients, and customer service. The most commonly reported improvement initiatives were changing office workflow, providing additional training for nonclinical staff, and adopting or enhancing an electronic health record. Despite statewide public reporting, physician groups' use of patient experience data varied widely. Integrated organizational models were associated with greater engagement, and efforts to enhance clinicians' interpersonal skills were uncommon, with groups predominantly focusing on office workflow and support staff.

Surgical Decompression for Chiari Malformation Type I: An Age-Based Outcomes Study Based on the Chicago Chiari Outcome Scale.

PubMed

Gilmer, Holly S; Xi, Mengqiao; Young, Sonja H

2017-11-01

There is currently inadequate evidence on the efficacy of surgical decompression for Chiari malformation type I (CM1) in different age groups of patients. In this study, we compared postoperative outcomes across 3 different age groups using the Chicago Chiari Outcome Scale (CCOS). A total of 144 patients who underwent Chiari decompression at our institution between 2008 and 2014 were divided into 3 groups: group A, children age 0-18 years; group B, younger adults age 19-40 years; and group C, older adults, age 41+ years. Patient outcomes were assigned a numerical value based on the CCOS and subjected to statistical analysis. Direct comparisons were made across the 3 age groups. The mean overall score was 14.0 over a mean follow-up of 27.2 months. All 3 groups demonstrated clinical improvement following Chiari decompression; however, group A demonstrated significantly better postoperative improvements than groups B and C in total CCOS scores (7.8% and 12.2%, respectively; P < 0.001) and all the component scores except complications. Group B was not significantly different from group C in total score or any of the component scores. There was a logarithmic relationship between age and outcome (R 2  = 0.64), in which the outcome scores experienced an initial decline with increasing age but leveled off by early adulthood. A direct comparison among the age groups revealed a negative age effect on surgical decompression outcomes in CM1 patients. Children performed significantly better than younger and older adults. This finding supports early surgical intervention for symptomatic pediatric patients to achieve long-term surgical benefit. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Declining Financial Capacity in Mild Cognitive Impairment: A Six-Year Longitudinal Study.

PubMed

Martin, Roy C; Gerstenecker, Adam; Triebel, Kristen L; Falola, Michael; McPherson, Tarrant; Cutter, Gary; Marson, Daniel C

2018-03-31

To investigate financial skill decline over a 6-year period in persons with mild cognitive impairment (MCI) presumed due to Alzheimer's disease (AD). Study participants were cognitively normal (CN) older adults (n = 82) and adults with MCI (n = 91) based on consensus conference diagnosis. Participants completed baseline and up to six annual follow-up assessments that included standardized financial skills measurement (Financial Capacity Instrument; FCI; nine FCI domain and two global scores). We examined FCI change over time using mixed-model repeated measures analysis adjusted for baseline age and follow-up duration. At baseline, the CN group performed better than the MCI group across both global and seven domain scores. Group × Time interaction effects (all p's <.02) were found for all global and domain scores. The largest interaction effects were observed for complex domains of Financial Conceptual Knowledge, Checkbook Management, Bank Statement Management, and Bill Payment (all p's <.0001). Annualized decline in the MCI group's global scores, calculated in relation to CN group performance, was 10-17% over the initial 3-year time span and 22-24% at 6 years. Decline in FCI domain scores ranged from 6% (Knowledge of Assets/Estate) to 22% (Investment Decision-Making) at 3 year follow-up, and from 15% (Basic Monetary Skills) to 37% (Financial Judgment) at 6 year follow-up. Over a 6-year period, persons with MCI demonstrated significant declines in multiple financial skills and in particular financial judgment. The findings highlight the importance of ongoing oversight by family members and clinicians of financial skills and activities in persons with MCI.

Exercise and health-related quality of life during the first year following acute stroke. A randomized controlled trial.

PubMed

Langhammer, Birgitta; Stanghelle, Johan K; Lindmark, Birgitta

2008-02-01

To evaluate the impact of two different physiotherapy exercise regimes in patients after acute stroke on health-related quality of life (HRQoL) and to investigate how the degree of motor and balance function, gait capacity, activities of daily living and instrumental activities of daily living influenced HRQoL. A longitudinal randomized controlled stratified trial of two interventions: the intensive exercise groups with scheduled intensive training during four periods of the first year after stroke and the regular exercise group with self-initiated training. There was a tendency of better HRQoL in the regular exercise group on NHP total score (p = 0.05). Patients with low scores in activities of daily living, balance and motor function and inability to perform 6-minute walk test on admission, scored lower on self-perceived health than patients with high scores and ability to perform the walking test. At 1 year post-stroke, total scores on NHP were moderately associated with motor function (r = -0.63), balance (r = -0.56), gait (r = -0.57), activities of daily living (r = -0.57) and instrumental activities of daily living (r = -0.49-0.58). The physical mobility sub-scale of NHP had the strongest association ranging from r = -0.47-0.82. The regular exercise group with self-initiated training seemed to enhance HRQoL more than the intensive exercise group with scheduled intensive training. The degree of motor function, balance, walking capacity and independence in activities of daily living is of importance for perceived HRQoL.

Cognitive function did not improve after initiation of natalizumab treatment in relapsing-remitting multiple sclerosis. A prospective one-year dual control group study.

PubMed

Sundgren, M; Piehl, Fredrik; Wahlin, Åke; Brismar, Tom

2016-11-01

Cognitive impairment in multiple sclerosis (MS) is common and has severe implications. Natalizumab (NZ) has documented effects on relapse rate and radiological disease activity in relapsing-remitting MS (RRMS) but studies regarding its specific effects on cognitive functioning are few. Previous studies have reported improvement, however, often lacking relevant control groups. The objective of the present study was to evaluate the cognitive effects of NZ treatment, compared to patients on stable first-line treatment and healthy control subjects. MS patients starting NZ (MS-NZ), MS controls with stable interferon beta therapy (MS-C) and healthy control subjects (HC) were evaluated twice with one year interval, using a cognitive test battery covering six cognitive domains. The effects of NZ on levels of self-reported depression, fatigue, daytime sleepiness and perceived health were also examined. MS patients (MS-NZ and MS-C) had significantly lower baseline cognitive performance compared to HC (global score, p=0.002), but there were no significant differences between MS-NZ and MS-C. At follow-up, both MS-NZ and MS-C had improved significantly in four and five cognitive domains, respectively, and in global score (p=0.013 and p<0.001, respectively). HC improved significantly in three cognitive domains but not in global score. A regression analysis including baseline cognitive z-score and z-score change showed that participants with lower baseline scores had a significantly greater improvement, compared to those with better initial performance (p=0.021). There were no significant changes in depression, fatigue, daytime sleepiness or perceived health in MS-NZ or MS-C. Initiation of NZ therapy did not result in true cognitive improvement over one year. Presumably, the increased test performance in both MS groups was artificial and due to retest effects that were stronger in patients with lower baseline performance. Adequate control groups are essential when evaluating cognitive functioning in intervention trials among RRMS patients. Copyright © 2016 Elsevier B.V. All rights reserved.

Comparison of credible patients of very low intelligence and non-credible patients on neurocognitive performance validity indicators.

PubMed

Smith, Klayton; Boone, Kyle; Victor, Tara; Miora, Deborah; Cottingham, Maria; Ziegler, Elizabeth; Zeller, Michelle; Wright, Matthew

2014-01-01

The purpose of this archival study was to identify performance validity tests (PVTs) and standard IQ and neurocognitive test scores, which singly or in combination, differentiate credible patients of low IQ (FSIQ ≤ 75; n = 55) from non-credible patients. We compared the credible participants against a sample of 74 non-credible patients who appeared to have been attempting to feign low intelligence specifically (FSIQ ≤ 75), as well as a larger non-credible sample (n = 383) unselected for IQ. The entire non-credible group scored significantly higher than the credible participants on measures of verbal crystallized intelligence/semantic memory and manipulation of overlearned information, while the credible group performed significantly better on many processing speed and memory tests. Additionally, credible women showed faster finger-tapping speeds than non-credible women. The credible group also scored significantly higher than the non-credible subgroup with low IQ scores on measures of attention, visual perceptual/spatial tasks, processing speed, verbal learning/list learning, and visual memory, and credible women continued to outperform non-credible women on finger tapping. When cut-offs were selected to maintain approximately 90% specificity in the credible group, sensitivity rates were highest for verbal and visual memory measures (i.e., TOMM trials 1 and 2; Warrington Words correct and time; Rey Word Recognition Test total; RAVLT Effort Equation, Trial 5, total across learning trials, short delay, recognition, and RAVLT/RO discriminant function; and Digit Symbol recognition), followed by select attentional PVT scores (i.e., b Test omissions and time to recite four digits forward). When failure rates were tabulated across seven most sensitive scores, a cut-off of ≥ 2 failures was associated with 85.4% specificity and 85.7% sensitivity, while a cut-off of ≥ 3 failures resulted in 95.1% specificity and 66.0% sensitivity. Results are discussed in light of extant literature and directions for future research.

Relationship between the Self-Rating Anxiety Scale score and the success rate of 64-slice computed tomography coronary angiography.

PubMed

Li, Hui; Jin, Dan; Qiao, Fang; Chen, Jianchang; Gong, Jianping

Computed tomography coronary angiography, a key method for obtaining coronary artery images, is widely used to screen for coronary artery diseases due to its noninvasive nature. In China, 64-slice computed tomography systems are now the most common models. As factors that directly affect computed tomography performance, heart rate and rhythm control are regulated by the autonomic nervous system and are highly related to the emotional state of the patient. The aim of this prospective study is to use a pre-computed tomography scan Self-Rating Anxiety Scale assessment to analyze the effects of tension and anxiety on computed tomography coronary angiography success. Subjects aged 18-85 years who were planned to undergo computed tomography coronary angiography were enrolled; 1 to 2 h before the computed tomography scan, basic patient data (gender, age, heart rate at rest, and family history) and Self-Rating Anxiety Scale score were obtained. The same group of imaging department doctors, technicians, and nurses performed computed tomography coronary angiography for all the enrolled subjects and observed whether those subjects could finish the computed tomography coronary angiography scan and provide clear, diagnostically valuable images. Participants were divided into successful (obtained diagnostically useful coronary images) and unsuccessful groups. Basic data and Self-Rating Anxiety Scale scores were compared between the groups. The Self-Rating Anxiety Scale standard score of the successful group was lower than that of the unsuccessful group (P = 0.001). As the Self-Rating Anxiety Scale standard score rose, the success rate of computed tomography coronary angiography decreased. The Self-Rating Anxiety Scale score has a negative relationship with computed tomography coronary angiography success. Anxiety can be a disadvantage in computed tomography coronary angiography examination. The pre-computed tomography coronary angiography scan Self-Rating Anxiety Scale score may be a useful tool for assessing whether a computed tomography coronary angiography scan will be successful or not. © The Author(s) 2015.

Performance on large-scale science tests: Item attributes that may impact achievement scores

NASA Astrophysics Data System (ADS)

Gordon, Janet Victoria

Significant differences in achievement among ethnic groups persist on the eighth-grade science Washington Assessment of Student Learning (WASL). The WASL measures academic performance in science using both scenario and stand-alone question types. Previous research suggests that presenting target items connected to an authentic context, like scenario question types, can increase science achievement scores especially in underrepresented groups and thus help to close the achievement gap. The purpose of this study was to identify significant differences in performance between gender and ethnic subgroups by question type on the 2005 eighth-grade science WASL. MANOVA and ANOVA were used to examine relationships between gender and ethnic subgroups as independent variables with achievement scores on scenario and stand-alone question types as dependent variables. MANOVA revealed no significant effects for gender, suggesting that the 2005 eighth-grade science WASL was gender neutral. However, there were significant effects for ethnicity. ANOVA revealed significant effects for ethnicity and ethnicity by gender interaction in both question types. Effect sizes were negligible for the ethnicity by gender interaction. Large effect sizes between ethnicities on scenario question types became moderate to small effect sizes on stand-alone question types. This indicates the score advantage the higher performing subgroups had over the lower performing subgroups was not as large on stand-alone question types compared to scenario question types. A further comparison examined performance on multiple-choice items only within both question types. Similar achievement patterns between ethnicities emerged; however, achievement patterns between genders changed in boys' favor. Scenario question types appeared to register differences between ethnic groups to a greater degree than stand-alone question types. These differences may be attributable to individual differences in cognition, characteristics of test items themselves and/or opportunities to learn. Suggestions for future research are made.

Lumbopelvic control and pitching performance of professional baseball pitchers.

PubMed

Chaudhari, Ajit M W; McKenzie, Christopher S; Borchers, James R; Best, Thomas M

2011-08-01

This study assessed the correlation between lumbopelvic control during a single-leg balancing task and in-game pitching performance in Minor-League baseball pitchers. Seventy-five healthy professional baseball pitchers performed a standing lumbopelvic control test during the last week of spring training for the 2008 and 2009 seasons while wearing a custom-designed testing apparatus, the "Level Belt." With the Level Belt secured to the waist, subjects attempted to transition from a 2-leg to a single-leg pitching stance and balance while maintaining a stable pelvic position. Subjects were graded on the maximum sagittal pelvic tilt from a neutral position during the motion. Pitching performance, number of innings pitched (IP), and injuries were compared for all subjects who pitched at least 50 innings during a season. The median Level Belt score for the study group was 7°. Two-sample t-tests with equal variances were used to determine if pitchers with a Level Belt score <7° or ≥7° were more likely to perform differently during the baseball season, and chi-square analysis was used to compare injuries between groups. Subjects scoring <7° on the Level Belt test had significantly fewer walks plus hits per inning than subjects scoring ≥7° (walks plus hits per inning pitched, 1.352 ± 0.251 vs. 1.584 ± 0.360, p = 0.013) and significantly more IP during the season (IP, 78.89 ± 38.67 vs. 53.38 ± 42.47, p = 0.043). There was no significant difference in the number of pitchers injured between groups. These data suggest that lumbopelvic control influences overall performance for baseball pitchers and that a simple test of lumbopelvic control can potentially identify individuals who have a better chance of pitching success.

Implementing a Breastfeeding Toolkit for Nursing Education.

PubMed

Folker-Maglaya, Catherine; Pylman, Maureen E; Couch, Kimberly A; Spatz, Diane L; Marzalik, Penny R

All health professional organizations recommend exclusive breastfeeding for at least 6 months, with continued breastfeeding for 1 year or more after birth. Women cite lack of support from health professionals as a barrier to breastfeeding. Meanwhile, breastfeeding education is not considered essential to basic nursing education and students are not adequately prepared to support breastfeeding women. Therefore, a toolkit of comprehensive evidence-based breastfeeding educational materials was developed to provide essential breastfeeding knowledge. A study was performed to determine the effectiveness of the breastfeeding toolkit education in an associate degree nursing program. A pretest/posttest survey design with intervention and comparison groups was used. One hundred fourteen students completed pre- and posttests. Student knowledge was measured using a 12-item survey derived with minor modifications from Marzalik's 2004 instrument measuring breastfeeding knowledge. When pre- and posttests scores were compared within groups, both groups' knowledge scores increased. A change score was calculated with a significantly higher mean score for the intervention group. When regression analysis was used to control for the pretest score, belonging to the intervention group increased student scores but not significantly. The toolkit was developed to provide a curriculum that demonstrates enhanced learning to prepare nursing students for practice. The toolkit could be used in other settings, such as to educate staff nurses working with childbearing families.

Anticholinergic Drug Use and Risk of Cognitive Performance in Older Adults with Questionable Cognitive Impairment: A Cross-Sectional Analysis

PubMed Central

Swami, Sunil; Cohen, Ronald A.; Kairalla, John A.; Manini, Todd M.

2018-01-01

Background Age-associated decline in central cholinergic activity makes older adults susceptible to harmful effects of anticholinergic (AC) medications. However, there is an inadequate understanding of association and possible effects of AC drugs on cognition. This cross-sectional study examines the associations of AC medications on cognition among older adults with questionable cognitive impairment (QCI). Methods For this cross-sectional study, we used multicenter database of community dwelling older adults (N=7,351) aged 60+ years with QCI from September 2005 until March 2014 as baseline data. Anticholinergic Drug Scale was used to categorize AC drug load in no, low or moderate/high groups. Individuals with clinical dementia rating-sum of boxes score between 0.5 and 2.5 were identify as having QCI. Cognitive performance was evaluated using Neuropsychological Test Battery. The mean z-scores of neuropsychological tests were grouped into a global cognition score. Results Participants who took AC medications were older, largely female and had higher prevalence of incontinence than those without AC exposure. Global cognition was significantly greater in moderate/high AC group than no AC group (-0.23±0.53 vs. -0.32±0.53). Multivariable linear regression showed that global cognition score among low and moderate/high AC groups, as compared to no AC group, was higher by 0.064 (P=.006 and P=.12, respectively). Conclusions This cross-sectional study indicates that older adults with QCI who were exposed to AC medications might have higher global cognitive scores than those without AC exposure. The observed associations indicate that older adults might experience some beneficial cognitive effects from AC drugs, possibly due to the therapeutic effects of these medications in controlling comorbidities; thus, outweighing their adverse effects on cognition. PMID:27638818

EEG correlates of the alcohol-induced organic brain syndrome in man.

PubMed

Zilm, D H; Huszar, L; Carlen, P L; Kaplan, H L; Wilkinson, D A

1980-05-01

Fourteen chronic alcoholics were studied within 1 to 3 weeks of beginning abstinence for a duration of 6 to 10 weeks. Patients were drug-free during the study. Electroencephalograms were recorded on admission, and twice at 2- to 3-week intervals. Neurologic examinations were performed during the same week as EEGs, and patients received a psychologic examination and CT scan within 3 weeks. Two groups could be identified. One group had high neurologic impairment scores, low alpha production, high 20 to 30 Hz power, impaired gait, and mental performance, while the other had low scores, normal alpha rhythm, and reduced degree of mental dysfunction. The impaired group showed marked improvement in neurologic scores, alpha rhythm, and 20 to 30 Hz power within 4 to 6 weeks, in contrast to no change for the unimpaired group. There was no evidence that age, duration of drinking, time from last drink, or cortical atrophy were involved in predisposing alcoholics to demonstrate the observed changes. It is submitted that spontaneous recovery in brain function of neurologically impaired alcoholics accompanies abstinence from chronic alcohol consumption.

Verbal memory outcome in patients with normal preoperative verbal memory and left mesial temporal sclerosis.

PubMed

LoGalbo, Anthony; Sawrie, Stephen; Roth, David L; Kuzniecky, Ruben; Knowlton, Robert; Faught, Edward; Martin, Roy

2005-05-01

Previous studies have shown that structural integrity (i.e., presence/absence of mesial temporal sclerosis (MTS)) of the left mesial temporal lobe is associated with verbal memory outcome following left anterior temporal lobectomy (ATL). However, the functional integrity of the left temporal lobe, as exemplified by preoperative verbal memory performance, has also been associated with verbal memory outcome following surgery. We investigated the risk of verbal memory loss in patients with known structural abnormality (i.e., left mesial temporal sclerosis by MRI) and normal preoperative verbal memory performance who undergo left ATL. Seventeen patients with left temporal lobe epilepsy, MRI-based exclusive left MTS, and normal preoperative verbal memory were identified. Normal verbal memory was defined as performance on both Acquisition (learning across trials 1-5) and Retrieval (long delayed free recall) portions of the California Verbal Learning Test (CVLT) above a T score of 40 (>16%ile). Postoperative verbal memory outcome was established by incorporating standardized regression-based (SRB) change scores. Postoperative declines across both CVLT Retrieval T scores and Acquisition T scores (average 20% and average 15% declines from baseline scores, respectively) were measured for the group. The average CVLT Retrieval SRB change score was -2.5, and the average CVLT Acquisition SRB change score was -1.0. A larger proportion of patients demonstrated postoperative declines on Retrieval scores than Acquisition scores (64.7% vs 17.6%, respectively). Even in the presence of left MTS, patients exhibiting normal presurgical verbal memory are at risk for verbal memory declines following ATL. These results suggest that the functional integrity of the left mesial temporal lobe may play an important role in the verbal memory outcome in this patient group.

Objective Structured Assessment of Technical Skills (OSATS) evaluation of theoretical versus hands-on training of vaginal breech delivery management: a randomized trial.

PubMed

Buerkle, Bernd; Rueter, Katharina; Hefler, Lukas A; Tempfer-Bentz, Eva-Katrin; Tempfer, Clemens B

2013-12-01

To compare the skills of performing a vaginal breech (VB) delivery after hands-on training versus demonstration. We randomized medical students to a 30-min demonstration (group 1) or a 30-min hands-on (group 2) training session using a standardized VB management algorithm on a pelvic training model. Subjects were tested with a 25 item Objective Structured Assessment of Technical Skills (OSATS) scoring system immediately after training and 72 h thereafter. OSATS scores were the primary outcome. Performance time (PT), self assessment (SA), confidence (CON), and global rating scale (GRS) were the secondary outcomes. Statistics were performed using the Mann-Whitney U-test, chi-square test, and multiple linear regression analysis. 172 subjects were randomized. OSATS scores (primary outcome) were significantly higher in group 2 (n=88) compared to group 1 (n=84) (21.18±2.29 vs. 20.19±2.37, respectively; p=0.006). The secondary outcomes GRS (10.31±2.28 vs. 9.17±2.21; p=0.001), PT (214.60±57.97 s vs. 246.98±59.34 s; p<0.0001), and CON (3.14±0.89 vs. 2.85±0.90; p=0.04) were also significantly different between groups, favoring group 2. After 72 h, primary and secondary outcomes were not significantly different between groups. In a multiple linear regression analysis, group assignment (odds ratio [OR] 1.60; 95% confidence interval [CI] 1.14-2.05; p<0.0001) and gender (OR 2.91; 95% CI 2.45-3.38; p<0.0001) independently influenced OSATS scores. Hands-on training leads to a significant improvement of VB management in a pelvic training model, but this effect was only seen in the short term. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Effect of a brief training program based on cognitive behavioral therapy in improving work performance: A randomized controlled trial.

PubMed

Kimura, Risa; Mori, Makiko; Tajima, Miyuki; Somemura, Hironori; Sasaki, Norio; Yamamoto, Megumi; Nakamura, Saki; Okanoya, June; Ito, Yukio; Otsubo, Tempei; Tanaka, Katsutoshi

2015-01-01

Efforts to improve performance in the workplace with respect to positive mental health have increased, and cognitive behavioral therapy (CBT) has recently attracted attention as an intervention measure to this end. Here, we conducted a randomized controlled trial to evaluate the effectiveness of a brief training program on CBT for improving work performance of employees. The participants were employees of an electric company in Japan. The intervention consisted of 1 group session of CBT (120 min) and web-based CBT homework for 1 month. We evaluated employees in both the intervention and control groups at baseline and follow-up after three months. The main outcome was work performance, which was evaluated by a subjective score from 1 to 10. The secondary outcome was self-evaluation of cognitive flexibility. Analyses were conducted based on ITT. In the intervention group, 84 participants attended the group session, with 79 subsequently completing at least 1 instance of online homework. ITT analysis showed that the subjective performance of the intervention group was significantly improved compared with that of the control group (1.47 vs. 0.69, mean difference 0.78 [95% confidence interval {CI}, 0.05 to 1.51], Cohen's d=0.31). The ability to recognize dysfunctional thinking patterns and change them to positive ones significantly improved in the intervention group compared to the control group (0.71 vs. 0.26, mean difference 0.45 [95% CI 0.06 to 0.83], d=0.33). However, after adjustment for baseline scores, no significant difference was observed. The ability to view a situation from multiple perspectives and expand one's repertoire of thought patterns in the intervention group also significantly improved (0.83 vs. 0.35, mean difference 0.48 [95% CI 0.35 to 0.95], d=0.29), but here again, significance was lost after adjusting for baseline scores. Our results suggest that a brief training program that combines a group CBT session with web-based CBT homework improved subjective work performance. In addition, this program might help improve employees' cognitive flexibility.

Effects of oral iron(III) hydroxide polymaltose complex supplementation on hemoglobin increase, cognitive function, affective behavior and scholastic performance of adolescents with varying iron status: a single centre prospective placebo controlled study.

PubMed

Devaki, Pallaki Baby; Chandra, Ranjit K; Geisser, Peter

2009-01-01

To assess the effects of iron supplementation on iron status, cognitive function, affective behavior and scholastic performance in adolescents with varying iron status. Adolescents of both sexes with varying iron status were allocated to four treatment groups by using inclusion criteria. Three of the four groups (iron deficient anemic, iron deficient and control supplement) received iron(III) hydroxide polymaltose complex (IPC, Maltofer) containing 100 mg of elemental iron 6 days a week for 8 months, while the fourth group (control placebo) was given a placebo. Hematological parameters, cognitive function, affective behavior and scholastic performance were assessed at baseline, 4 months and 8 months of supplementation. Cognitive and scholastic performance test scores for the three supplemented groups increased from baseline to 4 months and from 4 months to 8 months (with concomitant increases in hematological parameters), whereas no increase was observed in the placebo group. No increase was seen in affective behavior scores for any of the groups during or after supplementation. IPC supplementation for eight months yielded significant improvements in cognitive function and scholastic performance in Indian adolescents with and without iron deficiency and anemia.

Anxiety and performance of nursing students in regard to assessment via clinical simulations in the classroom versus filmed assessments.

PubMed

de Souza Teixeira, Carla Regina; Kusumota, Luciana; Alves Pereira, Marta Cristiane; Merizio Martins Braga, Fernanda Titareli; Pirani Gaioso, Vanessa; Mara Zamarioli, Cristina; Campos de Carvalho, Emilia

2014-01-01

To compare the level of anxiety and performance of nursing students when performing a clinical simulation through the traditional method of assessment with the presence of an evaluator and through a filmed assessment without the presence of an evaluator. Controlled trial with the participation of Brazilian public university 20 students who were randomly assigned to one of two groups: a) assessment through the traditional method with the presence of an evaluator; or b) filmed assessment. The level of anxiety was assessed using the Zung test and performance was measured based on the number of correct answers. Averages of 32 and 27 were obtained on the anxiety scale by the group assessed through the traditional method before and after the simulation, respectively, while the filmed group obtained averages of 33 and 26; the final scores correspond to mild anxiety. Even though there was a statistically significant reduction in the intra-groups scores before and after the simulation, there was no difference between the groups. As for the performance assessments in the clinical simulation, the groups obtained similar percentages of correct answers (83% in the traditional assessment and 84% in the filmed assessment) without statistically significant differences. Filming can be used and encouraged as a strategy to assess nursing undergraduate students.

Prognostic value of continuous electroencephalography monitoring in children with severe brain damage.

PubMed

Lan, Yan-huai; Zhu, Xiao-mei; Zhou, Yuan-feng; Qiu, Peng-ling; Lu, Guo-ping; Sun, Dao-kai; Wang, Yi

2015-06-01

The purpose of this study is to determine whether there is a relationship between continuous electroencephalography (EEG) monitoring patterns and prognosis for children with severe brain damage. Patients and The different patterns of EEG were analyzed for 103 children (Glasgow Coma Scale [GCS] score < 8) who were monitored with continuous video-EEG (CVEEG) within 72 hours after the onset of coma. The clinical outcomes were scored and evaluated at hospital discharge by the modified Pediatric Cerebral and Overall Performance Category Scale (PCOPCS). EEG parameters of the different prognosis groups were compared and risk factors for prognosis were identified. Of the 103 children, 36 were in the good prognosis group (PCOPCS scores 1 and 2) and 67 were in the poor prognosis group (PCOPCS scores 3-6). The poor prognosis group had the lower proportion of events in reactive EEG patterns and sleep architecture, and a higher proportion of low-voltage events. Multivariate analyses showed that the lower GCS score and no sleep architecture were significantly associated with poor prognosis. Comatose children with higher GCS score and sleep architecture have better clinical outcomes in terms of morbidity and mortality. Georg Thieme Verlag KG Stuttgart · New York.

Validation of the Narrowing Beam Walking Test in Lower Limb Prosthesis Users.

PubMed

Sawers, Andrew; Hafner, Brian

2018-04-11

To evaluate the content, construct, and discriminant validity of the Narrowing Beam Walking Test (NBWT), a performance-based balance test for lower limb prosthesis users. Cross-sectional study. Research laboratory and prosthetics clinic. Unilateral transtibial and transfemoral prosthesis users (N=40). Not applicable. Content validity was examined by quantifying the percentage of participants receiving maximum or minimum scores (ie, ceiling and floor effects). Convergent construct validity was examined using correlations between participants' NBWT scores and scores or times on existing clinical balance tests regularly administered to lower limb prosthesis users. Known-groups construct validity was examined by comparing NBWT scores between groups of participants with different fall histories, amputation levels, amputation etiologies, and functional levels. Discriminant validity was evaluated by analyzing the area under each test's receiver operating characteristic (ROC) curve. No minimum or maximum scores were recorded on the NBWT. NBWT scores demonstrated strong correlations (ρ=.70‒.85) with scores/times on performance-based balance tests (timed Up and Go test, Four Square Step Test, and Berg Balance Scale) and a moderate correlation (ρ=.49) with the self-report Activities-specific Balance Confidence scale. NBWT performance was significantly lower among participants with a history of falls (P=.003), transfemoral amputation (P=.011), and a lower mobility level (P<.001). The NBWT also had the largest area under the ROC curve (.81) and was the only test to exhibit an area that was statistically significantly >.50 (ie, chance). The results provide strong evidence of content, construct, and discriminant validity for the NBWT as a performance-based test of balance ability. The evidence supports its use to assess balance impairments and fall risk in unilateral transtibial and transfemoral prosthesis users. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

A novel robotic surgical technique for thyroid surgery: bilateral axillary approach (BAA).

PubMed

Woo, Jung-Woo; Kim, Seo Ki; Park, Inhye; Choe, Jun Ho; Kim, Jung-Han; Kim, Jee Soo

2017-02-01

Bilateral axillo-breast approach (BABA) robotic thyroidectomy (RT) is proven to be a feasible method for the treatment of well-differentiated thyroid cancers in terms of oncology as well as cosmesis. However, BABA RT causes postoperative sternal discomfort and needs an incision over the nipple areolar area. Here, we suggest a novel robotic surgical technique for thyroid surgery that does not need a breast incision-bilateral axillary approach (BAA). We recruited 51 patients who were willing to undergo the novel BAA robotic thyroid surgery. We performed a propensity score-matched analysis to compare the BAA robotic thyroid surgery group (BAA group) with the conventional open thyroid surgery group (open group). Mean operation time in the BAA group (129.7 min) was significantly longer than that in the open group (103.1 min) (p < 0.001). However, no significant differences in the mean number of metastatic lymph nodes (LNs), mean number of retrieved LNs, vocal cord palsy, hypoparathyroidism, and mean stimulated thyroglobulin level were observed between the two groups. There was no case of postoperative bleeding or chyle leak. Of the 51 patients who had undergone the BAA procedure, 27 patients answered the questionnaire. The mean scale, ranging from 0 to 10, at postoperative 1 day/2 weeks was as follows: voice change score, 3.0/1.6; swallowing difficulty score, 4.0/2.0; anterior neck pain score, 4.6/3.6; anterior neck numbness score, 5.4/4.3; right chest pain score, 3.8/2.1; left chest pain score, 3.6/2.3; right chest numbness score, 3.2/2.8; left chest numbness score, 2.4/2.7; right breast pain score, 0.9/0; left breast pain score, 1.2/0; right breast numbness score, 1.7/0; and left breast numbness score, 2.6/0, respectively. BAA robotic thyroid surgery is a novel, safe, and feasible oncoplastic method, especially for patients who have fear of procedures around the nipple areolar complex.

Effects of non-sporting and sporting qigong on frailty and quality of life among breast cancer patients receiving chemotherapy.

PubMed

Huang, Sheng-Miauh; Tseng, Ling-Ming; Chien, Li-Yin; Tai, Chen-Jei; Chen, Ping-Ho; Hung, Chia Tai; Hsiung, Yvonne

2016-04-01

To explore the effects of non-sporting qigong (NSQG) and sporting qigong (SQG) on frailty and quality of life (QOL) of breast cancer patients during chemotherapy. A time series (three-group, pre-test-post-test) quasi-experimental design was applied in the study. Ninety-five participants were assigned to three groups: controls (n = 31), NSQG (n = 33), or SQG (n = 31). All patients performed the qigong interventions three times per week for at least 30 min per session. Data were collected in face-to-face interviews before chemotherapy and at 1 and 3 months after chemotherapy. Frailty was assessed using the Edmonton Frail Scale. The Medical Outcomes Survey Short-Form 36-Taiwanese version was used to evaluate the physical and mental component scores of QOL. In the 1st and 3rd months after practicing qigong, patients in the SQG group had lower frailty scores than those in the control group. In the 3rd month after the intervention, patients in the NSQG group also had lower frailty scores and higher mental component scores for QOL than those in the control group. Patients with higher frailty scores had worse physical and mental component scores for QOL than those with lower frailty scores. The Sobel test showed that the frailty score mediated SQG and physical component scores for QOL. SQG and NSQG appeared to be beneficial for improving frailty and QOL among the breast cancer patients receiving chemotherapy in the study. The results are preliminary and larger, well-constructed clinical studies are needed to verify the findings. Copyright © 2015 Elsevier Ltd. All rights reserved.

An explorative study of school performance and antipsychotic medication.

PubMed

van der Schans, J; Vardar, S; Çiçek, R; Bos, H J; Hoekstra, P J; de Vries, T W; Hak, E

2016-09-21

Antipsychotic therapy can reduce severe symptoms of psychiatric disorders, however, data on school performance among children on such treatment are lacking. The objective was to explore school performance among children using antipsychotic drugs at the end of primary education. A cross-sectional study was conducted using the University Groningen pharmacy database linked to academic achievement scores at the end of primary school (Dutch Cito-test) obtained from Statistics Netherlands. Mean Cito-test scores and standard deviations were obtained for children on antipsychotic therapy and reference children, and statistically compared using analyses of covariance. In addition, differences in subgroups as boys versus girls, ethnicity, household income, and late starters (start date within 12 months of the Cito-test) versus early starters (start date > 12 months before the Cito-test) were tested. In all, data from 7994 children could be linked to Cito-test scores. At the time of the Cito-test, 45 (0.6 %) were on treatment with antipsychotics. Children using antipsychotics scored on average 3.6 points lower than the reference peer group (534.5 ± 9.5). Scores were different across gender and levels of household income (p < 0.05). Scores of early starters were significantly higher than starters within 12 months (533.7 ± 1.7 vs. 524.1 ± 2.6). This first exploration showed that children on antipsychotic treatment have lower school performance compared to the reference peer group at the end of primary school. This was most noticeable for girls, but early starters were less affected than later starters. Due to the observational cross-sectional nature of this study, no causality can be inferred, but the results indicate that school performance should be closely monitored and causes of underperformance despite treatment warrants more research.

The Distribution of Thai Mental State Examination Scores among Non-Demented Elderly in Suburban Bangkok Metropolitan and Associated Factors.

PubMed

Muangpaisan, Weerasak; Assantachai, Prasert; Sitthichai, Kobkul; Richardson, Kathryn; Brayne, Carol

2015-09-01

To obtain the distribution of Thai Mental State Examination (TMSE) scores in the Thai population across different age groups and educational levels in men and women aged 50 years and older and its relationship with demographic factors. The different cutpoints in literate and illiterate participants and item performance in both groups were also determined. Community-dwelling participants aged 50 years and over were invited to join the study. Personal information, general health history, and specific illness questionnaires including the activities of daily living, designed by the Survey in Europe on Nutrition and the Elderly, a ConcertedAction (SENECA), and the Thai Mental State Examination (TMSE) were completed in the face-to-face interview. There were 4,459 participants with no specific reported conditions that could potentially influence cognitive performance. The mean (SD) age was 64.2 (7.9) years and mostparticipants were women (71.7%). The median (interquartile range) of the TMSE was 27 (25-29) and 23 (19-26) in literate and illiterate participants, respectively. The distribution of TMSE scores were reported here determined by age, gender and educational level. Percentage of correct response in each TMSE item was low in recall and calculation performance. TMSE score declined with age in both genders and had greater variation with increasing age. TMSE score also increased with increasing levels of education and better financial status. Gender was not associated with the TMSE score adjusting for age, educational level, and economic status. Age, education, and economic status have an influence on the TMSE performance. Controllingfor these three factors, genders does not contribute to significant differences in TMSE performance. Norms adjustedfor these factors should be considered before employing single cutpoints to identify impairment.

Differences in Perception of Musical Stimuli among Acoustic, Electric, and Combined Modality Listeners.

PubMed

Prentiss, Sandra M; Friedland, David R; Nash, John J; Runge, Christina L

2015-05-01

Cochlear implants have shown vast improvements in speech understanding for those with severe to profound hearing loss; however, music perception remains a challenge for electric hearing. It is unclear whether the difficulties arise from limitations of sound processing, the nature of a damaged auditory system, or a combination of both. To examine music perception performance with different acoustic and electric hearing configurations. Chord discrimination and timbre perception were tested in subjects representing four daily-use listening configurations: unilateral cochlear implant (CI), contralateral bimodal (CIHA), bilateral hearing aid (HAHA) and normal-hearing (NH) listeners. A same-different task was used for discrimination of two chords played on piano. Timbre perception was assessed using a 10-instrument forced-choice identification task. Fourteen adults were included in each group, none of whom were professional musicians. The number of correct responses was divided by the total number of presentations to calculate scores in percent correct. Data analyses were performed with Kruskal-Wallis one-way analysis of variance and linear regression. Chord discrimination showed a narrow range of performance across groups, with mean scores ranging between 72.5% (CI) and 88.9% (NH). Significant differences were seen between the NH and all hearing-impaired groups. Both the HAHA and CIHA groups performed significantly better than the CI groups, and no significant differences were observed between the HAHA and CIHA groups. Timbre perception was significantly poorer for the hearing-impaired groups (mean scores ranged from 50.3-73.9%) compared to NH (95.2%). Significantly better performance was observed in the HAHA group as compared to both groups with electric hearing (CI and CIHA). There was no significant difference in performance between the CIHA and CI groups. Timbre perception was a significantly more difficult task than chord discrimination for both the CI and CIHA groups, yet the easier task for the NH group. A significant difference between the two tasks was not seen in the HAHA group. Having impaired hearing decreases performance compared to NH across both chord discrimination and timbre perception tasks. For chord discrimination, having acoustic hearing improved performance compared to electric hearing only. Timbre perception distinguished those with acoustic hearing from those with electric hearing. Those with bilateral acoustic hearing, even if damaged, performed significantly better on this task than those requiring electrical stimulation, which may indicate that CI sound processing fails to capture and deliver the necessary acoustic cues for timbre perception. Further analysis of timbre characteristics in electric hearing may contribute to advancements in programming strategies to obtain optimal hearing outcomes. American Academy of Audiology.

Relationship between procrastination and academic performance among a group of undergraduate dental students in India.

PubMed

Lakshminarayan, Nagesh; Potdar, Shrudha; Reddy, Siddana Goud

2013-04-01

Procrastination, generally defined as a voluntary, irrational delay of behavior, is a prevalent phenomenon among college students throughout the world and occurs at alarmingly high rates. For this study, a survey was conducted of 209 second-, third-, and fourth-year undergraduate dental students of Bapuji Dental College and Hospital, Davangere, India, to identify the relationship between their level of procrastination and academic performance. A sixteen-item questionnaire was used to assess the level of procrastination among these students. Data related to their academic performance were also collected. Spearman's correlation coefficient test was used to assess the relationship between procrastination and academic performance. It showed a negative correlation of -0.63 with a significance level of p<0.01 (two-tailed test), indicating that students who showed high procrastination scores performed below average in their academics. In addition, analysis with the Mann-Whitney U test found a significant difference in procrastination scores between the two gender groups (p<0.05). Hence, among the Indian undergraduate dental students evaluated in this study, it appeared that individuals with above average and average academic performance had lower scores of procrastination and vice versa.

Independent and combined influence of neonatal and current body composition on academic performance in youth: The UP & DOWN Study.

PubMed

Esteban-Cornejo, I; Tejero-González, C M; Castro-Piñero, J; Conde-Caveda, J; Cabanas-Sanchez, V; Sallis, J F; Veiga, Óscar L

2015-06-01

Unhealthy body composition is a cause for concern across the lifespan. The objective of this study was to examine the independent and combined associations between neonatal and current body composition with academic performance among youth. This cross-sectional study was conducted with a total of 1557 youth (745 girls) aged 10.4 ± 3.4 years. Birth weight and length at birth were self-reported. Current body composition was assessed by body mass index (BMI), waist circumference (WC) and percentage of body fat (BF%). Academic performance was assessed through schools records. Birth weight was related to all academic variables in boys, independent of potential confounders, including BMI; whereas WC, BMI and BF% were related to all academic performance indicators in both boys and girls, independent of potential confounders, including birth weight (all P < 0.05). In addition, the combined adverse effects of low birth weight and current overweight on academic performance were observed in both boys and girls for grade point average (GPA) indicator. Boys in the group with none adverse effect had significantly higher scores in GPA (score +0.535; 95% confidence interval, 0.082-0.989) than boys in the group of both adverse effects (P < 0.007); among girls, GPA score was higher in the group with none adverse effect than in the groups with one or two adverse effects (P for trend = 0.029). Neonatal and current body composition, both independently and combined, may influence academic performance in youth. © 2014 The Authors. Pediatric Obesity © 2014 World Obesity.

Performance evaluation of Al-Zahra academic medical center based on Iran balanced scorecard model

PubMed Central

Raeisi, Ahmad Reza; Yarmohammadian, Mohammad Hossein; Bakhsh, Roghayeh Mohammadi; Gangi, Hamid

2012-01-01

Background: Growth and development in any country's national health system, without an efficient evaluation system, lacks the basic concepts and tools necessary for fulfilling the system's goals. The balanced scorecard (BSC) is a technique widely used to measure the performance of an organization. The basic core of the BSC is guided by the organization's vision and strategies, which are the bases for the formation of four perspectives of BSC. The goal of this research is the performance evaluation of Al-Zahra Academic Medical Center in Isfahan University of Medical Sciences, based on Iran BSC model. Materials and Methods: This is a combination (quantitative–qualitative) research which was done at Al-Zahra Academic Medical Center in Isfahan University of Medical Sciences in 2011. The research populations were hospital managers at different levels. Sampling method was purposive sampling in which the key informed personnel participated in determining the performance indicators of hospital as the BSC team members in focused discussion groups. After determining the conceptual elements in focused discussion groups, the performance objectives (targets) and indicators of hospital were determined and sorted in perspectives by the group discussion participants. Following that, the performance indicators were calculated by the experts according to the predetermined objectives; then, the score of each indicator and the mean score of each perspective were calculated. Results: Research findings included development of the organizational mission, vision, values, objectives, and strategies. The strategies agreed upon by the participants in the focus discussion group included five strategies, which were customer satisfaction, continuous quality improvement, development of human resources, supporting innovation, expansion of services and improving the productivity. Research participants also agreed upon four perspectives for the Al-Zahra hospital BSC. In the patients and community perspective (customer), two objectives and three indicators were agreed upon, with a mean score of 75.9%. In the internal process perspective, 4 objectives and 14 indicators were agreed upon, with a mean score of 79.37%. In the learning and growth perspective, four objectives and eight indicators were agreed upon, with a mean score of 81.11%. Finally, in the financial perspective, two objectives and five indicators were agreed upon, with a mean score of 67.15%. Conclusion: One way to create demand for hospital services is performance evaluation by paying close attention to all BSC perspectives, especially the non-financial perspectives such as customers and internal processes perspectives. In this study, the BSC showed the differences in performance level of the organization in different perspectives, which would assist the hospital managers improve their performance indicators. The learning and growth perspective obtained the highest score, and the financial perspective obtained the least score. Since the learning and growth perspective acts as a base for all other perspectives and they depend on it, hospitals must continuously improve the service processes and the quality of services by educating staff and updating their policies and procedures. This can increase customer satisfaction and productivity and finally improve the BSC in financial perspective. PMID:23555104

Kernel Equating Under the Non-Equivalent Groups With Covariates Design

PubMed Central

Bränberg, Kenny

2015-01-01

When equating two tests, the traditional approach is to use common test takers and/or common items. Here, the idea is to use variables correlated with the test scores (e.g., school grades and other test scores) as a substitute for common items in a non-equivalent groups with covariates (NEC) design. This is performed in the framework of kernel equating and with an extension of the method developed for post-stratification equating in the non-equivalent groups with anchor test design. Real data from a college admissions test were used to illustrate the use of the design. The equated scores from the NEC design were compared with equated scores from the equivalent group (EG) design, that is, equating with no covariates as well as with equated scores when a constructed anchor test was used. The results indicate that the NEC design can produce lower standard errors compared with an EG design. When covariates were used together with an anchor test, the smallest standard errors were obtained over a large range of test scores. The results obtained, that an EG design equating can be improved by adjusting for differences in test score distributions caused by differences in the distribution of covariates, are useful in practice because not all standardized tests have anchor tests. PMID:29881012

Kernel Equating Under the Non-Equivalent Groups With Covariates Design.

PubMed

Wiberg, Marie; Bränberg, Kenny

2015-07-01

When equating two tests, the traditional approach is to use common test takers and/or common items. Here, the idea is to use variables correlated with the test scores (e.g., school grades and other test scores) as a substitute for common items in a non-equivalent groups with covariates (NEC) design. This is performed in the framework of kernel equating and with an extension of the method developed for post-stratification equating in the non-equivalent groups with anchor test design. Real data from a college admissions test were used to illustrate the use of the design. The equated scores from the NEC design were compared with equated scores from the equivalent group (EG) design, that is, equating with no covariates as well as with equated scores when a constructed anchor test was used. The results indicate that the NEC design can produce lower standard errors compared with an EG design. When covariates were used together with an anchor test, the smallest standard errors were obtained over a large range of test scores. The results obtained, that an EG design equating can be improved by adjusting for differences in test score distributions caused by differences in the distribution of covariates, are useful in practice because not all standardized tests have anchor tests.

Performance of residents and anesthesiologists in a simulation-based skill assessment.

PubMed

Murray, David J; Boulet, John R; Avidan, Michael; Kras, Joseph F; Henrichs, Bernadette; Woodhouse, Julie; Evers, Alex S

2007-11-01

Anesthesiologists and anesthesia residents are expected to acquire and maintain skills to manage a wide range of acute intraoperative anesthetic events. The purpose of this study was to determine whether an inventory of simulated intraoperative scenarios provided a reliable and valid measure of anesthesia residents' and anesthesiologists' skill. Twelve simulated acute intraoperative scenarios were designed to assess the performance of 64 residents and 35 anesthesiologists. The participants were divided into four groups based on their training and experience. There were 31 new CA-1, 12 advanced CA-1, and 22 CA-2/CA-3 residents as well as a group of 35 experienced anesthesiologists who participated in the assessment. Each participant managed a set of simulated events. The advanced CA-1 residents, CA-2/CA-3 residents, and 35 anesthesiologists managed 8 of 12 intraoperative simulation exercises. The 31 CA-1 residents each managed 3 intraoperative scenarios. The new CA-1 residents received lower scores on the simulated intraoperative events than the other groups of participants. The advanced CA-1 residents, CA-2/CA-3 residents, and anesthesiologists performed similarly on the overall assessment. There was a wide range of scores obtained by individuals in each group. A number of the exercises were difficult for the majority of participants to recognize and treat, but most events effectively discriminated among participants who achieved higher and lower overall scores. This simulation-based assessment provided a valid method to distinguish the skills of more experienced anesthesia residents and anesthesiologists from residents in early training. The overall score provided a reliable measure of a participant's ability to recognize and manage simulated acute intraoperative events. Additional studies are needed to determine whether these simulation-based assessments are valid measures of clinical performance.

The relationship between physical performance and cardiac function in an elderly Russian cohort.

PubMed

Tadjibaev, Pulod; Frolova, Elena; Gurina, Natalia; Degryse, Jan; Vaes, Bert

2014-01-01

This study aims to determine the cardiac dysfunction prevalence, to investigate the relationship between the Short Physical Performance Battery (SPPB) test and structural and functional echocardiographic parameters and to determine whether SPPB scores and cardiac dysfunction are independent mortality predictors in an elderly Russian population. A random sample of 284 community-dwelling adults aged 65 and older were selected from a population-based register and divided into two age groups (65-74 and ≥75). The SPPB test, echocardiography and all-cause mortality were measured. The prevalence of cardiac dysfunction was 12% in the 65-74 group and 23% in the ≥75 group. The multivariate models could explain 15% and 23% of the SPPB score total variance for the 65-74 and ≥75 age groups, respectively. In the younger age group, the mean follow-up time was 2.6±0.46 years, and the adjusted hazard ratio (HR) for risk of mortality from cardiac dysfunction was 4.9. In the older age group, the mean follow-up time was 2.4±0.61 years, and both cardiac dysfunction and poor physical performance were found to be independent predictors of mortality (adjusted HR=3.4 and adjusted HR=4.2, respectively). The cardiac dysfunction prevalence in this elderly Russian population was found to be comparable to, or even lower than, reported prevalences for Western countries. Furthermore, the observed correlations between echocardiographic abnormalities and SPPB scores were limited. Cardiac dysfunction was shown to be a strong mortality predictor in both age groups, and poor physical performance was identified as an independent mortality predictor in the oldest subjects. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Impact of video game genre on surgical skills development: a feasibility study.

PubMed

de Araujo, Thiago Bozzi; Silveira, Filipe Rodrigues; Souza, Dante Lucas Santos; Strey, Yuri Thomé Machado; Flores, Cecilia Dias; Webster, Ronaldo Scholze

2016-03-01

The playing of video games (VGs) was previously shown to improve surgical skills. This is the first randomized, controlled study to assess the impact of VG genre on the development of basic surgical skills. Twenty first-year, surgically inexperienced medical students attended a practical course on surgical knots, suturing, and skin-flap technique. Later, they were randomized into four groups: control and/or nongaming (ContG), first-person-shooter game (ShotG), racing game (RaceG), and surgery game (SurgG). All participants had 3 wk of Nintendo Wii training. Surgical and VG performances were assessed by two independent, blinded surgeons who evaluated basal performance (time 0) and performance after 1 wk (time 1) and 3 wk (time 2) of training. The training time of RaceG was longer than that of ShotG and SurgG (P = 0.045). Compared to SurgG and RaceG, VG scores for ShotG improved less between times 0 and 1 (P = 0.010) but more between times 1 and 2 (P = 0.004). Improvement in mean surgical performance scores versus time differed in each VG group (P = 0.011). At time 2, surgical performance scores were significantly higher in ShotG (P = 0.002) and SurgG (P = 0.022) than in ContG. The surgical performance scores of RaceG were not significantly different from the score achieved by ContG (P = 0.279). Different VG genres may differentially impact the development of surgical skills by medical students. More complex games seem to improve performance even if played less. Although further studies are needed, surgery-related VGs with sufficient complexity and playability could be a feasible adjuvant to improving surgical skills. Copyright © 2016 Elsevier Inc. All rights reserved.

Hey Teacher, Don't Leave Them Kids Alone: Action Is Better for Memory than Reading.

PubMed

Hainselin, Mathieu; Picard, Laurence; Manolli, Patrick; Vankerkore-Candas, Sophie; Bourdin, Béatrice

2017-01-01

There is no consensus on how the enactment effect (EE), although it is robust, enhances memory. Researchers are currently investigating the cognitive processes underlying this effect, mostly during adulthood; the link between EE and crucial function identified in adulthood such as episodic memory and binding process remains elusive. Therefore, this study aims to verify the existence of EE in 6-10 years old and assess cognitive functions potentially linked to this effect in order to shed light on the mechanisms underlying the EE during childhood. Thirty-five children (15 second graders and 20 fifth graders) were included in this study. They encoded 24 action phrases from a protocol adapted from Hainselin et al. (2014). Encoding occurred under four conditions: Verbal Task, Listening Task, Experimenter-Performed Task, and Subject-Performed Task. Memory performance was assessed for free and cued recall, as well as source memory abilities. ANOVAS were conducted to explore age-related effects on the different scores according to encoding conditions. Correlations between EE scores (Subject-Performed Task/Listening Task) and binding memory scores (short-term binding and episodic memory) were run. Both groups benefited from EE. However, in both groups, performance did not significantly differ between Subject-Performed Task and Experimenter-Performed Task. A positive correlation was found between EE and episodic memory score for second graders and a moderate negative correlation was found between EE and binding scores for fifth graders. Our results confirm the existence of EE in 6 and 10 year olds, but they do not support the multimodal theory (Engelkamp, 2001) or the "glue" theory (Kormi-Nouri and Nilsson, 2001). This suggests instead that episodic memory might not underlie EE during early childhood.

Do increases in selected fitness parameters affect the aesthetic aspects of classical ballet performance?

PubMed

Twitchett, Emily A; Angioi, Manuela; Koutedakis, Yiannis; Wyon, Matthew

2011-03-01

Research has indicated that classical ballet dancers tend to have lower fitness levels and increased injury rates compared to other athletes with similar workloads. The aim of the current study was to examine the effects of a specifically tailored fitness training programme on the incidence of injury and the aesthetic quality of performance of classical ballet dancers compared to a control group. Proficiency in performance was evaluated at the beginning and end of the intervention period for both groups through a 4-min dance sequence using previously ratified marking criteria. The intervention group (n = 8) partook in a weekly 1-hr training session that included aerobic interval training, circuit training, and whole body vibration. All dancers' performance proficiency scores increased from pre-intervention testing to post-intervention. The intervention group's overall performance scores demonstrated a significantly greater increase (p = 0.03) than the equivalent for the control group. It was concluded that supplementary fitness training has a positive effect on aspects related to aesthetic dance performance as studied herein; further research is recommended on a larger and more varied sample. Practical applications from this study suggest that supplemental training should be part of a ballet dancer's regime, and minimal intervention time is required to have observable effects.

Improved procedural performance following a simulation training session may not be transferable to the clinical environment.

PubMed

Finan, E; Bismilla, Z; Campbell, C; Leblanc, V; Jefferies, A; Whyte, H E

2012-07-01

Neonatal intubation is a life-saving procedural skill required by pediatricians. Trainees receive insufficient clinical exposure to develop this competency. Traditional training comprises a Neonatal Resuscitation Program (NRP) complemented by clinical experience. More recently, simulation is being used in procedural skills training. The objective of this study is to examine the impact of a simulation session, which teaches the skill of neonatal intubation by comparing pre- and post-intervention performance, and examining transferability of skill acquisition to the clinical setting. First-year pediatric residents with NRP training, but no previous neonatal experience, attended a 2-h intubation education session conducted by two experienced respiratory therapists. Individual components of the skill were taught, followed by practice on a high-fidelity infant mannequin with concurrent feedback. Skills were assessed using a validated neonatal intubation checklist (CL) and a five-point global rating scale (GRS), pre- and immediately post-intervention, using the mannequin. Clinical intubations performed in the subsequent 8-week neonatal intensive-care unit (NICU) rotation were evaluated by documenting success rates, time taken to intubate, and CL and GRS scores. Performance was also compared with similar data collected on intubations performed by a historical cohort of first-year residents who did not receive the training intervention. Data were analyzed using descriptive statistics, Student's t-test and χ (2)-test as appropriate, and analysis of variance. Thirteen residents participated in the educational session. Mean pre-intervention CL score was 65.4 ± 18% (s.d.) and GRS was 3 ± 0.7 (s.d.). Performance improved following the intervention with post-training CL score of 93 ± 5% (P<0.0001) and GRS of 3.92 ± 0.4 (P=0.0003). These trainees performed 40 intubations during their subsequent NICU rotation, with a success rate of 67.5% compared with 63.15% in the cohort group (NS). However, mean CL score for the study trainees during the NICU rotation was 64.6 ± 20%, significantly lower than their post-training CL score (P<0.001), and significantly lower than the historical cohort score of 82.5 ± 15.4% (P=0.001). In the intervention group, there were no significant differences between the pre-intervention and real-life CL scores of 65 ± 18% and 64.63 %, respectively, and the pre-intervention and real-life GRS of 3.0 ± 0.7 and 2.95 ± 0.86, respectively. Trainees showed significant improvement in intubation skills immediately post intervention, but this did not translate into improved-clinical performance, with performance returning to baseline. In fact, significantly higher CL scores were demonstrated by the cohort group. These data suggest that improved performance in the simulation environment may not be transferable to the clinical setting. They also support the evidence that although concurrent feedback may lead to improved performance immediately post training intervention, this does not result in improved skill retention overall.

Impact of complications and bladder cancer stage on quality of life in patients with different types of urinary diversions.

PubMed

Prcic, Alden; Aganovic, Damir; Hadziosmanovic, Osman

2013-12-01

Determine correlation between complications and stage of the disease and their impact on quality of life in patients with different types of ileal urinary derivation after radical cystectomy, and upon estimation of acquired results, to suggest the most acceptable type of urinary diversion. In five year period a prospective clinical study was performed on 106 patients, to whom a radical cystectomy was performed due to bladder cancer. Patients were divided into two groups, 66 patients with ileal conduit derivation and 40 patients with orthotopic derivation, whereby in each group a comparison between reflux and anti-reflux technique of orthotopic bladder was made. All patients from both groups filled the Sickness Impact Profile score six months after the operation. All patients had CT urography or Intravenous urography performed, as well as standard laboratory, vitamin B12 blood values, in order to evaluate early (ileus or subileus, wound dehiscence, bladder fistula, rupture of orthotopic bladder, urine extravazation) and late complications (VUR, urethral stricture, ureter stenosis, metabolic acidosis, mineral dis-balance, hypovitaminosis of vitamin B12, increased resorption of bone calcium, urinary infection, kidney damage, relapse of primary disease), so as disease stage and it's impact on quality of life. From gained results we observe that each category of SIP score correlates with different rate of correlation with the type of operation, group, T, N, and R grade, except work category. Average value of SIP score rises depending on the type of operation and T stage. It is notable that there is no difference in T1 stage, no matter the type of operation. So the average value of SIP score in T1 stage for conduit was 20.3, for Abol-Enein and Ghoneim 17.25 and Hautmann 18.75 respectively. Average value of SIP score in T2 stage for conduit was 31, for Abol-Enein and Ghoneim 19.1 and Hautmann 17.8. Average value of SIP score in T3 stage for conduit was 38.03, for Abol-Enein and Ghoneim 18.75 and Hautmann 19.5. SIP score for T4 was present only in patients with conduit performed and average value od SIP score was 40.42. There is a high level of correlation of late complications and psychosocial and physical dimension with their parameters, while for an independent dimension of correlation is not significant. Early complications have insignificant correlation in all categories of SIP score. Upon analyzing quality of life and morbidity, significant advantage is given to orthotopic derivations, especially Hautmann derivation with Chimney modification, unless there are no absolute contraindications for performing this type of operation. Factors which mostly influence quality of life are cancer stage, type of derivation, late complications and patient age. SIP score, as a well validated questionnaire, are applicable in this kind of research.

Can formative quizzes predict or improve summative exam performance?*

PubMed Central

Zhang, Niu; Henderson, Charles N.R.

2015-01-01

Objective Despite wide use, the value of formative exams remains unclear. We evaluated the possible benefits of formative assessments in a physical examination course at our chiropractic college. Methods Three hypotheses were examined: (1) Receiving formative quizzes (FQs) will increase summative exam (SX) scores, (2) writing FQ questions will further increase SE scores, and (3) FQs can predict SX scores. Hypotheses were tested across three separate iterations of the class. Results The SX scores for the control group (Class 3) were significantly less than those of Classes 1 and 2, but writing quiz questions and taking FQs (Class 1) did not produce significantly higher SX scores than only taking FQs (Class 2). The FQ scores were significant predictors of SX scores, accounting for 52% of the SX score. Sex, age, academic degrees, and ethnicity were not significant copredictors. Conclusion Our results support the assertion that FQs can improve written SX performance, but students producing quiz questions didn't further increase SX scores. We concluded that nonthreatening FQs may be used to enhance student learning and suggest that they also may serve to identify students who, without additional remediation, will perform poorly on subsequent summative written exams. PMID:25517737

Language assessment of children with severe liver disease in a public service in Brazil

PubMed Central

de-Paula, Erica Macêdo; Porta, Gilda; Tannuri, Ana Cristina Aoun; Tannuri, Uenis; Befi-Lopes, Debora Maria

2017-01-01

OBJECTIVE: The aim of this research was to compare language development (expressive and receptive skills) in children awaiting liver transplantation with that of children who have already undergone the surgical procedure. METHODS: An observational, descriptive, cross-sectional study was conducted with 76 children divided into groups, as follows: 31 children who were candidates for liver transplantation (Group 1; G1), 45 children who had already undergone liver transplantation (Group 2; G2), and a control group (CG) of 60 healthy, normally developing children. Health status information was gathered, and the Test of Early Language Development (TELD)-3 was used to assess language skills. Family household monthly income data were also gathered using a specific questionnaire. RESULTS: G1 had poorer language performance compared with G2 and the CG. G2 had lower language performance when compared with the CG. However, when considering the TELD-3 standard scores, G2 had scores within normal limits. The regression analysis indicated age as a risk factor for language deficits in Group 1 and family income as a risk factor for language deficits in G2. CONCLUSIONS: The results suggested that children with chronic liver disease have delays in language development. Transplanted children have linguistic performance within normal limits, but their scores tended to be lower than the CG. PMID:28658434

[Impact of a psychosocial intervention in caregiver burden of children with cerebral palsy].

PubMed

Martínez Lazcano, Félix; Avilés Cura, Manuel; Ramírez Aranda, José Manuel; Riquelme Heras, Héctor; Garza Elizondo, Teófilo; Barrón Garza, Fabiola

2014-10-01

To demonstrate that problem-solving therapy is effective in reducing the burden on caregivers of children with cerebral palsy. Randomized clinical trial. Check primary care within a private nonprofit association. 140caregivers divided into control group (CG) and experimental group (EG). We performed in both groups a psychosocial intervention with a frequency of one session per week for three weeks to complete 120minutes. In the EG performed a shortened form of problem-solving therapy with a focus on caregiver burden and the CG performed an educational intervention focusing on respiratory diseases. The response variable corresponds to the score obtained by Zarit questionnaire. The independent variable accounted for psychosocial intervention. In the EG according to Zarit questionnaire score was obtained by averaging 45.0 points pre intervention against 45.3 points in the CP after intervention Zarit was obtained by averaging 29.8 points in the EG and 44.3 points in the CG (P<.0001). The catalog groups according to their score Zarit in charge: none, mild, moderate and severe impact differences were found in the different intervention categories (Wilcoxon test Z=6.281, P<.00001). Problem solving therapy is effective in reducing the burden on caregivers of children with cerebral palsy. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

Conflict resolution abilities in children with Specific Language Impairment.

PubMed

Paula, Erica Macêdo de; Befi-Lopes, Debora Maria

2013-01-01

To investigate the conflict resolution abilities of children with Specific Language Impairment, and to verify whether the time of speech-language therapy correlates to the performance on the conflict resolution task. Participants included 20 children with Specific Language Impairment (Research Group) and 40 children with normal language development (Control Group), with ages ranging from 7 years to 8 years and 11 months. To assess the conflict resolution abilities, five hypothetical contexts of conflict were presented. The strategies used by the children were classified and scored by the following levels: level 0 (solutions that do not match the other levels), level 1 (physical solutions), level 2 (unilateral solutions), level 3 (cooperative solutions), and level 4 (mutual solutions). Statistical analysis showed group effect for the variable total score. There was a difference between the groups for modal development level, with higher level of modal development observed in the Control Group. There was no correlation between the period of speech-language therapy attendance and the total score. Children with Specific Language Impairment present difficulties in solving problems, in view of the fact that they mainly use physical and unilateral strategies. There was no correlation between the time of speech-language therapy and performance in the task.

Pre-liver transplant psychosocial evaluation predicts post-transplantation outcomes.

PubMed

Benson, Ariel A; Rowe, Mina; Eid, Ahmad; Bluth, Keren; Merhav, Hadar; Khalaileh, Abed; Safadi, Rifaat

2018-08-01

Psychosocial factors greatly impact the course of patients throughout the liver transplantation process. A retrospective chart review was performed of patients who underwent liver transplantation at Hadassah-Hebrew University Medical Center between 2002 and 2012. A composite psychosocial score was computed based on the patient's pre-transplant evaluation. Patients were divided into two groups based on compliance, support and insight: Optimal psychosocial score and Non-optimal psychosocial score. Post-liver transplantation survival and complication rates were evaluated. Out of 100 patients who underwent liver transplantation at the Hadassah-Hebrew University Medical Center between 2002 and 2012, 93% had a complete pre-liver transplant psychosocial evaluation in the medical record performed by professional psychologists and social workers. Post-liver transplantation survival was significantly higher in the Optimal group (85%) as compared to the Non-optimal group (56%, p = .002). Post-liver transplantation rate of renal failure was significantly lower in the Optimal group. No significant differences were observed between the groups in other post-transplant complications. A patient's psychosocial status may impact outcomes following transplantation as inferior psychosocial grades were associated with lower overall survival and increased rates of complications. Pre-liver transplant psychosocial evaluations are an important tool to help predict survival following transplantation.

Impact of seductive details on the acquisition and transfer of laparoscopic suturing skills: Emotionally interesting or cognitively taxing?

PubMed

Gardner, Aimee K; Clanton, Jesse; Jabbour, Ibrahim I; Scott, Lauren; Scott, Daniel J; Russo, Michael A

2016-09-01

A common strategy to increase learner engagement is to interweave educational material with interesting but slightly tangential tidbits of information (eg, "war stories" and funny anecdotes), known as seductive details. Our objective was to examine the impact of seductive details on initial acquisition and transfer of basic laparoscopic surgical skills. Novices (first- to fourth-year medical students) were randomized into control (N = 47) or seductive details (N = 42) groups. Curricula consisted of a baseline skills assessment (Fundamentals of Laparoscopic Surgery Task 1), instructional video on intracorporeal laparoscopic suturing (Fundamentals of Laparoscopic Surgery Task 5), multiple choice quiz, practice, and assessment on both primary and transfer tasks. Two separate instructional videos were used for Task 5; 20% of the seductive details group's instructional video consisted of seductive details, whereas the control group's video included no seductive details. Participants completed questionnaires of mental workload and task engagement after training. We also conducted a mediation analysis, which is a statistical approach to identify causal paths among a group of variables. Baseline skill scores (control: 112 ± 52; standard deviation: 118 ± 56; 0 = lowest possible score; 600 = highest possible score) and knowledge scores (control: 76 ± 19; standard deviation: 74 ± 16; 0 = lowest possible score; 100 = highest possible score) were similar for both groups. The control group demonstrated better (higher) performance on both the primary (434 ± 193 vs 399 ± 133, P < .05) and transfer (184 ± 74 vs 149 ± 91, P < .05) suturing tasks. Mental workload, as measured by the National Aeronautics and Space Administration-Task Load Index, was more demanding (higher) for the seductive details group (3.8 ± 0.5 vs 3.4 ± 0.7, P < .01; 1 = low workload; 5 = high workload) and was investigated as the possible mechanism by which group assignment impacted performance. Mediational paths using hierarchical regression were significant (P < .05), suggesting that trainees in the seductive details group performed worse because of their increased workload. Our findings suggest that the inclusion of seductive details may be detrimental to the acquisition and transfer of laparoscopic surgical skills due to increased mental workload for trainees. Copyright © 2016 Elsevier Inc. All rights reserved.

Executive function in children with high and low attentional skills: correspondences between behavioural and cognitive profiles.

PubMed

Scope, Alison; Empson, Janet; McHale, Sue

2010-06-01

Cognitive performance was compared between two groups of typically developing children, who had been observed and rated as differing significantly in their attentional skills at school. The participants were 24 8- and 9-year-old children scoring poorly relative to peers, on a classroom observation scale and teacher rating scale for attention, hyperactivity, and impulsivity [low-attentional skills (LAS) group] and 24 sex- and age-matched children scoring at a high level compared to peers [high-attentional skills (HAS) group]. The two groups were compared on a series of cognitive tasks to assess executive function (EF). The LAS group performed within the typical range yetat a significantly lower level than the HAS group on the majority of the EF tasks administered, namely working memory and inhibition measures, even though there were no significant differences between the groups on a measure of intellectual ability. Working memory measures followed by measures of inhibition emerged as the best predictors of group membership. These findings provide empirical evidence that there are individual differences in attentional skills. Specifically, that there is a relationship between behavioural inattention, hyperactivity, and impulsivity and cognitive performance on working memory and inhibitory control tasks.

Collagen Augmentation Improves the Quality of Cartilage Repair After Microfracture in Patients Undergoing High Tibial Osteotomy: A Randomized Controlled Trial.

PubMed

Kim, Man Soo; Koh, In Jun; Choi, Young Jun; Pak, Kyu Hyung; In, Yong

2017-07-01

The quality of cartilage repair after marrow stimulation is unpredictable. To overcome the shortcomings of the microfracture technique, various augmentation techniques have been developed. However, their efficacies remain unclear. The quality of cartilage repair and clinical outcomes would be superior in patients undergoing high tibial osteotomy (HTO) with microfracture and collagen augmentation compared to those undergoing HTO with microfracture alone without collagen augmentation for the treatment of medial compartment osteoarthritis (OA) of the knee. Randomized controlled trial; Level of evidence, 2. Twenty-eight patients undergoing HTO were randomized into 2 groups: microfracture alone (group 1, n = 14) or microfracture with collagen augmentation (group 2, n = 14). At 1 year postoperatively, second-look arthroscopic surgery and biopsy of repaired cartilage were performed at the time of HTO plate removal. Biopsy specimens were graded using the International Cartilage Repair Society Visual Assessment Scale II (ICRS II). In addition, imaging outcomes in terms of the magnetic resonance observation of cartilage repair tissue (MOCART) score were assessed based on magnetic resonance imaging (MRI). Finally, clinical outcomes in terms of the visual analog scale (VAS) for pain score, Knee Injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC) score, and Tegner activity scale score were evaluated. The mean ICRS II score in group 2 was significantly higher than that in group 1 (1053.2 vs 885.4, respectively; P = .002). Group 2 showed greater improvement in tissue morphology, cell morphology, surface architecture, middle/deep zone assessment, and overall assessment compared with group 1 ( P < .050 for all comparisons). Imaging outcomes based on the MOCART score were superior in group 2 compared to those in group 1 on MRI at 1 year postoperatively (64.6 vs 45.4, respectively; P = .001). The degree of defect repair was better in group 2 than in group 1 ( P = .040). Clinical outcomes in terms of the VAS for pain score, KOOS, IKDC score, and Tegner activity scale score were improved in both groups without between-group differences ( P > .100 for all comparisons). The quality of cartilage repair after microfracture with collagen augmentation was superior to that after microfracture alone in patients undergoing HTO. Clinical results after 1 year did not reflect this difference in tissue repair. Therefore, a longer follow-up of the cohort is needed to answer this question.

Visual distraction alone for the improvement of colonoscopy-related pain and satisfaction

PubMed Central

Umezawa, Shotaro; Higurashi, Takuma; Uchiyama, Shiori; Sakai, Eiji; Ohkubo, Hidenori; Endo, Hiroki; Nonaka, Takashi; Nakajima, Atsushi

2015-01-01

AIM: To evaluate the effect of a relaxing visual distraction alone on patient pain, anxiety, and satisfaction during colonoscopy. METHODS: This study was designed as an endoscopist-blinded randomized controlled trial with 60 consecutively enrolled patients who underwent elective colonoscopy at Yokohama City University Hospital, Japan. Patients were randomly assigned to two groups: group 1 watched a silent movie using a head-mounted display, while group 2 only wore the display. All of the colonoscopies were performed without sedation. We examined pain, anxiety, and the satisfaction of patients before and after the procedure using questionnaires that included the Visual Analog Scale. Patients were also asked whether they would be willing to use the same method for a repeat procedure. RESULTS: A total of 60 patients were allocated to two groups. Two patients assigned to group 1 and one patient assigned to group 2 were excluded after the randomization. Twenty-eight patients in group 1 and 29 patients in group 2 were entered into the final analysis. The groups were similar in terms of gender, age, history of prior colonoscopy, and pre-procedural anxiety score. The two groups were comparable in terms of the cecal insertion rate, the time to reach the cecum, the time needed for the total procedure, and vital signs. The median anxiety score during the colonoscopy did not differ significantly between the two groups (median scores, 20 vs 24). The median pain score during the procedure was lower in group 1, but the difference was not significant (median scores, 24.5 vs 42). The patients in group 1 reported significantly higher median post-procedural satisfaction levels, compared with the patients in group 2 (median scores, 89 vs 72, P = 0.04). Nearly three-quarters of the patients in group 1 wished to use the same method for repeat procedures, and the difference in rates between the two groups was statistically significant (75.0% vs 48.3%, P = 0.04). Patients with greater levels of anxiety before the procedure tended to feel a painful sensation. Among patients with a pre-procedural anxiety score of 50 or higher, the anxiety score during the procedure was significantly lower in the group that received the visual distraction (median scores, 20 vs 68, P = 0.05); the pain score during the colonoscopy was also lower (median scores, 23 vs 57, P = 0.04). No adverse effects arising from the visual distraction were recognized. CONCLUSION: Visual distraction alone improves satisfaction in patients undergoing colonoscopy and decreases anxiety and pain during the procedure among patients with a high pre-procedural anxiety score. PMID:25914482

Concomitant SLAP repair does not influence the surgical outcome for arthroscopic Bankart repair of traumatic shoulder dislocations.

PubMed

Aydin, Nuri; Unal, Mehmet Bekir; Asansu, Mustafa; Tok, Okan

2017-01-01

Prior studies revealed the presence of superior labrum anterior-to-posterior (SLAP) injury together with Bankart lesions in some patients. The purpose of the study is to compare the clinical results of isolated Bankart repairs with the clinical results of Bankart repairs when performed with concomitant SLAP repairs. The patients who underwent arthroscopic surgery for treatment of anterior glenohumeral instability were evaluated retrospectively. Group 1 consisted of 19 patients who had arthroscopic SLAP repair together with Bankart repair. The mean age of the patients was 23. Group 2 consisted of 38 patients who underwent isolated Bankart repair. The mean age was 24. Knotless anchors were used in both groups. The mean follow-up was 34 months (range: 26-72). In group 1, the mean preoperative Constant score was 84 (range: 74-90, standard deviation (SD): 5.91) and Rowe score was 64.1 (range: 40-70, SD: 8.14). In group 2, the preoperative Constant score was 84.4 (range: 70-96, SD: 5.88) and Rowe score was 60 (range: 45-70, SD: 7.95). In group 1, the postoperative mean Constant score raised to 96.8 (range: 88-100, SD: 2.91) and the mean Rowe score raised to 92.3 (range: 85-100, SD: 5.17). In group 2, the postoperative mean Constant score was 94.9 (range: 88-100, SD: 3.70) and the mean Rowe score was 94.2 (range: 80-100, SD: 4.71). The difference between the scores of two groups was insignificant ( p > 0.05). When the numbers of redislocations and range of motion were compared, no significant difference was found ( p > 0.05). Accompanying SLAP repair in surgical treatment with Bankart repair for shoulder instability does not affect the results negatively. Properly repaired labral tears extending from anterior inferior to the posterior superior of the glenoid in instability treatment have the same outcome in overall results as repaired isolated Bankart lesions.

The effect of video game "warm-up" on performance of laparoscopic surgery tasks.

PubMed

Rosser, James C; Gentile, Douglas A; Hanigan, Kevin; Danner, Omar K

2012-01-01

Performing laparoscopic procedures requires special training and has been documented as a significant source of surgical errors. "Warming up" before performing a task has been shown to enhance performance. This study investigates whether surgeons benefit from "warming up" using select video games immediately before performing laparoscopic partial tasks and clinical tasks. This study included 303 surgeons (249 men and 54 women). Participants were split into a control (n=180) and an experimental group (n=123). The experimental group played 3 previously validated video games for 6 minutes before task sessions. The Cobra Rope partial task and suturing exercises were performed immediately after the warm-up sessions. Surgeons who played video games prior to the Cobra Rope drill were significantly faster on their first attempt and across all 10 trials. The experimental and control groups were significantly different in their total suturing scores (t=2.28, df=288, P<.05). The overall Top Gun score showed that the experimental group performed marginally better overall. This study demonstrates that subjects completing "warming-up" sessions with select video games prior to performing laparoscopic partial and clinical tasks (intracorporeal suturing) were faster and had fewer errors than participants not engaging in "warm-up." More study is needed to determine whether this translates into superior procedural execution in the clinical setting.

More than a score: a qualitative study of ancillary benefits of performance measurement.

PubMed

Powell, Adam A; White, Katie M; Partin, Melissa R; Halek, Krysten; Hysong, Sylvia J; Zarling, Edwin; Kirsh, Susan R; Bloomfield, Hanna E

2014-08-01

Prior research has examined clinical effects of performance measurement systems. To the extent that non-clinical effects have been researched, the focus has been on negative unintended consequences. Yet, these same systems may also have ancillary benefits for patients and providers--that is, benefits that extend beyond improvements on clinical measures. The purpose of this study is to identify and describe potential ancillary benefits of performance measures as perceived by primary care staff and facility leaders in a large US healthcare system. In-person individual semistructured interviews were conducted with 59 primary care staff and facility leaders at four Veterans Health Administration facilities. Transcribed interviews were coded and organised into thematic categories. Interviewed staff observed that local performance measurement implementation practices can result in increased patient knowledge and motivation. These effects on patients can lead to improved performance scores and additional ancillary benefits. Performance measurement implementation can also directly result in ancillary benefits for the patients and providers. Patients may experience greater satisfaction with care and psychosocial benefits associated with increased provider-patient communication. Ancillary benefits of performance measurement for providers include increased pride in individual or organisational performance and greater confidence that one's practice is grounded in evidence-based medicine. A comprehensive understanding of the effects of performance measurement systems needs to incorporate ancillary benefits as well as effects on clinical performance scores and negative unintended consequences. Although clinical performance has been the focus of most evaluations of performance measurement to date, both patient care and provider satisfaction may improve more rapidly if all three categories of effects are considered when designing and evaluating performance measurement systems. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Behaviour of 4- to 5-year-old nondisabled ELBW children: Outcomes following group-based physiotherapy intervention.

PubMed

Brown, L; Burns, Y R; Watter, P; Gray, P H; Gibbons, K S

2018-03-01

Extreme prematurity or extremely low birth weight (ELBW) can adversely affect behaviour. Nondisabled ELBW children are at risk of behavioural problems, which may become a particular concern after commencement of formal education. This study explored the frequency of behavioural and emotional problems amongst nondisabled ELBW children at 4 to 5 years of age and whether intervention had a positive influence on behaviour. The relationship between behaviour, gender, and other areas of performance at 5 years was explored. Fifty 4-year-old children (born <28 weeks gestation or birth weight <1,000 g) with minimal/mild motor impairment were randomly allocated to intervention (n = 24) or standard care (n = 26). Intervention was 6 group-based physiotherapy weekly sessions and home programme. Standard care was best practice advice. The Child Behavior Checklist (CBCL) for preschool children was completed at baseline and at 1-year post-baseline. Other measures at follow-up included Movement Assessment Battery for Children Second Edition, Beery Visual-Motor Integration Test 5th Edition, and Peabody Picture Vocabulary Test 4th Edition. The whole cohort improved on CBCL total problems score between baseline (mean 50.0, SD 11.1) and 1-year follow-up (mean 45.2, SD 10.3), p = .004. There were no significant differences between groups over time on CBCL internalizing, externalizing, or total problems scores. The intervention group showed a mean difference in total problems score of -3.8 (CI [1.5, 9.1]) between times, with standard care group values being -4.4 (CI [1.6, 7.1]). Males had higher total problems scores than females (p = .026), although still performed within the "normal" range. CBCL scores did not correlate with other scores. The behaviour of nondisabled ELBW children was within the "normal" range at 4 to 5 years, and both intervention and standard care may have contributed to improved behavioural outcomes. Behaviour was not related to performance in other developmental domains. © 2017 John Wiley & Sons Ltd.

Effective scoring of scapha prevents helix irregularity in prominent ear correction - a biomechanical study.

PubMed

Nagasao, Tomohisa; Miyamoto, Junpei; Shimizu, Yusuke; Kasai, Shogo; Kishi, Kazuo; Kaneko, Tsuyoshi

2014-09-01

As the antihelix is created in the operation for prominent ear, the helix often presents irregularities. This biomechanical study aims to elucidate effective techniques to prevent these irregularities. Finite element models were produced simulating 10 prominent ears. The scaphas of the 10 models were thinned to simulate scoring or abrasion of the cartilage. The thinning was conducted in four fashions. In the first group, no thinning was conducted (Non-Scoring Models); in the second group, the upper half of the scapha was thinned (Upper-Scoring Models); in the third group, the lower half of the scapha was thinned (Lower-Scoring Models); in the fourth group, the whole scapha was thinned (Whole-Scoring Models). Mattress sutures were applied to create the antihelix to simulate Mustarde's in-suture technique. Thereafter, transformation of the helix's contour was evaluated. Irregularity developed on the upper region of the helix with Non-Scoring and Lower-Scoring Models; the degree of the upper-region's irregularity was reduced with Upper-Scoring Models and Whole-Scoring Models. Although the edge of the helix moved in the posterior-medial direction with other type models, it moved in the anterior direction with Whole-Scoring Models. Irregularity of the upper region of the helix can be prevented by performing scoring or abrasion of the upper part of the scapha. The prominence of the helix and width of the auricle are adjustable by varying the areas of the scapha receiving scoring or abrasion. These findings are useful in improving operative outcomes in the treatment of prominent ears. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Effectiveness of braille and audio-tactile performance technique for improving oral hygiene status of visually impaired adolescents.

PubMed

Deshpande, Sushmita; Rajpurohit, Ladusingh; Kokka, Vivian Varghese

2017-01-01

Visually impaired people encounter numerous challenges in their daily life which makes it a cumbersome task to pay special attention to oral health needs. Furthermore, there is little knowledge about oral health practices among caretakers and visually impaired individuals, due to which oral health is often neglected when compared to the general health. Hence, there was a need to educate visually challenged individuals about oral hygiene practices in a customized format so that the comprehension of brushing techniques could be conveyed at its best. The present study was a randomized control trial of sixty visually impaired adolescents who were divided into three groups of 20 each. In Group 1, Braille was used, whereas in Group 2, audio-tactile performance (ATP) technique and in Group 3, a combination of both the methods were used to teach tooth brushing as a part of oral health education. Pre- and post-plaque index score using Silness and Loe (1967) after health education were calculated and tabulated for statistical analysis. The postintervention mean plaque index score increased in Group 1 from 29.45 to 42.98, whereas the mean plaque score decreased in Groups 2 and 3 from 30.83-29.9 to 30.23-18.73, respectively. Intergroup comparison of postplaque index score using Kruskal-Wallis and ANOVA analysis showed significant difference among all three study groups. The combination of Braille and ATP technique of health education served as the most effective medium to teach oral hygiene methods to visually impaired adolescents.

Effectiveness of braille and audio-tactile performance technique for improving oral hygiene status of visually impaired adolescents

PubMed Central

Deshpande, Sushmita; Rajpurohit, Ladusingh; Kokka, Vivian Varghese

2017-01-01

Background: Visually impaired people encounter numerous challenges in their daily life which makes it a cumbersome task to pay special attention to oral health needs. Furthermore, there is little knowledge about oral health practices among caretakers and visually impaired individuals, due to which oral health is often neglected when compared to the general health. Hence, there was a need to educate visually challenged individuals about oral hygiene practices in a customized format so that the comprehension of brushing techniques could be conveyed at its best. Materials and Methods: The present study was a randomized control trial of sixty visually impaired adolescents who were divided into three groups of 20 each. In Group 1, Braille was used, whereas in Group 2, audio-tactile performance (ATP) technique and in Group 3, a combination of both the methods were used to teach tooth brushing as a part of oral health education. Pre- and post-plaque index score using Silness and Loe (1967) after health education were calculated and tabulated for statistical analysis. Results: The postintervention mean plaque index score increased in Group 1 from 29.45 to 42.98, whereas the mean plaque score decreased in Groups 2 and 3 from 30.83–29.9 to 30.23–18.73, respectively. Intergroup comparison of postplaque index score using Kruskal–Wallis and ANOVA analysis showed significant difference among all three study groups. Conclusion: The combination of Braille and ATP technique of health education served as the most effective medium to teach oral hygiene methods to visually impaired adolescents. PMID:29386797

Short Physical Performance Battery for cardiovascular disease inpatients: implications for critical factors and sarcopenia.

PubMed

Yasuda, Tomohiro; Nakajima, Toshiaki; Sawaguchi, Tatsuya; Nozawa, Naohiro; Arakawa, Tomoe; Takahashi, Reiko; Mizushima, Yuta; Katayanagi, Satoshi; Matsumoto, Kazuhisa; Toyoda, Shigeru; Inoue, Teruo

2017-12-12

We examined the relationship between Short Physical Performance Battery (SPPB) and clinical and laboratory factors and the effect of sarcopenia and sarcopenic obesity (SO) on clinical and laboratory factors for cardiovascular disease (CVD) inpatients. CVD male (n = 318) and female (n = 172) inpatients were recruited. A stepwise multiple-regression analysis was performed to predict total SPPB scores and assess clinical and laboratory factors (physical characteristics, functional and morphological assessments, etc.). Each test outcome were compared among sarcopenia, SO and non-sarcopenic groups. To predict total SPPB scores, the predicted handgrip, Controlling Nutritional Status score, % body fat, anterior mid-thigh muscle thickness, standing height and systolic blood pressure were calculated for males and anterior mid-thigh MTH, BMI, knee extension and fat mass were calculated for females. There were no differences in blood pressure, total SPPB scores and functional assessments between sarcopenia and SO groups for CVD male and female inpatients. In conclusion, the physical performance of CVD inpatients can be predicted by nutritional, functional, clinical and anthropometric variables, regardless the gender and the presence of sarcopenia. Furthermore, the presence of sarcopenia has a negative effect on the clinical and laboratory factors, but there is a difference in impact between sarcopenia and SO regardless the gender.

Performance-oriented mobility assessment (POMA) balance score indicates need for assistive device.

PubMed

Mitchell, Kathryn D; Newton, Roberta A

2006-06-01

To determine (1) if older adults using an assistive device (AD) score lower on the Performance-Oriented Mobility Assessment (POMA) balance subscale (B-subscale) than individuals not using an AD; and (2) if a cut-score of 12 would indicate the need to use an AD. Elderly persons (n = 82, mean age = 82.1 years) were surveyed about AD use, health status, activity level and fall history. A one-time assessment of balance was conducted using the B-subscale. The 'arising task' was repeated to evaluate performance on the sit-to-stand task without using hands. A significant difference in B-subscale scores was observed between the two groups (AD; no AD), (P < 0.001). AD use was associated with lower activity level and health status. A cut-score of 12 points indicated device use (P = 0.000). The repeated 'arising task' demonstrated that 76.8% performed the task without using hands for support. Older adults using an AD will score lower on the B-subscale and report lower activity level and health status. A score of less than 12 on the B-subscale is indicative of AD need. Older adults who use an AD and self-report a falls history will score lower on the B-subscale than individuals using an AD and no reported history of falls.

Comparison of Actigraphy Immobility Rules with Polysomnographic Sleep Onset Latency in Children and Adolescents

PubMed Central

Meltzer, Lisa J.; Walsh, Colleen M.; Peightal, Ashley A.

2015-01-01

Purpose While actigraphy has gained popularity in pediatric sleep research, questions remain about the validity of actigraphy as an estimate of sleep-wake patterns. In particular, there is little consistency in the field in terms of scoring rules used to determine sleep onset latency. The purpose of this study was to evaluate different criteria of immobility as a measure of sleep onset latency in children and adolescents. Methods Ninety-five youth (ages 3-17 years, 46% male) wore both the Ambulatory-Monitoring Inc. Motionlogger Sleep Watch (AMI) and the Philips Respironics Mini-Mitter Actiwatch-2 (PRMM) during overnight polysomnography in a pediatric sleep lab. We examined different sleep onset latency scoring rules (3, 5, 10, 15, and 20 minutes of immobility) using different algorithms (Sadeh and Cole-Kripke) and sensitivity settings (Low, Medium, High) for the devices. Comparisons were also made across age groups (preschoolers, school-aged, adolescents) and sleep disordered breathing status (no obstructive sleep apnea [OSA], mild OSA, clinically significant OSA). Results For the AMI device, shorter scoring rules performed best for children and longer scoring rules were better for adolescents, with shorter scoring rules best across sleep disordered breathing groups. For the PRMM device, medium to longer scoring rules performed best across age and sleep disordered breathing groups. Conclusions Researchers are encouraged to determine the scoring rule that best fits their population of interest. Future studies are needed with larger samples of children and adolescents to further validate actigraphic immobility as a proxy for sleep onset latency. PMID:25687438

Predictive value of the model for end-stage liver disease score in patients undergoing left ventricular assist device implantation.

PubMed

Deo, Salil V; Daly, Richard C; Altarabsheh, Salah E; Hasin, Tal; Zhao, Yanjun; Shah, Ishan K; Stulak, John M; Boilson, Barry A; Schirger, John A; Joyce, Lyle D; Park, Soon J

2013-01-01

Axial flow left ventricular assist device (LVAD) implantation is an effective therapy for patients with advanced heart failure. As the preoperative hepatic and renal function play a critical role in determining adverse events after LVAD implantation, we analyzed the predictive role of the model for end-stage liver disease (MELD) score in determining in-hospital mortality after surgery. One hundred twenty-six patients underwent implant of an LVAD at our institution. Their individual preoperative MELD scores and perioperative total blood product usage (TBPU) were calculated. As LVAD implant as a reoperation is known to influence postoperative bleeding and mortality independently, the patients were divided into group I (first cardiac surgery) and group II (reoperative surgery). Group I: LVAD implantation was performed in 68/126 (54%) patients as their first cardiac surgery. The mean MELD score was 16.3 ± 6. Median TBPU for this group was 20.7 (0, 135) units. Inhospital mortality/30-day mortality was 4/68 (5.8%). Increasing MELD score (c-statistic = 0.88) and TBPU were found to be predictors of early mortality. An increasing MELD score was associated with more TBPU (p < 0.01) with a 10.9 ± 3 TBPU increase per a 10 unit rise in the MELD score. Group II: Of the 126 patients, 58 (46%) underwent LVAD implantation as a reoperation. Mean MELD score for these patients was 16 ± 5. Inhospital mortality/30-day mortality in this group was 12% and median TBPU was 30 (4,153) units. The MELD score was not predictive of inhospital mortality in these patients (p = 0.97). The MELD score is predictive of early mortality in patients undergoing LVAD implantation as their first cardiac surgery. Use of this score to select patients for LVAD implantation may be appropriate.

Effect of exposure to good vs poor medical trainee performance on attending physician ratings of subsequent performances.

PubMed

Yeates, Peter; O'Neill, Paul; Mann, Karen; Eva, Kevin W

2012-12-05

Competency-based models of education require assessments to be based on individuals' capacity to perform, yet the nature of human judgment may fundamentally limit the extent to which such assessment is accurately possible. To determine whether recent observations of the Mini Clinical Evaluation Exercise (Mini-CEX) performance of postgraduate year 1 physicians influence raters' scores of subsequent performances, consistent with either anchoring bias (scores biased similar to previous experience) or contrast bias (scores biased away from previous experience). Internet-based randomized, blinded experiment using videos of Mini-CEX assessments of postgraduate year 1 trainees interviewing new internal medicine patients. Participants were 41 attending physicians from England and Wales experienced with the Mini-CEX, with 20 watching and scoring 3 good trainee performances and 21 watching and scoring 3 poor performances. All then watched and scored the same 3 borderline video performances. The study was completed between July and November 2011. The primary outcome was scores assigned to the borderline videos, using a 6-point Likert scale (anchors included: 1, well below expectations; 3, borderline; 6, well above expectations). Associations were tested in a multivariable analysis that included participants' sex, years of practice, and the stringency index (within-group z score of initial 3 ratings). The mean rating scores assigned by physicians who viewed borderline video performances following exposure to good performances was 2.7 (95% CI, 2.4-3.0) vs 3.4 (95% CI, 3.1-3.7) following exposure to poor performances (difference of 0.67 [95% CI, 0.28-1.07]; P = .001). Borderline videos were categorized as consistent with failing scores in 33 of 60 assessments (55%) in those exposed to good performances and in 15 of 63 assessments (24%) in those exposed to poor performances (P < .001). They were categorized as consistent with passing scores in 5 of 60 assessments (8.3%) in those exposed to good performances compared with 25 of 63 assessments (39.5%) in those exposed to poor performances (P < .001). Sex and years of attending practice were not associated with scores. The priming condition (good vs poor performances) and the stringency index jointly accounted for 45% of the observed variation in raters' scores for the borderline videos (P < .001). In an experimental setting, attending physicians exposed to videos of good medical trainee performances rated subsequent borderline performances lower than those who had been exposed to poor performances, consistent with a contrast bias.

QNOTE: an instrument for measuring the quality of EHR clinical notes.

PubMed

Burke, Harry B; Hoang, Albert; Becher, Dorothy; Fontelo, Paul; Liu, Fang; Stephens, Mark; Pangaro, Louis N; Sessums, Laura L; O'Malley, Patrick; Baxi, Nancy S; Bunt, Christopher W; Capaldi, Vincent F; Chen, Julie M; Cooper, Barbara A; Djuric, David A; Hodge, Joshua A; Kane, Shawn; Magee, Charles; Makary, Zizette R; Mallory, Renee M; Miller, Thomas; Saperstein, Adam; Servey, Jessica; Gimbel, Ronald W

2014-01-01

The outpatient clinical note documents the clinician's information collection, problem assessment, and patient management, yet there is currently no validated instrument to measure the quality of the electronic clinical note. This study evaluated the validity of the QNOTE instrument, which assesses 12 elements in the clinical note, for measuring the quality of clinical notes. It also compared its performance with a global instrument that assesses the clinical note as a whole. Retrospective multicenter blinded study of the clinical notes of 100 outpatients with type 2 diabetes mellitus who had been seen in clinic on at least three occasions. The 300 notes were rated by eight general internal medicine and eight family medicine practicing physicians. The QNOTE instrument scored the quality of the note as the sum of a set of 12 note element scores, and its inter-rater agreement was measured by the intraclass correlation coefficient. The Global instrument scored the note in its entirety, and its inter-rater agreement was measured by the Fleiss κ. The overall QNOTE inter-rater agreement was 0.82 (CI 0.80 to 0.84), and its note quality score was 65 (CI 64 to 66). The Global inter-rater agreement was 0.24 (CI 0.19 to 0.29), and its note quality score was 52 (CI 49 to 55). The QNOTE quality scores were consistent, and the overall QNOTE score was significantly higher than the overall Global score (p=0.04). We found the QNOTE to be a valid instrument for evaluating the quality of electronic clinical notes, and its performance was superior to that of the Global instrument. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Resident training for eclampsia and magnesium toxicity management: simulation or traditional lecture?

PubMed

Fisher, Nelli; Bernstein, Peter S; Satin, Andrew; Pardanani, Setul; Heo, Hye; Merkatz, Irwin R; Goffman, Dena

2010-10-01

To compare eclampsia and magnesium toxicity management among residents randomly assigned to lecture or simulation-based education. Statified by year, residents (n = 38) were randomly assigned to 3 educational intervention groups: Simulation→Lecture, Simulation, and Lecture. Postintervention simulations were performed for all and scored using standardized lists. Maternal, fetal, eclampsia management, and magnesium toxcity scores were assigned. Mann-Whitney U, Wilcoxon rank sum and χ(2) tests were used for analysis. Postintervention maternal (16 and 15 vs 12; P < .05) and eclampsia (19 vs 16; P < .05) scores were significantly better in simulation based compared with lecture groups. Postintervention magnesium toxcitiy and fetal scores were not different among groups. Lecture added to simulation did not lead to incremental benefit when eclampsia scores were compared between Simulation→Lecture and Simulation (19 vs 19; P = nonsignificant). Simulation training is superior to traditional lecture alone for teaching crucial skills for the optimal management of both eclampsia and magnesium toxicity, 2 life-threatening obstetric emergencies. Published by Mosby, Inc.

Relations of mindfulness facets with psychological symptoms among individuals with a diagnosis of obsessive-compulsive disorder, major depressive disorder, or borderline personality disorder.

PubMed

Didonna, Fabrizio; Rossi, Roberta; Ferrari, Clarissa; Iani, Luca; Pedrini, Laura; Rossi, Nicoletta; Xodo, Erica; Lanfredi, Mariangela

2018-03-25

To explore differences in mindfulness facets among patients with a diagnosis of either obsessive-compulsive disorder (OCD), major depressive disorder (MDD), or borderline personality disorder (BPD), and healthy controls (HC), and their associations with clinical features. One hundred and fifty-three patients and 50 HC underwent a clinical assessment including measures of mindfulness (Five Facets Mindfulness Questionnaire - FFMQ), psychopathological symptoms (Symptom Check List-90-R), dissociation (Dissociative Experience Scale), alexithymia (Alexithymia Scale 20), and depression (Beck Depression Inventory-II). Analysis of variance (ANOVA) and analysis of covariance (ANCOVA) were performed to assess differences in mindfulness scores and their associations with clinical features. The three diagnostic groups scored lower on all mindfulness facets (apart from FFMQobserving) compared to the HC group. OCD group had a significant higher FFMQ total score (FFMQ-TS) and FFMQacting with awareness compared to the BPD group, and scored higher on FFMQdescribing compared to BPD and MDD groups. The scores in non-judging facet were significantly lower in all the three diagnostic groups compared to the HC group. Interestingly, higher FFMQ-TS was inversely related to all psychological measures, regardless of diagnostic group. Deficits in mindfulness skills were present in all diagnostic groups. Furthermore, we found disease-specific relationships between some mindfulness facets and specific psychological variables. Clinical implications are discussed. The study showed deficits in mindfulness scores in all diagnostic groups compared to a healthy control group. Overall, mindfulness construct has a significantly negative association with indexes of global distress, dissociative symptoms, alexithymia, and depression. Mindfulness-based interventions in clinical settings should take into account different patterns of mindfulness skills and their impact on disease-specific maladaptive cognitive strategies or symptomatology. © 2018 The British Psychological Society.

Score Reliability and Construct Validity of the Flinn Performance Screening Tool for Adults With Symptoms of Carpal Tunnel Syndrome

PubMed Central

Flinn, Sharon R.; Pease, William S.; Freimer, Miriam L.

2013-01-01

OBJECTIVE We investigated the psychometric properties of the Flinn Performance Screening Tool (FPST) for people referred with symptoms of carpal tunnel syndrome (CTS). METHOD An occupational therapist collected data from 46 participants who completed the Functional Status Scale (FSS) and FPST after the participants’ nerve conduction velocity study to test convergent and contrasted-group validity. RESULTS Seventy-four percent of the participants had abnormal nerve conduction studies. Cronbach’s α coefficients for subscale and total scores of the FPST ranged from .96 to .98. Intrarater reliability for six shared items of the FSS and the FPST was supported by high agreement (71%) and a fair κ statistic (.36). Strong to moderate positive relationships were found between the FSS and FPST scores. Functional status differed significantly among severe, mild, and negative CTS severity groups. CONCLUSION The FPST shows adequate psychometric properties as a client-centered screening tool for occupational performance of people referred for symptoms of CTS. PMID:22549598

Isoflavones, calcium, vitamin D and inulin improve quality of life, sexual function, body composition and metabolic parameters in menopausal women: result from a prospective, randomized, placebo-controlled, parallel-group study

PubMed Central

Caruso, Salvatore; Rapisarda, Agnese Maria Chiara; Cianci, Stefano; Cianci, Antonio

2018-01-01

Introduction Menopause results in metabolic changes that contribute to increase risk of cardiovascular diseases: increase in low density lipoprotein (LDL) and triglycerides and decrease in high density lipoprotein (HDL), weight gain are associated with a correspondent increase in incidence of hypertension and diabetes. The aim of this study was to evaluate the effect of a preparation of isoflavones, calcium vitamin D and inulin in menopausal women. Material and methods We performed a prospective, randomized, placebo-controlled, parallel-group study. A total of 50 patients were randomized to receive either oral preparations of isoflavones (40 mg), calcium (500 mg) vitamin D (300 UI) and inulin (3 g) or placebo (control group). Pre- and post-treatment assessment of quality of life and sexual function were performed through Menopause-Specific Quality of Life Questionnaire (MENQOL) and Female Sexual Function Index (FSFI); evaluations of anthropometric indicators, body composition through bioelectrical impedance analyser, lumbar spine and proximal femur T-score and lipid profile were performed. Results After 12 months, a significant reduction in MENQOL vasomotor, physical and sexual domain scores (p < 0.05) and a significant increase in all FSFI domain scores (p < 0.05) were observed in treatment group. Laboratory tests showed significant increase in serum levels of HDL (p < 0.05). No significant changes of lumbar spine and femur neck T-score (p > 0.05) were found in the same group. Conclusions According to our data analysis, isoflavones, calcium, vitamin D and inulin may exert favourable effects on menopausal symptoms and signs. PMID:29725283

Effects of Music Interventions on Emotional States and Running Performance

PubMed Central

Lane, Andrew M.; Davis, Paul A.; Devonport, Tracey J.

2011-01-01

The present study compared the effects of two different music interventions on changes in emotional states before and during running, and also explored effects of music interventions upon performance outcome. Volunteer participants (n = 65) who regularly listened to music when running registered online to participate in a three-stage study. Participants attempted to attain a personally important running goal to establish baseline performance. Thereafter, participants were randomly assigned to either a self-selected music group or an Audiofuel music group. Audiofuel produce pieces of music designed to assist synchronous running. The self-selected music group followed guidelines for selecting motivating playlists. In both experimental groups, participants used the Brunel Music Rating Inventory-2 (BMRI-2) to facilitate selection of motivational music. Participants again completed the BMRI-2 post- intervention to assess the motivational qualities of Audiofuel music or the music they selected for use during the study. Results revealed no significant differences between self-selected music and Audiofuel music on all variables analyzed. Participants in both music groups reported increased pleasant emotions and decreased unpleasant emotions following intervention. Significant performance improvements were demonstrated post-intervention with participants reporting a belief that emotional states related to performance. Further analysis indicated that enhanced performance was significantly greater among participants reporting music to be motivational as indicated by high scores on the BMRI-2. Findings suggest that both individual athletes and practitioners should consider using the BMRI-2 when selecting music for running. Key points Listening to music with a high motivational quotient as indicated by scores on the BMRI-2 was associated with enhanced running performance and meta-emotional beliefs that emotions experienced during running helped performance. Beliefs on the effectiveness of music intended to alter emotions were associated with high scores on the BMRI-2. Runners seeking to use music as an emotion regulating strategy should consider using the BMRI-2 as an effective means by which to identify potentially motivating tracks. PMID:24149889

A comparison of performances of consultant surgeons, NCHDs and medical students in a modified HPAT examination.

PubMed

Quinn, A; Corrigan, M A; Broderick, J; McEntee, G; Hill, A D K

2010-06-01

Following the implementation of the Fottrell report, entry to medical school in Ireland has undergone significant change. Medical school studentship is now awarded based on a combination of points obtained from the final examination of Irish secondary schools (the leaving certificate) combined with HPAT scores (Health Professions Admissions Test). The HPAT is designed to test a candidate's knowledge in several different fields including problem solving skills, logical and non verbal reasoning. A sample HPAT was administered to a test group composed of consultant surgeons, non consultant hospital doctors, and medical students. Statistical analysis was performed and no significant difference was found between the performances of the groups. This is surprising as it was expected that groups with greater experience at medical problem solving would have translated to higher scores. This exposes a flaw within the HPAT system and a potential weakness in the process of doctor selection.

Replication and validation of higher order models demonstrated that a summary score for the EORTC QLQ-C30 is robust.

PubMed

Giesinger, Johannes M; Kieffer, Jacobien M; Fayers, Peter M; Groenvold, Mogens; Petersen, Morten Aa; Scott, Neil W; Sprangers, Mirjam A G; Velikova, Galina; Aaronson, Neil K

2016-01-01

To further evaluate the higher order measurement structure of the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30), with the aim of generating a summary score. Using pretreatment QLQ-C30 data (N = 3,282), we conducted confirmatory factor analyses to test seven previously evaluated higher order models. We compared the summary score(s) derived from the best performing higher order model with the original QLQ-C30 scale scores, using tumor stage, performance status, and change over time (N = 244) as grouping variables. Although all models showed acceptable fit, we continued in the interest of parsimony with known-groups validity and responsiveness analyses using a summary score derived from the single higher order factor model. The validity and responsiveness of this QLQ-C30 summary score was equal to, and in many cases superior to the original, underlying QLQ-C30 scale scores. Our results provide empirical support for a measurement model for the QLQ-C30 yielding a single summary score. The availability of this summary score can avoid problems with potential type I errors that arise because of multiple testing when making comparisons based on the 15 outcomes generated by this questionnaire and may reduce sample size requirements for health-related quality of life studies using the QLQ-C30 questionnaire when an overall summary score is a relevant primary outcome. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Long-term outcome of cochlear implant in patients with chronic otitis media: one-stage surgery is equivalent to two-stage surgery.

PubMed

Jang, Jeong Hun; Park, Min-Hyun; Song, Jae-Jin; Lee, Jun Ho; Oh, Seung Ha; Kim, Chong-Sun; Chang, Sun O

2015-01-01

This study compared long-term speech performance after cochlear implantation (CI) between surgical strategies in patients with chronic otitis media (COM). Thirty patients with available open-set sentence scores measured more than 2 yr postoperatively were included: 17 who received one-stage surgeries (One-stage group), and the other 13 underwent two-stage surgeries (Two-stage group). Preoperative inflammatory status, intraoperative procedures, postoperative outcomes were compared. Among 17 patients in One-stage group, 12 underwent CI accompanied with the eradication of inflammation; CI without eradicating inflammation was performed on 3 patients; 2 underwent CIs via the transcanal approach. Thirteen patients in Two-stage group received the complete eradication of inflammation as first-stage surgery, and CI was performed as second-stage surgery after a mean interval of 8.2 months. Additional control of inflammation was performed in 2 patients at second-stage surgery for cavity problem and cholesteatoma, respectively. There were 2 cases of electrode exposure as postoperative complication in the two-stage group; new electrode arrays were inserted and covered by local flaps. The open-set sentence scores of Two-stage group were not significantly higher than those of One-stage group at 1, 2, 3, and 5 yr postoperatively. Postoperative long-term speech performance is equivalent when either of two surgical strategies is used to treat appropriately selected candidates.

Controlled Social Interaction Tasks to Measure Self-Perceptions: No Evidence of Positive Illusions in Boys with ADHD.

PubMed

Jiang, Yuanyuan; Johnston, Charlotte

2017-08-01

Studies have suggested that children with Attention-Deficit/Hyperactivity Disorder (ADHD) possess a Positive Illusory Bias (PIB) where they have higher self-perceptions of competence than more objective measures of their competence. However, recent research calls into question the primary methodology of these studies, that is, difference scores. This study investigated the PIB in boys with ADHD within the social domain using a novel methodology that refrains from using difference scores. Eighty-one 8- to 12-year-old boys with and without ADHD completed social interaction tasks where their actual social performance was made comparable, allowing for tests of between-group differences in self-perceptions that do not rely on difference scores. In addition, to examine whether clarity of social feedback moderates the presence of the PIB, the social tasks presented unclear, clear positive, or clear negative feedback. Boys rated how well they performed in each social interaction task, and these ratings were compared between ADHD and non-ADHD groups. Compared to the non-ADHD group, boys with ADHD did not show a PIB in their ratings of performance on the social tasks. There also was no moderation of boys' ratings by type of feedback received. In contrast, when the PIB was calculated using difference scores based on child and parent ratings of child competence, boys with ADHD showed a PIB compared to boys without ADHD. These findings call attention to the need to re-examine the phenomenon of the PIB using methodologies outside of difference scores.

Tracing prehistoric activities: musculoskeletal stress marker analysis of a Stone-Age population on the island of Gotland in the Baltic sea.

PubMed

Molnar, Petra

2006-01-01

The skeletal remains from the Middle Neolithic (2750-2300 BC) burial ground at Ajvide, Gotland, are analyzed in order to explore musculoskeletal patterns and to attempt to trace general as well as three specific prehistoric activities (archery, harpooning, and kayaking) that are likely to have been performed in this marine setting of fishing, hunting, and gathering. Scoring of muscular and ligament attachments is performed using the scoring method of Hawkey and Merbs ([1995] Int. J. Osteoarchaeol. 5:324-338) for muskuloskeletal stress markers (MSM). The skeletal material consists of 24 male and 15 female adult individuals divided into three age groups: young (<24 years), middle (25-39 years), and old (>40 years). Thirty upper body MSM sites, on both the left and right sides, are scored and form the basis of the study. Results show that males most frequently have higher mean MSM scores than females. Bilateral asymmetry was noted as low in both sexes. Age proved to be a contributing factor to increased MSM scores, with a greater age-related increase in females. MSM patterns were analyzed statistically in muscle groups associated with the three investigated activities. Significant positive correlations were observed in male individuals in muscle groups associated with archery and to some extent harpooning, an indication that these activities would mainly have been performed by men. Correlations in kayaking muscles were not evidently consistent with the kayaking motion. Furthermore, the costoclavicular ligament, often referred to in connection with "kayaker's clavicle," showed no positive statistical correlation with the kayaking muscles.

Randomized clinical trial of virtual reality simulation for laparoscopic skills training.

PubMed

Grantcharov, T P; Kristiansen, V B; Bendix, J; Bardram, L; Rosenberg, J; Funch-Jensen, P

2004-02-01

This study examined the impact of virtual reality (VR) surgical simulation on improvement of psychomotor skills relevant to the performance of laparoscopic cholecystectomy. Sixteen surgical trainees performed a laparoscopic cholecystectomy on patients in the operating room (OR). The participants were then randomized to receive VR training (ten repetitions of all six tasks on the Minimally Invasive Surgical Trainer-Virtual Reality (MIST-VR)) or no training. Subsequently, all subjects performed a further laparoscopic cholecystectomy in the OR. Both operative procedures were recorded on videotape, and assessed by two independent and blinded observers using predefined objective criteria. Time to complete the procedure, error score and economy of movement score were assessed during the laparoscopic procedure in the OR. No differences in baseline variables were found between the two groups. Surgeons who received VR training performed laparoscopic cholecystectomy significantly faster than the control group (P=0.021). Furthermore, those who had VR training showed significantly greater improvement in error (P=0.003) and economy of movement (P=0.003) scores. Surgeons who received VR simulator training showed significantly greater improvement in performance in the OR than those in the control group. VR surgical simulation is therefore a valid tool for training of laparoscopic psychomotor skills and could be incorporated into surgical training programmes. Copyright 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Effect of a simulation-based workshop on multidisplinary teamwork of newborn emergencies: an intervention study.

PubMed

Rovamo, Liisa; Nurmi, Elisa; Mattila, Minna-Maria; Suominen, Pertti; Silvennoinen, Minna

2015-11-12

Video analyses of real-life newborn resuscitations have shown that Neonatal Resuscitation Program (NRP) guidelines are followed in fewer than 50% of cases. Multidisciplinary simulation is used as a first-rate tool for the improvement of teamwork among health professionals. In the study we evaluated the impact of the crisis resource management (CRM) and anesthesia non-technical skills instruction on teamwork during simulated newborn emergencies. Ninety-nine participants of two delivery units (17 pediatricians, 16 anesthesiologists, 14 obstetricians, 31 midwives, and 21 neonatal nurses) were divided to an intervention group (I-group, 9 teams) and a control group (C-group, 6 teams). The I-group attended a CRM and ANTS instruction before the first scenario. After each scenario the I-group performed either self- or peer-assessment depending on whether they had acted or observed in the scenario. All the teams participated in two and observed another two scenarios. All the scenarios were video-recorded and scored by three experts with Team Emergency Assessment Measure (TEAM). SPSS software and nlme package were used for the statistical analyses. The total TEAM scores of the first scenario between the I- and C-group did not differ from each other. Neither there was an increase in the TEAM scoring between the first and second scenario between the groups. The CRM instruction did not improve the I-group's teamwork performance. Unfortunately the teams were not comparable because the teams had been allowed to self-select their members in the study design. The total TEAM scores varied a lot between the teams. Mixed-model linear regression revealed that the background of the team leader had an impact on differences of the total teamwork scores (D = 6.50, p = 0.039). When an anesthesia consultant was the team leader the mean teamwork improved by 6.41 points in comparison to specialists of other disciplines (p = 0.043). The instruction of non-technical skills before simulation training did not enhance the acquisition of teamwork skills of the intervention groups over the corresponding set of skills of the control groups. The teams led by an anesthesiologist scored the best. Experience of team leaders improved teamwork over the CRM instruction.

The Effect of Cartilage Fragments on Femoral Tunnel Widening After Anterior Cruciate Ligament Reconstruction: A Prospective Randomized Controlled Study.

PubMed

Zhang, Chi; Pan, Jun; Chen, Jian-De; Zhang, Yi-Jun; Gu, Peng-Cheng; Lin, Xiang-Jin; Cai, You-Zhi

2018-05-03

To analyze the effect of cartilage fragments on tunnel widening and tendon-bone integration at 2 years' follow-up after anterior cruciate ligament reconstruction (ACLR). A prospective randomized controlled study was performed in 116 patients who underwent ACLR with autologous hamstring tendons augmented with cartilage fragments (study group, n = 56) or without any augmentation (control group, n = 60). All patients were followed up for 25.6 months (range, 24-28 months), and the International Knee Documentation Committee score, Lysholm score, and visual analog scale score were determined. Computed tomography scans of all patients were obtained 2 years after surgery to evaluate the diameter of the femoral tunnel and thereby assess the amount of tunnel widening. Magnetic resonance imaging evaluation was performed 2 years postoperatively to evaluate the status of the graft in the femoral tunnel. In addition, 5 patients underwent biopsy of the tendon-bone interface at 24 months postoperatively with histologic assessment and transmission electron microscopy. A total of 107 patients completed the follow-up. There were no significant differences between the 2 groups in terms of International Knee Documentation Committee score (P = .07), Lysholm score (P = .10), and visual analog scale score (P = .57) at 24 months' follow-up. The femoral tunnel diameter and the tunnel widening percentage in the study group were significantly smaller than those in the control group (P < .001). The signal-noise quotient value of the graft in the femoral tunnel was 10.4 ± 7.0 in the study group, which was significantly lower than that in the control group (19.5 ± 9.2, P < .001). Histologic studies of the tendon-bone interface showed that there were more bone formations containing chondroid cells with aligned connective tissue in the study group compared with the control group; in addition, the diameter of the collagen fibrils in the study group was considerably thicker than that in the control group (P < .05). The use of cartilage fragments was effective in preventing femoral tunnel widening and seemed to promote the tendon-bone integration process after ACLR. Level II, prospective randomized controlled study. Copyright © 2018 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Effects of repetitive subconcussive head trauma on the neuropsychological test performance of high school athletes: A comparison of high, moderate, and low contact sports.

PubMed

Tsushima, William T; Ahn, Hyeong Jun; Siu, Andrea M; Yoshinaga, Kara; Choi, So Yung; Murata, Nathan M

2018-02-02

The aim of this study was to examine the neuropsychological test results of non-concussed high school athletes playing at three different levels of contact sports. Based on the concussion risk data of 12 different sports, a High Contact group (n=2819; wrestling/martial arts, cheerleading, track and field, football), a Moderate Contact group (n=2323; softball, basketball, soccer), and a Low Contact group (n=1580; baseball, volleyball, water polo, tennis, cross-country) were formed and compared in terms of their scores on the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT). The results revealed that the High Contact group obtained small but statistically poorer performances in ImPACT Visual Memory, Visual Motor Speed, Impulse Control, and Total Symptom scores compared to the Moderate and Low Contact groups. The High Contact group also had poorer Reaction Time scores compared to the Low Contact group. No differences between the Moderate and Low Contact groups were noted. The findings, along with prior similar results, tentatively raise concerns that participant in high contact sports, exposed to repetitive subconcussive head trauma, may be at greater risk for lowered neuropsychological functioning and increased symptoms, compared to other high school athletes. In view of the preliminary nature of this investigation, more research into the effects of frequent head impacts in high school sports is strongly recommended.

Relationships of anxiety scores to academy and field training performance of air traffic control specialists.

DOT National Transportation Integrated Search

1989-05-01

State-trait anxiety scores were used prior to the 1981 strike of air traffic control specialists (ATCSs) to estimate perceived levels of job stress in field studies of this occupational group. The present study assessed the relationship between anxie...

Effects of Boron-Based Gel on Radiation-Induced Dermatitis in Breast Cancer: A Double-Blind, Placebo-Controlled Trial.

PubMed

Aysan, Erhan; Idiz, Ufuk Oguz; Elmas, Leyla; Saglam, Esra Kaytan; Akgun, Zuleyha; Yucel, Serap Baskaya

2017-06-01

This study is aimed to evaluate the effects of boron on radiation-induced skin reactions (RISR) in breast cancer patients. After 47 patients with invasive ductal carcinoma underwent radiotherapy, 23 (49%) received a boron-based gel, and 24 (51%) received placebo. Assessments were performed according to the Radiation Therapy Oncology Group (RTOG) skin scale and a Five-Point Horizontal Scale (FPHS). At the end of the fifth week of radiotherapy, the RTOG scores in the boron group were significantly lower than those in the placebo group (p = .024). The FPHS score was higher in the placebo group than in the boron group, and this difference was not statistically significant (p = .079). Using the RTOG scoring system, we revealed that the application of a boron-based gel diminished RISR. The mechanism of action is unclear but may be related to antioxidant, wound healing, and thermal degradation effects of boron.

A better way to teach knot tying: a randomized controlled trial comparing the kinesthetic and traditional methods.

PubMed

Huang, Emily; Chern, Hueylan; O'Sullivan, Patricia; Cook, Brian; McDonald, Erik; Palmer, Barnard; Liu, Terrence; Kim, Edward

2014-10-01

Knot tying is a fundamental and crucial surgical skill. We developed a kinesthetic pedagogical approach that increases precision and economy of motion by explicitly teaching suture-handling maneuvers and studied its effects on novice performance. Seventy-four first-year medical students were randomized to learn knot tying via either the traditional or the novel "kinesthetic" method. After 1 week of independent practice, students were videotaped performing 4 tying tasks. Three raters scored deidentified videos using a validated visual analog scale. The groups were compared using analysis of covariance with practice knots as a covariate and visual analog scale score (range, 0 to 100) as the dependent variable. Partial eta-square was calculated to indicate effect size. Overall rater reliability was .92. The kinesthetic group scored significantly higher than the traditional group for individual tasks and overall, controlling for practice (all P < .004). The kinesthetic overall mean was 64.15 (standard deviation = 16.72) vs traditional 46.31 (standard deviation = 16.20; P < .001; effect size = .28). For novices, emphasizing kinesthetic suture handling substantively improved performance on knot tying. We believe this effect can be extrapolated to more complex surgical skills. Copyright © 2014 Elsevier Inc. All rights reserved.

Shade matching performance of normal and color vision-deficient dental professionals with standard daylight and tungsten illuminants.

PubMed

Gokce, Hasan Suat; Piskin, Bulent; Ceyhan, Dogan; Gokce, Sila Mermut; Arisan, Volkan

2010-03-01

The lighting conditions of the environment and visual deficiencies such as red-green color vision deficiency affect the clinical shade matching performance of dental professionals. The purpose of this study was to evaluate the shade matching performance of normal and color vision-deficient dental professionals with standard daylight and tungsten illuminants. Two sets of porcelain disc replicas of 16 shade guide tabs (VITA Lumin) were manufactured to exact L*a*b* values by using a colorimeter. Then these twin porcelain discs (13 mm x 2.4 mm) were mixed up and placed into a color-matching cabinet that standardized the lighting conditions for the observation tests. Normal and red-green color vision-deficient dental professionals were asked to match the 32 porcelain discs using standard artificial daylight D65 (high color temperature) and tungsten filament lamp light (T) (low color temperature) illuminants. The results were analyzed by repeated-measures ANOVA and paired and independent samples t tests for the differences between dental professionals and differences between the illuminants (alpha=.05). Regarding the sum of the correct shade match scores of all observations with both illuminants, the difference between normal vision and red-green color vision-deficient dental professional groups was not statistically significant (F=4.132; P=.054). However, the correct shade match scores of each group were significantly different for each illuminant (P<.005). The correct shade matching scores of normal color vision dental professionals were significantly higher with D65 illuminant (t=7.004; P<.001). Color matching scores of red-green color vision-deficient dental professionals (approximately 5.7 more pairs than with D65) were significantly higher with T illuminant (t=5.977; P<.001). CONCLUSIONS.: Within the limitations of this study, the shade matching performance of dental professionals was affected by color vision deficiency and the color temperature of the illuminant. The color vision-deficient group was notably unsuccessful with the D65 illuminant in shade matching. In contrast, there was a significant increase in the shade matching performance of the color vision-deficient group with T illuminant. The lower color temperature illuminant dramatically decreased the normal color vision groups' correct shade matching score. (c) 2010 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

Low aerobic fitness and obesity are associated with lower standardized test scores in children.

PubMed

Roberts, Christian K; Freed, Benjamin; McCarthy, William J

2010-05-01

To investigate whether aerobic fitness and obesity in school children are associated with standardized test performance. Ethnically diverse (n = 1989) 5th, 7th, and 9th graders attending California schools comprised the sample. Aerobic fitness was determined by a 1-mile run/walk test; body mass index (BMI) was obtained from state-mandated measurements. California standardized test scores were obtained from the school district. Students whose mile run/walk times exceeded California Fitnessgram standards or whose BMI exceeded Centers for Disease Control sex- and age-specific body weight standards scored lower on California standardized math, reading, and language tests than students with desirable BMI status or fitness level, even after controlling for parent education among other covariates. Ethnic differences in standardized test scores were consistent with ethnic differences in obesity status and aerobic fitness. BMI-for-age was no longer a significant multivariate predictor when covariates included fitness level. Low aerobic fitness is common among youth and varies among ethnic groups, and aerobic fitness level predicts performance on standardized tests across ethnic groups. More research is needed to uncover the physiological mechanisms by which aerobic fitness may contribute to performance on standardized academic tests.

Is the effectiveness of patellofemoral bracing modified by patellofemoral alignment and trochlear morphology?

PubMed

Zhang, Xi; Eyles, Jillian P; Makovey, Joanna; Williams, Matthew J; Hunter, David J

2017-04-21

This study was performed to determine if the effectiveness of patellofemoral bracing as a treatment for patellofemoral osteoarthritis is influenced by patellofemoral joint alignment and trochlear morphology. We hypothesized that those with more extreme patellar malalignment would benefit more from bracing. Thirty-eight patients who had received bracing as part of a comprehensive treatment plan for patellofemoral osteoarthritis were selected for this study. Ten measures of patellar alignment were taken from X-rays. These alignment measures were divided into percentile groups (tertiles) for contingency table analysis. Treatment outcome was measured by Western Ontario and Macmasters Universities Osteoarthritis Index (WOMAC) scores and these were dichotomised into two groups according to "Improved" or "Not Improved" according to the minimum clinically important difference (MCID). Spearman's rho test was performed for continuous variables and Fisher's exact test was performed for correlation between tertile groups and MCID categories. Thirty-eight patients (9 male and 29 female) between the ages of 51 to 89 were included in this study. WOMAC scores ranged from -25 to 41.67, with a mean change of -3.97, 31.6, 44.7 and 31.6% of patients falling into the "Improved" group for Global, Pain and Function scores respectively. We found a non-significant trend shown (p = 0.058, correlation coefficient 0.31) between bisect offset and change in WOMAC global, indicating a trend for higher change in WOMAC scores with increasing bisect offset. Statistically significant correlations were found between mean MCID categories for the WOMAC global and function groups when analysed against percentile groups for bisect offset (p < 0.01) and patellar subluxation distance (p < 0.05), indicating those in higher percentile groups were more likely not to improve after six months. Higher bisect offset and patellar subluxation distance measures were associated with poorer outcomes. However, due to the limited sample size, more studies are required to fully examine this relationship.

Burden among Family Caregivers of Dementia in the Oldest-Old: An Exploratory Study.

PubMed

Win, Khin Khin; Chong, Mei Sian; Ali, Noorhazlina; Chan, Mark; Lim, Wee Shiong

2017-01-01

With >85 years, the fastest growing age segment in developed countries, dementia in the oldest-old is projected to increase exponentially. Being older, caregivers of dementia in oldest-old (CDOO) may experience unique challenges compared with younger-age groups. Thus, we aim to explore demographic characteristics and burden pattern among CDOO. We studied 458 family caregiver-patient dyads attending an outpatient memory clinic. We classified patients into three age-groups: <75, 75-84, and ≥85 years. We measured caregiver burden using the Zarit Burden Interview (ZBI) 4-factor structure described by Cheah et al. (1). We compared care recipient characteristics, caregiver demographics, and ZBI total/factors scores between the three age-groups, and performed 2-way analysis of variance (ANOVA) to ascertain the effect of age-group by disease severity interaction. Oldest-old care recipients were more impaired in cognitive function and instrumental ADL; there was no difference in behavior and basic ADL. Compared with the other two age-groups, CDOO were older (mean age: 50.4 vs 55.5 vs 56.8 years, P  < 0.01), and overwhelmingly adult children (85.9%) as opposed to spouses (5.3%). CDOO also had higher ZBI total score, role strain, and personal strain (all P  < 0.05). However, there was no difference in worry about performance scores. 2-way ANOVA did not reveal significant age-group by disease severity interaction for ZBI total and factor scores, although distinctive differences were seen between role/personal strain with worry about performance in mild cognitive impairment and very mild dementia. Our study highlighted that CDOO were mainly older adult children who experienced significant role and personal strain independent of disease severity while caring for their family member with more impaired cognitive and physical function. These results pave the way for targeted interventions to address the unique burden faced by this rapidly growing group of caregivers.

The Effects of Ramadhan Fasting on Clinical Symptoms in Patients with Gastroesophageal Reflux Disease.

PubMed

Mardhiyah, Radhiyatam; Makmun, Dadang; Syam, Ari Fahrial; Setiati, Siti

2016-07-01

to determine the effects of Ramadhan fasting on GERD symptoms. a total of 130 GERD patients participated in this study. Patients were divided into two groups, i.e. those who performed Ramadhan fasting (n=66), and those who did not perform Ramadhan fasting (n=64). The evaluation was done using Indonesian version of GERD questionnaire (GERD-Q) between the two groups, and between Ramadhan month and non-Ramadhan month in the Ramadhan fasting group. there was a statistically significant difference (p<0.01) in the median of GERD-Q score in Ramadhan-fasting group subjects and non-Ramadhan-fasting group subjects (0 vs. 4). Moreover, a statistically significant difference (p<0.01) was also found in the median of GERD-Q score in Ramadhan-fasting group subjects and non-fasting group subjects (p<0.01). subjects in Ramadhan fasting group, GERD symptoms experienced less severe during fasting month (Ramadhan) than non-fasting month. During Ramadhan month, GERD symptoms were also milder in Ramadhan fasting group than those in non-fasting group subjects.

Validation of a Novel Laparoscopic Adjustable Gastric Band Simulator

PubMed Central

Sankaranarayanan, Ganesh; Adair, James D.; Halic, Tansel; Gromski, Mark A.; Lu, Zhonghua; Ahn, Woojin; Jones, Daniel B.; De, Suvranu

2011-01-01

Background Morbid obesity accounts for more than 90,000 deaths per year in the United States. Laparoscopic adjustable gastric banding (LAGB) is the second most common weight loss procedure performed in the US and the most common in Europe and Australia. Simulation in surgical training is a rapidly advancing field that has been adopted by many to prepare surgeons for surgical techniques and procedures. Study Aim The aim of our study was to determine face, construct and content validity for a novel virtual reality laparoscopic adjustable gastric band simulator. Methods Twenty-eight subjects were categorized into two groups (Expert and Novice), determined by their skill level in laparoscopic surgery. Experts consisted of subjects who had at least four years of laparoscopic training and operative experience. Novices consisted of subjects with medical training, but with less than four years of laparoscopic training. The subjects performed the virtual reality laparoscopic adjustable band surgery simulator. They were automatically scored, according to various tasks. The subjects then completed a questionnaire to evaluate face and content validity. Results On a 5-point Likert scale (1 – lowest score, 5 – highest score), the mean score for visual realism was 4.00 ± 0.67 and the mean score for realism of the interface and tool movements was 4.07 ± 0.77 [Face Validity]. There were significant differences in the performance of the two subject groups (Expert and Novice), based on total scores (p<0.001) [Construct Validity]. Mean scores for utility of the simulator, as addressed by the Expert group, was 4.50 ± 0.71 [Content Validity]. Conclusion We created a virtual reality laparoscopic adjustable gastric band simulator. Our initial results demonstrate excellent face, construct and content validity findings. To our knowledge, this is the first virtual reality simulator with haptic feedback for training residents and surgeons in the laparoscopic adjustable gastric banding procedure. PMID:20734069

General surgery training and robotics: Are residents improving their skills?

PubMed

Finnerty, Brendan M; Afaneh, Cheguevara; Aronova, Anna; Fahey, Thomas J; Zarnegar, Rasa

2016-02-01

While robotic-assisted operations have become more prevalent, many general surgery residencies do not have a formal robotic training curriculum. We sought to ascertain how well current general surgery training permits acquisition of robotic skills by comparing robotic simulation performance across various training levels. Thirty-six participants were categorized by level of surgical training: eight medical students (MS), ten junior residents (JR), ten mid-level residents (MLR), and eight senior residents (SR). Participants performed three simulation tasks on the da Vinci (®) Skills Simulator (MatchBoard, EnergyDissection, SutureSponge). Each task's scores (0-100) and cumulative scores (0-300) were compared between groups. There were no differences in sex, hand dominance, video gaming history, or prior robotic experience between groups; however, SR was the oldest (p < 0.001). The median overall scores did not differ: 188 (84-201) for MS, 183 (91-234) for JR, 197 (153-218) for MLR, and 205 (169-229) for SR (p = 0.14). The median SutureSponge score was highest for SR (61, range 39-81) compared to MS (43, range 26-61), JR (43, range 11-72), and MLR (55, range 36-68) (p = 0.039). However, there were no significant differences in MatchBoard (p = 0.27) or EnergyDissection (p = 0.99) scores between groups. There was a positive correlation between SutureSponge score and number of laparoscopic cases logged (p = 0.005, r(2) = 0.21), but this correlation did not exist for the MatchBoard or EnergyDissection tasks. Lastly, there was no correlation between total lifetime hours of video gaming and overall score (p = 0.89, R(2) = 0.0006). Robotic skillsets acquired during general surgery residency show minimal improvement during the course of training, although laparoscopic experience is correlated with advanced robotic task performance. Changes in residency curricula or pursuit of fellowship training may be warranted for surgeons seeking proficiency.

Effect of mobile application-based versus DVD-based CPR training on students’ practical CPR skills and willingness to act: a cluster randomised study

PubMed Central

Nord, Anette; Svensson, Leif; Hult, Håkan; Kreitz-Sandberg, Susanne; Nilsson, Lennart

2016-01-01

Objectives The aim was to compare students’ practical cardiopulmonary resuscitation (CPR) skills and willingness to perform bystander CPR, after a 30 min mobile application (app)-based versus a 50 min DVD-based training. Settings Seventh grade students in two Swedish municipalities. Design A cluster randomised trial. The classes were randomised to receive app-based or DVD-based training. Willingness to act and practical CPR skills were assessed, directly after training and at 6 months, by using a questionnaire and a PC Skill Reporting System. Data on CPR skills were registered in a modified version of the Cardiff test, where scores were given in 12 different categories, adding up to a total score of 12–48 points. Training and measurements were performed from December 2013 to October 2014. Participants 63 classes or 1232 seventh grade students (13-year-old) were included in the study. Primary and secondary outcome measures Primary end point was the total score of the modified Cardiff test. The individual variables of the test and self-reported willingness to make a life-saving intervention were secondary end points. Results The DVD-based group was superior to the app-based group in CPR skills; a total score of 36 (33–38) vs 33 (30–36) directly after training (p<0.001) and 33 (30–36) and 31 (28–34) at 6 months (p<0.001), respectively. At 6 months, the DVD group performed significantly better in 8 out of 12 CPR skill components. Both groups improved compression depth from baseline to follow-up. If a friend suffered cardiac arrest, 78% (DVD) versus 75% (app) would do compressions and ventilations, whereas only 31% (DVD) versus 32% (app) would perform standard CPR if the victim was a stranger. Conclusions At 6 months follow-up, the 50 min DVD-based group showed superior CPR skills compared with the 30 min app-based group. The groups did not differ in regard to willingness to make a life-saving effort. PMID:27130166

Differences in Neuropsychological Functioning Between Homicidal and Nonviolent Schizophrenia Samples.

PubMed

Stratton, John; Cobia, Derin J; Reilly, James; Brook, Michael; Hanlon, Robert E

2018-02-07

Few studies have compared performance on neurocognitive measures between violent and nonviolent schizophrenia samples. A better understanding of neurocognitive dysfunction in violent individuals with schizophrenia could increase the efficacy of violence reduction strategies and aid in risk assessment and adjudication processes. This study aimed to compare neuropsychological performance between 25 homicide offenders with schizophrenia and 25 nonviolent schizophrenia controls. The groups were matched for age, race, sex, and handedness. Independent t-tests and Mann-Whitney U-tests were used to compare the schizophrenia groups' performance on measures of cognition, including composite scores assessing domain level functioning and individual neuropsychological tests. Results indicated the violent schizophrenia group performed worse on measures of memory and executive functioning, and the Intellectual Functioning composite score, when compared to the nonviolent schizophrenia sample. These findings replicate previous research documenting neuropsychological deficits specific to violent individuals with schizophrenia and support research implicating fronto-limbic dysfunction among violent offenders with schizophrenia. © 2018 American Academy of Forensic Sciences.

Performances on simulator and da Vinci robot on subjects with and without surgical background.

PubMed

Moglia, Andrea; Ferrari, Vincenzo; Melfi, Franca; Ferrari, Mauro; Mosca, Franco; Cuschieri, Alfred; Morelli, Luca

2017-08-17

To assess whether previous training in surgery influences performance on da Vinci Skills Simulator and da Vinci robot. In this prospective study, thirty-seven participants (11 medical students, 17 residents, and 9 attending surgeons) without previous experience in laparoscopy and robotic surgery performed 26 exercises at da Vinci Skills Simulator. Thirty-five then executed a suture using a da Vinci robot. The overall scores on the exercises at the da Vinci Skills Simulator show a similar performance among the groups with no statistically significant pair-wise differences (p < .05). The quality of the suturing based on the unedited videos of the test run was similar for the intermediate (7 (4, 10)) and expert group (6.5 (4.5, 10)), and poor for the untrained groups (5 (3.5, 9)), without statistically significant difference (p < .05). This study showed, for subjects new to laparoscopy and robotic surgery, insignificant differences in the scores at the da Vinci Skills Simulator and at the da Vinci robot on inanimate models.

Relative frequency of knowledge of performance and motor skill learning.

PubMed

Weeks, D L; Kordus, R N

1998-09-01

This study examined the effects of variations in relative frequency of knowledge of performance (KP) on acquisition, retention, and transfer of form for a multilimb closed sport skill. Two groups received either 100% relative frequency of KP or 33% relative frequency of KP while learning the soccer throw-in skill. Participants were boys between the ages of 11 and 14 years who were unfamiliar with the skill. Participants performed a 30-trial acquisition phase in which KP was provided about one of eight aspects of form. Following acquisition, five trial retention and transfer (to a target at a different distance than experienced in acquisition) tests were administered at 5 min, 24 hr, and 72 hr. Although no group differences were found for accuracy scores, the 33% group had higher form scores in acquisition and all retention and transfer tests. It was concluded that reducing the relative frequency of KP eliminated a dependency on KP to guide performance in acquisition, which was beneficial for maintaining form in conditions in which KP was absent.

Acute exercise and motor memory consolidation: Does exercise type play a role?

PubMed

Thomas, R; Flindtgaard, M; Skriver, K; Geertsen, S S; Christiansen, L; Korsgaard Johnsen, L; Busk, D V P; Bojsen-Møller, E; Madsen, M J; Ritz, C; Roig, M; Lundbye-Jensen, J

2017-11-01

A single bout of high-intensity exercise can augment off-line gains in skills acquired during motor practice. It is currently unknown if the type of physical exercise influences the effect on motor skill consolidation. This study investigated the effect of three types of high-intensity exercise following visuomotor skill acquisition on the retention of motor memory in 40 young (25.3 ±3.6 years), able-bodied male participants randomly assigned to one of four groups either performing strength training (STR), circuit training (CT), indoor hockey (HOC) or rest (CON). Retention tests of the motor skill were performed 1 (R1h) and 24 h (R1d) post acquisition. For all exercise groups, mean motor performance scores decreased at R1h compared to post acquisition (POST) level; STR (P = 0.018), CT (P = 0.02), HOC (P = 0.014) and performance scores decreased for CT compared to CON (P = 0.049). Mean performance scores increased from POST to R1d for all exercise groups; STR (P = 0.010), CT (P = 0.020), HOC (P = 0.007) while performance scores for CON decreased (P = 0.043). Changes in motor performance were thus greater for STR (P = 0.006), CT (P < 0.001) and HOC (P < 0.001) compared to CON from POST to R1d. The results demonstrate that high-intensity, acute exercise can lead to a decrease in motor performance assessed shortly after motor skill practice (R1h), but enhances offline effects promoting long-term retention (R1d). Given that different exercise modalities produced similar positive off-line effects on motor memory, we conclude that exercise-induced effects beneficial to consolidation appear to depend primarily on the physiological stimulus rather than type of exercise and movements employed. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Instructional video for teaching venepuncture.

PubMed

Pan, Michael; Harcharik, Sara; Moskalenko, Marina; Luber, Adam; Bernardo, Sebastian; Levitt, Jacob

2014-10-01

Safe venepuncture technique is a critical skill for health care professionals, to avoid accidental occupational injury. This study investigates whether watching an instructional video improves medical students' ability to perform venepuncture safely. This was a randomised, controlled, assessor-blinded trial that evaluated the utility of an instructional video, with the primary outcome of the ability to perform venepuncture safely. Forty-two second-year medical students were recruited and randomised to receive either video instruction (group A, n = 20) or no intervention (group B, n = 22). Prior to the study, all students attended an instructor-led workshop on venepuncture. During the study, students were paired and instructed to perform venepuncture on a partner. Performance was assessed using a points-based checklist. Pre- and post-study surveys were conducted to assess confidence with technique. The mean total checklist score was higher in group A than in group B, with values of 14.15 and 9.18, respectively (p < 0.0001, maximum 18 points). Mean scores were also higher in group A than in group B among students who performed first (p = 0.008) and students who performed second (p = 0.005) within the pair. From the post-procedure survey, only group A rated increased confidence in performing venepuncture after the study (p = 0.008). Students who watched an instructional video performed venepuncture more effectively and reported greater confidence with the technique. Medical students can benefit from having access to an instructional video on venepuncture as an adjunct to the standard curriculum. Safe venepuncture technique is a critical skill for health care professionals. © 2014 John Wiley & Sons Ltd.

Effects of Group Gender Composition on Mental Rotation Test Performance in Women.

PubMed

Moè, Angelica

2018-06-01

Mental rotation is a task in which men outscore women by up to one standard deviation. Many biological, strategic, experiential, and motivational factors concur to explain this gender gap. Among these there are gender stereotypes, which could either harm or favor performance, giving rise, respectively, to stereotype threat or lift effects. This study examined effects due to stereotypes induced by testing women in a minority mixed-gender group composition (subtle message) when provided with instructions about men's or women's superiority (blatant message), in order to assess the hypothesis that the effort of disconfirming a negative stereotype causes increased performance when two messages, either blatant or subtle, are provided. Sixty-six men and 78 women tested either in a mixed-gender or a same-gender group composition were provided with one of the three instructions (men better, women better, nullifying) after performing a mental rotation test (baseline measure) and before taking another one. Results showed that women increased performance mainly when instructed that men score higher in the mixed-gender group composition, and after the nullifying instructions when tested in the same-gender group composition. Men increased performance mainly when they were instructed that women scored higher. Taken together, the results showed that both genders improve performance, when two threats arise both subtly and blatantly, or when no threat is in the air. Effects of implicit and explicit activated stereotypes are discussed.

Applying glass ionomer cement to MTA flow™ and biodentine™ and its effects on the interface layer

NASA Astrophysics Data System (ADS)

Savitri, D.; Suprastiwi, E.; Margono, A.

2017-08-01

This study compared the interface layer formation between Glass Ionomer Cement (GIC) with Biodentine™ and between GIC with MTA Flow™. There were 10 samples in each group. Biodentine™ and MTA Flow™ were filled with GIC in plastic molds then incubated at a temperature of 37 °C with 100% humidity for 24 hours. Samples were sectioned vertically with diamond discs and examined using a scanning electron microscope. The statistical analysis was performed using the Mann-Whitney Test. In group 1, 80% of the samples showed a score of 1 and 20% of the samples showed a score of 2. In group 2, 30% of the samples showed a score of 2 and 70% of the samples showed a score of 3. This clinical trial showed that the formation of interface layers in Biodentine™ and MTA Flow™ were significantly different.

THE COMPARISON OF INTELLIGENCE QUOTIENTS OF ATOPIC AND NONATOPIC CHILDREN IN IBADAN, NIGERIA

PubMed Central

Daramola, O O M; Ayoola, O O; Ogunbiyi, A O

2010-01-01

Background: Atopy-related illnesses such as atopic dermatitis and asthma are chronic illnesses, and children suffering from such illnesses are subjected to frequent absenteeism from school. Studies have shown that the performance of children with asthma was comparable to their healthy counterparts despite their absenteeism at school, in contrast to findings in other chronic illnesses like epilepsy. Aim: In the present study, we investigated the association between atopy and intelligence quotient (IQ) scores in a group of Nigerian children in Ibadan, a city in southwestern Nigeria. Materials and Methods: This is a cross-sectional study of children in an urban elementary school. Questionnaires to ascertain the presence of atopy-associated conditions such as hay fever, atopic dermatitis, asthma, allergic rhinitis, and allergic conjunctivitis were administered to the parents of 128 pupils in the 3rd to 6th grades of elementary school. Based on the responses to the questionnaire, pupils were categorized as being atopic and nonatopic. All the pupils underwent the Standard Progressive Matrices IQ test. The IQ scores were then compared among these two groups of children. Results: Out of the children studied, 26.6% were found to have atopy and after adjusting for factors such as age and sex, the IQ scores in this atopic group were not found to be statistically different from the scores in the nonatopic group (r = 2.122872, P = 0.009). Conclusion: IQ scores were not statistically significantly different for children with and without atopy. Thus, the presence of atopy does not appear to be associated with low IQ scores and hence, may not be related to poor school performance. PMID:21063510

Designing and evaluating the effectiveness of a serious game for safe administration of blood transfusion: A randomized controlled trial.

PubMed

Tan, Apphia Jia Qi; Lee, Cindy Ching Siang; Lin, Patrick Yongxing; Cooper, Simon; Lau, Lydia Siew Tiang; Chua, Wei Ling; Liaw, Sok Ying

2017-08-01

Preparing nursing students for the knowledge and skills required for the administration and monitoring of blood components is crucial for entry into clinical practice. Serious games create opportunities to develop this competency, which can be used as a self-directed learning strategy to complement existing didactic learning and simulation-based strategies. To describe the development and evaluation of a serious game to improve nursing students' knowledge, confidence, and performance in blood transfusion. An experiential gaming model was applied to guide the design of the serious game environment. A clustered, randomized controlled trial was conducted with 103 second-year undergraduate nursing students who were randomized into control or experimental groups. After a baseline evaluation of the participants' knowledge and confidence on blood transfusion procedure, the experimental group undertook a blood transfusion serious game and completed a questionnaire to evaluate their learning experience. All participants' clinical performances were evaluated in a simulated environment. The post-test knowledge and confidence mean scores of the experimental group improved significantly (p<0.001) after the serious game intervention compared to pre-test mean scores and to post-test mean scores of the control group (p<0.001). However, no significance difference (p=0.11) was found between the experimental and control groups on the post-test performance mean scores. The participants evaluated the serious game positively. The study provided evidence on the effectiveness of a serious game in improving the knowledge and confidence of nursing students on blood transfusion practice. The features of this serious game could be further developed to incorporate additional scenarios with repetitive exercises and feedback to enhance the impact on clinical performance. Given the flexibility, practicality, and scalability of such a game, they can serve as a promising approach to optimize learning when blended with high-fidelity simulation. Copyright © 2017. Published by Elsevier Ltd.

Construct-related validity of the TOCS measures: comparison of intelligibility and speaking rate scores in children with and without speech disorders.

PubMed

Hodge, Megan M; Gotzke, Carrie L

2014-01-01

This study evaluated construct-related validity of the Test of Children's Speech (TOCS). Intelligibility scores obtained using open-set word identification tasks (orthographic transcription) for the TOCS word and sentence tests and rate scores for the TOCS sentence test (words per minute or WPM and intelligible words per minute or IWPM) were compared for a group of 15 adults (18-30 years of age) with normal speech production and three groups of children: 48 3-6 year-olds with typical speech development and neurological histories (TDS), 48 3-6 year-olds with a speech sound disorder of unknown origin and no identified neurological impairment (SSD-UNK), and 22 3-10 year-olds with dysarthria and cerebral palsy (DYS). As expected, mean intelligibility scores and rates increased with age in the TDS group. However, word test intelligibility, WPM and IWPM scores for the 6 year-olds in the TDS group were significantly lower than those for the adults. The DYS group had significantly lower word and sentence test intelligibility and WPM and IWPM scores than the TDS and SSD-UNK groups. Compared to the TDS group, the SSD-UNK group also had significantly lower intelligibility scores for the word and sentence tests, and significantly lower IWPM, but not WPM scores on the sentence test. The results support the construct-related validity of TOCS as a tool for obtaining intelligibility and rate scores that are sensitive to group differences in 3-6 year-old children, with and without speech sound disorders, and to 3+ year-old children with speech disorders, with and without dysarthria. Readers will describe the word and sentence intelligibility and speaking rate performance of children with typically developing speech at age levels of 3, 4, 5 and 6 years, as measured by the Test of Children's Speech, and how these compare with adult speakers and two groups of children with speech disorders. They will also recognize what measures on this test differentiate children with speech sound disorders of unknown origin from children with cerebral palsy and dysarthria. Copyright © 2014 Elsevier Inc. All rights reserved.

Service quality from the perspective of myocardial infarction patients.

PubMed

Gholipour, Kamal; Tabrizi, Jafar Sadegh; Azimzadeh, Solmaz; Ghafari, Samad; Iezadi, Shabnam

2018-04-01

Service quality (SQ) generally refers to the nonclinical aspects of health services and primarily focuses on the relationship between the care provider and the customers, and the environment in which care services are delivered. The aim of this study was to assess the SQ provided for myocardial infarction (MI) from the patients' perspective. A cross-sectional study was conducted with 164 patients with MI at the Tabriz Shahid Madani cardiology clinic. Study participants were selected using convenience sampling. SQ was measured using a validated Comprehensive Quality Measurement in Healthcare SQ questionnaire. The reliability was confirmed based on Cronbach's alpha coefficient (α=0.81). SQ was calculated using the formula SQ=10- (importance × performance), based on the importance and performance of non-health-related aspects from the customers' perspective. Importance scores ranged from 1 to 10 and performance was scored between 0 and 1. Of 164 participants, about 75% were men and almost 44% were between 51 and 65 years of age. From the customers' perspective, the total SQ score was 6.80 (0-10 scale), and the individual scores for all SQ aspects were below an acceptable level. Confidentiality, dignity and continuity were given the highest scores, while availability of support groups had the lowest score. The study findings revealed an opportunity to improve SQ. Patient and provider participation in quality improvement activities could be an effective strategy to improve the aspects of health care quality that were most important to the customers and those with low scores, such as availability of support groups.

Tailored instructor feedback leads to more effective virtual-reality laparoscopic training.

PubMed

Paschold, M; Huber, T; Zeißig, S R; Lang, H; Kneist, Werner

2014-03-01

Laparoscopic novices begin at different performance levels, and studies on tailored training concepts are warranted. The effect of verbal instructor feedback has been investigated with varying results, and its effectiveness in virtual-reality laparoscopic (VRL) simulations still is unclear. This study aimed to determine whether laparoscopic novices with lower initial performance statuses may profit from training with intensive instructor feedback. A prospective, single-blinded study was performed within a week-long curricular course. In this study, 20 medical students performed a complex bimanual maneuver on a VRL simulator. There was a division in performance levels, with a high-performer group (HPG) that received a better median score and a low-performer group (LPG). During the training phase, only the initial LPG received standardized instructor feedback in a one-to-one setting. The final assessment of skills for both groups involved performing the task without feedback at the end of the course. The HPG and LPG showed significantly different initial performance levels according global and categorized (time, economics, error) scores (p < 0.005). This difference disappeared quickly throughout the instructor feedback phase. The final assessment demonstrated that both groups were at the same level of performance. This is the first study to use a tailored training concept with instructor feedback limited to the LPG. The tailored training was effective and economic for the laparoscopic novices and their teachers.

Cross-cultural adaptation and validation of the Italian version of the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow score.

PubMed

Merolla, Giovanni; Corona, Katia; Zanoli, Gustavo; Cerciello, Simone; Giannotti, Stefano; Porcellini, Giuseppe

2017-12-01

The Kerlan-Jobe Orthopaedic Clinic (KJOC) Shoulder and Elbow score is a reliable and sensitive tool to measure the performance of overhead athletes. The purpose of this study was to carry out a cross-cultural adaptation and validation of the KJOC questionnaire in Italian and to assess its reliability, validity, and responsiveness. Ninety professional athletes with a painful shoulder were included in this study and were assigned to the "injury group" (n = 32) or the "overuse group" (n = 58); 65 were managed conservatively and 25 were treated by arthroscopic surgery. To assess the reliability of the KJOC score, patients were asked to fill in the questionnaire at baseline and after 2 weeks. To test the construct validity, KJOC scores were compared to those obtained with the Italian version of the Disabilities of the Arm, Shoulder, and Hand (DASH) scale, and with the DASH sports/performing arts module. To test KJOC score responsiveness, the follow-up KJOC scores of the participants treated conservatively were compared to those of the patients treated by arthroscopic surgery. Statistical analysis demonstrated that the KJOC questionnaire is reliable in terms of the single items and the overall score (ICC 0.95-0.99); that it has high construct validity (r s  = -0.697; p < 0.01); and that it is responsive to clinical differences in shoulder function (p < 0.0001). The Italian version of the KJOC Shoulder and Elbow score performed in a similar way to the English version and demonstrated good validity, reliability, and responsiveness after conservative and surgical treatment. II.

What Is the Relationship Between a Preclerkship Portfolio Review and Later Performance in Clerkships?

PubMed

O'Brien, Celia Laird; Thomas, John X; Green, Marianne M

2018-01-01

Medical educators struggle to find effective ways to assess essential competencies such as communication, professionalism, and teamwork. Portfolio-based assessment provides one method of addressing this problem by allowing faculty reviewers to judge performance, as based on a longitudinal record of student behavior. At the Feinberg School of Medicine, the portfolio system measures behavioral competence using multiple assessments collected over time. This study examines whether a preclerkship portfolio review is a valid method of identifying problematic student behavior affecting later performance in clerkships. The authors divided students into two groups based on a summative preclerkship portfolio review in 2014: students who had concerning behavior in one or more competencies and students progressing satisfactorily. They compared how students in these groups later performed on two clerkship outcomes as of October 2015: final grades in required clerkships, and performance on a clerkship clinical composite score. They used Mann-Whitney tests and multiple linear regression to examine the relationship between portfolio review results and clerkship outcomes. They used USMLE Step 1 to control for knowledge acquisition. Students with concerning behavior preclerkship received significantly lower clerkship grades than students progressing satisfactorily (P = .002). They also scored significantly lower on the clinical composite score (P < .001). Regression analysis indicated concerning behavior was associated with lower clinical composite scores, even after controlling for knowledge acquisition. The results show a preclerkship portfolio review can identify behaviors that impact clerkship performance. A comprehensive portfolio system is a valid way to measure behavioral competencies.

The first OSCE; does students' experience of performing in public affect their results?

PubMed

Chan, Michael; Bax, Nigel; Woodley, Caroline; Jennings, Michael; Nicolson, Rod; Chan, Philip

2015-03-26

Personal qualities have been shown to affect students' exam results. We studied the effect of experience, and level, of public performance in music, drama, dance, sport, and debate at the time of admission to medical school as a predictor of student achievement in their first objective structured clinical examination (OSCE). A single medical school cohort (n = 265) sitting their first clinical exam in 2011 as third year students were studied. Pre-admission statements made at the time of application were coded for their stated achievements in the level of public performance; participation in each activity was scored 0-3, where 0 was no record, 1 = leisure time activity, 2 = activity at school or local level, 3 = activity at district, regional or national level. These scores were correlated to OSCE results by linear regression and t-test. Comparison was made between the highest scoring students in each area, and students scoring zero by t-test. There was a bell shaped distribution in public performance score in this cohort. There was no significant linear regression relationship between OSCE results and overall performance score, or between any subgroups. There was a significant difference between students with high scores in theatre, debate and vocal music areas, grouped together as verbal performance, and students scoring zero in these areas. (p < 0.05, t-test) with an effect size of 0.4. We found modest effects from pre-admission experience of verbal performance on students' scores in the OSCE examination. As these data are taken from students' admission statements, we call into question the received wisdom that such statements are unreliable.

Assessing the learning curve for the acquisition of laparoscopic skills on a virtual reality simulator.

PubMed

Sherman, V; Feldman, L S; Stanbridge, D; Kazmi, R; Fried, G M

2005-05-01

The aim of this study was to develop summary metrics and assess the construct validity for a virtual reality laparoscopic simulator (LapSim) by comparing the learning curves of three groups with different levels of laparoscopic expertise. Three groups of subjects ('expert', 'junior', and 'naïve') underwent repeated trials on three LapSim tasks. Formulas were developed to calculate scores for efficiency ('time-error') and economy of 'motion' ('motion') using metrics generated by the software after each drill. Data (mean +/- SD) were evaluated by analysis of variance (ANOVA). Significance was set at p < 0.05. All three groups improved significantly from baseline to final for both 'time-error' and 'motion' scores. There were significant differences between groups in time error performances at baseline and final, due to higher scores in the 'expert' group. A significant difference in 'motion' scores was seen only at baseline. We have developed summary metrics for the LapSim that differentiate among levels of laparoscopic experience. This study also provides evidence of construct validity for the LapSim.

Effects of visual feedback balance training on the balance and ankle instability in adult men with functional ankle instability.

PubMed

Nam, Seung-Min; Kim, Kyoung; Lee, Do Youn

2018-01-01

[Purpose] This study examined the effects of visual feedback balance training on the balance and ankle instability in adult men with functional ankle instability. [Subjects and Methods] Twenty eight adults with functional ankle instability, divided randomly into an experimental group, which performed visual feedback balance training for 20 minutes and ankle joint exercises for 10 minutes, and a control group, which performed ankle joint exercise for 30 minutes. Exercises were completed three times a week for 8 weeks. Bio rescue was used for balance ability. It measured limit of stability at one minute. For ankle instability was measured using Cumberland ankle instability tool (CAIT). This measure was performed before and after the experiments in each group. [Results] The experimental group had significant increase in the Limit of Stability and CAIT score. The control group had significant increase in CAIT score. While the Limit of Stability increased without significance. [Conclusion] In conclusion, visual feedback balance training can be recommended as a treatment method for patients with functional ankle instability.

Stress Counter-Response Training Via Physiological Self-Regulation During Flight Simulation

NASA Technical Reports Server (NTRS)

Palsson, Olafur S.

2000-01-01

This study provided the first evaluation of a new training concept and technology aimed at training pilots to maintain physiological equilibrium during circumstances in an airplane cockpit. Thirty healthy subjects (16 males and 14 females) between the ages of 18 and 35 were randomized into two study groups, A and B. Subjects participated individually in a sequence of four study sessions. In the first visit, subjects were taught to operate a desktop fighter jet flight simulation program. In the three sessions that followed, subjects in group A were trained to minimize their autonomic deviation from baseline values while operating the desktop flight simulation. This was done by making their skin conductance and hand temperature deviations from baseline impair the functionality of the aircraft controls. Subjects also received auditory and visual cues about their autonomic deviation, and were instructed to keep these within pre-set limits to retain full control of the aircraft. Subjects in group B were subjected to periods of impaired aircraft functionality independent of their physiologic activity, and thus served as a control group. No statistically significant group differences were found in the flight performance scores from the three training sessions, and post-training flight performance scores of the two groups were not different. We conclude that this study did not provide clear support for this training methodology in optimizing pilot performance. However, a number of shortcomings in the current status of this training methodology may account for the lack of demonstrable training benefit to the experimental group. Suggested future modifications for research on this training methodology include: Limiting the amount of instrument impairment resulting from physiological deviations; conducting a greater number of physiological training sessions per subject; using pre-post training performance tests which invoke a greater amount of stress in subjects; and developing a more detailed performance scoring system.

Fundamentals of Arthroscopic Surgery Training Program Improves Knee Arthroscopy Simulator Performance in Arthroscopic Trainees.

PubMed

Cychosz, Chris C; Tofte, Josef N; Johnson, Alyssa; Gao, Yubo; Phisitkul, Phinit

2018-05-01

To determine the effectiveness of a nonanatomic simulator in developing basic arthroscopy motor skills transferable to an anatomic model. Forty-three arthroscopy novice individuals currently enrolled in medical school were recruited to perform a diagnostic knee arthroscopy using a high-fidelity virtual reality arthroscopic simulator providing haptic feedback after viewing a video of an expert performing an identical procedure. Students were then randomized into an experimental or control group. The experimental group then completed a series of self-guided training modules using the fundamentals of arthroscopy simulator training nonanatomic modules including camera centering, tracking, periscoping, palpation, and collecting stars in a three-dimensional space. Both groups completed another diagnostic knee arthroscopy between 1 and 2 weeks later. Camera path length, time, tibia and femur cartilage damage, as well as a composite score were recorded by the simulator on each attempt. The experimental group (n = 22) showed superior performance in composite score (30.09 vs 24, P = .046) and camera path length (71.51 cm vs 109.07 cm, P = .0274) at the time of the second diagnostic knee arthroscope compared with the control group (n = 21). The experimental group also showed significantly greater improvement in composite score between the first and second arthroscopes compared with the control group (14.27 vs 4.95, P < .01). Femoral and tibial cartilage damage were not significantly improved between arthroscopy attempts (-0.86% vs -1.45%, P = .40) and (-1.10 vs -1.27%, P = .83), respectively. The virtual reality-based fundamentals of arthroscopy simulator training nonanatomic simulator is beneficial in developing basic motor skills in arthroscopy novice individuals resulting in significantly greater composite performance in an anatomic knee model. Based on the results of this study, it appears that there may be benefit from nonanatomic simulators in general as part of an arthroscopy training program. Level II, randomized trial. Published by Elsevier Inc.

Excessive daytime sleepiness in adult patients with ADHD as measured by the Maintenance of Wakefulness Test, an electrophysiologic measure.

PubMed

Bioulac, Stéphanie; Chaufton, Cyril; Taillard, Jacques; Claret, Astrid; Sagaspe, Patricia; Fabrigoule, Colette; Bouvard, Manuel P; Philip, Pierre

2015-07-01

To quantify the objective level of sleepiness in adult attention-deficit/hyperactivity disorder (ADHD) patients and to determine the relationship between excessive daytime sleepiness and simulated driving performance. Forty adult ADHD patients (DSM-IV criteria) and 19 matched healthy control subjects were included between June 30, 2010, and June 19, 2013. All participants completed the Epworth Sleepiness Scale and the Manchester Driving Behavior Questionnaire. After nocturnal polysomnography, they performed 2 neuropsychological tests, a 4 × 40-minute Maintenance of Wakefulness Test, and a 1-hour driving session. The primary outcome measure was the mean sleep latency on the Maintenance of Wakefulness Test. ADHD patients were divided into 3 groups defined by their Maintenance of Wakefulness Test scores. Participants (patients and control subjects) were allocated as follows: sleepy ADHD (0-19 min), intermediate ADHD (20-33 min), alert ADHD (34-40 min), and control group (34-40 min). The driving performance outcome was the mean standard deviation of lateral position of the vehicle during the simulated session. The group mean (SD) Epworth Sleepiness Scale score was higher in ADHD patients (12.1 [4.4]) than in controls (6.0 [2.7]) (P < .001). On the basis of the Maintenance of Wakefulness Test scores, 14 patients (35%) were in the sleepy group, 20 (50%) were in the intermediate group, and only 6 (15%) were in the alert group. Sleepy ADHD patients exhibited significantly deteriorated driving performance compared to the other 3 groups (P < .01). Our study shows that a significant proportion of adult ADHD patients exhibit an objective excessive daytime sleepiness, which, in addition, has an impact on simulated driving performance. Excessive daytime sleepiness, therefore, may be a key element needed to better evaluate these ADHD patients. ClinicalTrials.gov identifier: NCT01160874. © Copyright 2015 Physicians Postgraduate Press, Inc.

APACHE II score in massive upper gastrointestinal haemorrhage from peptic ulcer: prognostic value and potential clinical applications.

PubMed

Schein, M; Gecelter, G

1989-07-01

This study examined the prognostic value of the APACHE II scoring system in patients undergoing emergency operations for bleeding peptic ulcer. There were 96 operations for gastric ulcers and 58 for duodenal ulcers. The mean scores in survivors and in patients who died were 10.8 and 17.5 respectively. None of the 66 patients with an APACHE II score less than 11 died, while the mortality rate in those scored greater than 10 was 22 per cent. In patients scored greater than 10 non-resective procedures carried less risk of mortality than gastrectomy. The APACHE II score is useful when measuring the severity of the acute disease and predicting the outcome in these patients. If used in daily practice it may assist the surgeon in stratifying patients into a low-risk group (score less than 11) in which major operations are well tolerated and outcome is favourable and a high-risk group (score greater than 10) in which the risk of mortality is high and the performance of procedures of lesser magnitude is probably more likely to improve survival.

Spatial perception predicts laparoscopic skills on virtual reality laparoscopy simulator.

PubMed

Hassan, I; Gerdes, B; Koller, M; Dick, B; Hellwig, D; Rothmund, M; Zielke, A

2007-06-01

This study evaluates the influence of visual-spatial perception on laparoscopic performance of novices with a virtual reality simulator (LapSim(R)). Twenty-four novices completed standardized tests of visual-spatial perception (Lameris Toegepaste Natuurwetenschappelijk Onderzoek [TNO] Test(R) and Stumpf-Fay Cube Perspectives Test(R)) and laparoscopic skills were assessed objectively, while performing 1-h practice sessions on the LapSim(R), comprising of coordination, cutting, and clip application tasks. Outcome variables included time to complete the tasks, economy of motion as well as total error scores, respectively. The degree of visual-spatial perception correlated significantly with laparoscopic performance on the LapSim(R) scores. Participants with a high degree of spatial perception (Group A) performed the tasks faster than those (Group B) who had a low degree of spatial perception (p = 0.001). Individuals with a high degree of spatial perception also scored better for economy of motion (p = 0.021), tissue damage (p = 0.009), and total error (p = 0.007). Among novices, visual-spatial perception is associated with manual skills performed on a virtual reality simulator. This result may be important for educators to develop adequate training programs that can be individually adapted.

The Arthroscopic Surgical Skill Evaluation Tool (ASSET)

PubMed Central

Koehler, Ryan J.; Amsdell, Simon; Arendt, Elizabeth A; Bisson, Leslie J; Braman, Jonathan P; Butler, Aaron; Cosgarea, Andrew J; Harner, Christopher D; Garrett, William E; Olson, Tyson; Warme, Winston J.; Nicandri, Gregg T.

2014-01-01

Background Surgeries employing arthroscopic techniques are among the most commonly performed in orthopaedic clinical practice however, valid and reliable methods of assessing the arthroscopic skill of orthopaedic surgeons are lacking. Hypothesis The Arthroscopic Surgery Skill Evaluation Tool (ASSET) will demonstrate content validity, concurrent criterion-oriented validity, and reliability, when used to assess the technical ability of surgeons performing diagnostic knee arthroscopy on cadaveric specimens. Study Design Cross-sectional study; Level of evidence, 3 Methods Content validity was determined by a group of seven experts using a Delphi process. Intra-articular performance of a right and left diagnostic knee arthroscopy was recorded for twenty-eight residents and two sports medicine fellowship trained attending surgeons. Subject performance was assessed by two blinded raters using the ASSET. Concurrent criterion-oriented validity, inter-rater reliability, and test-retest reliability were evaluated. Results Content validity: The content development group identified 8 arthroscopic skill domains to evaluate using the ASSET. Concurrent criterion-oriented validity: Significant differences in total ASSET score (p<0.05) between novice, intermediate, and advanced experience groups were identified. Inter-rater reliability: The ASSET scores assigned by each rater were strongly correlated (r=0.91, p <0.01) and the intra-class correlation coefficient between raters for the total ASSET score was 0.90. Test-retest reliability: there was a significant correlation between ASSET scores for both procedures attempted by each individual (r = 0.79, p<0.01). Conclusion The ASSET appears to be a useful, valid, and reliable method for assessing surgeon performance of diagnostic knee arthroscopy in cadaveric specimens. Studies are ongoing to determine its generalizability to other procedures as well as to the live OR and other simulated environments. PMID:23548808

Successful schools and risky behaviors among low-income adolescents.

PubMed

Wong, Mitchell D; Coller, Karen M; Dudovitz, Rebecca N; Kennedy, David P; Buddin, Richard; Shapiro, Martin F; Kataoka, Sheryl H; Brown, Arleen F; Tseng, Chi-Hong; Bergman, Peter; Chung, Paul J

2014-08-01

We examined whether exposure to high-performing schools reduces the rates of risky health behaviors among low-income minority adolescents and whether this is due to better academic performance, peer influence, or other factors. By using a natural experimental study design, we used the random admissions lottery into high-performing public charter high schools in low-income Los Angeles neighborhoods to determine whether exposure to successful school environments leads to fewer risky (eg, alcohol, tobacco, drug use, unprotected sex) and very risky health behaviors (e.g., binge drinking, substance use at school, risky sex, gang participation). We surveyed 521 ninth- through twelfth-grade students who were offered admission through a random lottery (intervention group) and 409 students who were not offered admission (control group) about their health behaviors and obtained their state-standardized test scores. The intervention and control groups had similar demographic characteristics and eighth-grade test scores. Being offered admission to a high-performing school (intervention effect) led to improved math (P < .001) and English (P = .04) standard test scores, greater school retention (91% vs. 76%; P < .001), and lower rates of engaging in ≥1 very risky behaviors (odds ratio = 0.73, P < .05) but no difference in risky behaviors, such as any recent use of alcohol, tobacco, or drugs. School retention and test scores explained 58.0% and 16.2% of the intervention effect on engagement in very risky behaviors, respectively. Increasing performance of public schools in low-income communities may be a powerful mechanism to decrease very risky health behaviors among low-income adolescents and to decrease health disparities across the life span. Copyright © 2014 by the American Academy of Pediatrics.

The Effect Of Different Corrective Feedback Methods on the Outcome and Self Confidence of Young Athletes

PubMed Central

Tzetzis, George; Votsis, Evandros; Kourtessis, Thomas

2008-01-01

This experiment investigated the effects of three corrective feedback methods, using different combinations of correction, or error cues and positive feedback for learning two badminton skills with different difficulty (forehand clear - low difficulty, backhand clear - high difficulty). Outcome and self-confidence scores were used as dependent variables. The 48 participants were randomly assigned into four groups. Group A received correction cues and positive feedback. Group B received cues on errors of execution. Group C received positive feedback, correction cues and error cues. Group D was the control group. A pre, post and a retention test was conducted. A three way analysis of variance ANOVA (4 groups X 2 task difficulty X 3 measures) with repeated measures on the last factor revealed significant interactions for each depended variable. All the corrective feedback methods groups, increased their outcome scores over time for the easy skill, but only groups A and C for the difficult skill. Groups A and B had significantly better outcome scores than group C and the control group for the easy skill on the retention test. However, for the difficult skill, group C was better than groups A, B and D. The self confidence scores of groups A and C improved over time for the easy skill but not for group B and D. Again, for the difficult skill, only group C improved over time. Finally a regression analysis depicted that the improvement in performance predicted a proportion of the improvement in self confidence for both the easy and the difficult skill. It was concluded that when young athletes are taught skills of different difficulty, different type of instruction, might be more appropriate in order to improve outcome and self confidence. A more integrated approach on teaching will assist coaches or physical education teachers to be more efficient and effective. Key pointsThe type of the skill is a critical factor in determining the effectiveness of the feedback types.Different instructional methods of corrective feedback could have beneficial effects in the outcome and self-confidence of young athletesInstructions focusing on the correct cues or errors increase performance of easy skills.Positive feedback or correction cues increase self-confidence of easy skills but only the combination of error and correction cues increase self confidence and outcome scores of difficult skills. PMID:24149905

[Memory characteristic in boys with attention deficit/hyperactivity disorder comorbid learning disability].

PubMed

Wu, Zhaomin; Wang, Na; Qian, Qiujin; Yang, Li; Qian, Ying; Liu, Lu; Liu, Yuxin; Cheng, Jia; Sun, Li; Cao, Qingjiu; Wang, Yufeng

2014-06-10

To explore the memory characteristic in boys with attention-deficit/hyperactivity disorder (ADHD) plus learning disability (LD). A total of 97 ADHD boys with comorbid LD (ADHD+LD), 97 ADHD boys without comorbid LD (ADHD-LD) and 97 healthy controls (based on the criteria of DSM-IV) were recruited from the outpatient clinic of Peking University Sixth Hospital from December 2003 to September 2012. Individuals across three groups were matched by ages, intelligence quotient (IQ) and ADHD subtypes. The Wechsler Memory Scale (WMS) was used to access the characteristics of several memory domains. ADHD +LD group performed the worst and control group the best in memory quotient (MQ) (90 ± 15 vs 98 ± 14 & 104 ± 14) and long-term memory domain ((36.0 ± 10.2) vs (42.1 ± 7.8) & (45.6 ± 6.7) score, all P < 0.05) . ADHD+LD group scored significantly lower than the control group in short-term memory ( (53.0 ± 9.2) vs (58.0 ± 9.7) score, P < 0.05) and immediate memory domains ((10.0 ± 3.3) vs (11.3 ± 3.5) score, P < 0.05). However, ADHD+LD group scored slightly but not significantly lower than the ADHD-LD group ((54.9 ± 10.7),(10.8 ± 3.2) score, P > 0.05). In most subscales of WMS, ADHD+LD group scored significantly lower than both ADHD-LD and control group in current information and orientation, mental control (1→100) , mental control (100→1) and associate learning subscales ( (8.8 ± 3.1) vs (10.0 ± 3.0) & (9.9 ± 2.3) score, (8.7 ± 4.1) vs (10.0 ± 3.9) & (11.1 ± 3.6) score, (10.7 ± 3.9) vs (12.9 ± 2.8) & (13.7 ± 2.2) score, (9.8 ± 3.1) vs (10.8 ± 2.6) & (11.1 ± 2.1) score, all P < 0.05) . In mental control (accumulation) subscale, all pairwise comparisons were statistically significant (all P < 0.05) . In subscales of figure memory, visual reproduction and digit span, ADHD+LD scored significantly lower than the control group (all P < 0.05), but not the ADHD-LD group (all P > 0.05). Boys with ADHD comorbid LD show deficits in overall memory function and long-term memory while short-term memory is partially damaged. Impairment in immediate memory is not detected.

Evaluating Middle School Students' Spatial-scientific Performance in Earth-space Science

NASA Astrophysics Data System (ADS)

Wilhelm, Jennifer; Jackson, C.; Toland, M. D.; Cole, M.; Wilhelm, R. J.

2013-06-01

Many astronomical concepts cannot be understood without a developed understanding of four spatial-mathematics domains defined as follows: a) Geometric Spatial Visualization (GSV) - Visualizing the geometric features of a system as it appears above, below, and within the system’s plane; b) Spatial Projection (SP) - Projecting to a different location and visualizing from that global perspective; c) Cardinal Directions (CD) - Distinguishing directions (N, S, E, W) in order to document an object’s vector position in space; and d) Periodic Patterns - (PP) Recognizing occurrences at regular intervals of time and/or space. For this study, differences were examined between groups of sixth grade students’ spatial-scientific development pre/post implementation of an Earth/Space unit. Treatment teachers employed a NASA-based curriculum (Realistic Explorations in Astronomical Learning), while control teachers implemented their regular Earth/Space units. A 2-level hierarchical linear model was used to evaluate student performance on the Lunar Phases Concept Inventory (LPCI) and four spatial-mathematics domains, while controlling for two variables (gender and ethnicity) at the student level and one variable (teaching experience) at the teacher level. Overall LPCI results show pre-test scores predicted post-test scores, boys performed better than girls, and Whites performed better than non-Whites. We also compared experimental and control groups’ by spatial-mathematics domain outcomes. For GSV, it was found that boys, in general, tended to have higher GSV post-scores. For domains CD and SP, no statistically significant differences were observed. PP results show Whites performed better than non-Whites. Also for PP, a significant cross-level interaction term (gender-treatment) was observed, which means differences in control and experimental groups are dependent on students’ gender. These findings can be interpreted as: (a) the experimental girls scored higher than the control girls and/or (b) the control group displayed a gender gap in favor of boys while no gender gap was displayed within the experimental group.

Diagnostic value of non stress test in latent phase of labor and maternal and fetal outcomes.

PubMed

Raouf, Shiva; Sheikhan, Fatemeh; Hassanpour, Shirin; Bani, Soheila; Torabi, Rogayye; Shamsalizadeh, Neda

2014-10-28

The Non Stress Test (NST) is the one of the significant diagnostic fetal well being testes. The purpose of this study is to access diagnostic value of NST during latent phase of labor by considering maternal and neonatal outcomes. This case study control study was performed on 450 healthy pregnant women with gestational age between 38-42 weeks in AL-Zahra teaching hospital in Tabriz, Iran. All participants underwent NST after being admitted to labor during their latent phase of delivery. Participants were divided into groups including the study group which included 150 participants with non-reactive NST results whereas 300 subjects with reactive NST results assigned in the control group. Subjects in both groups were hospitalized for pregnancy termination because of the delivery time. In order to find out the importance of routine performance of NST during delivery, the relationship between NST results and maternal and fetal outcomes was evaluated. Several criteria including type of delivery, meconium defecation, descent arrest, bradicardia, Apgar score, and still birth were compared between two types. Finding of this study showed that descent arrest occurred in 2.7% of the subjects in the study group, whereas it occurred in 4.7% of the participants in the control group (p=0.44). Bradicardia found in 28% of the participants in study group and 3.3% of the control group (p<0.001). The low Apgar Score was found in 2.7% of case group however; no the low apgar score detected in the control group. Meconium defecation observed in 11.3% of the subjects in the study group and 9.7% of the participants in control group (p=0.62). The amount of stillbirth were found in control group. There was a significant difference between the results of both groups in terms of bradicardia, descent arrest, and the low Apgar score and cesarean section. Results of this study revealed that participants in study group with nonreactive NST results had more fetal complications than those with reactive NST results. NST was found to be a value diagnostic test for diagnosis of fetal distress during delivery in the latent phase. This findings of this study suggest that NST should be performed routinely as a valuable diagnostic test during the latent phase of delivery.

[Mini Mental State Examination (MMSE): determination of cutoff scores according to age and educational level].

PubMed

Solias, A; Skapinakis, P; Degleris, N; Pantoleon, M; Katirtzoglou, E; Politis, A

2014-01-01

For the last 38 years, Mini Mental State Examination (MMSE) has been widely used as a dementia screening measure in everyday clinical practice as well as in both cohort and cross-sectional studies. Its validity and reliability for the Greek population has explicitly been documented. However, the effect of age and education on the subject's performance makes it necessary to reckon them in the estimation of the "cutoff score". The purpose of this study is to estimate the prevalence of dementia in Greek population and determine the "cutoff score" by age and education-corrected norms. Cross sectional study of 630 patients older than 55 years, who live independently in Ilion and Helioupolis Municipalities was conducted, 27.3% of the subjects tested in the study were diagnosed with memory disorder according to their MMSE scores and the validation for the Greek population. The effect of age and education to the subjects' performance was statistically significant (p=.000). The use of standard "cutoff score" was not proved to be useful for the personalized interpretation of the results, as documented by the fact that older individuals with lower education had a poorer performance relatively to younger, highly educated subjects. Comparatively to the group age of 55-60 years, the odds ratio after the age of 75 years varies from 2.58 to 4.91. Regarding the variable factor of education, the odds ratio for the first degree education graduates decreases from 1.43 to 3.19 for the third degree education graduates in comparison with the group of illiterates. In conclusion, the use of the "cutoff score" algorithm and the simultaneous estimation of age and education effect on MMSE score may prove useful for the proper evaluation of MMSE performance. According to the age and education of examine candidates in the community and the primary care, we propose the use of the 25th percentile as a more useful cutoff score in order to decrease the false positive results.

Comparison of Wells and Revised Geneva Rule to Assess Pretest Probability of Pulmonary Embolism in High-Risk Hospitalized Elderly Adults.

PubMed

Di Marca, Salvatore; Cilia, Chiara; Campagna, Andrea; D'Arrigo, Graziella; Abd ElHafeez, Samar; Tripepi, Giovanni; Puccia, Giuseppe; Pisano, Marcella; Mastrosimone, Gianluca; Terranova, Valentina; Cardella, Antonella; Buonacera, Agata; Stancanelli, Benedetta; Zoccali, Carmine; Malatino, Lorenzo

2015-06-01

To assess and compare the diagnostic power for pulmonary embolism (PE) of Wells and revised Geneva scores in two independent cohorts (training and validation groups) of elderly adults hospitalized in a non-emergency department. Prospective clinical study, January 2011 to January 2013. Unit of Internal Medicine inpatients, University of Catania, Italy. Elderly adults (mean age 76 ± 12), presenting with dyspnea or chest pain and with high clinical probability of PE or D-dimer values greater than 500 ng/mL (N = 203), were enrolled and consecutively assigned to a training (n = 101) or a validation (n = 102) group. The clinical probability of PE was assessed using Wells and revised Geneva scores. Clinical examination, D-dimer test, and multidetector computed angiotomography were performed in all participants. The accuracy of the scores was assessed using receiver operating characteristic analyses. PE was confirmed in 46 participants (23%) (24 training group, 22 validation group). In the training group, the area under the receiver operating characteristic curve was 0.91 (95% confidence interval (CI) = 0.85-0.98) for the Wells score and 0.69 (95% CI = 0.56-0.82) for the revised Geneva score (P < .001). These results were confirmed in the validation group (P < .05). The positive (LR+) and negative likelihood ratios (LR-) (two indices combining sensitivity and specificity) of the Wells score were superior to those of the revised Geneva score in the training (LR+, 7.90 vs 1.34; LR-, 0.23 vs 0.66) and validation (LR+, 13.5 vs 1.46; LR-, 0.47 vs 0.54) groups. In high-risk elderly hospitalized adults, the Wells score is more accurate than the revised Geneva score for diagnosing PE. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

Association of Practice-Level Social and Medical Risk With Performance in the Medicare Physician Value-Based Payment Modifier Program

PubMed Central

Epstein, Arnold M.; Orav, E. John; Filice, Clara E.; Samson, Lok Wong; Joynt Maddox, Karen E.

2017-01-01

Importance Medicare recently launched the Physician Value-Based Payment Modifier (PVBM) Program, a mandatory pay-for-performance program for physician practices. Little is known about performance by practices that serve socially or medically high-risk patients. Objective To compare performance in the PVBM Program by practice characteristics. Design, Setting, and Participants Cross-sectional observational study using PVBM Program data for payments made in 2015 based on performance of large US physician practices caring for fee-for-service Medicare beneficiaries in 2013. Exposures High social risk (defined as practices in the top quartile of proportion of patients dually eligible for Medicare and Medicaid) and high medical risk (defined as practices in the top quartile of mean Hierarchical Condition Category risk score among fee-for-service beneficiaries). Main Outcomes and Measures Quality and cost z scores based on a composite of individual measures. Higher z scores reflect better performance on quality; lower scores, better performance on costs. Results Among 899 physician practices with 5 189 880 beneficiaries, 547 practices were categorized as low risk (neither high social nor high medical risk) (mean, 7909 beneficiaries; mean, 320 clinicians), 128 were high medical risk only (mean, 3675 beneficiaries; mean, 370 clinicians), 102 were high social risk only (mean, 1635 beneficiaries; mean, 284 clinicians), and 122 were high medical and social risk (mean, 1858 beneficiaries; mean, 269 clinicians). Practices categorized as low risk performed the best on the composite quality score (z score, 0.18 [95% CI, 0.09 to 0.28]) compared with each of the practices categorized as high risk (high medical risk only: z score, −0.55 [95% CI, −0.77 to −0.32]; high social risk only: z score, −0.86 [95% CI, −1.17 to −0.54]; and high medical and social risk: −0.78 [95% CI, −1.04 to −0.51]) (P < .001 across groups). Practices categorized as high social risk only performed the best on the composite cost score (z score, −0.52 [95% CI, −0.71 to −0.33]), low risk had the next best cost score (z score, −0.18 [95% CI, −0.25 to −0.10]), then high medical and social risk (z score, 0.40 [95% CI, 0.23 to 0.57]), and then high medical risk only (z score, 0.82 [95% CI, 0.65 to 0.99]) (P < .001 across groups). Total per capita costs were $9506 for practices categorized as low risk, $13 683 for high medical risk only, $8214 for high social risk only, and $11 692 for high medical and social risk. These patterns were associated with fewer bonuses and more penalties for high-risk practices. Conclusions and Relevance During the first year of the Medicare Physician Value-Based Payment Modifier Program, physician practices that served more socially high-risk patients had lower quality and lower costs, and practices that served more medically high-risk patients had lower quality and higher costs. PMID:28763549

Positive correlation between motion analysis data on the LapMentor virtual reality laparoscopic surgical simulator and the results from videotape assessment of real laparoscopic surgeries.

PubMed

Matsuda, Tadashi; McDougall, Elspeth M; Ono, Yoshinari; Hattori, Ryohei; Baba, Shiro; Iwamura, Masatsugu; Terachi, Toshiro; Naito, Seiji; Clayman, Ralph V

2012-11-01

We studied the construct validity of the LapMentor, a virtual reality laparoscopic surgical simulator, and the correlation between the data collected on the LapMentor and the results of video assessment of real laparoscopic surgeries. Ninety-two urologists were tested on basic skill tasks No. 3 (SK3) to No. 8 (SK8) on the LapMentor. They were divided into three groups: Group A (n=25) had no experience with laparoscopic surgeries as a chief surgeon; group B (n=33) had <35 experiences; and group C (n=34) had ≥35 experiences. Group scores on the accuracy, efficacy, and time of the tasks were compared. Forty physicians with ≥20 experiences supplied unedited videotapes showing a laparoscopic nephrectomy or an adrenalectomy in its entirety, and the videos were assessed in a blinded fashion by expert referees. Correlations between the videotape score (VS) and the performances on the LapMentor were analyzed. Group C showed significantly better outcomes than group A in the accuracy (SK5) (P=0.013), efficacy (SK8) (P=0.014), or speed (SKs 3 and 8) (P=0.009 and P=0.002, respectively) of the performances of LapMentor. Group B showed significantly better outcomes than group A in the speed and efficacy of the performances in SK8 (P=0.011 and P=0.029, respectively). Analyses of motion analysis data of LapMentor demonstrated that smooth and ideal movement of instruments is more important than speed of the movement of instruments to achieve accurate performances in each task. Multiple linear regression analysis indicated that the average score of the accuracy in SK4, 5, and 8 had significant positive correlation with VS (P=0.01). This study demonstrated the construct and predictive validity of the LapMentor basic skill tasks, supporting their possible usefulness for the preclinical evaluation of laparoscopic skills.

A comparison of two microscale laboratory reporting methods in a secondary chemistry classroom

NASA Astrophysics Data System (ADS)

Martinez, Lance Michael

This study attempted to determine if there was a difference between the laboratory achievement of students who used a modified reporting method and those who used traditional laboratory reporting. The study also determined the relationships between laboratory performance scores and the independent variables score on the Group Assessment of Logical Thinking (GALT) test, chronological age in months, gender, and ethnicity for each of the treatment groups. The study was conducted using 113 high school students who were enrolled in first-year general chemistry classes at Pueblo South High School in Colorado. The research design used was the quasi-experimental Nonequivalent Control Group Design. The statistical treatment consisted of the Multiple Regression Analysis and the Analysis of Covariance. Based on the GALT, students in the two groups were generally in the concrete and transitional stages of the Piagetian cognitive levels. The findings of the study revealed that the traditional and the modified methods of laboratory reporting did not have any effect on the laboratory performance outcome of the subjects. However, the students who used the traditional method of reporting showed a higher laboratory performance score when evaluation was conducted using the New Standards rubric recommended by the state. Multiple Regression Analysis revealed that there was a significant relationship between the criterion variable student laboratory performance outcome of individuals who employed traditional laboratory reporting methods and the composite set of predictor variables. On the contrary, there was no significant relationship between the criterion variable student laboratory performance outcome of individuals who employed modified laboratory reporting methods and the composite set of predictor variables.

A simple strategy to reduce stereotype threat for orthopedic residents

PubMed Central

Gomez, Everlyne; Wright, James G.

2014-01-01

Background Stereotype threat, defined as the predicament felt by people in either positive or negative learning experiences where they could conform to negative stereotypes associated with their own group membership, can interfere with learning. The purpose of this study was to determine if a simple orientation session could reduce stereotype threat for orthopedic residents. Methods The intervention group received an orientation on 2 occasions focusing on their possible responses to perceived poor performance in teaching rounds and the operating room (OR). Participants completed a survey with 7 questions typical for stereotype threat evaluating responses to their experiences. The questions had 7 response options with a maximum total score of 49, where higher scores indicated greater degree of experiences typical of stereotype threat. Results Of the 84 eligible residents, 49 participated: 22 in the nonintervention and 27 in the intervention group. The overall scores were 29 and 29.4, and 26.2 and 25.8 in the nonintervention and intervention groups for their survey responses to perceived poor performance in teaching rounds (p = 0.85) and the OR (p = 0.84), respectively. Overall, responses typical of stereotype threat were greater for perceived poor performance at teaching rounds than in the OR (p = 0.001). Conclusion Residents experience low self-esteem following perceived poor performance, particularly at rounds. A simple orientation designed to reduce stereotype threat was unsuccessful in reducing this threat overall. Future research will need to consider longer-term intervention as possible strategies to reduce perceived poor performance at teaching rounds and in the OR. PMID:24666454

Improving Resident Performance in Knee Arthroscopy: A Prospective Value Assessment of Simulators and Cadaveric Skills Laboratories.

PubMed

Camp, Christopher L; Krych, Aaron J; Stuart, Michael J; Regnier, Terry D; Mills, Karen M; Turner, Norman S

2016-02-03

Cadaveric skills laboratories and virtual reality simulators are two common methods used outside of the operating room to improve residents' performance of knee arthroscopy. We are not aware of any head-to-head comparisons of the educational values of these two methodologies. The purpose of this prospective randomized trial was to assess the efficacy of these training methods, compare their rates of improvement, and provide economic value data to programs seeking to implement such technologies. Orthopaedic surgery residents were randomized to one of three groups: control, training on cadavera (cadaver group), and training with use of a simulator (simulator group). Residents completed pretest and posttest diagnostic knee arthroscopies on cadavera that were timed and video-recorded. Between the pretest and posttest, the control group performed no arthroscopy, the cadaver group performed four hours of practice on cadavera, and the simulator group trained for four hours on a simulator. All tests were scored in a blinded, randomized fashion using the validated Arthroscopy Surgical Skill Evaluation Tool (ASSET). The mean improvement in the ASSET score and in the time to complete the procedure were compared between the pretest and posttest and among the groups. Forty-five residents (fifteen per group) completed the study. The mean difference in the ASSET score from the pretest to the posttest was -0.40 (p = 0.776) in the control group, +4.27 (p = 0.002) in the cadaver group, and +1.92 (p = 0.096) in the simulator group (p = 0.015 for the comparison among the groups). The mean difference in the test-completion time (minutes:seconds) from the pretest to the posttest was 0:07 (p = 0.902) in the control group, 3:01 (p = 0.002) in the cadaver group, and 0:28 (p = 0.708) in the simulator group (p = 0.044 for the comparison among groups). Residents in the cadaver group improved their performance at a mean of 1.1 ASSET points per hour spent training whereas those in the simulator group improved 0.5 ASSET point per hour of training. Cadaveric skills laboratories improved residents' performance of knee arthroscopy compared with that of matched controls. Residents practicing on cadaveric specimens improved twice as fast as those utilizing a high-fidelity simulator; however, based on cost estimation specific to our institution, the simulator may be more cost-effective if it is used at least 300 hours per year. Additional study of this possibility is warranted. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.

Asperger syndrome and schizophrenia: Overlap of self-reported autistic traits using the Autism-spectrum Quotient (AQ).

PubMed

Lugnegård, Tove; Hallerbäck, Maria Unenge; Gillberg, Christopher

2015-05-01

In clinical practice, the differential diagnosis of Asperger syndrome (AS) versus schizophrenia can be a challenge. Some self-report instruments-such as the Autism-spectrum Quotient (AQ)-have been portrayed as proxies for the diagnosis of AS. However, it has not been demonstrated to what extent autistic traits-as measured by the AQ-separate AS from schizophrenia. To examine the AS-schizophrenia discriminating ability of the AQ. The AQ is a 50-item self-administered questionnaire (with score range 0-50) for measuring "autistic traits" in adults. Here, it was completed by 136 individuals: 36 with schizophrenic psychosis, 51 with AS and 49 non-clinical comparison cases. A receiver operating characteristic (ROC) analysis for the total AQ score was performed to examine the discriminating power of the instrument. Both individuals with schizophrenia and individuals with AS scored significantly higher on AQ than the non-clinical group. The mean total AQ score (± standard deviation) of the AS group (26.7 ± 8.9; range 9-44) was significantly higher than that of the schizophrenia group (22.7 ± 6.2; range 10-35) (P = 0.041). However, when using the full Likert scale for scoring, the difference did not reach significance. In the ROC analysis of total AQ scores for AS versus schizophrenia, the area under the curve (AUC) was 0.65 (P = 0.02). Although mean AQ scores separated AS and schizophrenia at a group comparison level, significant overlap of AQ scores across the two diagnostic groups clearly reduces the discriminating power of the AQ in the separation of schizophrenia from AS.

Effects of edaravone on early outcomes in acute ischemic stroke patients treated with recombinant tissue plasminogen activator.

PubMed

Wada, Tomoki; Yasunaga, Hideo; Inokuchi, Ryota; Horiguchi, Hiromasa; Fushimi, Kiyohide; Matsubara, Takehiro; Nakajima, Susumu; Yahagi, Naoki

2014-10-15

We investigated whether edaravone could improve early outcomes in acute ischemic stroke patients treated with recombinant tissue plasminogen activator (rtPA). We conducted a retrospective cohort study using the Japanese Diagnosis Procedure Combination database. We identified patients admitted with a primary diagnosis of ischemic stroke from 1 July 2010 to 31 March 2012 and treated with rtPA on the same day of stroke onset or the following day. Thereafter, we selected those who received edaravone on the same day of rtPA administration (edaravone group), and those who received rtPA without edaravone (control group). The primary outcomes were modified Rankin Scale (mRS) scores at discharge. One-to-one propensity-score matching was performed between the edaravone and control groups. An ordinal logistic regression analysis for mRS scores at discharge was performed with adjustment for possible variables as well as clustering of patients within hospitals using a generalized estimating equation. We identified 6336 eligible patients for inclusion in the edaravone group (n=5979; 94%) and the control group (n=357; 6%) as the total population. In 356 pairs of the propensity-matched population, the ordinal logistic regression analysis showed that edaravone was significantly associated with lower mRS scores of patients at discharge (adjusted odds ratio: 0.74; 95% confidence interval: 0.57-0.96). Edaravone may improve early outcomes in acute ischemic stroke patients treated with rtPA. Copyright © 2014 Elsevier B.V. All rights reserved.

A trial of team-based versus small-group learning for second-year medical students: does the size of the small group make a difference?

PubMed

Willett, Laura Rees; Rosevear, G Craig; Kim, Sarang

2011-01-01

Team-based learning is a large-group instructional modality intended to provide active learning with modest faculty resources. The goal is to determine if team-based learning could be substituted for small-group learning in case sessions without compromising test performance or satisfaction. One hundred and sixty-seven students were assigned to team-based or small-group learning for 6 case discussion sessions. Examination scores and student satisfaction were compared. Instruction modality had no meaningful effect on examination score, 81.7% team based versus 79.7% small-group, p=.56 after multivariate adjustment. Student satisfaction was lower with team-based learning, 2.45 versus 3.74 on a 5-point scale, p<.001. Survey responses suggested that the very small size (8-10 students) of our small groups influenced the preference for small-group learning. Team-based learning does not adversely affect examination performance. However, student satisfaction may be inferior, especially if compared to instruction in very small groups of 10 or fewer students.

Intellectual Development of Battered Children.

ERIC Educational Resources Information Center

Oates, Kim; Peacock, Anthony

1984-01-01

Thirty-eight children hospitalized because of physical abuse were compared with a control group. Abuse Ss had significantly lower mean scores than the comparison children on the verbal, performance and full scale scores of the Wechsler Intelligence Scale for Children Revised and the Wechsler Preschool and Primary Scale of Intelligence. (Author/CL)

Evaluation of the Talar Cartilage in Chronic Lateral Ankle Instability with Lateral Ligament Injury Using Biochemical T2* Mapping: Correlation with Clinical Symptoms.

PubMed

Hu, Yiwen; Tao, Hongyue; Qiao, Yang; Ma, Kui; Hua, Yinghui; Yan, Xu; Chen, Shuang

2018-06-19

This study aims to quantitatively compare T2* measurements of the talar cartilage between chronic lateral ankle instability (LAI) patients with lateral ligament injury and healthy volunteers, and to assess the association of T2* value with American Orthopedic Foot and Ankle Society (AOFAS) score. Nineteen consecutive patients with chronic LAI (LAI group) and 19 healthy individuals (control group) were enrolled. Biochemical magnetic resonance examination of the ankle was performed in all participants using three-dimensional gradient-echo T2* mapping. Total talar cartilage was divided into six subcompartments, including medial anterior (MA), central medial, medial posterior, lateral anterior, central lateral (LC), and lateral posterior regions. T2* values of respective cartilage areas were measured and compared between the two groups using Student t test. AOFAS scoring was performed for clinical evaluation. Then, the association of T2* value with AOFAS score was evaluated by Pearson correlation. The T2* values of total talar cartilage, as well as MA and LC cartilage compartments, in the chronic LAI group were significantly higher than control values (P <.001, P = .039, and P = .014, respectively). Furthermore, the T2* value of MA in the chronic LAI group was negatively correlated with AOFAS score (r =-0.8089, P <.001). Chronic LAI with lateral ligament injury may have a causal connection with early cartilage degeneration in the ankle joint, especially in MA and LC cartilage compartments, as assessed by quantitative T2* measurements. The clinical score correlates highly with T2* value of the MA cartilage compartment, indicating that MA may be the principal cartilage area conferring clinical symptoms. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Comparison of Direct Instruction and Problem Centered Instruction for Army Institutional Training

DTIC Science & Technology

2013-04-01

of the ALC small group classrooms and were briefed on the general research objectives. They then completed the pretest and Demographic...Findings For this research, we measured participants’ performance on well-defined (WD) tasks in terms of their score on the pretest and posttest ...WD score was 49% on the pretest and 52% on the posttest . Similarly, we measured participants’ performance on ill-defined (ID) tasks in terms of

Nutritional Status Changes and Activities of Daily Living after Hip Fracture in Convalescent Rehabilitation Units: A Retrospective Observational Cohort Study from the Japan Rehabilitation Nutrition Database.

PubMed

Nishioka, Shinta; Wakabayashi, Hidetaka; Momosaki, Ryo

2018-07-01

Several studies have suggested that malnutrition impedes functional recovery in patients with hip fracture, but there are few reports on improvement in nutritional status and return to activities of daily living (ADL) in these patients. This study was conducted to evaluate the relationship between change in nutritional status and recovery of ADL in malnourished patients after hip fracture and to identify predictors of functional recovery among the characteristic features of undernutrition. This was a retrospective observational cohort study. Data for patients aged ≥65 years with hip fracture and malnutrition (Mini Nutritional Assessment-Short Form [MNA-SF] score ≤7) at the time of admission to convalescent rehabilitation units were obtained from the Japan Rehabilitation Nutrition Database between November 2015 and August 2017. The main outcome measures were Functional Independence Measure (FIM) at discharge and the proportion of patients discharged home. Patients were divided into two groups based on MNA-SF scores at discharge: improvement in nutritional status (>7, IN group) and non-improvement in nutritional status (≤7, NN group). Clinical characteristics and outcomes were compared between the groups. Multivariable regression analysis was performed to adjust for confounders including age, sex, comorbidity, pre-fracture ADL level, and FIM score on admission. Of 876 patients, 110 met the eligibility criteria (mean age, 85 years; 78.2% female); 77 of the patients were assigned to the IN group and 33 to the NN group. The patients in the IN group were younger and had higher FIM and MNA-SF scores on admission than those in the NN group. At discharge, the median FIM score was significantly higher in the IN group than in the NN group (110 vs 83, P<0.001). Multivariable analysis revealed a significant association between improvement in nutritional status and higher FIM score at discharge (B=7.377 [B=partial regression coefficient], P=0.036) but no association with discharge to home. Mobility, neuropsychological impairment, and weight loss subscores of MNA-SF were independently associated with discharge FIM score (R 2 =0.659). In older patients with hip fracture and malnutrition, improvement in nutritional status was independently associated with improved performance of ADL during inpatient rehabilitation. Weight loss may be an important nutritional indicator for these patients. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Comparative evaluation of different periods of enamel microabrasion on the microleakage of class V resin-modified glass ionomer and compomer restorations: An In vitro study.

PubMed

Bansal, Disha; Mahajan, Mrinalini

2017-01-01

The design of the class V cavity presents a clinical challenge in the field of adhesive dentistry as the margin placement is partially in enamel and partly in dentin, and the trouble associated with this design is the microleakage at the dentinal margin. When these restorations undergo microabrasion due to cosmetic reasons, this trouble aggravates to the significant levels. The aim of this study was the measurement of microleakage of class V glass ionomer restorations over two different periods of enamel microabrasion. This in vitro experimental study was conducted on 120 class V cavities which had been prepared on the buccal and lingual surfaces of 60 sound human premolars. One-half of the cavities were restored with the resin-modified glass ionomer cement (GIC) (60 cavities) and another half with the compomer (60 cavities). Finishing and polishing were performed. Then, the teeth were classified into six groups (n = 20). Microabrasion treatment was performed with Opaluster (Ultradent Product Inc., South Jordan, UT, USA) for 0 (control no treatment), 60 and 120 s. Then, teeth were thermocycled between 5°C and 55°C, immersed in rhodamine B solution (24 h), and sectioned longitudinally in buccolingual direction. Dye penetration was examined with stereomicroscope (×10). Microleakage scores were statistically analyzed. The mean occlusal margin scores and gingival margin scores were compared between all the groups using the Kruskal-Wallis test, Mann-Whitney U-test, Wilcoxon signed-rank test, and post hoc comparison. There was a significant difference between Group 1a, Group 2a, Group 1b, Group 2b, Group 1c, and Group 2c. Statistical analysis used in this study was Kruskal-Wallis test, Mann-Whitney U-test, Wilcoxon signed-rank test, and post hoc comparison. The least microleakage scores were observed in occlusal margins of control groups (without microabrasion). Moreover, in both restorations, the microleakage scores in occlusal margins were higher than gingival margins, and compoglass had less microleakage in occlusal and occlusal plus axial walls of class V cavities compared with resin-modified GIC. Whereas, the light-cured glass ionomer had less microleakage in the gingival and gingival plus axial walls of class V cavities when compared with compoglass. The least microleakage scores were observed in occlusal margins of control groups (without microabrasion). Moreover, in both restorations, the microleakage scores in occlusal margins were higher than gingival margins.

The effects of supplemental instruction (SI) on student performance in a college-level biology course

NASA Astrophysics Data System (ADS)

Fest, Brenda Joyce Rowland

1999-10-01

This experimental study examined the effects of participation in a Supplemental Instruction (SI) program on student performance in a college level biology course. SI is an academic support program which incorporates study techniques into the framework of an academic course through discussion sessions. According to Blanc, DeBuhr, and Martin (1983) and Kenney (1988), students who experienced Supplemental Instruction had higher course grades, semester grade point averages, and rates of re-enrollment than did non-participants. The present study was conducted within the scheduled discussion sections of a large lecture class of biology for science majors (n = 135). The researcher and another graduate student conducted these discussion sessions in which half of the sections served as the SI treatment group and half of the sections served as the non-SI (traditional) control group. This design eliminated both time on task and motivation as potential contaminating variables. This posttest only, quasi-experimental design study uses a modified nonequivalent control group design. The academic performance of students who participated in SI discussion sessions was compared to the academic performance of students who participated in traditional review-type discussion sessions. Other research questions examined the interactive effect of SI on student performance with respect to SI leader experience, student ability level as measured by total SAT scores, previous academic success as measured by previous college GPA, and different cognitive level of examination questions. t-test and ANOVA statistical methods were used to analyze the data. The results of the t-tests to compare the means of the SI group to the non-SI group (p < .458) do not indicate any significant difference in the semester course scores between the two groups. Thus, the data did not show an overall effect of SI on student performance. The most important results obtained from this study are those with respect to the interactive effect of SI and student ability groups as measured by SAT total scores and prior college GPA. In this study the students in middle ability groups seemed to benefit more from SI than did the lower and higher ability students.

The effect of single-task and dual-task balance exercise programs on balance performance in adults with osteoporosis: a randomized controlled preliminary trial.

PubMed

Konak, H E; Kibar, S; Ergin, E S

2016-11-01

Osteoporosis is a serious disease characterized by muscle weakness in the lower extremities, shortened length of trunk, and increased dorsal kyphosis leading to poor balance performance. Although balance impairment increases in adults with osteoporosis, falls and fall-related injuries have been shown to occur mainly during the dual-task performance. Several studies have shown that dual-task performance was improved with specific repetitive dual-task exercises. The aims of this study were to compare the effect of single- and dual-task balance exercise programs on static balance, dynamic balance, and activity-specific balance confidence in adults with osteoporosis and to assess the effectiveness of dual-task balance training on gait speed under dual-task conditions. Older adults (N = 42) (age range, 45-88 years) with osteoporosis were randomly assigned into two groups. Single-task balance training group was given single-task balance exercises for 4 weeks, whereas dual-task balance training group received dual-task balance exercises. Participants received 45-min individualized training session, three times a week. Static balance was evaluated by one-leg stance (OLS) and a kinesthetic ability trainer (KAT) device. Dynamic balance was measured by the Berg Balance Scale (BBS), Time Up and Go (TUG) test, and gait speed. Self-confidence was assessed with the Activities-specific Balance Confidence (ABC-6) scale. Assessments were performed at baseline and after the 4-week program. At the end of the treatment periods, KAT score, BBS score, time in OLS and TUG, gait speeds under single- and dual-task conditions, and ABC-6 scale scores improved significantly in all patients (p < 0.05). However, BBS and gait speeds under single- and dual-task conditions showed significantly greater improvement in the dual-task balance training group than in the single-task balance training group (p < 0.05). ABC-6 scale scores improved more in the single-task balance training group than in the dual-task balance training group (p < 0.05). A 4-week single- and dual-task balance exercise programs are effective in improving static balance, dynamic balance, and balance confidence during daily activities in older adults with osteoporosis. However, single- and dual-task gait speeds showed greater improvement following the application of a specific type of dual-task exercise programs. 24102014-2.

Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery-VMI): lessons from exploration of cultural variations in visual-motor integration performance of preschoolers.

PubMed

Lim, C Y; Tan, P C; Koh, C; Koh, E; Guo, H; Yusoff, N D; See, C Q; Tan, T

2015-03-01

Visual-motor integration (VMI) is important in children's development because it is associated with the performance of many functional skills. Deficits in VMI have been linked to difficulties in academic performance and functional tasks. Clinical assessment experience of occupational therapists in Singapore suggested that there is a potential difference between the VMI performance of Singaporean and American children. Cross-cultural studies also implied that culture has an influence on a child's VMI performance, as it shapes the activities that a child participates in. The purpose of this study was to (1) explore if there was a difference between the VMI performance of Singaporean and American preschoolers, and (2) determine if there were ethnic differences in the VMI performance of Singaporean preschoolers. The Beery-VMI, which was standardized in America, is commonly used by occupational therapists in Singapore to assess the VMI ability of children. We administered the Beery-VMI (fifth edition) full form test (excluding the supplemental tests) to 385 preschoolers (mean age = 63.3 months) from randomly selected schools in Singapore. We compared the scores of Singaporean preschoolers with those of the American standardization norms using the one-sample t-test. Scores of different ethnic groups among the Singapore population were also compared using a one-way anova, followed by the Bonferroni post-hoc test. Singaporean preschoolers and the standardization sample of American children performed significantly differently in all age groups (P < 0.05). Among the Singapore population, the scores were also significantly different (P < 0.05) between the (i) Chinese and Malay and (ii) Chinese and Indians ethnic groups. Preschoolers from different cultural and ethnic groups had different VMI performance. Certain cultural beliefs and practices may affect VMI performance. Clinicians should exercise caution when using an assessment in communities and cultures outside the ones on which it was standardized. © 2014 John Wiley & Sons Ltd.

The Impact of Awareness of and Concern About Memory Performance on the Prediction of Progression From Mild Cognitive Impairment to Alzheimer Disease Dementia.

PubMed

Munro, Catherine E; Donovan, Nancy J; Amariglio, Rebecca E; Papp, Kate V; Marshall, Gad A; Rentz, Dorene M; Pascual-Leone, Alvaro; Sperling, Reisa A; Locascio, Joseph J; Vannini, Patrizia

2018-05-03

To investigate the relationship of awareness of and concern about memory performance to progression from mild cognitive impairment (MCI) to Alzheimer disease (AD) dementia. Participants (n = 33) had a diagnosis of MCI at baseline and a diagnosis of MCI or AD dementia at follow-up. Participants were categorized as "Stable-MCI" if they retained an MCI diagnosis at follow-up (mean follow-up = 18.0 months) or "Progressor-MCI" if they were diagnosed with AD dementia at follow-up (mean follow-up = 21.6 months). Awareness was measured using the residual from regressing a participant's objective memory score onto their subjective complaint score (i.e., residual<0 indicates overestimation of performance). Concern was assessed using a questionnaire examining the degree of concern when forgetting. Logistic regression was used to determine whether the presence of these syndromes could predict future diagnosis of AD dementia, and repeated measures analysis of covariance tests were used to examine longitudinal patterns of these syndromes. Baseline anosognosia was apparent in the Progressor-MCI group, whereas participants in the Stable-MCI group demonstrated relative awareness of their memory performance. Baseline awareness scores successfully predicted whether an individual would progress to AD-dementia. Neither group showed change in awareness of performance over time. Neither group showed differences in concern about memory performance at baseline or change in concern about performance over time. These data suggest that anosognosia may appear prior to the onset of AD dementia, while anosodiaphoria likely does not appear until later in the AD continuum. Additionally, neither group showed significant changes in awareness or concern over time, suggesting that change in these variables may happen over longer periods. Copyright © 2018 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Norms of the Mini-Mental state Examination for Japanese subjects that underwent comprehensive brain examinations: the Kashima Scan Study.

PubMed

Yakushiji, Yusuke; Horikawa, Etsuo; Eriguchi, Makoto; Nanri, Yusuke; Nishihara, Masashi; Hirotsu, Tatsumi; Hara, Hideo

2014-01-01

The distribution of the Mini-Mental State Examination (MMSE) scores by age and educational level was investigated in subjects that underwent comprehensive brain examinations. This cross-sectional study included 1,414 adults without neurological disorders who underwent health-screening tests of the brain, referred to as the "Brain Dock," in our center. The MMSE scores were compared between age groups (40-44, 45-49, 50-54, 55-59, 60-64, 65-69, or ≥70 years) and educational levels [the low education level group (6-12 years) and the high education level group (≥13 years)]. The median age was 59 years, and 763 (54%) were women. There was no significant difference in the MMSE total score between women and men. The stepwise method of the multiple linear regression analysis confirmed that a higher age [β value, -0.129; standard error (S.E.), 0.020; p<0.001], low education level (6-12 years) (β value, -0.226; S.E., 0.075; p=0.003), and women (β values, 0.148; S.E., 0.066; p=0.024) was significantly associated with decreased MMSE score. In general, both the percentile scores and mean scores decreased with aging and were lower in the low education level group than in the high education level group. The degree of decrement in scores with age was stronger in the low education level group than in the high education level group. The provided data for age- and education-specific reference norms will be useful for both clinicians and investigators who perform comprehensive brain examinations to assess the cognitive function of subjects.

Relationships between the Comprehensive Osteopathic Medical Achievement Test (COMAT) subject examinations and the COMLEX-USA Level 2-Cognitive Evaluation.

PubMed

Li, Feiming; Kalinowski, Kevin E; Song, Hao; Bates, Bruce P

2014-09-01

The relationship between the Comprehensive Osteopathic Medical Achievement Test (COMAT) series of subject examinations and the Comprehensive Osteopathic Medical Licensing Examination-USA Level 2-Cognitive Evaluation (COMLEX-USA Level 2-CE) has not been thoroughly examined. To investigate the factors associated with performance on COMAT subject examinations and how COMAT scores correlate with COMLEX-USA Level 2-CE scores. We examined scores of participants from 2 COMAT examination cycles in 2011 and 2012. According to surveys, most schools used COMAT scores in clerkship and clinical rotation evaluation, which were classified as being used for "high-stakes" purposes. We matched first-attempt COMAT scores with first-attempt COMLEX-USA Level 2-CE scores, and we conducted correlation analyses between the scores from the 7 COMAT subject examinations, as well as between COMAT and COMLEX-USA Level 2-CE scores. Multiple linear regression analyses were performed to investigate how much variance in COMLEX-USA Level 2-CE scores was explained by COMAT scores. In 2011 and 2012, respectively, 3751 and 3786 COMAT candidates had COMLEX-USA Level 2-CE scores (53.0% and 93.9%, respectively, had ⩾1 high-stakes COMAT score). Intercorrelations between COMAT scores were low to moderate (r=0.27-0.53), as hypothesized. Correlations between COMAT and Level 2-CE scores were moderate to high, with the highest correlations for internal medicine COMAT scores (r=0.63-0.65). All regressions showed internal medicine scores as the strongest predictor of Level 2-CE performance. Groups with high-stakes scores had larger adjusted coefficients of determination than those with low-stakes scores (eg, R(2)=0.63 vs 0.52, respectively, in 2011). For 2012 candidates with high-stakes scores, all predictors were statistically significant. The COMAT subject examination scores were moderately intercorrelated, as hypothesized, with higher correlations between COMAT and COMLEX-USA Level 2-CE scores. The COMAT performance was predictive of COMLEX-USA Level 2-CE performance. © 2014 The American Osteopathic Association.

Development of the Word Auditory Recognition and Recall Measure: A Working Memory Test for Use in Rehabilitative Audiology.

PubMed

Smith, Sherri L; Pichora-Fuller, M Kathleen; Alexander, Genevieve

The purpose of this study was to develop the Word Auditory Recognition and Recall Measure (WARRM) and to conduct the inaugural evaluation of the performance of younger adults with normal hearing, older adults with normal to near-normal hearing, and older adults with pure-tone hearing loss on the WARRM. The WARRM is a new test designed for concurrently assessing word recognition and auditory working memory performance in adults who may have pure-tone hearing loss. The test consists of 100 monosyllabic words based on widely used speech-recognition test materials. The 100 words are presented in recall set sizes of 2, 3, 4, 5, and 6 items, with 5 trials in each set size. The WARRM yields a word-recognition score and a recall score. The WARRM was administered to all participants in three listener groups under two processing conditions in a mixed model (between-subjects, repeated measures) design. The between-subjects factor was group, with 48 younger listeners with normal audiometric thresholds (younger listeners with normal hearing [YNH]), 48 older listeners with normal thresholds through 3000 Hz (older listeners with normal hearing [ONH]), and 48 older listeners with sensorineural hearing loss (older listeners with hearing loss [OHL]). The within-subjects factor was WARRM processing condition (no additional task or with an alphabet judgment task). The associations between results on the WARRM test and results on a battery of other auditory and memory measures were examined. Word-recognition performance on the WARRM was not affected by processing condition or set size and was near ceiling for the YNH and ONH listeners (99 and 98%, respectively) with both groups performing significantly better than the OHL listeners (83%). The recall results were significantly better for the YNH, ONH, and OHL groups with no processing (93, 84, and 75%, respectively) than with the alphabet processing (86, 77, and 70%). In both processing conditions, recall was best for YNH, followed by ONH, and worst for OHL listeners. WARRM recall scores were significantly correlated with other memory measures. In addition, WARRM recall scores were correlated with results on the Words-In-Noise (WIN) test for the OHL listeners in the no processing condition and for ONH listeners in the alphabet processing condition. Differences in the WIN and recall scores of these groups are consistent with the interpretation that the OHL listeners found listening to be sufficiently demanding to affect recall even in the no processing condition, whereas the ONH group listeners did not find it so demanding until the additional alphabet processing task was added. These findings demonstrate the feasibility of incorporating an auditory memory test into a word-recognition test to obtain measures of both word recognition and working memory simultaneously. The correlation of WARRM recall with scores from other memory measures is evidence of construct validity. The observation of correlations between the WIN thresholds with each of the older groups and recall scores in certain processing conditions suggests that recall depends on listeners' word-recognition abilities in noise in combination with the processing demands of the task. The recall score provides additional information beyond the pure-tone audiogram and word-recognition scores that may help rehabilitative audiologists assess the listening abilities of patients with hearing loss.

Effect of a Home-Based Exercise Intervention of Wearable Technology and Telephone Coaching on Walking Performance in Peripheral Artery Disease: The HONOR Randomized Clinical Trial.

PubMed

McDermott, Mary M; Spring, Bonnie; Berger, Jeffrey S; Treat-Jacobson, Diane; Conte, Michael S; Creager, Mark A; Criqui, Michael H; Ferrucci, Luigi; Gornik, Heather L; Guralnik, Jack M; Hahn, Elizabeth A; Henke, Peter; Kibbe, Melina R; Kohlman-Trighoff, Debra; Li, Lingyu; Lloyd-Jones, Donald; McCarthy, Walter; Polonsky, Tamar S; Skelly, Christopher; Tian, Lu; Zhao, Lihui; Zhang, Dongxue; Rejeski, W Jack

2018-04-24

Clinical practice guidelines support home-based exercise for patients with peripheral artery disease (PAD), but no randomized trials have tested whether an exercise intervention without periodic medical center visits improves walking performance. To determine whether a home-based exercise intervention consisting of a wearable activity monitor and telephone coaching improves walking ability over 9 months in patients with PAD. Randomized clinical trial conducted at 3 US medical centers. Patients with PAD were randomized between June 18, 2015, and April 4, 2017, to home-based exercise vs usual care for 9 months. Final follow-up was on December 5, 2017. The exercise intervention group (n = 99) received 4 weekly medical center visits during the first month followed by 8 months of a wearable activity monitor and telephone coaching. The usual care group (n = 101) received no onsite sessions, active exercise, or coaching intervention. The primary outcome was change in 6-minute walk distance at 9-month follow-up (minimal clinically important difference [MCID], 20 m). Secondary outcomes included 9-month change in subcomponents of the Walking Impairment Questionnaire (WIQ) (0-100 score; 100, best), SF-36 physical functioning score, Patient-Reported Outcomes Measurement Information System (PROMIS) mobility questionnaire (higher = better; MCID, 2 points), PROMIS satisfaction with social roles questionnaire, PROMIS pain interference questionnaire (lower = better; MCID range, 3.5-4.5 points), and objectively measured physical activity. Among 200 randomized participants (mean [SD] age, 70.2 [10.4] years; 105 [52.5%] women), 182 (91%) completed 9-month follow-up. The mean change from baseline to 9-month follow-up in the 6-minute walk distance was 5.5 m in the intervention group vs 14.4 m in the usual care group (difference, -8.9 m; 95% CI, -26.0 to 8.2 m; P = .31). The exercise intervention worsened the PROMIS pain interference score, mean change from baseline to 9 months was 0.7 in the intervention group vs -2.8 in the usual care group (difference, 3.5; 95% CI, 1.3 to 5.8; P = .002). There were no significant between-group differences in the WIQ score, the SF-36 physical functioning score, or the PROMIS mobility or satisfaction with social roles scores. Among patients with PAD, a home-based exercise intervention consisting of a wearable activity monitor and telephone coaching, compared with usual care, did not improve walking performance at 9-month follow-up. These results do not support home-based exercise interventions of wearable devices and telephone counseling without periodic onsite visits to improve walking performance in patients with PAD. clinicaltrials.gov Identifier: NCT02462824.

Evaluation of the protective effects of CoQ₁₀ on ovarian I/R injury: an experimental study.

PubMed

Ozler, Ali; Turgut, Abdulkadir; Görük, Neval Yaman; Alabalik, Ulas; Basarali, Mustafa Kemal; Akdemir, Fatih

2013-01-01

The aim of this study was to investigate the protective effects of coenzyme Q₁₀ (CoQ₁₀) on ovarian ischemia/reperfusion injury in an experimental rat adnexal torsion model. 48 female adult Wistar albino rats, weighing 220-250 g, were randomly equally divided into six groups (n = 8): sham, torsion, detorsion, sham+CoQ₁₀, torsion+CoQ₁₀, and detorsion+CoQ₁₀ groups. Bilateral adnexal torsion was performed for 3 h in all groups, except the sham and sham+CoQ₁₀ groups. Bilateral adnexal detorsion was performed on the detorsion and detorsion+CoQ₁₀ groups. CoQ₁₀ was injected intraperitoneally 30 min before the sham operation, torsion, and detorsion. The torsion and detorsion groups had significantly higher histologic evaluation scores, as well as higher MDA levels, TOS values, and oxidative stress index values than the sham group. A strong correlation between total histologic evaluation scores for ischemia/reperfusion injury and the oxidative stress index was found. The mean oxidant marker levels and histopathologic scores for the ovarian tissue significantly decreased after using CoQ₁₀, which is a potent antioxidant. Conservative surgery (detorsion) was found to provide inadequate protection to ovarian tissue. The results of this study suggest that CoQ₁₀ could be useful for the protection of ovarian tissue before conservative surgery. © 2013 S. Karger AG, Basel.

Comparison of the goals and MISTELS scores for the evaluation of surgeons on training benches.

PubMed

Wolf, Rémi; Medici, Maud; Fiard, Gaëlle; Long, Jean-Alexandre; Moreau-Gaudry, Alexandre; Cinquin, Philippe; Voros, Sandrine

2018-01-01

Evaluation of surgical technical abilities is a major issue in minimally invasive surgery. Devices such as training benches offer specific scores to evaluate surgeons but cannot transfer in the operating room (OR). A contrario, several scores measure performance in the OR, but have not been evaluated on training benches. Our aim was to demonstrate that the GOALS score, which can effectively grade in the OR the abilities involved in laparoscopy, can be used for evaluation on a laparoscopic testbench (MISTELS). This could lead to training systems that can identify more precisely the skills that have been acquired or must still be worked on. 32 volunteers (surgeons, residents and medical students) performed the 5 tasks of the MISTELS training bench and were simultaneously video-recorded. Their performance was evaluated with the MISTELS score and with the GOALS score based on the review of the recording by two experienced, blinded laparoscopic surgeons. The concurrent validity of the GOALS score was assessed using Pearson and Spearman correlation coefficients with the MISTELS score. The construct validity of the GOALS score was assessed with k-means clustering and accuracy rates. Lastly, abilities explored by each MISTELS task were identified with multiple linear regression. GOALS and MISTELS scores are strongly correlated (Pearson correlation coefficient = 0.85 and Spearman correlation coefficient = 0.82 for the overall score). The GOALS score proves to be valid for construction for the tasks of the training bench, with a better accuracy rate between groups of level after k-means clustering, when compared to the original MISTELS score (accuracy rates, respectively, 0.75 and 0.56). GOALS score is well suited for the evaluation of the performance of surgeons of different levels during the completion of the tasks of the MISTELS training bench.

Effects of coordination and manipulation therapy for patients with Parkinson disease.

PubMed

Zhao, Mingming; Hu, Caiyou; Wu, Zhixin; Chen, Yu; Li, Zhengming; Zhang, Mingsheng

2017-09-01

To determine the effects of a new exercise training regimen, i.e. coordination and manipulation therapy (CMT), on motor, balance, and cardiac functions in patients with Parkinson disease (PD). We divided 36 PD patients into the CMT (n = 22) and control (n = 14) groups. The patients in the CMT group performed dry-land swimming (imitation of the breaststroke) and paraspinal muscle stretching for 30 min/workday for 1 year. The control subjects did not exercise regularly. The same medication regimen was maintained in both groups during the study. Clinical characteristics, Unified Parkinson's Disease Rating Scale (UPDRS) scores, Berg balance scale (BBS) scores, mechanical balance measurements, timed up and go (TUG) test, and left ventricular ejection fraction (LVEF) were compared at 0 (baseline), 6, and 12 months. Biochemical test results were compared at 0 and 12 months. The primary outcome was motor ability. The secondary outcome was cardiac function. In the CMT group, UPDRS scores significantly improved, TUG test time and step number significantly decreased, BBS scores significantly increased, and most mechanical balance measurements significantly improved after 1 year of regular exercise therapy (all p < 0.05). In the control group, UPDRS scores significantly deteriorated, TUG test time and step number significantly increased, BBS scores significantly decreased, and most mechanical balance measurements significantly worsened after 1 year (all P < 0.05). LVEF improved in the CMT group only (P = 0.01). This preliminary study suggests that CMT effectively improved mobility disorder, balance, and cardiac function in PD patients over a 1-year period.

Understanding planning ability measured by the Tower of London: an evaluation of its internal structure by latent variable modeling.

PubMed

Koppenol-Gonzalez, Gabriela V; Bouwmeester, Samantha; Boonstra, A Marije

2010-12-01

The Tower of London (TOL) is a widely used instrument for assessing planning ability. Inhibition and (spatial) working memory are assumed to contribute to performance on the TOL, but findings about the relationship between these cognitive processes are often inconsistent. Moreover, the influence of specific properties of TOL problems on cognitive processes and difficulty level is often not taken into account. Furthermore, it may be expected that several planning strategies can be distinguished that cannot be extracted from the total score. In this study, a factor analysis and a latent class regression analysis were performed to address these issues. The results showed that 4 strategy groups that differed with respect to preplanning time could be distinguished. The effect of problem properties also differed for the 4 groups. Additional analyses showed that the groups differed on average planning performance but that there were no significant differences between inhibition and spatial working memory performance. Finally, it seemed that multiple factors influence performance on the TOL, the most important ones being the score measurements, the problem properties, and strategy use.

Dominant Achievement Goals and Academic Outcomes across Tracks in High School

ERIC Educational Resources Information Center

Scheltinga, Peter A. M.; Timmermans, Anneke C.; van der Werf, Greetje P. C.

2017-01-01

The self-reported grades Dutch, English and Math of 13,970 students in the third grade of Dutch secondary education (US grade 9) were investigated with regard to educational track-level and dominant achievement goal (DAG). The performance approach goal group scored significantly higher on all three subjects than the performance avoidance group,…

Personality changes and the role of counseling in the rehabilitation of patients with laryngeal cancer.

PubMed

Sharma, Deepika; Nagarkar, Anu N; Jindal, Pankaj; Kaur, Rajinder; Gupta, Ashok K

2008-08-01

We conducted a study of 65 adults who had undergone laryngectomy for the treatment of laryngeal cancer. Our goal was to identify any abnormal personality traits in these patients and to assess the effect that psychological counseling might have on correcting these abnormalities and thereby improving postoperative voice rehabilitation. A Personality Trait Inventory (PTI) administered to all patients preoperatively identified 47 patients who had abnormal scores for at least three personality traits. These 47 patients were sent for preoperative psychological counseling, and 3 months following surgery, they underwent a follow-up PTI. At the follow-up assessment, 40 of these patients-32 men and 8 women-still registered abnormal scores for at least three traits. Half of the men and half of the women were randomized to receive 12 sessions of individualized psychological counseling over 6 months in addition to standard speech therapy (group I); the other patients received speech therapy only (group II). A follow-up PTI was administered at the completion of psychological counseling and/or speech therapy (postoperative month 9). Statistical analysis of the data was performed with the paired-samples test. Intragroup analysis of the follow-up PTI results revealed that both groups experienced a significant improvement in activity scores (p < 0.001) compared with their previous PTI results and that group I had significantly better scores for two other PTI traits-cyclothymia (mood swings) and depressive tendency (p < 0.05); neither group showed a significant improvement in dominance scores. Intergroup comparisons revealed that group I's activity and depressive tendency scores were significantly better than those of group II; there was no significant difference between the two groups in cyclothymia and dominance scores. Finally, comparison of results by sex, regardless of group, revealed that men had a significantly higher score for dominance and women had significantly higher scores for depressive tendency, emotional instability, introversion, and social desirability. We conclude that a preoperative personality analysis should be carried out in all patients scheduled for laryngectomy to identify those with personality problems that might benefit from psychological counseling. Correction of these problems should help in the physical, mental, vocational, and social rehabilitation of these patients.

Deficits of organizational strategy and visual memory in obsessive-compulsive disorder.

PubMed

Shin, M S; Park, S J; Kim, M S; Lee, Y H; Ha, T H; Kwon, J S

2004-10-01

This study was conducted to investigate the deficits of organizational strategy and visual memory in obsessive-compulsive disorder (OCD). Thirty OCD patients and 30 healthy controls aged 20-35 years participated. The Maudsley Obsessive-Compulsive Inventory, Beck Anxiety Inventory, Wechsler Adult Intelligence Scale, and Rey-Osterrieth Complex Figure (ROCF) test were administered to participants. The authors scored ROCF performances using the Boston Qualitative Scoring System. The OCD patients showed poorer planning ability and higher fragmentation than did healthy controls when copying the ROCF, and they showed even poorer performances in the immediate and delayed recall conditions. The authors found that the Organization score in the copy condition mediated the difference between the OCD group and the healthy group in immediate recall. The direct effect of diagnosis (OCD or healthy) on the immediate recall condition of the ROCF was also significant. This study indicates that people with OCD have poor memory function and organizational deficits.

Cognitive inflexibility in Japanese adolescents and adults with autism spectrum disorders

PubMed Central

Yasuda, Yuka; Hashimoto, Ryota; Ohi, Kazutaka; Yamamori, Hidenaga; Fujimoto, Michiko; Umeda-Yano, Satomi; Fujino, Haruo; Takeda, Masatoshi

2014-01-01

AIM: To investigate executive function in Japanese adolescents and adults with autism spectrum disorders (ASD) compared to Japanese controls. METHODS: Thirty-three individuals with ASD and 33 controls participated. The ASD and control groups’ demographic variables were matched for gender (male/female: 20/13 vs 20/13), age (26.1 ± 11.5 vs 26.8 ± 9.6), years of education (13.2 ± 2.9 vs 14.2 ± 1.9), full-scale intelligence quotient (IQ) (103.0 ± 16.7 vs 103.7 ± 14.7), performance IQ (96.2 ± 16.1 vs 97.8 ± 15.0), and verbal IQ (107.9 ± 16.3 vs 107.7 ± 14.4). Participants performed the Wisconsin Card Sorting Test (WCST), which assesses the executive processes involved in problem solving and cognitive flexibility, and the Continuous Performance Test (CPT), which assesses attention and impulsivity. Symptoms were assessed by the Autism-Spectrum Quotient Japanese version (AQ-J). First, we compared the scores of the WCST between the groups using a Mann-Whitney U-test and conducted an analysis of covariance for the variables with the scores of category archives and CPT scores as covariates. Second, we analyzed the correlation between the scores of the WCST and the AQ-J in the ASD group using Pearson’s r. RESULTS: The total errors (TE) and the percentages of perseverative errors of the Milner type (%PEM) and Nelson type (%PEN) among the TE in the ASD group were significantly worse compared with the control group (ASD vs Control, respectively: TE: 16.0 ± 6.2 vs 12.6 ± 3.5, P = 0.012; %PEM: 11.7 ± 10.7 vs 6.6 ± 8.9, P = 0.037; %PEN: 20.1 ± 14.5 vs 8.7 ± 10.4, P = 0.0011). In contrast, no significant difference was observed between the two groups in the scores of categories achieved on the WCST or the CPT. An analysis of covariance revealed significant differences between the groups in the %PEN scores (P = 0.0062) but not in the TE or the %PEM scores. These results suggest that Japanese adolescents and adults with ASD have cognitive inflexibility. Furthermore, our results suggest that Japanese adolescents and adults with ASD may have difficulties using negative feedback because perseverative errors of the Nelson type indicate persistence in choosing the incorrect reaction. By contrast, there was no significant correlation between the WCST and AQ-J scores. CONCLUSION: We confirmed the presence of cognitive inflexibility in Japanese adolescents and adults with ASD. Our results also indicated that subjects with ASD may not use negative feedback effectively. PMID:25019056

Congenital heart disease: interrelation between German diagnosis-related groups system and Aristotle complexity score.

PubMed

Sinzobahamvya, Nicodème; Photiadis, Joachim; Arenz, Claudia; Kopp, Thorsten; Hraska, Viktor; Asfour, Boulos

2010-06-01

The Disease-Related Groups (DRGs) system postulates that inpatient stays with similar levels of clinical complexity are expected to consume similar amounts of resources. This, applied to surgery of congenital heart disease, suggests that the higher the complexity of procedures as estimated by the Aristotle complexity score, the higher hospital reimbursement should be. This study analyses how much case-mix index (CMI) generated by German DRG 2009 version correlates with Aristotle score. A total of 456 DRG cases of year 2008 were regrouped according to German DRG 2009 and related cost-weight values and overall CMI evaluated. Corresponding Aristotle basic and comprehensive complexity scores (ABC and ACC) and levels were determined. Associated surgical performance (Aristotle score times hospital survival) was estimated. Spearman 'r' correlation coefficients were calculated between Aristotle scores and cost-weights. Goodness of fit 'r(2)' from derived regression was determined. Correlation was estimated to be optimal if Spearman 'r' and derived goodness of fit 'r(2)' approached 1 value. CMI was 8.787 while mean ABC and ACC scores were 7.64 and 9.27, respectively. Hospital survival was 98.5%: therefore, surgical performance attained 7.53 (ABC score) and 9.13 (ACC score). ABC and ACC scores and levels positively correlated with cost-weights. With Spearman 'r' of 1 and goodness of fit 'r(2)' of 0.9790, scores of the six ACC levels correlated at best. The equation was y = 0.5591 + 0.939x, in which y stands for cost-weight (CMI) and x for score of ACC level. ACC score correlates almost perfectly with corresponding cost-weights (CMI) generated by the German DRG 2009. It could therefore be used as the basis for hospital reimbursement to compensate in conformity with procedures' complexity. Extrapolated CMI in this series would be 9.264. Modulation of reimbursement according to surgical performance could be established and thus 'reward' quality in congenital heart surgery. Copyright 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

Wechsler Adult Intelligence Scale-Fourth Edition performance in relapsing-remitting multiple sclerosis.

PubMed

Ryan, Joseph J; Gontkovsky, Samuel T; Kreiner, David S; Tree, Heather A

2012-01-01

Forty patients with relapsing-remitting multiple sclerosis (MS) completed the 10 core Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) subtests. Means for age and education were 42.05 years (SD = 9.94) and 14.33 years (SD = 2.40). For all participants, the native language was English. The mean duration of MS diagnosis was 8.17 years (SD = 7.75), and the mean Expanded Disability Status Scale (EDSS; Kurtzke, 1983 ) score was 3.73 (SD = 1.41) with a range from 2.0 to 6.5. A control group of healthy individuals with similar demographic characteristics also completed the WAIS-IV and were provided by the test publisher. Compared to controls, patients with MS earned significantly lower subtest and composite scores. The patients' mean scores were consistently in the low-average to average range, and the patterns of performance across groups did not differ significantly, although there was a trend towards higher scores on the Verbal Comprehension Index (VCI) and lower scores on the Processing Speed Index (PSI). Approximately 78% of patients had actual Full Scale IQs that were significantly lower than preillness, demographically based IQ estimates.

"Take-home" box trainers are an effective alternative to virtual reality simulators.

PubMed

Yiasemidou, Marina; de Siqueira, Jonathan; Tomlinson, James; Glassman, Daniel; Stock, Simon; Gough, Michael

2017-06-01

Practice on virtual reality simulators (VRSs) has been shown to improve surgical performance. However, VRSs are expensive and usually housed in surgical skills centers that may be inaccessible at times convenient for surgical trainees to practice. Conversely, box trainers (BT) are inexpensive and can be used anywhere at anytime. This study assesses "take-home" BTs as an alternative to VRS. After baseline assessments (two simulated laparoscopic cholecystectomies, one on a VRS and one on a BT), 25 surgical trainees were randomized to two groups. Trainees were asked to practice three basic laparoscopic tasks for 6 wk (BT group using a "take-home" box trainer; VR group using VRS in clinical skills centers). After the practice period, all performed two laparoscopic cholecystectomy, one on a VRS and one on a BT; (i.e., posttraining assessment). VRS provided metrics (total time [TT], number of movements instrument tip path length), and expert video assessment of cholecystectomy in a BT (Global Operative Assessment of Laparoscopic Skills [GOALS] score) were recorded. Performance during pretraining and posttraining assessment was compared. The BT group showed a significant improvement for all VRS metrics (P = 0.008) and the efficiency category of GOALS score (P = 0.03). Only TT improved in the VRS group, and none of the GOALS categories demonstrated a statistically significant improvement after training. Finally, the improvement in VRS metrics in the BT group was significantly greater than in the VR group (TT P = 0.005, number of movements P = 0.042, path length P = 0.031), although there were no differences in the GOALS scores between the groups. This study suggests that a basic "take-home" BT is a suitable alternative to VRS. Copyright © 2017 Elsevier Inc. All rights reserved.

Reproductive performance response to the male effect in goats is improved when doe live weight/body condition score is increasing.

PubMed

Gallego-Calvo, L; Gatica, M C; Guzmán, J L; Zarazaga, L A

2015-05-01

This study examines the nutritional and metabolic cue-induced modulation of the reproductive performance response of female goats to the male effect. During natural anoestrus, 48 Blanca Andaluza does were isolated from bucks for 45 days and distributed into two groups: (1) low body weight (BW)/low body condition score (BCS) animals (LL-gain group, N=18), which were fed 1.9 times their maintenance requirements; and (2) high BW/high BCS animals (HH-loss group, N=30), which were fed 0.4 times their maintenance requirements. Following isolation, oestrous activity was recorded daily by visual observation of the marks left by harness-equipped males. Weekly blood samples were taken for the determination of progesterone, glucose, insulin, non-esterified fatty acids (NEFAs) and leptin concentrations. Fecundity, fertility, prolificacy and productivity were also determined. Significantly greater ovarian and oestrous responses, and productivity, were observed in the LL-gain group compared to the HH-loss group (P<0.05). After the introduction to the males, no differences in NEFA concentration were seen between the groups; before introduction the values were higher in the HH-loss group. At the moment of detection of oestrus following male introduction, the insulin concentration of the LL-gain animals was higher (P<0.05). The present results show that the reproductive performances of does subjected to the male effect in spring are poorer in those with a decreasing BW and BCS and better in those with increasing scores. This might be explained by the differences between groups in terms of their plasma insulin concentrations. The NEFA concentration was clearly modified by introduction to the males. Copyright © 2015 Elsevier B.V. All rights reserved.

Teaching Dental Students to Understand the Temporomandibular Joint Using MRI: Comparison of Conventional and Digital Learning Methods.

PubMed

Arús, Nádia A; da Silva, Átila M; Duarte, Rogério; da Silveira, Priscila F; Vizzotto, Mariana B; da Silveira, Heraldo L D; da Silveira, Heloisa E D

2017-06-01

The aims of this study were to evaluate and compare the performance of dental students in interpreting the temporomandibular joint (TMJ) with magnetic resonance imaging (MRI) scans using two learning methods (conventional and digital interactive learning) and to examine the usability of the digital learning object (DLO). The DLO consisted of tutorials about MRI and anatomic and functional aspects of the TMJ. In 2014, dental students in their final year of study who were enrolled in the elective "MRI Interpretation of the TMJ" course comprised the study sample. After exclusions for nonattendance and other reasons, 29 of the initial 37 students participated in the study, for a participation rate of 78%. The participants were divided into two groups: a digital interactive learning group (n=14) and a conventional learning group (n=15). Both methods were assessed by an objective test applied before and after training and classes. Aspects such as support and training requirements, complexity, and consistency of the DLO were also evaluated using the System Usability Scale (SUS). A significant between-group difference in the posttest results was found, with the conventional learning group scoring better than the DLO group, indicated by mean scores of 9.20 and 8.11, respectively, out of 10. However, when the pretest and posttest results were compared, both groups showed significantly improved performance. The SUS score was 89, which represented a high acceptance of the DLO by the users. The students who used the conventional method of learning showed superior performance in interpreting the TMJ using MRI compared to the group that used digital interactive learning.

Effects of a laboratory-based skills curriculum on laparoscopic proficiency: a randomized trial.

PubMed

Coleman, Robert L; Muller, Carolyn Y

2002-04-01

The purpose of this study was to determine the effect and validity of an intensive laboratory-based laparoscopic skills training curriculum on operative proficiency in obstetrics and gynecology residents. This was a prospective, randomized, block-design trial of postgraduate year 3 and 4 residents. The following study schedule was used: week 1 (pre-randomization) included an orientation to study objectives, the administration of a laparoscopic experience questionnaire, timed video-laparoscopic drills (5 total), and the performance of a video-recorded laparoscopic partial salpingectomy; during weeks 2 and 3, the skills group residents repeated the laparoscopic drills 30 minutes daily for 10 days, and the control group residents had no formal practice sessions; during week 4, the week 1 evaluation was repeated. Operative proficiency was quantified by the Global Skills Assessment Tool through blinded, independent scoring of videotapes. Twenty-six residents (skills group, 12; control group, 14) consented to the trial. Patient-related issues excluded 8 residents (30%). At week 1, no significant differences existed in previous laparoscopic experience, timed video skills, or resident operative proficiency (Global Skills Assessment Tool score) between cohorts. At week 4, both groups significantly improved their timed drill test scores. The percent reduction in time from baseline was of greater magnitude in the skills group versus control group (51% vs 18%,P <.0001). Laparoscopic performance also improved in both cohorts (P =.002). However, only the skills group demonstrated significant intra-cohort improvement from baseline (mean, 4.9 points; P =.015; 95% CI, 1-7.5). A core curriculum of intensive video laparoscopic skills training improves not only technical but also operative performance among postgraduate year 3 and 4 residents.

Dissection videos do not improve anatomy examination scores.

PubMed

Mahmud, Waqas; Hyder, Omar; Butt, Jamaal; Aftab, Arsalan

2011-01-01

In this quasi-experimental study, we describe the effect of showing dissection videos on first-year medical students' performance in terms of test scores during a gross anatomy course. We also surveyed students' perception regarding the showing of dissection videos. Two hundred eighty-seven first-year medical students at Rawalpindi Medical College in Pakistan, divided into two groups, dissected one limb in first term and switched over to the other limb in the second term. During the second term, instruction was supplemented by dissection videos. Second-term anatomy examination marks were compared with first-term scores and with results from first-year medical students in previous years. Multiple linear regression analysis was performed, with term scores (continuous, 0-200) as the dependent variable. Students shown dissection videos scored 1.26 marks higher than those not shown. The relationship was not statistically significant (95% CI: -1.11, 3.70; P = 0.314). Ninety-three percent of students favored regular inclusion of dissection videos in curriculum, and 50% termed it the best source for learning gross anatomy. Seventy-six percent of students did not perform regular cadaver dissection. The most frequent reason cited for not performing regular dissection was high student-cadaver ratio. Dissection videos did not improve performance on final examination scores; however, students favored their use. Copyright © 2011 American Association of Anatomists.

Long-term and within-day variability of working memory performance and EEG in individuals.

PubMed

Gevins, Alan; McEvoy, Linda K; Smith, Michael E; Chan, Cynthia S; Sam-Vargas, Lita; Baum, Cliff; Ilan, Aaron B

2012-07-01

Assess individual-subject long-term and within-day variability of a combined behavioral and EEG test of working memory. EEGs were recorded from 16 adults performing n-back working memory tasks, with 10 tested in morning and afternoon sessions over several years. Participants were also tested after ingesting non-prescription medications or recreational substances. Performance and EEG measures were analyzed to derive an Overall score and three constituent sub-scores characterizing changes in performance, cortical activation, and alertness from each individual's baseline. Long-term and within-day variability were determined for each score; medication effects were assessed by reference to each individual's normal day-to-day variability. Over the several year period, the mean Overall score and sub-scores were approximately zero with standard deviations less than one. Overall scores were lower and their variability higher in afternoon relative to morning sessions. At the group level, alcohol, diphenhydramine and marijuana produced significant effects, but there were large individual differences. Objective working memory measures incorporating performance and EEG are stable over time and sensitive at the level of individual subjects to interventions that affect neurocognitive function. With further research these measures may be suitable for use in individualized medical care by providing a sensitive assessment of incipient illness and response to treatment. Published by Elsevier Ireland Ltd.

Use of Prehire Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) Police Candidate Scores to Predict Supervisor Ratings of Posthire Performance.

PubMed

Tarescavage, Anthony M; Brewster, JoAnne; Corey, David M; Ben-Porath, Yossef S

2015-08-01

We examined associations between prehire Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) scores and posthire performance ratings for a sample of 131 male police officers. Substantive scale scores in this sample were meaningfully lower than those obtained by the test's normative sample and substantially range restricted, but scores were consistent with those produced by members of the police candidate comparison group (Corey & Ben-Porath). After applying a statistical correction for range restriction, we found several associations between MMPI-2-RF substantive scale scores and supervisor ratings of job-related performance. Findings for scales from the emotional dysfunction and interpersonal functioning domains of the test were particularly strong. For example, scales assessing low positive emotions and social avoidance were associated with several criteria that may be affected by lack of engagement with one's environment and other people, including problems with routine task performance, decision making, assertiveness, conscientiousness, and social competence. Implications of these findings for assessment science and practice are discussed. © The Author(s) 2014.

Aggregate Interview Method of ranking orthopedic applicants predicts future performance.

PubMed

Geissler, Jacqueline; VanHeest, Ann; Tatman, Penny; Gioe, Terence

2013-07-01

This article evaluates and describes a process of ranking orthopedic applicants using what the authors term the Aggregate Interview Method. The authors hypothesized that higher-ranking applicants using this method at their institution would perform better than those ranked lower using multiple measures of resident performance. A retrospective review of 115 orthopedic residents was performed at the authors' institution. Residents were grouped into 3 categories by matching rank numbers: 1-5, 6-14, and 15 or higher. Each rank group was compared with resident performance as measured by faculty evaluations, the Orthopaedic In-Training Examination (OITE), and American Board of Orthopaedic Surgery (ABOS) test results. Residents ranked 1-5 scored significantly better on patient care, behavior, and overall competence by faculty evaluation (P<.05). Residents ranked 1-5 scored higher on the OITE compared with those ranked 6-14 during postgraduate years 2 and 3 (P⩽.5). Graduates who had been ranked 1-5 had a 100% pass rate on the ABOS part 1 examination on the first attempt. The most favorably ranked residents performed at or above the level of other residents in the program; they did not score inferiorly on any measure. These results support the authors' method of ranking residents. The rigorous Aggregate Interview Method for ranking applicants consistently identified orthopedic resident candidates who scored highly on the Accreditation Council for Graduate Medical Education resident core competencies as measured by faculty evaluations, performed above the national average on the OITE, and passed the ABOS part 1 examination at rates exceeding the national average. Copyright 2013, SLACK Incorporated.

Developing a cumulative anatomic scoring system for military perineal and pelvic blast injuries.

PubMed

Mossadegh, Somayyeh; Midwinter, M; Parker, P

2013-03-01

Improvised explosive device (IED) yields in Afghanistan have increased resulting in more proximal injuries. The injury severity score (ISS) is an anatomic aggregate score of the three most severely injured anatomical areas but does not accurately predict severity in IED related pelvi-perineal trauma patients. A scoring system based on abbreviated injury score (AIS) was developed to reflect the severity of these injuries in order to better understand risk factors, develop a tool for future audit and improve performance. Using standard AIS descriptors, injury scales were constructed for the pelvis (1, minor to 6, maximal). The perineum was divided into anterior and posterior zones as relevant to injury patterns and blast direction with each soft tissue structure being allocated a score from its own severity scale. A cumulative score, from 1 to 36 for soft tissue, or a maximum of 42 if a pelvic fracture was involved, was created for all structures injured in the anterior and posterior zones. Using this new scoring system, 77% of patients survived with a pelvi-perineal trauma score (PPTS) below 5. There was a significant increase in mortality, number of pelvic fractures and amputations with increase in score when comparing the first group (score 1-5) to the second group (score 6-10). For scores between 6 and 16 survival was 42% and 22% for scores between 17 and 21. In our cohort of 62 survivors, 1 patient with an IED related pelvi-perineal injury had a 'theoretically un-survivable' maximal ISS of 75 and survived, whereas there were no survivors with a PPTS greater than 22 but this group had no-one with an ISS of 75 suggesting ISS is not an accurate reflection of the true severity of pelvi-perineal blast injury. This scoring system is the initial part of a more complex logistic regression model that will contribute towards a unique trauma scoring system to aid surgical teams in predicting fluid requirements and operative timelines. In austere environments, it may also help to prevent futile resuscitations. Better correlation between measurement of severity and outcome would aid performance improvement monitoring. In the longer term it will also allow benchmarking of current survival rates and comparisons in the future.

Alterations in working memory as a function of leukoaraiosis in dementia.

PubMed

Lamar, Melissa; Price, Catherine C; Libon, David J; Penney, Dana L; Kaplan, Edith; Grossman, Murray; Heilman, Kenneth M

2007-01-28

Dementia research suggests executive dysfunction is best understood within the context of disease-specific neuropathology. Leukoaraiosis (LA) results in executive dysfunction yet little is known about its impact on specific aspects of working memory (WM). This study aimed to investigate the relationship between MRI LA severity and WM in dementia. A visual rating scale was used to assign patients with dementia into groups with minimal-mild LA (Low LA; n=34) and moderate-severe LA (High LA; n=32). A modified Digit Span Backward Task consisting of 3-, 4-, and 5-span trials measured specific components of WM. Short-term storage and rehearsal in WM were assessed by the total number of digits reported regardless of recall order (ANY-ORDER; e.g., 47981 recalled '18943', score=4). Mental manipulation in the form of disengagement and temporal re-ordering was assessed by the total number of digits recalled in correct position (SERIAL-ORDER; e.g., 47981 recalled '18943', score=3). There was no difference between LA groups on ANY-ORDER comparisons. The High LA group obtained lower SERIAL-ORDER scores than the Low LA group. Stepwise regression analyses were conducted that first entered MMSE scores then composite z-scores reflecting executive functioning, language and memory. ANY-ORDER performance variance was explained solely by dementia severity. SERIAL-ORDER performance variance was further explained by executive dysfunction. Results suggest that high degrees of LA do not interfere with immediate (digit) recall but do interfere with disengagement and temporal re-ordering. LA may disconnect the frontal lobes from subcortical and cortical structures that form the neuronal networks critical for these WM functions.

Leadership and professionalism curriculum in the Gross Anatomy course.

PubMed

Pawlina, Wojciech; Hromanik, Michael J; Milanese, Tia R; Dierkhising, Ross; Viggiano, Thomas R; Carmichael, Stephen W

2006-09-01

Today's physicians must demonstrate both professionalism and leadership skills in order to succeed in largely team-based healthcare environments. The purpose of this study was to determine if professionalism attributes, leadership style, and leadership style adaptability are associated with academic performance among first-year students early in their medical curriculum. Students were divided into 4-member dissection groups for the duration of the Gross and Developmental Anatomy course. Leadership responsibility was randomly assigned to a team member on a rotating basis every 5 weeks. After each 5-week block, student performance was measured by written and practical examinations, and each student assessed their leader's or their own professionalism attributes and leadership style using validated survey instruments. Most students demonstrated either a "selling" only (57%) or "participating" only (30%) leadership style with low to moderate leadership adaptability. "Participating" and "delegating" leadership styles have the highest average group written exam scores (89.4%, P <0.008). "Telling" only or "selling" only leaders have the lowest average group exam scores (83.5%, P <0.001). "Selling" and "participating" leaders have significantly lower average group practical exam scores than other styles (81.5%, P <0.007). Positive associations were observed between the written and practical examination scores and the leader's integrity (P = 0.003, P = 0.002) and responsibility (P <0.001, P = 0.037). This study demonstrates that various situational leadership styles and aspects of professionalism are associated with written and practical examination scores in the Gross and Developmental Anatomy course. Furthermore, it demonstrates that first-year medical students are in need of leadership skill development.

[Impact of an asthma educational intervention programme on teachers].

PubMed

Korta Murua, J; Pérez-Yarza, E G; Pértega Díaz, S; Aldasoro Ruiz, A; Sardón Prado, O; López-Silvarrey Varela, A; Corcuera Elósegui, P; Mintegui Aramburu, F J

2012-10-01

Our objective was to measure the impact of an educational intervention program on teacher's knowledge about asthma and its management. Before and after quasi-experimental study, with control group, of an educational intervention, which had as its aim to improve the teacher's knowledge of asthma and its management, was conducted in some schools of San Sebastian (Gipuzkoa), Spain. The Newcastle Asthma knowledge Questionnaire (NAKQ) was used as a measuring tool, and an adaptation of the asthma, sport and health program was used as an educational intervention. The Wilcoxon signed rank test was used to compare the total score of the questionnaire before and after the intervention, and the McNemar test was performed to compare the percentages of correct answers to each item. The Mann-Whitney U test was also performed to compare the baseline score and the score at three months between the intervention group and control group. The size of the effect and the standardised mean response were studied. A total of 138 teachers from 6 schools, which were chosen at random (study group), and 43 teachers in the control group participated in the study. In the study group, the mean score of the NAKQ before the educational intervention was 16.1±3.4 points, with a median of 16 (range 7 to 23). After the intervention the mean score increased to 22.3±4.1, with a median of 23 (range, 6 to 29). The mean difference in the overall score of the NAKQ was 7.0±4.2 points, with a median of 8 (range, -2 to17). Furthermore, the size of the effect was 2.0 (> 0.8) and the standardised mean response was 1.7. After 3 months of the intervention the mean score of the NAKQ was 21.4±3.0 points, with a median of 22 (range, 12 to 29) which was significantly higher than the score obtained before the intervention (P<.001) and slightly lower than the score obtained immediately after the intervention, assuming a size of the effect of 1.6 and a standardised mean response of 1.2. In the control group, the level of knowledge did not change modified and was lower than the level of the intervention group (P<.001). An educational intervention program conducted among teachers significantly increases their knowledge of asthma. Moreover, the increase reduces slightly but maintains its higher level for at least 3 months. In spite of the fact that some aspects of knowledge improved with the educational intervention, they were not optimal. Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

Using a quality improvement model to enhance providers' performance in maternal and newborn health care: a post-only intervention and comparison design.

PubMed

Ayalew, Firew; Eyassu, Gizachew; Seyoum, Negash; van Roosmalen, Jos; Bazant, Eva; Kim, Young Mi; Tekleberhan, Alemnesh; Gibson, Hannah; Daniel, Ephrem; Stekelenburg, Jelle

2017-04-12

The Standards Based Management and Recognition (SBM-R © ) approach to quality improvement has been implemented in Ethiopia to strengthen routine maternal and newborn health (MNH) services. This evaluation assessed the effect of the intervention on MNH providers' performance of routine antenatal care (ANC), uncomplicated labor and delivery and immediate postnatal care (PNC) services. A post-only evaluation design was conducted at three hospitals and eight health centers implementing SBM-R and the same number of comparison health facilities. Structured checklists were used to observe MNH providers' performance on ANC (236 provider-client interactions), uncomplicated labor and delivery (226 provider-client interactions), and immediate PNC services in the six hours after delivery (232 provider-client interactions); observations were divided equally between intervention and comparison groups. Main outcomes were provider performance scores, calculated as the percentage of essential tasks in each service area completed by providers. Multilevel analysis was used to calculate adjusted mean percentage performance scores and standard errors to compare intervention and comparison groups. There was no statistically significant difference between intervention and comparison facilities in overall mean performance scores for ANC services (63.4% at intervention facilities versus 61.0% at comparison facilities, p = 0.650) or in any specific ANC skill area. MNH providers' overall mean performance score for uncomplicated labor and delivery care was 11.9 percentage points higher in the intervention than in the comparison group (77.5% versus 65.6%; p = 0.002). Overall mean performance scores for immediate PNC were 22.2 percentage points higher at intervention than at comparison facilities (72.8% versus 50.6%; p = 0.001); and there was a significant difference of 22 percentage points between intervention and comparison facilities for each PNC skill area: care for the newborn and health check for the mother. The SBM-R quality improvement intervention made a significant positive impact on MNH providers' performance during labor and delivery and immediate PNC services, but not during ANC services. Scaling up the intervention to other facilities and regions may increase the availability of good quality MNH services across Ethiopia. The findings will also guide implementation of the government's five-year (2015-2020) health sector transformation plan and health care quality strategies needed to meet the country's MNH goals.

Bilingualism in older Mexican-American immigrants is associated with higher scores on cognitive screening.

PubMed

Padilla, Claudia; Mendez, Mario F; Jimenez, Elvira E; Teng, Edmond

2016-11-24

Bilingualism may protect against cognitive aging and delay the onset of dementia. However, studies comparing monolinguals and bilinguals on such metrics have produced inconsistent results complicated by confounding variables and methodological concerns. We addressed this issue by comparing cognitive performance in a more culturally homogeneous cohort of older Spanish-speaking monolingual (n = 289) and Spanish-English bilingual (n = 339) Mexican-American immigrants from the Sacramento Longitudinal Study on Aging. After adjusting for demographic differences and depressive symptoms, both groups performed similarly at baseline on verbal memory but the bilingual group performed significantly better than the monolingual group on a cognitive screening test, the Modified Mini-Mental State Examination (3MS; p < 0.001). Group differences on the 3MS were driven by language/executive and language/praxis factors. Within the bilingual group, neither language of testing nor degree of bilingualism was significantly associated with 3MS or verbal memory scores. Amongst individuals who performed in the normal or better range on both tests at baseline and were followed for an average of 6 years, both monolinguals and bilinguals exhibited similar rates of cognitive decline on both measures. These findings suggest that bilingualism is associated with modest benefits in cognitive screening performance in older individuals in cross-sectional analyses that persist across longitudinal analyses. The effects of bilingualism should be considered when cognitively screening is performed in aging immigrant populations.

Saccadic performance in questionnaire-identified schizotypes over time.

PubMed

Gooding, Diane C; Shea, Heather B; Matts, Christie W

2005-02-28

In the present study, 121 young adults (mean age=19 years), hypothesized to be at varying levels of risk for psychosis on the basis of their psychometric profiles, were administered saccadic (antisaccade and refixation) tasks at two separate assessments. At Time 1, individuals posited to be at heightened risk for the later development of schizophrenia-spectrum disorders (i.e., those individuals with elevated Social Anhedonia Scale [SAS] scores) produced significantly more antisaccade task errors than the controls. Despite apparent improvement in antisaccade task performance from initial testing to the follow-up (mean test-retest interval=59 months) across all groups, the Social Anhedonia (SocAnh) group continued to produce significantly more errors than the control group. The antisaccade task performance of the control group showed good temporal stability (Pearson's r=0.70, ICC=0.52), and the SocAnh group's performance showed excellent temporal stability (Pearson's r=0.85, ICC=0.83). The results of this investigation are twofold: First, antisaccade task performance is temporally stable, even in psychometrically identified schizotypes over long test-retest intervals; and secondly, Social Anhedonia Scale scores as well as Time 1 antisaccade task accuracy accounted for much of the variability in Time 2 antisaccade task performance. These findings add to the growing body of literature suggesting that antisaccade task deficits may serve as an endophenotypic marker of a schizophrenia diathesis.

Pre-training evaluation and feedback improve medical students' skills in basic life support.

PubMed

Li, Qi; Ma, Er-Li; Liu, Jin; Fang, Li-Qun; Xia, Tian

2011-01-01

Evaluation and feedback are two factors that could influence simulation-based medical education and the time when they were delivered contributes their different effects. To investigate the impact of pre-training evaluation and feedback on medical students' performance in basic life support (BLS). Forty 3rd-year undergraduate medical students were randomly divided into two groups, C group (the control) and pre-training evaluation and feedback group (E&F group), each of 20. After BLS theoretical lecture, the C group received 45 min BLS training and the E&F group was individually evaluated (video-taped) in a mock cardiac arrest (pre-training evaluation). Fifteen minutes of group feedback related with the students' BLS performance in pre-training evaluation was given in the E&F group, followed by a 30-min BLS training. After BLS training, both groups were evaluated with one-rescuer BLS skills in a 3-min mock cardiac arrest scenario (post-training evaluation). The score from the post-training evaluation was converted to a percentage and was compared between the two groups. The score from the post-training evaluation was higher in the E&F group (82.9 ± 3.2% vs. 63.9 ± 13.4% in C group). In undergraduate medical students without previous BLS training, pre-training evaluation and feedback improve their performance in followed BLS training.

School nurse online emergency preparedness training: an analysis of knowledge, skills, and confidence.

PubMed

Elgie, Robert; Sapien, Robert; Fullerton, Lynne; Moore, Brian

2010-10-01

The objective of this study was to evaluate the effectiveness of a computer-assisted emergency preparedness course for school nurses. Participants from a convenience sample (52) of school nurses from New Mexico were randomly assigned to intervention or control groups in an experimental after-only posttest design. Intervention group participants completed 15 online emergency preparedness training modules followed by posttests, and control group participants completed the posttests without taking the training modules. Tests measured emergency preparedness with written exams, confidence surveys, and skills performance in videotaped scenarios; the videotaped scenarios were scored by Pediatric Emergency Medicine physicians blinded to whether the participants were in the intervention or control group. The intervention group participants scored significantly higher in tests of knowledge and skills than control group participants. Confidence Survey scores did not differ significantly. The online training modules are a valuable resource for improving school nurse emergency preparedness knowledge and skills but may not affect participants' confidence.

Large sexual-orientation-related differences in performance on mental rotation and judgment of line orientation tasks.

PubMed

Rahman, Qazi; Wilson, Glenn D

2003-01-01

This study examined the performance of heterosexual and homosexual men and women on 2 tests of spatial processing, mental rotation (MR) and Benton Judgment of Line Orientation (JLO). The sample comprised 60 heterosexual men, 60 heterosexual women, 60 homosexual men, and 60 homosexual women. There were significant main effects of gender (men achieving higher scores overall) and Gender x Sexual Orientation interactions. Decomposing these interactions revealed large differences between the male groups in favor of heterosexual men on JLO and MR performance. There was a modest difference between the female groups on MR total correct scores in favor of homosexual women but no differences in MR percentage correct. The evidence suggests possible variations in the parietal cortex between homosexual and heterosexual persons.

Logistic regression function for detection of suspicious performance during baseline evaluations using concussion vital signs.

PubMed

Hill, Benjamin David; Womble, Melissa N; Rohling, Martin L

2015-01-01

This study utilized logistic regression to determine whether performance patterns on Concussion Vital Signs (CVS) could differentiate known groups with either genuine or feigned performance. For the embedded measure development group (n = 174), clinical patients and undergraduate students categorized as feigning obtained significantly lower scores on the overall test battery mean for the CVS, Shipley-2 composite score, and California Verbal Learning Test-Second Edition subtests than did genuinely performing individuals. The final full model of 3 predictor variables (Verbal Memory immediate hits, Verbal Memory immediate correct passes, and Stroop Test complex reaction time correct) was significant and correctly classified individuals in their known group 83% of the time (sensitivity = .65; specificity = .97) in a mixed sample of young-adult clinical cases and simulators. The CVS logistic regression function was applied to a separate undergraduate college group (n = 378) that was asked to perform genuinely and identified 5% as having possibly feigned performance indicating a low false-positive rate. The failure rate was 11% and 16% at baseline cognitive testing in samples of high school and college athletes, respectively. These findings have particular relevance given the increasing use of computerized test batteries for baseline cognitive testing and return-to-play decisions after concussion.

How to Assign Individualized Scores on a Group Project: An Empirical Evaluation

ERIC Educational Resources Information Center

Zhang, Bo; Ohland, Matthew W.

2009-01-01

One major challenge in using group projects to assess student learning is accounting for the differences of contribution among group members so that the mark assigned to each individual actually reflects their performance. This research addresses the validity of grading group projects by evaluating different methods that derive individualized…

Group Comparisons of Mathematics Performance from a Cognitive Diagnostic Perspective

ERIC Educational Resources Information Center

Chen, Yi-Hsin; Ferron, John M.; Thompson, Marilyn S.; Gorin, Joanna S.; Tatsuoka, Kikumi K.

2010-01-01

Traditional comparisons of test score means identify group differences in broad academic areas, but fail to provide substantive description of how the groups differ on the specific cognitive attributes required for success in the academic area. The rule space method (RSM) allows for group comparisons at the cognitive attribute level, which…

Measurement of Grit and Correlation to Student Pharmacist Academic Performance.

PubMed

Pate, Adam N; Payakachat, Nalin; Harrell, T Kristopher; Pate, Kristen A; Caldwell, David J; Franks, Amy M

2017-08-01

Objective. To describe grittiness of students from three pharmacy schools and determine if grit is associated with academic performance measures. Methods. Pharmacy students completed an electronic questionnaire that included the Short Grit Scale (Grit-S). Associations were determined using logistic regression. Results. Grit-S total score was a significant and independent predictor for participants who reported a GPA ≥3.5, and Consistency of Interest (COI) and Perseverance of Effort (POE) domain scores were significantly higher compared to participants with a GPA of 3.0-3.49. Participants reporting a D or F had slightly lower average total Grit-S scores and COI domain scores compared to participants who did not. In addition, the group who reported a GPA <3.0 had lower scores in the POE domain compared to those with a GPA of 3.0-3.4. Conclusion. Grittiness may be associated with student pharmacist academic performance and the Grit-S Scale may have substantive implications for use in pharmacy programs.

Ocular physiology and comfort in neophyte subjects fitted with daily disposable silicone hydrogel contact lenses.

PubMed

Morgan, Philip B; Chamberlain, Paul; Moody, Kurt; Maldonado-Codina, Carole

2013-06-01

To evaluate the performance of a silicone hydrogel daily disposable lens in neophyte subjects over 12 months. Seventy four subjects with no previous contact lens experience were randomised to wear narafilcon A (1 DAY ACUVUE(®) TruEye™) lenses (LW group) or to wear no contact lenses (NLW group) for 12 months. Biomicroscopy (performed by a masked investigator), visual acuity and subjective response scores were recorded at an initial visit and six follow-up visits, in addition to lens fit and surface evaluation for the LW group. Comfort was recorded with SMS messaging. Fifteen of the LW group discontinued before the end of the study, compared with six of the NLW group. Measured visual acuity was about half a line better for the NLW group as these subjects were provided with their full sphero-cylindrical over-refraction, compared to the LW group in their best spherical corrected contact lenses; subjective scores for vision were similar for the two groups. Bulbar conjunctival hyperaemia, limbal hyperaemia, corneal staining, conjunctival staining and papillary conjunctivitis were clinically equivalent for the two groups whereas conjunctival staining was higher in the LW group. Comfort scores assessed by SMS were equivalent for the LW and NLW groups; there was a measurable improvement in comfort during the first month of wear for the LW group. This work has demonstrated that modern soft lenses (narafilcon A daily disposable silicone hydrogel lenses) offer an excellent, comfortable form of vision correction, and are able to exhibit minimal alterations to ocular physiology. Copyright © 2012 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

Parent ratings of working memory are uniquely related to performance-based measures of secondary memory but not primary memory.

PubMed

Ralph, Kathryn J; Gibson, Bradley S; Gondoli, Dawn M

2018-03-06

Existing evidence suggests that performance- and rating-based measures of working memory (WM) correlate poorly. Although some researchers have interpreted this evidence as suggesting that these measures may be assessing distinct cognitive constructs, another possibility is that rating-based measures are related to some but not all theoretically motivated performance-based measures. The current study distinguished between performance-based measures of primary memory (PM) and secondary memory (SM), and examined the relation between each of these components of WM and parent-ratings on the WM subscale of the Behavior Rating Inventory of Executive Function (BRIEF-WM). Because SM and BRIEF-WM scores have both been associated with group differences in attention-deficit/hyperactivity disorder (ADHD), it was hypothesized that SM scores would be uniquely related to parent-rated BRIEF-WM scores. Participants were a sample of 77 adolescents with and without an ADHD diagnosis, aged 11 to 15 years, from a midwestern school district. Participant scores on verbal and spatial immediate free recall tasks were used to estimate both PM and SM capacities. Partial correlation analyses were used to evaluate the extent to which estimates of PM and SM were uniquely related parent-rated BRIEF-WM scores. Both verbal and spatial SM scores were significantly related to parent-rated BRIEF-WM scores, when corresponding PM scores were controlled. Higher verbal and spatial SM scores were associated with less frequent parent-report of WM-related failures in their child's everyday life. However, neither verbal nor spatial PM scores significantly related to parent-rated BRIEF-WM scores, when corresponding SM scores were controlled. The current study suggested that previously observed low correlations between performance- and rating-based measures of WM may result from use of performance-based WM measures that do not capture the unique contributions of PM and SM components of WM.

Comparison between β-thalassemia minor and normal individuals using the Wechsler Adult Intelligence Scale.

PubMed

Zangiabadi, Nasser; Yarahmadi, Fahimeh; Darekordi, Ali; Shabani, Mohammad; Dadgar, Mehrak Memaran

2013-01-01

The present study aimed at investigating and comparing patients suffering from β-thalassemia (β-thal) minor with normal individuals in regard to their performances in the short version of the Wechsler Adult Intelligence Scale (WAIS) test. Patients with β-thal minor are carriers of β-thal genes. They have mild microcytic and hypochromic anemia and are usually asymptomatic. In this cross-sectional study, a total of 60 individuals were divided into two equal groups of β-thal minor and normal subjects; they were then studied by the WAIS subscales. The mean performance scores of the normal group in the subtests of arithmetic and vocabulary (p <0.01) and picture completion (p <0.05) were higher than those of the thalassemia group. The mean performance score and ability of the normal group on the verbal scale was higher in comparison to the thalassemia group (p <0.05), while on the non verbal scale, there was no significant difference between the two groups. It can be concluded that β-thal minor negatively influences verbal fluency, reasoning and conceptualization, and sequencing tasks, perceptual skill, prediction of social situations and abstract thinking.