Sample records for highest average score

  1. Validity of four approaches of using repeaters' MCAT scores in medical school admissions to predict USMLE Step 1 total scores.

    PubMed

    Zhao, Xiaohui; Oppler, Scott; Dunleavy, Dana; Kroopnick, Marc

    2010-10-01

    This study investigated the validity of four approaches (the average, most recent, highest-within-administration, and highest-across-administration approaches) of using repeaters' Medical College Admission Test (MCAT) scores to predict Step 1 scores. Using the differential predication method, this study investigated the magnitude of differences in the expected Step 1 total scores between MCAT nonrepeaters and three repeater groups (two-time, three-time, and four-time test takers) for the four scoring approaches. For the average score approach, matriculants with the same MCAT average are expected to achieve similar Step 1 total scores regardless of whether the individual attempted the MCAT exam one or multiple times. For the other three approaches, repeaters are expected to achieve lower Step 1 scores than nonrepeaters; for a given MCAT score, as the number of attempts increases, the expected Step 1 decreases. The effect was strongest for the highest-across-administration approach, followed by the highest-within-administration approach, and then the most recent approach. Using the average score is the best approach for considering repeaters' MCAT scores in medical school admission decisions.

  2. [Effects of training of human intestinal parasitic diseases for basic health staff in Jiangsu Province].

    PubMed

    Jiang, Wen-cai; Li, Jian; Xu, Xiang-zhen; Shen, Ming-xue; Jin, Xiao-lin

    2013-08-01

    To evaluate the effect of the training of human intestinal parasitic diseases for basic health staff. A workshop including theory courses and practical operations was carried out. At the end of the workshop, the effects were evaluated through the examinations of theory and film-reading. The total score of film-reading was one hundred including reading ten modified thick Kato-Katz slides in five minutes per slide. The results were analyzed statistically with SAS 9.0. There were 162 trainees from 13 cities. All of them took part in the final examination. The highest score of theory test was 99 and the lowest was 60 with the average of 86.3. The average score of the female was higher than that of the male, and the average score of 30-40 years' age group was higher than that of the other groups. The average score of the staff in Northern Jiangsu Province was higher than that of the staff in southern area and middle area of Jiangsu Province (P < 0.05). The highest score of film-reading was 100 and the lowest score was 20 with the average of 73.4. Among the total 9 species, the egg detection rates of five species were more than 60.00%. The detection rate of Trichuris trichiura was highest (88.17%) and the rate of Taenia was only 14.7%. The total average score of the staff in Nanjing City was highest (181.3) and the score of the staff in Changzhou City was lowest (138.3). There were significant differences among different regions (P < 0.05). The technical capability of examining the human intestinal parasitic diseases of basic health staff is different among the different regions of Jiangsu Province. We still need to strengthen the capability of pathogen detection for basic health staff.

  3. Agreement between child self-reported and parent-reported scores for chronic pain secondary to specific pediatric diseases.

    PubMed

    Díez Rodriguez-Labajo, A; Castarlenas, E; Miró, J; Reinoso-Barbero, F

    2017-03-01

    Parental report on a child's secondary chronic pain is commonly requested by anesthesiologists when the child cannot directly provide information. Daily pain intensity is reported as highest, average and lowest. However, it is unclear whether the parents' score is a valid indicator of the child's pain experience. Nineteen children (aged 6-18years) with secondary chronic pain attending our anesthesiologist-run pediatric pain unit participated in this study. Identification of highest, average and lowest pain intensity levels were requested during initial screening interviews with the child and parents. Pain intensity was scored on a 0-10 numerical rating scale. Agreement was examined using: (i) intraclass correlation coefficient (ICC), and (ii) the Bland-Altman method. The ICC's between the children and the parents' pain intensity reports were: 0.92 for the highest, 0.68 for the average, and 0.50 for the lowest pain intensity domains. The limits of agreement set at 95% between child and parental reports were respectively +2.19 to -2.07, +3.17 to -3.88 and +5.15 to -5.50 for the highest, average and lowest pain domains. For the highest pain intensity domain, agreement between parents and children was excellent. If replicated this preliminary finding would suggest the highest pain intensity is the easiest domain for reporting pain intensity when a child cannot directly express him or herself. Copyright © 2016 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  4. Evaluation of the quality of the college library websites in Iranian medical Universities based on the Stover model.

    PubMed

    Nasajpour, Mohammad Reza; Ashrafi-Rizi, Hasan; Soleymani, Mohammad Reza; Shahrzadi, Leila; Hassanzadeh, Akbar

    2014-01-01

    Today, the websites of college and university libraries play an important role in providing the necessary services for clients. These websites not only allow the users to access different collections of library resources, but also provide them with the necessary guidance in order to use the information. The goal of this study is the quality evaluation of the college library websites in Iranian Medical Universities based on the Stover model. This study uses an analytical survey method and is an applied study. The data gathering tool is the standard checklist provided by Stover, which was modified by the researchers for this study. The statistical population is the college library websites of the Iranian Medical Universities (146 websites) and census method was used for investigation. The data gathering method was a direct access to each website and filling of the checklist was based on the researchers' observations. Descriptive and analytical statistics (Analysis of Variance (ANOVA)) were used for data analysis with the help of the SPSS software. The findings showed that in the dimension of the quality of contents, the highest average belonged to type one universities (46.2%) and the lowest average belonged to type three universities (24.8%). In the search and research capabilities, the highest average belonged to type one universities (48.2%) and the lowest average belonged to type three universities. In the dimension of facilities provided for the users, type one universities again had the highest average (37.2%), while type three universities had the lowest average (15%). In general the library websites of type one universities had the highest quality (44.2%), while type three universities had the lowest quality (21.1%). Also the library websites of the College of Rehabilitation and the College of Paramedics, of the Shiraz University of Medical Science, had the highest quality scores. The results showed that there was a meaningful difference between the quality of the college library websites and the university types, resulting in college libraries of type one universities having the highest average score and the college libraries of type three universities having the lowest score.

  5. Evaluation of the quality of the college library websites in Iranian medical Universities based on the Stover model

    PubMed Central

    Nasajpour, Mohammad Reza; Ashrafi-rizi, Hasan; Soleymani, Mohammad Reza; Shahrzadi, Leila; Hassanzadeh, Akbar

    2014-01-01

    Introduction: Today, the websites of college and university libraries play an important role in providing the necessary services for clients. These websites not only allow the users to access different collections of library resources, but also provide them with the necessary guidance in order to use the information. The goal of this study is the quality evaluation of the college library websites in Iranian Medical Universities based on the Stover model. Material and Methods: This study uses an analytical survey method and is an applied study. The data gathering tool is the standard checklist provided by Stover, which was modified by the researchers for this study. The statistical population is the college library websites of the Iranian Medical Universities (146 websites) and census method was used for investigation. The data gathering method was a direct access to each website and filling of the checklist was based on the researchers’ observations. Descriptive and analytical statistics (Analysis of Variance (ANOVA)) were used for data analysis with the help of the SPSS software. Findings: The findings showed that in the dimension of the quality of contents, the highest average belonged to type one universities (46.2%) and the lowest average belonged to type three universities (24.8%). In the search and research capabilities, the highest average belonged to type one universities (48.2%) and the lowest average belonged to type three universities. In the dimension of facilities provided for the users, type one universities again had the highest average (37.2%), while type three universities had the lowest average (15%). In general the library websites of type one universities had the highest quality (44.2%), while type three universities had the lowest quality (21.1%). Also the library websites of the College of Rehabilitation and the College of Paramedics, of the Shiraz University of Medical Science, had the highest quality scores. Discussion: The results showed that there was a meaningful difference between the quality of the college library websites and the university types, resulting in college libraries of type one universities having the highest average score and the college libraries of type three universities having the lowest score. PMID:25540794

  6. Assessing abstracts of Iranian systematic reviews and metaanalysis indexed in WOS and Scopus using PRISMA.

    PubMed

    Kazerani, Maryam; Davoudian, Atefeh; Zayeri, Farid; Soori, Hamid

    2017-01-01

    Background: Systematic reviews and meta-analysis have significant advantages over conventional reviews in that all available data should be presented. This study aimed to evaluate Iranian systematic reviews and meta-analysis abstracts indexed in WOS and Scopus during 2003-2012 based on PRISMA checklist. Methods: This is an analytical study. We evaluated 46 article abstracts indexed in WOS, 89 article abstracts indexed in Scopus and 158 article abstracts indexed in WOS and Scopus both (overlapped group). The quality of the abstracts was evaluated according to the PRISMA checklist for abstracts. Some indicators including distribution per year, total citation, average citations per year, average citations per documents and average citations per year in each article were determined through searching the WOS and Scopus Databases' analytical section. Then, the correlations between the abstract's PRISMA scores, average citations per year, and publication year were calculated. Results: The abstract's quality is not desirable as far as the PRISMA criteria are concerned. In other words, none of the articles' abstracts is in line with the PRISMA items. The average of scores of the current study was 5.9 while the maximum score was 12. The PRISMA criteria showed the highest compliance with "Objectives" (98.6%), the second highest with "Synthesis of result" (85%) and "Title" (80.2%) and the lowest compliance with "Registration" (2%). There was a positive correlation between the compliance of PRISMA score and the average citations per year while there was a negative correlation between PRISMA score and the publication year. Conclusion: It seems that the suggested criteria for reporting Iranian systematic reviews and meta-analysis are not considered adequately by the writers and even scientific journal editors.

  7. Assessing abstracts of Iranian systematic reviews and metaanalysis indexed in WOS and Scopus using PRISMA

    PubMed Central

    Kazerani, Maryam; Davoudian, Atefeh; Zayeri, Farid; Soori, Hamid

    2017-01-01

    Background: Systematic reviews and meta-analysis have significant advantages over conventional reviews in that all available data should be presented. This study aimed to evaluate Iranian systematic reviews and meta-analysis abstracts indexed in WOS and Scopus during 2003-2012 based on PRISMA checklist. Methods: This is an analytical study. We evaluated 46 article abstracts indexed in WOS, 89 article abstracts indexed in Scopus and 158 article abstracts indexed in WOS and Scopus both (overlapped group). The quality of the abstracts was evaluated according to the PRISMA checklist for abstracts. Some indicators including distribution per year, total citation, average citations per year, average citations per documents and average citations per year in each article were determined through searching the WOS and Scopus Databases’ analytical section. Then, the correlations between the abstract's PRISMA scores, average citations per year, and publication year were calculated. Results: The abstract’s quality is not desirable as far as the PRISMA criteria are concerned. In other words, none of the articles’ abstracts is in line with the PRISMA items. The average of scores of the current study was 5.9 while the maximum score was 12. The PRISMA criteria showed the highest compliance with "Objectives" (98.6%), the second highest with "Synthesis of result" (85%) and "Title" (80.2%) and the lowest compliance with "Registration" (2%). There was a positive correlation between the compliance of PRISMA score and the average citations per year while there was a negative correlation between PRISMA score and the publication year. Conclusion: It seems that the suggested criteria for reporting Iranian systematic reviews and meta-analysis are not considered adequately by the writers and even scientific journal editors. PMID:28955668

  8. Comparison of surgical techniques of 111 medial malleolar fractures classified by fracture geometry.

    PubMed

    Ebraheim, Nabil A; Ludwig, Todd; Weston, John T; Carroll, Trevor; Liu, Jiayong

    2014-05-01

    Evaluation of operative techniques used for medial malleolar fractures by classifying fracture geometry has not been well documented. One hundred eleven patients with medial malleolar fractures (transverse n = 63, oblique n = 29, vertical n = 7, comminuted n = 12) were included in this study. Seventy-two patients had complicating comorbidities. All patients were treated with buttress plate, lag screw, tension band, or K-wire fixation. Treatment outcomes were evaluated on the basis of radiological outcome (union, malunion, delayed union, or nonunion), need for operative revision, presence of postoperative complications, and AOFAS Ankle-Hindfoot score. For transverse fractures, tension band fixation showed the highest rate of union (79%), highest average AOFAS score (86), lowest revision rate (5%), and lowest complication rate (16%). For oblique fractures, lag screws showed the highest rate of union (71%), highest average AOFAS score (80), lowest revision rate (19%), and lowest complication rate (33%) of the commonly used fixation techniques. For vertical fractures, buttress plating was used in every case but 1, achieving union (whether normal or delayed) in all cases with an average AOFAS score of 84, no revisions, and a 17% complication rate. Comminuted fractures had relatively poor outcomes regardless of fixation method. The results of this study suggest that both tension bands and lag screws result in similar rates of union for transverse fractures of the medial malleolus, but that tension band constructs are associated with less need for revision surgery and fewer complications. In addition, our data demonstrate that oblique fractures were most effectively treated with lag screws and that vertical fractures attained superior outcomes with buttress plating. Level III, retrospective comparative series.

  9. [Systematic Review of the Methodology Quality in Lung Cancer Screening Guidelines].

    PubMed

    Li, Jiang; Su, Kai; Li, Fang; Tang, Wei; Huang, Yao; Wang, Le; Huang, Huiyao; Shi, Jufang; Dai, Min

    2016-10-20

    Lung cancer is the most common malignancy and screening can decrease the mortality. High quality screening guideline is necessary and important for effective work. Our study is to review and evaluate the basic characteristics and methodology quality of the current global lung cancer screening guidelines so as to provide useful information for domestic study in the future. Electronic searches were done in English and Chinese databases including PubMed, the Cochrane Library, Web of Science, Embase, CNKI, CBM, Wanfang, and some cancer official websites. Articles were screened according to the predefined inclusion and exclusion criteria by two researchers. The quality of guidelines was assessed by AGREE II. At last, a total of 11 guidelines with methodology were included. The guidelines were issued mainly by USA (81%). Canada and China developed one, respectively. As for quality, the average score in the "Scale and objective" of all guidelines was 80, the average score in the "Participants" was 52, the average score in the "rigorism" was 50, the average score in the "clarity" was 76, the average score in the "application" was 43 and the average score in the "independence" was 59. The highest average score was found in 2013 and 2015. Canada guideline had higher quality in six domains. 7 guidelines were evaluated as A level. The number of clinical guidelines showed an increasing trend. Most guidelines were issued by developed countries with heavy burden. Multi-country contribution to one guideline was another trend. Evidence-based methodology was accepted globally in the guideline development.

  10. Mild cognitive impairment: baseline and longitudinal structural MR imaging measures improve predictive prognosis.

    PubMed

    McEvoy, Linda K; Holland, Dominic; Hagler, Donald J; Fennema-Notestine, Christine; Brewer, James B; Dale, Anders M

    2011-06-01

    To assess whether single-time-point and longitudinal volumetric magnetic resonance (MR) imaging measures provide predictive prognostic information in patients with amnestic mild cognitive impairment (MCI). This study was conducted with institutional review board approval and in compliance with HIPAA regulations. Written informed consent was obtained from all participants or the participants' legal guardians. Cross-validated discriminant analyses of MR imaging measures were performed to differentiate 164 Alzheimer disease (AD) cases from 203 healthy control cases. Separate analyses were performed by using data from MR images obtained at one time point or by combining single-time-point measures with 1-year change measures. Resulting discriminant functions were applied to 317 MCI cases to derive individual patient risk scores. Risk of conversion to AD was estimated as a continuous function of risk score percentile. Kaplan-Meier survival curves were computed for risk score quartiles. Odds ratios (ORs) for the conversion to AD were computed between the highest and lowest quartile scores. Individualized risk estimates from baseline MR examinations indicated that the 1-year risk of conversion to AD ranged from 3% to 40% (average group risk, 17%; OR, 7.2 for highest vs lowest score quartiles). Including measures of 1-year change in global and regional volumes significantly improved risk estimates (P = 001), with the risk of conversion to AD in the subsequent year ranging from 3% to 69% (average group risk, 27%; OR, 12.0 for highest vs lowest score quartiles). Relative to the risk of conversion to AD conferred by the clinical diagnosis of MCI alone, MR imaging measures yield substantially more informative patient-specific risk estimates. Such predictive prognostic information will be critical if disease-modifying therapies become available. http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11101975/-/DC1. RSNA, 2011

  11. Quality of internet-based decision aids for shoulder arthritis: what are patients reading?

    PubMed

    Somerson, Jeremy S; Bois, Aaron J; Jeng, Jeffrey; Bohsali, Kamal I; Hinchey, John W; Wirth, Michael A

    2018-04-11

    The objective of this study was to assess the source, quality, accuracy, and completeness of Internet-based information for shoulder arthritis. A web search was performed using three common Internet search engines and the top 50 sites from each search were analyzed. Information sources were categorized into academic, commercial, non-profit, and physician sites. Information quality was measured using the Health On the Net (HON) Foundation principles, content accuracy by counting factual errors and completeness using a custom template. After removal of duplicates and sites that did not provide an overview of shoulder arthritis, 49 websites remained for analysis. The majority of sites were from commercial (n = 16, 33%) and physician (n = 16, 33%) sources. An additional 12 sites (24%) were from an academic institution and five sites (10%) were from a non-profit organization. Commercial sites had the highest number of errors, with a five-fold likelihood of containing an error compared to an academic site. Non-profit sites had the highest HON scores, with an average of 9.6 points on a 16-point scale. The completeness score was highest for academic sites, with an average score of 19.2 ± 6.7 (maximum score of 49 points); other information sources had lower scores (commercial, 15.2 ± 2.9; non-profit, 18.7 ± 6.8; physician, 16.6 ± 6.3). Patient information on the Internet regarding shoulder arthritis is of mixed accuracy, quality, and completeness. Surgeons should actively direct patients to higher-quality Internet sources.

  12. SCREENING FOR PSYCHOSOCIAL PROBLEMS IN CHILDREN ATTENDING THE PEDIATRIC CLINIC AT KING KHALID UNIVERSITY HOSPITAL (KKUH) IN RIYADH (KSA)

    PubMed Central

    Al-Ayed, Ibrahim H.; Al-Haider, Fatimah A.

    2008-01-01

    Introduction: Psychosocial problems are highly prevalent among children and adolescents. One approach to facilitating recognition and referral of these problems is to use parent-completed screening questionnaire as part of routine primary care. Aim and methods: The purpose of this study was to determine the prevalence and type of psychosocial problems in a random sample of children attending the pediatric clinic at KKUH at the time of the study. A 2-part questionnaire was designed for the study. The first part contained basic biographic data in addition to items which reflect the socioeconomic status of the family. The second part of the questionnaire comprised the inventory, which is a modified version of the Pediatric Symptoms Checklist (PSC).The inventory consisted of 38 items classified into five categories. The total score of the inventory ranged from 0-114. Results: Three-hundred-twelve questionnaires were completed. The average of the total score was only 22.3 out of 114. The lowest score was 0 and the highest 84. The average scores of behavioral symptoms (BS) were the highest (7.03 out of 27) while that of the learning problems (LP) was the lowest (1.5 out of 18). The average score for mood symptoms (MS) was 5.6 out of 24, that for personality characteristics (PC) was 4.5 out of 24 and that for somatic symptoms (SS) was 4.3 out of 24. Conclusion: This study revealed the feasibility of screening for behavioral problems of children in an outpatient setting. It is necessary to implement screening procedures for psycho-behavioral problems, and train pediatricians to screen children presenting at clinics. PMID:23012163

  13. Screening for psychosocial problems in children attending the pediatric clinic at king khalid university hospital (kkuh) in riyadh (ksa).

    PubMed

    Al-Ayed, Ibrahim H; Al-Haider, Fatimah A

    2008-01-01

    Psychosocial problems are highly prevalent among children and adolescents. One approach to facilitating recognition and referral of these problems is to use parent-completed screening questionnaire as part of routine primary care. The purpose of this study was to determine the prevalence and type of psychosocial problems in a random sample of children attending the pediatric clinic at KKUH at the time of the study. A 2-part questionnaire was designed for the study. The first part contained basic biographic data in addition to items which reflect the socioeconomic status of the family. The second part of the questionnaire comprised the inventory, which is a modified version of the Pediatric Symptoms Checklist (PSC).The inventory consisted of 38 items classified into five categories. The total score of the inventory ranged from 0-114. Three-hundred-twelve questionnaires were completed. The average of the total score was only 22.3 out of 114. The lowest score was 0 and the highest 84. The average scores of behavioral symptoms (BS) were the highest (7.03 out of 27) while that of the learning problems (LP) was the lowest (1.5 out of 18). The average score for mood symptoms (MS) was 5.6 out of 24, that for personality characteristics (PC) was 4.5 out of 24 and that for somatic symptoms (SS) was 4.3 out of 24. This study revealed the feasibility of screening for behavioral problems of children in an outpatient setting. It is necessary to implement screening procedures for psycho-behavioral problems, and train pediatricians to screen children presenting at clinics.

  14. Diversity efforts, admissions, and national rankings: can we align priorities?

    PubMed

    Heller, Caren A; Rúa, Sandra Hurtado; Mazumdar, Madhu; Moon, Jennifer E; Bardes, Charles; Gotto, Antonio M

    2014-01-01

    Increasing student body diversity is a priority for national health education and professional organizations and for many medical schools. However, national rankings of medical schools, such as those published by U.S. News & World Report, place a heavy emphasis on grade point average (GPA) and Medical College Admissions Test (MCAT) scores, without considering student body diversity. These rankings affect organizational reputation and admissions outcomes, even though there is considerable controversy surrounding the predictive value of GPA and MCAT scores. Our aim in this article was to explore the relationship between standard admissions practices, which typically aim to attract students with the highest academic scores, and student body diversity. We examined how changes in GPA and MCAT scores over 5 years correlated with the percentage of enrolled students who are underrepresented in medicine. In a majority of medical schools in the United States from 2005 to 2009, average GPA and MCAT scores of applicants increased, whereas the percentage of enrolled students who are underrepresented in medicine decreased. Our findings suggest that efforts to increase the diversity of medical school student bodies may be complicated by a desire to maintain high average GPA and MCAT scores. We propose that U.S. News revise its ranking methodology by incorporating a new diversity score into its student selectivity score and by reducing the weight placed on GPA and MCAT scores.

  15. Self-reported "worth it" rating of aesthetic surgery in social media.

    PubMed

    Domanski, Mark C; Cavale, Naveen

    2012-12-01

    A wide variety of surveys have been used to validate the satisfaction of patients who underwent aesthetic surgery. However, such studies are often limited by patient number and number of surgeons. Social media now allows patients, on a large scale, to discuss and rate their satisfaction with procedures. The views of aesthetic procedures patients expressed in social media provide unique insight into patient satisfaction. The "worth it" percentage, average cost, and number of respondents were recorded on October 16, 2011, for all topics evaluated on the aesthetic procedure social media site www.realself.com . Procedures were divided into categories: surgical, liposuction, nonsurgical, and dental. For each group, procedures with the most respondents were chosen and ordered by "worth it" score. A literature search was performed for the most commonly rated surgical procedures and the satisfaction rates were compared. A total of 16,949 evaluations of 159 aesthetic surgery topics were recorded. A correlation between cost of the procedure and percentage of respondents indicating that the procedure was "worth it" was not found. The highest-rated surgical procedure was abdominoplasty, with 93 % of the 1,589 self-selected respondents expressing that abdominoplasty was "worth it." The average self-reported cost was $8,400. The highest-rated nonsurgical product was Latisse, with 85 % of 231 respondents reporting it was "worth it" for an average cost of $200. The satisfaction scores in the literature for commonly rated surgical procedures ranged from 62 to 97.6 %. No statistically significant correlations between literature satisfaction scores and realself.com "worth it" scores were found. Abdominoplasty had the highest "worth it" rating among aesthetic surgical procedures. Aesthetic surgeons should be wary that satisfaction scores reported in the literature might not correlate with commonly achieved results. Social media has opened a new door into how procedures are evaluated and perceived. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the table of contents or the online instructions to authors www.springer.com/00266 .

  16. Radiation Dose and Cancer Risk Estimates in 16-Slice Computed Tomography Coronary Angiography

    PubMed Central

    Einstein, Andrew J.; Sanz, Javier; Dellegrottaglie, Santo; Milite, Margherita; Sirol, Marc; Henzlova, Milena; Rajagopalan, Sanjay

    2008-01-01

    Background Recent advances have led to a rapid increase in the number of computed tomography coronary angiography (CTCA) studies performed. While several studies have reported effective dose (E), there is no data available on cancer risk for current CTCA protocols. Methods and Results E and organ doses were estimated, using scanner-derived parameters and Monte Carlo methods, for 50 patients having 16-slice CTCA performed for clinical indications. Lifetime attributable risks (LARs) were estimated with models developed in the National Academies’ Biological Effects of Ionizing Radiation VII report. E of a complete CTCA averaged 9.5 mSv, while that of a complete study, including calcium scoring when indicated, averaged 11.7 mSv. Calcium scoring increased E by 25%, while tube current modulation reduced it by 34% and was more effective at lower heart rates. Organ doses were highest to the lungs and female breast. LAR of cancer incidence from CTCA averaged approximately 1 in 1600, but varied widely between patients, being highest in younger women. For all patients, the greatest risk was from lung cancer. Conclusions CTCA is associated with non-negligible risk of malignancy. Doses can be reduced by careful attention to scanning protocol. PMID:18371595

  17. Relationships Among Student Ability, School Performance, and Fleet Supervisor Ratings for Navy ’A’ School Graduates.

    DTIC Science & Technology

    1982-11-01

    April 1980. 9 NEMA ._ Technical Report 136 Subsequent reports in the series will present: " an analysis of relationships among training effectiveness...individualized courses were above the standardized norm (i.e., 50). Graduates 20 Technical Report 136 of the TO and MM600 courses had the highest...Ability Characteristics. The average AFQT percentile scores for all the conventional courses were above the standardized norm (50). Graduates of the FTM

  18. JOURNAL CLUB: Plagiarism in Manuscripts Submitted to the AJR: Development of an Optimal Screening Algorithm and Management Pathways.

    PubMed

    Taylor, Donna B

    2017-04-01

    The objective of this study was to investigate the incidence of plagiarism in a sample of manuscripts submitted to the AJR using CrossCheck, develop an algorithm to identify significant plagiarism, and formulate management pathways. A sample of 110 of 1610 (6.8%) manuscripts submitted to AJR in 2014 in the categories of Original Research or Review were analyzed using CrossCheck and manual assessment. The overall similarity index (OSI), highest similarity score from a single source, whether duplication was from single or multiple origins, journal section, and presence or absence of referencing the source were recorded. The criteria outlined by the International Committee of Medical Journal Editors were the reference standard for identifying manuscripts containing plagiarism. Statistical analysis was used to develop a screening algorithm to maximize sensitivity and specificity for the detection of plagiarism. Criteria for defining the severity of plagiarism and management pathways based on the severity of the plagiarism were determined. Twelve manuscripts (10.9%) contained plagiarism. Nine had an OSI excluding quotations and references of less than 20%. In seven, the highest similarity score from a single source was less than 10%. The highest similarity score from a single source was the work of the same author or authors in nine. Common sections for duplication were the Materials and Methods, Discussion, and abstract. Referencing the original source was lacking in 11. Plagiarism was undetected at submission in five of these 12 articles; two had been accepted for publication. The most effective screening algorithm was to average the OSI including quotations and references and the highest similarity score from a single source and to submit manuscripts with an average value of more than 12% for further review. The current methods for detecting plagiarism are suboptimal. A new screening algorithm is proposed.

  19. Family quality of life among families with a child who has a severe neurodevelopmental disability: Impact of family and child socio-demographic factors.

    PubMed

    Schertz, Mitchell; Karni-Visel, Yael; Tamir, Ada; Genizi, Jacob; Roth, Dana

    2016-01-01

    We aimed to examine family quality of life (FQOL) of Northern Israeli families having a child with a severe neurodevelopmental disability and its relation to socio-demographics. The cohort included caregivers of 70 children ages (mean ± standard deviation) 5.36 ± 3.53 years. Families were two-parent (85.7%), lived in the periphery (67.1%) and included Jews (60%), Muslims (18.6%), Druze (14.3%) and Christians (7.1%). Religiosity included: secular (38.6%), traditional (31.4%), religious (30%). Children's diagnosis included autistic spectrum disorder (41.4%), intellectual disability (21.4%), cerebral palsy (17.1%), genetic syndromes (17.1%) and sensorineural hearing loss (2.9%). Degree of support (1-minimal,5-greatest) required by the child was 3.67 ± 1.28 for physical and 3.49 ± 1.36 for communication. Primary caregivers completed the FQOL Survey. Domain scores were highest for family relations and lowest for financial well-being. Dimension scores were highest for importance and lowest for opportunities. Overall FQOL approximated average. Jewish families and residents of a major urban area reported higher and more religious families reported lower overall FQOL. Regression analysis found ethnicity contributing to overall FQOL and domain scores with residence contributing to support from services. Ethnicity and child dependence contributed to dimension scores. Northern Israeli families having a child with a severe neurodevelopmental disability report average FQOL scores. However, family and child dependence characteristics affect FQOL scores. Professionals working with these families should consider FQOL information when making recommendations. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Spatial clustering of pixels of a multispectral image

    DOEpatents

    Conger, James Lynn

    2014-08-19

    A method and system for clustering the pixels of a multispectral image is provided. A clustering system computes a maximum spectral similarity score for each pixel that indicates the similarity between that pixel and the most similar neighboring. To determine the maximum similarity score for a pixel, the clustering system generates a similarity score between that pixel and each of its neighboring pixels and then selects the similarity score that represents the highest similarity as the maximum similarity score. The clustering system may apply a filtering criterion based on the maximum similarity score so that pixels with similarity scores below a minimum threshold are not clustered. The clustering system changes the current pixel values of the pixels in a cluster based on an averaging of the original pixel values of the pixels in the cluster.

  1. How health information is received by diabetic patients?

    PubMed Central

    Zare-Farashbandi, Firoozeh; Lalazaryan, Anasik; Rahimi, Alireza; Zadeh, Akbar Hassan

    2015-01-01

    Background: Knowledge of correct information-seeking behavior by the patients can provide health specialists and health information specialists with valuable information in improving health care. This study aimed to investigate the passive receipt and active seeking of health information by diabetic patients. Materials and Methods: A survey method was used in this research on 6426 diabetic patients of whom 362 patients were selected by a no percentage stratified random sampling. The Longo information-seeking behavior questionnaire was used to collect data and they were analyzed by SPSS 20 software. Results: The most common information source by diabetic patients was practitioners (3.12). The minimum usage among the information sources were from charity organizations and emergency phone lines with a usage of close to zero. The amount of health information gained passively from each source has the lowest average of 4.18 and usage of this information in making health decision has the highest average score of 5.83. Analysis of the data related to active seeking of information showed that knowledge of available medical information from each source has the lowest average score of 3.95 and ability in using the acquired information for making medical decisions has the highest average score of 5.28. The paired t-test showed that differences between passive information receipt (41.68) and active information seeking (39.20) considered as statistically significant (P < 0.001). Conclusion: Because diabetic patients are more passive information receivers than active information seekers, the health information must be distributed by passive means to these patients. In addition, information-seeking behavior during different time periods should be investigated; to identify more effective distribution of health information. PMID:26261828

  2. Factors affecting the technical efficiency of general hospitals in Iran: data envelopment analysis.

    PubMed

    Kalhor, Rohollah; Amini, Saeed; Sokhanvar, Mobin; Lotfi, Farhad; Sharifi, Marziye; Kakemam, Edris

    2016-03-01

    Restrictions on resource accessibility and its optimal application is the main challenge in organizations nowadays. The aim of this research was to study the technical efficiency and its related factors in Tehran general hospitals. This descriptive analytical study was conducted retrospectively in 2014. Fifty-four hospitals with private, university, and social security ownerships from the total 110 general hospitals were randomly selected for inclusion into this study on the basis of the share of ownership. Data were collected using a checklist with three sections, including background variables, inputs, and outputs. Seventeen (31.48%) hospitals had an efficiency score of 1 (highest efficiency score). The highest average efficiency score was in social security hospitals (84.32). Private and university hospitals ranked next with an average of 84.29 and 79.64, respectively. Analytical results showed that there was a significant relationship between hospital ownership, hospital type in terms of duty and specialization, educational field of the chief executive officer, and technical efficiency. There was no significant relationship between education level of hospital manager and technical efficiency. Most of the studied hospitals were operating at low efficiency. Therefore, policymakers should plan to improve the hospital operations and promote hospitals to an optimal level of efficiency.

  3. Factors affecting the results of comprehensive pre-internship exam among medical students of Kermanshah University of Medical Sciences.

    PubMed

    Khazaei, Mohammad Rasool; Zarin, Afshin; Rezaei, Mansuor; Khazaei, Mozafar

    2018-06-01

    This study was aimed to evaluate the factors affecting the results of comprehensive pre-internship exam (CPIE) among medicals students of Kermanshah University of Medical Sciences. In this descriptive-analytical study, all students (n=240) participating in CPIE over a 3-year period (2012-2014) were selected. Data were gathered by a questionnaire, including the CPIE results and educational and demographic data. Spearman correlation coefficient, Mann-Whitney U-test, and analysis of variance were used to analyze the association of students' success with study variables. Also, regression analysis was applied to determine the role of independent variables in students' success. The frequency of the failed units in apprenticeship course was one of the most important risk factors associated with failure in CPIE. Average scores of pre-internship course were the most important factors of success in CPIE. The CPIE score had the highest direct relationship with grade point average (GPA) of apprenticeship course, total GPA of all three courses, GPAs of physiopathology and basic sciences courses, and score of comprehensive basic sciences examination, respectively. CPIE showed the highest inverse correlation with the number of failed units in apprenticeship course. The most important factors influencing this exam were failure in apprenticeship course and GPA of previous educational stages.

  4. A case-control study of determinants for high and low dental caries prevalence in Nevada youth

    PubMed Central

    2010-01-01

    Background The main purpose of this study was to compare the 30% of Nevada Youth who presented with the highest Decayed Missing and Filled Teeth (DMFT) index to a cohort who were caries free and to national NHANES data. Secondly, to explore the factors associated with higher caries prevalence in those with the highest DMFT scores compared to the caries-free group. Methods Over 4000 adolescents between ages 12 and 19 (Case Group: N = 2124; Control Group: N = 2045) received oral health screenings conducted in public/private middle and high schools in Nevada in 2008/2009 academic year. Caries prevalence was computed (Untreated decay scores [D-Score] and DMFT scores) for the 30% of Nevada Youth who presented with the highest DMFT score (case group) and compared to the control group (caries-free) and to national averages. Bivariate and multivariate logistic regression was used to analyze the relationship between selected variables and caries prevalence. Results A majority of the sample was non-Hispanic (62%), non-smokers (80%), and had dental insurance (70%). With the exception of gender, significant differences in mean D-scores were found in seven of the eight variables. All variables produced significant differences between the case and control groups in mean DMFT Scores. With the exception of smoking status, there were significant differences in seven of the eight variables in the bivariate logistic regression. All of the independent variables remained in the multivariate logistic regression model contributing significantly to over 40% of the variation in the increased DMFT status. The strongest predictors for the high DMFT status were racial background, age, fluoridated community, and applied sealants respectively. Gender, second hand smoke, insurance status, and tobacco use were significant, but to a lesser extent. Conclusions Findings from this study will aid in creating educational programs and other primary and secondary interventions to help promote oral health for Nevada youth, especially focusing on the subgroup that presents with the highest mean DMFT scores. PMID:21067620

  5. Assessment of Quality and Content of Online Information About Hip Arthroscopy.

    PubMed

    Ellsworth, Bridget; Patel, Hiren; Kamath, Atul F

    2016-10-01

    The purpose of this study was to assess the quality of information available to patients on the Internet when using popular search engines to search the term "hip arthroscopy." We analyzed the quality and content of information about hip arthroscopy (HA) on the first 50 websites returned by the search engines Google and Bing for the search term "hip arthroscopy." The sites were categorized by type, and quality and content were measured using the DISCERN score, along with an HA-specific content score. The HA-specific content score was used to assess each website for the presence or absence of 19 topics about HA determined to be important for a patient seeking information about the procedure. The Health on the Net Code (HONcode) status of each website was also noted. The mean DISCERN score for all websites analyzed was 39.5, considered "poor," while only 44.6% of sites were considered "fair" or "good." Governmental and nonprofit organization (NPO) websites had the highest average DISCERN score. The mean HA-specific content score was 8.6 (range, 2 to 16). The commercial website category had the highest average HA-specific content score, followed by the governmental and NPO category. Sites that bore the HONcode certification obtained significantly higher DISCERN scores than those without the certification (P = .0032) but did not obtain significantly higher HA-specific content scores. "Hip arthroscopy" is a fairly general term, and there is significant variability in the quality of HA information available online. The HONcode is useful to identify quality patient information websites; however, it is not commonly used in HA-specific websites and does not encompass all quality websites about HA. This study increases awareness of the quality of information on HA available online. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  6. Development of an analytical method for quantitative comparison of the e-waste management systems in Thailand, Laos, and China.

    PubMed

    Liang, Li; Sharp, Alice

    2016-11-01

    This study employed a set of quantitative criteria to analyse the three parameters; namely policy, process, and practice; of the respective e-waste management systems adopted in Thailand, Laos, and China. Questionnaire surveys were conducted to determine the current status of the three parameters in relation to mobile phones. A total of five, three, and six variables under Policy (P 1 ), Process (P 2 ), and Practice (P 3 ), respectively, were analysed and their weighted averages were calculated. The results showed that among the three countries surveyed, significant differences at p<0.01 were observed in all the P 1 , P 2 , and P 3 variables, except P 305 (sending e-waste to recovery centres) and P 306 (treating e-waste by retailers themselves). Based on the quantitative method developed in this study, Laos' e-waste management system received the highest scores in both P 1 average (0.130) and P 3 average (0.129). However, in the combined P total , China scored the highest (0.141), followed by Laos (0.132) and Thailand (0.121). This method could be used to assist decision makers in performing quantitative analysis of complex issues associating with e-waste management in a country. © The Author(s) 2016.

  7. The ideal smile and its orthodontic implications.

    PubMed

    Durgekar, Sujala Ganapati; K, Nagaraj; Naik, Vijay

    2010-01-01

    To determine the parameters for an ideal smile. Ten laypersons classified frontal photographs of 62 smiling individuals between 18 and 25 years of age into five categories: 1, poor; 2, fair; 3, good; 4, very good; and 5, excellent. The scores obtained for each smile were averaged. The five smiles with each the highest and lowest scores were analyzed for seven parameters: buccal corridor, smile index, smile symmetry, smile line ratio, upper lip line, smile arc, and upper lip curvature. The five smiles with the highest scores were symmetrical with an average upper lip line and a consonant smile arc. Three of the five had an upward upper lip curvature. The smile line ratio, buccal corridor, and smile index for all five subjects ranged from 1.0 to 1.3 mm, 9.0% to 11.0%, and 4.0 to 6.0 mm, respectively. Two of the five smiles with the lowest scores were asymmetrical and three had a high upper lip line and a downward curvature, but all five had a nonconsonant smile arc. The smile line ratio, buccal corridor, and smile index for all five subjects ranged from -1.0 to 1.3 mm, 18.0% to 22.0%, and 7.0 to 10.0 mm, respectively. The seven investigated smile parameters can define characteristics of an ideal smile. These smile components should be included in the orthodontic problem list to help clinicians select the appropriate mechanotherapy. © 2010 BY QUINTESSENCE PUBLISHING CO, INC.

  8. Self-assessed health, perceived stress and non-participation in breast cancer screening: A Danish cohort study.

    PubMed

    Jensen, Line Flytkjær; Pedersen, Anette Fischer; Andersen, Berit; Vedsted, Peter

    2015-12-01

    Population-based cancer screening is offered in many countries to detect early stages of cancer and reduce mortality. Screening efficiency and equality is susceptible due to a group of non-participants. We investigated associations between self-assessed health, perceived stress and subsequent non-participation in breast cancer screening. This population-based cohort study included 4512 women who had participated in a Health Survey in 2006 and who were also the target group (aged 50-69 years) for the first organised breast cancer screening programme -3 years later in the Central Denmark Region in 2008-2009. A U-shaped association was observed for physical health assessment as women with the highest (PR=1.28, 95% CI: 1.06-1.55), and the lowest (PR=1.41, 95% CI: 1.18-1.68) physical health scores were less likely to participate in the programme than women with physical health scores in the middle range. Women with low mental health assessment were more likely not to participate than women with mental health scores in the middle range (PR=1.44, 95% CI: 1.22-1.69). Higher non-participation propensity was also observed for women with the highest perceived stress scores (PR=1.27, 95% CI: 1.07-1.51) compared with women scoring in the middle range. Women with highest and lowest self-assessed physical health, with lowest mental health or highest perceived stress were significantly more likely not to participate in breast cancer screening 2-3 years later than women who reported average health. Interventions targeting these groups may promote equal participation in future breast cancer screening programmes. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. A cross-sectional assessment of quality of life of breast cancer patients in Saudi Arabia.

    PubMed

    Almutairi, K M; Mansour, E A; Vinluan, J M

    2016-07-01

    This aim of this study was to assess the quality of life of Saudi female breast cancer patients and determine the effects of the sociodemographic and clinical characteristics on the quality of life of those patients. This study was designed as a cross-sectional study. The data were collected from 145 female cancer patients who were recruited from outpatient units in different clinical settings in Riyadh, Saudi Arabia, from September 2014 to February 2015. Questionnaires were distributed to the patients during their visits to the outpatient clinics after obtaining informed consent. Quality of life was assessed using a validated Arabic version of the European Organisation for Research and Treatment of Cancer (EORTC) quality of life. Among functional scales, emotional functioning scored the highest (83.25 [95% CI 79.53-86.98]). The most distressing symptom on the symptom scale was insomnia (mean 84.14 [95% CI 79.95-88.32]), followed by appetite loss (mean 80.92 [95% CI 76.51-85.33]) and dyspnoea (mean 80.00 [95% CI 75.51-84.49]). Poor functioning was found in sexual enjoyment (mean 22.52 [95% CI 17.97-27.08]) while future perspective scored the highest (mean 76.32 [95% CI 70.52-82.12]). This study shows breast cancer survivors in Saudi had a low overall global quality of life. Saudi women showed average scores on all the functional scales but the emotional ones scored the highest. Insomnia, appetite loss, and dyspnoea were the distressing symptoms on symptom scales while future perspective domain scored the highest in item of QLQ-BR23. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  10. Performance of a light fluorescence device for the detection of microbial plaque and gingival inflammation.

    PubMed

    Rechmann, Peter; Liou, Shasan W; Rechmann, Beate M T; Featherstone, John D B

    2016-01-01

    The hypothesis to be tested was that using the SOPROCARE system in fluorescence perio-mode allows scoring of microbial plaque that is comparable to the Turesky modification of the Quigley Hein plaque index (T-QH) and scoring of gingival inflammation comparable to the Silness and Löe gingival inflammation index (GI). Fifty-five subjects with various amounts of microbial plaque were recruited. The T-QH and GI index were recorded. SOPROCARE pictures were recorded in fluorescence perio-mode and in daylight mode. Finally, conventional digital photographs were taken. All pictures were assessed using the same criteria as described for the clinical indices. The average T-QH was 1.1 ± 1.2 (mean ± SD). Scoring with SOPROCARE perio-mode led to a slightly higher average than the T-QH scores. SOPROCARE daylight mode and digital photography showed the highest plaque scores. The average GI index was 0.7 ± 0.9. SOPROCARE in perio-mode scored slightly lower. Linear regression fits between the different clinical indices and SOPROCARE scores were significantly different from zero demonstrating high goodness of fit. The study demonstrated that the SOPROCARE fluorescence assessment tool in perio-mode allows reliable judgment of microbial plaque and gingival inflammation levels similar to the established Turesky-modified Quigley Hein index and the Silness and Löe gingival inflammation index. Training on plaque-free teeth will actually reduce scoring errors. The SOPROCARE fluorescence tool in perio-mode provides reliable evaluation of microbial plaque and gingival inflammation for the dental clinician.

  11. Pre-admission factors and utilization of tutoring services in health professions educational programs.

    PubMed

    Olivares-Urueta, Mayra; Williamson, Jon W

    2013-01-01

    Pre-admission factors tend to serve as indicators of student success in health professions educational programs, but less is known about the effects that academic assistance programs have on student success. This study sought to determine whether specific pre-admission factors could help to identify students who may require academic support during their health professions education. This retrospective analysis aimed to identify differences in pre-admission variables between those students requiring tutoring and a matched sample of students who did not require tutoring. One-way ANOVA was used to assess differences for dependent variables-age, cumulative GPA (cGPA), science GPA (sGPA), verbal graduate record examination (GRE) score, quantitative GRE score, analytical GRE score and combined GRE score, community college hours, average credit hours per semester, and highest semester credit hour load-across three groups of students who received no tutoring (NT 0 hrs), some tutoring (ST <8 hrs), and more tutoring (MT >8 hrs). Total GRE and average semester hours differentiated NT from ST from MT (p<0.05). A linear regression model with these pre-admission factors found only four of the independent variables to be significant (r2=0.41; p<0.05) in predicting hours of tutoring: quantitative GRE, sGPA, cGPA and average semester hours taken. The combination of lower GRE scores and lighter average semester course load were most predictive of the need for academic assistance as defined by hours of tutoring. While the value of the GRE in admissions processes is generally accepted, the average semester hour load in college can also provide important information regarding academic preparation and the need for tutoring services.

  12. Targeting safety improvements through identification of incident origination and detection in a near-miss incident learning system.

    PubMed

    Novak, Avrey; Nyflot, Matthew J; Ermoian, Ralph P; Jordan, Loucille E; Sponseller, Patricia A; Kane, Gabrielle M; Ford, Eric C; Zeng, Jing

    2016-05-01

    Radiation treatment planning involves a complex workflow that has multiple potential points of vulnerability. This study utilizes an incident reporting system to identify the origination and detection points of near-miss errors, in order to guide their departmental safety improvement efforts. Previous studies have examined where errors arise, but not where they are detected or applied a near-miss risk index (NMRI) to gauge severity. From 3/2012 to 3/2014, 1897 incidents were analyzed from a departmental incident learning system. All incidents were prospectively reviewed weekly by a multidisciplinary team and assigned a NMRI score ranging from 0 to 4 reflecting potential harm to the patient (no potential harm to potential critical harm). Incidents were classified by point of incident origination and detection based on a 103-step workflow. The individual steps were divided among nine broad workflow categories (patient assessment, imaging for radiation therapy (RT) planning, treatment planning, pretreatment plan review, treatment delivery, on-treatment quality management, post-treatment completion, equipment/software quality management, and other). The average NMRI scores of incidents originating or detected within each broad workflow area were calculated. Additionally, out of 103 individual process steps, 35 were classified as safety barriers, the process steps whose primary function is to catch errors. The safety barriers which most frequently detected incidents were identified and analyzed. Finally, the distance between event origination and detection was explored by grouping events by the number of broad workflow area events passed through before detection, and average NMRI scores were compared. Near-miss incidents most commonly originated within treatment planning (33%). However, the incidents with the highest average NMRI scores originated during imaging for RT planning (NMRI = 2.0, average NMRI of all events = 1.5), specifically during the documentation of patient positioning and localization of the patient. Incidents were most frequently detected during treatment delivery (30%), and incidents identified at this point also had higher severity scores than other workflow areas (NMRI = 1.6). Incidents identified during on-treatment quality management were also more severe (NMRI = 1.7), and the specific process steps of reviewing portal and CBCT images tended to catch highest-severity incidents. On average, safety barriers caught 46% of all incidents, most frequently at physics chart review, therapist's chart check, and the review of portal images; however, most of the incidents that pass through a particular safety barrier are not designed to be capable of being captured at that barrier. Incident learning systems can be used to assess the most common points of error origination and detection in radiation oncology. This can help tailor safety improvement efforts and target the highest impact portions of the workflow. The most severe near-miss events tend to originate during simulation, with the most severe near-miss events detected at the time of patient treatment. Safety barriers can be improved to allow earlier detection of near-miss events.

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

    Novak, Avrey; Nyflot, Matthew J.; Ermoian, Ralph P.

    Purpose: Radiation treatment planning involves a complex workflow that has multiple potential points of vulnerability. This study utilizes an incident reporting system to identify the origination and detection points of near-miss errors, in order to guide their departmental safety improvement efforts. Previous studies have examined where errors arise, but not where they are detected or applied a near-miss risk index (NMRI) to gauge severity. Methods: From 3/2012 to 3/2014, 1897 incidents were analyzed from a departmental incident learning system. All incidents were prospectively reviewed weekly by a multidisciplinary team and assigned a NMRI score ranging from 0 to 4 reflectingmore » potential harm to the patient (no potential harm to potential critical harm). Incidents were classified by point of incident origination and detection based on a 103-step workflow. The individual steps were divided among nine broad workflow categories (patient assessment, imaging for radiation therapy (RT) planning, treatment planning, pretreatment plan review, treatment delivery, on-treatment quality management, post-treatment completion, equipment/software quality management, and other). The average NMRI scores of incidents originating or detected within each broad workflow area were calculated. Additionally, out of 103 individual process steps, 35 were classified as safety barriers, the process steps whose primary function is to catch errors. The safety barriers which most frequently detected incidents were identified and analyzed. Finally, the distance between event origination and detection was explored by grouping events by the number of broad workflow area events passed through before detection, and average NMRI scores were compared. Results: Near-miss incidents most commonly originated within treatment planning (33%). However, the incidents with the highest average NMRI scores originated during imaging for RT planning (NMRI = 2.0, average NMRI of all events = 1.5), specifically during the documentation of patient positioning and localization of the patient. Incidents were most frequently detected during treatment delivery (30%), and incidents identified at this point also had higher severity scores than other workflow areas (NMRI = 1.6). Incidents identified during on-treatment quality management were also more severe (NMRI = 1.7), and the specific process steps of reviewing portal and CBCT images tended to catch highest-severity incidents. On average, safety barriers caught 46% of all incidents, most frequently at physics chart review, therapist’s chart check, and the review of portal images; however, most of the incidents that pass through a particular safety barrier are not designed to be capable of being captured at that barrier. Conclusions: Incident learning systems can be used to assess the most common points of error origination and detection in radiation oncology. This can help tailor safety improvement efforts and target the highest impact portions of the workflow. The most severe near-miss events tend to originate during simulation, with the most severe near-miss events detected at the time of patient treatment. Safety barriers can be improved to allow earlier detection of near-miss events.« less

  14. Effect of Processing on the in Vitro and in Vivo Protein Quality of Yellow and Green Split Peas (Pisum sativum).

    PubMed

    Nosworthy, Matthew G; Franczyk, Adam J; Medina, Gerardo; Neufeld, Jason; Appah, Paulyn; Utioh, Alphonsus; Frohlich, Peter; House, James D

    2017-09-06

    In order to determine the effect of extrusion, baking, and cooking on the protein quality of yellow and green split peas, a rodent bioassay was conducted and compared to an in vitro method of protein quality determination. The Protein Digestibility-Corrected Amino Acid Score (PDCAAS) of green split peas (71.4%) was higher than that of yellow split peas (67.8%), on average. Similarly, the average Digestible Indispensable Amino Acid Score (DIAAS) of green split peas (69%) was higher than that of yellow split peas (67%). Cooked green pea flour had lower PDCAAS and DIAAS values (69.19% and 67%) than either extruded (73.61%, 70%) or baked (75.22%, 70%). Conversely, cooked yellow split peas had the highest PDCCAS value (69.19%), while extruded yellow split peas had the highest DIAAS value (67%). Interestingly, a strong correlation was found between in vivo and in vitro analysis of protein quality (R 2 = 0.9745). This work highlights the differences between processing methods on pea protein quality and suggests that in vitro measurements of protein digestibility could be used as a surrogate for in vivo analysis.

  15. Technical Efficiency of Hospitals in Tehran, Iran.

    PubMed

    Kakeman, Edris; Rahimi Forushani, Abbas; Dargahi, Hossein

    2016-04-01

    Nowadays, restriction on access and optimum use of resources is the main challenge of development in all organizations. Therefore, the aim of this study was to determine the technical efficiency and its factors, influencing hospitals of Tehran. This research was a descriptive-analytical and retrospective study conducted in 2014-2015. Fifty two hospitals with public, private, and social security ownership type were selected for this study. The required data was collected by a researcher-made check list in 3 sections of background data, inputs and outputs. The data was analyzed by DEAP 1.0.2, and STATA-13 technique. Seventeen (31/48) of hospitals had the efficiency score of 1 as the highest technical efficiency. The highest average score of efficiency was related to social security hospitals as 84.32, and then the public and private hospitals with the average of 84.29 and 79.64 respectively. Tobit regression results showed that the size, type of practice, and ownership of hospitals were effective on the degree of their technical efficiency. However, there was no significant correlation between teaching / non-teaching hospitals with technical efficiency. Establishment of competition system among hospitals, constitution of medium size hospitals and allocation of budget to hospitals based on national accreditation system are recommended.

  16. Two-year quality of life after free flap reconstruction in tumor-site discrepancy among Taiwanese with moderately advanced oral squamous cell carcinoma.

    PubMed

    Chang, Kao-Ping; Lai, Chung-Sheng; Hsieh, Tung-Ying; Wu, Yi-Chia; Chang, Chih-Hau

    2012-07-13

    This study describes 2-year impact on quality of life (QOL) in relation to the anatomical discrepancy among T4a oral cancer patients after free flap reconstruction in Taiwan. Thirty-two patients who underwent tumor ablation with simultaneous microvascular free flap transfer at 2-year follow-up were recruited. They were divided into six subgroups, according to the resected area, consisting of: (1) buccal/retromolar trigone; (2) cheek; (3) commissure; (4) lip; (5) mandible; and (6) tongue. Functional disturbances and daily activity were analyzed using the Version-1 UW QOL Questionnaire with one more specific category: 'Drooling'. Kruskal-Wallis rank sums analysis was used to test differences in average QOL scores between these subgroups. Post-hoc analysis was applied to assess influence of dominant categories between subgroups. The category 'Pain' revealed the highest average score and reached significant statistical difference (P = 0.019) among all the categories, however, the category 'Employment' averaged the lowest score. Regarding 'Pain', there existed a statistical significance (P = 0.0032) between the commissure- and cheek-involved groups, which described the former showed poorer pain quality of life. The commissure-involved group had the lowest average score, which might imply the worst QOL in our study, especially for the categories 'Pain' and 'Drooling'. This present study of T4a patients was the first carried out in Taiwan implementing the QOL questionnaire, and its results may serve for future reference.

  17. Staff happiness and work satisfaction in a tertiary psychiatric centre.

    PubMed

    Baruch, Y; Swartz, M; Sirkis, S; Mirecki, I; Barak, Y

    2013-09-01

    Mental health professionals are at a high risk of burnout. Positive psychology outcomes of staff in acute in-patient psychiatric wards are poorly researched and unclear. To quantify the satisfaction with life and work-life satisfaction of mental health staff at a large university-affiliated tertiary psychiatric centre. We utilized the Satisfaction with Life Scale (SWLS) and the Work-Life Satisfaction Questionnaire (WLSQ). Two hundred and nine out of 450 staff members (46%) participated; mean age 48.2 + 9.9 years; 63% were male. On average the participants had been practising their speciality for 21.1 + 9.8 years (range: 2-48). The mean total SWLS scores differed significantly between professions (P < 0.05). The highest levels of happiness were reported by psychologists and social workers, followed by the administrative staff, the psychiatrists and finally the nursing staff. Staff scored the highest for work as a 'calling' followed by work as a 'career' and the lowest rating for work as a 'job'. The mean total WLSQ score differed between professions, (P < 0.01). The highest levels of work as a calling were reported by psychiatrists (mean 2.87 of possible 5.0), followed by psychologists and social workers, nursing staff and finally administrative staff. Satisfaction with life and work orientation do not correlate among mental health professionals. Although highly motivated and perceiving psychiatry as a 'calling' psychiatrists score low on levels of satisfaction with life. Improving staff happiness may contribute to increase in moral and counter burnout.

  18. Knowledge of Prenatal Healthcare among Pregnant Women in Boyer-Ahmad and Dena County of Kohgiluyeh and Boyer-Ahmad Province, Iran.

    PubMed

    Safari, Mitra; Bahadornegad, Mohammad Hosien; Yazdanpanah, Behrouz; Safari, Marjan

    Prenatal care knowledge is critical for pregnant women's use of antenatal services. The aim of the study was to assess the extent of prenatal healthcare knowledge among pregnant women of the Boyer-Ahmad and Dena County of Kohgiluyeh and Boyer-Ahmad Province, Iran. A cross-sectional survey was conducted between April and June 2013. Pregnant women who came for delivery to the only available public hospital were interviewed by trained research assistants. Interview questions were designed to assess their knowledge on five broad categories of prenatal care practices of immunization, diet, supplementation, antenatal checkups and warning signs. Collected information was converted into numerical scores and average score for each individual was calculated. Independent-samples t-test, analysis of variance and multiple comparison tests were used to compare scores among groups with different demographic and socioeconomic status. A total of 400 pregnant women with 66.8% illiterate or lowly educated and an average age of 28.5 ± 6.1 years participated in the study. The average care knowledge score was 16.8 out of a maximum of 30. The highest awareness was observed on immunization (54.4%) and the lowest for prenatal checkup (20.3%).The average knowledge scores were significantly different among age groups, educational level, number of gravidity, type of occupation, place of residence and time of starting of prenatal care. There were no significant differences between women with and without obstetric complications. Not surprisingly, the level of education was the most significant factor influencing women's knowledge of parental healthcare, reinforcing the need for the improvement in literacy and expansion of health education among pregnant women using various educational methods.

  19. [Analysis of effect of prevention and control technique training of human important parasitic diseases in Jiangsu Province in 2017].

    PubMed

    Bi-Xian, Ni; Xiang-Zhen, Xu; Xiao-Ting, Wang; Ming-Xue, Sheng; Yang, Dai; Xiao-Lin, Jin

    2017-07-24

    To evaluate the effect of the prevention and control technique training of human important parasitic diseases for basic professional and technical personnel in Jiangsu Province in 2017. A workshop including theory courses and practical operations was carried out for the basic professional and technical personnel. At the end of the workshop, the effects were evaluated through the theoretical and microscopic examinations. There were 132 trainees from 13 cities, and all of them took part in the final examinations. The average score of total was 118.36. There were significant differences among different regions ( χ 2 = 13.38, P < 0.01). The pass rate of the theory test was 92.4% with the average score of 79.05. There were significant differences of theory scores among different regions ( χ 2 =14.51, P < 0.01). The theory score of Northern Jiangsu Province was significantly higher than the scores of Southern and Central Jiangsu Province ( P < 0.001, P = 0.009). The pass rate of microscopic examinations was 89.4% with the average score of 39.32. There was no significant difference of micro-scopic examination scores among different regions ( F = 2.37, P = 0.09). Among the total 7 species, the detection rate of Paragonimus westermani was the highest (75%) and the rates of Schistosoma japonicum and Fasciolopsis buski were only 51.5% and 54.5% respectively. The detection rates of eggs of Trichuris trichiura , unfertilized Ascaris lumbricoides , Clonorchis sinensis and Taenia solium were 71.2%, 65.9%, 72.7% and 72.0% respectively. The training course has promoted the capability of prevention and control of parasitic diseases for basic technical personnel. Also it provides the technical supports for parasitic disease monitoring, control and risk assessment in the next step.

  20. How well do second-year students learn physical diagnosis? Observational study of an Objective Structured Clinical Examination (OSCE).

    PubMed

    Hamann, Claus; Volkan, Kevin; Fishman, Mary B; Silvestri, Ronald C; Simon, Steven R; Fletcher, Suzanne W

    2002-01-01

    Little is known about using the Objective Structured Clinical Examination (OSCE) in physical diagnosis courses. The purpose of this study was to describe student performance on an OSCE in a physical diagnosis course. Cross-sectional study at Harvard Medical School, 1997-1999, for 489 second-year students. Average total OSCE score was 57% (range 39-75%). Among clinical skills, students scored highest on patient interaction (72%), followed by examination technique (65%), abnormality identification (62%), history-taking (60%), patient presentation (60%), physical examination knowledge (47%), and differential diagnosis (40%) (p <.0001). Among 16 OSCE stations, scores ranged from 70% for arthritis to 29% for calf pain (p <.0001). Teaching sites accounted for larger adjusted differences in station scores, up to 28%, than in skill scores (9%) (p <.0001). Students scored higher on interpersonal and technical skills than on interpretive or integrative skills. Station scores identified specific content that needs improved teaching.

  1. How well do second-year students learn physical diagnosis? Observational study of an objective structured clinical examination (OSCE)

    PubMed Central

    Hamann, Claus; Volkan, Kevin; Fishman, Mary B; Silvestri, Ronald C; Simon, Steven R; Fletcher, Suzanne W

    2002-01-01

    Background Little is known about using the Objective Structured Clinical Examination (OSCE) in physical diagnosis courses. The purpose of this study was to describe student performance on an OSCE in a physical diagnosis course. Methods Cross-sectional study at Harvard Medical School, 1997–1999, for 489 second-year students. Results Average total OSCE score was 57% (range 39–75%). Among clinical skills, students scored highest on patient interaction (72%), followed by examination technique (65%), abnormality identification (62%), history-taking (60%), patient presentation (60%), physical examination knowledge (47%), and differential diagnosis (40%) (p < .0001). Among 16 OSCE stations, scores ranged from 70% for arthritis to 29% for calf pain (p < .0001). Teaching sites accounted for larger adjusted differences in station scores, up to 28%, than in skill scores (9%) (p < .0001). Conclusions Students scored higher on interpersonal and technical skills than on interpretive or integrative skills. Station scores identified specific content that needs improved teaching. PMID:11888484

  2. Resources, indicators, data management, dissemination and use in health information systems in sub-Saharan Africa: results of a questionnaire-based survey.

    PubMed

    Mbondji, Peter Ebongue; Kebede, Derege; Soumbey-Alley, Edoh William; Zielinski, Chris; Kouvividila, Wenceslas; Lusamba-Dikassa, Paul-Samson

    2014-05-01

    To describe the status of health information systems in 14 sub-Saharan African countries of the World Health Organization African Region. A questionnaire-based survey. Fourteen sub-Saharan African countries of the African Region. Key informants in the ministries of health, national statistics offices, health programmes, donors and technical agencies. State of resources, indicators, data sources, data management, information products, dissemination and use of health information. The highest average score was in the identification and harmonisation of indicators (73%), reflecting successful efforts to identify priority indicators and reach international consensus on indicators for several diseases. This was followed by information products (63%), which indicated the availability of accurate and reliable data. The lowest score (41%) was in data management, the ability to collect, store, analyse and distribute data, followed by resources - policy and planning, human and financial resources, and infrastructure (53%). Data sources (e.g. censuses, surveys) were on average inadequate with a score of 56%. The average score for dissemination and use of health information was 57%, which indicated limited or inadequate use of data for advocacy, planning and decision-making. National health information systems are weak in the surveyed countries and much more needs to be done to improve the quality and relevance of data, and their management, sharing and use for policy-making and decision-making. © The Royal Society of Medicine.

  3. [Quality of life of pregnant women infected with the human immunodeficiency virus (HIV) in the city of São Paulo].

    PubMed

    Tirado, Maria do Carmo Braga do Amaral; Bortoletti, Fátima Ferrreira; Nakamura, Mary Uchiyama; Souza, Eduardo de; Soárez, Patrícia Coelho de; Castelo Filho, Adauto; Amed, Abês Mahmed

    2014-05-01

    It was to assess the quality of life (QOL) of HIV-infected pregnant women using the HIV/AIDS - Targeted Quality of Life (HAT-QoL) questionnaire. A descriptive study of 60 pregnant women attended at the Multidisciplinary Nucleus of Infectious Diseases During Pregnancy (NUPAIG) - UNIFESP/EPM and in the referral network of the Municipal Office of São Paulo, conducted from February 2011 to October 2012. Sociodemographic and clinical variables were collected from 60 HIV-infected pregnant women who answered the HAT-QoL questionnaire, which included 34 questions about quality of life. The average age was 30 years and the average period of HIV infection was 5.7 years. Only 8.3% of patients had a CD4 cell score of ≤200 cells/mm³ and 45% showed undetectable viral load. The average domain scores ranged from 47.5 to 83.7. The domains with the lowest scores were financial concerns and concerns about secrecy. The domains with the highest scores and lower impact on quality of life were concerns about medication and confidence in the professional. In this initial study with 60 pregnant women, we concluded that the HAT-QOL can contribute to the assessment of quality of life in the population of HIV-infected pregnant women in Brazil.

  4. MUSCLE: multiple sequence alignment with high accuracy and high throughput.

    PubMed

    Edgar, Robert C

    2004-01-01

    We describe MUSCLE, a new computer program for creating multiple alignments of protein sequences. Elements of the algorithm include fast distance estimation using kmer counting, progressive alignment using a new profile function we call the log-expectation score, and refinement using tree-dependent restricted partitioning. The speed and accuracy of MUSCLE are compared with T-Coffee, MAFFT and CLUSTALW on four test sets of reference alignments: BAliBASE, SABmark, SMART and a new benchmark, PREFAB. MUSCLE achieves the highest, or joint highest, rank in accuracy on each of these sets. Without refinement, MUSCLE achieves average accuracy statistically indistinguishable from T-Coffee and MAFFT, and is the fastest of the tested methods for large numbers of sequences, aligning 5000 sequences of average length 350 in 7 min on a current desktop computer. The MUSCLE program, source code and PREFAB test data are freely available at http://www.drive5. com/muscle.

  5. Prediction of the interaction site on the surface of an isolated protein structure by analysis of side chain energy scores.

    PubMed

    Liang, Shide; Zhang, Jian; Zhang, Shicui; Guo, Huarong

    2004-11-15

    We show that residues at the interfaces of protein-protein complexes have higher side-chain energy than other surface residues. Eight different sets of protein complexes were analyzed. For each protein pair, the complex structure was used to identify the interface residues in the unbound monomer structures. Side-chain energy was calculated for each surface residue in the unbound monomer using our previously developed scoring function.1 The mean energy was calculated for the interface residues and the other surface residues. In 15 of the 16 monomers, the mean energy of the interface residues was higher than that of other surface residues. By decomposing the scoring function, we found that the energy term of the buried surface area of non-hydrogen-bonded hydrophilic atoms is the most important factor contributing to the high energy of the interface regions. In spite of lacking hydrophilic residues, the interface regions were found to be rich in buried non-hydrogen-bonded hydrophilic atoms. Although the calculation results could be affected by the inaccuracy of the scoring function, patch analysis of side-chain energy on the surface of an isolated protein may be helpful in identifying the possible protein-protein interface. A patch was defined as 20 residues surrounding the central residue on the protein surface, and patch energy was calculated as the mean value of the side-chain energy of all residues in the patch. In 12 of the studied monomers, the patch with the highest energy overlaps with the observed interface. The results are more remarkable when only three residues with the highest energy in a patch are averaged to derive the patch energy. All three highest-energy residues of the top energy patch belong to interfacial residues in four of the eight small protomers. We also found that the residue with the highest energy score on the surface of a small protomer is very possibly the key interaction residue. (c) 2004 Wiley-Liss, Inc.

  6. Does the neighborhood context alter the link between youth's after-school time activities and developmental outcomes? A multilevel analysis.

    PubMed

    Fauth, Rebecca C; Roth, Jodie L; Brooks-Gunn, Jeanne

    2007-05-01

    This article examines links between different measures of after-school time activity participation (5 specific activities and breadth) on youth's developmental outcomes (anxiety/depression, delinquency, and substance use) over 6 years and whether these links are moderated by neighborhood-level variables. The sample (N=1,315) of 9- and 12-year-old youth was drawn from the Project on Human Development in Chicago Neighborhoods (PHDCN), a multilevel, longitudinal study of youth from 80 Chicago neighborhoods. Findings revealed that different types of activities and patterns of participation over time were associated with outcomes for youth and that, to some extent, these outcomes varied with neighborhood characteristics. In brief, sports participation was associated with fewer anxious/depressed symptoms, higher average delinquency scores, and increased substance use-both average scores and growth over time. Participation in the arts and student government were negatively associated with average substance use and attenuated increases in usage over time. Participation in community-based clubs was positively associated with youth's anxiety/depression in violent neighborhoods only, whereas church groups were protective against substance use in nonviolent neighborhoods. The direction of the influence of breadth of participation was nonlinear for delinquency such that delinquency scores were highest among youth who engaged in an average number of activities. Copyright (c) 2007 APA, all rights reserved.

  7. Suitability Assessment of Printed Dietary Guidelines for Pregnant Women and Parents of Infants and Toddlers From 7 European Countries.

    PubMed

    Garnweidner-Holme, Lisa Maria; Dolvik, Stina; Frisvold, Cathrine; Mosdøl, Annhild

    2016-02-01

    To evaluate selected European printed dietary guidelines for pregnant women and parents of infants and toddlers using the suitability assessment of materials (SAM) method. A descriptive study to determine the suitability of 14 printed dietary guidelines from 7 European countries based on deductive quantitative analyses. Materials varied greatly in format and content: 35.7% of materials were rated superior and 64.3% were rated adequate according to the overall SAM score for patient education material. None of the materials were scored not suitable. Among the categories, the highest average scores were for layout and typography and the lowest average scores were for cultural appropriateness and learning stimulation and motivation. Interrater reliability ranged from Cohen's kappa of 0.37 to 0.62 (mean, 0.41), indicating fair to moderate agreement among the 3 investigators. Overall, the suitability of the assessed printed dietary guidelines was adequate. Based on the SAM methodology, printed dietary guidelines may increase in suitability by emphasizing aspects related to health literacy and accommodating the needs of different food cultures within a population. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  8. Medial temporal lobe atrophy ratings in a large 75-year-old population-based cohort: gender-corrected and education-corrected normative data.

    PubMed

    Velickaite, V; Ferreira, D; Cavallin, L; Lind, L; Ahlström, H; Kilander, L; Westman, E; Larsson, E-M

    2018-04-01

    To find cut-off values for different medial temporal lobe atrophy (MTA) measures (right, left, average, and highest), accounting for gender and education, investigate the association with cognitive performance, and to compare with decline of cognitive function over 5 years in a large population-based cohort. Three hundred and ninety 75-year-old individuals were examined with magnetic resonance imaging of the brain and cognitive testing. The Scheltens's scale was used to assess visually MTA scores (0-4) in all subjects. Cognitive tests were repeated in 278 of them after 5 years. Normal MTA cut-off values were calculated based on the 10th percentile. Most 75-year-old individuals had MTA score ≤2. Men had significantly higher MTA scores than women. Scores for left and average MTA were significantly higher in highly educated individuals. Abnormal MTA was associated with worse results in cognitive test and individuals with abnormal right MTA had faster cognitive decline. At age 75, gender and education are confounders for MTA grading. A score of ≥2 is abnormal for low-educated women and a score of ≥2.5 is abnormal for men and high-educated women. Subjects with abnormal right MTA, but normal MMSE scores had developed worse MMSE scores 5 years later. • Gender and education are confounders for MTA grading. • We suggest cut-off values for 75-year-olds, taking gender and education into account. • Males have higher MTA scores than women. • Higher MTA scores are associated with worse cognitive performance.

  9. Two-year quality of life after free flap reconstruction in tumor-site discrepancy among Taiwanese with moderately advanced oral squamous cell carcinoma

    PubMed Central

    2012-01-01

    Background This study describes 2-year impact on quality of life (QOL) in relation to the anatomical discrepancy among T4a oral cancer patients after free flap reconstruction in Taiwan. Methods Thirty-two patients who underwent tumor ablation with simultaneous microvascular free flap transfer at 2-year follow-up were recruited. They were divided into six subgroups, according to the resected area, consisting of: (1) buccal/retromolar trigone; (2) cheek; (3) commissure; (4) lip; (5) mandible; and (6) tongue. Functional disturbances and daily activity were analyzed using the Version-1 UW QOL Questionnaire with one more specific category: ‘Drooling’. Kruskal-Wallis rank sums analysis was used to test differences in average QOL scores between these subgroups. Post-hoc analysis was applied to assess influence of dominant categories between subgroups. Results The category ‘Pain’ revealed the highest average score and reached significant statistical difference (P = 0.019) among all the categories, however, the category ‘Employment’ averaged the lowest score. Regarding ‘Pain’, there existed a statistical significance (P = 0.0032) between the commissure- and cheek-involved groups, which described the former showed poorer pain quality of life. Conclusions The commissure-involved group had the lowest average score, which might imply the worst QOL in our study, especially for the categories ‘Pain’ and ‘Drooling’. This present study of T4a patients was the first carried out in Taiwan implementing the QOL questionnaire, and its results may serve for future reference. PMID:22789070

  10. Perceptions of nursing students of educational environment at a private undergraduate School of Nursing in Karachi.

    PubMed

    Farooq, Salima; Rehman, Rehana; Hussain, Mehwish; Dias, Jacqueline Maria

    2018-02-01

    To assess educational environment at a nursing school.. The cross-sectional survey was carried out from May to October 2016 at Aga Khan University School of Nursing and Midwifery, Karachi, using the Dundee Ready Educational Environment Measure tool. The scores were obtained by merging five sub-scales of the inventory. The average scores of the scale and sub-scales were compared in terms of age, year of study, and living status using Mann-Whitney U test, and among years of study by Kruskal Wallis test.. Of the 442 students, 228(51.6%) had age below 20 years. Overall, 131(29.1%) subjects were in the first year, 152(33.8%) second year, 91(20.2%) third year and 76(16.9%) fourth year. The average Dundee Ready Educational Environment Measure score was 129.92±19.97 with reliability of 88.9%. Students aged 20 years and less had more positive perceptions than students over 20 years (p<0.0001). Students living in hostel secured higher scores (p<0.0001). First year nursing students attained significant highest scores in all sub-scales compared to the rest (p<0.0001). Scores reveal better perception from younger nursing students, as well as those living in the hostel and those who were in their initial years of nursing education.

  11. Reducing adolescent clients' anger in a residential substance abuse treatment facility.

    PubMed

    Adelman, Robert; McGee, Patricia; Power, Robert; Hanson, Cathy

    2005-06-01

    Sundown Ranch, a residential behavioral health care treatment facility for adolescents, tracked the progress and results of treatment by selecting performance measures from a psychosocial screening inventory. The temper scale was one of the two highest scales at admission and the highest scale at discharge. A clinical performance improvement (PI) project was conducted to assess improvements in clients' ability to manage anger after the incorporation of Rational Emotive Behavior Therapy (REBT) into treatment. Eighteen months of baseline data (July 1, 1999 - February 1, 2001) were collected, and 20 months of data (May 1, 2001 - December 31, 2002) were collected after the introduction of the PI activity. In all, data were collected for 541 consecutive admissions. A comparison of five successive quarterly reviews indicated average scores of 1.4 standard deviations (SDs) above the mean on the temper scale before the PI activity and .45 SD above the mean after. The performance threshold of reduction of the average temper scale score to < or =1 SD was met for 17 of 20 months. The fact that the PI activity reduced the temper scale elevations by almost one full SD is highly suggestive of the efficacy of REBT with the treatment population. After the project was completed, REBT was promoted as an additional therapeutic modality within the treatment program.

  12. The Changes of Ethical Dilemmas in Palliative Care A Lesson Learned from Comparison Between 1998 and 2013 in Taiwan

    PubMed Central

    Chih, An-Hsuan; Su, Peijen; Hu, Wen-Yu; Yao, Chien-An; Cheng, Shao-Yi; Lin, Yen-Chun; Chiu, Tai-Yuan

    2016-01-01

    Abstract The current ethical dilemmas met by healthcare professionals were never compared with those 15 years ago when the palliative care system was newly developing in Taiwan. The aim of the study was to investigate the ethical dilemmas met by palliative care physicians and nurses in 2013 and compare the results with the survey in 1998. This cross-sectional study surveyed 213 physicians and nurses recruited from 9 representative palliative care units across Taiwan in 2013. The compared survey in 1998 studied 102 physicians and nurses from the same palliative care units. All participants took a questionnaire to survey the “frequency” and “difficulty” of 20 frequently encountered ethical dilemmas, which were grouped into 4 domains by factor analysis. The “ethical dilemma” scores were calculated and then compared across 15 years by Student's t tests. A general linear model analysis was used to identify significant factors relating to a high average “ethical dilemma” score in each domain. All of the highest-ranking ethical dilemmas in 2013 were related to insufficient resources. Physicians with less clinical experience had a higher average “ethical dilemma” score in clinical management. Physicians with dissatisfaction in providing palliative care were associated a higher average “ethical dilemma” score in communication. Nurses reported higher “ethical dilemma” scores in all items of resource allocation in 2013. Further analysis confirmed that, in 2013, nurses had a higher average “ethical dilemma” score in resource allocation after adjustment for other relating factors. Palliative care nursing staff in Taiwan are more troubled by ethical dilemmas related to insufficient resources than they were 15 years ago. Training of decision making in nurses under the framework of ethical principles and community palliative care programs may improve the problems. To promote the dignity of terminal cancer patients, long-term fundraising plans are recommended for countries in which the palliative care system is in its early stages of development. PMID:26735533

  13. The Changes of Ethical Dilemmas in Palliative Care. A Lesson Learned from Comparison Between 1998 and 2013 in Taiwan.

    PubMed

    Chih, An-Hsuan; Su, Peijen; Hu, Wen-Yu; Yao, Chien-An; Cheng, Shao-Yi; Lin, Yen-Chun; Chiu, Tai-Yuan

    2016-01-01

    The current ethical dilemmas met by healthcare professionals were never compared with those 15 years ago when the palliative care system was newly developing in Taiwan. The aim of the study was to investigate the ethical dilemmas met by palliative care physicians and nurses in 2013 and compare the results with the survey in 1998. This cross-sectional study surveyed 213 physicians and nurses recruited from 9 representative palliative care units across Taiwan in 2013. The compared survey in 1998 studied 102 physicians and nurses from the same palliative care units. All participants took a questionnaire to survey the "frequency" and "difficulty" of 20 frequently encountered ethical dilemmas, which were grouped into 4 domains by factor analysis. The "ethical dilemma" scores were calculated and then compared across 15 years by Student's t tests. A general linear model analysis was used to identify significant factors relating to a high average "ethical dilemma" score in each domain. All of the highest-ranking ethical dilemmas in 2013 were related to insufficient resources. Physicians with less clinical experience had a higher average "ethical dilemma" score in clinical management. Physicians with dissatisfaction in providing palliative care were associated a higher average "ethical dilemma" score in communication. Nurses reported higher "ethical dilemma" scores in all items of resource allocation in 2013. Further analysis confirmed that, in 2013, nurses had a higher average "ethical dilemma" score in resource allocation after adjustment for other relating factors. Palliative care nursing staff in Taiwan are more troubled by ethical dilemmas related to insufficient resources than they were 15 years ago. Training of decision making in nurses under the framework of ethical principles and community palliative care programs may improve the problems. To promote the dignity of terminal cancer patients, long-term fundraising plans are recommended for countries in which the palliative care system is in its early stages of development.

  14. A healthy Nordic diet and physical performance in old age: findings from the longitudinal Helsinki Birth Cohort Study.

    PubMed

    Perälä, Mia-Maria; von Bonsdorff, Mikaela; Männistö, Satu; Salonen, Minna K; Simonen, Mika; Kanerva, Noora; Pohjolainen, Pertti; Kajantie, Eero; Rantanen, Taina; Eriksson, Johan G

    2016-03-14

    Epidemiological studies have shown that a number of nutrients are associated with better physical performance. However, little is still known about the role of the whole diet, particularly a healthy Nordic diet, in relation to physical performance. Therefore, we examined whether a healthy Nordic diet was associated with measures of physical performance 10 years later. We studied 1072 participants from the Helsinki Birth Cohort Study. Participants' diet was assessed using a validated 128-item FFQ at the mean age of 61 years, and a priori-defined Nordic diet score (NDS) was calculated. The score included Nordic fruits and berries, vegetables, cereals, PUFA:SFA and trans-fatty acids ratio, low-fat milk, fish, red and processed meat, total fat and alcohol. At the mean age of 71 years, participants' physical performance was measured using the Senior Fitness Test (SFT), and an overall SFT score was calculated. Women in the highest fourth of the NDS had on average 5 points higher SFT score compared with those in the lowest fourth (P for trend 0·005). No such association was observed in men. Women with the highest score had 17% better result in the 6-min walk test, 16% better arm curl and 20% better chair stand results compared with those with the lowest score (all P values<0·01). In conclusion, a healthy Nordic diet was associated with better overall physical performance among women and might help decrease the risk of disability in old age.

  15. Teaching research methodology in medical schools: students' attitudes towards and knowledge about science.

    PubMed

    Hren, Darko; Lukić, Ivan Kresimir; Marusić, Ana; Vodopivec, Ivana; Vujaklija, Ana; Hrabak, Maja; Marusić, Matko

    2004-01-01

    To explore the relationship between teaching scientific methodology in Year 2 of the medical curriculum and student attitudes towards and knowledge about science and scientific methodology. Anonymous questionnaire survey developed for this purpose. Zagreb University School of Medicine, Croatia. A total of 932 students (response rate 58%) from all 6 years were invited to participate. Score on attitude scale with 45 Likert-type statements and score on knowledge test consisting of 8 multiple choice questions. The average attitude score for all students was 166 +/- 22 out of a maximum of 225, indicating a positive attitude towards science and scientific research. The students' average score on the knowledge test was 3.2 +/- 1.7 on 8 questions. Students who had finished Year 2 had the highest mean attitude (173 +/- 24) and knowledge (4.7 +/- 1.7) scores compared with other year groups (P < 0.001, anova and Tukey posthoc test). For students who had attended a mandatory Year 2 course on the principles of scientific research in medicine (Years 3 to 6), multiple linear regression analysis showed that knowledge test score (B = 3.4; SE = 0.4; 95% confidence interval 2.5-4.2; P < 0.001) and average grades (B = 7.6; SE = 1.5; 95% CI 4.6-10.6; P < 0.001) were significant predictors of attitude towards science, but not sex or failure to pass a year (B = - 0.6; SE = 1.7; 95% CI - 3.9-2.6; P = 0.707; and B = - 3.1; SE = 1.9; 95% CI - 6.8-5.7; P = 0.097, respectively). Medical students have generally positive attitudes towards science and scientific research in medicine. Attendance of a course on research methodology is related to a positive attitude towards science.

  16. 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.

  17. Prognostic value of the Rockall score in patients with acute nonvariceal bleeding from the upper gastrointestinal tract.

    PubMed

    Cieniawski, Dominik; Kuźniar, Ewelina; Winiarski, Marek; Matłok, Maciej; Kostarczyk, Wojciech; Pedziwiatr, Michał

    2013-01-01

    Non-variceal upper gastrointestinal bleeding (UGIB) is a common problem in everyday clinical practice. While treating patients affected by UGIB, the estimation of the risk of complications is very important. The Rockall Score is one of the methods used in clinical practice that allows doing that. The aim of this paper is to assess the usefulness of the aforementioned scoring system while treating patients with UGIB. The analysis included, 651 patients with nonvariceal UGIB. The average age of the group was 62.86+16.96 years. Each patient was subjected to the retrospective analysis according to the Rockall Scale's criteria. Then the entire group was divided into the complication risk groups according to the obtained amount of points (low<3, moderate 3 to 8, high>8). After dividing into groups the effort has been taken to find a relationship between Rockall Score points and the occurrences of individual complications. Mortality among the respondents amounted to 11.36%. The hospitalization of 97.70% patients with <3 points on the scale progressed without complications (p<0.001; X2=22.90). In the moderate risk group the highest frequency of re-bleeding and need for surgery were observed. Whereas among patients with >8 points the mortality of 78.95% was noted. Rockall Score is a simple and useful method for assessing prognosis for patients with the non-variceal UGIB. The highest scores are obtained by the patients with a great risk of demise. Rockall Score may be used for classifying patients to appropriate risk groups.

  18. Hospital management practices and availability of surgery in sub-Saharan Africa: a pilot study of three hospitals.

    PubMed

    Funk, Luke M; Conley, Dante M; Berry, William R; Gawande, Atul A

    2013-11-01

    Sub-Saharan Africa has a high surgical burden of disease but performs a disproportionately low volume of surgery. Closing this surgical gap will require increased surgical productivity of existing systems. We examined specific hospital management practices in three sub-Saharan African hospitals that are associated with surgical productivity and quality. We conducted 54 face-to-face, structured interviews with administrators, clinicians, and technicians at a teaching hospital, district hospital, and religious mission hospital across two countries in sub-Saharan Africa. Questions focused on recommended general management practices within five domains: goal setting, operations management, talent management, quality monitoring, and financial oversight. Records from each interview were analyzed in a qualitative fashion. Each hospital's management practices were scored according to the degree of implementation of the management practices (1 = none; 3 = some; 5 = systematic). The mission hospital had the highest number of employees per 100 beds (226), surgeons per operating room (3), and annual number of operations per operating room (1,800). None of the three hospitals had achieved systematic implementation of management practices in all 14 measures. The mission hospital had the highest total management score (44/70 points; average = 3.1 for each of the 14 measures). The teaching and district hospitals had statistically significantly lower management scores (average 1.3 and 1.1, respectively; p < .001). It is possible to meaningfully assess hospital management practices in low resource settings. We observed substantial variation in implementation of basic management practices at the three hospitals. Future research should focus on whether enhancing management practices can improve surgical capacity and outcomes.

  19. The Relationship among Health Education Systems, Inc. Progression and Exit Examination Scores, Day or Evening Enrollment, Final Grade Point Average and NCLEX-RN® Success in Associate Degree Nursing Students

    ERIC Educational Resources Information Center

    Barnwell-Sanders, Pamela

    2015-01-01

    Graduates of associate degree (AD) nursing programs form the largest segment of first-time National Council Licensure Examination for Registered Nurses (NCLEX-RN®) test takers, yet also experience the highest rate of NCLEX-RN® failures. NCLEX-RN® failure delays entry into the profession, adding an emotional and financial toll to the unsuccessful…

  20. The Big Improvement in PISA 2009 Reading Achievements in Serbia: Improvement of the Quality of Education or Something Else?

    ERIC Educational Resources Information Center

    Pavlovic Babic, Dragica; Baucal, Aleksandar

    2011-01-01

    The PISA 2009 results in Serbia show a big improvement in reading literacy compared to 2006 -- the average score is 41 points higher, which is equal to the effect of a whole year of schooling in OECD countries and represents the second highest improvement ever recorded in a PISA study. In the present paper, we discuss potential reasons for such a…

  1. The corneal transplant score: a simple corneal graft candidate calculator.

    PubMed

    Rosenfeld, Eldar; Varssano, David

    2013-07-01

    Shortage of corneas for transplantation has created long waiting lists in most countries. Transplant calculators are available for many organs. The purpose of this study is to describe a simple automatic scoring system for keratoplasty recipient candidates, based on several parameters that we consider most relevant for tissue allocation, and to compare the system's accuracy in predicting decisions made by a cornea specialist. Twenty pairs of candidate data were randomly created on an electronic spreadsheet. A single priority score was computed from the data of each candidate. A cornea surgeon and the automated system then decided independently which candidate in each pair should have surgery if only a single cornea was available. The scoring system can calculate values between 0 (lowest priority) and 18 (highest priority) for each candidate. Average score value in our randomly created cohort was 6.35 ± 2.38 (mean ± SD), range 1.28 to 10.76. Average score difference between the candidates in each pair was 3.12 ± 2.10, range 0.08 to 8.45. The manual scoring process, although theoretical, was mentally and emotionally demanding for the surgeon. Agreement was achieved between the human decision and the calculated value in 19 of 20 pairs. Disagreement was reached in the pair with the lowest score difference (0.08). With worldwide donor cornea shortage, waiting for transplantation can be long. Manual sorting of priority for transplantation in a long waiting list is difficult, time-consuming and prone to error. The suggested system may help achieve a justified distribution of available tissue.

  2. Does the MCAT predict medical school and PGY-1 performance?

    PubMed

    Saguil, Aaron; Dong, Ting; Gingerich, Robert J; Swygert, Kimberly; LaRochelle, Jeffrey S; Artino, Anthony R; Cruess, David F; Durning, Steven J

    2015-04-01

    The Medical College Admissions Test (MCAT) is a high-stakes test required for entry to most U. S. medical schools; admissions committees use this test to predict future accomplishment. Although there is evidence that the MCAT predicts success on multiple choice-based assessments, there is little information on whether the MCAT predicts clinical-based assessments of undergraduate and graduate medical education performance. This study looked at associations between the MCAT and medical school grade point average (GPA), Medical Licensing Examination (USMLE) scores, observed patient care encounters, and residency performance assessments. This study used data collected as part of the Long-Term Career Outcome Study to determine associations between MCAT scores, USMLE Step 1, Step 2 clinical knowledge and clinical skill, and Step 3 scores, Objective Structured Clinical Examination performance, medical school GPA, and PGY-1 program director (PD) assessment of physician performance for students graduating 2010 and 2011. MCAT data were available for all students, and the PGY PD evaluation response rate was 86.2% (N = 340). All permutations of MCAT scores (first, last, highest, average) were weakly associated with GPA, Step 2 clinical knowledge scores, and Step 3 scores. MCAT scores were weakly to moderately associated with Step 1 scores. MCAT scores were not significantly associated with Step 2 clinical skills Integrated Clinical Encounter and Communication and Interpersonal Skills subscores, Objective Structured Clinical Examination performance or PGY-1 PD evaluations. MCAT scores were weakly to moderately associated with assessments that rely on multiple choice testing. The association is somewhat stronger for assessments occurring earlier in medical school, such as USMLE Step 1. The MCAT was not able to predict assessments relying on direct clinical observation, nor was it able to predict PD assessment of PGY-1 performance. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

  3. Quality of life among Iranian refugees resettled in Sweden.

    PubMed

    Ghazinour, Mehdi; Richter, Jörg; Eisemann, Martin

    2004-04-01

    The relationships between quality of life, psychopathological manifestations and coping related variables (coping resources, social support, sense of coherence) were examined among individuals who have perceived several severe traumata. One hundred Iranian refugees resettled in Sweden have been investigated by the Symptom Checklist (SCL-90-R), the Beck Depression Inventory (BDI), the Coping Resources Inventory (CRI), and the Interview Schedule for Social Interaction (ISSI), the Sense of Coherence Scale (SOC), and the WHOQoL-100 questionnaire in a cross-sectional study. Individuals, traumatized by combat experiences as a soldier during the war, with low BDI scores showed on average the significantly highest overall quality of life, the best physical health, the highest scores according to the sense of coherence most pronounced for "Meaningfulness," and the best availability of social integration compared to participants who did not had these experiences in combats and those with the experience but scored high in the BDI. Quality of life, coping resources, and social support were found closely related to psychopathological manifestations. Motivational orientations (highly developed Meaningfulness-SOC) and various coping competencies probably enable some traumatized individuals to resist against several traumata and to live in a good quality of life without psychopathological disturbances.

  4. Differential Item Functioning of the Psychological Domain of the Menopause Rating Scale.

    PubMed

    Monterrosa-Castro, Alvaro; Portela-Buelvas, Katherin; Oviedo, Heidi C; Herazo, Edwin; Campo-Arias, Adalberto

    2016-01-01

    Introduction. Quality of life could be quantified with the Menopause Rating Scale (MRS), which evaluates the severity of somatic, psychological, and urogenital symptoms in menopause. However, differential item functioning (DIF) analysis has not been applied previously. Objective . To establish the DIF of the psychological domain of the MRS in Colombian women. Methods . 4,009 women aged between 40 and 59 years, who participated in the CAVIMEC (Calidad de Vida en la Menopausia y Etnias Colombianas) project, were included. Average age was 49.0 ± 5.9 years. Women were classified in mestizo, Afro-Colombian, and indigenous. The results were presented as averages and standard deviation ( X ± SD). A p value <0.001 was considered statistically significant. Results . In mestizo women, the highest X ± SD were obtained in physical and mental exhaustion (PME) (0.86 ± 0.93) and the lowest ones in anxiety (0.44 ± 0.79). In Afro-Colombian women, an average score of 0.99 ± 1.07 for PME and 0.63 ± 0.88 for anxiety was gotten. Indigenous women obtained an increased average score for PME (1.33 ± 0.93). The lowest score was evidenced in depressive mood (0.50 ± 0.81), which is different from other Colombian women ( p < 0.001). Conclusions . The psychological items of the MRS show differential functioning according to the ethnic group, which may induce systematic error in the measurement of the construct.

  5. Differential Item Functioning of the Psychological Domain of the Menopause Rating Scale

    PubMed Central

    Portela-Buelvas, Katherin; Oviedo, Heidi C.; Herazo, Edwin; Campo-Arias, Adalberto

    2016-01-01

    Introduction. Quality of life could be quantified with the Menopause Rating Scale (MRS), which evaluates the severity of somatic, psychological, and urogenital symptoms in menopause. However, differential item functioning (DIF) analysis has not been applied previously. Objective. To establish the DIF of the psychological domain of the MRS in Colombian women. Methods. 4,009 women aged between 40 and 59 years, who participated in the CAVIMEC (Calidad de Vida en la Menopausia y Etnias Colombianas) project, were included. Average age was 49.0 ± 5.9 years. Women were classified in mestizo, Afro-Colombian, and indigenous. The results were presented as averages and standard deviation (X ± SD). A p value <0.001 was considered statistically significant. Results. In mestizo women, the highest X ± SD were obtained in physical and mental exhaustion (PME) (0.86 ± 0.93) and the lowest ones in anxiety (0.44 ± 0.79). In Afro-Colombian women, an average score of 0.99 ± 1.07 for PME and 0.63 ± 0.88 for anxiety was gotten. Indigenous women obtained an increased average score for PME (1.33 ± 0.93). The lowest score was evidenced in depressive mood (0.50 ± 0.81), which is different from other Colombian women (p < 0.001). Conclusions. The psychological items of the MRS show differential functioning according to the ethnic group, which may induce systematic error in the measurement of the construct. PMID:27847825

  6. Region 9 - Social Vulnerability Index

    EPA Pesticide Factsheets

    The Social Vulnerability Index is derived from the 2000 US Census data. The fields included are percent minority, median household income, age (under 18 and over 64), population without a high school diploma, linguistically isolated households, and single female head of households with own children under 18 (single moms). The data is at the block group level. Each field for each block group is assigned an index score of 0-3, based on whether the value of that dataset falls in the top quartile (score=3), second quartile (score=2), third quartile (score=1), or bottom quartile (score=0). The scores for each field are then added together to assign a comprehensive score to each block group (0-21). The highest scores are block groups that have the highest percentage of sensitive populations (highest percent minority, lowest per capita income, highest percent of population under 18 and over 64, highest percentage of population without a high school degree, highest percent of linguistically isolated households, and highest percent of single female head of households). Zoe Heller of the US EPA Region 9's Communities and Ecosystems Division, is responsible for the design and development of the Social Vulnerability Index data set.

  7. Arizona - Social Vulnerability Index

    EPA Pesticide Factsheets

    The Social Vulnerability Index is derived from the 2000 US Census data. The fields included are percent minority, median household income, age (under 18 and over 64), population without a high school diploma, linguistically isolated households, and single female head of households with own children under 18 (single moms). The data is at the block group level. Each field for each block group is assigned an index score of 0-3, based on whether the value of that dataset falls in the top quartile (score=3), second quartile (score=2), third quartile (score=1), or bottom quartile (score=0). The scores for each field are then added together to assign a comprehensive score to each block group (0-21). The highest scores are block groups that have the highest percentage of sensitive populations (highest percent minority, lowest per capita income, highest percent of population under 18 and over 64, highest percentage of population without a high school degree, highest percent of linguistically isolated households, and highest percent of single female head of households). Zoe Heller of the US EPA Region 9's Communities and Ecosystems Division, is responsible for the design and development of the Social Vulnerability Index data set.

  8. Care Coordination Challenges Among High-Needs, High-Costs Older Adults in a Medigap Plan

    PubMed Central

    Wells, Timothy S.; Bhattarai, Gandhi R.; Hawkins, Kevin; Cheng, Yan; Ruiz, Joann; Barnowski, Cynthia A.; Spivack, Barney; Yeh, Charlotte S.

    2016-01-01

    Purpose of the Study: Many adults 65 years or older have high health care needs and costs. Here, we describe their care coordination challenges. Primary Practice Setting: Individuals with an AARP Medicare Supplement Insurance plan insured by UnitedHealthcare Insurance Company (for New York residents, UnitedHealthcare Insurance Company of New York). Methodology and Sample: The three groups included the highest needs, highest costs (the “highest group”), the high needs, high costs (the “high group”), and the “all other group.” Eligibility was determined by applying an internally developed algorithm based upon a number of criteria, including hierarchical condition category score, the Optum ImpactPro prospective risk score, as well as diagnoses of coronary artery disease, congestive heart failure, or diabetes. Results: The highest group comprised 2%, although consumed 12% of health care expenditures. The high group comprised 20% and consumed 46% of expenditures, whereas the all other group comprised 78% and consumed 42% of expenditures. On average, the highest group had $102,798 in yearly health care expenditures, compared with $34,610 and $7,634 for the high and all other groups, respectively. Fifty-seven percent of the highest group saw 16 or more different providers annually, compared with 21% and 2% of the high and all other groups, respectively. Finally, 28% of the highest group had prescriptions from at least seven different providers, compared with 20% and 5% of the high and all other groups, respectively. Implications for Case Management Practice: Individuals with high health care needs and costs have visits to numerous health care providers and receive multiple prescriptions for pharmacotherapy. As a result, these individuals can become overwhelmed trying to manage and coordinate their health care needs. Care coordination programs may help these individuals coordinate their care. PMID:27301064

  9. Care Coordination Challenges Among High-Needs, High-Costs Older Adults in a Medigap Plan.

    PubMed

    Wells, Timothy S; Bhattarai, Gandhi R; Hawkins, Kevin; Cheng, Yan; Ruiz, Joann; Barnowski, Cynthia A; Spivack, Barney; Yeh, Charlotte S

    Many adults 65 years or older have high health care needs and costs. Here, we describe their care coordination challenges. Individuals with an AARP Medicare Supplement Insurance plan insured by UnitedHealthcare Insurance Company (for New York residents, UnitedHealthcare Insurance Company of New York). The three groups included the highest needs, highest costs (the "highest group"), the high needs, high costs (the "high group"), and the "all other group." Eligibility was determined by applying an internally developed algorithm based upon a number of criteria, including hierarchical condition category score, the Optum ImpactPro prospective risk score, as well as diagnoses of coronary artery disease, congestive heart failure, or diabetes. The highest group comprised 2%, although consumed 12% of health care expenditures. The high group comprised 20% and consumed 46% of expenditures, whereas the all other group comprised 78% and consumed 42% of expenditures. On average, the highest group had $102,798 in yearly health care expenditures, compared with $34,610 and $7,634 for the high and all other groups, respectively. Fifty-seven percent of the highest group saw 16 or more different providers annually, compared with 21% and 2% of the high and all other groups, respectively. Finally, 28% of the highest group had prescriptions from at least seven different providers, compared with 20% and 5% of the high and all other groups, respectively. Individuals with high health care needs and costs have visits to numerous health care providers and receive multiple prescriptions for pharmacotherapy. As a result, these individuals can become overwhelmed trying to manage and coordinate their health care needs. Care coordination programs may help these individuals coordinate their care.

  10. The efficacy of the Eustachian Tube Dysfunction Questionnaire (ETDQ-7) for patulous Eustachian tube patient.

    PubMed

    Ikeda, Ryoukichi; Kikuchi, Toshiaki; Miyazaki, Hiromitsu; Hidaka, Hiroshi; Kawase, Tetsuaki; Katori, Yukio; Kobayashi, Toshimitsu

    2018-01-01

    To assess the efficacy of the Eustachian Tube Dysfunction Questionnaire (ETDQ-7) for patulous Eustachian tube (PET) patients. A prospective survey of medical records identified 36 patients and 47 ears with PET, and 15 patients and 15 ears as control. The ETDQ-7, patulous Eustachian tube handicap inventory-10 (PHI-10) and Likert scale were evaluated. PET patients were divided into two groups based on severity of symptoms using the PHI score. The Cronbach α value of the PET group was 0.765. The average total score of the ETDQ-7 in the control group was 7.6 ± 1.1 and 22.5 ± 10.0 in the PET group (p < .01). No correlation was found between ETDQ-7 and Likert scale (r = 0.248, p = .09). The average total score of the ETDQ-7 in the mild or moderate PET group was 19.9 ± 9.0 and 25.3 ± 11.1 in the severe PET group and this was not statistically different (p = .08). The highest ETDQ-7 score was also observed in PET patients and in ET dysfunction patients. These findings necessitate careful discrimination between ET dysfunction and PET in balloon dilation Eustachian tuboplasty (BET) based on ETDQ-7.

  11. SU-E-T-105: An FMEA Survey of Intensity Modulated Radiation Therapy (IMRT) Step and Shoot Dose Delivery Failure Modes

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

    Faught, J Tonigan; Johnson, J; Stingo, F

    2015-06-15

    Purpose: To assess the perception of TG-142 tolerance level dose delivery failures in IMRT and the application of FMEA process to this specific aspect of IMRT. Methods: An online survey was distributed to medical physicists worldwide that briefly described 11 different failure modes (FMs) covered by basic quality assurance in step- and-shoot IMRT at or near TG-142 tolerance criteria levels. For each FM, respondents estimated the worst case H&N patient percent dose error and FMEA scores for Occurrence, Detectability, and Severity. Demographic data was also collected. Results: 181 individual and three group responses were submitted. 84% were from North America.more » Most (76%) individual respondents performed at least 80% clinical work and 92% were nationally certified. Respondent medical physics experience ranged from 2.5–45 years (average 18 years). 52% of individual respondents were at least somewhat familiar with FMEA, while 17% were not familiar. Several IMRT techniques, treatment planning systems and linear accelerator manufacturers were represented. All FMs received widely varying scores ranging from 1–10 for occurrence, at least 1–9 for detectability, and at least 1–7 for severity. Ranking FMs by RPN scores also resulted in large variability, with each FM being ranked both most risky (1st ) and least risky (11th) by different respondents. On average MLC modeling had the highest RPN scores. Individual estimated percent dose errors and severity scores positively correlated (p<0.10) for each FM as expected. No universal correlations were found between the demographic information collected and scoring, percent dose errors, or ranking. Conclusion: FMs investigated overall were evaluated as low to medium risk, with average RPNs less than 110. The ranking of 11 FMs was not agreed upon by the community. Large variability in FMEA scoring may be caused by individual interpretation and/or experience, thus reflecting the subjective nature of the FMEA tool.« less

  12. Evaluation of the level of depression among medical students from Poland, Portugal and Germany.

    PubMed

    Seweryn, Mariusz; Tyrała, Kinga; Kolarczyk-Haczyk, Aleksandra; Bonk, Magdalena; Bulska, Weronika; Krysta, Krzysztof

    2015-09-01

    Depression is a serious illness affecting health, family and professional life of many people of all sectors of society. It also concerns students, regardless of their geographical location. The Beck Depression Inventory (BDI) is a proper tool to brief check of the level of depression because it has high correlation with depression. The aim of this study was to assess and compare the level of depression among medical students from Poland, Portugal and Germany. Students from different countries were asked to fill in an electronic form containing the BDI. The form was created separately for each country, using official translation of the BDI, approved by the competent psychiatric association. Google Drive software was used for the electronic form, and Stat soft Statistica v10 software for statistical analysis. There were statistically significant differences (p<0.05) in terms of average score of the BDI and of the proportion of the scores more than 10 points of medical and technology students among kinds of studies and countries. The average score of the BDI of medical students: Poland: 13.76±9.99 points; Germany: 8.49±7.64 points; Portugal: 7.37±7.67 points. The average score of the BDI of technology students: Poland: 12.42±9.66 points; Germany: 10.51±8.49 points; Portugal: 9.25±8.97 points. The proportion of the scores more than 10 points of medical students: Poland 56.32% (285/506) Germany 34.92% (154/441) Portugal 26.03% (82/315). The proportion of the scores more than 10 points of technology students: Poland 55.01% (368/669) Germany 43.82% (156/356) Portugal 37.57% (136/362). The highest depression score among medical and technology students according the BDI was found in Poland. A proper monitoring of depression is required, as well as rapid and appropriate help for those who suffer from it.

  13. Determinants of Quality of Life and the Need for Support for the Elderly with Good Physical and Mental Functioning.

    PubMed

    Talarska, Dorota; Tobis, Sławomir; Kotkowiak, Marta; Strugała, Magdalena; Stanisławska, Joanna; Wieczorowska-Tobis, Katarzyna

    2018-03-19

    BACKGROUND The ageing of population is the reason that there are various strategies developed to help seniors acquire greater independence and a better quality of life. The aim of this study was to explore the relationship between the elderly peope's need for assistance and assessed quality of life. MATERIAL AND METHODS The study included 100 participants who were members of a Seniors Club in Poznań, Poland. The cross-sectional study utilized the following instruments: Abbreviated Mental Test Score (AMTS), Instrumental Activities of Daily Living (IADL), EASY-Care Standard 2010 questionnaire, (WHO Quality of Life-BREF (WHOQOL-BREF) questionnaire. RESULTS Members of the Seniors' Club showed good functional condition. In the AMTS test, they scored near maximum values (average 9.39±0.77 points), somewhat poorer results were found in the IADL scale (average 20.92±3.96 points). In the EASY-Care questionnaire, the study participants usually required partial support in the following areas: Mental health and well-being (59%), Staying healthy (29%), Getting around (22%), and Seeing, hearing and communicating (22%). The average score on Independence was 13.13±18.51, The risk of breakdown in care scale was 4.39±3.21. The risk of falls affected 21 participants (21%). Quality of life study using WHOQOL-BREF questionnaire found that the highest scores were achieved in Psychological and Environment domains, and the lowest score in the Physical health domain. CONCLUSIONS Quality of life as well as level of independence, risk of falls, and need for 24-hour care were significantly affected by the following factors: urinary incontinence, difficulties in mobility outside the home, despondency, and forgetfulness.

  14. Multilevel modeling and panel data analysis in educational research (Case study: National examination data senior high school in West Java)

    NASA Astrophysics Data System (ADS)

    Zulvia, Pepi; Kurnia, Anang; Soleh, Agus M.

    2017-03-01

    Individual and environment are a hierarchical structure consist of units grouped at different levels. Hierarchical data structures are analyzed based on several levels, with the lowest level nested in the highest level. This modeling is commonly call multilevel modeling. Multilevel modeling is widely used in education research, for example, the average score of National Examination (UN). While in Indonesia UN for high school student is divided into natural science and social science. The purpose of this research is to develop multilevel and panel data modeling using linear mixed model on educational data. The first step is data exploration and identification relationships between independent and dependent variable by checking correlation coefficient and variance inflation factor (VIF). Furthermore, we use a simple model approach with highest level of the hierarchy (level-2) is regency/city while school is the lowest of hierarchy (level-1). The best model was determined by comparing goodness-of-fit and checking assumption from residual plots and predictions for each model. Our finding that for natural science and social science, the regression with random effects of regency/city and fixed effects of the time i.e multilevel model has better performance than the linear mixed model in explaining the variability of the dependent variable, which is the average scores of UN.

  15. Inclusion of Highest Glasgow Coma Scale Motor Component Score in Mortality Risk Adjustment for Benchmarking of Trauma Center Performance.

    PubMed

    Gomez, David; Byrne, James P; Alali, Aziz S; Xiong, Wei; Hoeft, Chris; Neal, Melanie; Subacius, Harris; Nathens, Avery B

    2017-12-01

    The Glasgow Coma Scale (GCS) is the most widely used measure of traumatic brain injury (TBI) severity. Currently, the arrival GCS motor component (mGCS) score is used in risk-adjustment models for external benchmarking of mortality. However, there is evidence that the highest mGCS score in the first 24 hours after injury might be a better predictor of death. Our objective was to evaluate the impact of including the highest mGCS score on the performance of risk-adjustment models and subsequent external benchmarking results. Data were derived from the Trauma Quality Improvement Program analytic dataset (January 2014 through March 2015) and were limited to the severe TBI cohort (16 years or older, isolated head injury, GCS ≤8). Risk-adjustment models were created that varied in the mGCS covariates only (initial score, highest score, or both initial and highest mGCS scores). Model performance and fit, as well as external benchmarking results, were compared. There were 6,553 patients with severe TBI across 231 trauma centers included. Initial and highest mGCS scores were different in 47% of patients (n = 3,097). Model performance and fit improved when both initial and highest mGCS scores were included, as evidenced by improved C-statistic, Akaike Information Criterion, and adjusted R-squared values. Three-quarters of centers changed their adjusted odds ratio decile, 2.6% of centers changed outlier status, and 45% of centers exhibited a ≥0.5-SD change in the odds ratio of death after including highest mGCS score in the model. This study supports the concept that additional clinical information has the potential to not only improve the performance of current risk-adjustment models, but can also have a meaningful impact on external benchmarking strategies. Highest mGCS score is a good potential candidate for inclusion in additional models. Copyright © 2017 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  16. An interventional program for nursing staff on selected mass gathering infectious diseases at Hajj.

    PubMed

    El-Bahnasawy, Mamdouh M; Elmeniawy, Nagwa Zein El Abdeen A; Morsy, Tosson A

    2014-08-01

    This work improved military nursing staff knowledge on selected mass gathering infectious diseases at Hajj. The results showed that only (20%) of the participating nurses attended training program about health hazard during pilgrim. But only (40.0%) of them found the training programs were specific to nurses. Majority found the program useful (70.0%), and the average duration of this training program in weeks was 3.5+1.1. There was significant improvement P = < 0.001, of correct knowledge about meningitis regarding causes, organisms, mode of spread, people at risk, transmission, prevention and treatment, the highest improvement was in causes of meningitis the lowest was in adult vaccination. 25% of participants had adequate knowledge (> 60% from total score) in pre-test 93% in post-test 72% after 3 month with significant difference among tests regarding adequate knowledge. There was significant improvement of correct knowledge P = <0.001 about seasonal influenza and respiratory diseases during pilgrim, the highest improvement was in influenza vaccine strains the lowest was in antiviral drugs. 23% of nurses had adequate knowledge (> 60% from total score) in pre-test 94% in post-test 66% after 3 month with significant difference among tests regarding adequate knowledge. There was significant improvement P = < 0.001 of correct knowledge about gastrointestinal diseases and food poisoning during pilgrim among nurses at military hospital, the highest improvement was in risk factors of food poisoning the lowest was in what GE patient should do. 22% of participants had adequate knowledge (> 60% from total score) in pre-test 91% in post-test 58% after 3 month with significant difference among tests regarding adequate knowledge. There was significant improvement P = < 0.001 of correct knowledge about heat exhaustion during pilgrim among nurses at military hospital, the highest improvement was in non-communicable diseases the lowest was in sun stroke prevention. 27% of participant had adequate knowledge (> 60% from total score) in the pre-test 94% in the post-test 74% after 3 month with significant difference among pre, post and FU regarding adequate knowledge. Also, there were significant improvement P = < 0.001 of correct knowledge about hypertension, dengue fever, skin scalding & others diseases during pilgrim among nurses at military hospital, the highest improvement was in skin scalding prevention the lowest was in first aid bag. 28% of participant had adequate knowledge (> 60% from total score) in the pre-test 92% in the post-test 61% after 3 month with significant difference among pre, post and FU regarding adequate knowledge. There was a significant difference between total knowledge score according to education, and work experience (P > 0.05). in the pre, post and after 3 month in age and in all intervention time in department the highest was ICU then ward then operation room.

  17. Patient safety culture perceptions in the college of dentistry

    PubMed Central

    Al Sweleh, Fahad Saleh; Al Saedan, Abdullah Mohammed; Al Dayel, Omar Abdullah

    2018-01-01

    Abstract A positive safety culture is essential to patient safety because it improves quality of care. The aim of this study was to assess staff and student perceptions of the patient safety culture in the clinics of the College of Dentistry at King Saud University in Saudi Arabia. A cross-sectional study was conducted in the College of Dentistry at King Saud University in Saudi Arabia. It included 4th and 5th year students, interns, general practitioners, and dental assistants. The data were collected by using paper-based questionnaire of modified version of the Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture. Data were entered into SPSS Version 20. Score on a particular safety culture dimension was calculated. The overall response rate was 72.8% (390/536). Team work dimension had the highest average percent positive dimension score (72.3%) while staffing had the lowest score (10%). Dental assistant had high agreement in Teamwork dimension (87.8%); Supervisor/Manager Expectations and Actions Promoting Patient Safety dimension (66.9%); Organizational Learning—Continuous Improvement dimension (79.1%); Management Support for Patient Safety dimension (84.5%); Feedback and Communication About Error dimension (58.3%); Frequency of Events Reported dimension (54.0%); Teamwork Across Units dimension (73.2%). Most of areas perceived that there is no event reported (76.1-85.3%) in the past 12 months. Overall patient safety grade is more than moderate in the clinic. Teamwork within Units and Organizational Learning—Continuous Improvement dimension had the highest score while staffing had the lowest score. Dental assistants perceived positive score in most dimensions while students perceived slight negative score in most dimensions. PMID:29480849

  18. Student assessment by objective structured examination in a neurology clerkship

    PubMed Central

    Adesoye, Taiwo; Smith, Sandy; Blood, Angela; Brorson, James R.

    2012-01-01

    Objectives: We evaluated the reliability and predictive ability of an objective structured clinical examination (OSCE) in the assessment of medical students at the completion of a neurology clerkship. Methods: We analyzed data from 195 third-year medical students who took the OSCE. For each student, the OSCE consisted of 2 standardized patient encounters. The scores obtained from each encounter were compared. Faculty clinical evaluations of each student for 2 clinical inpatient rotations were also compared. Hierarchical regression analysis was applied to test the ability of the averaged OSCE scores to predict standardized written examination scores and composite clinical scores. Results: Students' OSCE scores from the 2 standardized patient encounters were significantly correlated with each other (r = 0.347, p < 0.001), and the scores for all students were normally distributed. In contrast, students' faculty clinical evaluation scores from 2 different clinical inpatient rotations were uncorrelated, and scores were skewed toward the highest ratings. After accounting for clerkship order, better OSCE scores were predictive of better National Board of Medical Examiners standardized examination scores (R2Δ = 0.131, p < 0.001) and of better faculty clinical scores (R2Δ = 0.078, p < 0.001). Conclusions: Student assessment by an OSCE provides a reliable and predictive objective assessment of clinical performance in a neurology clerkship. PMID:22855865

  19. Improving Anatomic Pathology in Sub-Saharan Africa to Support Cancer Care.

    PubMed

    Wilson, Michael L; Ayers, Stephanie; Berney, Daniel; Eslan, Alexia; Guarner, Jeannette; Lester, Susan; Masia, Ricard; Moloo, Zahir; Mutuku, Angela; Roberts, Drucilla; Stall, Jennifer; Sayed, Shahin

    2018-03-07

    Cancer care requires both accurate pathologic diagnosis as well as pathologic cancer staging. We evaluated three approaches to training pathologists in sub-Saharan Africa to perform pathologic cancer staging of breast, cervix, prostate, and colorectal cancers. One of three training methods was used at each workshop: didactic, case-based testing (CBT), or a blended approach. The project involved 52 participants from 16 pathology departments in 11 countries in East, Central, and Southern Africa. Evaluation of each method included pre- and postworkshop knowledge assessments, online pre- and postworkshop surveys of practice changes at the individual and institutional levels, and selected site visits. While CBT resulted in the highest overall average postassessment individual scores, both CBT and blended approaches resulted in 19% increases in average scores from pre- to postworkshop assessments. Institutions that participated in the blended workshop had increased changes in practice as indicated by the institutional survey. Both CBT and a blended approach are effective methods for training pathologists in pathologic cancer staging. Both are superior to traditional lectures alone.

  20. Prehospital severity scoring at major rock concert events.

    PubMed

    Erickson, T B; Koenigsberg, M; Bunney, E B; Schurgin, B; Levy, P; Willens, J; Tanner, L

    1997-01-01

    Rock and contemporary music concerts are popular, recurrent events requiring on-site medical staffing. To describe a novel severity score used to stratify the level of acuity of patients presenting to first-aid stations at these events. Retrospective review of charts generated at the first-aid stations of five major rock concerts within a 60,000 spectator capacity, outdoor, professional sports stadium. Participants included all concert patrons presenting to the stadium's first-aid stations as patients. Data were collected on patient demographics, history of drug or ethanol usage while at the concert event, first-aid station time, treatment rendered, diagnosis, and disposition. All patients evaluated were retrospectively assigned a "DRUG-ROCK" Injury Severity Score (DRISS) to stratify their level of acuity. Individual concert events and patient dispositions were compared statistically using chi-square, Fisher's exact, and the ANOVA Mean tests. Approximately 250,000 spectators attended the five concert events. First-aid stations evaluated 308 patients (utilization rate of 1.2 per 1,000 patrons). The most common diagnosis was minor trauma (130; 42%), followed in frequency by ethanol/illicit drug intoxication (98; 32%). The average time in the first-aid station was 23.5 +/- 22.5 minutes (+/- standard deviation; range: 5-150 minutes). Disposition of patients included 100 (32.5%) who were treated and released; 98 (32%) were transported by paramedics to emergency departments (EDs); and 110 (35.5%) signed-out against medical advise (AMA), refusing transport. The mean DRISS was 4.1 (+/- 2.65). Two-thirds (67%) of the study population were ranked as mild by DRISS criteria (score = 1-4), with 27% rated as moderate (score = 5-9), and 6% severe (score > 10). The average of severity scores was highest (6.5) for patients transported to hospitals, and statistically different from the scores of the average of the treated and released and AMA groups (p < 0.005). The DRISS was useful in stratifying the acuity level of this patient population. This severity score may serve as a potential triage mechanism for future mass gatherings such as rock concerts.

  1. Treatment Complexity in Cystic Fibrosis: Trends over Time and Associations with Site-Specific Outcomes

    PubMed Central

    Sawicki, Gregory S.; Ren, Clement L.; Konstan, Michael W.; Millar, Stefanie J.; Pasta, David J.; Quittner, Alexandra L.

    2014-01-01

    Background Patients with cystic fibrosis (CF) have increasing treatment complexity and high treatment burden. We describe trends in treatment complexity and evaluate its relationship with health outcomes. Methods Using Epidemiologic Study of Cystic Fibrosis (ESCF) data, we developed a treatment complexity score (TCS) from 37 chronic therapies and assessed change by age group (6–13, 14–17, and 18+ years) over a three year period. Differences in average site TCS were evaluated by quartiles based on FEV1, BMI, or Treatment Burden score on the Cystic Fibrosis Questionnaire-Revised (CFQ-R). Results TCS scores were calculated for 7252 individual patients (42% child, 16% adolescent, 43% adult) across 153 sites. In 2003, mean TCS was 11.1 for children, 11.8 for adolescents, and 12.1 for adults. In all 3 age groups, TCS increased over 3 years; the increase in TCS from 2003–2005 for children was 1.25 (95% CI 1.16–1.34), for adolescents 0.77 (0.62–0.93), and for adults 1.20 (1.08–1.31) (all p<0.001 for trend over time). At the site level, there were no significant differences in mean TCS based on FEV1 quartile. Mean TCS was higher in the highest BMI z-score quartile. Across all 3 versions of the CFQ-R, mean TCS was lower at sites in the highest quartiles (lowest burden) for CFQ-R Treatment Burden scores. Conclusion Treatment complexity was highest among adults with CF, although over 3 years, we observed a significant increase in treatment complexity in all age groups. Such increases in treatment complexity pose a challenge to patient self-management and adherence. Future research is needed to understand the associations between treatment complexity and subsequent health outcomes to reduce treatment burden and improve disease management. PMID:23352205

  2. Healthy Snacks: Using Nutrient Profiling to Evaluate the Nutrient-Density of Common Snacks in the United States.

    PubMed

    Hess, Julie M; Slavin, Joanne L

    2017-09-01

    To quantify and compare the nutrient-density of commonly consumed snacks using two nutrient-density measures, Nutrient Rich Foods Indices 9.3 (NRF 9.3) and 15.3 (NRF 15.3). Identify commonly consumed categories of snacks and individual snack foods, calculate NRF 9.3 and 15.3 scores, rank snacks by category and by individual food based on nutrient density, compare and contrast scores generated by the two NRF Indices. NRF 9.3 and 15.3 scores. Averages and standard deviations of nutrient-density scores for each snack category. Vegetables and coffee/tea received the highest category scores on both indices. Cakes/cookies/pastries and sweets had the lowest category scores. NRF 9.3 scores for individual snacks ranged from -46 (soda) to 524 (coffee). NRF 15.3 scores ranged from -45 (soda) to 736 (coffee). If added to food labels, NRF scores could help consumers identify more nutritious choices. The differences between NRF 9.3 and 15.3 scores generated for the same foods and the limitations of these indices highlight the need for careful consideration of which nutrient-density measure to include on food labels as well as consumer education. © 2017 Institute of Food Technologists®.

  3. Assessment of the Effectiveness of Protected Areas Management in Iran: Case Study in Khojir National Park

    NASA Astrophysics Data System (ADS)

    Kolahi, Mahdi; Sakai, Tetsuro; Moriya, Kazuyuki; Makhdoum, Majid F.; Koyama, Lina

    2013-08-01

    The requirement to assess the management effectiveness (ME) in protected areas (PAs) is increasing around the world to help improve management and accountability. An evaluation of ME for Khojir National Park (KNP), one of the Iran's oldest PAs, was conducted using a multi-method approach that consisted of structured interviews, open interviews, and site visits. This was the first ME evaluation in Iran. The structured interview was based on the management effectiveness tracking tool methodology. KNP received an average score of 43 %, which is lower than the global average, illustrating that its general management was in the low-intermediate level. The indices of legal status, resource inventory, planning for land and water use, regulations, and objectives received the highest average scores, whereas education and awareness, community co-management, regular work plan, boundary demarcation, visitor facilities, budget sources, staff training, protection systems, and management plan received the lowest ones. The management system of KNP was generally established, but many problems of the management still need to be resolved. To improve ME, some countermeasures should be taken, such as increasing funding, strengthening capacity building, planning, and adaptive management, and implementing community participation.

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

    Li, B; Fujita, A; Buch, K

    Purpose: To investigate the correlation between texture analysis-based model observer and human observer in the task of diagnosis of ischemic infarct in non-contrast head CT of adults. Methods: Non-contrast head CTs of five patients (2 M, 3 F; 58–83 y) with ischemic infarcts were retro-reconstructed using FBP and Adaptive Statistical Iterative Reconstruction (ASIR) of various levels (10–100%). Six neuro -radiologists reviewed each image and scored image quality for diagnosing acute infarcts by a 9-point Likert scale in a blinded test. These scores were averaged across the observers to produce the average human observer responses. The chief neuro-radiologist placed multiple ROIsmore » over the infarcts. These ROIs were entered into a texture analysis software package. Forty-two features per image, including 11 GLRL, 5 GLCM, 4 GLGM, 9 Laws, and 13 2-D features, were computed and averaged over the images per dataset. The Fisher-coefficient (ratio of between-class variance to in-class variance) was calculated for each feature to identify the most discriminating features from each matrix that separate the different confidence scores most efficiently. The 15 features with the highest Fisher -coefficient were entered into linear multivariate regression for iterative modeling. Results: Multivariate regression analysis resulted in the best prediction model of the confidence scores after three iterations (df=11, F=11.7, p-value<0.0001). The model predicted scores and human observers were highly correlated (R=0.88, R-sq=0.77). The root-mean-square and maximal residual were 0.21 and 0.44, respectively. The residual scatter plot appeared random, symmetric, and unbiased. Conclusion: For diagnosis of ischemic infarct in non-contrast head CT in adults, the predicted image quality scores from texture analysis-based model observer was highly correlated with that of human observers for various noise levels. Texture-based model observer can characterize image quality of low contrast, subtle texture changes in addition to human observers.« less

  5. Fractures of the talus: experience of two level 1 trauma centers.

    PubMed

    Elgafy, H; Ebraheim, N A; Tile, M; Stephen, D; Kase, J

    2000-12-01

    Fifty-eight patients with 60 talar fractures were retrospectively reviewed. There were 39 men and 19 women. The age average was 32 (range, 14-74). Eighty six percent of the patients had multiple injuries. The most common mechanism of injury was a motor vehicle accident. Twenty-seven (45%) of the fractures were neck, 22 (36.7%) process, and 11 (18.3%) body. Forty-eight fractures had operative treatment and 12 had non-operative management. The average follow-up period was 30 months (range, 24-65). Thirty-two fractures (53.3%) developed subtalar arthritis. Two patients had subsequent subtalar fusion. Fifteen fractures (25%) developed ankle arthritis. None of these patients required ankle fusion. Fractures of the body of the talus were associated with the highest incidence of degenerative joint disease of both the subtalar and ankle joints. Ten fractures (16.6%) developed avascular necrosis (AVN), only one of which had subsequent slight collapse. Avascular necrosis occurred mostly after Hawkins Type 3 and 2 fractures of the talar neck. Three rating scores were used in this series to assess the outcome: the American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score, Maryland Foot Score, and Hawkins Evaluation Criteria. The outcome was different with every rating system. However, the outcome with AOFAS Ankle-Hindfoot Score and Hawkins Evaluation Criteria were almost equivalent. Assessment with the three rating scores showed that the process fractures had the best results followed by the neck and then the body fractures.

  6. Fatigue and pain related to internet usage among university students.

    PubMed

    Dol, Kim Sang

    2016-04-01

    [Purpose] This study was performed to assess fatigue and pain levels related to internet usage among university students. The dominant regions of fatigue and pain in the body were examined, as well as differences in fatigue and pain levels among students. [Subjects and Methods] The study used a descriptive survey and a convenience sample of 378 students from a single university. The data were collected from January 1 to June 31, 2015. Fatigue and pain levels were measured using a visual analog scale. [Results] The average reported by the participants 4.7 and 3.7 levels of fatigue and pain, respectively. The regions with the highest fatigue scores were the eyes, followed by the neck, and shoulders. The regions with the highest pain scores were the neck, followed by the shoulders, and the waist. The results show that participants' fatigue and pain levels depended on the duration of their internet use per day. [Conclusion] These findings indicate that control of internet usage time is needed to maintain the well-being of university students who use the internet.

  7. Multisource feedback analysis of pediatric outpatient teaching

    PubMed Central

    2013-01-01

    Background This study aims to evaluate the outpatient communication skills of medical students via multisource feedback, which may be useful to map future directions in improving physician-patient communication. Methods Family respondents of patients, a nurse, a clinical teacher, and a research assistant evaluated video-recorded medical students’ interactions with outpatients by using multisource feedback questionnaires; students also assessed their own skills. The questionnaire was answered based on the video-recorded interactions between outpatients and the medical students. Results A total of 60 family respondents of the 60 patients completed the questionnaires, 58 (96.7%) of them agreed with the video recording. Two reasons for reluctance were “personal privacy” issues and “simply disagree” with the video recording. The average satisfaction score of the 58 students was 85.1 points, indicating students’ performance was in the category between satisfied and very satisfied. The family respondents were most satisfied with the “teacher”s attitude,“ followed by ”teaching quality”. In contrast, the family respondents were least satisfied with “being open to questions”. Among the 6 assessment domains of communication skills, the students scored highest on “explaining” and lowest on “giving recommendations”. In the detailed assessment by family respondents, the students scored lowest on “asking about life/school burden”. In the multisource analysis, the nurses’ mean score was much higher and the students’ mean self-assessment score was lower than the average scores on all domains. Conclusion The willingness and satisfaction of family respondents were high in this study. Students scored the lowest on giving recommendations to patients. Multisource feedback with video recording is useful in providing more accurate evaluation of students’ communication competence and in identifying the areas of communication that require enhancement. PMID:24180615

  8. Comparison of the RTS and ISS scores on prediction of survival chances in multiple trauma patients.

    PubMed

    Akhavan Akbari, G; Mohammadian, A

    2012-01-01

    Trauma represents the third cause of death after cardio vascular disease and tumors. Also in Iran, road accidents are one of the leading causes of death. Rapid evaluation of trauma severity and prediction of prognosis and mortality rate and probability of survival and rapid treatment of patients is necessary. One of the useful instruments for this is ISS and RTS scoring systems. This study evaluated 70 multi trauma patients in Fatemi trauma center affiliated to Ardabil University of medical science. This study was prospective study populations were 70 trauma patients admitted in Fatemi trauma center. During the II month, and patients data was collected by clinical evaluating of patients and follow up them and arranged as a questionnaire then related findings were evaluated by SPSS software. The average age of patients was 37.6±23.5 years and minimum and maximum age was 1 and 85 years. The most common involved group was 10-19 years (13 men and 1 woman). 81.4% of patients (57 cases were male) and 18.6% were female (13 cases). The most common causes of trauma was car accident with 64.2% frequency (43 cases) and then motorcycle accident with 16.4% frequency (11 cases) and all injured patient due to motorcycle accident compose the age group less than 40 years old. Also car accident had the highest frequency in both gender. Other causes of trauma were fall down with 13.5% frequency (9 cases) and under debris 5.9% (4 cases). Also from 70 studied patients, 67 cases (95.7%) had blunt trauma and 3 cases (4.3%) had penetrating trauma. The most penetrating trauma occurs in ages less than 50 years and was in the range of 30-50 years. The average RTS and ISS was 10.67±1.45 and 18.11±8.64, high and low scores of ISS existed in all age groups but a low score of RTS was highest in the children age group. The average length of ICU stay was 12.14±11.11 days. Overall mortality was 15.7 (11 cases). In this study, by the ISS increasing, the mortality rate also increased. But there is no relation between the mortality rate and RTS ratio. The ISS scoring system performed better than the RTS in predicting of mortality and probability of survival and the length of ICU stay and had high accuracy and can predict patients' outcome better by ISS measuring.

  9. Community Knowledge and Experience of Mosquitoes and Personal Prevention and Control Practices in Lhasa, Tibet

    PubMed Central

    Liu, Xiaobo; Wan, Fangjun; Cirendunzhu; Cirenwangla; Bai, Li; Pengcuociren; Zhou, Lin; Baimaciwang; Guo, Yuhong; Dazhen; Xu, Junfang; Sang, Shaowei; Li, Xiaolu; Gu, Shaohua; Wu, Haixia; Wang, Jun; Dawa; Xiraoruodeng; Liu, Qiyong

    2014-01-01

    Since 2009, great public attention has been paid in Lhasa City (Tibet, China) to mosquito bites and accompanying inflammatory complications. However, the potential contribution of knowledge levels, experiences, disease control and preventive practices (KEP) towards mosquitoes has not received much attention. To investigate community KEP concerning mosquitoes in Lhasa, a cross-sectional survey was undertaken in four sub-districts of urban Lhasa in 2012. Questionnaires were designed to collect information regarding socio-demographics and KEP concerning the harmful effects of mosquitoes on participants. The scoring for KEP was developed after consultation of literature. A total of 591 eligible questionnaires were examined. The majority of respondents were female (61.8%) with a mean age of 46 years. Nearly all of the respondents were of Tibetan nationality (97.4%) and living in registered native households (92.7%), who have less than primary school education. The averages of overall score, knowledge score, experience score, and practice score were 9.23, 4.53, 1.80, 2.90, respectively. The registered household with the highest overall score, knowledge score and practice score was non-native. Female subjects with monthly incomes between 1000 and 3000 RMB had higher experience scores. The correlation analysis revealed that significant positive linear correlations existed between knowledge and experience, knowledge and practices, and experience and practices towards mosquitoes. Past experiences with mosquitoes can result in a better knowledge of effective mosquito control practices in the present and the future. Though the average of overall scores related to mosquitoes is high among the participants in Lhasa, however, the knowledge about the ecological habits of mosquitoes should be strengthened. The findings in this study may help to develop strategies and measures of mosquito and mosquito-borne diseases in the future, not only in Lhasa, but also in similar altitude, latitude and longitude regions worldwide. PMID:25250847

  10. Community knowledge and experience of mosquitoes and personal prevention and control practices in Lhasa, Tibet.

    PubMed

    Liu, Xiaobo; Wan, Fangjun; Cirendunzhu; Cirenwangla; Bai, Li; Pengcuociren; Zhou, Lin; Baimaciwang; Guo, Yuhong; Dazhen; Xu, Junfang; Sang, Shaowei; Li, Xiaolu; Gu, Shaohua; Wu, Haixia; Wang, Jun; Dawa; Xiraoruodeng; Liu, Qiyong

    2014-09-23

    Since 2009, great public attention has been paid in Lhasa City (Tibet, China) to mosquito bites and accompanying inflammatory complications. However, the potential contribution of knowledge levels, experiences, disease control and preventive practices (KEP) towards mosquitoes has not received much attention. To investigate community KEP concerning mosquitoes in Lhasa, a cross-sectional survey was undertaken in four sub-districts of urban Lhasa in 2012. Questionnaires were designed to collect information regarding socio-demographics and KEP concerning the harmful effects of mosquitoes on participants. The scoring for KEP was developed after consultation of literature. A total of 591 eligible questionnaires were examined. The majority of respondents were female (61.8%) with a mean age of 46 years. Nearly all of the respondents were of Tibetan nationality (97.4%) and living in registered native households (92.7%), who have less than primary school education. The averages of overall score, knowledge score, experience score, and practice score were 9.23, 4.53, 1.80, 2.90, respectively. The registered household with the highest overall score, knowledge score and practice score was non-native. Female subjects with monthly incomes between 1000 and 3000 RMB had higher experience scores. The correlation analysis revealed that significant positive linear correlations existed between knowledge and experience, knowledge and practices, and experience and practices towards mosquitoes. Past experiences with mosquitoes can result in a better knowledge of effective mosquito control practices in the present and the future. Though the average of overall scores related to mosquitoes is high among the participants in Lhasa, however, the knowledge about the ecological habits of mosquitoes should be strengthened. The findings in this study may help to develop strategies and measures of mosquito and mosquito-borne diseases in the future, not only in Lhasa, but also in similar altitude, latitude and longitude regions worldwide.

  11. Prenatal Exposure to Organophosphate Pesticides and IQ in 7-Year-Old Children

    PubMed Central

    Bouchard, Maryse F.; Chevrier, Jonathan; Harley, Kim G.; Kogut, Katherine; Vedar, Michelle; Calderon, Norma; Trujillo, Celina; Johnson, Caroline; Bradman, Asa; Barr, Dana Boyd

    2011-01-01

    Context: Organophosphate (OP) pesticides are neurotoxic at high doses. Few studies have examined whether chronic exposure at lower levels could adversely affect children’s cognitive development. Objective: We examined associations between prenatal and postnatal exposure to OP pesticides and cognitive abilities in school-age children. Methods: We conducted a birth cohort study (Center for the Health Assessment of Mothers and Children of Salinas study) among predominantly Latino farmworker families from an agricultural community in California. We assessed exposure to OP pesticides by measuring dialkyl phosphate (DAP) metabolites in urine collected during pregnancy and from children at 6 months and 1, 2, 3.5, and 5 years of age. We administered the Wechsler Intelligence Scale for Children, 4th edition, to 329 children 7 years of age. Analyses were adjusted for maternal education and intelligence, Home Observation for Measurement of the Environment score, and language of cognitive assessment. Results: Urinary DAP concentrations measured during the first and second half of pregnancy had similar relations to cognitive scores, so we used the average of concentrations measured during pregnancy in further analyses. Averaged maternal DAP concentrations were associated with poorer scores for Working Memory, Processing Speed, Verbal Comprehension, Perceptual Reasoning, and Full-Scale intelligence quotient (IQ). Children in the highest quintile of maternal DAP concentrations had an average deficit of 7.0 IQ points compared with those in the lowest quintile. However, children’s urinary DAP concentrations were not consistently associated with cognitive scores. Conclusions: Prenatal but not postnatal urinary DAP concentrations were associated with poorer intellectual development in 7-year-old children. Maternal urinary DAP concentrations in the present study were higher but nonetheless within the range of levels measured in the general U.S. population. PMID:21507776

  12. Data inconsistencies from states with unconventional oil and gas activity.

    PubMed

    Malone, Samantha; Kelso, Matthew; Auch, Ted; Edelstein, Karen; Ferrar, Kyle; Jalbert, Kirk

    2015-01-01

    The quality and availability of unconventional oil and gas (O&G) data in the United States have never been compared methodically state-to-state. By conducting such an assessment, this study seeks to better understand private and publicly sourced data variability and to identify data availability gaps. We developed an exploratory data-grading tool - Data Accessibility and Usability Index (DAUI) - to guide the review of O&G data quality. Between July and October 2013, we requested, collected, and assessed 5 categories of unconventional O&G data (wells drilled, violations, production, waste, and Class II disposal wells) from 10 states with active drilling activity. We based our assessment on eight data quality parameters (accessibility, usability, point location, completeness, metadata, agency responsiveness, accuracy, and cost). Using the DAUI, two authors graded the 10 states and then averaged their scores. The average score received across all states, data categories, and parameters was 67.1 out of 100, largely insufficient for proper data transparency. By state, Pennsylvania received the highest average ( = 93.5) and ranked first in all but one data category. The lowest scoring state was Texas ( = 44) largely due to its policy of charging for certain data. This article discusses the various reasons for scores received, as well as methodological limitations of the assessment metrics. We argue that the significant variability of unconventional O&G data-and its availability to the public-is a barrier to regulatory and industry transparency. The lack of transparency also impacts public education and broader participation in industry governance. This study supports the need to develop a set of data best management practices (BMPs) for state regulatory agencies and the O&G industry, and suggests potential BMPs for this purpose.

  13. Assessment of the effectiveness of physical activity interventions in the Brazilian Unified Health System

    PubMed Central

    Ribeiro, Evelyn Helena Corgosinho; Garcia, Leandro Martin Totaro; Salvador, Emanuel Péricles; Costa, Evelyn Fabiana; Andrade, Douglas Roque; Latorre, Maria do Rosario Dias de Oliveira; Florindo, Alex Antonio

    2017-01-01

    ABSTRACT OBJECTIVE To assess the effect of interventions on the levels of physical activity of healthy adults, users of the Brazilian Unified Health System and attended by the Family Health Strategy. METHODS Non-randomized experimental study with 157 adults allocated in three groups: 1) physical exercise classes (n = 54), 2) health education (n = 54), 3) control (n = 49). The study lasted for18 months, with 12 months of interventions and six months of follow-up after intervention. Assessments took place at the beginning, in the 12 months, and in the 18 months of study. Physical activity has been assessed by questionnaires and accelerometry. For the analyses, we have used the intention-to-treat principle and generalized estimating equations. RESULTS After 12 months, both intervention groups have increased the minutes of weekly leisure time physical activity and annual scores of physical exercise, leisure and transport-related physical activity. The exercise class group has obtained the highest average annual physical exercises score when compared to the other groups (p < 0.001). In the follow-up period, the exercise class group reduced its annual score (average: -0.3; 95%CI -0.5–-0.1), while the health education group increased this score (average: 0.2; 95%CI 0.1–0.4). There have been no differences in the levels of physical activity measured by accelerometry. CONCLUSIONS The interventions have been effective in increasing the practice of physical activity. However, we have observed that the health education intervention was more effective for maintaining the practice of physical activity in the period after intervention. We recommend the use of both interventions to promote physical activity in the Brazilian Unified Health System, according to the local reality of professionals, facilities, and team objectives. PMID:28678906

  14. Effect of prepubertal and postpubertal growth and age at first calving on production and reproduction traits during the first 3 lactations in Holstein dairy cattle.

    PubMed

    Krpálková, L; Cabrera, V E; Vacek, M; Stípková, M; Stádník, L; Crump, P

    2014-05-01

    The objective of this study was to evaluate the effect of body condition score (BCS), body weight (BW), average daily weight gain (ADG), and age at first calving (AFC) of Holstein heifers on production and reproduction parameters in the 3 subsequent lactations. The data set consisted of 780 Holstein heifers calved at 2 dairy farms in the Czech Republic from 2007 to 2011. Their BW and BCS were measured at monthly intervals during the rearing period (5 to 18 mo of age), and the milk production and reproduction data of the first 3 lactations were collected over an 8-yr period (2005 to 2012). The highest milk yield in the first lactation was found in the group with medium ADG (5 to 14 mo of age; 0.949 to 0.850 kg of ADG). The highest average milk yield over lifetime performance was detected in heifers with the highest total ADG (≥ 0.950 kg/d). The difference in milk yield between the evaluated groups of highest ADG (in total and postpubertal growth ≥ 0.950 kg/d and in prepubertal growth ≥ 0.970 kg/d) and the lowest ADG (≤ 0.849 kg/d) was approximately 1,000 kg/305 d per cow. The highest milk yield in the first lactation was found in the group with the highest AFC ≥ 751 d, for which fat and protein content in the milk was not reduced. Postpubertal growth (11 to 14 mo of age) had the greatest effect on AFC. The group with lowest AFC ≤ 699 d showed a negative effect on milk yield but only in the first 100 d of the first parity. The highest ADG was detrimental to reproduction parameters in the first lactation. The highest BW at 14 mo (≥ 420 kg) led to lower AFC. Groups according to BCS at 14 mo showed no differences in AFC or milk yield in the first lactation or lifetime average production per lactation. We concluded that low AFC ≤ 699 d did not show a negative effect on subsequent production and reproduction parameters. Therefore, a shorter rearing period is recommended for dairy herds with suitable management. Copyright © 2014 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  15. Hurricane Harvey: Infrastructure Damage Assessment of Texas' Central Gulf Coast Region

    NASA Astrophysics Data System (ADS)

    Mooney, W. D.; Fovenyessy, S.; Patterson, S. F.

    2017-12-01

    We report a detailed ground-based damage survey for Hurricane Harvey, the first major hurricane to make landfall along the central Texas coast since the 1970 Category 3 Hurricane Celia. Harvey, a Category 4 storm, made landfall near Rockport, Texas on August 25th, 2017 at 10 PM local time. From September 2nd to 5th we visited Rockport and 22 nearby cities to assess the severity of the damage. Nearly all damage observed occurred as a direct result of the hurricane-force winds, rather than a storm surge. This observation is in contrast to the severe damage caused by both high winds and a significant storm surge, locally 3 to 5 m in height, in the 2013 Category 5 Hurricane Haiyan, that devastated the Philippines. We have adopted a damage scale and have given an average damage score for each of the areas investigated. Our damage contour map illustrates the areal variation in damage. The damage observed was widespread with a high degree of variability. Different types of damage included: (1) fallen fences and utility poles; (2) trees with branches broken or completely snapped in half; (3) business signs that were either partially or fully destroyed; (4) partially sunken or otherwise damaged boats; (5) and sheet metal sheds either completely or partially destroyed. There was also varying degrees of damage to both residential and commercial structures. Many homes had (6) roof damage, ranging from minor damage to complete destruction of the roof and second story, and (7) siding damage, where parts or whole sections of the homes siding had been removed. The area that had the lowest average damage score was Corpus Christi, and the areas that had the highest average damage score was both Fulton and Holiday Beach. There is no simple, uniform pattern of damage distribution. Rather, the damage was scattered, revealing hot spots of areas that received more damage than the surrounding area. However, when compared to the NOAA wind swath map, all of the damage was contained within the zone of highest wind speed.

  16. Cryotherapy and Topical Minocycline as Adjunctive Measures to Control Pain After Third Molar Surgery: An Exploratory Study

    PubMed Central

    Gelesko, Savannah; Long, Leann; Faulk, Jan; Phillips, Ceib; Dicus, Carolyn; White, Raymond P.

    2013-01-01

    Purpose To assess the impact of cryotherapy or topical minocycline on patients’ perceptions of recovery from pain after third molar surgery in an exploratory comparative-effectiveness study. Patients and Methods Subjects aged at least 14 years who were having all 4 third molars removed were enrolled in 3 separate institutional review board–approved studies. Study groups included subjects treated with a passively applied cold wrap for 24 hours postoperatively, subjects treated with topical minocycline during surgery, and subjects enrolled in a nonconcurrent comparison group who had received neither topical minocycline nor directed cryotherapy. Third molar surgery was performed in all cases by trained surgeons using the same protocol. An exact Kruskal-Wallis test was used to compare the distributions of the worst and average pain scores and a Fisher exact test to compare verbal responses from Gracely pain scales among the 3 groups for postsurgical days (PSDs) 1 to 3. Results This study comprised 51 cryotherapy subjects (2005–2009), 63 minocycline subjects (2003–2004), and 92 comparison-group subjects (2002–2006) who were treated at academic centers and in community practices across the United States (N = 206). Demographic descriptors were similar among all groups. For PSDs 1 through 3 (unadjusted), the highest scores for worst pain (6–7 [out of 7] on Likert-type scale) were reported less frequently in each of the study groups than in subjects in the comparison group, although the numbers of subjects reporting the highest scores were few. The distribution of pain outcomes was significantly different among the 3 groups for worst pain and affective words on PSD 1 (P = .04 for both). However, the small number of subjects who reported the highest pain scores precluded adequate multivariate statistical analyses for all outcomes on PSD 1 to 3. Conclusions Data from this exploratory study suggest that adjunctive therapy to decrease postoperative pain—cryotherapy or topical minocycline—might be effective at moderating the patient’s highest pain levels after third molar surgery. The topic should be studied further in a multicenter, prospective, randomized trial. PMID:21802812

  17. Sports- and Work-Related Outcomes After Shoulder Hemiarthroplasty.

    PubMed

    Garcia, Grant H; Mahony, Gregory T; Fabricant, Peter D; Wu, Hao-Hua; Dines, David M; Warren, Russell F; Craig, Edward V; Gulotta, Lawrence V

    2016-02-01

    With an active aging population, more patients expect to return to previous activities and work after surgery. To determine the rate and timing to return of sports and employment after shoulder hemiarthroplasty. Case series; Level of evidence, 4. This was a retrospective review of consecutive patients who underwent shoulder hemiarthroplasty from 2007 to 2013. Follow-up consisted of a patient-reported questionnaire regarding physical fitness, sporting activities, and work status. From 105 patients screened, 79 were available for follow-up. The average follow-up time was 63.1 months, and the average age at follow-up was 69 years. Scores on the visual analog scale for pain improved from 6.2 to 2.1 (P < .001) postoperatively, and those on the American Shoulder and Elbow Surgeons (ASES) shoulder assessment improved from 34.6 to 71.3 (P < .001). Patients older than 65 years had significantly lower absolute postoperative ASES scores (P = .041) but experienced similar improvement from their preoperative baseline (P = .158) compared with patients younger than 65 years. There were 58 patients who played sports preoperatively, and 67.2% of these restarted at least 1 of their previous sports postoperatively. The average time to return to full sports was 6.5 months for those who returned. Direct rates of return were as follows: fitness sports (69%), swimming (65%), running (64%), cycling (63%), and doubles tennis (57%). Younger age was associated with highest demand level achieved (P = .023). Forty-nine patients worked preoperatively, with 69.4% returning to previous employment after surgery; the average time to return to work was 1.4 months. In comparative analysis, patients who did not return to work had a higher mean body mass index (32 ± 7 vs 27 ± 5 kg/m(2); P < .008). In this hemiarthroplasty cohort, there was a 67.2% rate of return to 1 or more sports at an average of 6.5 months postoperatively. Patients older than 65 years experienced similar improvements in ASES scores compared with patients younger than 65 years, although absolute scores were lower on average. Those who returned to higher demand sports were younger on average. Of patients working preoperatively, 69.4% returned to their previous employment at an average of 1.4 months. Patients who did not return to employment had significantly higher body mass index on average. These findings will help surgeons manage expectations of shoulder hemiarthroplasty candidates preoperatively. © 2015 The Author(s).

  18. The job competency of radiological technologists in Korea based on specialists opinion and questionnaire survey.

    PubMed

    Lim, Chang-Seon; Lee, Yang-Sub; Lee, Yong-Dae; Kim, Hyun-Soo; Jin, Gye-Hwan; Choi, Seong-Youl; Hur, Yera

    2017-01-01

    Although there are over 40,000 licensed radiological technologists (RTs) in Korea, job competency standards have yet to be defined. This study aims to clarify the job competency of Korean RTs. A task force team of 11 professional RTs were recruited in order to analyze the job competency of domestic and international RTs. A draft for the job competency of Korean RTs was prepared. A survey was then conducted sampling RTs and the attitudes of their competencies were recorded from May 21 to July 30, 2016. We identified five modules of professionalism, patient management, health and safety, operation of equipment, and procedure management and 131 detailed job competencies for RTs in Korea. "Health and safety" had the highest average score and "professionalism" had the lowest average score for both job performance and importance. The content validity ratios for the 131 subcompetencies were mostly valid. Establishment of standard guidelines for RT job competency for multidisciplinary healthcare at medical institutions may be possible based on our results, which will help educators of RT training institutions to clarify their training and education.

  19. Characterization of hidden rules linking symptoms and selection of acupoint using an artificial neural network model.

    PubMed

    Jung, Won-Mo; Park, In-Soo; Lee, Ye-Seul; Kim, Chang-Eop; Lee, Hyangsook; Hahm, Dae-Hyun; Park, Hi-Joon; Jang, Bo-Hyoung; Chae, Younbyoung

    2018-04-12

    Comprehension of the medical diagnoses of doctors and treatment of diseases is important to understand the underlying principle in selecting appropriate acupoints. The pattern recognition process that pertains to symptoms and diseases and informs acupuncture treatment in a clinical setting was explored. A total of 232 clinical records were collected using a Charting Language program. The relationship between symptom information and selected acupoints was trained using an artificial neural network (ANN). A total of 11 hidden nodes with the highest average precision score were selected through a tenfold cross-validation. Our ANN model could predict the selected acupoints based on symptom and disease information with an average precision score of 0.865 (precision, 0.911; recall, 0.811). This model is a useful tool for diagnostic classification or pattern recognition and for the prediction and modeling of acupuncture treatment based on clinical data obtained in a real-world setting. The relationship between symptoms and selected acupoints could be systematically characterized through knowledge discovery processes, such as pattern identification.

  20. Representation of ophthalmology concepts by electronic systems: adequacy of controlled medical terminologies.

    PubMed

    Chiang, Michael F; Casper, Daniel S; Cimino, James J; Starren, Justin

    2005-02-01

    To assess the adequacy of 5 controlled medical terminologies (International Classification of Diseases 9, Clinical Modification [ICD9-CM]; Current Procedural Terminology 4 [CPT-4]; Systematized Nomenclature of Medicine, Clinical Terms [SNOMED-CT]; Logical Identifiers, Names, and Codes [LOINC]; Medical Entities Dictionary [MED]) for representing concepts in ophthalmology. Noncomparative case series. Twenty complete ophthalmology case presentations were sequentially selected from a publicly available ophthalmology journal. Each of the 20 cases was parsed into discrete concepts, and each concept was classified along 2 axes: (1) diagnosis, finding, or procedure and (2) ophthalmic or medical concept. Electronic or paper browsers were used to assign a code for every concept in each of the 5 terminologies. Adequacy of assignment for each concept was scored on a 3-point scale. Findings from all 20 case presentations were combined and compared based on a coverage score, which was the average score for all concepts in that terminology. Adequacy of assignment for concepts in each terminology, based on a 3-point Likert scale (0, no match; 1, partial match; 2, complete match). Cases were parsed into 1603 concepts. SNOMED-CT had the highest mean overall coverage score (1.625+/-0.667), followed by MED (0.974+/-0.764), LOINC (0.781+/-0.929), ICD9-CM (0.280+/-0.619), and CPT-4 (0.082+/-0.337). SNOMED-CT also had higher coverage scores than any of the other terminologies for concepts in the diagnosis, finding, and procedure categories. Average coverage scores for ophthalmic concepts were lower than those for medical concepts. Controlled terminologies are required for electronic representation of ophthalmology data. SNOMED-CT had significantly higher content coverage than any other terminology in this study.

  1. EDITORIAL: Are higher quality papers cited more often? Are higher quality papers cited more often?

    NASA Astrophysics Data System (ADS)

    Patterson, Michael S.; Harris, Simon

    2009-09-01

    Most researchers are aware of the increasing emphasis placed on citations as an indicator of quality by their colleagues, as well as by administrators and librarians. But is it true that high quality papers are cited more often? In what we believe to be the only previous publication to examine this question, West and McIlwaine (2002) selected 79 papers that had been published in the journal Addiction in 1997. These papers were rated by an assistant editor of the journal on a five-level quality scale (ranging from 'among the top 10%' to 'should not have been published') as well as a second 'blind' rater. The authors found that the number of citations to each paper from 1997 to 2000 did not correlate with the mean score of the two reviewers, the score assigned by the editors, or the score assigned by the blind referees. The peer-review system used by Physics in Medicine and Biology (PMB) facilitates a larger, prospective study with much less effort. In general, two reviewers are asked to assign each paper a score of 1 to 10 in each of three categories: originality, soundness and significance. The total scores (out of 30) are averaged and on this basis manuscripts are given a quality rating from Q1 (highest quality) to Q5. In a paper recently published in Scientometrics (Patterson and Harris 2009), we compared the number of citations to papers published in PMB in 2003, 2004 and 2005 to the mean quality rating assigned by the reviewers. In total, data were analyzed for 1095 published papers. For each year we found that there was a low but statistically robust correlation between citations and quality rating: for 2003, -0.227 (p < 0.001); for 2004, -0.238 (p < 0.001), and for 2005, -0.154 (p < 0.01). The low correlation means that it is not possible to predict the citation frequency of an individual paper with accuracy but, as a group, the highest ranked papers were cited about twice as often as the average for all published papers. We also examined the data retrospectively by dividing the papers published in each year into five citation quintiles. A paper of the highest quality (Q1) was about ten times more likely to be found in the most-cited quintile than in the least-cited. While it is reassuring to find that the best papers in PMB are, indeed, cited more often on average, we cannot discount the hypothesis that both measures might be influenced by an extrinsic factor, such as the reputation of the authors. We suggest that a study similar to ours be performed for a journal that utilizes a system of double-blind peer review. Michael S Patterson Editorial Board Member Simon Harris Publisher References West R and McIlwaine A 2002 What do citation counts count for in the field of addiction? An empirical evaluation of citation counts and their link with peer ratings of quality Addiction 97 501-4 Patterson M S and Harris S 2009 The relationship between reviewers' quality-scores and number of citations for papers published in the journal Physics in Medicine and Biology from 2003-2005 Scientometrics 80 343-9

  2. Quality of life of patients with chronic obstructive pulmonary disease in the Gulf Cooperation Council countries.

    PubMed

    Al Moamary, Mohamed S; Tamim, Hani M; Al-Mutairi, Sana S; Al-Khouzaie, Thamer H; Mahboub, Bassam H; Al-Jawder, Suhaila E; Alamoudi, Omer S; Al Ghobain, Mohammed O

    2012-10-01

    To assess the health-related quality of life (HRQL) of patients with chronic obstructive pulmonary disease (COPD) in 4 Gulf Council Cooperation (GCC) countries. We conducted a cross-sectional survey between December 2011 and March 2012 in the following countries: Kingdom of Saudi Arabia (Riyadh, Dammam, and Jeddah), Kuwait, Bahrain, and the United Arab Emirates. The HRQL was measured using the COPD Assessment Test (CAT) and the Chronic Respiratory Disease Questionnaire-Self-Administered Standardized questionnaire (CRQ-SAS). We recruited 120 patients from 6 centers in 4 countries. Their average forced expiratory volume (FEV)1 was 49.3% ( +/- 13.4) of predicted, and the ratio of FEV1 to forced vital capacity was 0.58 ( +/- 0.11). The average COPD Assessment Test (CAT) score was 20.4 +/- 7.6; CAT scores were highest for Riyadh (24.1 +/- 7.7) and lowest for Kuwait (18.5 +/- 9.2), with no significant difference between the centers. For the CRQ-SAS, the dyspnea domain score was 4.6 +/- 1.6, the fatigue domain score was 4.3 +/- 1.3, the emotional domain was 4.6 +/- 1.2, and the mastery domain was 4.8 +/- 1.4. The correlation coefficients of the association between the CAT score and the 4 domains of the CRQ-SAS for all of the centers combined was statistically significant. The CAT and CRQ-SAS revealed that the patients with COPD experienced a moderate to severe impact from the disease, and a considerably compromised quality of life in the GCC countries.

  3. Study for the quality assessment of abstracts presented to Italian public health national conferences: a six years survey.

    PubMed

    Castaldi, S; Colombo, A; D'Errico, R; Bert, F; Siliquini, R; Ceruti, M; Curti, S; Gaietta, M; Garavelli, E; Legouellec, L; Lovato, E; Martinese, M; Visco, F

    2013-01-01

    Oral and poster presentations at congresses are essential to spread scientific knowledge among the medical community. Many scientific societies have analyzed the quality of papers presented at their meetings but no information on abstracts' evaluation has been presented in Public Health field. This study aims to examine the quality of abstracts presented at annual meetings of Italian Public Health Society (SItI) in the period 2005-2010 through a validated checklist grid, evaluating eight dimensions: Inherency, Structure, Originality, Objectives, Study design, Sources, Results, Conclusions. Each item was scored from 0 to 3 points (max score: 24) and we used the average score in our study (15) as threshold of good quality. A multivariate analysis was performed in order to investigate predictors of score of abstracts presented. A total of 4,399 abstracts (1,172 oral communications, 3,227 posters) was examined. Around 60% were submitted by Universities and around 40% were from Central Italy. The highest quality was found in the fields of Vaccines (average score 18.9), Infectious Diseases (18) and in abstracts submitted by Universities (16.4). Predictors of lower quality identified were geographical area and affiliation (p= 0.002). Abstracts containing well-written Results, Conclusions and Objectives (3 points) were more likely to be of high quality(OR=55.6, OR=41.9, and OR=157.4; p>0.001) CONCLUSIONS: This is the first European study evaluating the quality of abstracts in the public health field. A reliable evaluation tool is fundamental to offer a transparent methodology of assessment and to improve the quality of research.

  4. Team-Based Learning and Open-Book Quizzes: Determining What Works in an Introductory Geoscience Course

    NASA Astrophysics Data System (ADS)

    Teed, R.

    2008-12-01

    Concepts in Geology (EES 345) is an inquiry-based ten-week geoscience course for pre-service elementary and middle-school teachers at Wright State University. For most of them, this is the first and last geoscience class that they take. Required readings are an important part of the class because of the amount of vocabulary and number of concepts that students need to master. It is not possible to spend much class time on lectures that cover the same material, as students are expected to be doing hands-on activities, presentations, discussions, and laboratory exercises applying the material learned from reading. As the instructor, I administer frequent quizzes to encourage students to do the reading and to take notes. The quizzes are 10 multiple-choice questions each and the students are allowed to use a single page of notes. After they complete their quizzes individually, the students gather in groups of three or four and work on the same questions, but are allowed to discuss their answers. This motivates students further to be scrupulous about reading, enables them to help each other overcome mistakes, and helps them work out difficult problems that overwhelmed individuals in the group. The average group scores on in-class, closed- book quizzes are almost always higher than highest average individual score (more than 5% on the average), so even the best-prepared person in the group is managing to learn something from his or her peers. After the all the scores are recorded, I tally the number of correct group and individual answers to each question. If one or more groups gets a question wrong, it's clearly a hard question and worth going over during class time. If more than half of the groups get a question wrong, it is not scored as part of the total. When I used a new text last spring, students found the quizzes overwhelmingly hard. So I let students take the individual quizzes home to answer directly from the book and continued to give group quizzes in class. Students no longer brought notes to the group quizzes. In some groups, all individuals gave identical wrong answers to the same questions (and repeated that answer on the group quiz) indicating probable cooperation on the individual quizzes. The average group scores were no longer significantly higher than the average individual scores, indicating less learning, and the groups still had trouble answering questions involving problem-solving or synthesis or comparison of ideas.

  5. Gender and urban-rural difference in anthropometric indices predicting dyslipidemia in Chinese primary school children: a cross-sectional study.

    PubMed

    Zheng, Wei; Zhao, Ai; Xue, Yong; Zheng, Yingdong; Chen, Yun; Mu, Zhishen; Wang, Peiyu; Zhang, Yumei

    2016-04-30

    Childhood dyslipidemia is a critical factor of lifelong health. Therefore, screening and controlling dyslipidemia from childhood is a practical healthy strategy. However, few studies have examined the performance of anthropometric predictors of dyslipidemia in Chinese children, let alone the potential gender and urban-rural disparity. Thus, we evaluated anthropometric indices predicting dyslipidemia by genders and living areas in Chinese children. Data were from a health and nutrition survey conducted in seven urban areas and two rural areas in China between 2011 and 2012. The serum lipid levels of the participants were compared between genders and living areas. The body mass index z-score (BMI z-score), waist-hip ratio (WHR), waist-height ratio (WHtR), and mid-upper arm height ratio (MaHtR) were used as predictors. The receiver operating characteristic (ROC) analysis was performed to investigate the ability of anthropometric indices predicting dyslipidemia. A total of 773 participants (average age = 9.3 ± 1.7 y) were included. The prevalence of dyslipidemia was 10.9%. Anthropometric indices were all significantly related to blood lipid profiles in boys after adjustment for age. The areas under the ROC curves (ACUs) were significantly larger than 0.5 in boys (ranged between 0.66-0.73), and were larger in rural boys (ranged between 0.68 and 0.94). MaHtR and WHR were associated with the highest specificity (93.8%) and highest sensitivity (100%), respectively. Using anthropometric indices, screening for dyslipidemia may be more appropriate in boys than in girls in China, especially in rural boys. The BMI z-score, WHR, WHtR, and MaHtR were all significantly associated with dyslipidemia in boys; using WHR and MaHtR as indicators achieved the highest sensitivity and specificity, respectively.

  6. The effectiveness of school educating program for betel quid chewing: A pilot study in Papua New Guinea.

    PubMed

    Chen, Gene; Hsieh, Ming-Yu; Chen, Andy Wei-Ge; Kao, Nina Hsiao-Ling; Chen, Mu-Kuan

    2018-04-01

    To investigate the effectiveness of educating program among primary and secondary school students in Papua New Guinea, where has the highest incidence of oral cancer all over the world. A cross-sectional school based survey was arranged in primary and secondary school in Papua New Guinea in June, 2015. A self-administrated questionnaire was administered before and after education done by health experts from Taiwan. The subjects were chosen by random. The schools provided the students we educated and did the questionnaires on. Ninety five primary school students and 55 secondary school students in Papua New Guinea participated in the study. Before education, both groups lacked the knowledge that betel quid is harmful to health and had no motivation to quit betel quid consumption with the average score 4.580 out of the total score of 8 for primary school students, and the average score of 4.600 out of the total score of 8 for secondary school students. After education, improvements were noted in knowledge of betel quid among both groups, and reached the statistical significance for secondary school students (mean difference 0.700 ± 0.277, 95% CI 0.164-1.248, p-value = 0.018). A great achievement was gained by a short time of education. To prevent the incidence and mortality of oral cancer in Papua New Guinea, education programs should be arranged aggressively and effectively. Copyright © 2017. Published by Elsevier Taiwan LLC.

  7. Environmental scan and evaluation of best practices for online systematic review resources.

    PubMed

    Parker, Robin M N; Boulos, Leah M; Visintini, Sarah; Ritchie, Krista; Hayden, Jill

    2018-04-01

    Online training for systematic review methodology is an attractive option due to flexibility and limited availability of in-person instruction. Librarians often direct new reviewers to these online resources, so they should be knowledgeable about the variety of available resources. The objective for this project was to conduct an environmental scan of online systematic review training resources and evaluate those identified resources. The authors systematically searched for electronic learning resources pertaining to systematic review methods. After screening for inclusion, we collected data about characteristics of training resources and assigned scores in the domains of (1) content, (2) design, (3) interactivity, and (4) usability by applying a previously published evaluation rubric for online instruction modules. We described the characteristics and scores for each training resource and compared performance across the domains. Twenty training resources were evaluated. Average overall score of online instructional resources was 61%. Online courses (n=7) averaged 73%, web modules (n=5) 64%, and videos (n=8) 48%. The top 5 highest scoring resources were in course or web module format, featured high interactivity, and required a longer (>5hrs) time commitment from users. This study revealed that resources include appropriate content but are less likely to adhere to principles of online training design and interactivity. Awareness of these resources will allow librarians to make informed recommendations for training based on patrons' needs. Future online systematic review training resources should use established best practices for e-learning to provide high-quality resources, regardless of format or user time commitment.

  8. Clinical excellence: evidence on the assessment of senior doctors' applications to the UK Advisory Committee on Clinical Excellence Awards. Analysis of complete national data set

    PubMed Central

    Campbell, John L; Abel, Gary

    2016-01-01

    Objectives To inform the rational deployment of assessor resource in the evaluation of applications to the UK Advisory Committee on Clinical Excellence Awards (ACCEA). Setting ACCEA are responsible for a scheme to financially reward senior doctors in England and Wales who are assessed to be working over and above the standard expected of their role. Participants Anonymised applications of consultants and senior academic GPs for awards were considered by members of 14 regional subcommittees and 2 national assessing committees during the 2014–2015 round of applications. Design It involved secondary analysis of complete anonymised national data set. Primary and secondary outcome measures We analysed scores for each of 1916 applications for a clinical excellence award across 4 levels of award. Scores were provided by members of 16 subcommittees. We assessed the reliability of assessments and described the variance in the assessment of scores. Results Members of regional subcommittees assessed 1529 new applications and 387 renewal applications. Average scores increased with the level of application being made. On average, applications were assessed by 9.5 assessors. The highest contributions to the variance in individual assessors' assessments of applications were attributable to assessors or to residual variance. The applicant accounted for around a quarter of the variance in scores for new bronze applications, with this proportion decreasing for higher award levels. Reliability in excess of 0.7 can be attained where 4 assessors score bronze applications, with twice as many assessors being required for higher levels of application. Conclusions Assessment processes pertaining in the competitive allocation of public funds need to be credible and efficient. The present arrangements for assessing and scoring applications are defensible, depending on the level of reliability judged to be required in the assessment process. Some relatively minor reconfiguration in approaches to scoring might usefully be considered in future rounds of assessment. PMID:27256095

  9. Verbal Aggressiveness Among Physicians and Trainees.

    PubMed

    Lazarus, Jenny Lynn; Hosseini, Motahar; Kamangar, Farin; Levien, David H; Rowland, Pamela A; Kowdley, Gopal C; Cunningham, Steven C

    2016-01-01

    To better understand verbal aggressiveness among physicians and trainees, including specialty-specific differences. The Infante Verbal Aggressiveness Scale (IVAS) was administered as part of a survey to 48 medical students, 24 residents, and 257 attending physicians. The 72 trainees received the IVAS and demographic questions, whereas the attending physicians received additional questions regarding type of practice, career satisfaction, litigation, and personality type. The IVAS scores showed high reliability (Cronbach α = 0.83). Among all trainees, 56% were female with mean age 28 years, whereas among attending physicians, 63% were male with mean age 50 years. Average scores of trainees were higher than attending physicians with corresponding averages of 1.88 and 1.68, respectively. Among trainees, higher IVAS scores were significantly associated with male sex, non-US birthplace, choice of surgery, and a history of bullying. Among attending physicians, higher IVAS scores were significantly associated with male sex, younger age, self-reported low-quality of patient-physician relationships, and low enjoyment talking to patients. General surgery and general internal medicine physicians were significantly associated with higher IVAS scores than other specialties. General practitioners (surgeons and medical physicians) had higher IVAS scores than the specialists in their corresponding fields. No significant correlation was found between IVAS scores and threats of legal action against attending physicians, or most personality traits. Additional findings regarding bullying in medical school, physician-patient interactions, and having a method to deal with inappropriate behavior at work were observed. Individuals choosing general specialties display more aggressive verbal communication styles, general surgeons displaying the highest. The IVAS scoring system may identify subgroups of physicians with overly aggressive (problematic) communication skills and may provide a backdrop for educating physician communicators. The relationship between verbal aggressiveness and efficacy of clinical communication merits inquiry. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  10. Assessment and self-assessment of the pharmacists' competencies using the global competency framework (GbCF) in Serbia.

    PubMed

    Stojkov, Svetlana; Tadić, Ivana; Crnjanski, Tatjana; Krajnović, Dušanka

    2016-09-01

    Pharmacists' competence represents a dynamic framework of knowledge, skills and abilities to carry out tasks, and it reflects on improving the quality of life and on patients’ health. One of the documents for the Evaluation and Competency Development of Pharmacists is the Global Competency Framework (GbCF). The aim of this study was to implement the GBCF document into Serbian pharmacies, to perform assessment and self assessment of the competencies. The assessment and self-assessment of pharmacists’ competencies were performed during the period 2012−13 year in eight community pharmacy chains, in seven cities in Serbia. For assessment and self-assessment of pharmacists competencies the GbCF model was applied, which was adjusted to pharmaceutical practice and legislation in Serbia. External assessment was conducted by teams of pharmacists using the structured observation of the work of pharmacists during regular working hours. Evaluated pharmacists filled out the questionnaire about demographic indicators about the pharmacist and the pharmacy where they work. A total of 123 pharmacists were evaluated. Pharmacists’ Professional Competency Cluster (KK1) had the lowest score (average value 2.98), while the cluster Management and Organizational Competency (KK2) had the highest score (average value 3.15). The competence Recognition of the Diagnosis and Patient Counseling (K8), which belonged to the cluster KK1, had the lowest score (average value for assessment and self-assessment were 2.09, and 2.34, respectively) among the all evaluated competencies. GbCF might be considered as an instrument for the competencies' evaluation/selfevaluation and their improvement, accordingly.

  11. The linkage between geopotential height and monthly precipitation in Iran

    NASA Astrophysics Data System (ADS)

    Shirvani, Amin; Fadaei, Amir Sabetan; Landman, Willem A.

    2018-04-01

    This paper investigates the linkage between large-scale atmospheric circulation and monthly precipitation during November to April over Iran. Canonical correlation analysis (CCA) is used to set up the statistical linkage between the 850 hPa geopotential height large-scale circulation and monthly precipitation over Iran for the period 1968-2010. The monthly precipitation dataset for 50 synoptic stations distributed in different climate regions of Iran is considered as the response variable in the CCA. The monthly geopotential height reanalysis dataset over an area between 10° N and 60° N and from 20° E to 80° E is utilized as the explanatory variable in the CCA. Principal component analysis (PCA) as a pre-filter is used for data reduction for both explanatory and response variables before applying CCA. The optimal number of principal components and canonical variables to be retained in the CCA equations is determined using the highest average cross-validated Kendall's tau value. The 850 hPa geopotential height pattern over the Red Sea, Saudi Arabia, and Persian Gulf is found to be the major pattern related to Iranian monthly precipitation. The Pearson correlation between the area averaged of the observed and predicted precipitation over the study area for Jan, Feb, March, April, November, and December months are statistically significant at the 5% significance level and are 0.78, 0.80, 0.82, 0.74, 0.79, and 0.61, respectively. The relative operating characteristic (ROC) indicates that the highest scores for the above- and below-normal precipitation categories are, respectively, for February and April and the lowest scores found for December.

  12. A Survey of Knowledge and Practices of Transfusion Medicine Among Post Intern Doctors in Specialized Hospital in Sri Lanka.

    PubMed

    Kumarage, Samantha; Fernando, Rahal; Gunasekara, Lanka

    2017-02-01

    Knowledge of transfusion medicine is the key element of better transfusion practices. This deficit observed at the blood bank end on daily basis exposing the patients for redundant risk. We assessed the knowledge of transfusion medicine among post intern doctors. To assess the knowledge of transfusion medicine among post intern doctors in working in our hospital. Self administrated questionnaire was used. 45 questions of transfusion medicine included in the questioner. A total 57 post internship doctors participated in the survey. Statistical analysis was done using SPSS. In overall survey average score was 41.45%. Lowest score 19.8% was for the area of lab result interpretation. Highest score 56.63% obtained for the administration of blood component. Differences among the medical officers of various specialties were not statistically significant. Transfusion medicine knowledge among post internship doctors in our hospital need to be upgraded. © American Society for Clinical Pathology, 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  13. Results from the second year of a collaborative effort to forecast influenza seasons in the United States.

    PubMed

    Biggerstaff, Matthew; Johansson, Michael; Alper, David; Brooks, Logan C; Chakraborty, Prithwish; Farrow, David C; Hyun, Sangwon; Kandula, Sasikiran; McGowan, Craig; Ramakrishnan, Naren; Rosenfeld, Roni; Shaman, Jeffrey; Tibshirani, Rob; Tibshirani, Ryan J; Vespignani, Alessandro; Yang, Wan; Zhang, Qian; Reed, Carrie

    2018-02-24

    Accurate forecasts could enable more informed public health decisions. Since 2013, CDC has worked with external researchers to improve influenza forecasts by coordinating seasonal challenges for the United States and the 10 Health and Human Service Regions. Forecasted targets for the 2014-15 challenge were the onset week, peak week, and peak intensity of the season and the weekly percent of outpatient visits due to influenza-like illness (ILI) 1-4 weeks in advance. We used a logarithmic scoring rule to score the weekly forecasts, averaged the scores over an evaluation period, and then exponentiated the resulting logarithmic score. Poor forecasts had a score near 0, and perfect forecasts a score of 1. Five teams submitted forecasts from seven different models. At the national level, the team scores for onset week ranged from <0.01 to 0.41, peak week ranged from 0.08 to 0.49, and peak intensity ranged from <0.01 to 0.17. The scores for predictions of ILI 1-4 weeks in advance ranged from 0.02-0.38 and was highest 1 week ahead. Forecast skill varied by HHS region. Forecasts can predict epidemic characteristics that inform public health actions. CDC, state and local health officials, and researchers are working together to improve forecasts. Published by Elsevier B.V.

  14. Sports Nutrition Knowledge Among Collegiate Athletes, Coaches, Athletic Trainers, and Strength and Conditioning Specialists

    PubMed Central

    Torres-McGehee, Toni M.; Pritchett, Kelly L.; Zippel, Deborah; Minton, Dawn M.; Cellamare, Adam; Sibilia, Mike

    2012-01-01

    Context: Coaches, athletic trainers (ATs), strength and conditioning specialists (SCSs), and registered dietitians are common nutrition resources for athletes, but coaches, ATs, and SCSs might offer only limited nutrition information. Little research exists about sports nutrition knowledge and current available resources for nutrition information for athletes, coaches, ATs, and SCSs. Objective: To identify resources of nutrition information that athletes, coaches, ATs, and SCSs use; to examine nutrition knowledge among athletes, coaches, ATs, and SCSs; and to determine confidence levels in the correctness of nutrition knowledge questions within all groups. Design: Cross-sectional study. Setting: National Collegiate Athletic Association Division I, II, and III institutions across the United States. Patients and Other Participants: The 579 participants consisted of athletes (n = 185), coaches (n = 131), ATs (n = 192), and SCSs (n = 71). Main Outcome Measure(s): Participants answered questions about nutrition resources and domains regarding basic nutrition, supplements and performance, weight management, and hydration. Adequate sports nutrition knowledge was defined as an overall score of 75% in all domains (highest achievable score was 100%). Results: Participants averaged 68.5% in all domains. The ATs (77.8%) and SCSs (81.6%) had the highest average scores. Adequate knowledge was found in 35.9% of coaches, 71.4% of ATs, 83.1% of SCSs, and only 9% of athletes. The most used nutrition resources for coaches, ATs, and SCSs were registered dietitians. Conclusions: Overall, we demonstrated that ATs and SCSs have adequate sports nutrition knowledge, whereas most coaches and athletes have inadequate knowledge. Athletes have frequent contact with ATs and SCSs; therefore, proper nutrition education among these staff members is critical. We suggest that proper nutrition programming should be provided for athletes, coaches, ATs, and SCSs. However, a separate nutrition program should be integrated for ATs and SCSs. This integrative approach is beneficial for the continuity of care, as both categories of professionals might be developing and integrating preventive or rehabilitative programs for athletes. PMID:22488287

  15. Adjustment to Life with Lung Cancer.

    PubMed

    Czerw, Aleksandra I; Religioni, Urszula; Deptała, Andrzej

    2016-01-01

    In Poland, lung cancer is the most common type of cancer in males (20% of all cases) and third most common type of cancer in females (9% of all cases), right behind breast and colorectal cancers. Recently, 28,000 new cases of lung cancer per year were reported in both genders. The objective of the study was to asses coping strategies, pain management, acceptance of illness and adjustment to cancer in patients diagnosed with pulmonary carcinoma and the effect of socioeconomic variables on the abovementioned issues. The study included 243 patients diagnosed with lung cancer during outpatient chemotherapy (classical chemotherapy and molecularly targeted therapies) at the Center of Oncology, Maria Skłodowska-Curie Institute in Warszawa. We applied the Paper and Pencil Interview (PAPI) technique. The questionnaire interview was composed of demographic questions and the following four psychometric tests: BPCQ measuring the influence of factors affecting pain management in patients, CSQ designed to evaluate pain coping strategies, AIS questionnaire, measuring disease acceptance, and the mini-Mac scale, assessing psychological adjustment to disease. The highest mean score recorded in the BPCQ was recorded in the powerful doctors subscale (16.79) and the lowest in the internal factors section (15.64). Education, professional status and income were the variables which differentiated the scores. We recorded the top average score in CSQ in the coping self statements subscale (mean = 19.64), and the lowest score in the reinterpreting pain sensations subscale (mean score = 10.32). The results of the test were differentiated by education and income. Patients had the highest Mini-MAC scale scores in the fighting spirit section (21.91). In the case of patients affected with lung cancer, education and professional status affect the way patients treat doctors in the disease process. These variables are also critical in patients' approach to disease and methods of coping with it.

  16. Assessment of medication adherence app features, functionality, and health literacy level and the creation of a searchable Web-based adherence app resource for health care professionals and patients.

    PubMed

    Heldenbrand, Seth; Martin, Bradley C; Gubbins, Paul O; Hadden, Kristie; Renna, Catherine; Shilling, Rebecca; Dayer, Lindsey

    2016-01-01

    To assess the features and level of health literacy (HL) of available medication adherence apps and to create a searchable website to assist health care providers (HCP) and patients identify quality adherence apps. Medication nonadherence continues to be a significant problem and leads to poor health outcomes and avoidable health care expense. The average adherence rate for chronic medications, regardless of disease state, is approximately 50% leaving significant room for improvement. Smartphone adherence apps are a novel resource to address medication nonadherence. With widespread smartphone use and the growing number of adherence apps, both HCP and patients should be able to identify quality adherence apps to maximize potential benefits. Assess the features, functionality and level of HL of available adherence apps and create a searchable website to help both HCP and patients identify quality adherence apps. Online marketplaces (iTunes, Google Play, Blackberry) were searched in June of 2014 to identify available adherence apps. Online descriptions were recorded and scored based on 28 author-identified features across 4 domains. The 100 highest-scoring apps were user-tested with a standardized regimen to evaluate their functionality and level of HL. 461 adherence apps were identified. 367 unique apps were evaluated after removing "Lite/Trial" versions. The median initial score based on descriptions was 15 (max of 68; range: 3 to 47). Only 77 apps of the top 100 highest-scoring apps completed user-testing and HL evaluations. The median overall user-testing score was 30 (max of 73; range: 16 to 55). App design, functionality, and level of HL varies widely among adherence apps. While no app is perfect, several apps scored highly across all domains. The website www.medappfinder.com is a searchable tool that helps HCP and patients identify quality apps in a crowded marketplace. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  17. Evaluating YouTube as a Source of Patient Education on the Role of the Hospitalist: A Cross-Sectional Study

    PubMed Central

    Hudali, Tamer; Bhattarai, Mukul; Deckard, Alan; Hingle, Susan

    2017-01-01

    Background Hospital medicine is a relatively new specialty field, dedicated to the delivery of comprehensive medical care to hospitalized patients. YouTube is one of the most frequently used websites, offering access to a gamut of videos from self-produced to professionally made. Objective The aim of our study was to determine the adequacy of YouTube as an effective means to define and depict the role of hospitalists. Methods YouTube was searched on November 17, 2014, using the following search words: “hospitalist,” “hospitalist definition,” “what is the role of a hospitalist,” “define hospitalist,” and “who is a hospitalist.” Videos found only in the first 10 pages of each search were included. Non-English, noneducational, and nonrelevant videos were excluded. A novel 7-point scoring tool was created by the authors based on the definition of a hospitalist adopted by the Society of Hospital Medicine. Three independent reviewers evaluated, scored, and classified the videos into high, intermediate, and low quality based on the average score. Results A total of 102 videos out of 855 were identified as relevant and included in the analysis. Videos uploaded by academic institutions had the highest mean score. Only 6 videos were classified as high quality, 53 as intermediate quality, and 42 as low quality, with 82.4% (84/102) of the videos scoring an average of 4 or less. Conclusions Most videos found in the search of a hospitalist definition are inadequate. Leading medical organizations and academic institutions should consider producing and uploading quality videos to YouTube to help patients and their families better understand the roles and definition of the hospitalist. PMID:28073738

  18. Predictors of performance in an ophthalmology residency program.

    PubMed

    Alfawaz, Abdullah M; Al-Dahmash, Saad A

    2016-06-01

    To assess the value of current selection criteria and additional factors as predictors of performance in an ophthalmology residency training program. A retrospective study. Data were collected from the files of 166 residents who were collectively trained in an ophthalmology residency program from 2000 to 2013. The program's selection criteria included medical school grade point average (GPA), Saudi licensing examination (SLE) score, multiple-choice question ophthalmology selection (MCQ) examination score, and interview mark. Indicators of performance included average scores in the promotion examination for 4 years of training (average R), King Saud University fellowship examination (KSU) score, and Saudi Board in Ophthalmology examination (SBO) score. An average of KSU and SBO scores was also used as a performance indicator. Times of program completion and average performance score across all years in the residency program were used as second-level indicators of performance. There were strong correlations between the MCQ examination score and each training performance indicator (average R, KSU score, SBO score, and average of KSU and SBO scores; p = 0.002, 0.008, 0.05, and 0.002, respectively). The interview mark correlated well with average R (p = 0.001) but not with other indicators. The MCQ examination score and the interview mark were the only predictors of second-level indicators of performance (p = 0.009 and 0.029, respectively). The MCQ examination score and interview mark were the 2 best predictors of performance as an ophthalmology resident. GPA and SLE score were poor predictors of performance. Copyright © 2016 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

  19. Direct short-term effects of EBP teaching: change in knowledge, not in attitude; a cross-cultural comparison among students from European and Asian medical schools

    PubMed Central

    Widyahening, Indah S.; van der Heijden, Geert J.M.G.; Moy, Foong Ming; van der Graaf, Yolanda; Sastroasmoro, Sudigdo; Bulgiba, Awang

    2012-01-01

    Introduction We report about the direct short-term effects of a Clinical Epidemiology and Evidence-based Medicine (CE-EBM) module on the knowledge, attitude, and behavior of students in the University Medical Center Utrecht (UMCU), Universitas Indonesia (UI), and University of Malaya (UM). Methods We used an adapted version of a 26-item validated questionnaire, including four subscales: knowledge, attitude, behavior, and future use of evidence-based practice (EBP). The four components were compared among the students in the three medical schools before the module using one-way ANOVA. At the end of the module, we measured only knowledge and attitudes. We computed Cronbach's α to assess the reliability of the responses in our population. To assess the change in knowledge and attitudes, we used the paired t-test in the comparison of scores before and after the module. Results In total, 526 students (224 UI, 202 UM, and 100 UMCU) completed the questionnaires. In the three medical schools, Cronbach's α for the pre-module total score and the four subscale scores always exceeded 0.62. UMCU students achieved the highest pre-module scores in all subscales compared to UI and UM with the comparison of average (SD) score as the following: knowledge 5.04 (0.4) vs. 4.73 (0.69) and 4.24 (0.74), p<0.001; attitude 4.52 (0.64) vs. 3.85 (0.68) and 3.55 (0.63), p<0.001; behavior 2.62 (0.55) vs. 2.35 (0.71) and 2.39 (0.92), p=0.016; and future use of EBP 4.32 (0.59) vs. 4.08 (0.62) and 3.7 (0.71), p<0.01. The CE-EBM module increased the knowledge of the UMCU (from average 5.04±0.4 to 5.35±0.51; p<0.001) and UM students (from average 4.24±0.74 to 4.53±0.72; p<0.001) but not UI. The post-module scores for attitude did not change in the three medical schools. Conclusion EBP teaching had direct short-term effects on knowledge, not on attitude. Differences in pre-module scores are most likely related to differences in the system and infrastructure of both medical schools and their curriculum. PMID:23121993

  20. Direct short-term effects of EBP teaching: change in knowledge, not in attitude; a cross-cultural comparison among students from European and Asian medical schools.

    PubMed

    Widyahening, Indah S; van der Heijden, Geert J M G; Moy, Foong Ming; van der Graaf, Yolanda; Sastroasmoro, Sudigdo; Bulgiba, Awang

    2012-10-31

    We report about the direct short-term effects of a Clinical Epidemiology and Evidence-based Medicine (CE-EBM) module on the knowledge, attitude, and behavior of students in the University Medical Center Utrecht (UMCU), Universitas Indonesia (UI), and University of Malaya (UM). We used an adapted version of a 26-item validated questionnaire, including four subscales: knowledge, attitude, behavior, and future use of evidence-based practice (EBP). The four components were compared among the students in the three medical schools before the module using one-way ANOVA. At the end of the module, we measured only knowledge and attitudes. We computed Cronbach's α to assess the reliability of the responses in our population. To assess the change in knowledge and attitudes, we used the paired t-test in the comparison of scores before and after the module. In total, 526 students (224 UI, 202 UM, and 100 UMCU) completed the questionnaires. In the three medical schools, Cronbach's α for the pre-module total score and the four subscale scores always exceeded 0.62. UMCU students achieved the highest pre-module scores in all subscales compared to UI and UM with the comparison of average (SD) score as the following: knowledge 5.04 (0.4) vs. 4.73 (0.69) and 4.24 (0.74), p<0.001; attitude 4.52 (0.64) vs. 3.85 (0.68) and 3.55 (0.63), p<0.001; behavior 2.62 (0.55) vs. 2.35 (0.71) and 2.39 (0.92), p=0.016; and future use of EBP 4.32 (0.59) vs. 4.08 (0.62) and 3.7 (0.71), p<0.01. The CE-EBM module increased the knowledge of the UMCU (from average 5.04±0.4 to 5.35±0.51; p<0.001) and UM students (from average 4.24±0.74 to 4.53±0.72; p<0.001) but not UI. The post-module scores for attitude did not change in the three medical schools. EBP teaching had direct short-term effects on knowledge, not on attitude. Differences in pre-module scores are most likely related to differences in the system and infrastructure of both medical schools and their curriculum.

  1. Cervical cancer screening and treatment training course in El Salvador: experience and lessons learned.

    PubMed

    Masch, Rachel; Ditzian, Lauren R; April, Ayana K; Maza, Mauricio; Peralta, Ethel; Cremer, Miriam L

    2011-09-01

    Visual inspection with acetic acid (VIA) is a simple, low-cost alternative to traditional Pap smears that could greatly benefit the amount of screening and treatment available in low-resource areas, such as rural El Salvador. The objective of this study was to train Salvadoran health providers in VIA and cryotherapy using a week-long competency course. Health providers participated in the VIA training course, which consisted of 1 half-day of didactics, followed by 4 and 1 half days of clinical training. Pretests and posttests were administered. A 1-day didactic refresher course was administered to assess the quality of services being provided. Sixty-eight nurses and physicians completed the training course. Each trainee screened approximately 120 women and performed, on average, seven cryotherapy treatments. The average trainee improved his or her score by 15% on the theoretical test and 16.7% on the image test. At the completion of the 1-day refresher, average test scores were the highest among all the courses. The final assessment was based on 41 providers. The course proved a successful tool for training healthcare providers in methods of cervical cancer screening and treatment. The course is replicable in other low-resource settings in different countries. It also provided trainees with the opportunity to adapt their clinical skills in their realistic work setting.

  2. Optimization of 3D Print Material for the Recreation of Patient-Specific Temporal Bone Models.

    PubMed

    Haffner, Max; Quinn, Austin; Hsieh, Tsung-Yen; Strong, E Bradley; Steele, Toby

    2018-05-01

    Identify the 3D printed material that most accurately recreates the visual, tactile, and kinesthetic properties of human temporal bone Subjects and Methods: Fifteen study participants with an average of 3.6 years of postgraduate training and 56.5 temporal bone (TB) procedures participated. Each participant performed a mastoidectomy on human cadaveric TB and five 3D printed TBs of different materials. After drilling each unique material, participants completed surveys to assess each model's appearance and physical likeness on a Likert scale from 0 to 10 (0 = poorly representative, 10 = completely life-like). The 3D models were acquired by computed tomography (CT) imaging and segmented using 3D Slicer software. Polyethylene terephthalate (PETG) had the highest average survey response for haptic feedback (HF) and appearance, scoring 8.3 (SD = 1.7) and 7.6 (SD = 1.5), respectively. The remaining plastics scored as follows for HF and appearance: polylactic acid (PLA) averaged 7.4 and 7.6, acrylonitrile butadiene styrene (ABS) 7.1 and 7.2, polycarbonate (PC) 7.4 and 3.9, and nylon 5.6 and 6.7. A PETG 3D printed temporal bone models performed the best for realistic appearance and HF as compared with PLA, ABS, PC, and nylon. The PLA and ABS were reliable alternatives that also performed well with both measures.

  3. An FMEA evaluation of intensity modulated radiation therapy dose delivery failures at tolerance criteria levels.

    PubMed

    Faught, Jacqueline Tonigan; Balter, Peter A; Johnson, Jennifer L; Kry, Stephen F; Court, Laurence E; Stingo, Francesco C; Followill, David S

    2017-11-01

    The objective of this work was to assess both the perception of failure modes in Intensity Modulated Radiation Therapy (IMRT) when the linac is operated at the edge of tolerances given in AAPM TG-40 (Kutcher et al.) and TG-142 (Klein et al.) as well as the application of FMEA to this specific section of the IMRT process. An online survey was distributed to approximately 2000 physicists worldwide that participate in quality services provided by the Imaging and Radiation Oncology Core - Houston (IROC-H). The survey briefly described eleven different failure modes covered by basic quality assurance in step-and-shoot IMRT at or near TG-40 (Kutcher et al.) and TG-142 (Klein et al.) tolerance criteria levels. Respondents were asked to estimate the worst case scenario percent dose error that could be caused by each of these failure modes in a head and neck patient as well as the FMEA scores: Occurrence, Detectability, and Severity. Risk probability number (RPN) scores were calculated as the product of these scores. Demographic data were also collected. A total of 181 individual and three group responses were submitted. 84% were from North America. Most (76%) individual respondents performed at least 80% clinical work and 92% were nationally certified. Respondent medical physics experience ranged from 2.5 to 45 yr (average 18 yr). A total of 52% of individual respondents were at least somewhat familiar with FMEA, while 17% were not familiar. Several IMRT techniques, treatment planning systems, and linear accelerator manufacturers were represented. All failure modes received widely varying scores ranging from 1 to 10 for occurrence, at least 1-9 for detectability, and at least 1-7 for severity. Ranking failure modes by RPN scores also resulted in large variability, with each failure mode being ranked both most risky (1st) and least risky (11th) by different respondents. On average MLC modeling had the highest RPN scores. Individual estimated percent dose errors and severity scores positively correlated (P < 0.01) for each FM as expected. No universal correlations were found between the demographic information collected and scoring, percent dose errors or ranking. Failure modes investigated overall were evaluated as low to medium risk, with average RPNs less than 110. The ranking of 11 failure modes was not agreed upon by the community. Large variability in FMEA scoring may be caused by individual interpretation and/or experience, reflecting the subjective nature of the FMEA tool. © 2017 American Association of Physicists in Medicine.

  4. [Stress in nurses at a hemodynamics ward in Rio Grande do Sul, Brazil].

    PubMed

    Linch, Graciele Fernanda da Costa; Guido, Laura de Azevedo

    2011-03-01

    This study aimed to evaluate the relationship between stress and symptoms reported by nurses working in units hemodynamics. Data were collected through a questionnaire. For analysis, the results were considered statistically significant if p < 0.05, with an interval of 95% confidence. The population consisted of 63 nurses with a predominance of females (90.5%) and average age of 35.24 (+/- 8.21) years. Most participants werepostgraduate (77.8%) and did not have another job (77.8%). In relation to stress, 52.4% of nurses had an average between 1.11 and 1.97, classified as medium stress, and the critical situations domain presented the highest score (1.63 +/- 0.29). Regarding symptoms, the domain skeletal muscle had a higher average (1.39 +/- 0.94). In this study, there was high significant positive correlation between stress and symptoms (r = 0.629, p < 0.001), thus it is concluded that stress is directly related to the symptomspresented by the nurses.

  5. The Relationship between Senior Year Examinations at a Medical School and the Korean Medical Licensing Examination.

    PubMed

    Jung, Ki Hoon; Jung, Ho Keun; Lee, Kwan

    2009-03-01

    Most medical schools prepare for the Korean medical licensing examination (KMLE) with various tests. By assessing the degree to which these exams and the KMLE are related, students, professors, and institutions can be well prepared and some schools use these exams as predictive tools for KMLE scores. Therefore, we determined the relevance of KMLE results to midterm exams and the objective structured clinical examination (OSCE), administered to senior students at a medical school. From 2002 to 2004, KMLE results were compared with midterm examinations, the KMLE, and the OSCE. The total score, or T-score, of the KMLE was used, as was a pass or nonpass score. Windows SPSS 14.0 and MedCalc 9.0 were used for statistical analysis. The yearly correlation coefficient of the KMLE and school exams was highest for the midterm exams in 2002 and the KMLE in 2003 and 2004. The correlation coefficient of midterm exams and the KMLE were related to a high degree, yet the values were as low as that of the OSCE. Compared with the KMLE results, the sensitivity and specificity of the average midterm exam were 100.0% and 93.8%, and the sensitivity and specificity of the average trial exams were 100.0% and 95.8%, respectively. In conclusion, the KMLE results have a strong relationship with midterm exams, trial exams, and the combination of midterm and trial exams, but not with the OSCE. Thus, we believe that using both midterm exams and trial exams to predict KMLE results is superior to the use of only one type of school exam.

  6. A system to evaluate the scientific quality of biological and restoration objectives using National Wildlife Refuge Comprehensive Conservation Plans as a case study

    USGS Publications Warehouse

    Schroeder, R.L.

    2006-01-01

    It is widely accepted that plans for restoration projects should contain specific, measurable, and science-based objectives to guide restoration efforts. The United States Fish and Wildlife Service (USFWS) is in the process of developing Comprehensive Conservation Plans (CCPs) for more than 500 units in the National Wildlife Refuge System (NWRS). These plans contain objectives for biological and ecosystem restoration efforts on the refuges. Based on USFWS policy, a system was developed to evaluate the scientific quality of such objectives based on three critical factors: (1) Is the objective specific, measurable, achievable, results-oriented, and time-fixed? (2) What is the extent of the rationale that explains the assumptions, logic, and reasoning for the objective? (3) How well was available science used in the development of the objective? The evaluation system scores each factor on a scale of 1 (poor) to 4 (excellent) according to detailed criteria. The biological and restoration objectives from CCPs published as of September 2004 (60 total) were evaluated. The overall average score for all biological and restoration objectives was 1.73. Average scores for each factor were: Factor 1-1.97; Factor 2-1.86; Factor 3-1.38. The overall scores increased from 1997 to 2004. Future restoration efforts may benefit by using this evaluation system during the process of plan development, to ensure that biological and restoration objectives are of the highest scientific quality possible prior to the implementation of restoration plans, and to allow for improved monitoring and adaptive management.

  7. Incidence, Intensity, and Impact of Pain in Recently Discharged Adult Trauma Patients: An Exploratory Study.

    PubMed

    Goldsmith, Helen; Curtis, Kate; McCloughen, Andrea

    The long-term implications of pain following injury are well known; however, the immediate posthospitalization incidence and impact of pain is less understood. Inadequate pain relief during this time can delay return to work, leading to psychological stress and chronic pain. This exploratory study aimed to identify the incidence, intensity, and impact of injury-related pain in recently discharged adult trauma patients. During July to December 2014, 82 recently discharged adult trauma patients completed a questionnaire about their injury-related pain experience approximately 2 weeks posthospital discharge from a Level 1 trauma center. The questionnaire was developed using the Brief Pain Inventory, assessing severity, and impact of pain through a score from 0 to 10. The average age of participants was 52 years, the median Injury Severity Score was 6, and almost all (n = 80, 98%) experienced a blunt injury. The majority of participants reported pain since discharge (n = 80, 98%), with 65 (81%) still experiencing pain on the day of data collection. Normal work was most affected by pain, with an average score of 6.6 of 10, closely followed by effect on general activity (6.1 of 10) and enjoyment of life (5.7 of 10). The highest pain severity was reported by those with injuries from road trauma, with low Injury Severity Scores, who were female, and did not speak English at home. Pain in the recently discharged adult trauma patient is common, intense and interferes with quality of life. Identification of barriers to effective pain management and interventions to address these barriers are required.

  8. Health Care Providers' Perception of Their Competence in Providing Spiritual Care for Patients.

    PubMed

    Ebrahimi, Hossein; Areshtanab, Hossein Namdar; Jafarabadi, Mohammad Asghari; Khanmiri, Soraya Golipoor

    2017-01-01

    Spiritual care is an important part of health-care provision. Spiritual care can improve patients' health. One of the requirements for providing appropriate spiritual care for patients is having the required competence. This study was conducted to investigate the perception of health-care providers of their own competence in providing spiritual cares for patients hospitalized in medical-educational centers of Iran. This study is a cross-sectional, analytical research conducted on 555 nurses of medical-educational centers in Tabriz, Iran, in 2014. Data were collected using a two-part questionnaire including demographic information and the spiritual care competence scale. Data analysis was performed using descriptive (frequency, percentage, mean, and standard deviation) and inferential (independent t -test, Pearson, Spearman, ANOVA with Tukey test) statistics in SPSS software version 13. Results showed that the mean score for nurses' perception of their competence in providing spiritual care for patients was average, that is, 95.2 ± 14.4. Mean score of nurses' perception of their competence in providing spiritual care in each aspect was significantly higher than average ( P < 0.05). The highest score was related to individual support and consulting with patients, that is, 21.1 (4.0), and the lowest score was related to reference to experts, that is, 9.5 (2.3). The type of employment and participation in workshops had significant relationships with nurses' perception of their competence for providing spiritual care ( P < 0.05). The findings indicate that authorities and policymakers should take steps in planning for nurses' training for promoting their competence in providing spiritual care for patients; therefore, holding workshops is necessary.

  9. Environmental scan and evaluation of best practices for online systematic review resources

    PubMed Central

    Parker, Robin M. N.; Boulos, Leah M.; Visintini, Sarah; Ritchie, Krista; Hayden, Jill

    2018-01-01

    Objective Online training for systematic review methodology is an attractive option due to flexibility and limited availability of in-person instruction. Librarians often direct new reviewers to these online resources, so they should be knowledgeable about the variety of available resources. The objective for this project was to conduct an environmental scan of online systematic review training resources and evaluate those identified resources. Methods The authors systematically searched for electronic learning resources pertaining to systematic review methods. After screening for inclusion, we collected data about characteristics of training resources and assigned scores in the domains of (1) content, (2) design, (3) interactivity, and (4) usability by applying a previously published evaluation rubric for online instruction modules. We described the characteristics and scores for each training resource and compared performance across the domains. Results Twenty training resources were evaluated. Average overall score of online instructional resources was 61%. Online courses (n=7) averaged 73%, web modules (n=5) 64%, and videos (n=8) 48%. The top 5 highest scoring resources were in course or web module format, featured high interactivity, and required a longer (>5hrs) time commitment from users. Conclusion This study revealed that resources include appropriate content but are less likely to adhere to principles of online training design and interactivity. Awareness of these resources will allow librarians to make informed recommendations for training based on patrons’ needs. Future online systematic review training resources should use established best practices for e-learning to provide high-quality resources, regardless of format or user time commitment. PMID:29632443

  10. SU-C-207B-07: Deep Convolutional Neural Network Image Matching for Ultrasound Guidance in Radiotherapy

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

    Zhu, N; Najafi, M; Hancock, S

    Purpose: Robust matching of ultrasound images is a challenging problem as images of the same anatomy often present non-trivial differences. This poses an obstacle for ultrasound guidance in radiotherapy. Thus our objective is to overcome this obstacle by designing and evaluating an image blocks matching framework based on a two channel deep convolutional neural network. Methods: We extend to 3D an algorithmic structure previously introduced for 2D image feature learning [1]. To obtain the similarity between two 3D image blocks A and B, the 3D image blocks are divided into 2D patches Ai and Bi. The similarity is then calculatedmore » as the average similarity score of Ai and Bi. The neural network was then trained with public non-medical image pairs, and subsequently evaluated on ultrasound image blocks for the following scenarios: (S1) same image blocks with/without shifts (A and A-shift-x); (S2) non-related random block pairs; (S3) ground truth registration matched pairs of different ultrasound images with/without shifts (A-i and A-reg-i-shift-x). Results: For S1 the similarity scores of A and A-shift-x were 32.63, 18.38, 12.95, 9.23, 2.15 and 0.43 for x=ranging from 0 mm to 10 mm in 2 mm increments. For S2 the average similarity score for non-related block pairs was −1.15. For S3 the average similarity score of ground truth registration matched blocks A-i and A-reg-i-shift-0 (1≤i≤5) was 12.37. After translating A-reg-i-shift-0 by 0 mm, 2 mm, 4 mm, 6 mm, 8 mm, and 10 mm, the average similarity scores of A-i and A-reg-i-shift-x were 11.04, 8.42, 4.56, 2.27, and 0.29 respectively. Conclusion: The proposed method correctly assigns highest similarity to corresponding 3D ultrasound image blocks despite differences in image content and thus can form the basis for ultrasound image registration and tracking.[1] Zagoruyko, Komodakis, “Learning to compare image patches via convolutional neural networks', IEEE CVPR 2015,pp.4353–4361.« less

  11. Healthy Lifestyles Related to Subsequent Prevalence of Age-Related Macular Degeneration

    PubMed Central

    Mares, JA; Voland, R.; Sondel, SA; Millen, A.E.; LaRowe, T; Moeller, SM; Klein, M.L.; Blodi, B.A; Chappell, R.; Tinker, L.; Ritenbaugh, C; Gehrs, K; Sarto, G; Johnson, E.J; Snodderly, M; Wallace, RB

    2010-01-01

    Purpose The relationships between lifestyle behaviors of diet, smoking and physical activity and the subsequent prevalence of age-related macular degeneration (AMD) were investigated. Methods The population included 1,313 participants (55 to 74 years) in the Carotenoids in Age-Related Eye Disease Study (CAREDS), an ancillary study of the Women's Health Initiative Observational Study (WHIOS). Scores on a modified 2005 Healthy Eating Index (mHEI) were assigned using responses to a food frequency questionnaire administered at WHIOS baseline (1994-1998). Physical activity and lifetime smoking history were queried. An average of six years later, stereoscopic fundus photographs were taken to assess presence and severity of AMD; present in 202 women, 94% of whom had early AMD, the primary outcome. Results In multivariate models, women whose diets scored in the highest compared with the lowest quintile on the mHEI had a 46% lower odds for early AMD. Women in the highest vs. lowest quintile for physical activity (MET- Hrs/Wk) had 54% lower odds for early AMD. Although smoking, alone was not independently associated with AMD, having a combination of three healthy lifestyles (healthy diet, physical activity and not smoking) was associated with a 71% lower odds for AMD compared with having high risk scores (P=0.0004). Conclusions Modifying lifestyles might reduce risk for early AMD as much as 3-fold, lowering the risk for advanced AMD in a person's lifetime and the social and economic costs of AMD to society. PMID:21149749

  12. Using lean Six Sigma to improve hospital based outpatient imaging satisfaction.

    PubMed

    McDonald, Angelic P; Kirk, Randy

    2013-01-01

    Within the hospital based imaging department at Methodist Willowbrook, outpatient, inpatient, and emergency patients are all performed on the same equipment with the same staff. The critical nature of the patient is the deciding factor as to who gets done first and in what order procedures are performed. After an aggressive adoption of Intentional Tools, the imaging department was finally able to move from a two year mean Press Ganey, outpatient satisfaction average score of 91.2 and UHC percentile ranking of 37th to a mean average of 92.1 and corresponding UHC ranking of 60th percentile. It was at the 60th percentile ranking that the department flat lined. Using the Six Sigma DMAIC process, opportunity for further improvement was identified. A two week focus pilot was conducted specifically on areas identified through the Six Sigma process. The department was able to jump to 88th percentile ranking and a mean of 93.7. With pay for performance focusing on outpatient satisfaction and a financial incentive to improving and maintaining the highest scores, it was important to know where the imaging department should apply its financial resources to obtain the greatest impact.

  13. The job competency of radiological technologists in Korea based on specialists opinion and questionnaire survey

    PubMed Central

    2017-01-01

    Purpose Although there are over 40,000 licensed radiological technologists (RTs) in Korea, job competency standards have yet to be defined. This study aims to clarify the job competency of Korean RTs. Methods A task force team of 11 professional RTs were recruited in order to analyze the job competency of domestic and international RTs. A draft for the job competency of Korean RTs was prepared. A survey was then conducted sampling RTs and the attitudes of their competencies were recorded from May 21 to July 30, 2016. Results We identified five modules of professionalism, patient management, health and safety, operation of equipment, and procedure management and 131 detailed job competencies for RTs in Korea. “Health and safety” had the highest average score and “professionalism” had the lowest average score for both job performance and importance. The content validity ratios for the 131 subcompetencies were mostly valid. Conclusion Establishment of standard guidelines for RT job competency for multidisciplinary healthcare at medical institutions may be possible based on our results, which will help educators of RT training institutions to clarify their training and education. PMID:28502973

  14. Central and non-central networks, cognition, clinical symptoms, and polygenic risk scores in schizophrenia.

    PubMed

    Alloza, Clara; Bastin, Mark E; Cox, Simon R; Gibson, Jude; Duff, Barbara; Semple, Scott I; Whalley, Heather C; Lawrie, Stephen M

    2017-12-01

    Schizophrenia is a complex disorder that may be the result of aberrant connections between specific brain regions rather than focal brain abnormalities. Here, we investigate the relationships between brain structural connectivity as described by network analysis, intelligence, symptoms, and polygenic risk scores (PGRS) for schizophrenia in a group of patients with schizophrenia and a group of healthy controls. Recently, researchers have shown an interest in the role of high centrality networks in the disorder. However, the importance of non-central networks still remains unclear. Thus, we specifically examined network-averaged fractional anisotropy (mean edge weight) in central and non-central subnetworks. Connections with the highest betweenness centrality within the average network (>75% of centrality values) were selected to represent the central subnetwork. The remaining connections were assigned to the non-central subnetwork. Additionally, we calculated graph theory measures from the average network (connections that occur in at least 2/3 of participants). Density, strength, global efficiency, and clustering coefficient were significantly lower in patients compared with healthy controls for the average network (p FDR  < 0.05). All metrics across networks were significantly associated with intelligence (p FDR  < 0.05). There was a tendency towards significance for a correlation between intelligence and PGRS for schizophrenia (r = -0.508, p = 0.052) that was significantly mediated by central and non-central mean edge weight and every graph metric from the average network. These results are consistent with the hypothesis that intelligence deficits are associated with a genetic risk for schizophrenia, which is mediated via the disruption of distributed brain networks. Hum Brain Mapp 38:5919-5930, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  15. The comparative study of resonance disorders for Vietnamese and Korean cleft palate speakers using nasometer.

    PubMed

    Shin, Yu-Jeong; Kim, Yongsoo; Kim, Hyun-Gi

    2017-12-01

    Nasalance is used to evaluate the velopharyngeal incompetence in clinical diagnoses using a nasometer. The aim of this study is to find the nasalance differences between Vietnamese cleft palate children and Korean cleft palate children by measuring the nasalance of five oral vowels. Ten Vietnamese cleft palate children after surgery, three Vietnamese children for the control group, and ten Korean cleft palate children after surgery with the same age participated in this experimentation. Instead of Korean control, the standard value of Korean version of the simplified nasometric assessment procedures (kSNAP) was used. The results are as follows: (1) the highest nasalance score among the Vietnamese normal vowels is the low vowel /a/; however, that of Korean normal vowels is the high vowel /i/. (2) The average nasalance score of Korean cleft palate vowels is 18% higher than that of Vietnamese cleft palate vowels. There was a nasalance score of over 45% among the vowels /e/ and /i/ in Vietnamese cleft palate patients and /i/, /o/, and /u/ in Korean cleft palate patients. These different nasalance scores of the same vowels seem to cause an ethnic difference between Vietnamese and Korean cleft palate children.

  16. Evidence-based practice guidelines in OHS: are they agree-able?

    PubMed

    Hulshof, Carel; Hoenen, John

    2007-01-01

    The purpose of this study was to evaluate the acceptance, validity, reliability and feasibility of the AGREE (Appraisal of Guidelines and REsearch and Evaluation) instrument to assess the quality of evidence-based practice guidelines for occupational physicians. In total, 6 practice guidelines of the Netherlands Society of Occupational Medicine (NVAB) were appraised by 20 occupational health professionals and experts in guideline development or implementation. Although appraisers often disagreed on individual item scores, the internal consistency and interrater reliability for most domains was sufficient. The AGREE criteria were in general considered relevant and no major suggestions for additional items for use in the context of occupational health were brought up. The domain scores for the individual guidelines show a wide variety: 'applicability' had on average the lowest mean score (53%) while 'scope and purpose' had the highest one (87%). Low scores indicate where improvements are possible and necessary, e.g. by providing more information about the development. Key experts in occupational health report that AGREE is a relevant and easy to use instrument to evaluate quality aspects and the included criteria provide a good framework to develop or update evidence-based practice guidelines in the field of occupational health.

  17. Factors Associated with Hepatitis C Knowledge Before and After an Educational Intervention among Vietnamese Americans

    PubMed Central

    Lee, Sunmin; Zhai, Shumenghui; Zhang, Guo (Yolanda); Ma, Xiang S; Lu, Xiaoxiao; Tan, Yin; Siu, Philip; Seals, Brenda; Ma, Grace X

    2015-01-01

    BACKGROUND Hepatitis C virus (HCV) is a major cause of chronic liver disease and cancer. Vietnamese Americans are at high risk of HCV infection, with men having the highest US incidence of liver cancer. This study examines an intervention to improve HCV knowledge among Vietnamese Americans. STUDY Seven Vietnamese community-based organizations in Pennsylvania and New Jersey recruited a total of 306 Vietnamese participants from 2010 to 2011. RESULTS Average knowledge scores for pretest and posttest were 3.32 and 5.88, respectively (maximum 10). After adjusting for confounding variables, age and higher education were positively associated with higher pretest scores and having a physician who spoke English or Vietnamese was negatively associated with higher pretest scores. Additionally, after adjusting for confounding variables, household income, education, and having an HCV-infected family member significantly increased knowledge scores. CONCLUSIONS Promotion and development of HCV educational programs can increase HCV knowledge among race and ethnic groups, such as Vietnamese Americans. Giving timely information to at-risk groups provides the opportunity to correct misconceptions, decrease HCV risk behaviors, and encourage testing that might improve timely HCV diagnosis and treatment. PMID:26561280

  18. Relationship of CogScreen-AE to flight simulator performance and pilot age.

    PubMed

    Taylor, J L; O'Hara, R; Mumenthaler, M S; Yesavage, J A

    2000-04-01

    We report on the relationship between CogScreen-Aeromedical Edition (AE) factor scores and flight simulator performance in aircraft pilots aged 50-69. Some 100 licensed, civilian aviators (average age 58+/-5.3 yr) performed aviation tasks in a Frasca model 141 flight simulator and the CogScreen-AE battery. The aviation performance indices were: a) staying on course; b) dialing in communication frequencies; c) avoiding conflicting traffic; d) monitoring cockpit instruments; e) executing the approach; and f) a summary score, which was the mean of these scores. The CogScreen predictors were based on a factor structure reported by Kay (11), which comprised 28 CogScreen scores. Through principal components analysis of Kay's nine factors, we reduced the number of predictors to five composite CogScreen scores: Speed/Working Memory (WM), Visual Associative Memory, Motor Coordination, Tracking, and Attribute Identification. Speed/WM scores had the highest correlation with the flight summary score, Spearman r(rho) = 0.57. A stepwise-forward multiple regression analysis indicated that four CogScreen variables could explain 45% of the variance in flight summary scores. Significant predictors, in order of entry, were: Speed/WM, Visual Associative Memory, Motor Coordination, and Tracking (p<0.05). Pilot age was found to significantly improve prediction beyond that which could be predicted by the four cognitive variables. In addition, there was some evidence for specific ability relationships between certain flight component scores and CogScreen scores, such as approach performance and tracking errors. These data support the validity of CogScreen-AE as a cognitive battery that taps skills relevant to piloting.

  19. An assessment of primary care attributes from the perspective of female healthcare users1

    PubMed Central

    Lima, Eliane de Fátima Almeida; Sousa, Ana Inês; Primo, Cândida Caniçali; Leite, Francielie Marabotti Costa; Lima, Rita de Cassia Duarte; Maciel, Ethel Leonor Nóia

    2015-01-01

    OBJECTIVE: this study sought to assess the quality of the Family Health Strategy (FHS) and investigated the association between primary care attributes (PCAs) and the sociodemographic characteristics of users. METHOD: a total of 215 female FHS users were interviewed for this descriptive and cross-sectional study. The Primary Care Assessment Tool (PCATool), Adult Edition was used, and the results were analyzed using Fisher's exact tests, Pearson's chi-square tests and logistic regressions. RESULTS: the lowest average score corresponded to the dimension "accessibility" (1.80), and the highest score corresponded to "access" (8.76). The results corresponding to the attributes "longitudinality", "coordination", "comprehensiveness", and "orientation" were not significant. No association was found between the participants' sociodemographic characteristics and the essential, derivative, and general attributes (p>0.05). CONCLUSION: several attributes must be improved across all the investigated services from the perspective of female FHS users. PMID:26155006

  20. Critical Thinking Disposition of Nurse Practitioners in Taiwan.

    PubMed

    Hsu, Hsiu-Ying; Chang, Shu-Chen; Chang, Ai-Ling; Chen, Shiah-Lian

    2017-09-01

    Critical thinking disposition (CTD) is crucial for nurse practitioners who face complex patient care scenarios. This study explored the CTD of nurse practitioners and related factors. The study was a cross-sectional descriptive design. A purposive sample was recruited from a medical center and its hospital branches in central Taiwan. A structured questionnaire was used to collect data from 210 nurse practitioners. The participants obtained the highest average score on systematicity and analyticity. CTD had a significant positive correlation with fundamental knowledge readiness, professional knowledge readiness, and confidence in making clinical decisions. Professional knowledge readiness, education level, and on-the-job training predicted the score of the participants on overall CTD. On-the-job training and education level may influence the CTD of nurse practitioners. Providing formal or on-the-job continuing education training to nurse practitioners may help enhance their CTD. J Contin Educ Nurs. 2017;48(9):425-430. Copyright 2017, SLACK Incorporated.

  1. Determination of Key Flavor Components in Methylene Chloride Extracts from Processed Grapefruit Juice.

    PubMed

    Jella; Rouseff; Goodner; Widmer

    1998-01-19

    The relative correlation of 52 aroma and 5 taste components in commercial not-from-concentrate grapefruit juices with flavor panel preference was determined. Methylene chloride extracts of juice were analyzed using GC/MS with a DB-5 column. Nonvolatiles determined included limonin and naringin by HPLC, degrees Brix, total acids, and degrees Brix/acid ratio. Juice samples were classified into low, medium, or high categories, based on average taste panel preference scores (nine-point hedonic scale). Principal component analysis demonstrated that highest quality juices were tightly clustered. Discriminant analysis indicated that 82% of the samples could be identified in the correct preference category using only myrcene, beta-caryophyllene, linalool, nootkatone, and degrees Brix. Nootkatone alone was not strongly associated with preference scores. The most preferred juices were strongly associated with low myrcene, low linalool, and intermediate levels of beta-caryophyllene.

  2. Service quality assessment of a referral hospital in southern Iran with SERVQUAL technique: patients' perspective.

    PubMed

    Aghamolaei, Teamur; Eftekhaari, Tasnim Eghbal; Rafati, Shideh; Kahnouji, Kobra; Ahangari, Shamsieh; Shahrzad, Mohammad Esmaeil; Kahnouji, Ataollah; Hoseini, Seyedeh Hamideh

    2014-07-27

    Providing services to patients according to their expectations and needs is necessary for the success of an organization in order to remain in the competitive market. Recognizing these needs and expectations is an important step in offering high quality services. This study was designed to determine the service quality gap of the main hospital of Hormozgan province. This cross sectional study was conducted in 2013 in Bandar Abbas ShahidMohammadi Hospital in the south of Iran. All 96 participants of this study were provided by SERVQUAL questionnaire. Data was analyzed by Wilcoxon and Kruskal-Wallis tests. Service quality gaps were seen in all five service quality dimensions and the overall quality of service. The mean of quality perception score and quality expectation score was 3.44 ± 0.693 and 4.736 ± 0.34, respectively. The highest perception was in assurance dimension and the highest expectation was in Responsiveness and assurance dimensions. Also, the lowest perception was in responsiveness dimension and the lowest expectation was about empathy. In this study, 56.1% of participants defined the quality of services as average. According to the results, this hospital was not able to meet patients' expectations completely. Therefore, action must be taken to decrease the gap between the perception and expectation of the patients.

  3. Assessing pediatrics residents' mathematical skills for prescribing medication: a need for improved training.

    PubMed

    Glover, Mark L; Sussmane, Jeffrey B

    2002-10-01

    To evaluate residents' skills in performing basic mathematical calculations used for prescribing medications to pediatric patients. In 2001, a test of ten questions on basic calculations was given to first-, second-, and third-year residents at Miami Children's Hospital in Florida. Four additional questions were included to obtain the residents' levels of training, specific pediatrics intensive care unit (PICU) experience, and whether or not they routinely double-checked doses and adjusted them for each patient's weight. The test was anonymous and calculators were permitted. The overall score and the score for each resident class were calculated. Twenty-one residents participated. The overall average test score and the mean test score of each resident class was less than 70%. Second-year residents had the highest mean test scores, although there was no significant difference between the classes of residents (p =.745) or relationship between the residents' PICU experiences and their exam scores (p =.766). There was no significant difference between residents' levels of training and whether they double-checked their calculations (p =.633) or considered each patient's weight relative to the dose prescribed (p =.869). Seven residents committed tenfold dosing errors, and one resident committed a 1,000-fold dosing error. Pediatrics residents need to receive additional education in performing the calculations needed to prescribe medications. In addition, residents should be required to demonstrate these necessary mathematical skills before they are allowed to prescribe medications.

  4. Fatigue: an important feature of late-onset Pompe disease.

    PubMed

    Hagemans, Marloes L C; van Schie, Sabine P M; Janssens, A Cecile J W; van Doorn, Pieter A; Reuser, Arnold J J; van der Ploeg, Ans T

    2007-07-01

    To investigate the prevalence and severity of fatigue in adult patients with Pompe disease. The Fatigue Severity Scale (FSS) was assessed in an international population of 225 adults with Pompe disease, a metabolic disorder presenting as a slowly progressive proximal myopathy. The FSS scores were compared to those of healthy controls and the relationship between the level of fatigue and other patient characteristics was investigated. The mean age of the participants was 47 (SD 13) years and the mean disease duration 11 (SD 8) years. 43% used a wheelchair and 46% had respiratory support, 29% needed both. 67% of the participants had a FSS score > or =5, indicating severe fatigue. The mean FSS score was 5.2 (SD 1.5), which was significantly higher than that of healthy controls (p < 0.001). Fatigue was not related to age, sex or disease duration. Patients who used a wheelchair or respiratory support were on average more fatigued than those who did not (p = 0.01). However, of the patients who did not use these aids, 59% also had a FSS score > or =5. FSS scores were highest among patients who reported a high frequency of sleep disorders, but patients who never experienced sleep difficulties were also fatigued (mean FSS score = 4.8). Fatigue is highly prevalent among both mildly and severely affected adult patients with Pompe disease. The FSS appears a useful tool in assessing fatigue in Pompe disease.

  5. Review and Analysis of Existing Mobile Phone Apps to Support Heart Failure Symptom Monitoring and Self-Care Management Using the Mobile Application Rating Scale (MARS).

    PubMed

    Masterson Creber, Ruth M; Maurer, Mathew S; Reading, Meghan; Hiraldo, Grenny; Hickey, Kathleen T; Iribarren, Sarah

    2016-06-14

    Heart failure is the most common cause of hospital readmissions among Medicare beneficiaries and these hospitalizations are often driven by exacerbations in common heart failure symptoms. Patient collaboration with health care providers and decision making is a core component of increasing symptom monitoring and decreasing hospital use. Mobile phone apps offer a potentially cost-effective solution for symptom monitoring and self-care management at the point of need. The purpose of this review of commercially available apps was to identify and assess the functionalities of patient-facing mobile health apps targeted toward supporting heart failure symptom monitoring and self-care management. We searched 3 Web-based mobile app stores using multiple terms and combinations (eg, "heart failure," "cardiology," "heart failure and self-management"). Apps meeting inclusion criteria were evaluated using the Mobile Application Rating Scale (MARS), IMS Institute for Healthcare Informatics functionality scores, and Heart Failure Society of America (HFSA) guidelines for nonpharmacologic management. Apps were downloaded and assessed independently by 2-4 reviewers, interclass correlations between reviewers were calculated, and consensus was met by discussion. Of 3636 potentially relevant apps searched, 34 met inclusion criteria. Most apps were excluded because they were unrelated to heart failure, not in English or Spanish, or were games. Interrater reliability between reviewers was high. AskMD app had the highest average MARS total (4.9/5). More than half of the apps (23/34, 68%) had acceptable MARS scores (>3.0). Heart Failure Health Storylines (4.6) and AskMD (4.5) had the highest scores for behavior change. Factoring MARS, functionality, and HFSA guideline scores, the highest performing apps included Heart Failure Health Storylines, Symple, ContinuousCare Health App, WebMD, and AskMD. Peer-reviewed publications were identified for only 3 of the 34 apps. This review suggests that few apps meet prespecified criteria for quality, content, or functionality, highlighting the need for further refinement and mapping to evidence-based guidelines and room for overall quality improvement in heart failure symptom monitoring and self-care related apps.

  6. 45 CFR 270.8 - How will we allocate the bonus award funds?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... absolute measure; (2) Award $6 million to the three States with the highest scores on the Medicaid/SCHIP absolute measure; (3) Award $14 million to the seven States with the highest scores on the Food Stamp...

  7. Adolescent Self-Esteem: Differences by Race/Ethnicity, Gender, and Age

    PubMed Central

    Bachman, Jerald G.; O’Malley, Patrick M.; Freedman-Doan, Peter; Trzesniewski, Kali H.; Donnellan, M. Brent

    2012-01-01

    Large-scale representative surveys of 8th-, 10th-, and 12th-grade students in the United States show high self-esteem scores for all groups. African-American students score highest, Whites score slightly higher than Hispanics, and Asian Americans score lowest. Males score slightly higher than females. Multivariate controls for grades and college plans actually heighten these race/ethnic/gender differences. A truncated scoring method, designed to counter race/ethnic differences in extreme response style, reduced but did not eliminate the subgroup differences. Age differences in self-esteem are modest, with 12th graders reporting the highest scores. The findings are highly consistent across 18 annual surveys from 1991 through 2008, and self-esteem scores show little overall change during that period. PMID:22279425

  8. Predictive power of the DASA-IV: Variations in rating method and timescales.

    PubMed

    Nqwaku, Mphindisi; Draycott, Simon; Aldridge-Waddon, Luke; Bush, Emma-Louise; Tsirimokou, Alexandra; Jones, Dominic; Puzzo, Ignazio

    2018-05-10

    This project evaluated the predictive validity of the Dynamic Appraisal of Situational Aggression - Inpatient Version (DASA-IV) in a high-secure psychiatric hospital in the UK over 24 hours and over a single nursing shift. DASA-IV scores from three sequential nursing shifts over a 24-hour period were compared with the mean (average of three scores across the 24-hour period) and peak (highest of the three scores across the 24-hour period) scores across these shifts. In addition, scores from a single nursing shift were used to predict aggressive incidents over each of the following three shifts. The DASA-IV was completed by nursing staff during handover meetings, rating 43 male psychiatric inpatients over a period of 6 months. Data were compared to incident reports recorded over the same period. Receiver operating characteristic (ROC) curves and generalized estimating equations assessed the predictive ability of various DASA-IV scores over 24-hour and single-shift timescales. Scores from the DASA-IV based on a single shift had moderate predictive ability for aggressive incidents occurring the next calendar day, whereas scores based on all three shifts had excellent predictive ability. DASA-IV scores from a single shift showed moderate predictive ability for each of the following three shifts. The DASA-IV has excellent predictive ability for aggressive incidents within a secure setting when data are summarized over a 24-hour period, as opposed to when a single rating is taken. In addition, it has moderate value for predicting incidents over even shorter timescales. © 2018 Australian College of Mental Health Nurses Inc.

  9. Assessment of pain, acceptance of illness, adjustment to life with cancer and coping strategies in breast cancer patients.

    PubMed

    Czerw, Aleksandra; Religioni, Urszula; Deptała, Andrzej

    2016-07-01

    Breast cancer is the most common malignant neoplasm in women. Over the past 40 years, the number of patients diagnosed with breast cancer quadrupled. Breast cancer is one of the most frequent causes of death in women aged 65 and more in Poland. The purpose of the study was to evaluate coping strategies, pain management, disease acceptance and adjustment to cancer in patients diagnosed with breast cancer and to assess the effect of socioeconomic variables on the above mentioned issues. The study included 193 patients diagnosed with breast cancer during outpatient chemotherapy (classical chemotherapy, hormone therapy, molecularly targeted therapies) at the Center of Oncology, Maria Skłodowska-Curie Institute in Warsaw. We applied the Paper and Pencil Interview (PAPI) technique. The questionnaire interview consisted of demographic questions (socioeconomic variables) and the following four psychometric tests: BPCQ (Beliefs about Pain Control Questionnaire), measuring the influence of factors affecting pain management in patients, CSQ (Coping Strategies Questionnaire), designed to evaluate pain coping strategies, AIS (Acceptance of Illness Scale) questionnaire, measuring disease acceptance, and the mini-MAC (Mental Adjustment to Cancer) scale. The results of BPCQ show that breast cancer patients mostly believe that doctors control pain; the mean result for the group was 17.09 and test values were differentiated by education and professional status. The top average score in the pain coping strategies questionnaire was recorded in the positive coping self-statement subscale (mean score = 21.81), whereas the lowest, in the catastrophizing subscale (mean score = 10.60). Here, education and income proved most significant in accounting for the differences recorded. The mean score on the AIS was 28.45, and the key factor differentiating the results was income. As far as the mini-MAC is concerned, we reported the highest score in the fighting spirit subscale (23.43). The average results in the scale were slightly differentiated by socioeconomic variables. Breast cancer patients mostly believe that those who control pain are doctors. Amongst the strategies of coping with pain, the top average score was recorded in the positive coping self-statement subscale. We found out that the level of disease acceptance depends on respondent's income. The higher the income, the greater the acceptance of illness.

  10. Characterizing Vegetation Model Skill and Uncertainty in Simulated Ecosystem Response to Climate Change in the United States

    NASA Astrophysics Data System (ADS)

    Drapek, R. J.; Kim, J. B.

    2013-12-01

    We simulated ecosystem response to climate change in the USA and Canada at a 5 arc-minute grid resolution using the MC1 dynamic global vegetation model and nine CMIP3 future climate projections as input. The climate projections were produced by 3 GCMs simulating 3 SRES emissions scenarios. We examined MC1 outputs for the conterminous USA by summarizing them by EPA level II and III ecoregions to characterize model skill and evaluate the magnitude and uncertainties of simulated ecosystem response to climate change. First, we evaluated model skill by comparing outputs from the recent historical period with benchmark datasets. Distribution of potential natural vegetation simulated by MC1 was compared with Kuchler's map. Above ground live carbon simulated by MC1 was compared with the National Biomass and Carbon Dataset. Fire return intervals calculated by MC1 were compared with maximum and minimum values compiled for the United States. Each EPA Level III Ecoregion was scored for average agreement with corresponding benchmark data and an average score was calculated for all three types of output. Greatest agreement with benchmark data happened in the Western Cordillera, the Ozark / Ouachita-Appalachian Forests, and the Southeastern USA Plains (EPA Level II Ecoregions). The lowest agreement happened in the Everglades and the Tamaulipas-Texas Semiarid Plain. For simulated ecosystem response to future climate projections we examined MC1 output for shifts in vegetation type, vegetation carbon, runoff, and biomass consumed by fire. Each ecoregion was scored for the amount of change from historical conditions for each variable and an average score was calculated. Smallest changes were forecast for Western Cordillera and Marine West Coast Forest ecosystems. Largest changes were forecast for the Cold Deserts, the Mixed Wood Plains, and the Central USA Plains. By combining scores of model skill for the historical period for each EPA Level 3 Ecoregion with scores representing the magnitude of ecosystem changes in the future, we identified high and low uncertainty ecoregions. The largest anticipated changes and the lowest measures of model skill coincide in the Central USA Plains and the Mixed Wood Plains. The combination of low model skill and high degree of ecosystem change elevate the importance of our uncertainty in this ecoregion. The highest projected changes coincide with relatively high model skill in the Cold Deserts. Climate adaptation efforts are the most likely to pay off in these regions. Finally, highest model skill and lowest anticipated changes coincide in the Western Cordillera and the Marine West Coast Forests. These regions may be relatively low-risk for climate change impacts when compared to the other ecoregions. These results represent only the first step in this type of analysis; there exist many ways to strengthen it. One, MC1 calibrations can be optimized using a structured optimization technique. Two, a larger set of climate projections can be used to capture a fuller range of GCMs and emissions scenarios. And three, employing an ensemble of vegetation models would make the analysis more robust.

  11. The impact of healthcare reform on the efficiency of public county hospitals in China.

    PubMed

    Jiang, Shuai; Min, Rui; Fang, Peng-Qian

    2017-12-20

    The new round of Healthcare Reform in China has implemented over 3 years since 2009, and promoted greatly the development of public county hospitals. The purpose of this study is to evaluate county hospitals efficiency before and after the healthcare reform, and further assess the reform effectiveness through the comparative analysis of the efficiency. Data envelopment analysis (DEA) was employed to calculate the efficiency of 1105 sample hospitals which were selected from 31 provinces of China, also, Tobit regression was used to regress against those main external environmental factors. Our results show that the scales and amounts of service of hospitals had increased sharply, however, the efficiency was relatively low and decreased slightly from 2008 to 2012. Thirteen (1.18%) in 2008 and six (0.54%) hospitals in 2012 were defined as technically efficient, and the average scores were 0.2916 and 0.2503. The technical efficiency average score of the post-reform was significantly less than that of the pre-reform (p < 0.001), and the score of eastern region was highest and the western was lowest among three regions of China. It suggests the reform had not well improved county hospital efficiency although hospitals have reached a fair developing scale, and the corresponding policies and measures should be put into effect for improving efficiency, especially in the level and structure of health investment, operation and supervision mechanism of county hospitals.

  12. Identification of priorities for improvement of medication safety in primary care: a PRIORITIZE study.

    PubMed

    Tudor Car, Lorainne; Papachristou, Nikolaos; Gallagher, Joseph; Samra, Rajvinder; Wazny, Kerri; El-Khatib, Mona; Bull, Adrian; Majeed, Azeem; Aylin, Paul; Atun, Rifat; Rudan, Igor; Car, Josip; Bell, Helen; Vincent, Charles; Franklin, Bryony Dean

    2016-11-16

    Medication error is a frequent, harmful and costly patient safety incident. Research to date has mostly focused on medication errors in hospitals. In this study, we aimed to identify the main causes of, and solutions to, medication error in primary care. We used a novel priority-setting method for identifying and ranking patient safety problems and solutions called PRIORITIZE. We invited 500 North West London primary care clinicians to complete an open-ended questionnaire to identify three main problems and solutions relating to medication error in primary care. 113 clinicians submitted responses, which we thematically synthesized into a composite list of 48 distinct problems and 45 solutions. A group of 57 clinicians randomly selected from the initial cohort scored these and an overall ranking was derived. The agreement between the clinicians' scores was presented using the average expert agreement (AEA). The study was conducted between September 2013 and November 2014. The top three problems were incomplete reconciliation of medication during patient 'hand-overs', inadequate patient education about their medication use and poor discharge summaries. The highest ranked solutions included development of a standardized discharge summary template, reduction of unnecessary prescribing, and minimisation of polypharmacy. Overall, better communication between the healthcare provider and patient, quality assurance approaches during medication prescribing and monitoring, and patient education on how to use their medication were considered the top priorities. The highest ranked suggestions received the strongest agreement among the clinicians, i.e. the highest AEA score. Clinicians identified a range of suggestions for better medication management, quality assurance procedures and patient education. According to clinicians, medication errors can be largely prevented with feasible and affordable interventions. PRIORITIZE is a new, convenient, systematic, and replicable method, and merits further exploration with a view to becoming a part of a routine preventative patient safety monitoring mechanism.

  13. Montreal Cognitive Assessment Memory Index Score (MoCA-MIS) as a predictor of conversion from mild cognitive impairment to Alzheimer's disease.

    PubMed

    Julayanont, Parunyou; Brousseau, Mélanie; Chertkow, Howard; Phillips, Natalie; Nasreddine, Ziad S

    2014-04-01

    To assess the usefulness of the Montreal Cognitive Assessment (MoCA) total score (MoCA-TS) and Memory Index Score (MoCA-MIS) in predicting conversion to Alzheimer's disease (AD) in individuals with mild cognitive impairment (MCI). Retrospective chart review. Community-based memory clinic. Individuals meeting Petersen's MCI criteria (N = 165). Baseline MoCA scores at MCI diagnosis were collected from charts of eligible individuals with MCI, and MoCA-TS, MoCA-MIS, and a cognitive domain index score were calculated to assess their prognostic value in predicting conversion to AD. One hundred fourteen participants progressed to AD (MCI-AD), and 51 did not (nonconverters; MCI-NC); 90.5% of participants with MCI with a MoCA-TS less than 20/30 and a MoCA-MIS less than 7/15 at baseline converted to AD within the average follow-up period of 18 months, compared with 52.7% of participants with MCI above the cutoffs on both scores. Individuals with multiple-domain amnestic MCI had the highest AD conversion rates (73.9%). Identifying individuals with MCI at high risk of conversion to AD is important clinically and for selecting appropriate subjects for therapeutic trials. Individuals with MCI with a low MoCA-TS and a low newly devised memory index score (MoCA-MIS) are at greater risk of short-term conversion to AD. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

  14. The Effect of Complementary and Alternative Medicine Claims on Risk Adjustment

    PubMed Central

    Lind, Bonnie K.; Abrams, Chad; Lafferty, William E.; Kiehr, Paula K.; Grembowski, David E.

    2006-01-01

    Objective To assess how the inclusion of diagnoses from complementary and alternative medicine (CAM) providers affects measures of morbidity burden and expectations of health care resource use for insured patients. Methods Claims data from Washington State were used to create two versions of a case-mix index. One version included claims from all provider types; the second version omitted claims from CAM providers who are covered under commercial insurance. Expected resource use was also calculated. The distribution of expected and actual resource use was then compared for the two indices. Results Inclusion of CAM providers shifts many patients into higher morbidity categories; 54% of 61,914 CAM users had higher risk scores in the index which included CAM providers. When expected resource use categories were defined based on all providers, CAM users in the highest morbidity category had average (± s.d.) annual expenditures of $6661 (± $13,863). This was less than those in the highest morbidity category when CAM providers were not included in the index ($8562 ± $16,354), and was also lower than the highest morbidity patients who did not use any CAM services ($8419 ± $18,885). Conclusions Inclusion of services from CAM providers under third party payment increases risk scores for their patients but expectations of costs for this group are lower than expected had costs been estimated based only on services from traditional providers. Additional work is needed to validate risk adjustment indices when adding services from provider groups not included in the development of the index. PMID:17122711

  15. Normal variability of children's scaled scores on subtests of the Dutch Wechsler Preschool and Primary scale of Intelligence - third edition.

    PubMed

    Hurks, P P M; Hendriksen, J G M; Dek, J E; Kooij, A P

    2013-01-01

    Intelligence tests are included in millions of assessments of children and adults each year (Watkins, Glutting, & Lei, 2007a , Applied Neuropsychology, 14, 13). Clinicians often interpret large amounts of subtest scatter, or large differences between the highest and lowest scaled subtest scores, on an intelligence test battery as an index for abnormality or cognitive impairment. The purpose of the present study is to characterize "normal" patterns of variability among subtests of the Dutch Wechsler Preschool and Primary Scale of Intelligence - Third Edition (WPPSI-III-NL; Wechsler, 2010 ). Therefore, the frequencies of WPPSI-III-NL scaled subtest scatter were reported for 1039 healthy children aged 4:0-7:11 years. Results indicated that large differences between highest and lowest scaled subtest scores (or subtest scatter) were common in this sample. Furthermore, degree of subtest scatter was related to: (a) the magnitude of the highest scaled subtest score, i.e., more scatter was seen in children with the highest WPPSI-III-NL scaled subtest scores, (b) Full Scale IQ (FSIQ) scores, i.e., higher FSIQ scores were associated with an increase in subtest scatter, and (c) sex differences, with boys showing a tendency to display more scatter than girls. In conclusion, viewing subtest scatter as an index for abnormality in WPPSI-III-NL scores is an oversimplification as this fails to recognize disparate subtest heterogeneity that occurs within a population of healthy children aged 4:0-7:11 years.

  16. Health Care Providers' Perception of Their Competence in Providing Spiritual Care for Patients

    PubMed Central

    Ebrahimi, Hossein; Areshtanab, Hossein Namdar; Jafarabadi, Mohammad Asghari; Khanmiri, Soraya Golipoor

    2017-01-01

    Background: Spiritual care is an important part of health-care provision. Spiritual care can improve patients' health. One of the requirements for providing appropriate spiritual care for patients is having the required competence. Aim: This study was conducted to investigate the perception of health-care providers of their own competence in providing spiritual cares for patients hospitalized in medical-educational centers of Iran. Subjects and Methods: This study is a cross-sectional, analytical research conducted on 555 nurses of medical-educational centers in Tabriz, Iran, in 2014. Data were collected using a two-part questionnaire including demographic information and the spiritual care competence scale. Data analysis was performed using descriptive (frequency, percentage, mean, and standard deviation) and inferential (independent t-test, Pearson, Spearman, ANOVA with Tukey test) statistics in SPSS software version 13. Results: Results showed that the mean score for nurses' perception of their competence in providing spiritual care for patients was average, that is, 95.2 ± 14.4. Mean score of nurses' perception of their competence in providing spiritual care in each aspect was significantly higher than average (P < 0.05). The highest score was related to individual support and consulting with patients, that is, 21.1 (4.0), and the lowest score was related to reference to experts, that is, 9.5 (2.3). The type of employment and participation in workshops had significant relationships with nurses' perception of their competence for providing spiritual care (P < 0.05). Conclusion: The findings indicate that authorities and policymakers should take steps in planning for nurses' training for promoting their competence in providing spiritual care for patients; therefore, holding workshops is necessary. PMID:28216864

  17. Are pelvic adhesions associated with pain, physical, emotional and functional characteristics of women presenting with chronic pelvic pain? A cluster analysis.

    PubMed

    Cheong, Ying; Saran, Mili; Hounslow, James William; Reading, Isabel Claire

    2018-01-08

    Chronic pelvic pain is a debilitating condition. It is unknown if there is a clinical phenotype for adhesive disorders. This study aimed to determine if the presence or absence, nature, severity and extent of adhesions correlated with demographic and patient reported clinical characteristics of women presenting with CPP. Women undergoing a laparoscopy for the investigation of chronic pelvic pain were recruited prospectively; their pain and phenotypic characteristics were entered into a hierarchical cluster analysis. The groups with differing baseline clinical and operative characteristics in terms of adhesions involvement were analyzed. Sixty two women were recruited where 37 had adhesions. A low correlation was found between women's reported current pain scores and that of most severe (r = 0.34) or average pain experienced (r = 0.44) in the last 6 months. Three main groups of women with CPP were identified: Cluster 1 (n = 35) had moderate severity of pain, with poor average and present pain intensity; Cluster 2 (n = 14) had a long duration of symptoms/diagnosis, the worst current pain and worst physical, emotional and social functions; Cluster 3 (n = 11) had the shortest duration of pain and showed the best evidence of coping with low (good) physical, social and emotional scores. This cluster also had the highest proportion of women with adhesions (82%) compared to 51% in Cluster 1 and 71% in Cluster 2. In this study, we found that there is little or no correlation between patient-reported pain, physical, emotional and functional characteristics scores with the presence or absence of intra-abdominal/pelvic adhesions found during investigative laparoscopy. Most women who had adhesions had the lowest reported current pain scores.

  18. 12 CFR Appendix B to Subpart A of... - Conversion of Scorecard Measures into Score

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 327—Conversion of Scorecard Measures into Score 1. Weighted Average CAMELS Rating Weighted average CAMELS ratings between 1 and 3.5 are assigned a score between 25 and 100 according to the following equation: S = 25 + [(20/3) * (C 2 −1)], where: S = the weighted average CAMELS score; and C = the weighted...

  19. 12 CFR Appendix B to Subpart A of... - Conversion of Scorecard Measures into Score

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 327—Conversion of Scorecard Measures into Score 1. Weighted Average CAMELS Rating Weighted average CAMELS ratings between 1 and 3.5 are assigned a score between 25 and 100 according to the following equation: S = 25 + [(20/3) * (C 2 −1)], where: S = the weighted average CAMELS score; and C = the weighted...

  20. 12 CFR Appendix B to Subpart A of... - Conversion of Scorecard Measures into Score

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 327—Conversion of Scorecard Measures into Score 1. Weighted Average CAMELS Rating Weighted average CAMELS ratings between 1 and 3.5 are assigned a score between 25 and 100 according to the following equation: S = 25 + [(20/3) * (C 2 −1)], where: S = the weighted average CAMELS score; and C = the weighted...

  1. Health-related quality of life and sense of coherence among the unemployed with autotelic, average, and non-autotelic personalities: a cross-sectional survey in Hiroshima, Japan.

    PubMed

    Hirao, Kazuki; Kobayashi, Ryuji

    2013-01-01

    Unemployment is known to have a negative effect on the quality of life (QOL) of individuals. However, the influence of an autotelic personality on QOL and SOC of unemployed individuals remains unclear. Our study compared health-related quality of life (HRQOL) and sense of coherence (SOC) among 3 groups: (i) an autotelic personality group (AP), which tends to "go with the flow," (ii) an average group (AV), and (iii) a non-autotelic personality group (NAP). In October 2010, we conducted a cross-sectional survey among 140 job trainees not receiving unemployment benefits in Hiroshima, Japan. We collected 134 completed questionnaires. Autotelic personality was investigated using the Flow Experience Checklist, health-related quality of life was assessed using the Short Form (SF-8) Health Survey, and SOC was measured using the University of Tokyo Health Sociology version of the SOC3 scale (SOC3-UTHS). The average age of participants was 36.14±11.54 year. Participants were classified into 3 groups based on daily activity values: 4+ for AP (n = 22), 1-3 for AV (n = 82), and 0 for NAP (n = 30). Significant differences were observed in mental component summary (MCS) score and SOC3-UTHS total scores in the ranking order of AP (highest), AV, and NAP. Our findings indicate a need to develop programs for facilitating AP among unemployed people to enhance mental QOL and SOC.

  2. Ethnic differences in pain perception and patient-controlled analgesia usage for postoperative pain.

    PubMed

    Tan, Ene-Choo; Lim, Yvonne; Teo, Yik-Ying; Goh, Rachelle; Law, Hai-Yang; Sia, Alex T

    2008-09-01

    There are reports suggesting that sensitivity to and tolerance of both clinical and experimental pain differ among ethnic groups. We examined self-rated pain score and morphine usage in 1034 women who underwent elective lower cesarian section (LSCS) for their deliveries. Data on pain scores and amount of total morphine use according to patient-controlled analgesia were collected every 4 hours. Overall, lowest pain scores were recorded 12 hours after surgery and highest at 24 hours. Morphine consumption was highest within the first 4 hours and lowest between 12 and 16 hours. There were statistically significant ethnic group differences in pain scores (P = 1.7 x 10(-7)) and morphine usage (P = 2.8 x 10(-15)) between ethnic groups, with Indians having the highest mean pain score and using the highest amount of morphine. The ethnic differences in pain score and morphine self-administration persisted after controlling for age, body mass index, and duration of operation. Our findings of highly significant ethnic group difference in self-reported pain level and the amount of analgesia self-administered may have implications on optimal management of acute postoperative pain. Inadequate management of pain after cesarian deliveries might affect the emotional well-being and physical recovery of patients and affect mother-child bonding.

  3. Physician Satisfaction With Clinical Laboratory Services: A College of American Pathologists Q-Probes Study of 81 Institutions.

    PubMed

    McCall, Shannon J; Souers, Rhona J; Blond, Barbara; Massie, Larry

    2016-10-01

    -Assessment of customer satisfaction is a vital component of the laboratory quality improvement program. -To survey the level of physician satisfaction with hospital clinical laboratory services. -Participating institutions provided demographic information and survey results of physician satisfaction, with specific features of clinical laboratory services individually rated on a scale of 5 (excellent) to 1 (poor). -Eighty-one institutions submitted 2425 surveys. The median overall satisfaction score was 4.2 (10th percentile, 3.6; 90th percentile, 4.6). Of the 16 surveyed areas receiving the highest percentage of excellent/good ratings (combined scores of 4 and 5), quality of results was highest along with test menu adequacy, staff courtesy, and overall satisfaction. Of the 4 categories receiving the lowest percentage values of excellent/good ratings, 3 were related to turnaround time for inpatient "STAT" (tests performed immediately), outpatient STAT, and esoteric tests. The fourth was a new category presented in this survey: ease of electronic order entry. Here, 11.4% (241 of 2121) of physicians assigned below-average (2) or poor (1) scores. The 5 categories deemed most important to physicians included quality of results, turnaround times for inpatient STAT, routine, and outpatient STAT tests, and clinical report format. Overall satisfaction as measured by physician willingness to recommend their laboratory to another physician remains high at 94.5% (2160 of 2286 respondents). -There is a continued trend of high physician satisfaction and loyalty with clinical laboratory services. Physician dissatisfaction with ease of electronic order entry represents a new challenge. Test turnaround times are persistent areas of dissatisfaction, representing areas for improvement.

  4. Using the Interpersonal Skills tool to assess interpersonal skills of internationally educated nurses.

    PubMed

    Shen, Jay J; Xu, Yu; Staples, Shelley; Bolstad, Anne L

    2014-07-01

    To assess interpersonal skills of internationally educated nurses (IEN) while interacting with standardized patients. Participants included 52 IEN at two community hospitals in the southwestern region of the USA. Standardized patients were used to create patient-nurse encounter. Seventeen items in four domains ("skills in interviewing and collecting information"; "skills in counseling and delivering information"; "rapport"; and "personal manner") in an Interpersonal Skills (IPS) instrument were measured by a Likert scale 1-4 with 4 indicating the best performance. The average composite score per domain and scores of the 17 items were compared across the domains. On 10 of the 17 items, the nurses received scores under 3. Counseling with an average score of 2.10 and closure with an average score of 2.44 in domain 2, small talk with an average score of 2.06 in domain 3, and physical exam with average score of 2.21 in domain 4 were below 2.5. The average composite score of domain 1 was 3.54, significantly higher than those of domains 2-4 (2.77, 2.81, and 2.71, respectively). Age was moderately related to the average score per domain with every 10 year increase in age resulting in a 0.1 increase in the average score. Sex and country of origin showed mixed results. The interpersonal skills of IEN in three of the four domains need improvement. Well-designed educational programs may facilitate the improvement, especially in areas of small talk, counseling, closure, and physical exam. Future research should examine relationships between the IPS and demographics factors. © 2013 The Authors. Japan Journal of Nursing Science © 2013 Japan Academy of Nursing Science.

  5. Carcass Production of Cattle Slaughtered at Salatiga City Slaughter House, Salatiga, Central Java, Indonesia

    NASA Astrophysics Data System (ADS)

    Purbowati, E.; Lestari, C. M. S.; Ma'ruf, M. J.; Sutaryo, S.

    2018-02-01

    The objective of this study was to evaluate the breed, age, sex, slaughter weight, carcass weight, and carcass percentage of cattle which was slaughtered at Slaughter House in Salatiga, Central Java. The materials used in the study were 156 head of catlle. The sampling used was incidental sampling to identify the breed, age, sex, slaughter weight and carcass weight. The data gathered were analyzed descriptively. The result showed that the sex of all the cattle slaughtered were male. The breeds of the cattle were Frisian Holstein Grade (70.51%), Simmental (15.38+3.21), Simmental-Ongole Grade (5.13%), and Limousine-Ongole Grade (5.77%). The average age of the cattle were 2.34 year old, with an average of slaughter weight of 529.34 kg, while the averages of carcass weight were 277.61 kg. The average of carcass percentage was as high as 52.56%. The conclusion of the study was the highest number of breeds of the cattle slaughtered at Slaughter House in Salatiga were young Frisian Holstein, the body weights were included in large frame score, and the carcass percentage were moderate.

  6. The American Academy of Sleep Medicine Inter-scorer Reliability Program: Sleep Stage Scoring

    PubMed Central

    Rosenberg, Richard S.; Van Hout, Steven

    2013-01-01

    Study Objectives: The program provides a unique opportunity to compare a large number of scorers with varied levels of experience to determine sleep stage scoring agreement. The objective is to examine areas of disagreement to inform future revisions of the AASM Manual for the Scoring of Sleep and Associated Events. Methods: The sample included 9 record fragments, 1,800 epochs and more than 3,200,000 scoring decisions. More than 2,500 scorers, most with 3 or more years of experience, participated. The analysis determined agreement with the score chosen by the majority of scorers. Results: Sleep stage agreement averaged 82.6%. Agreement was highest for stage R sleep with stages N2 and W approaching the same level. Scoring agreement for stage N3 sleep was 67.4% and was lowest for stage N1 at 63.0%. Scorers had particular difficulty with the last epoch of stage W before sleep onset, the first epoch of stage N2 after stage N1 and the first epoch of stage R after stage N2. Discrimination between stages N2 and N3 was particularly difficult for scorers. Conclusions: These findings suggest that with current rules, inter-scorer agreement in a large group is approximately 83%, a level similar to that reported for agreement between expert scorers. Agreement in the scoring of stages N1 and N3 sleep was low. Modifications to the scoring rules to improve scoring during sleep stage transitions may result in improvement. Commentary: A commentary on this article appears in this issue on page 89. Citation: Rosenberg RS; Van Hout S. The American Academy of Sleep Medicine inter-scorer reliability program: sleep stage scoring. J Clin Sleep Med 2013;9(1):81–87. PMID:23319910

  7. Quality of MR thermometry during palliative MR-guided high-intensity focused ultrasound (MR-HIFU) treatment of bone metastases.

    PubMed

    Lam, Mie K; Huisman, Merel; Nijenhuis, Robbert J; van den Bosch, Maurice Aaj; Viergever, Max A; Moonen, Chrit Tw; Bartels, Lambertus W

    2015-01-01

    Magnetic resonance (MR)-guided high-intensity focused ultrasound has emerged as a clinical option for palliative treatment of painful bone metastases, with MR thermometry (MRT) used for treatment monitoring. In this study, the general image quality of the MRT was assessed in terms of signal-to-noise ratio (SNR) and apparent temperature variation. Also, MRT artifacts were scored for their occurrence and hampering of the treatment monitoring. Analyses were performed on 224 MRT datasets retrieved from 13 treatments. The SNR was measured per voxel over time in magnitude images, in the target lesion and surrounding muscle, and was averaged per treatment. The standard deviation over time of the measured temperature per voxel in MRT images, in the muscle outside the heated region, was defined as the apparent temperature variation and was averaged per treatment. The scored MRT artifacts originated from the following sources: respiratory and non-respiratory time-varying field inhomogeneities, arterial ghosting, and patient motion by muscle contraction and by gross body movement. Distinction was made between lesion type, location, and procedural sedation and analgesic (PSA). The average SNR was highest in and around osteolytic lesions (21 in lesions, 27 in surrounding muscle, n = 4) and lowest in the upper body (9 in lesions, 16 in surrounding muscle, n = 4). The average apparent temperature variation was lowest in osteolytic lesions (1.2°C, n = 4) and the highest in the upper body (1.7°C, n = 4). Respiratory time-varying field inhomogeneity MRT artifacts occurred in 85% of the datasets and hampered treatment monitoring in 81%. Non-respiratory time-varying field inhomogeneities and arterial ghosting MRT artifacts were most frequent (94% and 95%) but occurred only locally. Patient motion artifacts were highly variable and occurred less in treatments of osteolytic lesions and using propofol and esketamine as PSA. In this study, the general image quality of MRT was observed to be higher in osteolytic lesions and lower in the upper body. Respiratory time-varying field inhomogeneity was the most prominent MRT artifact. Patient motion occurrence varied between treatments and seemed to be related to lesion type and type of PSA. Clinicians should be aware of these observed characteristics when interpreting MRT images.

  8. Measuring coding intensity in the Medicare Advantage program.

    PubMed

    Kronick, Richard; Welch, W Pete

    2014-01-01

    In 2004, Medicare implemented a system of paying Medicare Advantage (MA) plans that gave them greater incentive than fee-for-service (FFS) providers to report diagnoses. Risk scores for all Medicare beneficiaries 2004-2013 and Medicare Current Beneficiary Survey (MCBS) data, 2006-2011. Change in average risk score for all enrollees and for stayers (beneficiaries who were in either FFS or MA for two consecutive years). Prevalence rates by Hierarchical Condition Category (HCC). Each year the average MA risk score increased faster than the average FFS score. Using the risk adjustment model in place in 2004, the average MA score as a ratio of the average FFS score would have increased from 90% in 2004 to 109% in 2013. Using the model partially implemented in 2014, the ratio would have increased from 88% to 102%. The increase in relative MA scores appears to largely reflect changes in diagnostic coding, not real increases in the morbidity of MA enrollees. In survey-based data for 2006-2011, the MA-FFS ratio of risk scores remained roughly constant at 96%. Intensity of coding varies widely by contract, with some contracts coding very similarly to FFS and others coding much more intensely than the MA average. Underpinning this relative growth in scores is particularly rapid relative growth in a subset of HCCs. Medicare has taken significant steps to mitigate the effects of coding intensity in MA, including implementing a 3.4% coding intensity adjustment in 2010 and revising the risk adjustment model in 2013 and 2014. Given the continuous relative increase in the average MA risk score, further policy changes will likely be necessary.

  9. Personnel attitudes toward people with mental illness at a psychiatric hospital in Taiwan.

    PubMed

    Chen, Ming-De; Chang, Yen-Ching

    2016-06-01

    The attitudes of psychiatric hospital personnel are critically related to the quality of mental health care, but few studies have investigated this issue. This study is aimed at an exploration of the attitudes of psychiatric hospital personnel toward people with mental illness and at an examination of the associated factors. A self-report questionnaire, the Mental Illness Attitude Scale (MIAS), was used to collect data from psychiatric hospital personnel in Taiwan (n = 290). The MIAS included 46 items and 4 dimensions: acceptance, rehabilitation and prognosis, social distance and recommendations for interventions. Rehabilitation and prognosis had the highest item average scores (4.03) and social distance had the lowest item average scores (3.22). Stigmatization and the number of different types of contacted clients were two significantly associated attitude factors. Psychiatric hospital personnel in Taiwan tend to have positive attitudes toward people with mental illness in general situations but hold less positive attitudes in terms of community integration-related issues and intimate relationships. More evidence-based community services should be conducted to decrease personnel concerns about the successful community integration of those who are mentally ill. Future studies can investigate the concept and impact of stigmatization more deeply. © The Author(s) 2016.

  10. Dentist-assistant interaction styles in Jordan.

    PubMed

    Khader, Y S; Abu-Sharbain, G

    2009-05-01

    To assess dentist-assistant interaction and communication styles and their associated factors in Jordan. Three different areas in Amman where private dental clinics heavily cluster were chosen. The researcher visited all dental clinics in these areas and invited dentists to participate in this study. A structured self-administered questionnaire was designed and included the 22 items on staff communication that were used by Gorter and Freeman to assess communication styles. The culturally adapted items were analysed in such a way to reflect the structure that is used in the original study. There was a significant interaction between dentist's gender and communication styles (F = 3.8, P = 0.022). The only significant difference between men and women was for professional leadership style (P = 0.011) where men were more likely to adopt professional leadership style than women. For men, the average score for friendly leadership style was significantly lower than that for other styles. For women, the average score was the highest for gender interacting style which was significantly higher than that for friendly leadership style and professional interacting style, but not business leadership style. Communication and interaction styles between Jordanian dentists and their assistants differ according to gender. Jordanian dentists are less likely to adopt friendly leadership communication style compared with other styles.

  11. Global Positioning System Use in the Community to Evaluate Improvements in Walking After Revascularization

    PubMed Central

    Gernigon, Marie; Le Faucheur, Alexis; Fradin, Dominique; Noury-Desvaux, Bénédicte; Landron, Cédric; Mahe, Guillaume; Abraham, Pierre

    2015-01-01

    Abstract Revascularization aims at improving walking ability in patients with arterial claudication. The highest measured distance between 2 stops (highest-MDCW), the average walking speed (average-WSCW), and the average stop duration (average-DSCW) can be measured by global positioning system, but their evolution after revascularization is unknown. We included 251 peripheral artery diseased patients with self-reported limiting claudication. The patients performed a 1-hour stroll, recorded by a global positioning system receiver. Patients (n = 172) with confirmed limitation (highest-MDCW <2000m) at inclusion were reevaluated after 6 months. Patients revascularized during the follow-up period were compared with reference patients (ie, with unchanged lifestyle medical or surgical status). Other patients (lost to follow-up or treatment change) were excluded (n = 89). We studied 44 revascularized and 39 reference patients. Changes in highest-MDCW (+442 vs. +13 m) and average-WSCW (+0.3 vs. −0.2 km h−1) were greater in revascularized than in reference patients (both P < 0.01). In contrast, no significant difference in average-DSCW changes was found between the groups. Among the revascularized patients, 13 (29.5%) had a change in average-WSCW, but not in highest-MDCW, greater than the mean + 1 standard deviation of the change observed for reference patients. Revascularization may improve highest-MDCW and/or average-WSCW. This first report of changes in community walking ability in revascularized patients suggests that, beyond measuring walking distances, average-WSCW measurement is essential to monitor these changes. Applicability to other surgical populations remains to be evaluated. Registration: http://www.clinicaltrials.gov/ct2/show/NCT01141361 PMID:25950694

  12. Global positioning system use in the community to evaluate improvements in walking after revascularization: a prospective multicenter study with 6-month follow-up in patients with peripheral arterial disease.

    PubMed

    Gernigon, Marie; Le Faucheur, Alexis; Fradin, Dominique; Noury-Desvaux, Bénédicte; Landron, Cédric; Mahe, Guillaume; Abraham, Pierre

    2015-05-01

    Revascularization aims at improving walking ability in patients with arterial claudication. The highest measured distance between 2 stops (highest-MDCW), the average walking speed (average-WSCW), and the average stop duration (average-DSCW) can be measured by global positioning system, but their evolution after revascularization is unknown.We included 251 peripheral artery diseased patients with self-reported limiting claudication. The patients performed a 1-hour stroll, recorded by a global positioning system receiver. Patients (n = 172) with confirmed limitation (highest-MDCW <2000m) at inclusion were reevaluated after 6 months. Patients revascularized during the follow-up period were compared with reference patients (ie, with unchanged lifestyle medical or surgical status). Other patients (lost to follow-up or treatment change) were excluded (n = 89).We studied 44 revascularized and 39 reference patients. Changes in highest-MDCW (+442 vs. +13 m) and average-WSCW (+0.3 vs. -0.2 km h) were greater in revascularized than in reference patients (both P < 0.01). In contrast, no significant difference in average-DSCW changes was found between the groups. Among the revascularized patients, 13 (29.5%) had a change in average-WSCW, but not in highest-MDCW, greater than the mean + 1 standard deviation of the change observed for reference patients.Revascularization may improve highest-MDCW and/or average-WSCW. This first report of changes in community walking ability in revascularized patients suggests that, beyond measuring walking distances, average-WSCW measurement is essential to monitor these changes. Applicability to other surgical populations remains to be evaluated. http://www.clinicaltrials.gov/ct2/show/NCT01141361.

  13. Quality of life and self-esteem among the elderly in the community.

    PubMed

    Tavares, Darlene Mara Dos Santos; Matias, Thaís Gabriela Cruz; Ferreira, Pollyana Cristina Dos Santos; Pegorari, Maycon Sousa; Nascimento, Janaina Santos; Paiva, Mariana Mapelli de

    2016-11-01

    This study sought to investigate the association between the scores for quality of life (QoL) and self-esteem among the elderly in an urban community. A cross-sectional, quantitative and analytical household survey was conducted with 1,691 elderly persons resident in an urban area in a county in Minas Gerais state. The World Health Organization Quality of Life BREF (WHOQOL-BREF), the World Health Organization Quality of Life OLD (WHOQOL-OLD) questionnaires and the Rosenberg Self-Esteem Scale were used in this study. A descriptive statistical analysis and a linear regression model (p < 0.05) were conducted. The results revealed that the social relationships domain (71.19) and the topic of death and dying (74.30) had the highest mean scores among the elderly; while the lowest mean scores were the environment domain (60.39) and the topic of social participation (63.06). The self-esteem scores showed an average of 9.36 ± 4.09. Associations were evident for the lower scores of quality of life in all the WHOQOL-BREF domains and WHOQOL-OLD aspects (except death and dying) with lower levels of self-esteem (p <0.001). The results provide data that contribute to a better understanding of the aspects that influence the QoL of the elderly due to reduced self-esteem, thus providing information for the development of health strategies.

  14. Variation in the Early Trajectories of Autism Symptoms Is Related to the Development of Language, Cognition, and Behavior Problems.

    PubMed

    Visser, Janne C; Rommelse, Nanda N J; Lappenschaar, Martijn; Servatius-Oosterling, Iris J; Greven, Corina U; Buitelaar, Jan K

    2017-08-01

    The objectives of this study were to model more homogeneous subgroups within autism spectrum disorder (ASD) based on early trajectories of core symptoms; and to further characterize these subgroups in terms of trajectories of language, cognition, co-occurring (attention-deficit/hyperactivity disorder [ADHD]-related) traits and clinical outcome diagnosis. Children (N = 203) referred for possible ASD at ages 1 to 4 years were assessed at three time points at intervals ranging from 9 months to 3 years. Assessments included standardized measures for ASD (Autism Diagnostic Observation Schedule [ADOS]), language (ADOS-language item), nonverbal IQ (NV-IQ; different tests adequate to chronological/mental age), and parent-reported behavioral problems (Infant-Toddler Social and Emotional Assessment, Child Behavior Checklist). Latent-class growth curve analysis with ADOS total scores led to the identification of three main stable and two small improving groups: a severe-stable group (19.5% of sample)-the only group without considerable language improvement-showed persistent low NV-IQ and marked increase in attention problems over time; a moderate-stable group (21.7%) with below-average increasing NV-IQ; and a mild-stable group (48%) with stable-average NV-IQ and the highest scores on ADHD-related traits, whose ASD outcome diagnoses increased despite stable-low ASD scores. Two groups (each 5.4%) improved: one moved from severe to moderate ASD scores, and the other moved from moderate to mild/nonspectrum scores. Both of these groups improved on language, NV-IQ, and ADHD-related traits. Results support the high stability of ASD symptoms into various severity levels, but also highlight the significant contribution of non-ASD domains in defining and explaining the different ASD trajectories. Copyright © 2017 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  15. Consumer Mobile Apps for Potential Drug-Drug Interaction Check: Systematic Review and Content Analysis Using the Mobile App Rating Scale (MARS).

    PubMed

    Kim, Ben Yb; Sharafoddini, Anis; Tran, Nam; Wen, Emily Y; Lee, Joon

    2018-03-28

    General consumers can now easily access drug information and quickly check for potential drug-drug interactions (PDDIs) through mobile health (mHealth) apps. With aging population in Canada, more people have chronic diseases and comorbidities leading to increasing numbers of medications. The use of mHealth apps for checking PDDIs can be helpful in ensuring patient safety and empowerment. The aim of this study was to review the characteristics and quality of publicly available mHealth apps that check for PDDIs. Apple App Store and Google Play were searched to identify apps with PDDI functionality. The apps' general and feature characteristics were extracted. The Mobile App Rating Scale (MARS) was used to assess the quality. A total of 23 apps were included for the review-12 from Apple App Store and 11 from Google Play. Only 5 of these were paid apps, with an average price of $7.19 CAD. The mean MARS score was 3.23 out of 5 (interquartile range 1.34). The mean MARS scores for the apps from Google Play and Apple App Store were not statistically different (P=.84). The information dimension was associated with the highest score (3.63), whereas the engagement dimension resulted in the lowest score (2.75). The total number of features per app, average rating, and price were significantly associated with the total MARS score. Some apps provided accurate and comprehensive information about potential adverse drug effects from PDDIs. Given the potentially severe consequences of incorrect drug information, there is a need for oversight to eliminate low quality and potentially harmful apps. Because managing PDDIs is complex in the absence of complete information, secondary features such as medication reminder, refill reminder, medication history tracking, and pill identification could help enhance the effectiveness of PDDI apps. ©Ben YB Kim, Anis Sharafoddini, Nam Tran, Emily Y Wen, Joon Lee. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 28.03.2018.

  16. Evaluating YouTube as a Source of Patient Education on the Role of the Hospitalist: A Cross-Sectional Study.

    PubMed

    Hudali, Tamer; Papireddy, Muralidhar; Bhattarai, Mukul; Deckard, Alan; Hingle, Susan

    2017-01-10

    Hospital medicine is a relatively new specialty field, dedicated to the delivery of comprehensive medical care to hospitalized patients. YouTube is one of the most frequently used websites, offering access to a gamut of videos from self-produced to professionally made. The aim of our study was to determine the adequacy of YouTube as an effective means to define and depict the role of hospitalists. YouTube was searched on November 17, 2014, using the following search words: "hospitalist," "hospitalist definition," "what is the role of a hospitalist," "define hospitalist," and "who is a hospitalist." Videos found only in the first 10 pages of each search were included. Non-English, noneducational, and nonrelevant videos were excluded. A novel 7-point scoring tool was created by the authors based on the definition of a hospitalist adopted by the Society of Hospital Medicine. Three independent reviewers evaluated, scored, and classified the videos into high, intermediate, and low quality based on the average score. A total of 102 videos out of 855 were identified as relevant and included in the analysis. Videos uploaded by academic institutions had the highest mean score. Only 6 videos were classified as high quality, 53 as intermediate quality, and 42 as low quality, with 82.4% (84/102) of the videos scoring an average of 4 or less. Most videos found in the search of a hospitalist definition are inadequate. Leading medical organizations and academic institutions should consider producing and uploading quality videos to YouTube to help patients and their families better understand the roles and definition of the hospitalist. ©Tamer Hudali, Muralidhar Papireddy, Mukul Bhattarai, Alan Deckard, Susan Hingle. Originally published in the Interactive Journal of Medical Research (http://www.i-jmr.org/), 10.01.2017.

  17. Consumer Mobile Apps for Potential Drug-Drug Interaction Check: Systematic Review and Content Analysis Using the Mobile App Rating Scale (MARS)

    PubMed Central

    Kim, Ben YB; Sharafoddini, Anis; Tran, Nam; Wen, Emily Y

    2018-01-01

    Background General consumers can now easily access drug information and quickly check for potential drug-drug interactions (PDDIs) through mobile health (mHealth) apps. With aging population in Canada, more people have chronic diseases and comorbidities leading to increasing numbers of medications. The use of mHealth apps for checking PDDIs can be helpful in ensuring patient safety and empowerment. Objective The aim of this study was to review the characteristics and quality of publicly available mHealth apps that check for PDDIs. Methods Apple App Store and Google Play were searched to identify apps with PDDI functionality. The apps’ general and feature characteristics were extracted. The Mobile App Rating Scale (MARS) was used to assess the quality. Results A total of 23 apps were included for the review—12 from Apple App Store and 11 from Google Play. Only 5 of these were paid apps, with an average price of $7.19 CAD. The mean MARS score was 3.23 out of 5 (interquartile range 1.34). The mean MARS scores for the apps from Google Play and Apple App Store were not statistically different (P=.84). The information dimension was associated with the highest score (3.63), whereas the engagement dimension resulted in the lowest score (2.75). The total number of features per app, average rating, and price were significantly associated with the total MARS score. Conclusions Some apps provided accurate and comprehensive information about potential adverse drug effects from PDDIs. Given the potentially severe consequences of incorrect drug information, there is a need for oversight to eliminate low quality and potentially harmful apps. Because managing PDDIs is complex in the absence of complete information, secondary features such as medication reminder, refill reminder, medication history tracking, and pill identification could help enhance the effectiveness of PDDI apps. PMID:29592848

  18. Do cancer-specific websites meet patient's information needs?

    PubMed

    Warren, Emily; Footman, Katharine; Tinelli, Michela; McKee, Martin; Knai, Cécile

    2014-04-01

    To evaluate commonly used cancer websites' information provision, we developed and applied an Information Comprehensiveness Tool to breast and prostate cancer websites. We first collated questions from a systematic literature review on patient information needs. We then classified the questions in terms of spectrum of care, theme, and nature of question. "Breast cancer" and "prostate cancer" were typed into Google, and websites listed on the first page of results were selected. Two researchers, blind to each others' scores, assessed the same websites using the coding system. Each question was scored on a 3-point scale as not (0%), partially (50%) and fully (100%) answered by two researchers. Average scores were calculated across all questions. Inter-rater reliability was assessed. We identified 79 general, 5 breast, and 5 prostate cancer questions. Inter-rater reliability was good, with an intraclass coefficient of 0.756 (95% CIs 0.729-0.781). 17 questions were not answered thoroughly by any website. Questions about "future planning", "monitoring", and "decision-making" were discussed least. Biomedical questions scored highest. More comprehensive information needs to be provided on breast and prostate cancer websites. This ICT can improve cancer information online and enable patients to engage more actively regarding their information needs. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  19. The father-daughter relationship in the wake of maternal death from breast cancer.

    PubMed

    Cohen, Marie M; Wellisch, David K; Ormseth, Sarah R; Yarema, Valerie G

    2017-11-08

    This paper examines whether a relationship exists between paternal psychological stability and daughters' symptomatology following the death of a wife/mother from breast cancer. Specifically, is there a relationship between paternal parenting style and the daughters' subsequent capacity to form committed relationships later in life? We assessed 68 adult daughters (average age = 23.5 years) since the mother's breast cancer diagnosis by means of a semistructured clinical interview and psychological testing. The daughters were subdivided into three psychiatric risk groups. Those in the highest risk group were most likely to be single and to have high CES-Depression and STAI-Anxiety scores. Daughters in the highest risk group were also most likely to have fathers who abused substances, fathers who had experienced a serious psychiatric event, and families with the most closed communication about the mother's cancer. Psychopathology in fathers correlated with increasing anxiety and depression in adult daughters. Daughters at the highest level of risk had the most severe affective states, the most disturbed father-daughter bonding, and the least ability to create successful interpersonal relationships as adults. We suggest specific interventions for these daughters of the lowest-functioning fathers.

  20. 30 Do nice guys finish last?

    PubMed

    Turner, Chris; Turner, Jake

    2017-12-01

    : Emergency medicine is widely recognised as an intense specialty. Interruptions are known to derail thoughts, increasing cognitive load and result in longer periods before deep thought is re-established. Although approachability and warmth are regarded as important factors in clinicians we wondered what impact these characteristics had on the number of interruptions. A team of 6 medical students were trained in the use of abespoke tool to record shop floor activities. Over 4 months we conducted 100 hours of minute by minute time and motion study of emergency medicine consultants during their clinical shifts, and noted how often they were interrupted. At the end of shifts the assessors were asked a set of qualitative questions on the behaviour and attitudes of the consultants. These questions were completed in seclusion and in an anonymous format, to minimise the chance of bias/influence. QUESTIONS INCLUDED: 'How friendly was the consultant with other staff?' 'How friendly was this consultant with patients?' And, 'How would you rate this consultant's 'general positivity'?'We then assessed whether consultants that scored 'higher' inthese areas were more likely to be interrupted. Our hypothesis was that consultants who were more friendly were less intimidating for juniors and nurses to approach with questions, and so may suffer from an increase in cognitive load due to being interrupted and questioned more frequently than consultants who were felt to be less approachable.We found that consultants who scored 1(highest) in friendliness had an average of 7.38 interruptions per hour, compared to consultants who scored 3 or greater, who had an average of 3.59. Our average interruptions were close to those found in previous publications (between 6 and 9 interruptions per hour), however there was a large amount of inter-consultant variability, with one consultant during one shift being interrupted over 12 times per hour on average. If the results of this study are replicable, then it may raise questions about how best to manage this extra cognitive load. Although some may argue that being seen as slightly less friendly has an advantage in the reduction of interruptions, this may come at a cost to patient safety. There is clearly a fine balance to be made.emermed;34/12/A879-c/F1F1F1Figure 1Average interruptions per hour by friendliness score. © 2017, 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.

  1. The Healthy LifeWorks Project: a pilot study of the economic analysis of a comprehensive workplace wellness program in a Canadian government department.

    PubMed

    Makrides, Lydia; Smith, Steven; Allt, Jane; Farquharson, Jane; Szpilfogel, Claudine; Curwin, Sandra; Veinot, Paula; Wang, Feifei; Edington, Dee

    2011-07-01

    To examine the relationship between health risks and absenteeism and drug costs vis-a-vis comprehensive workplace wellness. Eleven health risks, and change in drug claims, short-term and general illness calculated across four risk change groups. Wellness score examined using Wilcoxon test and regression model for cost change. The results showed 31% at risk; 9 of 11 risks associated with higher drug costs. Employees moving from low to high risk showed highest relative increase (81%) in drug costs; moving from high to low had lowest (24%). Low-high had highest increase in absenteeism costs (160%). With each risk increase, absenteeism costs increased by $CDN248 per year (P < 0.05) with average decrease of 0.07 risk factors and savings $CDN6979 per year. Both high-risk reduction and low-risk maintenance are important to contain drug costs. Only low-risk maintenance also avoids absenteeism costs associated with high risks.

  2. Correlations among Social Anxiety, Self-Esteem, Impulsivity, and Game Genre in Patients with Problematic Online Game Playing

    PubMed Central

    Park, Jeong Ha; Han, Doug Hyun; Kim, Bung-Nyun; Cheong, Jae Hoon

    2016-01-01

    Objective Recent studies of online game addiction have suggested that social interaction and impulsivity are critical factors for the etiology and progress of online game addiction. We hypothesized that the genre of the online game is associated with impulsivity and sociality in individuals with online game addictions. Methods In total, 212 patients with problematic online game playing were divided into four groups by game genre: 1) massive multiplayer online role playing game (MMORPG), 2) real-time strategy (RTS), 3) first-person shooter (FPS), and 4) other. Their symptoms and characteristics were assessed using 8 scales and 2 tests to estimate self-esteem, impulsiveness, comorbidity, social interaction status, and cognitive function. Results The mean social anxiety score was highest in the MMORPG group and lowest in the FPS group. The mean self-esteem score was highest in the RTS group. Social anxiety score was positively correlated with Internet addiction score in the MMORPG group, and the self-esteem score was positively correlated with Internet addiction score in the RTS group. Conclusion The genre of online game was not associated with impulsivity, but social anxiety status varied significantly with game genre, and differences in social anxiety were especially pronounced in patients playing the MMORPG (highest social anxiety) and FPS (lowest social anxiety) game genres. In addition, self-esteem was highest in the RTS game genre. PMID:27247595

  3. Correlations among Social Anxiety, Self-Esteem, Impulsivity, and Game Genre in Patients with Problematic Online Game Playing.

    PubMed

    Park, Jeong Ha; Han, Doug Hyun; Kim, Bung-Nyun; Cheong, Jae Hoon; Lee, Young-Sik

    2016-05-01

    Recent studies of online game addiction have suggested that social interaction and impulsivity are critical factors for the etiology and progress of online game addiction. We hypothesized that the genre of the online game is associated with impulsivity and sociality in individuals with online game addictions. In total, 212 patients with problematic online game playing were divided into four groups by game genre: 1) massive multiplayer online role playing game (MMORPG), 2) real-time strategy (RTS), 3) first-person shooter (FPS), and 4) other. Their symptoms and characteristics were assessed using 8 scales and 2 tests to estimate self-esteem, impulsiveness, comorbidity, social interaction status, and cognitive function. The mean social anxiety score was highest in the MMORPG group and lowest in the FPS group. The mean self-esteem score was highest in the RTS group. Social anxiety score was positively correlated with Internet addiction score in the MMORPG group, and the self-esteem score was positively correlated with Internet addiction score in the RTS group. The genre of online game was not associated with impulsivity, but social anxiety status varied significantly with game genre, and differences in social anxiety were especially pronounced in patients playing the MMORPG (highest social anxiety) and FPS (lowest social anxiety) game genres. In addition, self-esteem was highest in the RTS game genre.

  4. Service quality assessment of a referral hospital in Southern Iran with SERVQUAL technique: patients’ perspective

    PubMed Central

    2014-01-01

    Background Providing services to patients according to their expectations and needs is necessary for the success of an organization in order to remain in the competitive market. Recognizing these needs and expectations is an important step in offering high quality services. This study was designed to determine the service quality gap of the main hospital of Hormozgan province. Methods This cross sectional study was conducted in 2013 in Bandar Abbas ShahidMohammadi Hospital in the south of Iran. All 96 participants of this study were provided by SERVQUAL questionnaire. Data was analyzed by Wilcoxon and Kruskal-Wallis tests. Results Service quality gaps were seen in all five service quality dimensions and the overall quality of service. The mean of quality perception score and quality expectation score was 3.44 ± 0.693 and 4.736 ± 0.34, respectively. The highest perception was in assurance dimension and the highest expectation was in Responsiveness and assurance dimensions. Also, the lowest perception was in responsiveness dimension and the lowest expectation was about empathy. In this study, 56.1% of participants defined the quality of services as average. Conclusion According to the results, this hospital was not able to meet patients’ expectations completely. Therefore, action must be taken to decrease the gap between the perception and expectation of the patients. PMID:25064475

  5. Life cycle toxicity assessment of pesticides used in integrated and organic production of oranges in the Comunidad Valenciana, Spain.

    PubMed

    Juraske, Ronnie; Sanjuán, Neus

    2011-02-01

    The relative impacts of 25 pesticides including acaricides, fungicides, herbicides, insecticides, and post-harvest fungicides, used in the production of oranges in Spain were assessed with current life cycle impact assessment (LCIA) tools. Chemical specific concentrations were combined with pesticide emission data and information on chemical toxicity to assess human toxicity and freshwater ecotoxicity impacts. As a case study, the relative impacts of two orange production systems in the region of Valencia, integrated pest management (IP) and organic production (OP), were assessed. The evaluation of active ingredients showed that on average acaricides have the highest human toxicity impact scores, while for freshwater ecotoxicity insecticides show the highest impact. In both impact categories the lowest impact scores were calculated for herbicides. In the production of 1 kg of orange fruits, where several kinds of pesticides are combined, results show that post-harvest fungicides can contribute more than 95% to the aggregate human toxicity impacts. More than 85% of aquatic ecotoxicity is generated by fungicides applied before harvest. The potential to reduce impacts on freshwater ecosystems is seven orders of magnitude, while impacts on human health can be reduced by two orders of magnitude. Hence, this stresses the importance of a careful pre-selection of active ingredients. In both impact categories, organic production represents the least toxic pest-control method. Copyright © 2010 Elsevier Ltd. All rights reserved.

  6. Improving Docking Performance Using Negative Image-Based Rescoring.

    PubMed

    Kurkinen, Sami T; Niinivehmas, Sanna; Ahinko, Mira; Lätti, Sakari; Pentikäinen, Olli T; Postila, Pekka A

    2018-01-01

    Despite the large computational costs of molecular docking, the default scoring functions are often unable to recognize the active hits from the inactive molecules in large-scale virtual screening experiments. Thus, even though a correct binding pose might be sampled during the docking, the active compound or its biologically relevant pose is not necessarily given high enough score to arouse the attention. Various rescoring and post-processing approaches have emerged for improving the docking performance. Here, it is shown that the very early enrichment (number of actives scored higher than 1% of the highest ranked decoys) can be improved on average 2.5-fold or even 8.7-fold by comparing the docking-based ligand conformers directly against the target protein's cavity shape and electrostatics. The similarity comparison of the conformers is performed without geometry optimization against the negative image of the target protein's ligand-binding cavity using the negative image-based (NIB) screening protocol. The viability of the NIB rescoring or the R-NiB, pioneered in this study, was tested with 11 target proteins using benchmark libraries. By focusing on the shape/electrostatics complementarity of the ligand-receptor association, the R-NiB is able to improve the early enrichment of docking essentially without adding to the computing cost. By implementing consensus scoring, in which the R-NiB and the original docking scoring are weighted for optimal outcome, the early enrichment is improved to a level that facilitates effective drug discovery. Moreover, the use of equal weight from the original docking scoring and the R-NiB scoring improves the yield in most cases.

  7. Profile and genetic parameters of dairy cattle locomotion score and lameness across lactation.

    PubMed

    Kougioumtzis, A; Valergakis, G E; Oikonomou, G; Arsenos, G; Banos, G

    2014-01-01

    This study investigated the profile of locomotion score and lameness before the first calving and throughout the first (n=237) and second (n=66) lactation of 303 Holstein cows raised on a commercial farm. Weekly heritability estimates of locomotion score and lameness, and their genetic and phenotypic correlations with milk yield, body condition score, BW and reproduction traits were derived. Daughter future locomotion score and lameness predictions from their sires��� breeding values for conformation traits were also calculated. First-lactation cows were monitored weekly from 6 weeks before calving to the end of lactation. Second-lactation cows were monitored weekly throughout lactation. Cows were locomotion scored on a scale from one (sound) to five (severely lame); a score greater than or equal to two defined presence of lameness. Cows��� weekly body condition score and BW was also recorded. These records were matched to corresponding milk yield records, where the latter were 7-day averages on the week of inspection. The total number of repeated records amounted to 12 221. Data were also matched to the farm���s reproduction database, from which five traits were derived. Statistical analyses were based on uni- and bivariate random regression models. The profile analysis showed that locomotion and lameness problems in first lactation were fewer before and immediately after calving, and increased as lactation progressed. The profile of the two traits remained relatively constant across the second lactation. Highest heritability estimates were observed in the weeks before first calving (0.66 for locomotion score and 0.54 for lameness). Statistically significant genetic correlations were found for first lactation weekly locomotion score and lameness with body condition score, ranging from ���0.31 to ���0.65 and from ���0.44 to ���0.76, respectively, suggesting that cows genetically pre-disposed for high body condition score have fewer locomotion and lameness issues. Negative (favourable) phenotypic correlations between first lactation weekly locomotion score/lameness and milk yield averaged ���0.27 and ���0.17, respectively, and were attributed to management factors. Also a phenotypic correlation between lameness and conception rate of ���0.19 indicated that lame cows were associated with lower success at conceiving. First-lactation daughter locomotion score and/or lameness predictions from sires��� estimated breeding values for conformation traits revealed a significant linear effect of rear leg side view, rear leg rear view, overall conformation, body condition score and locomotion, and a quadratic effect of foot angle.

  8. Are modern contraceptives acceptable to people and where do they source them from across Nigeria?

    PubMed

    Onwujekwe, Obinna E; Enemuoh, Jane C; Ogbonna, Chinwe; Mbachu, Chinyere; Uzochukwu, Benjamin Sc; Lawson, Agathe; Ndyanabangi, Bannet

    2013-01-23

    Understanding the extent that different modern contraceptives are acceptable to different populations groups and where they get the commodities from will help in developing specific interventions that will help to scale-up the availability of the contraceptives. The study took place in urban and rural sites in six states across Nigeria. Data on acceptability and sources of the contraceptives was collected from at least 770 randomly selected mostly female householders from each state respectively using a questionnaire. Acceptability of the different contraceptives was scored by the respondents on a scale of 1 (lowest) to 10 (highest). The relationships between acceptability and sources of the contraceptives with socio-economic status and geographic location of the respondents were examined. The use of modern contraceptives in general was acceptable to 87% of the respondents. Male condom was the most acceptable means of contraceptive with an average score of 5.0. It was followed by implants with and oral contraceptive pill with average scores of 4.0, whilst IUD was the least acceptable with an average score of 2.9. The private sector was the major source of contraceptives to different population groups. Both male and female condoms were mostly procured from patent medicine dealers (PMD) and pharmacy shops. Intra Uterine Devices (IUDs) and implants were mostly sourced from public and private hospitals in the urban areas, whilst injectibles were mostly sourced from private hospitals. Oral contraceptives were mostly sourced from pharmacy shops and patent medicine dealers. There were SES and geographic differences for both acceptability and sources of the contraceptives. Also, the sources of different contraceptives depended on the type of the contraceptive. The different contraceptives were acceptable to the respondents and the major source of the contraceptives was the private sector. Hence, public-private partnership arrangements should be explored so that universal coverage with contraceptives could be easily achieved. Interventions should be developed to eliminate the inequities in both acceptability and sources of different contraceptives. The acceptability of all the contraceptives should be enhanced with relevant behaviour change communication interventions especially in areas with the lowest levels of acceptability.

  9. Are modern contraceptives acceptable to people and where do they source them from across Nigeria?

    PubMed Central

    2013-01-01

    Background Understanding the extent that different modern contraceptives are acceptable to different populations groups and where they get the commodities from will help in developing specific interventions that will help to scale-up the availability of the contraceptives. Methods The study took place in urban and rural sites in six states across Nigeria. Data on acceptability and sources of the contraceptives was collected from at least 770 randomly selected mostly female householders from each state respectively using a questionnaire. Acceptability of the different contraceptives was scored by the respondents on a scale of 1 (lowest) to 10 (highest). The relationships between acceptability and sources of the contraceptives with socio-economic status and geographic location of the respondents were examined. Results The use of modern contraceptives in general was acceptable to 87% of the respondents. Male condom was the most acceptable means of contraceptive with an average score of 5.0. It was followed by implants with and oral contraceptive pill with average scores of 4.0, whilst IUD was the least acceptable with an average score of 2.9. The private sector was the major source of contraceptives to different population groups. Both male and female condoms were mostly procured from patent medicine dealers (PMD) and pharmacy shops. Intra Uterine Devices (IUDs) and implants were mostly sourced from public and private hospitals in the urban areas, whilst injectibles were mostly sourced from private hospitals. Oral contraceptives were mostly sourced from pharmacy shops and patent medicine dealers. There were SES and geographic differences for both acceptability and sources of the contraceptives. Also, the sources of different contraceptives depended on the type of the contraceptive. Conclusion The different contraceptives were acceptable to the respondents and the major source of the contraceptives was the private sector. Hence, public-private partnership arrangements should be explored so that universal coverage with contraceptives could be easily achieved. Interventions should be developed to eliminate the inequities in both acceptability and sources of different contraceptives. The acceptability of all the contraceptives should be enhanced with relevant behaviour change communication interventions especially in areas with the lowest levels of acceptability. PMID:23343579

  10. [Interest of ambulatory simplified acute physiology score (ASAPS) applied to patients admitted in an intensive care unit of an infectious diseases unit in Dakar].

    PubMed

    Dia, N M; Diallo, I; Manga, N M; Diop, S A; Fortes-Deguenonvo, L; Lakhe, N A; Ka, D; Seydi, M; Diop, B M; Sow, P S

    2015-08-01

    The evaluation of patients by a scale of gravity allows a better categorization of patients admitted in intensive care unit (ICU). Our study had for objective to estimate interest of Ambulatory Simplified Acute Physiologic Score (ASAPS) applied to patients admitted in ICU of infectious diseases department of FANN hospital. It was about a descriptive and analytical retrospective study, made from the data found in patients' files admitted into the USI infectious diseases department of FANN hospital in Dakar, from January 1(st), 2009 till December 31st, 2009.The data of 354 patients' files were analyzed. The sex-ratio was 1.77 with an average age of 37.6 years ± 19.4 years old [5-94 years]. The majority of the patients were unemployed paid (39.6%). The most frequent failures were the following ones: neurological (80.5%), cardio-respiratory (16.7%). The average duration of stay was 6.2 days ± 8.2 days going of less than 24 hours to more than 10 weeks. The deaths arose much more at night (53.1%) than in the daytime (46.9%) and the strongest rate of death was recorded in January (61.5%), most low in October (26.7%). The global mortality was 48.3%. The rate of lethality according to the highest main diagnosis was allocated to the AIDS (80.5%). The average ambulatory simplified acute physiology score was 5.3 ± 3.6 with extremes of 0 and 18. The deaths in our series increased with this index (p = 0.000005). The female patients had a rate of lethality higher than that of the men people, 55.5% against 44.2% (p = 0.03). In spite of a predictive score of a high survival (ASAPS < 8), certain number of patients died (n = 105) that is 61.4% of the deaths. The metabolic disturbances, hyperleukocytosis or leukopenia when realised, the presence of a chronic disease, seemed also to influence this lethality. ASAPS only, although interesting, would not good estimate the gravity of patients, where from the necessity thus of a minimum biological balance sheet. It seems better adapted for patients with a high value (ASAPS≥8). This score when it is low, is not correlated, in our study, at a high survival rate as waited in this population.

  11. Countries' Biomedical Publications and Attraction Scores. A PubMed-based assessment.

    PubMed

    Xu, Qinyi; Boggio, Andrea; Ballabeni, Andrea

    2014-01-01

    Studying publication volumes at the country level is key to understanding and improving a country's research system. PubMed is a public search engine of publications in all life sciences areas. Here, we show how this search engine can be used to assess the outputs of life science-related research by country. We have measured the numbers of publications during different time periods based on the country of affiliation of the first authors. Moreover, we have designed scores, which we have named Attraction Scores, to appraise the relative focus either toward particular types of studies, such as clinical trials or reviews, or toward specific research areas, such as public health and pharmacogenomics, or toward specific topics, for instance embryonic stem cells; we have also investigated a possible use of these Attraction Scores in connection with regulatory policies. We have weighed the statistics against general indicators such as country populations and gross domestic products (GDP). During the 5-year period 2008-2012, the United States was the country with the highest number of publications and Denmark the one with the highest number of publications per capita. Among the 40 countries with the highest GDPs, Israel had the highest publications-to-GDP ratio. Among the 20 countries with the most publications, Japan had the highest Attraction Score for induced pluripotent stem (iPS) cells and Italy the highest proportion of review publications. More than 50% of publications in English were from countries in which English is not the primary language. We show an assorted and extensive collection of rankings and charts that will inform scholars and policymakers in studying and improving the research systems both at the national and international level.

  12. Countries’ Biomedical Publications and Attraction Scores. A PubMed-based assessment

    PubMed Central

    Xu, Qinyi; Boggio, Andrea; Ballabeni, Andrea

    2015-01-01

    Studying publication volumes at the country level is key to understanding and improving a country’s research system. PubMed is a public search engine of publications in all life sciences areas. Here, we show how this search engine can be used to assess the outputs of life science-related research by country. We have measured the numbers of publications during different time periods based on the country of affiliation of the first authors. Moreover, we have designed scores, which we have named Attraction Scores, to appraise the relative focus either toward particular types of studies, such as clinical trials or reviews, or toward specific research areas, such as public health and pharmacogenomics, or toward specific topics, for instance embryonic stem cells; we have also investigated a possible use of these Attraction Scores in connection with regulatory policies. We have weighed the statistics against general indicators such as country populations and gross domestic products (GDP). During the 5-year period 2008-2012, the United States was the country with the highest number of publications and Denmark the one with the highest number of publications per capita. Among the 40 countries with the highest GDPs, Israel had the highest publications-to-GDP ratio. Among the 20 countries with the most publications, Japan had the highest Attraction Score for induced pluripotent stem (iPS) cells and Italy the highest proportion of review publications. More than 50% of publications in English were from countries in which English is not the primary language. We show an assorted and extensive collection of rankings and charts that will inform scholars and policymakers in studying and improving the research systems both at the national and international level. PMID:26401263

  13. Development of Hospitalization Resource Intensity Scores for Kids (H-RISK) and Comparison across Pediatric Populations.

    PubMed

    Richardson, Troy; Rodean, Jonathan; Harris, Mitch; Berry, Jay; Gay, James C; Hall, Matt

    2018-04-25

    In the Medicare population, measures of relative severity of illness (SOI) for hospitalized patents have been used in prospective payment models. Similar measures for pediatric populations have not been fully developed. To develop hospitalization resource intensity scores for kids (H-RISK) using pediatric relative weights (RWs) for SOI and to compare hospital types on case-mix index (CMI). Using the 2012 Kids' Inpatient Database (KID), we developed RWs for each All Patient Refined Diagnosis Related Group (APR-DRG) and SOI level. RW corresponded to the ratio of the adjusted mean cost for discharges in an APR-DRG SOI combination over adjusted mean cost of all discharges in the dataset. RWs were applied to every discharge from 3,117 hospitals in the database with at least 20 discharges. RWs were then averaged at the hospital level to provide each hospital's CMI. CMIs were compared by hospital type using Kruskal- Wallis tests. The overall adjusted mean cost of weighted discharges in Healthcare Cost and Utilization Project KID 2012 was $6,135 per discharge. Solid organ and bone marrow transplantations represented 4 of the 10 highest procedural RWs (range: 35.5 to 91.7). Neonatal APRDRG SOIs accounted for 8 of the 10 highest medical RWs (range: 19.0 to 32.5). Free-standing children's hospitals yielded the highest median (interquartile range [IQR]) CMI (2.7 [2.2-3.1]), followed by urban teaching hospitals (1.8 [1.3-2.6]), urban nonteaching hospitals (1.1 [0.9-1.5]), and rural hospitals (0.8 [0.7-0.9]; P < .001). H-RISK for populations of pediatric admissions are sensitive to detection of substantial differences in SOI by hospital type. © 2018 Society of Hospital Medicine.

  14. [Frequency of healthy eating habits measured by the 10 Steps to Healthy Eating score proposed by the Ministry of Health: Pelotas, Rio Grande do Sul State, Brazil].

    PubMed

    Vinholes, Daniele Botelho; Assunção, Maria Cecília Formoso; Neutzling, Marilda Borges

    2009-04-01

    This study aimed to measure frequency of healthy eating habits and associated factors using the 10 Steps to Healthy Eating score proposed by the Ministry of Health in the adult population in Pelotas, Rio Grande do Sul State, Brazil. A cross-sectional population-based survey was conducted on a cluster sample of 3,136 adult residents in Pelotas. The frequency of each step to healthy eating was collected with a pre-coded questionnaire. Data analysis consisted of descriptive analysis, followed by bivariate analysis using the chi-square test. Only 1.1% of the population followed all the recommended steps. The average number of steps was six. Step four, salt intake, showed the highest frequency, while step nine, physical activity, showed the lowest. Knowledge of the population's eating habits and their distribution according to demographic and socioeconomic variables is important to guide local and national strategies to promote healthy eating habits and thus improve quality of life.

  15. Have Nursing Home Compare quality measure scores changed over time in response to competition?

    PubMed

    Castle, Nicholas G; Engberg, John; Liu, Darren

    2007-06-01

    Currently, the Centers for Medicare and Medicaid Services report on 15 Quality Measures (QMs) on the Nursing Home Compare (NHC) website. It is assumed that nursing homes are able to make improvements on these QMs, and in doing so they will attract more residents. In this investigation, we examine changes in QM scores, and whether competition and/or excess demand have influenced these change scores over a period of 1 year. Data come from NHC and the On-line Survey Certification And Recording (OSCAR) system. QM change scores are calculated using values from January 2003 to January 2004. A series of regression analyses are used to examine the association of competition and excess demand on QM scores. Eight QMs show an average decrease in scores (ie, better quality) and six QMs show an average increase in scores (ie, worse quality). However, for 13 of the 14 QMs these average changes averaged less than 1%. The regression analyses show an association between higher competition and improving QM scores and an association between lower occupancy and improving QM scores. As would be predicted based on the market-driven mechanism underlying quality improvements using report cards, we show that it is in the most competitive markets and those with the lowest average occupancy rates that improvements in the QM scores are more likely.

  16. The Influence of Protein Supplementation on Muscle Hypertrophy

    NASA Astrophysics Data System (ADS)

    Fardi, A.; Welis, W.

    2018-04-01

    The problem of this study was the lack of knowledge about nutrition, so the use of protein supplements to support the occurrence of muscle hypertrophy is not optimal. The use of natural supplements is a substitute of the manufacturer's supplements. The purpose of this study was to determine the effect of natural protein supplementation to muscle hypertrophy.The method of the research was a quasi experiment. There are 26 subject and were divided two group. Instrument of this research is to use tape measure and skinfold to measure muscle rim and thickness of fat in arm and thigh muscle. Then to calculate the circumference of the arm and thigh muscles used the formula MTC - (3.14 x TSF). MTC is the arm muscle or thigh muscle and TSF is the thickness of the muscles of the arm or thigh muscles. Data analysis technique used was t test at 5% significant level. The result of the research showed that average score of arm muscle hypertrophy at pretest control group was 255.61 + 17.69 mm and posttest average score was 263.48.58 + 17.21 mm and average score of thigh muscle hypertrophy at pretest control group was 458.32 + 8.72 mm and posttest average score was 468.78 + 11.54 mm. Average score of arm muscle hypertrophy at pretest experiment group was 252.67 + 16.05 mm and posttest average score was 274.58 ± 16.89 mm and average score of thigh muscle hypertrophy at pretest experiment group was 459.49 ± 6.99 mm and posttest average score was 478.70 + 9.05 mm. It can be concluded that there was a significant effect of natural protein supplementation on muscle hypertrophy.

  17. Level of Motivation Amongst Health Personnel Working in A Tertiary Care Government Hospital of New Delhi, India

    PubMed Central

    Jaiswal, Poonam; Singhal, Ashok K.; Gadpayle, Adesh K.; Sachdeva, Sandeep; Padaria, Rabindra

    2014-01-01

    Aims: To assess the level and factors of motivation amongst permanent government employees working in a tertiary health care institution. Material and Methods: A sample of 200 health personnel (50 in each category) i.e. doctors, nurses, technician, and support staff were contacted through face to face interview. Motivation was measured as the degree to which an individual possessed various identified motivation domains like Drive, Control, Challenge, Relationship and Rewards. Each domain was represented by 4 dimensions- accordingly a closed-ended statement represented each of these dimensions and responses were assessed on a Likert based scale. Data management was done using SPSS, ver. 19. Results: The average age for different health personnel were: Doctors 48.68 (±8.53), nurses 40.72 (±7.76), technician 38.4 (±10.65) and support staff 43.24 (±9.52) years. The average year of work experience was: Doctor 19.09 (±9.77), nurses 17.2 (±8.420), technician 14.84 (±10.45), support staff 18.24 (±10.28). A comparison of overall motivation index (mean score) revealed that nurse had highest level (3.47), followed by support staff (3.46), doctor (3.45) and technician (3.43). Based on their individual mean scores, the healthcare providers were categorised into three different levels of motivation and it was found that majority of the health personnel i.e.70% of support staff, 62% nurse, 56% doctor and technician, had high to very high level of motivation index. The mean scores for all the five factors as well as their respective ranks were also found out and it was deduced that “relationship” assumed first rank for doctors (mean score: 3.71) and technician (mean score: 3.75), whereas “control” assumed greatest significance for nurses (mean score, 3.62) and support staff (mean scores, 3.61). Based upon the mean scores, “reward” assumed third rank among all the four categories. Kruskal-Wallis test was applied to test if the different categories of health personnel varied with respect to five factors of motivation and it was found that their orientation towards the various motivational components differed significantly only with respect to Drive (P < 0.01). Conclusion: There is scope for enhancing staff motivation. PMID:25364148

  18. Nurses caring for ENT patients in a district general hospital without a dedicated ENT ward score significantly less in a test of knowledge than nurses caring for ENT patients in a dedicated ENT ward in a comparable district general hospital.

    PubMed

    Foxton, C R; Black, D; Muhlschlegel, J; Jardine, A

    2014-12-01

    To assess whether there is a difference in ENT knowledge amongst nurses caring for patients on a dedicated ENT ward and nurses caring for ENT patients in a similar hospital without a dedicated ENT ward. A test of theoretical knowledge of ENT nursing care was devised and administered to nurses working on a dedicated ENT ward and then to nurses working on generic non-subspecialist wards regularly caring for ENT patients in a hospital without a dedicated ENT ward. The test scores were then compared. A single specialist ENT/Maxillo-Facial/Opthalmology ward in hospital A and 3 generic surgical wards in hospital B. Both hospitals are comparable district general hospitals in the south west of England. Nursing staff working in hospital A and hospital B on the relevant wards were approached during the working day. 11 nurses on ward 1, 10 nurses on ward 2, 11 nurses on ward 3 and 10 nurses on ward 4 (the dedicated ENT ward). Each individual test score was used to generate an average score per ward and these scores compared to see if there was a significant difference. The average score out of 10 on ward 1 was 6.8 (+/-1.6). The average score on ward two was 4.8 (+/-1.6). The average score on ward three was 5.5 (+/-2.1). The average score on ward 4, which is the dedicated ENT ward, was 9.7 (+/-0.5). The differences in average test score between the dedicated ENT ward and all of the other wards are statistically significant. Nurses working on a dedicated ENT ward have an average higher score in a test of knowledge than nurses working on generic surgical wards. This difference is statistically significant and persists despite banding or training. © 2014 John Wiley & Sons Ltd.

  19. Protein evaluation of four oat (Avena sativa L.) cultivars adapted for cultivation in the south of Brazil.

    PubMed

    Pedó, I; Sgarbieri, V C; Gutkoski, L C

    1999-01-01

    Four oat cultivars adapted for soil and climate conditions in the southern region of Brazil were evaluated for protein nutritive value. Evaluations were done both in vitro and in vivo. In vitro evaluation was done by essential amino acid profile, available lysine, amino acid scoring, and protein digestibility corrected amino acid-scoring (PDCAAS). Nitrogen balance indices and PER were determined in vivo with rats. In all four cultivars (UFP-15, UFP-16, CTC-03, UFRGS-14), lysine was the most limiting amino acid. Available lysine, amino acid score and PDCAAS were highest for cultivar UFRGS-14 and lowest for CTC-03. When compared to casein, only nitrogen retention for UFRGS-14 did not differ statistically (p>0.05); all other indices of protein quality were inferior to casein for the oat cultivars. The oat cultivars tended to be identical among themselves, except for apparent protein digestibility which was significantly higher in the UFRGS-14 and CTC-03 cultivars. On average, the PER values of the oat cultivars were 82% of casein; the net protein utilization was 88% of casein as determined in vivo and 49% by the estimation in vitro (PDCAAS).

  20. [Dental caries and early childhood development: a pilot study].

    PubMed

    Núñez, F Loreto; Sanz, B Javier; Mejía, L Gloria

    2015-01-01

    To investigate the association between dental caries and early childhood development in 3-year-olds from Talca, Chile. A pilot study with a convenience sample of 3-year-olds from Talca (n = 39) who attend public healthcare centers. Child development was measured by the Psychomotor Development Index (PDI), a screening tool used nationally among pre-school children to assess language development, fine motor skills and coordination areas. Dental caries prevalence was evaluated by decayed, missing, filled teeth (DFMT) and decayed, missing, filled tooth surfaces (DFMS) ceo-d and ceo-s indexes. The children were divided into two groups according to the PDIscore: those with a score of 40 or more were considered developmentally normal (n = 32), and those with a score below 40 were considered as having impaired development (n = 7). The severity of caries (DMFT) was negatively correlated with PDI (r = -0.82), and children with the lowest TEPSI score had the highest DFMT values. The average DMFT in children with normal development was 1.31, and 3.57 for those with impaired development. This pilot study indicates that the severity of dental caries is correlated with early childhood development. Copyright © 2015. Publicado por Elsevier España, S.L.U.

  1. 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.

  2. Concurrent validity, discriminatory power and feasibility of the instrument for Identification of Parents At Risk for child Abuse and Neglect (IPARAN)

    PubMed Central

    Horrevorts, Esther M B; van Grieken, Amy; Mieloo, Cathelijne L; Hafkamp-de Groen, Esther; Bannink, Rienke; Bouwmeester-Landweer, Merian B R; Broeren, Suzanne; Raat, Hein

    2017-01-01

    Objectives To determine the feasibility, concurrent validity and discriminatory power of the instrument for Identification of Parents At Risk for child Abuse and Neglect (IPARAN) among Dutch parents with a newborn child. Setting Community paediatrics. Participants Data from a controlled trial were used. In total, 2659 Dutch parents with a newborn child were invited to participate. Of the 2659 parents, 759 parents filled in the consent form and participated in the study. Primary and secondary outcome measures Concurrent validity was determined by calculating correlations—using the Pearson’s correlation (r)—between the IPARAN score and related constructs from the following instruments: the Empowerment Questionnaire 2.0, the Family Functioning Questionnaire and the Parenting Stress Questionnaire. Discriminatory power was determined by calculating receiver operating characteristic (ROC) curves between high-risk mothers and low-risk mothers according to their scores on the related constructs. Feasibility was determined by examining the percentage of missing answers. Results In terms of concurrent validity, we found that 3 out of 12 correlations between the IPARAN score and related constructs were strong (ie, r>0.50) and 4 out of 12 were medium (ie, r=0.30–0.49). In terms of discriminatory power, mothers with a score in the borderline/clinical range or lowest 10 percent (P10) range of the related constructs (high-risk mothers) had a higher IPARAN score than mothers with a score in the normal range or highest 90 percent (P90) range of the related constructs (low-risk mothers). Effect sizes varied from d=0.37 to d=1.93, and the area under the ROC curve varied from 0.62 to 0.93. Regarding feasibility, the part of the IPARAN filled in by the mother had on average 0.7% missing answers, whereas the part of the IPARAN filled in by the father had on average 1.7% missing answers. Conclusion The results of this study support the concurrent validity, discriminatory power and feasibility of the IPARAN among a population of Dutch parents with a newborn child. PMID:28838892

  3. High malnutrition rate in Venezuelan Yanomami compared to Warao Amerindians and Creoles: significant associations with intestinal parasites and anemia.

    PubMed

    Verhagen, Lilly M; Incani, Renzo N; Franco, Carolina R; Ugarte, Alejandra; Cadenas, Yeneska; Sierra Ruiz, Carmen I; Hermans, Peter W M; Hoek, Denise; Campos Ponce, Maiza; de Waard, Jacobus H; Pinelli, Elena

    2013-01-01

    Children in rural areas experience the interrelated problems of poor growth, anemia and parasitic infections. We investigated the prevalence of and associations between intestinal helminth and protozoan infections, malnutrition and anemia in school-age Venezuelan children. This cross-sectional study was conducted in 390 children aged 4-16 years from three rural areas of Venezuela: the Amazon Region, Orinoco Delta and Carabobo State. Stool samples were collected for direct parasitic examinations. Anthropometric indicators of chronic (height-for-age Z score) and acute (weight-for-height and Body Mass Index (BMI)-for-age Z score in respectively children under 5 years of age and children aged 5 years and above) malnutrition were calculated. Multivariate linear and logistic regression models were built to determine factors associated with nutritional status and polyparasitism. Hookworm and Strongyloides stercoralis prevalences were highest in children from the Amazon rainforest (respectively 72% and 18%) while children from the Orinoco Delta and Carabobo State showed higher rates of Ascaris lumbricoides (respectively 28% and 37%) and Trichuris trichiura (40% in both regions). The prevalence of Giardia lamblia infection was not significantly different between regions (average: 18%). Anemia prevalence was highest in the Amazon Region (24%). Hemoglobin levels were significantly decreased in children with a hookworm infection. Malnutrition was present in respectively 84%, 30% and 13% of children from the Amazon Region, Orinoco Delta and Carabobo State. In multivariate analysis including all regions, G. lamblia and helminth infections were significantly and negatively associated with respectively height-for-age and weight-for-height/BMI-for-age Z scores. Furthermore, hemoglobin levels were positively associated with the height-for-age Z score (0.11, 95% CI 0.02 - 0.20). In rural populations in Venezuela helminthiasis and giardiasis were associated with acute and chronic nutritional status respectively. These data highlight the need for an integrated approach to control transmission of parasites and improve the health status of rural Venezuelan children.

  4. High Malnutrition Rate in Venezuelan Yanomami Compared to Warao Amerindians and Creoles: Significant Associations WITH Intestinal Parasites and Anemia

    PubMed Central

    Verhagen, Lilly M.; Incani, Renzo N.; Franco, Carolina R.; Ugarte, Alejandra; Cadenas, Yeneska; Sierra Ruiz, Carmen I.; Hermans, Peter W. M.; Hoek, Denise; Campos Ponce, Maiza; de Waard, Jacobus H.; Pinelli, Elena

    2013-01-01

    Background Children in rural areas experience the interrelated problems of poor growth, anemia and parasitic infections. We investigated the prevalence of and associations between intestinal helminth and protozoan infections, malnutrition and anemia in school-age Venezuelan children. Methods This cross-sectional study was conducted in 390 children aged 4-16 years from three rural areas of Venezuela: the Amazon Region, Orinoco Delta and Carabobo State. Stool samples were collected for direct parasitic examinations. Anthropometric indicators of chronic (height-for-age Z score) and acute (weight-for-height and Body Mass Index (BMI)-for-age Z score in respectively children under 5 years of age and children aged 5 years and above) malnutrition were calculated. Multivariate linear and logistic regression models were built to determine factors associated with nutritional status and polyparasitism. Results Hookworm and Strongyloides stercoralis prevalences were highest in children from the Amazon rainforest (respectively 72% and 18%) while children from the Orinoco Delta and Carabobo State showed higher rates of Ascaris lumbricoides (respectively 28% and 37%) and Trichuris trichiura (40% in both regions). The prevalence of Giardia lamblia infection was not significantly different between regions (average: 18%). Anemia prevalence was highest in the Amazon Region (24%). Hemoglobin levels were significantly decreased in children with a hookworm infection. Malnutrition was present in respectively 84%, 30% and 13% of children from the Amazon Region, Orinoco Delta and Carabobo State. In multivariate analysis including all regions, G. lamblia and helminth infections were significantly and negatively associated with respectively height-for-age and weight-for-height/BMI-for-age Z scores. Furthermore, hemoglobin levels were positively associated with the height-for-age Z score (0.11, 95% CI 0.02 - 0.20). Conclusions In rural populations in Venezuela helminthiasis and giardiasis were associated with acute and chronic nutritional status respectively. These data highlight the need for an integrated approach to control transmission of parasites and improve the health status of rural Venezuelan children. PMID:24143243

  5. The Impact of City-level Permitting Processes on Residential Photovoltaic Installation Prices and Development Times: An Empirical Analysis of Solar Systems in California Cities

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

    Wiser, Ryan; Dong, Changgui

    Business process or “soft” costs account for well over 50% of the installed price of residential photovoltaic (PV) systems in the United States, so understanding these costs is crucial for identifying PV cost-reduction opportunities. Among these costs are those imposed by city-level permitting processes, which may add both expense and time to the PV development process. Building on previous research, this study evaluates the effect of city-level permitting processes on the installed price of residential PV systems and on the time required to develop and install those systems. The study uses a unique dataset from the U.S. Department of Energy’smore » Rooftop Solar Challenge Program, which includes city-level permitting process “scores,” plus data from the California Solar Initiative and the U.S. Census. Econometric methods are used to quantify the price and development-time effects of city-level permitting processes on more than 3,000 PV installations across 44 California cities in 2011. Results indicate that city-level permitting processes have a substantial and statistically significant effect on average installation prices and project development times. The results suggest that cities with the most favorable (i.e., highest-scoring) permitting practices can reduce average residential PV prices by $0.27–$0.77/W (4%–12% of median PV prices in California) compared with cities with the most onerous (i.e., lowest-scoring) permitting practices, depending on the regression model used. Though the empirical models for development times are less robust, results suggest that the most streamlined permitting practices may shorten development times by around 24 days on average (25% of the median development time). These findings illustrate the potential price and development-time benefits of streamlining local permitting procedures for PV systems.« less

  6. Population differentiation in allele frequencies of obesity-associated SNPs.

    PubMed

    Mao, Linyong; Fang, Yayin; Campbell, Michael; Southerland, William M

    2017-11-10

    Obesity is emerging as a global health problem, with more than one-third of the world's adult population being overweight or obese. In this study, we investigated worldwide population differentiation in allele frequencies of obesity-associated SNPs (single nucleotide polymorphisms). We collected a total of 225 obesity-associated SNPs from a public database. Their population-level allele frequencies were derived based on the genotype data from 1000 Genomes Project (phase 3). We used hypergeometric model to assess whether the effect allele at a given SNP is significantly enriched or depleted in each of the 26 populations surveyed in the 1000 Genomes Project with respect to the overall pooled population. Our results indicate that 195 out of 225 SNPs (86.7%) possess effect alleles significantly enriched or depleted in at least one of the 26 populations. Populations within the same continental group exhibit similar allele enrichment/depletion patterns whereas inter-continental populations show distinct patterns. Among the 225 SNPs, 15 SNPs cluster in the first intron region of the FTO gene, which is a major gene associated with body-mass index (BMI) and fat mass. African populations exhibit much smaller blocks of LD (linkage disequilibrium) among these15 SNPs while European and Asian populations have larger blocks. To estimate the cumulative effect of all variants associated with obesity, we developed the personal composite genetic risk score for obesity. Our results indicate that the East Asian populations have the lowest averages of the composite risk scores, whereas three European populations have the highest averages. In addition, the population-level average of composite genetic risk scores is significantly correlated (R 2 = 0.35, P = 0.0060) with obesity prevalence. We have detected substantial population differentiation in allele frequencies of obesity-associated SNPs. The results will help elucidate the genetic basis which may contribute to population disparities in obesity prevalence.

  7. Validation of a fecal scoring scale in puppies during the weaning period.

    PubMed

    Grellet, Aurélien; Feugier, Alexandre; Chastant-Maillard, Sylvie; Carrez, Bruno; Boucraut-Baralon, Corine; Casseleux, Gregory; Grandjean, Dominique

    2012-10-01

    In puppies weaning is a high risk period. Fecal changes are frequent and can be signs of infection by digestive pathogens (bacteria, viruses, parasites) and indicators of nutritional and environmental stress. The aim of this study was to define a pathological fecal score for weaning puppies, and to study the impact on that score of two intestinal viruses (canine parvovirus type 2 and canine coronavirus). For this, the quality of stools was evaluated on 154 puppies between 4 and 8 weeks of age (100 from small breeds and 54 from large breeds). The scoring was performed immediately after a spontaneous defecation based on a 13-point scale (from 1; liquid to 13; dry and hard feces). Fecal samples were frozen for further viral analysis. Each puppy was weighed once a week during the study period. The fecal score regarded as pathological was the highest score associated with a significant reduction in average daily gain (ADG). Fecal samples were checked by semi-quantitative PCR or RT-PCR for canine parvovirus type 2 and canine coronavirus identification, respectively. The quality of feces was affected by both age and breed size. In small breeds, the ADG was significantly reduced under a fecal score of 6 and 7 for puppies at 4-5 and 6-8 weeks of age, respectively. In large breeds, the ADG was significantly reduced under a fecal score of 5 whatever the age of the puppy. Whereas a high viral load of canine parvovirus type 2 significantly impacted feces quality, no effect was recorded for canine coronavirus. This study provides an objective threshold for evaluation of fecal quality in weaning puppies. It also emphasizes the importance to be given to age and breed size in that evaluation. Copyright © 2012 Elsevier B.V. All rights reserved.

  8. High Fidelity Virtual Environments: Does Shader Quality or Higher Polygon Count Models Increase Presence and Learning

    NASA Astrophysics Data System (ADS)

    Horton, Scott

    This research study investigated the effects of high fidelity graphics on both learning and presence, or the "sense of being there," inside a Virtual Learning Environment (VLE). Four versions of a VLE on the subject of the element mercury were created, each with a different combination of high and low fidelity polygon models and high and low fidelity shaders. A total of 76 college age (18+ years of age) participants were randomly assigned to one of the four conditions. The participants interacted with the VLE and then completed several posttest measures on learning, presence, and attitudes towards the VLE experience. Demographic information was also collected, including age, computer gameplay experience, number of virtual environments interacted with, gender and time spent in this virtual environment. The data was analyzed as a 2 x 2 between subjects ANOVA. The main effects of shader fidelity and polygon fidelity were both non-significant for both learning and all presence subscales inside the VLE. In addition, there was no significant interaction between shader fidelity and model fidelity. However, there were two significant results on the supplementary variables. First, gender was found to have a significant main effect on all the presence subscales. Females reported higher average levels of presence than their male counterparts. Second, gameplay hours, or the number of hours a participant played computer games per week, also had a significant main effect on participant score on the learning measure. The participants who reported playing 15+ hours of computer games per week, the highest amount of time in the variable, had the highest score as a group on the mercury learning measure while those participants that played 1-5 hours per week had the lowest scores.

  9. Validation of the Temps-A in university student population in Serbia.

    PubMed

    Hinić, Darko; Akiskal, S Hagop; Akiskal, K Kareen; Jović, Jelena; Ignjatović Ristić, Dragana

    2013-07-01

    The TEMPS-A scale is a self-evaluation measure which assesses five affective temperaments. This study is a comparative analysis of affective temperament types in different educational fields, and the first validation of the Serbian version of the TEMPS-A. The TEMPS-A questionnaire has been adapted following the translation-back translation methodology from English to Serbian. It was then administered to 770 undergraduate students from eight different faculties. Five factors were extracted through Principal Component Analysis (Varimax rotation), each including ten items with loadings above 0.40. The internal consistency of this abbreviated 50-item scale was α=0.77 and the average test-retest coefficient (rho=0.82) indicates a stable reliability. The correlations among the temperaments ranged from weak to moderate, with the highest positive correlations obtained between the depressive and cyclothymic, and, depressive and anxious scales. The highest score was detected among the hyperthymic (0.64) and lowest among the depressive temperament (0.15). The male participants attained significantly higher scores for the hyperthymic temperament, while female scored significantly higher on the depressive and anxious temperaments. The students of physical education showed significantly lower results on the depressive and anxious subscales and higher on the hyperthymic, in comparison to other educational fields. The student sample is not representative of the general population, therefore further investigation in older population would be necessary for the evaluation of norms in additional age categories. The external validation with other personality scales has not been the subject of this research, but will be a part of some future studies. The Serbian 50-item version of the TEMPS-A showed good overall internal consistency and reliability, and the results generally cohere with those from previously validated versions in other languages. Copyright © 2013 Elsevier B.V. All rights reserved.

  10. Reliability and validity of measures used in assessing dental anxiety in 5- to 15-year-old Croatian children.

    PubMed

    Majstorovic, M; Veerkamp, J S; Skrinjaric, I

    2003-12-01

    The aim of the study was to evaluate reliability and validity of different questionnaires and predict related causes, as concomitant factors in assessing different aspects of children's dental anxiety. Children were interviewed on dental anxiety, dispositional risk factors and satisfaction with the dentist after dental treatment had been accomplished. Parents were interviewed on dental anxiety as well. The study population included 165 children (91 boys) aged 5 to 15 years, referred to a university dental clinic by general dental practitioners because of a history of fear and uncooperative behaviour during previous dental visits. Children were treated by two dentists, both experienced in treating fearful children. Statistical analysis was performed in Statistics for Windows, Release 5.5 and Release 7.5. Pearson's correlation coefficients were calculated for validity and Cronbach alpha for reliability of the measures. Spearman Brown prophecy formula was used for correction of the alpha scores. Results The children's total average CFSS-DS score was 27.02, with no significant difference with respect to gender. The highest Cronbach alpha scores regarding reliability were obtained for the S-DAI, the CFSS-DS and the PDAS. Pearson's correlations regarding validity presented significant correlations between the CMFQ, the CDAS and the S-DAI, between the OAS, the CDAS and the S-DAI, as well as between the OAS and the DVSS-SV. Previous negative medical experience had significant influence on children's dental anxiety, supporting Rachman's conditioning theory. Anxious children were more likely to show behaviour problems (aggression) and more introvert in expressing their judgement regarding the dentist. Both the S-DAI and the CFSS-DS, which were standardized in the Croatian population sample, showed the highest reliability in assessment of children's dental anxiety.

  11. Popular on YouTube: a critical appraisal of the educational quality of information regarding asthma.

    PubMed

    Gonzalez-Estrada, Alexei; Cuervo-Pardo, Lyda; Ghosh, Bitan; Smith, Martin; Pazheri, Foussena; Zell, Katrina; Wang, Xiao-Feng; Lang, David M

    2015-01-01

    Asthma affects >300 million people globally, including 25 million in the United States. Patients with asthma frequently use the Internet as a source of information. YouTube is one of the three most popular Web sites. To determine the educational quality of YouTube videos for asthma. We performed a YouTube search by using the keyword "asthma." The 200 most frequently viewed relevant videos were included in the study. Asthma videos were analyzed for characteristics, source, and content. Source was further classified as asthma health care provider, other health care provider, patient, pharmaceutical company, and professional society and/or media. A scoring system was created to evaluate quality (-10 to 30 points). Negative points were assigned for misleading information. Two hundred videos were analyzed, with a median of 18,073.5 views, 31.5 likes, and 2 dislikes, which spanned a median of 172 seconds. More video presenters were male (60.5%). The most common type of video source was other health care providers (34.5%). The most common video content was alternative treatments (38.0%), including live-fish ingestion; reflexology; acupressure and/or acupuncture; Ayurveda; yoga; raw food, vegan, gluten-free diets; marijuana; Buteyko breathing; and salt therapy. Scores for videos supplied by asthma health care providers were statistically significantly different from other sources (p < 0.001) and had the highest average score (9.91). YouTube videos of asthma were frequently viewed but were a poor source of accurate health care information. Videos by asthma health care providers were rated highest in quality. The allergy/immunology community has a clear opportunity to enhance the value of educational material on YouTube.

  12. Polygenic hazard scores in preclinical Alzheimer disease.

    PubMed

    Tan, Chin Hong; Hyman, Bradley T; Tan, Jacinth J X; Hess, Christopher P; Dillon, William P; Schellenberg, Gerard D; Besser, Lilah M; Kukull, Walter A; Kauppi, Karolina; McEvoy, Linda K; Andreassen, Ole A; Dale, Anders M; Fan, Chun Chieh; Desikan, Rahul S

    2017-09-01

    Identifying asymptomatic older individuals at elevated risk for developing Alzheimer disease (AD) is of clinical importance. Among 1,081 asymptomatic older adults, a recently validated polygenic hazard score (PHS) significantly predicted time to AD dementia and steeper longitudinal cognitive decline, even after controlling for APOE ɛ4 carrier status. Older individuals in the highest PHS percentiles showed the highest AD incidence rates. PHS predicted longitudinal clinical decline among older individuals with moderate to high Consortium to Establish a Registry for Alzheimer's Disease (amyloid) and Braak (tau) scores at autopsy, even among APOE ɛ4 noncarriers. Beyond APOE, PHS may help identify asymptomatic individuals at highest risk for developing Alzheimer neurodegeneration. Ann Neurol 2017;82:484-488. © 2017 American Neurological Association.

  13. 40 CFR 60.58b - Compliance and performance testing.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... demonstrated municipal waste combustor unit load shall be the highest 4-hour arithmetic average load achieved... shall be the highest 4-hour arithmetic average temperature achieved at the particulate matter control...

  14. The region makes the difference: disparities in management of acute myocardial infarction within Switzerland.

    PubMed

    Insam, Charlène; Paccaud, Fred; Marques-Vidal, Pedro

    2014-05-01

    In Switzerland, health policies are decided at the local level, but little is known regarding their impact on the management of acute myocardial infarction (AMI). In this study, we assessed geographical differences within Switzerland regarding management of AMI. Cross-sectional study. Swiss hospital discharge database for period 2007-2008 (26,204 discharges from AMI). Seven Swiss regions (Leman, Mittelland, Northwest, Zurich, Central, Eastern, and Ticino) were analysed. Almost 53.7% of discharges from AMI were managed in a single hospital, ranging from 62.1% (Leman) to 31.6% (Ticino). The highest intensive care unit admission rate was in Leman (69.4%), the lowest (16.9%) in Ticino (Swiss average: 36.0%). Intracoronary revascularization rates were highest in Leman (51.1%) and lowest (30.9%) in Central Switzerland (average: 41.0%). Bare (non-drug-eluting) stent use was highest in Leman (61.4%) and lowest (16.9%) in Ticino (average: 42.1%), while drug-eluting stent use was highest (83.2%) in Ticino and lowest (38.6%) in Leman (average: 57.9%). Coronary artery bypass graft rates were highest (4.8%) in Ticino and lowest (0.5%) in Eastern Switzerland (average: 2.8%). Mechanical circulatory assistance rates were highest (4.2%) in Zurich and lowest (0.5%) in Ticino (average: 1.8%). The differences remained after adjusting for age, single or multiple hospital management, and gender. In Switzerland, significant geographical differences in management and revascularization procedures for AMI were found.

  15. Health-Related Quality of Life and Sense of Coherence among the Unemployed with Autotelic, Average, and Non-Autotelic Personalities: A Cross-Sectional Survey in Hiroshima, Japan

    PubMed Central

    Hirao, Kazuki; Kobayashi, Ryuji

    2013-01-01

    Background Unemployment is known to have a negative effect on the quality of life (QOL) of individuals. However, the influence of an autotelic personality on QOL and SOC of unemployed individuals remains unclear. Our study compared health-related quality of life (HRQOL) and sense of coherence (SOC) among 3 groups: (i) an autotelic personality group (AP), which tends to “go with the flow,” (ii) an average group (AV), and (iii) a non-autotelic personality group (NAP). Methods In October 2010, we conducted a cross-sectional survey among 140 job trainees not receiving unemployment benefits in Hiroshima, Japan. We collected 134 completed questionnaires. Autotelic personality was investigated using the Flow Experience Checklist, health-related quality of life was assessed using the Short Form (SF-8) Health Survey, and SOC was measured using the University of Tokyo Health Sociology version of the SOC3 scale (SOC3–UTHS). Results The average age of participants was 36.14±11.54 year. Participants were classified into 3 groups based on daily activity values: 4+ for AP (n = 22), 1–3 for AV (n = 82), and 0 for NAP (n = 30). Significant differences were observed in mental component summary (MCS) score and SOC3–UTHS total scores in the ranking order of AP (highest), AV, and NAP. Conclusion Our findings indicate a need to develop programs for facilitating AP among unemployed people to enhance mental QOL and SOC. PMID:24069249

  16. Lesson plan profile of senior high school biology teachers in Subang

    NASA Astrophysics Data System (ADS)

    Rohayati, E.; Diana, S. W.; Priyandoko, D.

    2018-05-01

    Lesson plan have important role for biology teachers in teaching and learning process. The aim of this study was intended to gain an overview of lesson plan of biology teachers’ at Senior High Schools in Subang which were the members of biology teachers association in Subang. The research method was descriptive method. Data was collected from 30 biology teachers. The result of study showed that lesson plan profile in terms of subject’s identity had good category with 83.33 % of average score. Analysis on basic competence in fair category with 74.45 % of average score. The compatibility of method/strategy was in fair category with average score 72.22 %. The compatibility of instrument, media, and learning resources in fair category with 71.11 % of average score. Learning scenario was in good category with 77.00 % of average score. The compatibility of evaluation was in low category with 56.39 % of average score. It can be concluded that biology teachers in Subang were good enough in making lesson plan, however in terms of the compatibility of evaluation needed to be fixed. Furthermore, teachers’ training for biology teachers’ association was recommended to increasing teachers’ skill to be professional teachers.

  17. Statistical analysis of the radon-222 potential of rocks in Virginia, U.S.A.

    USGS Publications Warehouse

    Brown, C. Erwin; Mose, D.G.; Mushrush, G.W.; Chrosniak, C.E.

    1992-01-01

    More than 3,200 indoor radon-222 (222Rn) measurements were made seasonally in an area of about 1,000 square kilometers of the Coastal Plain and Piedmont physiographic provinces in Virginia, U.S.A. Results of these measurements indicate that some geological units are associated, on the average, with twice as much indoor222Rn as other geological units, and that indoor222Rn varies seasonally. The Kruskal-Wallis test was used to test whether indoor222Rn concentrations for data gathered over the winter and summer seasons differ significantly by rock unit. The tests concluded that indoor222Rn concentrations for different rock units were not equal at the 5-percent significance level. The rocks associated with the highest median indoor222Rn concentration are specific rocks in the Mesozoic Culpeper basin, including shale and siltstone units with Jurassic diabase intrusives, and mica schists in the Piedmont physiographic province. The pre-Triassic Peters Creek Schist has the highest ranking in terms of indoor222Rn concentration. The rocks associated with the lowest indoor222Rn concentrations include coastal plain sediments, the Occoquan Granite, Falls Church Tonalite, Piney Branch Mafic and Ultramafic complex, and unnamed mafic and ultramafic inclusions, respectively. The rocks have been ranked according to observed222Rn concentration by transforming the average rank of indoor222Rn concentrations to z scores. ?? 1992 Springer-Verlag New York Inc.

  18. Glue ear: how good is the information on the World Wide Web?

    PubMed

    Ritchie, L; Tornari, C; Patel, P M; Lakhani, R

    2016-02-01

    This paper objectively evaluates current information available to the general public related to glue ear on the World Wide Web. The term 'glue ear' was typed into the 3 most frequently used internet search engines - Google, Bing and Yahoo - and the first 20 links were analysed. The first 400 words of each page were used to calculate the Flesch-Kincaid readability score. Each website was subsequently graded using the Discern instrument, which gauges quality and content of literature. The websites Webmd.boots.com, Bupa.co.uk and Patient.co.uk received the highest overall scores. These reflected top scores in either readability or Discern instrument assessment, but not both. Readability and Discern scores increased with the presence of a marketing or advertising incentive. The Patient.co.uk website had the highest Discern score and third highest readability score. There is huge variation in the quality of information available to patients on the internet. Some websites may be accessible to a wide range of reading ages but have poor quality content, and vice versa. Clinicians should be aware of indicators of quality, and use validated instruments to assess and recommend literature.

  19. Syntax and reading comprehension: a meta-analysis of different spoken-syntax assessments.

    PubMed

    Brimo, Danielle; Lund, Emily; Sapp, Alysha

    2018-05-01

    Syntax is a language skill purported to support children's reading comprehension. However, researchers who have examined whether children with average and below-average reading comprehension score significantly different on spoken-syntax assessments report inconsistent results. To determine if differences in how syntax is measured affect whether children with average and below-average reading comprehension score significantly different on spoken-syntax assessments. Studies that included a group comparison design, children with average and below-average reading comprehension, and a spoken-syntax assessment were selected for review. Fourteen articles from a total of 1281 reviewed met the inclusionary criteria. The 14 articles were coded for the age of the children, score on the reading comprehension assessment, type of spoken-syntax assessment, type of syntax construct measured and score on the spoken-syntax assessment. A random-effects model was used to analyze the difference between the effect sizes of the types of spoken-syntax assessments and the difference between the effect sizes of the syntax construct measured. There was a significant difference between children with average and below-average reading comprehension on spoken-syntax assessments. Those with average and below-average reading comprehension scored significantly different on spoken-syntax assessments when norm-referenced and researcher-created assessments were compared. However, when the type of construct was compared, children with average and below-average reading comprehension scored significantly different on assessments that measured knowledge of spoken syntax, but not on assessments that measured awareness of spoken syntax. The results of this meta-analysis confirmed that the type of spoken-syntax assessment, whether norm-referenced or researcher-created, did not explain why some researchers reported that there were no significant differences between children with average and below-average reading comprehension, but the syntax construct, awareness or knowledge, did. Thus, when selecting how to measure syntax among school-age children, researchers and practitioners should evaluate whether they are measuring children's awareness of spoken syntax or knowledge of spoken syntax. Other differences, such as participant diagnosis and the format of items on the spoken-syntax assessments, also were discussed as possible explanations for why researchers found that children with average and below-average reading comprehension did not score significantly differently on spoken-syntax assessments. © 2017 Royal College of Speech and Language Therapists.

  20. Topographic characterisation of dental implants for commercial use.

    PubMed

    Mendoza-Arnau, A; Vallecillo-Capilla, M-F; Cabrerizo-Vílchez, M-Á; Rosales-Leal, J-I

    2016-09-01

    To characterize the surface topography of several dental implants for commercial use. Dental implants analyzed were Certain (Biomet 3i), Tissue Level (Straumann), Interna (BTI), MG-InHex (MozoGrau), SPI (Alphabio) and Hikelt (Bioner). Surface topography was ascertained using a confocal microscope with white light. Roughness parameters obtained were: Ra, Rq, Rv, Rp, Rt, Rsk and Rku. The results were analysed using single-factor ANOVA and Student-Neuman-Keuls (p<0.05) tests. Certain and Hikelt obtained the highest Ra and Rq scores, followed by Tissue Level. Interna and SPI obtained lower scores, and MG-InHex obtained the lowest score. Rv scores followed the same trend. Certain obtained the highest Rp score, followed by SPI and Hikelt, then Interna and Tissue Level. MG-InHex obtained the lowest scores. Certain obtained the highest Rt score, followed by Interna and Hikelt, then SPI and Tissue Level. The lowest scores were for MG-InHex. Rsk was negative (punctured surface) in the MG-InHex, SPI and Tissue Level systems, and positive (pointed surface) in the other systems. Rku was higher than 3 (Leptokurtic) in Tissue Level, Interna, MG-InHex and SPI, and lower than 3 (Platykurtic) in Certain and Hikelt. The type of implant determines surface topography, and there are differences in the roughness parameters of the various makes of implants for clinical use.

  1. 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.

  2. Evaluating CollaboRATE in a clinical setting: analysis of mode effects on scores, response rates and costs of data collection.

    PubMed

    Barr, Paul J; Forcino, Rachel C; Thompson, Rachel; Ozanne, Elissa M; Arend, Roger; Castaldo, Molly Ganger; O'Malley, A James; Elwyn, Glyn

    2017-03-24

    Shared decision-making (SDM) has become a policy priority, yet its implementation is not routinely assessed. To address this gap we tested the delivery of CollaboRATE, a 3-item patient reported experience measure of SDM, via multiple survey modes. To assess CollaboRATE response rates and respondent characteristics across different modes of administration, impact of mode and patient characteristics on SDM performance and cost of administration per response in a real-world primary care practice. Observational study design, with repeated assessment of SDM performance using CollaboRATE in a primary care clinic over 15 months of data collection. Different modes of administration were introduced sequentially including paper, patient portal, interactive voice response (IVR) call, text message and tablet computer. Consecutive patients ≥18 years, or parents/guardians of patients <18 years, visiting participating primary care clinicians. CollaboRATE assesses three core SDM tasks: (1) explanation about health issues, (2) elicitation of patient preferences and (3) integration of patient preferences into decisions. Responses to each item range from 0 (no effort was made) to 9 (every effort was made). CollaboRATE scores are calculated as the proportion of participants who report a score of nine on each of the three CollaboRATE questions. Scores were sensitive to mode effects: the paper mode had the highest average score (81%) and IVR had the lowest (61%). However, relative clinician performance rankings were stable across the different data collection modes used. Tablet computers administered by research staff had the highest response rate (41%), although this approach was costly. Clinic staff giving paper surveys to patients as they left the clinic had the lowest response rate (12%). CollaboRATE can be introduced using multiple modes of survey delivery while producing consistent clinician rankings. This may allow routine assessment and benchmarking of clinician and clinic SDM performance. 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/.

  3. The effect of proposed software products' features on the satisfaction and dissatisfaction of potential customers

    NASA Astrophysics Data System (ADS)

    Hussain, Azham; Mkpojiogu, Emmanuel O. C.; Yusof, Muhammad Mat

    2016-08-01

    This paper reports the effect of proposed software products features on the satisfaction and dissatisfaction of potential customers of proposed software products. Kano model's functional and dysfunctional technique was used along with Berger et al.'s customer satisfaction coefficients. The result shows that only two features performed the most in influencing the satisfaction and dissatisfaction of would-be customers of the proposed software product. Attractive and one-dimensional features had the highest impact on the satisfaction and dissatisfaction of customers. This result will benefit requirements analysts, developers, designers, projects and sales managers in preparing for proposed products. Additional analysis showed that the Kano model's satisfaction and dissatisfaction scores were highly related to the Park et al.'s average satisfaction coefficient (r=96%), implying that these variables can be used interchangeably or in place of one another to elicit customer satisfaction. Furthermore, average satisfaction coefficients and satisfaction and dissatisfaction indexes were all positively and linearly correlated.

  4. Interactive and additive influences of Gender, BMI and Apolipoprotein 4 on cognition in children chronically exposed to high concentrations of PM2.5 and ozone. APOE 4 females are at highest risk in Mexico City.

    PubMed

    Calderón-Garcidueñas, Lilian; Jewells, Valerie; Galaz-Montoya, Carolina; van Zundert, Brigitte; Pérez-Calatayud, Angel; Ascencio-Ferrel, Eric; Valencia-Salazar, Gildardo; Sandoval-Cano, Marcela; Carlos, Esperanza; Solorio, Edelmira; Acuña-Ayala, Hilda; Torres-Jardón, Ricardo; D'Angiulli, Amedeo

    2016-10-01

    Children's air pollution exposures are associated with systemic and brain inflammation and the early hallmarks of Alzheimer's disease (AD). The Apolipoprotein E (APOE) 4 allele is the most prevalent genetic risk for AD, with higher risk for women. We assessed whether gender, BMI, APOE and metabolic variables in healthy children with high exposures to ozone and fine particulate matter (PM2.5) influence cognition. The Wechsler Intelligence Scale for Children (WISC-R) was administered to 105 Mexico City children (12.32±5.4 years, 69 APOE 3/3 and 36 APOE 3/4). APOE 4v 3 children showed decrements on attention and short-term memory subscales, and below-average scores in Verbal, Performance and Full Scale IQ. APOE 4 females had higher BMI and females with normal BMI between 75-94% percentiles had the highest deficits in Total IQ, Performance IQ, Digit Span, Picture Arrangement, Block Design and Object Assembly. Fasting glucose was significantly higher in APOE 4 children p=0.006, while Gender was the main variable accounting for the difference in insulin, HOMA-IR and leptin (p<.05). Gender, BMI and APOE influence children's cognitive responses to air pollution and glucose is likely a key player. APOE 4 heterozygous females with >75% to <94% BMI percentiles are at the highest risk of severe cognitive deficits (1.5-2SD from average IQ). Young female results highlight the urgent need for gender-targeted health programmes to improve cognitive responses. Multidisciplinary intervention strategies could provide paths for prevention or amelioration of female air pollution targeted cognitive deficits and possible long-term AD progression. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. 45 CFR 270.8 - How will we allocate the bonus award funds?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... will allocate and award $140 million to the ten States with the highest scores for each work measure as... Work Force—$21 million; (b) In FY 2002 and beyond, we will allocate and award $20 million to the ten States with the highest scores on the Food Stamp measures and $20 million to the ten States with the...

  6. A study of the influence of a preservice science teacher education program over time

    NASA Astrophysics Data System (ADS)

    Maher, Terrence Patrick

    2009-12-01

    This dissertation looks at the beliefs and practices of thirteen science teachers across the teaching continuum. Three pre-service teachers, four student teachers, three first year teachers and three teachers with three or more years of experience were participants in this longitudinal study that took place between 2006 and 2009. All participants were graduates of a large university in the southeastern United States. The study found that inquiry-based teaching practices were taught at the university and most participants believe that it is a superior way of teaching science. Using the Reformed Teaching Observation Protocol (RTOP) instrument to measure the amount of inquiry-based teaching, the following findings were made: The highest level of inquiry-based teaching occurs during pre-service education. This was the only group to score within the "reformed-based" teaching range. The total RTOP scores decreased into the traditional teaching practice range during student teaching. The scores continued to decrease during the first and second years of teaching, showing an even stronger prevalence toward traditional teaching. A slight increase in the average total RTOP scores was noted with teachers having three or more years of experience. But even these teachers' scores were well within the traditional teaching method range. When interviewed, the most common reasons cited by these teachers for not using inquiry-based practice in the public classrooms were high stakes testing, crowded class sizes, and lack of equipment/support.

  7. The quality of school wellness policies and energy-balance behaviors of adolescent mothers.

    PubMed

    Haire-Joshu, Debra; Yount, Byron W; Budd, Elizabeth L; Schwarz, Cynthia; Schermbeck, Rebecca; Green, Scoie; Elliott, Michael

    2011-03-01

    In this study, we 1) compared the quality of school wellness policies among schools participating in Moms for a Healthy Balance (BALANCE), a school- and home-based weight loss study conducted with postpartum adolescents in 27 states; and 2) assessed the relationship between policy quality with energy-balance behaviors and body mass index z scores of postpartum adolescents. As a part of BALANCE, we collected data on high-calorie food and beverage consumption, minutes spent walking, and height and weight for 647 participants. The School Wellness Policy Coding Tool was used to assess the strength and comprehensiveness of school district wellness policies from 251 schools attended by participating adolescent mothers. Schools averaged low scores for wellness policy comprehensiveness and strength. When compared with participants in schools with the lowest policy comprehensiveness scores, adolescent mothers in schools with the highest scores reported consuming significantly fewer daily calories from sweetened beverages while reporting higher consumption of water (P = .04 and P = .01, respectively). School wellness policy strength was associated with lower BMI z scores among adolescent mothers (P = .01). School wellness policies associated with BALANCE may be limited in their ability to promote a healthy school environment. Future studies are needed to evaluate the effect of the strength and comprehensiveness of policy language on energy balance in high-risk postpartum adolescents. Evidence from this work can provide additional guidance to federal or state government in mandating not only policy content, but also systematic evaluation.

  8. Job satisfaction survey among health centers staff.

    PubMed

    Shahnazi, Hossein; Daniali, Seyede Shahrbanoo; Sharifirad, Gholamreza

    2014-01-01

    Due to the importance of health care organizations with significant responsibility for prevention and care, assessment of job satisfaction among health care staff is essential. Quality of health services will be decreased provided they are not satisfied. This study was a cross-sectional analysis of health care staff in Khomeinishahr (centers, buildings, and networks) If they had at least 6 months work experience, they could enter the study. Data included a two-part questionnaire with a standardized questionnaire, demographic variables, and Smith job descriptive index, which is a questionnaire with six domains. Reliability was obtained for each domain and its validity was reported 0.93. The results showed an overall satisfaction score averages 43.55 ± 12.8 (from 100). Job satisfaction score was not significantly different between the sexes. However, within the current attitude toward job satisfaction, men scores was better than women (P = 0.001). Highest score in job satisfaction was related to relationships with colleagues and lowest score was related to the income, benefits, and job promotion. The more the years of work, the less the job satisfaction was. The attitude toward the current job had a direct relationship with income (P = 0.01). There was a significant inverse relationship between educational level and job satisfaction in domains promotion, income, and benefits (P = 0.01). The staff with higher education levels was less satisfied with income and job promotion qualification. Managers should focus on job qualification to increase job satisfaction and improve the quality of work.

  9. Biological Diversity, Ecological Health and Condition of Aquatic Assemblages at National Wildlife Refuges in Southern Indiana, USA

    PubMed Central

    Morris, Charles C.; Robb, Joseph R.; McCoy, William

    2015-01-01

    Abstract The National Wildlife Refuge system is a vital resource for the protection and conservation of biodiversity and biological integrity in the United States. Surveys were conducted to determine the spatial and temporal patterns of fish, macroinvertebrate, and crayfish populations in two watersheds that encompass three refuges in southern Indiana. The Patoka River National Wildlife Refuge had the highest number of aquatic species with 355 macroinvertebrate taxa, six crayfish species, and 82 fish species, while the Big Oaks National Wildlife Refuge had 163 macroinvertebrate taxa, seven crayfish species, and 37 fish species. The Muscatatuck National Wildlife Refuge had the lowest diversity of macroinvertebrates with 96 taxa and six crayfish species, while possessing the second highest fish species richness with 51 species. Habitat quality was highest in the Muscatatuck River drainage with increased amounts of forested habitats compared to the Patoka River drainage. Biological integrity of the three refuges ranked the Patoka NWR as the lowest biological integrity (mean IBI reach scores = 35 IBI points), while Big Oaks had the highest biological integrity (mean IBI reach score = 41 IBI points). The Muscatatuck NWR had a mean IBI reach score of 31 during June, which seasonally increased to a mean of 40 IBI points during summer. Watershed IBI scores and habitat condition were highest in the Big Oaks NWR. PMID:25632261

  10. Characteristics and Implications of Diagnostic Justification Scores Based on the New Patient Note Format of the USMLE Step 2 CS Exam.

    PubMed

    Yudkowsky, Rachel; Park, Yoon Soo; Hyderi, Abbas; Bordage, Georges

    2015-11-01

    To determine the psychometric characteristics of diagnostic justification scores based on the patient note format of the United States Medical Licensing Examination Step 2 Clinical Skills exam, which requires students to document history and physical findings, differential diagnoses, diagnostic justification, and plan for immediate workup. End-of-third-year medical students at one institution wrote notes for five standardized patient cases in May 2013 (n = 180) and 2014 (n = 177). Each case was scored using a four-point rubric to rate each of the four note components. Descriptive statistics and item analyses were computed and a generalizability study done. Across cases, 10% to 48% provided no diagnostic justification or had several missing or incorrect links between history and physical findings and diagnoses. The average intercase correlation for justification scores ranged from 0.06 to 0.16; internal consistency reliability of justification scores (coefficient alpha across cases) was 0.38. Overall, justification scores had the highest mean item discrimination across cases. The generalizability study showed that person-case interaction (12%) and task-case interaction (13%) had the largest variance components, indicating substantial case specificity. The diagnostic justification task provides unique information about student achievement and curricular gaps. Students struggled to correctly justify their diagnoses; performance was highly case specific. Diagnostic justification was the most discriminating element of the patient note and had the greatest variability in student performance across cases. The curriculum should provide a wide range of clinical cases and emphasize recognition and interpretation of clinically discriminating findings to promote the development of clinical reasoning skills.

  11. Changes in self-directed learning readiness in dental students: a mixed-methods study.

    PubMed

    Premkumar, Kalyani; Pahwa, Punam; Banerjee, Ankona; Baptiste, Kellen; Bhatt, Hitesh; Lim, Hyun J

    2014-06-01

    The purpose of this study was to identify changes in dental students' self-directed learning (SDL) readiness during their education. Guglielmino's SDL readiness scale (SDLRS) was completed at admission by dental students at the University of Saskatchewan and at the end of each year of training. The response rates varied from year to year. Between twenty-seven and thirty students completed the questionnaire each year at admission (93-100 percent of the entering class). The numbers of participants were lower in succeeding years: numbers used for analysis ranged from eleven to twenty-six; years in which fewer than eleven students participated were not included in the analysis. At admission, the students' mean SDLRS score was 228.98 (on a scale from 58 to 290, with 290 the highest); this score was higher than that of the average adult population (214±25.59). There was no significant effect of years of predental education, prior unsuccessful applications to dental school, interview scores, age, or admission test scores. There was a significant drop in SDLRS scores at the end of the first year for most of the cohorts (p<0.001). In addition to the questionnaire part of the study, two instructors and five first- and second-year students participated in focus groups. Those results showed that the individuals defined SDL narrowly and had similar perceptions of curricular factors that affect SDL readiness. The drop in scores one year after admission and lack of change with increased training suggests that current educational interventions may require re-examination and alteration to those that promote self-direction.

  12. Efficacy of postoperative pain management in head and neck cancer patients.

    PubMed

    Hinther, Ashley; Nakoneshny, Steven C; Chandarana, Shamir P; Wayne Matthews, T; Dort, Joseph C

    2018-05-02

    Our study quantifies the effectiveness of perioperative pain control in a cohort of patients undergoing major head and neck surgery with free flap reconstruction. Our long-term goal is to improve pain control and thereby increase mobility, decrease postoperative complications and decrease hospital stay. A retrospective analysis was performed at a tertiary, academic head and neck surgical oncology program in Calgary, Alberta, Canada from January 1, 2015 - December 31, 2015. Pain scores were recorded prospectively. Primary outcomes were frequency of postoperative pain assessments and pain intensity using the numeric rating scale. The cohort included 41 patients. Analysis was limited to pain scores recorded from postoperative days 1-14. There was an average of 7.3 pain measurements per day (SD 4.6, range 1-24) with the most frequent monitoring on postoperative days 1-4. Median pain scores ranged from 0 to 4.5 with the highest median score on postoperative day 6. The daily maximum pain scores recorded ranged from 8 to 10 with scores of 10 recorded on postoperative days 1, 2, 3, 5, 7, 8, and 10. Patients most frequently had inadequate pain control on postoperative days 1, 2, 4, and 5 with the majority occurring on postoperative day 1. Postoperative pain control could be improved at our centre. The frequency of pain assessments is also highly variable. Ongoing measurement, audit, and feedback of analgesic protocol effectiveness is an excellent first step in improving perioperative pain management in patients undergoing major head and neck cancer surgery with free flap reconstruction.

  13. [Information quality in general public French-speaking websites dedicated to oral cancer detection].

    PubMed

    Vivien, A; Kowalski, V; Chatellier, A; Babin, E; Bénateau, H; Veyssière, A

    2017-02-01

    The goal set by the French highest national authorities in the 2014-2019 Cancer Plan is to "heal more sick persons by promoting early diagnosis through screening". Screening requires information. Nowadays, Internet allows for access to information "in one click". The aim of our study was to evaluate the quality of information found on the Internet. Several sites dedicated to oral cavity cancer screening were selected on Google. The quality of health information found in these sites was evaluated by the DISCERN questionnaire. The quality of decision support provided by the sites was evaluated by the IPDAS checklist. Twenty-seven sites were selected. The average DISCERN score was 25.1/75 (15/75 to 40/75). Eighteen sites (66.6%) had very poor, 8 sites (29.6%) had poor and 1 site had average information quality. IPDAS scores ranged from 11.1 to 38.1. Eight sites (29.6%) had less than 20%, 14 sites (51.9%) had between 20 and 30% and 5 sites (18.5%) had 30% or more validated criteria. No site achieved the pass mark. The quality of general public French-speaking website dedicated to oral cancer detection is very bad. The role of health professionals such as general practitioners and head and neck surgeons, remains essential. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  14. Globally-Applicable Predictive Wildfire Model   a Temporal-Spatial GIS Based Risk Analysis Using Data Driven Fuzzy Logic Functions

    NASA Astrophysics Data System (ADS)

    van den Dool, G.

    2017-11-01

    This study (van den Dool, 2017) is a proof of concept for a global predictive wildfire model, in which the temporal-spatial characteristics of wildfires are placed in a Geographical Information System (GIS), and the risk analysis is based on data-driven fuzzy logic functions. The data sources used in this model are available as global datasets, but subdivided into three pilot areas: North America (California/Nevada), Europe (Spain), and Asia (Mongolia), and are downscaled to the highest resolution (3-arc second). The GIS is constructed around three themes: topography, fuel availability and climate. From the topographical data, six derived sub-themes are created and converted to a fuzzy membership based on the catchment area statistics. The fuel availability score is a composite of four data layers: land cover, wood loads, biomass, biovolumes. As input for the climatological sub-model reanalysed daily averaged, weather-related data is used, which is accumulated to a global weekly time-window (to account for the uncertainty within the climatological model) and forms the temporal component of the model. The final product is a wildfire risk score (from 0 to 1) by week, representing the average wildfire risk in an area. To compute the potential wildfire risk the sub-models are combined usinga Multi-Criteria Approach, and the model results are validated against the area under the Receiver Operating Characteristic curve.

  15. Judging in Rhythmic Gymnastics at Different Levels of Performance.

    PubMed

    Leandro, Catarina; Ávila-Carvalho, Lurdes; Sierra-Palmeiro, Elena; Bobo-Arce, Marta

    2017-12-01

    This study aimed to analyse the quality of difficulty judging in rhythmic gymnastics, at different levels of performance. The sample consisted of 1152 difficulty scores concerning 288 individual routines, performed in the World Championships in 2013. The data were analysed using the mean absolute judge deviation from the final difficulty score, a Cronbach's alpha coefficient and intra-class correlations, for consistency and reliability assessment. For validity assessment, mean deviations of judges' difficulty scores, the Kendall's coefficient of concordance W and ANOVA eta-squared values were calculated. Overall, the results in terms of consistency (Cronbach's alpha mostly above 0.90) and reliability (intra-class correlations for single and average measures above 0.70 and 0.90, respectively) were satisfactory, in the first and third parts of the ranking on all apparatus. The medium level gymnasts, those in the second part of the ranking, had inferior reliability indices and highest score dispersion. In this part, the minimum of corrected item-total correlation of individual judges was 0.55, with most values well below, and the matrix for between-judge correlations identified remarkable inferior correlations. These findings suggest that the quality of difficulty judging in rhythmic gymnastics may be compromised at certain levels of performance. In future, special attention should be paid to the judging analysis of the medium level gymnasts, as well as the Code of Points applicability at this level.

  16. Judging in Rhythmic Gymnastics at Different Levels of Performance

    PubMed Central

    Ávila-Carvalho, Lurdes; Sierra-Palmeiro, Elena; Bobo-Arce, Marta

    2017-01-01

    Abstract This study aimed to analyse the quality of difficulty judging in rhythmic gymnastics, at different levels of performance. The sample consisted of 1152 difficulty scores concerning 288 individual routines, performed in the World Championships in 2013. The data were analysed using the mean absolute judge deviation from the final difficulty score, a Cronbach’s alpha coefficient and intra-class correlations, for consistency and reliability assessment. For validity assessment, mean deviations of judges’ difficulty scores, the Kendall’s coefficient of concordance W and ANOVA eta-squared values were calculated. Overall, the results in terms of consistency (Cronbach’s alpha mostly above 0.90) and reliability (intra-class correlations for single and average measures above 0.70 and 0.90, respectively) were satisfactory, in the first and third parts of the ranking on all apparatus. The medium level gymnasts, those in the second part of the ranking, had inferior reliability indices and highest score dispersion. In this part, the minimum of corrected item-total correlation of individual judges was 0.55, with most values well below, and the matrix for between-judge correlations identified remarkable inferior correlations. These findings suggest that the quality of difficulty judging in rhythmic gymnastics may be compromised at certain levels of performance. In future, special attention should be paid to the judging analysis of the medium level gymnasts, as well as the Code of Points applicability at this level. PMID:29339996

  17. Nurses' Knowledge and Attitudes about Pain: Personal and Professional Characteristics and Patient Reported Pain Satisfaction.

    PubMed

    Brant, Jeannine M; Mohr, Carla; Coombs, Nicholas C; Finn, Susan; Wilmarth, Estella

    2017-08-01

    Pain is a nursing sensitive indicator and yet pain is often not well managed in both hospital and ambulatory settings. Improving nurse knowledge and attitudes about pain may translate to improved patient outcomes. The objective of this study was to investigate knowledge and attitudes about pain (KAP) in nurses who work in diverse settings, professional and personal characteristics that predict KAP, and whether KAP correlated with patient satisfaction according to Hospital Consumer Assessment of Healthcare Providers (HCAHPS). Descriptive, cross-sectional, correlational study. A large integrated health care facility in the northwest. A total of 217 registered nurses working in acute, ambulatory, and long-term care. A Pain Knowledge and Attitudes Survey was administered to registered nurses in diverse settings. Scores were examined for personal and professional predictors of KAP and correlated with HCAHPS patient satisfaction surveys. Nurses scored an average of 72%; nurses in long-term care scored the highest. Having more than 5 years of nursing experience, being a certified nurse, and receiving pain education in the last year were predictive of a higher score on the KAP survey, which explained only 9.8% of the variance. Unit mean KAP scores were highly correlated with unit-based HCAHPS scores (r = 0.917, p = .01). Certified nurses scored higher on the KAP survey, consistent with other studies. This study suggests that having more knowledge and better attitudes about pain may improve patient satisfaction of pain. Further studies are needed that link knowledge and attitudes about pain to patient outcomes. Copyright © 2017 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  18. Seasonal abundance of eggplant leafminer Liriomyza sativae (Blanchard, 1938) (Diptera, Agromyzidae) in plastic-house

    NASA Astrophysics Data System (ADS)

    Kathiar, S. A.; Flaih, S. K.; Al-Khazraji, H. I.; Ismael, S. K.

    2018-05-01

    The eggplant Solanum melongena L. crop is attacked by one of the most common pests which is the leafminer Liriomyza sativae (Blanchard, 1938); therefore, this investigation was conducted to study the seasonal abundance of the eggplant leafminer in eggplant Plastic-house. The results showed that the highest average of infested leaves was 6.67 leaf, the highest average of tunnels by leaf miner was 9.87 tunnels and the highest percent of infestation was recorded 30.5% in 23. April. 2017. This study showed the parasitoid Diglyphus isaea (Walker, 1838) (Hymenoptera, Eulophidae) was recorded as a natural enemy to control the pest and the highest incidence of parasitism was 32.2 parasites on average in 16. April. 2017.

  19. 76 FR 79579 - Approval and Promulgation of Implementation Plans and Designation of Areas for Air Quality...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-22

    ... posting of the availability of the submittal on EPA's Adequacy Web site (at http://www.epa.gov/otaq... average annual fourth-highest daily maximum 8-hour average ozone concentration), if it had a 1-hour design... ozone standard is attained when the three-year average of the annual fourth-highest daily maximum 8-hour...

  20. Work-related behaviour and experience patterns of physicians compared to other professions.

    PubMed

    Voltmer, Edgar; Kieschke, Ulf; Spahn, Claudia

    2007-08-11

    To identify health risk factors and resources of physicians in comparison with other professions. Data of cross-sectional mail surveys conducted among German physicians (n = 344), teachers (n = 5169), policemen (n = 851), prison officers (n = 3653), and starting entrepreneurs (n = 632) were analysed regarding eleven health-relevant dimensions and four behaviour patterns examined by the questionnaire "Work-Related Behaviour and Experience Pattern (AVEM)". Only 17% of the physicians showed healthy behaviour and experience patterns. With 43%, they scored highest in terms of reduced working motivation. Together with the teachers, they also had the highest scores for resignation and burnout (27%). Satisfaction with life and work as well as social support showed medium scores. Starting entrepreneurs showed the healthiest patterns (45%), but also the highest risk pattern for overexertion (38%). It was possible to identify clear risk patterns for profession-related psychosocial symptoms and impairments. The high scores for reduced working motivation demonstrate the need for interventions to improve organisation of health care and individual coping strategies.

  1. On residents' satisfaction with community health services after health care system reform in Shanghai, China, 2011.

    PubMed

    Li, Zhijian; Hou, Jiale; Lu, Lin; Tang, Shenglan; Ma, Jin

    2012-01-01

    Health care system reform is a major issue in many countries and therefore how to evaluate the effects of changes is incredibly important. This study measured residents' satisfaction with community health care service in Shanghai, China, and aimed to evaluate the effect of recent health care system reform. Face-to-face interviews were performed with a stratified random sample of 2212 residents of the Shanghai residents using structured questionnaires. In addition, 972 valid responses were retrieved from internet contact. Controlling for sex, age, income and education, the study used logistic regression modeling to analyze factors associated with satisfaction and to explain the factors that affect the residents' satisfaction. Comparing current attitudes with those held at the initial implementation of the reform in this investigation, four dimensions of health care were analyzed: 1) the health insurance system; 2) essential drugs; 3) basic clinical services; and 4) public health services. Satisfaction across all dimensions improved since the reform was initiated, but differences of satisfaction level were found among most dimensions and groups. Residents currently expressed greater satisfaction with clinical service (average score=3.79, with 5 being most satisfied) and the public health/preventive services (average score=3.62); but less satisfied with the provision of essential drugs (average score=3.20) and health insurance schemes (average score=3.23). The disadvantaged groups (the elderly, the retired, those with only an elementary education, those with lower incomes) had overall poorer satisfaction levels on these four aspects of health care (P<0.01). 25.39% of the respondents thought that their financial burden had increased and 38.49% thought that drugs had become more expensive. The respondents showed more satisfaction with the clinical services (average score=3.79) and public health services/interventions (average score=3.79); and less satisfaction with the health insurance system (average score=3.23) and the essential drug system (average score=3.20). Disadvantaged groups showed lower satisfaction levels overall relative to non-disadvantaged groups.

  2. [Analysis of results of Assessment on National Parasitic Disease Control and Prevention Techniques in 2015].

    PubMed

    Yao, Ruan; Li-Ying, Wang; Ting-Jun, Zhu; Men-Bao, Qian; Chun-Li, Cao; Yu-Wan, Hao; Tian, Tian; Shi-Zhu, Li

    2017-03-01

    To assess the theoretical knowledge and practical skills of parasitic diseases among technicians from disease control and prevention institutions. The Assessment on National Parasitic Disease Control and Prevention Techniques was organized in September, 2015. Together, 124 subjects from disease control and prevention institutions at province, prefecture or county levels in 31 provinces joined the assessment. A database was built consisting of subjects' basic information and assessment scores. Statistical analysis was used to analyze the scores by gender, age, professional title, institutions and places of participants. The average total score of all the subjects was 123.3, with a passing rate of 57.3%. The average scores of male subjects (48 subjects) and female subjects (76 subjects) were 125.9 and 121.7 respectively; the average scores of the subjects aged under 30 years (57 subjects), between 30 and 40 years (61 subjects) and above 40 years (6 subjects) were 119.6, 128.1 and 111.2 respectively; the average scores of persons with junior (94 subjects), intermediate (28 subjects) and senior (2 subjects) professional titles were 119.2, 135.9 and 140.5 respectively. The average theoretical assessment score of all the subjects was 61.9, with a passing rate of 62.9%. The average practical skill assessment score of all the subjects was 61.4, with a passing rate of 58.1%. The theoretical assessment results range widely. The theoretical knowledge results of technicians from disease control and prevention institutions are low in general. Therefore, the specific training based on daily work needs to be enhanced.

  3. MPOWER, needs and challenges: trends in the implementation of the WHO FCTC in the Eastern Mediterranean Region.

    PubMed

    Heydari, Gholamreza; Zaatari, Ghazi; Al-Lawati, Jawad A; El-Awa, Fatimah; Fouad, Heba

    2018-04-05

    WHO MPOWER aims to help countries prioritize tobacco control measures in line with the WHO Framework Convention on Tobacco Control. This paper assessed the progress and challenges in implementing the 6 priority policies of MPOWER in countries of the WHO Eastern Mediterranean Region since 2011. A checklist was developed and scores assigned based on the MPOWER indicators (maximum score 37). MPOWER data for the Region in the 2015 and 2017 tobacco control reports were extracted and scored. Data from similar analyses for 2011 and 2013 were also included. Countries were ranked by scores for each indicator for 2015 and 2017 and for overall scores for 2011 to 2017. The Islamic Republic of Iran, Egypt and Pakistan had the highest scores in 2015 (33, 29 and 27 respectively) and the Islamic Republic of Iran, Pakistan and Yemen had the highest scores in 2017 (34, 31 and 27 respectively). The indicators with the highest and lowest combined score for all countries were for advertising bans and compliance with smoke-free policies: 67 and 18 respectively in 2015, and 73 and 15 respectively in 2017. Most countries (15/22) had higher total scores in 2017 than 2015: Afghanistan, Bahrain and Syrian Arab Republic had the greatest increases. The total score for the Region increased from 416 out of a maximum score of 814 in 2011 to 471 in 2017. Although notable achievements have been made in the Region, many challenges to policy implementation remain and require urgent action by governments of the countries of the Region. Copyright © World Health Organization (WHO) 2018. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license (https://creativecommons.org/licenses/by-nc-sa/3.0/igo).

  4. Physiology response of fourth generation saline resistant soybean (Glycine max (L.) Merrill) with application of several types of antioxidants

    NASA Astrophysics Data System (ADS)

    Manurung, I. R.; Rosmayati; Rahmawati, N.

    2018-02-01

    Antioxidant applications are expected to reduce the adverse effects of soil saline. This research was conducted in plastic house, Plant Tissue Laboratory Faculty of Agriculture and Plant Physiology Laboratory Faculty of Mathematic and Natural Science, Universitas Sumatera Utara, Medan also in Research Centers and Industry Standardization, Medan from July-December 2016. The objective of the research was to know the effect of various antioxidant treatments with different concentrations (control, ascorbic acid 250, 500 and 750 ppm; salicylic acid 250, 500 and 750 ppm; α-tocopherol 250, 500 and 750 ppm) on fourth generation soybean physiology in saline condition (Electric Conductivity 5-6 dS/m). The results of this research showed that the antioxidant type and concentration affected not significantly to physiology of fourth generation soybean. Descriptively the highest average of superoxide dismutase and peroxide dismutase was showed on ascorbic acid 250 ppm. The highest average of ascorbate peroxidase was showed on α-tocopherol 750 ppm. The highest average of carotenoid content was showed on ascorbic acid 500 ppm. The highest average of chlorophyll content was showed on α-tocopherol 250 ppm. The highest average of ratio of K/Na was showed on salicylic acid 250 ppm.

  5. The Nation's Report Card Mathematics 2011 Trial Urban District Snapshot Report. School District of Philadelphia. Grade 8, Public Schools

    ERIC Educational Resources Information Center

    National Center for Education Statistics, 2011

    2011-01-01

    This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

  6. The Nation's Report Card Mathematics 2011 Trial Urban District Snapshot Report. Dallas Public Schools. Grade 4, Public Schools

    ERIC Educational Resources Information Center

    National Center for Education Statistics, 2011

    2011-01-01

    This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

  7. The Nation's Report Card Mathematics 2011 Trial Urban District Snapshot Report. Dallas Public Schools. Grade 8, Public Schools

    ERIC Educational Resources Information Center

    National Center for Education Statistics, 2011

    2011-01-01

    This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

  8. The Nation's Report Card Reading 2011 Trial Urban District Snapshot Report. Dallas Public Schools. Grade 4, Public Schools

    ERIC Educational Resources Information Center

    National Center for Education Statistics, 2011

    2011-01-01

    This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

  9. The Nation's Report Card Reading 2011 Trial Urban District Snapshot Report. Dallas Public Schools. Grade 8, Public Schools

    ERIC Educational Resources Information Center

    National Center for Education Statistics, 2011

    2011-01-01

    This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

  10. The Nation's Report Card Mathematics 2011 Trial Urban District Snapshot Report. Cleveland Metropolitan School District. Grade 4, Public Schools

    ERIC Educational Resources Information Center

    National Center for Education Statistics, 2011

    2011-01-01

    This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

  11. The Nation's Report Card Reading 2011 Trial Urban District Snapshot Report. San Diego Unified School District. Grade 8, Public Schools

    ERIC Educational Resources Information Center

    National Center for Education Statistics, 2011

    2011-01-01

    This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

  12. The Nation's Report Card Mathematics 2011 Trial Urban District Snapshot Report. San Diego Unified School District. Grade 8, Public Schools

    ERIC Educational Resources Information Center

    National Center for Education Statistics, 2011

    2011-01-01

    This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

  13. The Nation's Report Card Mathematics 2011 Trial Urban District Snapshot Report. San Diego Unified School District. Grade 4, Public Schools

    ERIC Educational Resources Information Center

    National Center for Education Statistics, 2011

    2011-01-01

    This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

  14. The Nation's Report Card Reading 2011 Trial Urban District Snapshot Report. San Diego Unified School District. Grade 4, Public Schools

    ERIC Educational Resources Information Center

    National Center for Education Statistics, 2011

    2011-01-01

    This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

  15. The Nation's Report Card Reading 2011 Trial Urban District Snapshot Report. Austin Independent School District. Grade 4, Public Schools

    ERIC Educational Resources Information Center

    National Center for Education Statistics, 2011

    2011-01-01

    This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

  16. The Nation's Report Card Reading 2011 Trial Urban District Snapshot Report. Austin Independent School District. Grade 8, Public Schools

    ERIC Educational Resources Information Center

    National Center for Education Statistics, 2011

    2011-01-01

    This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

  17. The Nation's Report Card Mathematics 2011 Trial Urban District Snapshot Report. Austin Independent School District. Grade 8, Public Schools

    ERIC Educational Resources Information Center

    National Center for Education Statistics, 2011

    2011-01-01

    This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

  18. The Nation's Report Card Mathematics 2011 Trial Urban District Snapshot Report. Austin Independent School District. Grade 4, Public Schools

    ERIC Educational Resources Information Center

    National Center for Education Statistics, 2011

    2011-01-01

    This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

  19. The Nation's Report Card Reading 2011 Trial Urban District Snapshot Report. Albuquerque Public Schools. Grade 4, Public Schools

    ERIC Educational Resources Information Center

    National Center for Education Statistics, 2011

    2011-01-01

    This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

  20. The Nation's Report Card Reading 2011 Trial Urban District Snapshot Report. Albuquerque Public Schools. Grade 8, Public Schools

    ERIC Educational Resources Information Center

    National Center for Education Statistics, 2011

    2011-01-01

    This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

  1. The Nation's Report Card Mathematics 2011 Trial Urban District Snapshot Report. Albuquerque Public Schools. Grade 4, Public Schools

    ERIC Educational Resources Information Center

    National Center for Education Statistics, 2011

    2011-01-01

    This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

  2. The Nation's Report Card Mathematics 2011 Trial Urban District Snapshot Report. Albuquerque Public Schools. Grade 8, Public Schools

    ERIC Educational Resources Information Center

    National Center for Education Statistics, 2011

    2011-01-01

    This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

  3. Teaching emergency medicine with workshops improved medical student satisfaction in emergency medicine education.

    PubMed

    Sricharoen, Pungkava; Yuksen, Chaiyaporn; Sittichanbuncha, Yuwares; Sawanyawisuth, Kittisak

    2015-01-01

    There are different teaching methods; such as traditional lectures, bedside teaching, and workshops for clinical medical clerkships. Each method has advantages and disadvantages in different situations. Emergency Medicine (EM) focuses on emergency medical conditions and deals with several emergency procedures. This study aimed to compare traditional teaching methods with teaching methods involving workshops in the EM setting for medical students. Fifth year medical students (academic year of 2010) at Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand participated in the study. Half of students received traditional teaching, including lectures and bedside teaching, while the other half received traditional teaching plus three workshops, namely, airway workshop, trauma workshop, and emergency medical services workshop. Student evaluations at the end of the clerkship were recorded. The evaluation form included overall satisfaction, satisfaction in overall teaching methods, and satisfaction in each teaching method. During the academic year 2010, there were 189 students who attended the EM rotation. Of those, 77 students (40.74%) were in the traditional EM curriculum, while 112 students were in the new EM curriculum. The average satisfaction score in teaching method of the new EM curriculum group was higher than the traditional EM curriculum group (4.54 versus 4.07, P-value <0.001). The top three highest average satisfaction scores in the new EM curriculum group were trauma workshop, bedside teaching, and emergency medical services workshop. The mean (standard deviation) satisfaction scores of those three teaching methods were 4.70 (0.50), 4.63 (0.58), and 4.60 (0.55), respectively. Teaching EM with workshops improved student satisfaction in EM education for medical students.

  4. [Quality of life of people living with HIV/AIDS and its relationship with CD4+ lymphocytes, viral load and time of diagnosis].

    PubMed

    Ferreira, Brunno Elias; Oliveira, Isabele Mendes; Paniago, Anamaria Mello Miranda

    2012-03-01

    Quality of life (QOL) has accompanied the treatment of AIDS patients, along with pharmacological innovations that have allowed patients to live longer and maintain their well-being. The present study aimed at evaluating the QOL of these patients and correlate it with clinical and laboratory data. The study included 205 patients with HIV/AIDS, who answered the WHOQOL-120-HIV; and whose socio-demographic data, clinical and laboratory findings were collected. The average age was 40.59 ± 11.81 years; CD4+ lymphocyte count, 397.9 ± 232.84 mm³; and years of diagnosis of HIV, 5.23 ± 3.94. Viral load was <50 copies/ml in 115 patients; 50 to 10.000 in 61; and above 10.000 copies in 29 patients. Domains achieved satisfactory average scores, and the best were the psychological (14.5 ± 2.7), followed by social relationships (13.7 ± 2.2), physical (12.7 ± 3.5), independence (12.6 ± 2.5), personal beliefs (12.4 ± 2.4), and environment (12.4 ± 1.8). The best scores on pain, pleasure, social support, physical environment, and personal belief facets were observed for those with higher CD4 levels (p < 0.05). The best scores for the finance, leisure, concerns about the future, overall QOL, and perceived health facets were observed for patients with viral load <50 (p < 0.05). The highest rates for energy, fatigue, sexual activity, information, transportation, symptoms, care, and concerns about the future facets were seen in patients with less time of diagnosis (p < 0.05). HIV/AIDS patients in the study had an intermediate QOL correlating to CD4 levels, VL, and time of diagnosis.

  5. Influence of oral health on quality of life in pregnant women.

    PubMed

    Moimaz, Suzely As; Rocha, Najara B; Garbin, Artênio Ji; Garbin, Cléa As; Saliba, Orlando

    2016-09-01

    This study evaluated the relationships between oral conditions and oral health-related quality of life (OHRQoL), as well as related factors. A crosssectional study was performed on 119 postnatal women who had sought prenatal care during pregnancy in the public health system of São Paulo State, Brazil. The women received oral clinical exams and were interviewed using the questions on the OHIP14. A second survey with information about their socioeconomic status, pregnancy and health habits was administered. The highest OHIP14 scores were found in the area of physical pain, with an average score of 10.6. Average DMFT rate for the population was 12.2 (±6.1), with the majority having DMFT ≥4.5 (89.9%). Most of the women needed some type of dental prosthesis (59.7%), had some type of periodontal disease (90.8%), tooth decay (73.9%), missing teeth (64.7%) and were in need of oral treatment (68.1%). The OHIP14 scores were significantly associated with age (p=0.02), first pregnancy (p<0.001), need for dental prosthesis (p<0.001), presence of dental caries (p<0.001) and missing teeth (p=0.01). In the multivariate analysis, the worst OHRQoL was significantly associated with the presence of caries (p=0.03). The results suggest an association between the worst oral condition and poorer quality of life during pregnancy. This risk group should be prioritized in the health services in order to treat and recover the oral health of pregnant women, promoting better oral health conditions and better quality of life for their children. Sociedad Argentina de Investigación Odontológica.

  6. Unmet needs of outpatients with late-life depression; a comparison of patient, staff and carer perceptions.

    PubMed

    Houtjes, W; van Meijel, B; Deeg, D J H; Beekman, A T F

    2011-11-01

    There is evidence that late life depression is associated with high levels of unmet needs. Only a minority of the depressed patients appears to be adequately treated. Ninety-nine older patients (58-92 years), 96 informal carers and 85 health-care professionals were recruited from six outpatient facilities for old age psychiatry in the Netherlands and interviewed to identify met and unmet needs, using the Camberwell Assessment of Needs for the Elderly (CANE). The severity of depression was measured with the Montgomery Åsberg Depression Rating Scale (MADRS). On average patients scored more unmet needs than staff and carers. On item level, patients and staff showed the highest agreement in the psychological needs category. Patient and carers showed the highest agreement on physical health needs. Logistic regression showed that severe depression is a significant predictor of low concordance between stakeholders on a substantial number of CANE items. Kappa coefficients were computed to determine agreement between parties involved. However, Kappa coefficients should be interpreted with caution, especially when obvious disparity in unmet needs scores between groups of interest can be observed. Home dwelling older patients with major depressive disorder, their practitioners and their informal carers have different perceptions of the older patients unmet needs.Practitioners should be aware of the negative impact of depression severity on reaching agreement regarding unmet needs and its possible consequences for mutual goal setting and compliance. Copyright © 2011 Elsevier B.V. All rights reserved.

  7. The Relationship between Academic Averages of Primary School Science and Technology Class and Test Sub-Test Scores of Placement Test of Science

    ERIC Educational Resources Information Center

    Guzeller, Cem Oktay

    2012-01-01

    In this research, the relationship between written exam scores of science and technology class of 6th, 7th, and 8th grades, project, participation in class activities and performance work, year-end academic success point averages and sub-test raw scores of LDT science of 6th, 7th and 8th grades. Academic success point averages were used as…

  8. Topographic characterisation of dental implants for commercial use

    PubMed Central

    Mendoza-Arnau, Amparo; Vallecillo-Capilla, Manuel-Francisco; Cabrerizo-Vílchez, Miguel-Ángel

    2016-01-01

    Background To characterize the surface topography of several dental implants for commercial use. Material and Methods Dental implants analyzed were Certain (Biomet 3i), Tissue Level (Straumann), Interna (BTI), MG-InHex (MozoGrau), SPI (Alphabio) and Hikelt (Bioner). Surface topography was ascertained using a confocal microscope with white light. Roughness parameters obtained were: Ra, Rq, Rv, Rp, Rt, Rsk and Rku. The results were analysed using single-factor ANOVA and Student-Neuman-Keuls(p<0.05) tests. Results Certain and Hikelt obtained the highest Ra and Rq scores, followed by Tissue Level. Interna and SPI obtained lower scores, and MG-InHex obtained the lowest score. Rv scores followed the same trend. Certain obtained the highest Rp score, followed by SPI and Hikelt, then Interna and Tissue Level. MG-InHex obtained the lowest scores. Certain obtained the highest Rt score, followed by Interna and Hikelt, then SPI and Tissue Level. The lowest scores were for MG-InHex. Rsk was negative (punctured surface) in the MG-InHex, SPI and Tissue Level systems, and positive (pointed surface) in the other systems. Rku was higher than 3 (Leptokurtic) in Tissue Level, Interna, MG-InHex and SPI, and lower than 3 (Platykurtic) in Certain and Hikelt. Conclusions The type of implant determines surface topography, and there are differences in the roughness parameters of the various makes of implants for clinical use. Key words:Implants for clinical use, topography, confocal microscopy. PMID:27475680

  9. 75 FR 43069 - Approval of One-Year Extension for Attaining the 1997 8-Hour Ozone Standard in the Baltimore...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-23

    ... standard (NAAQS). This extension is based in part on air quality data for the 4th highest daily 8-hour... attainment date if: (a) For the first one-year extension, the area's 4th highest daily 8-hour average in the... 4th highest daily 8-hour value, averaged over both the original attainment year and the first...

  10. Psychological distress is associated with inadequate dietary intake in Vietnamese marriage immigrant women in Korea.

    PubMed

    Hwang, Ji-Yun; Lee, Sang Eun; Kim, Sun Hye; Chung, Hye Won; Kim, Wha Young

    2010-05-01

    Previous studies have reported that the nutritional status of Vietnamese female marriage immigrants in Korea is inadequate. And the mediation of acculturation stress can contribute to problems in their eating practices and dietary intakes. This study examines an association between psychological distress and inadequate dietary intake in Vietnamese female marriage immigrants living in Korea. A cross-sectional study analyzed baseline data (n=570) from the Cohort of Intermarried Women in Korea. Daily nutrient intakes were compared according to the quartiles of distress scores assessed by the Psychological Well-Being Index-Short Form. One-way analysis of variance and chi(2) tests were used to compare eating practices and nutrient intake across quartiles of psychological distress. Subjects in the highest stress scores were more likely to skip breakfast and to change their dietary habits after living in Korea than those in groups with low stress scores. Analyses of the subjects' Mini Dietary Assessments revealed that those with the highest stress scores were less likely to consume milk or dairy products, eat regular meals, or have balanced diets than those with the lowest stress scores. Nutrient intakes were found to be inadequate in the subjects, and those with the highest stress scores showed lower consumptions of energy, carbohydrate, protein, fat, calcium, zinc, thiamin, riboflavin, and folate compared to those with the lowest scores. The prevalence of underweight (body mass index [calculated as kg/m(2)] <18.5) increased from the lowest to highest quartiles of psychological distress scores. Psychological distress in Vietnamese female marriage immigrants living in Korea was negatively associated with dietary intake. These findings can assist dietetics practitioners working with minority immigrants because such information is important in designing appropriate strategies for dietary counseling. A follow-up study should address the underlying mechanisms of the observed diet-distress association in Vietnamese marriage immigrant women in Korea, as well as other various ethnic minority immigrants in Korea. Copyright 2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

  11. The contribution of clinical assessments to the diagnostic algorithm of pulmonary embolism.

    PubMed

    Turan, Onur; Turgut, Deniz; Gunay, Turkan; Yilmaz, Erkan; Turan, Ayse; Akkoclu, Atila

    2017-01-01

    Pulmonary thromboembolism (PE) is a major disease in respiratory emergencies. Thoracic CT angiography (CTA) is an important method of visualizing PE. Because of the high radiation and contrast exposure, the method should be performed selectively in patients in whom PE is suspected. The aim of the study was to identify the role of clinical scoring systems utilizing CTA results to diagnose PE. The study investigated 196 patients referred to the hospital emergency service in whom PE was suspected and CTA performed. They were evaluated by empirical, Wells, Geneva and Miniati assessments and classified as low, intermediate and high clinical probability. They were also classified according to serum D-dimer levels. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated and evaluated according to CTA findings. Empirical scoring was found to have the highest sensitivity, while the Wells system had the highest specificity. When low D-dimer levels and "low probabilty" were evaluated together for each scoring system, the sensitivity was found to be 100% for all methods. Wells scoring with a cut-off score of 4 had the highest specificity (56.1%). Clinical scoring systems may be guides for patients in whom PE is suspected in the emergency department. The empirical and Wells scoring systems are effective methods for patient selection. Adding evaluation of D-dimer serum levels to the clinical scores could identify patients in whom CTA should be performed. Since CTA can only be used conservatively, the use of clinical scoring systems in conjunction with D-dimer levels can be a useful guide for patient selection.

  12. The Effect of Paid Leave on Maternal Mental Health.

    PubMed

    Mandal, Bidisha

    2018-06-07

    Objectives I examined the relationship between paid maternity leave and maternal mental health among women returning to work within 12 weeks of childbirth, after 12 weeks, and those returning specifically to full-time work within 12 weeks of giving birth. Methods I used data from 3850 women who worked full-time before childbirth from the Early Childhood Longitudinal Study-Birth Cohort. I utilized propensity score matching techniques to address selection bias. Mental health was measured using the Center for Epidemiologic Studies Depression (CESD) scale, with high scores indicating greater depressive symptoms. Results Returning to work after giving birth provided psychological benefits to women who used to work full-time before childbirth. The average CESD score of women who returned to work was 0.15 standard deviation (p < 0.01) lower than the average CESD score of all women who worked full-time before giving birth. Shorter leave, on the other hand, was associated with adverse effects on mental health. The average CESD score of women who returned within 12 weeks of giving birth was 0.13 standard deviation higher (p < 0.05) than the average CESD score of all women who rejoined labor market within 9 months of giving birth. However, receipt of paid leave was associated with an improved mental health outcome. Among all women who returned to work within 12 weeks of childbirth, those women who received some paid leave had a 0.17 standard deviation (p < 0.05) lower CESD score than the average CESD score. The result was stronger for women who returned to full-time work within 12 weeks of giving birth, with a 0.32 standard deviation (p < 0.01) lower CESD score than the average CESD score. Conclusions The study revealed that the negative psychological effect of early return to work after giving birth was alleviated when women received paid leave.

  13. 4: A STUDY ON THE RATE OF INFORMATION LITERACY OF FACULTY MEMBERS AND PHD STUDENTS OF FACULTY OF NURSING AND MIDWIFERY, TABRIZ UNIVERSITY OF MEDICAL SCIENCES, BASED ON SUCCESSFUL EVIDENCE HEALTHCARE

    PubMed Central

    Razmkhah, Maryam; Moghadam, Hadi Sharif; Ziaei, Soraya; Zarea, Vahideh; Narimani, Mohammad Reza

    2017-01-01

    Background and aims Evidence based care is an approach to clinical problem-solving in which merging the results of several studies and information on specialty clinical care as well as patients' wishes and values leads to effective decision making, to avoid seeking frequent care facilitating the patient cares, empowering healthcare workers, maintaining and improving the health of patients and the families. Results of the conducted studies suggest that using such an approach requires information literacy skills. Therefore, the present study aimed to assess information literacy of the faculty members and PhD students of Nursing and Midwifery School of Tabriz University of Medical Sciences about evidence based care. Methods In this cross-sectional survey 53 PhD students and faculty members were selected using census sampling method. Data gathering tool was a researcher-made questionnaire. This inventory was developed regarding valid scientific literature on information literacy and evidence-based care with 68 items and 5 standards of literacy prepared within some steps. After confirming the validity, its reliability was concluded by Cranach's Alpha (0.89). Data was analyzed using SPSS/22. Results Average information literacy skill level for faculty members and students related to evidence-based care and information literacy standards was higher than the average index, except for “information exchange” standard (50±10). The highest and lowest mean scores in evidence based care were for, respectively, questions formation (respectively, 96.18±18.6.17 and 48.51±14.69) and evaluation results (respectively 95.56±6.66 and 45.94±14.08). For information literacy standards there were calculated for (respectively) finding information as the highest score for (respectively, 95.56±6.66 and 72.44±13.62) and the lowest for information exchange (respectively, 74.19±11.83 and 48.51±11.35). Conclusion According to the results of this study and also regarding to this subject that PhD students' and faculty members' information literacy level was above the average; it is recommended to develop optimal measures to promote evidence based decision making.

  14. Relative performance of different dental professional groups in screening for occlusal caries.

    PubMed

    Brocklehurst, Paul; Ashley, James; Walsh, Tanya; Tickle, Martin

    2012-06-01

    The use of role substitution, where different levels of practitioner undertake the duties of the most qualified clinician, is common in medicine and dentistry. Proponents argue that role substitution has the potential to increase dentists' efficiency and effectiveness, thereby freeing up resources to improve access and reduce oral health inequalities. Given the current global economic climate, many countries are re-examining models of service provision to utilize role substitution. The objective of this study was to determine whether different members of the dental team could meet the diagnostic threshold set by the World Health Organization, when screening photographs of occlusal surfaces for dental caries. Participants were sampled purposively and included; final-year dental students, final-year hygiene-therapy students, primary care dentists, hygiene-therapists and dental nurses. Following a brief training package, participants were asked to score 102 clinical photographs of both carious and noncarious extracted teeth and determine whether the tooth was 'healthy' or had 'suspected decay'. The time delay between consecutive photographs was set at 8-s. Judgment decisions were compared against the International Caries Detection and Assessment System as the gold standard, with scores of two or less representing 'healthy'. Sensitivity, specificity and predictive values were determined for each participant and clinical group. Kappa was calculated to determine test-retest reliability. Dental nurses had the highest median sensitivity (87.9%), although all groups were comparable. The median specificity for the groups was lower than their sensitivity scores, with dentists scoring the highest (71.0%). Dentists also scored the highest median positive predictive value (57.8%), whilst dental nurses scored the highest negative predictive value (91.3%). The median level of agreement was high for all groups; the highest median score was for the final-year dental students (88.9%). Even with minimal training, different members of the dental team show the potential to screen for occlusal caries to a similar standard as primary care dentists. This requires further testing in vivo, but has important implications for the productivity and design of the future dental workforce. © 2012 John Wiley & Sons A/S.

  15. Bayesian Model Averaging for Propensity Score Analysis

    ERIC Educational Resources Information Center

    Kaplan, David; Chen, Jianshen

    2013-01-01

    The purpose of this study is to explore Bayesian model averaging in the propensity score context. Previous research on Bayesian propensity score analysis does not take into account model uncertainty. In this regard, an internally consistent Bayesian framework for model building and estimation must also account for model uncertainty. The…

  16. Socioeconomic differences in childhood BMI trajectories in Belarus.

    PubMed

    Patel, Rita; Tilling, Kate; Lawlor, Debbie A; Howe, Laura D; Hughes, Rachael A; Bogdanovich, Natalia; Matush, Lidia; Nicoli, Emily; Oken, Emily; Kramer, Michael S; Martin, Richard M

    2018-02-28

    To examine associations of parental socioeconomic position with early-life offspring body mass index (BMI) trajectories in a middle-income country. Overall, 12,385 Belarusian children born 1996-97 and enrolled in a randomised breastfeeding promotion trial at birth, with 3-14 measurements of BMI from birth to 7 years. Cohort analysis in which exposures were parental education (common secondary or less; advanced secondary or partial university; completed university) and occupation (manual; non-manual) at birth, and the outcome was BMI z-score trajectories estimated using multilevel linear spline models, controlling for trial arm, location, parental BMI, maternal smoking status and number of older siblings. Infants born to university-educated mothers were heavier at birth than those born to secondary school-educated mothers [by 0.13 BMI z-score units (95% confidence interval, CI: 0.07, 0.19) for girls and 0.11 (95% CI: 0.05, 0.17) for boys; equivalent for an infant of average birth length to 43 and 38 g, respectively]. Between the ages of 3-7 years children of the most educated mothers had larger BMI increases than children of the least educated mothers. At age 7 years, after controlling for trial arm and location,  children of university-educated mothers had higher BMIs than those born to secondary school-educated mothers by 0.11 z-score (95% CI: 0.03, 0.19) among girls and 0.18 (95% CI: 0.1, 0.27) among boys, equivalent to differences in BMI for a child of average height of 0.19 and 0.26 kg/m 2 , respectively. After further controlling for parental BMI, these differences attenuated to 0.08 z-score (95% CI: 0, 0.16) and 0.16 z-score (95% CI: 0.07, 0.24), respectively, but changed very little after additional adjustment for number of older siblings and mother's smoking status. Associations were similar when based on paternal educational attainment and highest household occupation. In Belarus, consistent with some middle-income countries, higher socioeconomic position was associated with greater BMI trajectories from age 3 onwards.

  17. Open-to-Air Is a Viable Option for Initial Wound Care in Necrotizing Soft Tissue Infection that Allows Early Detection of Recurrence without Need for Painful Dressing Changes or Return to Operating Room.

    PubMed

    Yang, Derek; Davies, April; Burge, Bailey; Watkins, Phillip; Dissanaike, Sharmila

    2018-01-01

    The standard treatment of necrotizing soft tissue infection (NSTI) includes extensive surgical debridement. Care of these debridements is challenging because of the size of the wound and associated pain. A potential solution is to leave the wounds open-to-air in the period after the initial debridement, allowing for regular inspection at bedside while reducing pain associated with frequent dressing changes. We evaluated the feasibility of this approach from a pain control standpoint. An audit of wound care modalities used on adult patients with NSTI admitted to a regional burn center between January 2009 and May 2014 was performed. Patients with at least one operation were included. Those opting for palliative care were excluded. Wound care was divided into four categories: open-to-air (OTA), negative-pressure wound therapy (NPWT), packing, and ointment. Wound care, pain score, pain medication use, and number of operations were collected for the first seven days after initial debridement. Pain management was assessed by pain scores. Analgesic use was measured and compared using conversion to morphine milligram equivalents (MME). Ninety-six patients were included; 67% were men with average age of 50 years, resulting in a total of 672 days of wound care evaluated: 69 days of OTA, 127 days of NPWT, 200 days of packing, and 126 days of ointment (150 days were undocumented). Average daily pain score from all wound care modalities was 2.00. Negative pressure wound therapy had the highest reported daily pain score (2.18, p = 0.034), whereas OTA had the lowest pain score (1.63, p < 0.05). Mortality was lower in the OTA cohort but was not statistically significant; there were no other differences in long-term outcome. Leaving wounds OTA is a safe and viable option in the immediate post-debridement period of NSTI to reduce pain, while permitting frequent re-evaluation for quick recognition of disease progression and repeat operative debridement if necessary.

  18. Multi-criteria decision analysis of concentrated solar power with thermal energy storage and dry cooling.

    PubMed

    Klein, Sharon J W

    2013-12-17

    Decisions about energy backup and cooling options for parabolic trough (PT) concentrated solar power have technical, economic, and environmental implications. Although PT development has increased rapidly in recent years, energy policies do not address backup or cooling option requirements, and very few studies directly compare the diverse implications of these options. This is the first study to compare the annual capacity factor, levelized cost of energy (LCOE), water consumption, land use, and life cycle greenhouse gas (GHG) emissions of PT with different backup options (minimal backup (MB), thermal energy storage (TES), and fossil fuel backup (FF)) and different cooling options (wet (WC) and dry (DC). Multicriteria decision analysis was used with five preference scenarios to identify the highest-scoring energy backup-cooling combination for each preference scenario. MB-WC had the highest score in the Economic and Climate Change-Economy scenarios, while FF-DC and FF-WC had the highest scores in the Equal and Availability scenarios, respectively. TES-DC had the highest score for the Environmental scenario. DC was ranked 1-3 in all preference scenarios. Direct comparisons between GHG emissions and LCOE and between GHG emissions and land use suggest a preference for TES if backup is require for PT plants to compete with baseload generators.

  19. Primary caregivers of in-home oxygen-dependent children: predictors of stress based on characteristics, needs and social support.

    PubMed

    Wang, Kai-Wei K; Lin, Hung-Ching; Lee, Chin-Ting; Lee, Kuo-Sheng

    2016-07-01

    To identify the predictors of primary caregivers' stress in caring for in-home oxygen-dependent children by examining the association between their levels of stress, caregiver needs and social support. Increasing numbers of primary caregivers of oxygen-dependent children experience caregiving stress that warrants investigation. The study used a cross-sectional design with three psychometric scales - Modified-Parenting Stress Index, Caregiver Needs Scale and Social Support Index. The data collected during 2010-2011 were from participants who were responsible for their child's care that included oxygen therapy for ≧6 hours/day; the children's ages ranged from 3 months-16 years. Descriptive statistics and multivariable linear regression were used. A total of 104 participants (M = 34, F = 70) were recruited, with an average age of 39·7 years. The average age of the oxygen-dependent children was 6·68 years and their daily use of oxygen averaged 11·39 hours. The caregivers' overall levels of stress were scored as high and information needs were scored as the highest. The most available support from family and friends was emotional support. Informational support was mostly received from health professionals, but both instrumental and emotional support were important. Levels of stress and caregiver needs were significantly correlated. Multivariable linear regression analyses identified three risk factors predicting stress, namely, the caregiver's poor health status, the child's male gender and the caregiver's greater financial need. To support these caregivers, health professionals can maintain their health status and provide instrumental, emotional, informational and financial support. © 2016 John Wiley & Sons Ltd.

  20. Mean Platelet Volume, Red Cell Distribution Width to Platelet Count Ratio, Globulin Platelet Index, and 16 Other Indirect Noninvasive Fibrosis Scores: How Much Do Routine Blood Tests Tell About Liver Fibrosis in Chronic Hepatitis C?

    PubMed

    Thandassery, Ragesh B; Al Kaabi, Saad; Soofi, Madiha E; Mohiuddin, Syed A; John, Anil K; Al Mohannadi, Muneera; Al Ejji, Khalid; Yakoob, Rafie; Derbala, Moutaz F; Wani, Hamidullah; Sharma, Manik; Al Dweik, Nazeeh; Butt, Mohammed T; Kamel, Yasser M; Sultan, Khaleel; Pasic, Fuad; Singh, Rajvir

    2016-07-01

    Many indirect noninvasive scores to predict liver fibrosis are calculated from routine blood investigations. Only limited studies have compared their efficacy head to head. We aimed to compare these scores with liver biopsy fibrosis stages in patients with chronic hepatitis C. From blood investigations of 1602 patients with chronic hepatitis C who underwent a liver biopsy before initiation of antiviral treatment, 19 simple noninvasive scores were calculated. The area under the receiver operating characteristic curves and diagnostic accuracy of each of these scores were calculated (with reference to the Scheuer staging) and compared. The mean age of the patients was 41.8±9.6 years (1365 men). The most common genotype was genotype 4 (65.6%). Significant fibrosis, advanced fibrosis, and cirrhosis were seen in 65.1%, 25.6, and 6.6% of patients, respectively. All the scores except the aspartate transaminase (AST) alanine transaminase ratio, Pohl score, mean platelet volume, fibro-alpha, and red cell distribution width to platelet count ratio index showed high predictive accuracy for the stages of fibrosis. King's score (cutoff, 17.5) showed the highest predictive accuracy for significant and advanced fibrosis. King's score, Göteborg university cirrhosis index, APRI (the AST/platelet count ratio index), and Fibrosis-4 (FIB-4) had the highest predictive accuracy for cirrhosis, with the APRI (cutoff, 2) and FIB-4 (cutoff, 3.25) showing the highest diagnostic accuracy.We derived the study score 8.5 - 0.2(albumin, g/dL) +0.01(AST, IU/L) -0.02(platelet count, 10/L), which at a cutoff of >4.7 had a predictive accuracy of 0.868 (95% confidence interval, 0.833-0.904) for cirrhosis. King's score for significant and advanced fibrosis and the APRI or FIB-4 score for cirrhosis could be the best simple indirect noninvasive scores.

  1. Oral health attitudes and behavior of dental students at the University of Zagreb, Croatia.

    PubMed

    Badovinac, Ana; Božić, Darko; Vučinac, Ivana; Vešligaj, Jasna; Vražić, Domagoj; Plancak, Darije

    2013-09-01

    The aim of this study was to investigate oral health behavior and attitudes of dental students in years 1 to 6 at the University of Zagreb, Croatia. The Croatian version of the Hiroshima University-Dental Behavioral Inventory (HU-DBI) was administered to predoctoral dental students, and collected data were analyzed. A total of 503 students (22.3 ± 2.6 mean age) completed the questionnaire. The response rate was 85.1 percent, and 72.4 percent of the respondents were female. These dental students' answers to eleven out of twenty HU-DBI items differed significantly by academic year. The mean questionnaire score was 6.62 ± 1.54, and the highest value of the HU-DBI score was in the fourth year (7.24 ± 1.54). First-year students were most likely to have a toothbrush with hard bristles and felt they had not brushed well unless done with hard strokes. Students in the sixth year were least worried about visiting a dentist and most frequently put off going to a dentist until having a toothache, indicating that rise of knowledge contributes to higher self-confidence. The mean HU-DBI score for these students showed average value, pointing out the need for a comprehensive oral hygiene and preventive program from the start of dental school.

  2. Effectiveness of Jigsaw learning compared to lecture-based learning in dental education.

    PubMed

    Sagsoz, O; Karatas, O; Turel, V; Yildiz, M; Kaya, E

    2017-02-01

    The objective of this study was to evaluate the success levels of students using the Jigsaw learning method in dental education. Fifty students with similar grade point average (GPA) scores were selected and randomly assigned into one of two groups (n = 25). A pretest concerning 'adhesion and bonding agents in dentistry' was administered to all students before classes. The Jigsaw learning method was applied to the experimental group for 3 weeks. At the same time, the control group was taking classes using the lecture-based learning method. At the end of the 3 weeks, all students were retested (post-test) on the subject. A retention test was administered 3 weeks after the post-test. Mean scores were calculated for each test for the experimental and control groups, and the data obtained were analysed using the independent samples t-test. No significant difference was determined between the Jigsaw and lecture-based methods at pretest or post-test. The highest mean test score was observed in the post-test with the Jigsaw method. In the retention test, success with the Jigsaw method was significantly higher than that with the lecture-based method. The Jigsaw method is as effective as the lecture-based method. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. 40 CFR 51.907 - For an area that fails to attain the 8-hour NAAQS by its attainment date, how does EPA interpret...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... to 1-year extensions of the attainment date if: (a) For the first 1-year extension, the area's 4th... extension, the area's 4th highest daily 8-hour value, averaged over both the original attainment year and... section, the area's 4th highest daily 8-hour average shall be from the monitor with the highest 4th...

  4. 40 CFR 51.907 - For an area that fails to attain the 8-hour NAAQS by its attainment date, how does EPA interpret...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... to 1-year extensions of the attainment date if: (a) For the first 1-year extension, the area's 4th... extension, the area's 4th highest daily 8-hour value, averaged over both the original attainment year and... section, the area's 4th highest daily 8-hour average shall be from the monitor with the highest 4th...

  5. 40 CFR 51.907 - For an area that fails to attain the 8-hour NAAQS by its attainment date, how does EPA interpret...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... to 1-year extensions of the attainment date if: (a) For the first 1-year extension, the area's 4th... extension, the area's 4th highest daily 8-hour value, averaged over both the original attainment year and... section, the area's 4th highest daily 8-hour average shall be from the monitor with the highest 4th...

  6. Diet quality varies by race/ethnicity of Head Start mothers.

    PubMed

    Hoerr, Sharon L; Tsuei, Eugenia; Liu, Yan; Franklin, Frank A; Nicklas, Theresa A

    2008-04-01

    Despite the key role that women from limited income families play as family food providers and their high risk for diet-related chronic diseases, there is a paucity of data about their diet quality and how it might vary by race/ethnicity. To compare nutrient and food intakes of multiethnic mothers with children in Head Start from Texas and Alabama. Cross-sectional, secondary data analysis. The sample was 603 mothers, 33% Hispanic American from Texas; 19% African American from Texas; 24% African American from Alabama; and 24% white from Alabama who were interviewed from fall 2004 to spring 2005. Diet quality was evaluated by averaging 24-hour dietary recalls from 3 nonconsecutive days and calculating the percent meeting the Estimated Average Requirement, the Dietary Guidelines for fat and added sugar, and the mean adequacy ratio for eight nutrients. For multiple comparisons, the least square means statement was used for general linear model procedures, adjusted for age, body mass index, and energy intake. The average mean adequacy ratio scores for diet quality were low overall, but 44% of Hispanic Americans had mean adequacy ratio scores <85, whereas 96% to 97% of other groups did. Most mothers exceeded 35% of energy from fat, with Hispanic Americans having the lowest percentage. Overall, 15% of mothers exceeded 25% of energy from added sugars, with Hispanic Americans having 5% with excess intakes. Energy intakes were highest for Hispanic Americans (2,017 kcal) and lowest for African Americans (1,340 kcal). The Hispanic Americans surveyed averaged 4.6 c fruit and vegetables per day compared to 3.2, 2.3, and 2.9 c/day among African Americans from Texas, African Americans from Alabama, and whites from Alabama, respectively. Despite limited food resources, Hispanic-American mothers consumed adequate amounts of fruit and vegetables. There was considerable variation in diet quality among race/ethnic groups on a low income budget.

  7. Pledgeted repair of giant hiatal hernia provides excellent long-term results.

    PubMed

    Kang, Thomas; Urrego, Hernan; Gridley, Asahel; Richardson, William S

    2014-10-01

    Use of mesh in hiatal hernia repairs is a topic of debate. We present our experience in laparoscopic primary (nonmesh) repair of giant hiatal hernia. All laparoscopic antireflux procedures done by a single surgeon from November 1997 to October 2006 were retrospectively reviewed. Inclusion criteria were primary crural closure with pledgets and giant hiatal hernia (greater than one-third of the stomach in the chest by esophagram, greater than 5 cm in length endoscopically, or greater than one-third of the stomach in the chest operatively). We attempted to reach all patients who met inclusion criteria and administered the Reflux Symptom Index (RSI) and Quality of Life Scale for Gastroesophageal Reflux Disease (QLSGR) questionnaires. In total, 89 patients met inclusion criteria. The male-to-female ratio was 32:57. Average age was 62.7 years. Average body mass index was 29.3 kg/m(2). Average length of stay was 2 days, and mean clinic follow-up was 161 days. At the most recent follow-up, 62% of patients were asymptomatic. The most common postoperative symptoms were dysphagia (16%), reflux/emesis (5%), bloating (5%), nausea (4%), epigastric pain (4%), and heartburn (3%). There were six (6.7%) recurrences on esophagogastroduodenoscopy or upper gastrointestinal examination. Five patients with recurrence were symptomatic. Of the 89 patients, 29 (33%) completed the questionnaire, with a mean follow-up of 69.7 months. Average RSI score was 12 (maximum possible score, 45). In six of nine categories, the average score was less than 1 (possible score, 0-5). Average QLSGR score was 12 (maximum possible score, 45). For satisfaction with the present condition, the average score was 4.34 (maximum score, 5), and 82.7% of respondents were satisfied or very satisfied with their present condition. Laparoscopic primary repair of giant hiatal hernia provides excellent long-term results. We found that 62% of patients were asymptomatic at the last follow-up and that 82% of respondents were satisfied or very satisfied. The recurrence rate was 6.7%.

  8. Peer Teaching to Foster Learning in Physiology.

    PubMed

    Srivastava, Tripti K; Waghmare, Lalitbhushan S; Mishra, Ved Prakash; Rawekar, Alka T; Quazi, Nazli; Jagzape, Arunita T

    2015-08-01

    Peer teaching is an effective tool to promote learning and retention of knowledge. By preparing to teach, students are encouraged to construct their own learning program, so that they can explain effectively to fellow learners. Peer teaching is introduced in present study to foster learning and pedagogical skills amongst first year medical under-graduates in physiology with a Hypothesis that teaching is linked to learning on part of the teacher. Non-randomized, Interventional study, with mixed methods design. Cases experienced peer teaching whereas controls underwent tutorials for four consecutive classes. Quantitative Evaluation was done through pre/post test score analysis for Class average normalized gain and tests of significance, difference in average score in surprise class test after one month and percentage of responses in closed ended items of feedback questionnaire. Qualitative Evaluation was done through categorization of open ended items and coding of reflective statements. The average pre and post test score was statistically significant within cases (p = 0.01) and controls (p = 0.023). The average post test scores was more for cases though not statistically significant. The class average normalized gain (g) for Tutorials was 49% and for peer teaching 53%. Surprise test had average scoring of 36 marks (out of 50) for controls and 41 marks for cases. Analysed section wise, the average score was better for Long answer question (LAQ) in cases. Section wise analysis suggested that through peer teaching, retention was better for descriptive answers as LAQ has better average score in cases. Feedback responses were predominantly positive for efficacy of peer teaching as a learning method. The reflective statements were sorted into reflection in action, reflection on action, claiming evidence, describing experience, and recognizing discrepancies. Teaching can stimulate further learning as it involves interplay of three processes: metacognitive awareness; deliberate practice, and self-explanation. Coupled with immediate feedback and reflective exercises, learning can be measurably enhanced along with improved teaching skills.

  9. Peer Teaching to Foster Learning in Physiology

    PubMed Central

    Srivastava, Tripti K; Waghmare, Lalitbhushan S.; Mishra, Ved Prakash; Rawekar, Alka T; Quazi, Nazli; Jagzape, Arunita T

    2015-01-01

    Introduction Peer teaching is an effective tool to promote learning and retention of knowledge. By preparing to teach, students are encouraged to construct their own learning program, so that they can explain effectively to fellow learners. Peer teaching is introduced in present study to foster learning and pedagogical skills amongst first year medical under-graduates in physiology with a Hypothesis that teaching is linked to learning on part of the teacher. Materials and Methods Non-randomized, Interventional study, with mixed methods design. Cases experienced peer teaching whereas controls underwent tutorials for four consecutive classes. Quantitative Evaluation was done through pre/post test score analysis for Class average normalized gain and tests of significance, difference in average score in surprise class test after one month and percentage of responses in closed ended items of feedback questionnaire. Qualitative Evaluation was done through categorization of open ended items and coding of reflective statements. Results The average pre and post test score was statistically significant within cases (p = 0.01) and controls (p = 0.023). The average post test scores was more for cases though not statistically significant. The class average normalized gain (g) for Tutorials was 49% and for peer teaching 53%. Surprise test had average scoring of 36 marks (out of 50) for controls and 41 marks for cases. Analysed section wise, the average score was better for Long answer question (LAQ) in cases. Section wise analysis suggested that through peer teaching, retention was better for descriptive answers as LAQ has better average score in cases. Feedback responses were predominantly positive for efficacy of peer teaching as a learning method. The reflective statements were sorted into reflection in action, reflection on action, claiming evidence, describing experience, and recognizing discrepancies. Conclusion Teaching can stimulate further learning as it involves interplay of three processes: metacognitive awareness; deliberate practice, and self-explanation. Coupled with immediate feedback and reflective exercises, learning can be measurably enhanced along with improved teaching skills. PMID:26435969

  10. Level of burnout in a small population of Australian midwives.

    PubMed

    Jordan, Kayleen; Fenwick, Jennifer; Slavin, Valerie; Sidebotham, Mary; Gamble, Jenny

    2013-06-01

    The aim of the study was to describe the level of burnout in midwives working at a maternity unit in South East Queensland, Australia. A self-administered questionnaire was distributed to all registered midwives (N=110) working at the study site during November 2011. The questionnaire included a demographic survey and the Copenhagen Burnout Inventory. Fifty-eight (52.7%) staff completed the package. Data was entered into SPSS database version 19 and descriptive statistics were used to determine means, ranges and frequencies. Almost 30% of the sample experienced moderate to high levels of burnout some 50% of participants scored moderate to high for personal burnout with a similar number scoring high for work-related burnout. In comparison, burnout related to working with clients was very low. Differences between participants were associated with years of experience, area of work and employment position (FT/PT, level of position and work area). Participants aged 35years or younger and with less than 10years midwifery experience scored highest on the personal and work-related domains whereas participants over 35years scored highest within the client-related domain. Midwives at level 1 (lowest pay group) scored highest for work-related burnout and client-related burnout. Midwives in more senior positions (level 2 and above) scored highest for personal burnout. Personal and work-related burnout was high in this group of midwives while burnout related to caring for women was low. These results provide insight into the emotional health of midwives in one maternity unit. While more work is needed, strategies to decrease and/or prevent burnout may include clinical mentorship and reorganising models of maternity care to increase work satisfaction and autonomy and strengthen relationships between midwives and women. Copyright © 2013 Australian College of Midwives. All rights reserved.

  11. Students’ Attitudes Towards Research at Mazandaran University of Medical Sciences in 2015

    PubMed Central

    Siamian, Hasan; Mahmoudi, Roghayeh; Habibi, Fatemeh; Latifi, Mahsoomeh; Zare-Gavgani, Vahideh

    2016-01-01

    Background: In today’s world, one of the criteria of progress in a country is research. In our country instead of paying to the research and study, attention is given to the training of human resources. Therefore, this study aimed to investigate Students’ Attitudes towards Research at Mazandaran University of Medical Sciences in 2015. Methods: In this cross-sectional study the data tool was questionnaire given to the study subjects. The study population were all the paramedical college students at Mazandaran University of Medical Sciences selected. Cochrane methodology was used to determine the sample size, the t test used to know the attitudes and the ANOVA test to assess differences between the groups. Results: The mean age of the students was 20 years (age range of 17 to 32 years), of them, 99 (61%) were female and 63 (39%) male, 100% undergraduate and 73% on their first semester. Their attitudes toward the usefulness of search for jobs and careers, anxiety, relationship with everyday life and Research problem was positive. Belief in research problem with the highest average and relation with everyday life with the lowest average, ranked the highest and lowest scores respectively. The findings also showed that there was insignificant difference between the variables of age, gender and level of education and the attitude of students towards research. Conclusion: The subjects under study had Positive attitude to research and in case of availability of research facilities, students would be more interested in performing research. PMID:28144202

  12. Using Technology to Expand and Enhance Applied Behavioral Analysis Programs for Children with Autism in Military Families

    DTIC Science & Technology

    2013-07-01

    on the BISWA on the pretest to an average score of 100% on the BISWA posttest , whereas the participants in the control group showed...only a 1% improvement from the pretest to the posttest . On the BISPA, participants in the test group improved from an average score of 0% during...the pretest to an average score of 100% during the posttest , whereas participants in the control group showed no improvement from pretest to

  13. The influence of learning styles on collaborative performances of allied health students in a clinical exercise.

    PubMed

    Sandmire, D A; Vroman, K G; Sanders, R

    2000-01-01

    With the increasing emphasis on interdisciplinary practice, there is a need to recognize factors that promote effective interdisciplinary teams. The influence of individual learning-style preference on collaborative performance was examined in 78 occupational and physical therapy students in a neuroscience course. They were randomly assigned in pairs to one of three subsets based upon their Kolb Learning Style Inventory scores (active experimenters vs reflective observers). The students viewed a videotape of a quadriplegic patient's physical examination and completed a collaborative exercise that required performance skills on all levels of Bloom's taxonomy of learning. Analysis of variance revealed no significant difference among learning-style subset pairs in performance (F2, 36 = 0.43, p > 0.05), but the exercise's overall grade correlated with the average of the pair's highest individual scores on two prior written exams (r = 0.631, p < 0.05), suggesting that background knowledge may predict performance better than learning styles do. It is suggested that differences in information-processing styles as measured by the Kolb inventory do not affect interdisciplinary team performance.

  14. Combined impact of negative lifestyle factors on cardiovascular risk in children: a randomized prospective study.

    PubMed

    Meyer, Ursina; Schindler, Christian; Bloesch, Tamara; Schmocker, Eliane; Zahner, Lukas; Puder, Jardena J; Kriemler, Susi

    2014-12-01

    Negative lifestyle factors are known to be associated with increased cardiovascular risk (CVR) in children, but research on their combined impact on a general population of children is sparse. Therefore, we aimed to quantify the combined impact of easily assessable negative lifestyle factors on the CVR scores of randomly selected children after 4 years. Of the 540 randomly selected 6- to 13-year-old children, 502 children participated in a baseline health assessment, and 64% were assessed again after 4 years. Measures included anthropometry, fasting blood samples, and a health assessment questionnaire. Participants scored one point for each negative lifestyle factor at baseline: overweight; physical inactivity; high media consumption; little outdoor time; skipping breakfast; and having a parent who has ever smoked, is inactive, or overweight. A CVR score at follow-up was constructed by averaging sex- and age-related z-scores of waist circumference, blood pressure, glucose, inverted high-density lipoprotein, and triglycerides. The age-, sex-, pubertal stage-, and social class-adjusted probabilities (95% confidence interval) for being in the highest CVR score tertile at follow-up for children who had at most one (n = 48), two (n = 64), three (n = 56), four (n = 41), or five or more (n = 14) risky lifestyle factors were 15.4% (8.9-25.3), 24.3% (17.4-32.8), 36.0% (28.6-44.2), 49.8% (38.6-61.0), and 63.5% (47.2-77.2), respectively. Even in childhood, an accumulation of negative lifestyle factors is associated with higher CVR scores after 4 years. These negative lifestyle factors are easy to assess in clinical practice and allow early detection and prevention of CVR in childhood. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  15. Parent-child acculturation profiles as predictors of Chinese American adolescents' academic trajectories.

    PubMed

    Kim, Su Yeong; Wang, Yijie; Chen, Qi; Shen, Yishan; Hou, Yang

    2015-06-01

    Acculturation plays a critical role in the adjustment of Asian Americans, as a large proportion of them are immigrants in the US. However, little is known about how acculturation influences Asian American adolescents' academic trajectories over time. Using a longitudinal sample of 444 Chinese American families (54% female children), the current study explored the effect of mothers', fathers', and adolescents' individual acculturation profiles and parent-child acculturation dissonance on adolescents' academic trajectories from 8th to 12th grade. Academic performance was measured by grade point average (GPA), and by standardized test scores in English language arts (ELA) and Math every year. Latent growth modeling analyses showed that adolescents with a Chinese-oriented father showed faster decline in GPA, and Chinese-oriented adolescents had lower initial ELA scores. Adolescents whose parents had American-oriented acculturation profiles tended to have lower initial Math scores. These results suggest that Chinese and American profiles may be disadvantageous for certain aspects of academic performance, and bicultural adolescents and/or adolescents with bicultural parents are best positioned to achieve across multiple domains. In terms of the role of parent-child acculturation dissonance on academic trajectories, the current study highlighted the importance of distinguishing among different types of dissonance. Adolescents who were more Chinese-oriented than their parents tended to have the lowest initial ELA scores, and adolescents experiencing more normative acculturation dissonance (i.e., who were more American-oriented than their parents) had the highest initial ELA scores. No effects of parent-child acculturation dissonance were observed for GPAs or standardized Math scores. Altogether, the current findings add nuances to the current understanding of acculturation and adolescent adjustment.

  16. Para I Famagu'on-Ta: Fruit and Vegetable Intake, Food Store Environment, and Childhood Overweight/Obesity in the Children's Healthy Living Program on Guam

    PubMed Central

    Matanane, Lenora; Silva, Joshua; Li, Fenfang; Nigg, Claudio; Leon Guerrero, Rachael T; Novotny, Rachel

    2017-01-01

    This cross-sectional study examined the: (1) association between food store environment (FSE), fruit and vegetable (FV) availability and access, and prevalence of early childhood overweight/obesity (COWOB); and (2) influence of young child actual FV intake on the relationship between the FSE and early COWOB prevalence. Anthropometric and socio-demographic data of children (2 to 8 years; N=466) in baseline communities on Guam participating in the Children's Healthy Living (CHL) Program community trial were included. CDC year 2000 growth charts were used to calculate BMI z-scores and categories. FSE factors (fresh FV scores, store type) were assessed using the CX3 Food Availability and Marketing Survey amended for CHL. ArcGIS maps were constructed with geographic coordinates of participant residences and food stores to calculate food store scores within 1 mile of participant's residences. A sub-sample of participants (n = 355) had Food and Activity Log data to calculate FV and energy intakes. Bivariate correlations and logistic regression evaluated associations. Of 111 stores surveyed, 73% were small markets, 16% were convenience stores, and 11% were large grocery/supermarkets. Supermarkets/large grocery stores averaged the highest FV scores. Most participants did not meet FV intake recommendations while nearly half exceeded energy intake recommendations. Living near a small market was negatively correlated with BMI z-score (r = - 0.129, P < .05) while living near a convenience store was positively correlated with BMI z-score (r = 0.092, P < .05). Logistic regression analysis yielded non-significant associations. The high density of small markets may be an opportunity for FSE intervention but further investigation of Guam's FSE influence on health is needed. PMID:28808612

  17. Parent-Child Acculturation Profiles as Predictors of Chinese American Adolescents’ Academic Trajectories

    PubMed Central

    Kim, Su Yeong; Wang, Yijie; Chen, Qi; Shen, Yishan; Hou, Yang

    2014-01-01

    Acculturation plays a critical role in the adjustment of Asian Americans, as a large proportion of them are immigrants in the U.S. However, little is known about how acculturation influences Asian American adolescents’ academic trajectories over time. Using a longitudinal sample of 444 Chinese American families (54% female children), the current study explored the effect of mothers’, fathers’, and adolescents’ individual acculturation profiles and parent-child acculturation dissonance on adolescents’ academic trajectories from 8th to 12th grade. Academic performance was measured by Grade Point Average (GPA), and by standardized test scores in English Language Arts (ELA) and Math every year. Latent growth modeling analyses showed that adolescents with a Chinese-oriented father showed faster decline in GPA, and Chinese-oriented adolescents had lower initial ELA scores. Adolescents whose parents had American-oriented acculturation profiles tended to have lower initial Math scores. These results suggest that Chinese and American profiles may be disadvantageous for certain aspects of academic performance, and bicultural adolescents and/or adolescents with bicultural parents are best positioned to achieve across multiple domains. In terms of the role of parent-child acculturation dissonance on academic trajectories, the current study highlighted the importance of distinguishing among different types of dissonance. Adolescents who were more Chinese-oriented than their parents tended to have the lowest initial ELA scores, and adolescents experiencing more normative acculturation dissonance (i.e., who were more American-oriented than their parents) had the highest initial ELA scores. No effects of parent-child acculturation dissonance were observed for GPAs or standardized Math scores. Altogether, the current findings add nuances to the current understanding of acculturation and adolescent adjustment. PMID:24820295

  18. Executive function, but not memory, associates with incident coronary heart disease and stroke.

    PubMed

    Rostamian, Somayeh; van Buchem, Mark A; Westendorp, Rudi G J; Jukema, J Wouter; Mooijaart, Simon P; Sabayan, Behnam; de Craen, Anton J M

    2015-09-01

    To evaluate the association of performance in cognitive domains executive function and memory with incident coronary heart disease and stroke in older participants without dementia. We included 3,926 participants (mean age 75 years, 44% male) at risk for cardiovascular diseases from the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER) with Mini-Mental State Examination score ≥24 points. Scores on the Stroop Color-Word Test (selective attention) and the Letter Digit Substitution Test (processing speed) were converted to Z scores and averaged into a composite executive function score. Likewise, scores of the Picture Learning Test (immediate and delayed memory) were transformed into a composite memory score. Associations of executive function and memory were longitudinally assessed with risk of coronary heart disease and stroke using multivariable Cox regression models. During 3.2 years of follow-up, incidence rates of coronary heart disease and stroke were 30.5 and 12.4 per 1,000 person-years, respectively. In multivariable models, participants in the lowest third of executive function, as compared to participants in the highest third, had 1.85-fold (95% confidence interval [CI] 1.39-2.45) higher risk of coronary heart disease and 1.51-fold (95% CI 0.99-2.30) higher risk of stroke. Participants in the lowest third of memory had no increased risk of coronary heart disease (hazard ratio 0.99, 95% CI 0.74-1.32) or stroke (hazard ratio 0.87, 95% CI 0.57-1.32). Lower executive function, but not memory, is associated with higher risk of coronary heart disease and stroke. Lower executive function, as an independent risk indicator, might better reflect brain vascular pathologies. © 2015 American Academy of Neurology.

  19. Para I Famagu'on-Ta: Fruit and Vegetable Intake, Food Store Environment, and Childhood Overweight/Obesity in the Children's Healthy Living Program on Guam.

    PubMed

    Matanane, Lenora; Fialkowski, Marie Kainoa; Silva, Joshua; Li, Fenfang; Nigg, Claudio; Leon Guerrero, Rachael T; Novotny, Rachel

    2017-08-01

    This cross-sectional study examined the: (1) association between food store environment (FSE), fruit and vegetable (FV) availability and access, and prevalence of early childhood overweight/obesity (COWOB); and (2) influence of young child actual FV intake on the relationship between the FSE and early COWOB prevalence. Anthropometric and socio-demographic data of children (2 to 8 years; N=466) in baseline communities on Guam participating in the Children's Healthy Living (CHL) Program community trial were included. CDC year 2000 growth charts were used to calculate BMI z-scores and categories. FSE factors (fresh FV scores, store type) were assessed using the CX3 Food Availability and Marketing Survey amended for CHL. ArcGIS maps were constructed with geographic coordinates of participant residences and food stores to calculate food store scores within 1 mile of participant's residences. A sub-sample of participants (n = 355) had Food and Activity Log data to calculate FV and energy intakes. Bivariate correlations and logistic regression evaluated associations. Of 111 stores surveyed, 73% were small markets, 16% were convenience stores, and 11% were large grocery/supermarkets. Supermarkets/large grocery stores averaged the highest FV scores. Most participants did not meet FV intake recommendations while nearly half exceeded energy intake recommendations. Living near a small market was negatively correlated with BMI z-score (r = - 0.129, P < .05) while living near a convenience store was positively correlated with BMI z-score (r = 0.092, P < .05). Logistic regression analysis yielded non-significant associations. The high density of small markets may be an opportunity for FSE intervention but further investigation of Guam's FSE influence on health is needed.

  20. [Simulation study of air quality health index in 5 cities in China: 2013-2015].

    PubMed

    Wang, W T; Sun, Q H; Qin, J; Li, T T; Shi, X M

    2017-03-10

    Objective: To construct the air quality health index (AQHI) by inclusion of air pollutants PM(2.5) and O(3) in Guangzhou, Shanghai, Xi' an, Beijing, Shenyang, and explore scientificity and feasibility of its application in China. Methods: The daily average concentrations of PM(2.5) and O(3) in air, and daily average mortality from 2013 to 2015 in the 5 cities in China, the exposure-response coefficients of PM(2.5) and O(3) and total mortality from Meta studies in China were used to construct local AQHI. The health risk levels of air pollution in the 5 cities were calculated and compared with the characteristics of single pollutant concentrationof PM(2.5) or O(3). Results: In the 5 cities, the average concentration of PM(2.5) was highest in Beijing (82 μg/m(3)) and lowest in Guangzhou (46 μg/m(3)). And the average concentration of O(3) was highest in Shanghai (72 μg/m(3)) and lowest in Xi' an (45 μg/m(3)). In all the cities, the average concentration of PM(2.5) was highest in winter and lowest in summer. In summer, the average concentration of O(3) was lowest. But the health risk level of AQHI showed that the 5 cities had higher frequency of low or medium risk averagely. And Beijing had the highest frequency of high risk in summer (5.69%). Xi' an had the highest frequency of extremely high risk in winter (1.63%). Conclusions: In this study, AQHI could be constructed by using air PM(2.5) and O(3) concentration data which can be obtained in many areas in China. The application of this index is scientific and feasible in China.

  1. The value of a combined word recognition and knowledge measure to understand characteristics of our patients' oral health literacy.

    PubMed

    Atchison, Kathryn A; Macek, Mark D; Markovic, Daniela

    2017-08-01

    The objective of the analysis was to examine the association between sociodemographic and dental understanding and utilization characteristics and lower oral health literacy (HL) and knowledge. The cross-sectional Multicenter Oral Health Literacy Research Study (MOHLRS) recruited and interviewed 923 English-speaking, initial care-seeking adults. The questionnaire included participant sociodemographic characteristics, measures of the participant's understanding and utilization of dentistry, and two oral HL measures, the Rapid Estimate of Adult Literacy in Medicine and Dentistry (REALM-D) and the Comprehensive Measure of Oral Health Knowledge (CMOHK), which were combined into a new composite HL and knowledge measure, the MOHLR-K. In adjusted multivariable analysis, persons who reported more understanding of dentist instructions had higher mean scores for all HL measures. Subjects reporting the highest level of understanding had greater scores by an average of 1.6 points for the MOHLR-K (95% CI: 0.85-2.40, P<.01), 2.11 points for REALMD-20 (95% CI: 0.75-3.48, P<.01) and 2.20 points for CMOHK (95% CI: 1.01-3.40, P<.01) after controlling for demographic and other dental understanding and utilization factors. Persons who reported history of tooth decay had higher MOHLR-K scores by an average of about 0.77 points (95% CI: 0.49-1.04, P<.01), higher REALMD-20 scores by 0.54 points (95% CI: 0.12-0.95, P=.01) and higher CMOHK scores by 1.22 points (95% CI: 0.82-1.63, P<.01) as compared to persons without tooth decay history after controlling for the other factors. Persons who had support all of the time for travel to the dentist had higher scores by an average of about 0.5 points for the MOHLR-K (95% CI: 0.04-0.96, P=.03) and about 0.89 points for the REALMD-20 (95% CI: 0-1.79, P=.05) as compared to subjects with no support after controlling for other factors. Report of periodontal history, financial challenges to delay a dental visit and dental utilization were not significantly associated with any of the HL measures once the other factors were adjusted for in the model. The analysis confirmed that pronunciation of medical and dental terms may not fully reflect comprehension and revealed that understanding both patients' sociodemographic and dental understanding and utilization factors, such as transportation to the dental office associated with lower oral HL and knowledge, could help the profession develop appropriate clear language programmes to improve access to dental care for vulnerable populations. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. The Spectrum of Altmetrics in Neurosurgery: The Top 100 "Trending" Articles in Neurosurgical Journals.

    PubMed

    Wang, Justin; Alotaibi, Naif M; Ibrahim, George M; Kulkarni, Abhaya V; Lozano, Andres M

    2017-07-01

    Social media are increasingly used for the dissemination of scientific publications by most medical journals. The role of social media in increasing awareness of published works in neurosurgery has not been previously explored. Here, we present a qualitative analysis of the highest trending works in neurosurgery along with a correlation analysis with their social media metrics. We performed a comprehensive search for neurosurgical publications using the Altmetric database. The Altmetric database provides a weighted total score of all online mentions for an article received on Facebook, Twitter, blogs, and mainstream media sources. Our search was limited to articles published within the social media era (January 2010-January 2017). Descriptive and correlational statistics were performed for all articles. The top 100 articles in altmetrics were selected for qualitative analysis. A total of 5794 articles were included in this study. The average Altmetric score in neurosurgical articles was 4.7 (standard deviation ±22.4). Journals with a social media account had significantly higher Altmetric scores for their articles compared with those without an account (P < 0.0001). The number of tweets and online mentions in news outlets had the strongest correlation values with Altmetric scores. The top 100 articles in altmetrics belonged primarily to the Journal of Neurosurgery (33%) followed by Neurosurgery (29%). This is the first study that details the spectrum of Altmetric scores among neurosurgical journals. Social media presence for journals is important for greater outreach and engagement. Prediction of traditional citation using altmetrics data requires a future prospective study. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. HEALTH RELATED QUALITY OF LIFE IN SCHOOL GOING ADOLESCENTS OF KHYBER PAKHTUN-KHWA PAKISTAN.

    PubMed

    Siddique, Muhammad; Ayub, Ayaz; Hussain, Hamid

    2015-01-01

    In several countries health related quality of life (HRQoL) scales have been used for adolescents, to assess the impact of disease. Health related quality of life scales are used on a range of different domains: physical, psychological, social and spiritual focusing on personal life including the concept of the World Health Organization definition of health. Health related quality of life in adolescent going to schools in the cantonment area of Peshawar garrison was assessed in a cross sectional descriptive study. Data was gathered by using a self-administered questionnaire (Kiddo-KINDL-R Questionnaire), previously tested to assess quality of life across six dimensions of health i.e. Physical and emotional well-being, self-esteem, family, social and school. A total of 300 students of average age 13.41±1.34 years, with 145 (48.3%) females. Mean (SD) of total QoL score was 86.98 (12.86). The mean total scores were 86.28±12.34 and 87.64±13.34 for girls and boys, respectively. On the whole quality of life scores of the adolescent are good in the four dimensions. Special attention is needed towards the school environment, as majority of the participants are not satisfied with their schools. Similarly self-esteem scores are also low in the majority. However it is encouraging that most of the participants have scored highest scales in dimensions of family and physical health. Any effort to assess quality of life of the adolescents at the national level will give better view of quality of life of our youth.

  4. [Association of pubertal timing and the different dimensionality of adolescents' aggressive behavior].

    PubMed

    Han, Hui; Wang, Gengfu; Su, Puyu

    2016-01-01

    To explore the relationship between pubertal timing and aggressive behaviors. Stratified random sampling was used to choose 5760 students from one junior high school and one high school. The pubertal development scale (PDS) questionnaire and perceived pubertal timing were used to evaluate the pubertal timing, and the Buss-Perry questionnaire was used to explore the students' aggressive behaviors. The score of aggressive behavior was significantly different in junior high school students with different perceived pubertal timing, the score of early pubertal timing was highest and the score of delay pubertal timing was lowest, and the score of physical aggression and verbal aggression of schoolboy in early pubertal timing and normal pubertal timing in high school was higher than the delay pubertal timing (P < 0.05). The score of physical aggression, anger and hostility of schoolgirl in early pubertal timing was highest, there was significant difference between them. The relationship between the perceived pubertal timing and the aggressive behavior was the physical aggression, anger and hostility score was highest in schoolgirls both in junior high school and high school, and the score of verbal aggression was higher in normal pubertal timing and early pubertal timing in schoolboys (P < 0.05), there was significant difference between them. There are closely relationship between the early pubertal timing and aggressive behaviors by used the PDS questionnaire, and the perceived pubertal timing is in a relatively large impact on girls' aggressive behaviors.

  5. D{sub 2} dopamine receptor gene and behavioral characteristics in nicotine dependence

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

    Noble, E.P.; Fitch, R.J.; Syndulko, K.

    1994-09-01

    The D{sub 2} dopamine receptor (DRD2) A1 allele has been recently associated with nicotine dependence. In the present study, TaqI A alleles (the minor A1 and the major A2 allele) of the DRD2 were determined in medically-ill subjects. The sample was composed of 41 non-smokers (N), 69 ex-smokers (X) and 63 active smokers (A). The relationships of DRD2 alleles to personality (Eysenick`s Addictive Personality [AP]), depression and nicotine dependence (Fagerstroem) scores were ascertained. A significant (P = 0.002) group effect prevailed in the AP scores, with the A group having the highest scores. Moreover, a significant (P = 0.025) allelemore » by group interaction was found, with A1 allelic subjects in group A showing the highest AP scores. Significant group effects were also found in both the depression (P = 0.0004) and the nicotine dependence (P = 0.0003) scores, with the A group again showing the highest scores. However, in contrast to the AP scores, no significant allele by group interaction was found either in the depression or the nicotine dependence scores. In conclusion, the present findings suggest a role for the DRD2 gene in personality of smokers. However, relationship of the DRD2 gene to the degree of depression or nicotine dependence was not found. The data indicate the importance of using behavioral and genetic variables in dissecting the complex set of variables associated with the smoking habit, and thus in achieving a better understanding of the biobehavioral bases of this addiction.« less

  6. Schizophrenia: multi-attribute utility theory approach to selection of atypical antipsychotics.

    PubMed

    Bettinger, Tawny L; Shuler, Garyn; Jones, Donnamaria R; Wilson, James P

    2007-02-01

    Current guidelines/algorithms recommend atypical antipsychotics as first-line agents for the treatment of schizophrenia. Because there are extensive healthcare costs associated with the treatment of schizophrenia, many institutions and health systems are faced with making restrictive formulary decisions regarding the use of atypical antipsychotics. Often, medication acquisition costs are the driving force behind formulary decisions, while other treatment factors are not considered. To apply a multi-attribute utility theory (MAUT) analysis to aid in the selection of a preferred agent among the atypical antipsychotics for the treatment of schizophrenia. Five atypical antipsychotics (risperidone, olanzapine, quetiapine, ziprasidone, aripiprazole) were selected as the alternative agents to be included in the MAUT analysis. The attributes identified for inclusion in the analysis were efficacy, adverse effects, cost, and adherence, with relative weights of 35%, 35%, 20%, and 10%, respectively. For each agent, attribute scores were calculated, weighted, and then summed to generate a total utility score. The agent with the highest total utility score was considered the preferred agent. Aripiprazole, with a total utility score of 75.8, was the alternative agent with the highest total utility score in this model. This was followed by ziprasidone, risperidone, and quetiapine, with total utility scores of 71.8, 69.0, and 65.9, respectively. Olanzapine received the lowest total utility score. A sensitivity analysis was performed and failed to displace aripiprazole as the agent with the highest total utility score. This model suggests that aripiprazole should be considered a preferred agent for the treatment of schizophrenia unless found to be otherwise inappropriate.

  7. Health, safety, and environmental risk assessment of steel production complex in central Iran using TOPSIS.

    PubMed

    Jozi, S A; Majd, N Moradi

    2014-10-01

    This research was carried out with the aim of presenting an environmental management plan for steel production complex (SPC) in central Iran. Following precise identification of the plant activities as well as the study area, possible sources of environmental pollution and adverse impacts on the air quality, water, soil, biological environment, socioeconomic and cultural environment, and health and safety of the employees were determined considering the work processes of the steel complex. Afterwards, noise, wastewater, and air pollution sources were measured. Subsequently, factors polluting the steel complex were identified by TOPSIS and then prioritized using Excel Software. Based on the obtained results, the operation of the furnaces in hot rolling process with the score 1, effluent derived from hot rolling process with the score 0.565, nonprincipal disposal and dumping of waste at the plant enclosure with the score 0.335, walking beam process with the score 1.483 respectively allocated themselves the highest priority in terms of air, water, soil and noise pollution. In terms of habitats, land cover and socioeconomic and cultural environment, closeness to the forest area and the existence of four groups of wildlife with the score 1.106 and proximity of villages and residential areas to the plant with the score 3.771 respectively enjoyed the highest priorities while impressibility and occupational accidents with the score 2.725 and cutting and welding operations with score 2.134 had the highest priority among health and safety criteria. Finally, strategies for the control of pollution sources were identified and Training, Monitoring and environmental management plan of the SPC was prepared.

  8. Can patients interpret health information? An assessment of the medical data interpretation test.

    PubMed

    Schwartz, Lisa M; Woloshin, Steven; Welch, H Gilbert

    2005-01-01

    To establish the reliability/validity of an 18-item test of patients' medical data interpretation skills. Survey with retest after 2 weeks. Subjects. 178 people recruited from advertisements in local newspapers, an outpatient clinic, and a hospital open house. The percentage of correct answers to individual items ranged from 20% to 87%, and medical data interpretation test scores (on a 0- 100 scale) were normally distributed (median 61.1, mean 61.0, range 6-94). Reliability was good (test-retest correlation=0.67, Cronbach's alpha=0.71). Construct validity was supported in several ways. Higher scores were found among people with highest versus lowest numeracy (71 v. 36, P<0.001), highest quantitative literacy (65 v. 28, P<0.001), and highest education (69 v. 42, P=0.004). Scores for 15 physician experts also completing the survey were significantly higher than participants with other postgraduate degrees (mean score 89 v. 69, P<0.001). The medical data interpretation test is a reliable and valid measure of the ability to interpret medical statistics.

  9. Evaluation of umami taste in mushroom extracts by chemical analysis, sensory evaluation, and an electronic tongue system.

    PubMed

    Phat, Chanvorleak; Moon, BoKyung; Lee, Chan

    2016-02-01

    Seventeen edible mushrooms commercially available in Korea were analysed for their umami taste compounds (5'-nucleotides: AMP, GMP, IMP, UMP, XMP; free amino acids: aspartic, glutamic acid) and subjected to human sensory evaluation and electronic tongue measurements. Amanita virgineoides featured the highest total 5'-nucleotide content (36.9 ± 1.50 mg/g), while monosodium glutamate-like components (42.4 ± 6.90 mg/g) were highest in Agaricus bisporus. The equivalent umami concentration (EUC) ranged from 1.51 ± 0.42 to 3890 ± 833 mg MSG/g dry weight; most mushrooms exhibited a high umami taste. Pleurotus ostreatus scored the highest in the human sensory evaluation, while Flammulina velutipes obtained the maximum score in the electronic tongue measurement. The EUC and the sensory score from the electronic tongue test were highly correlated, and also showed significant correlation with the human sensory evaluation score. These results suggest that the electronic tongue is suitable to determine the characteristic umami taste of mushrooms. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Reliability and Repetition Effect of the Center of Pressure and Kinematics Parameters That Characterize Trunk Postural Control During Unstable Sitting Test.

    PubMed

    Barbado, David; Moreside, Janice; Vera-Garcia, Francisco J

    2017-03-01

    Although unstable seat methodology has been used to assess trunk postural control, the reliability of the variables that characterize it remains unclear. To analyze reliability and learning effect of center of pressure (COP) and kinematic parameters that characterize trunk postural control performance in unstable seating. The relationships between kinematic and COP parameters also were explored. Test-retest reliability design. Biomechanics laboratory setting. Twenty-three healthy male subjects. Participants volunteered to perform 3 sessions at 1-week intervals, each consisting of five 70-second balancing trials. A force platform and a motion capture system were used to measure COP and pelvis, thorax, and spine displacements. Reliability was assessed through standard error of measurement (SEM) and intraclass correlation coefficients (ICC 2,1 ) using 3 methods: (1) comparing the last trial score of each day; (2) comparing the best trial score of each day; and (3) calculating the average of the three last trial scores of each day. Standard deviation and mean velocity were calculated to assess balance performance. Although analyses of variance showed some differences in balance performance between days, these differences were not significant between days 2 and 3. Best result and average methods showed the greatest reliability. Mean velocity of the COP showed high reliability (0.71 < ICC < 0.86; 10.3 < SEM < 13.0), whereas standard deviation only showed a low to moderate reliability (0.37 < ICC < 0.61; 14.5 < SEM < 23.0). Regarding the kinematic variables, only pelvis displacement mean velocity achieved a high reliability using the average method (0.62 < ICC < 0.83; 18.8 < SEM < 23.1). Correlations between COP and kinematics were high only for mean velocity (0.45

  11. National Drug Formulary review of statin therapeutic group using the multiattribute scoring tool

    PubMed Central

    Ramli, Azuana; Aljunid, Syed Mohamed; Sulong, Saperi; Md Yusof, Faridah Aryani

    2013-01-01

    Purpose HMG-CoA reductase inhibitors (statins) are extensively used in treating hypercholesterolemia. The statins available in Malaysia include atorvastatin, lovastatin, pravastatin, rosuvastatin, simvastatin, and fluvastatin. Over the years, they have accumulated in the National Drug Formulary; hence, the need for review. Effective selection of the best drugs to remain in the formulary can become complex due to the multiple drug attributes involved, and is made worse by the limited time and resources available. The multiattribute scoring tool (MAST) systematizes the evaluation of the drug attributes to facilitate the drug selection process. In this study, a MAST framework was developed to rank the statins based on their utilities or benefits. Methods Published literature on multicriteria decision analysis (MCDA) were studied and five sessions of expert group discussions were conducted to build the MAST framework and to review the evidence. The attributes identified and selected for analysis were efficacy (clinical efficacy, clinical endpoints), safety (drug interactions, serious side effects and documentation), drug applicability (drug strength/formulation, indications, dose frequency, side effects, food–drug interactions, and dose adjustments), and cost. The average weights assigned by the members for efficacy, safety, drug applicability and cost were 32.6%, 26.2%, 24.1%, and 17.1%, respectively. The utility values of the attributes were scored based on the published evidence or/and agreements during the group discussions. The attribute scores were added up to provide the total utility score. Results Using the MAST, the six statins under review were successfully scored and ranked. Atorvastatin scored the highest total utility score (TUS) of 84.48, followed by simvastatin (83.11). Atorvastatin and simvastatin scored consistently high, even before drug costs were included. The low scores on the side effects for atorvastatin were compensated for by the higher scores on the clinical endpoints resulting in a higher TUS for atorvastatin. Fluvastatin recorded the lowest TUS. Conclusion The multiattribute scoring tool was successfully applied to organize decision variables in reviewing statins for the formulary. Based on the TUS, atorvastatin is recommended to remain in the formulary and be considered as first-line in the treatment of hypercholesterolemia. PMID:24353428

  12. Concurrent validity, discriminatory power and feasibility of the instrument for Identification of Parents At Risk for child Abuse and Neglect (IPARAN).

    PubMed

    Horrevorts, Esther M B; van Grieken, Amy; Mieloo, Cathelijne L; Hafkamp-de Groen, Esther; Bannink, Rienke; Bouwmeester-Landweer, Merian B R; Broeren, Suzanne; Raat, Hein

    2017-08-23

    To determine the feasibility, concurrent validity and discriminatory power of the instrument for Identification of Parents At Risk for child Abuse and Neglect (IPARAN) among Dutch parents with a newborn child. Community paediatrics. Data from a controlled trial were used. In total, 2659 Dutch parents with a newborn child were invited to participate. Of the 2659 parents, 759 parents filled in the consent form and participated in the study. Concurrent validity was determined by calculating correlations-using the Pearson's correlation (r)-between the IPARAN score and related constructs from the following instruments: the Empowerment Questionnaire 2.0, the Family Functioning Questionnaire and the Parenting Stress Questionnaire. Discriminatory power was determined by calculating receiver operating characteristic (ROC) curves between high-risk mothers and low-risk mothers according to their scores on the related constructs. Feasibility was determined by examining the percentage of missing answers. In terms of concurrent validity, we found that 3 out of 12 correlations between the IPARAN score and related constructs were strong (ie, r>0.50) and 4 out of 12 were medium (ie, r=0.30-0.49). In terms of discriminatory power, mothers with a score in the borderline/clinical range or lowest 10 percent (P10) range of the related constructs (high-risk mothers) had a higher IPARAN score than mothers with a score in the normal range or highest 90 percent (P90) range of the related constructs (low-risk mothers). Effect sizes varied from d=0.37 to d=1.93, and the area under the ROC curve varied from 0.62 to 0.93. Regarding feasibility, the part of the IPARAN filled in by the mother had on average 0.7% missing answers, whereas the part of the IPARAN filled in by the father had on average 1.7% missing answers. The results of this study support the concurrent validity, discriminatory power and feasibility of the IPARAN among a population of Dutch parents with a newborn child. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  13. Cochlear implantation: An assessment of quality and readability of web-based information aimed at patients.

    PubMed

    Seymour, Nicky; Lakhani, Raj; Hartley, Benjamin; Cochrane, Lesley; Jephson, Christopher

    2015-01-01

    Patients should have access to high-quality health information websites on which to base their decision-making. There are concerns regarding the accuracy and quality of some health websites. We aimed to objectively measure website quality related to cochlear implantation. Selected patient-information websites were scored, depending on how highly they ranked on search engines and if they were ranked on more than one of the search engines used. The top 40 websites from three major search engines were analysed. The quality of each website was scored using the DISCERN tool and the readability was scored using the Flesch-Kincaid reading ease and the Gunning-Fog index. The average Flesch-Kincaid score was 49.7, giving an average reading age of a 15-17 years old, and the average Gunning-fog score was 13.1, which equals that of an 18 years old. Internet-based information regarding cochlear implantation is of varied quality and is written above the expected reading level of an average person.

  14. Readability assessment of online thyroid surgery patient education materials.

    PubMed

    Patel, Chirag R; Cherla, Deepa V; Sanghvi, Saurin; Baredes, Soly; Eloy, Jean Anderson

    2013-10-01

    Published guidelines recommend written health information be written at or below the sixth-grade level. We evaluate the readability of online materials related to thyroid surgery. Thyroid surgery materials were evaluated using Flesch Reading Ease Score (FRES), Flesch Kincaid Grade Level (FKGL), Gunning Frequency of Gobbledygook (GFOG), and Simple Measure of Gobbledygook (SMOG). Thirty-one documents were evaluated. FRES scores ranged from 29.3 to 67.8 (possible range = 0 to 100), and averaged 50.5. FKGL ranged from 6.9 to 14.9 (possible range = 3 to 12), and averaged 10.4. SMOG scores ranged from 11.8 to 14.5 (possible range = 3 to 19), and averaged 13.0. GFOG scores ranged from 10.6 to 18.0 (possible range = 3 to 19), and averaged 13.5. Readability scores for online thyroid surgery materials are higher (i.e., more difficult) than the recommended levels. However, readability is only one aspect of comprehension. Written information should be designed with that fact in mind. Copyright © 2013 Wiley Periodicals, Inc.

  15. Rural Health, Center of Excellence for Remote and Medically Under-served Area (CERMUSA)

    DTIC Science & Technology

    2007-05-01

    Pretest I Posttest of Cognitive Knowledge, • Pretest I Posttest of Knowledge (Self Perception), • VCS Feature Comparison. Pretest I Posttest of Cognitive...This measurement was the change between the pretest and posttest scores. Figure 6 represents the average pretest , posttest , and difference scores for...to the educational intervention, each case student’s average posttest scores increased over the pretest scores. Also, in each case, the

  16. More on TIMSS.

    ERIC Educational Resources Information Center

    Bracey, Gerald W.

    1997-01-01

    Singapore students scored highest on the Third International Mathematics and Science Study. Any nation that "outsources" its poverty (Malaysian street sweepers) and its low-achievers (who study in Malaysia) can get high test scores. U.S./Japan score differences stem from Japan's effective teaching practices. Among 13 occupations in the…

  17. Knowledge about primary health care among medical students from public and private medical universities of Karachi, Pakistan.

    PubMed

    Ehsan, Rubab; Hirani, Rahul; Bhesania, Nasha Homi; Zehra, Nosheen

    2017-10-01

    Primary health care (PHC) is the best approach to achieve health goals in a country. As medical students are a prominent part of future health care providers, it is important to assess their knowledge regarding basic concepts and functions of PHC. Total 400 medical students, 200 (50%) each from public and private medical universities responded in this study. Mean score was 15.21 ± 2.43 and 14.9 ± 2.89 respectively with no significant difference (P=0.370). On the basis of mean score the data is dichotomized into two groups i.e. above average and average (score > 15) and below average (score <15). Hence, 137 (68.5%) students from public and 131 (65.5%) students from the private university fell in the average and above average category. This study shows challenges related to the knowledge and the medical students' level of understanding of the functioning of PHC system.

  18. [Evaluation on effect of treatment and assistance to advanced schistosomiasis patients in Hunan Province from 2004 to 2013].

    PubMed

    Li, Sheng-ming; Zhao, Zheng-yuan; Peng, Zai-zhi; Wang, Zhang-hua; Li, Yuan; Guo, Feng-ying; Ren, Guang-hui

    2014-08-01

    To comprehensively evaluate the effect of the program of treatment and assistance to advanced schistosomiasis patients in Hunan Province from 2004 to 2013. The fund investment of the program, the profits of hospitals and the improvement of the patients' health were investigated by data collection and questionnaire survey. The evaluation index system of treatment and assistance to advanced schistosomiasis in Hunan Province was constructed by the Delphi method and analytic hierarchy process, and the program was assessed comprehensively. The evaluation index system including 6 primary indices and 33 secondary indices was established. Among all the primary indices, the score of the treatment and assistance (22.25) was the highest, and that of the satisfaction assessment (8.15) was the lowest, and the score of the comprehensive assessment was 87.06. The average cure rate of the patients was 13.08% from 2004 to 2013. More than 60% of the patients' disease condition got better, and nearly 70% of the patients' psychological condition improved, and more than 70% of patients' self-help ability and social contact improved, as well as family happiness increased. In addition, the annual average cost for caretakers decreased by 2000 Yuan, and the profits of all the fixed-point hospitals for treatment and assistance increased. The effectiveness and efficiency of the treatment and assistance to advanced schistosomiasis patients in Hunan Province is obvious, and the government should continuously invest in the program.

  19. Plantar pressures determinants in mild Hallux Valgus.

    PubMed

    Martínez-Nova, Alfonso; Sánchez-Rodríguez, Raquel; Pérez-Soriano, Pedro; Llana-Belloch, Salvador; Leal-Muro, Alejo; Pedrera-Zamorano, Juan Diego

    2010-07-01

    While podobarometric techniques have been applied to the study of pressures in Hallux Valgus (HV), little is known about its clinical and radiological determinants. So, the aim of the present study was to determine the plantar pressure pattern in participants with mild HV, comparing to a control group, and their clinical and anthropometric determinants. Biofoot/IBV(®) in-shoe system was used to evaluate 79 participants with mild HV. Computerized measurements of the 1st intermetatarsal angle (IMA) and the hallux abductus angle (HAA) were made on antero-posterior radiographs. The clinical outcome was assessed using the AOFAS score. The dependent baropodometric variables and the independent clinical and anthropometric variables were subjected to a multiple regression analysis. In both groups, the highest average pressure was in the 2nd metatarsal head (MTH). The mean pressure under the Hallux was significantly higher in HV group (controls, 146.5±92.5kPa; HV, 328.5±113.2kPa; p<0.001). An 18.6% of average pressure under the 1st MTH was accounted for pain, first ray alignment and total AOFAS score. Variations of the HAA explained 26.8% of the mean Hallux pressure. Women with mild HV present with pathologically increased pressure under the Hallux, which is caused by the altered alignment of the first ray. Pain and clinical result were associated with the pressure under the 1st MTH and the remaining variables were only moderate predictors of dynamic plantar pressures. Copyright © 2010 Elsevier B.V. All rights reserved.

  20. Investigating the predictive of risk-taking attitudes and behaviors among Iranian drivers

    PubMed Central

    Habibi, Ehsanollah; Haghi, Azam; Maracy, Mohammad Reza

    2014-01-01

    Background: World Health Organization findings shows that up to year 2020 the number of fatality due to driving accidents will increases up to 65%, which is 80% is in developing countries. Iran has one of the highest rates of road traffic accident mortality rate in the world. Materials and Methods: The cross-sectional study was carried out in the center and west of Iran upon 540 ordinary and taxi drivers who were driving regularly from bus terminals and the travel agencies to other cities. Data collection tool is a questionnaire that measuring driving risk taking by two items of risky driving behaviors and risk taking attitudes. Findings: The results of this study showed that the averages of risk driving behaviors scores were higher than the average of risk taking attitudes scores. The results of logistic regression test showed that the risky driving behaviors can be a predictor of driving accidents due to individuals’ risk taking (P = 0.014). Among all these variables, attitude toward rule violations and speeding, aggressive driving and violation of the road laws respectively are important predictive of drivers’ risk taking (P < 0.0010). Discussion and Conclusion: Although attitude toward risk taking has been located at a low level by different ways, a desired result was not obtained from the reduction of those high risky behaviors; in fact, high-rate of accidents and traffic incidence in Iran indicates this matter well. PMID:24741659

  1. Cigarette availability and price in low and high socioeconomic areas.

    PubMed

    Dalglish, Emma; McLaughlin, Deirdre; Dobson, Annette; Gartner, Coral

    2013-08-01

    To determine whether tobacco retailer density and cigarette prices differ between low and high socioeconomic status suburbs in South-East Queensland. A survey of retail outlets selling cigarettes was conducted in selected suburbs over a two-day period. The suburbs were identified by geographical cluster sampling based on their Index of Relative Socio-economic Advantage and Disadvantage score and size of retail complex within the suburb. All retail outlets within the suburb were visited and the retail prices for the highest ranking Australian brands were recorded at each outlet. A significant relationship was found between Index of Relative Socioeconomic Advantage and Disadvantage score (in deciles) and the number of tobacco retail outlets (r=0.93, p=0.003), with the most disadvantaged suburbs having a greater number of tobacco retailers. Results also demonstrate that cigarettes were sold in a broader range of outlets in suburbs of low SES. The average price of the packs studied was significantly lower in the most disadvantaged suburbs compared to the most advantaged. While cigarettes were still generally cheaper in the most disadvantaged suburbs, the difference was no longer statistically significant when the average price of cigarette packs was compared according to outlet type (supermarket, newsagent, etc). In South-East Queensland, cigarettes are more widely available in the most disadvantaged suburbs and at lower prices than in the most advantaged suburbs. © 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia.

  2. Challenging patient safety culture: survey results.

    PubMed

    Hellings, Johan; Schrooten, Ward; Klazinga, Niek; Vleugels, Arthur

    2007-01-01

    The purpose of this paper is to measure patient safety culture in five Belgian general hospitals. Safety culture plays an important role in the approach towards greater patient safety in hospitals. The Patient Safety Culture Hospital questionnaire was distributed hospital-wide in five general hospitals. It evaluates ten patient safety culture dimensions and two outcomes. The scores were expressed as the percentage of positive answers towards patient safety for each dimension. The survey was conducted from March through November 2005. In total, 3,940 individuals responded (overall response rate = 77 per cent), including 2,813 nurses and assistants, 462 physicians, 397 physiotherapists, laboratory and radiology assistants, social workers and 64 pharmacists and pharmacy assistants. The dimensional positive scores were found to be low to average in all the hospitals. The lowest scores were "hospital management support for patient safety" (35 per cent), "non-punitive response to error" (36 per cent), "hospital transfers and transitions" (36 per cent), "staffing" (38 per cent), and "teamwork across hospital units" (40 per cent). The dimension "teamwork within hospital units" generated the highest score (70 per cent). Although the same dimensions were considered problematic in the different hospitals, important variations between the five hospitals were observed. A comprehensive and tailor-made plan to improve patient safety culture in these hospitals can now be developed. Results indicate that important aspects of the patient safety culture in these hospitals need improvement. This is an important challenge to all stakeholders wishing to improve patient safety.

  3. Decentralization and hospital pharmacy services: the case of Iranian university affilliated hospitals.

    PubMed

    Ashna Delkhosh, Reza; Ardama, Ali; Salamzadeh, Jamshid

    2013-01-01

    The aim of this study was to evaluate the satisfaction rate of hospital managerial/clinical teams (HMCTs) including principles (chief executives), managers, supervisor pharmacists and head nurses from services presented by private sectors directing 10 pharmacy departments in hospitals affiliated to Shahid Beheshti University of Medical Sciences. This study is an observational and descriptive study in which a questionnaire containing 16 questions evaluating the satisfaction of the HMCTs from private sectors, and questions about demography of the responders was used for data collection. Collected data was applied to assign a satisfaction score (maximum 64) for each respondent. SPSS 17.0 and Microsoft Office Excel 2007 were used for statistical description and analysis of these information (where applicable). Overall, 97 people in charge of the hospitals (HMCTs) entered the study. The average satisfaction score was 26.38 ± 6.81 with the lowest satisfaction rate observed in Mofid children specialty hospital (19.5%) and the highest rate obtained for Imam Hussein (p.b.u.h) general hospital (65.3%). Generally, 59% of the HMCTs believed that the function of the private sector in the pharmacy of hospitals is satisfactory. Assuming that the satisfaction scores under 75% of the total obtainable score (i.e. 48 out of 64) could not be considered as an indicator of desired pharmacy services, our results revealed that the status of the services offered by private sectors are far behind the desired satisfactory level.

  4. Identity development in adolescents with mental problems.

    PubMed

    Jung, Emanuel; Pick, Oliver; Schlüter-Müller, Susanne; Schmeck, Klaus; Goth, Kirstin

    2013-07-31

    In the revision of the Diagnostic and Statistical Manual (DSM-5), "Identity" is an essential diagnostic criterion for personality disorders (self-related personality functioning) in the alternative approach to the diagnosis of personality disorders in Section III of DSM-5. Integrating a broad range of established identity concepts, AIDA (Assessment of Identity Development in Adolescence) is a new questionnaire to assess pathology-related identity development in healthy and disturbed adolescents aged 12 to 18 years. Aim of the present study is to investigate differences in identity development between adolescents with different psychiatric diagnoses. Participants were 86 adolescent psychiatric in- and outpatients aged 12 to 18 years. The test set includes the questionnaire AIDA and two semi-structured psychiatric interviews (SCID-II, K-DIPS). The patients were assigned to three diagnostic groups (personality disorders, internalizing disorders, externalizing disorders). Differences were analyzed by multivariate analysis of variance MANOVA. In line with our hypotheses, patients with personality disorders showed the highest scores in all AIDA scales with T>70. Patients with externalizing disorders showed scores in an average range compared to population norms, while patients with internalizing disorders lay in between with scores around T=60. The AIDA total score was highly significant between the groups with a remarkable effect size of f= 0.44. Impairment of identity development differs between adolescent patients with different forms of mental disorders. The AIDA questionnaire is able to discriminate between these groups. This may help to improve assessment and treatment of adolescents with severe psychiatric problems.

  5. Flooded area and plant zonation in isolated wetlands in well fields in the Northern Tampa Bay Region, Florida, following reductions in groundwater-withdrawal rates

    USGS Publications Warehouse

    Haag, Kim H.; Pfeiffer, William R.

    2012-01-01

    WAP scores and weighted average scores for wetland vegetation were generally consistent with the results of the flooded area analysis. The WAP scores and weighted average scores were higher overall and did not decline with time at four wetlands in well fields (W-33, W-56, Starkey N, and Starkey 108) during the years following reductions in groundwater-withdrawal rates. These four wetlands also had increases in the extent and duration of the flooded area during the post-reduction period. Scores for trees were more consistent than scores for shrubs and groundcover. WAP scores remained relatively low or generally declined at five well-field wetlands (Q-1, W-17, W-41, Starkey D, and Starkey E) during the years following reductions in groundwater-withdrawal rates, and weighted average scores either declined over time or remained low. These five wetlands either did not have an increase in the extent and duration of the flooded area, or if there was an increase, it was small.

  6. Record of El Niño in planktonic foraminiferal assemblages from the Gulf of Tehuantepec, Mexico (Eastern Tropical Pacific)

    NASA Astrophysics Data System (ADS)

    Machain-Castillo, M. L.; Nava-Fernandez, X. A.; Thunell, R.; Tappa, E.

    2013-05-01

    The planktonic foraminiferal assemblages from two sediment traps deployed in the Gulf of Tehuantepec, Mexico (Eastern Tropical Pacific) during a five year period (2006 to 2010) were recorded. The species abundance data were subjected to a Q-mode factor analysis that depicts alternating associations of planktonic foraminifera, generally related to seasonally varying oceanographic conditions. During winter-spring season, the oceanography of the Gulf of Tehuantepec is driven by strong northern winds that cross the Isthmus of Tehuantepec and produce intense upwelling in the gulf. This upwelling of cold, nutrient-rich waters induces high biological productivity and the dominance of the planktonic foraminiferal species Globigerina bulloides. Summer-fall oceanographic conditions are dominated by the northward flow of the Costa Rica Coastal Current and a stratified water column. Chlorophyll-a concentrations are much lower than during the upwelling season and the Globorotalia menardii assemblage is characteristic. The above pattern was recorded for most of the study period, except during ENSO conditions in winter 2007 and summer-fall of 2009. From mid-January to early March 2007, the assemblage was dominated by G. menardii instead of the typical G. bulloides. This period had the highest sea surface temperatures and lowest surface chlorophyll-a values recorded for the entire five year study period. During the similar time period of ENSO 2010, the G. bulloides assemblage shows the highest scores in the factor analysis, although the G. menardii assemblage also has somewhat high scores. Temperature is slightly lower and chlorophyll-a values are slightly higher than during 2007, suggesting the conditions were not strong enough to induce a change in faunal dominance. During ENSO 2009 (July 8th to November 12th), the summer-fall dominant assemblage of Globorotalia menardii was replaced by the Globigerinoides ruber - Globigerinita glutinata assemblage, associated to the summer-fall highest average temperatures and lowest chlorophyll-a concentrations at the studied site.

  7. Perception of the nursing team of a Surgical Center regarding Hospital Accreditation at a University Hospital.

    PubMed

    Fernandes, Hellen Maria de Lima Graf; Peniche, Aparecida de Cássia Giani

    2015-02-01

    Objective To analyze the perception of nursing teams at a surgical center regarding the process of hospital accreditation, in the evaluative aspects of structure, process, and result. Method The study takes a quantitative and exploratory-descriptive approach, carried out at a university hospital. Result The population consisted of 69 nursing professionals, and the data collection was performed in the months of January and February 2014 by way of a questionnaire, utilizing the Likert scale. The methodology used a Cronbach's Alpha equal to 0.812. In the comparison of the three aspects, the one with the highest favorability score was "result", with an average of 47.12 (dp±7.23), and the smallest was "structure," with an average of 40.70 (dp±5.19). Conclusion This situational diagnostic can assist in the restructuring of the vulnerable areas evaluated in these three aspects, mainly in the aspect of structure, with a goal of level 2 accreditation by the ONA (Brazilian's National Organization for Accreditation) defended by the Institution.

  8. Market segmentation using perceived constraints

    Treesearch

    Jinhee Jun; Gerard Kyle; Andrew Mowen

    2008-01-01

    We examined the practical utility of segmenting potential visitors to Cleveland Metroparks using their constraint profiles. Our analysis identified three segments based on their scores on the dimensions of constraints: Other priorities--visitors who scored the highest on 'other priorities' dimension; Highly Constrained--visitors who scored relatively high on...

  9. Dispositional Differences in Critical Thinking Related to Gender and Academic Major.

    ERIC Educational Resources Information Center

    Walsh, Catherine M.; Hardy, Robert C.

    1999-01-01

    The California Critical Thinking Disposition Inventory was completed by 334 college students. Majors in English, psychology, and nursing scored highest. Nonpractice disciplines (English, history, psychology) generally scored higher than practice disciplines (nursing, education, business). Females scored higher on open-mindedness and maturity. (SK)

  10. The influence of community well-being on mortality among Registered First Nations people.

    PubMed

    Oliver, Lisa N; Penney, Chris; Peters, Paul A

    2016-07-20

    Living in a community with lower socioeconomic status is associated with higher mortality. However, few studies have examined associations between community socioeconomic characteristics and mortality among the First Nations population. The 1991-to-2006 Census Mortality and Cancer Cohort follow-up, which tracked a 15% sample of Canadians aged 25 or older, included 57,300 respondents who self-identified as Registered First Nations people or Indian band members. The Community Well-Being Index (CWB), a measure of the social and economic well-being of communities, consists of income, education, labour force participation, and housing components. A dichotomous variable was used to indicate residence in a community with a CWB score above or below the average for First Nations communities. Age-standardized mortality rates (ASMRs) were calculated for First Nations cohort members in communities with CWB scores above and below the First Nations average. Cox proportional hazards models examined the impact of CWB when controlling for individual characteristics. The ASMR for First Nations cohort members in communities with a below-average CWB was 1,057 per 100,000 person-years at risk, compared with 912 for those in communities with an above-average CWB score. For men, living in a community with below-average income and labour force participation CWB scores was associated with an increased hazard of death, even when individual socioeconomic characteristics were taken into account. Women in communities with below-average income scores had an increased hazard of death. First Nations people in communities with below-average CWB scores tended to have higher mortality rates. For some components of the CWB, effects remained even when individual socioeconomic characteristics were taken into account.

  11. Falling Behind: New Evidence on the Black-White Achievement Gap

    ERIC Educational Resources Information Center

    Levitt, Steven D.; Fryer, Roland G.

    2004-01-01

    On average, black students typically score one standard deviation below white students on standardized tests--roughly the difference in performance between the average 4th grader and the average 8th grader. Historically, what has come to be known as the black-white test-score gap has emerged before children enter kindergarten and has tended to…

  12. ACT Average Composite by State: 2000 ACT-Tested Graduates.

    ERIC Educational Resources Information Center

    American Coll. Testing Program, Iowa City, IA.

    This table contains average composite scores by state for high school graduates who took the ACT Assessment in 2000. For each state the percentage of graduates taking the ACT Assessment and the average composite score are given, with the same information for those who completed the recommended core curriculum and those who did not, as well as for…

  13. 40 CFR 63.2263 - Initial compliance demonstration for a dry rotary dryer.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... operate a dry rotary dryer, you must demonstrate that your dryer processes furnish with an inlet moisture.... You must record the inlet furnish moisture content (dry basis) and inlet dryer operating temperature... highest recorded 24-hour average inlet furnish moisture content and the highest recorded 24-hour average...

  14. 40 CFR 63.2263 - Initial compliance demonstration for a dry rotary dryer.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... operate a dry rotary dryer, you must demonstrate that your dryer processes furnish with an inlet moisture.... You must record the inlet furnish moisture content (dry basis) and inlet dryer operating temperature... highest recorded 24-hour average inlet furnish moisture content and the highest recorded 24-hour average...

  15. Determination of concentration factors for Cs-137 and Ra-226 in the mullet species Chelon labrosus (Mugilidae) from the South Adriatic Sea.

    PubMed

    Antovic, Ivanka; Antovic, Nevenka M

    2011-07-01

    Concentration factors for Cs-137 and Ra-226 transfer from seawater, and dried sediment or mud with detritus, have been determined for whole, fresh weight, Chelon labrosus individuals and selected organs. Cesium was detected in 5 of 22 fish individuals, and its activity ranged from 1.0 to 1.6 Bq kg(-1). Radium was detected in all fish, and ranged from 0.4 to 2.1 Bq kg(-1), with an arithmetic mean of 1.0 Bq kg(-1). In regards to fish organs, cesium activity concentration was highest in muscles (maximum - 3.7 Bq kg(-1)), while radium was highest in skeletons (maximum - 25 Bq kg(-1)). Among cesium concentration factors, those for muscles were the highest (from seawater - an average of 47, from sediment - an average of 3.3, from mud with detritus - an average of 0.8). Radium concentration factors were the highest for skeleton (from seawater - an average of 130, from sediment - an average of 1.8, from mud with detritus - an average of 1.5). Additionally, annual intake of cesium and radium by human adults consuming muscles of this fish species has been estimated to provide, in aggregate, an effective dose of about 4.1 μSv y(-1). 2011 Elsevier Ltd. All rights reserved.

  16. Effects of distillation system and yeast strain on the aroma profile of Albariño (Vitis vinifera L.) grape pomace spirits.

    PubMed

    Arrieta-Garay, Y; Blanco, P; López-Vázquez, C; Rodríguez-Bencomo, J J; Pérez-Correa, J R; López, F; Orriols, I

    2014-10-29

    Orujo is a traditional alcoholic beverage produced in Galicia (northwest Spain) from distillation of grape pomace, a byproduct of the winemaking industry. In this study, the effect of the distillation system (copper charentais alembic versus packed column) and the yeast strain (native yeast L1 versus commercial yeast L2) on the chemical and sensory characteristics of orujo obtained from Albariño (Vitis vinifera L.) grape pomace has been analyzed. Principal component analysis, with two components explaining 74% of the variance, is able to clearly differentiate the distillates according to distillation system and yeast strain. Principal component 1, mainly defined by C6-C12 esters, isoamyl octanoate, and methanol, differentiates L1 from L2 distillates. In turn, principal component 2, mainly defined by linear alcohols, linalool, and 1-hexenol, differentiates alembic from packed column distillates. In addition, an aroma descriptive test reveals that the distillate obtained with a packed column from a pomace fermented with L1 presented the highest positive general impression, which is associated with the highest fruity and smallest solvent aroma scores. Moreover, chemical analysis shows that use of a packed column increases average ethanol recovery by 12%, increases the concentration of C6-C12 esters by 25%, and reduces the concentration of higher alcohols by 21%. In turn, L2 yeast obtained lower scores in the alembic distillates aroma profile. In addition, with L1, 9% higher ethanol yields were achieved, and L2 distillates contained 34%-40% more methanol than L1 distillates.

  17. NASA/DOD Aerospace Knowledge Diffusion Research Project. Report 13: Source selection and information use by US aerospace engineers and scientists: Results of a telephone survey

    NASA Technical Reports Server (NTRS)

    Pinelli, Thomas E.; Glassman, Nanci A.

    1992-01-01

    A telephone survey of U.S. aerospace engineers and scientists belonging to the Society of Automotive Engineers (SAE) was conducted between December 4, 1991 and January 5, 1992. The survey was undertaken to (1) validate the telephone survey as an appropriate technique for collecting data from U.S. aerospace engineers and scientists; (2) collect information about how the results of NASA/DoD aerospace research are used in the R&D process; (3) identify those selection criteria which affect the use of federally-funded aerospace R&D; and (4) obtain information that could be used to develop a self-administered mail questionnaire for use with the same population. The average rating of importance of U.S. government technical reports was 2.5 (on a 4-point scale); The mean/median number of times U.S. government technical reports were used per 6 months was 8/2. Factors scoring highest for U.S. government technical reports were technical accuracy (2.9), reliable data and technical information (2.8), and contains comprehensive data and information (2.7) on a 4-point system. The factors scoring highest for influencing the use of U.S. government technical reports were relevance (3.1), technical accuracy (3.06), and reliable data/information (3.02). Ease of use, familiarity, technical accuracy, and relevance correlated with use of U.S. government technical reports. Survey demographics, survey questionnaire, and the NASA/DoD Aerospace Knowledge Diffusion Research Project publications list are included.

  18. Emotional state and coping style among gynecologic patients undergoing surgery.

    PubMed

    Matsushita, Toshiko; Murata, Hinako; Matsushima, Eisuke; Sakata, Yu; Miyasaka, Naoyuki; Aso, Takeshi

    2007-02-01

    The aim of the present study was to investigate changes in emotional state and the relationship between emotional state and demographic/clinical factors and coping style among gynecologic patients undergoing surgery. Using the Japanese version of the Profile of Mood States (POMS), 90 patients (benign disease: 32, malignancy: 58) were examined on three occasions: before surgery, before discharge, and 3 months after discharge. They were also examined using the Coping Inventory for Stressful Situations (CISS) on one occasion before discharge. The scores for the subscales depression, anger, and confusion were the highest after discharge while those for anxiety were the highest before surgery. The average scores of the POMS subscales for all subjects were within the normal range. With regard to the relationship between these emotional states and other factors, multiple regressions showed that the principal determinants of anxiety before surgery were religious belief, psychological symptoms during hospitalization and emotion-oriented (E) coping style; further, it was found that depression after discharge could be explained by chemotherapy, duration of hospitalization, and E coping style. The principal determinants of anger after discharge and vigor before surgery were length of education and E coping style, and severity of disease, chemotherapy, E coping style and task-oriented coping style, respectively. Those of post-discharge fatigue and confusion were length of education, psychological symptoms, and E coping style. In summary it is suggested that the following should be taken into account in patients undergoing gynecologic surgery: anxiety before surgery, depression, anger, and confusion after surgery, including coping styles.

  19. Concentrated affluence, concentrated disadvantage, and children's readiness for school: a population-based, multi-level investigation.

    PubMed

    Carpiano, Richard M; Lloyd, Jennifer E V; Hertzman, Clyde

    2009-08-01

    A number of studies demonstrates a relationship between neighbourhood concentration of affluence and disadvantage and the health and development of its residents. We contribute to this literature by testing hypotheses about the relationship between neighbourhood-level concentrated affluence/disadvantage and child-level developmental outcomes in a study population of 37,798 Kindergarten children residing in 433 neighbourhoods throughout the province of British Columbia, Canada. We utilise a previously-validated measure of neighbourhood socioeconomic composition--the Index of Concentration at the Extremes (ICE)--which not only allows for more precise estimation of the competing influences of concentrated affluence and disadvantage, but also facilitates examination of the potential impact of neighbourhood-level income inequality. Our findings show that increases in neighbourhood affluence are associated with increases in children's scores on the Early Development Instrument (EDI), a holistic measure of Kindergarteners' readiness for school. Particularly noteworthy is that, for four of the five EDI scales (physical, social, emotional, and communication) and the total score, results indicate a significant curvilinear relationship--whereby the highest average child-level outcomes are not found in locations with the highest concentrations of affluence, but rather in locations with relatively equal proportions of affluent and disadvantaged families. This finding suggests, first, that concentrated affluence may have diminishing rates of return on contributing to enhanced child development, and, second, that children residing in mixed-income neighbourhoods may benefit both from the presence of affluent residents and from the presence of services and institutions aimed at assisting lower-income residents. Implications and future directions are discussed.

  20. Impact of flexible insulin therapy on blood glucose variability, oxidative stress and inflammation in type 1 diabetic patients: the VARIAFIT study.

    PubMed

    Benhamou, P Y; Somers, F; Lablanche, S; Debaty, I; Borel, A L; Nasse, L; Stanke-Labesque, F; Faure, P; Boizel, R; Halimi, S

    2014-09-01

    HbA1c only partially predicts vascular risk in patients with type 1 diabetes (T1D), and a role for blood glucose variability (BGV) is a matter of debate. For this reason, this study investigated the impact of an educational programme of flexible insulin therapy (FIT) on BGV and oxidative stress. Tests were conducted on 30 adult T1D patients in a prospective, single-centre trial at baseline (M0), and at 3 and 6 months (M3 and M6, respectively) of the FIT programme to determine BGV, as reflected by mean amplitude of glycaemic excursions (MAGE), low blood glucose index (LBGI), lability index (LI), average daily risk range (ADRR), glycaemic lability (scored by two diabetologists), urinary leukotriene E4 (LTE4), 11-dehydro-thromboxane B2 (TXB2) and 8-iso-prostaglandin F2α (PGF2). HbA1c (7.7 ± 0.9%), ADRR, MAGE, LBGI and LI did not change from M0 to M3 and M6, although ADRR and LBGI significantly improved at M3 and M6 in patients with the highest baseline indices (≥ 40 and ≥ 5, respectively). TXB2 declined at M6 (832 ± 625 vs. 633 ± 972 pg/mg; P=0.048), whereas LTE4 and PGF2 remained stable. ADRR showed the strongest correlation with glycaemic lability scores at all visits (r≥0.84, P<0.0001). A FIT educational programme improved BGV only in patients with the highest baseline variability, and led to no changes in HbA1c, while ADRR closely correlated with glycaemic lability score. Our data do not support a relationship between BGV and oxidative stress in T1D patients, although the impact of variability on TXB2 deserves further investigation (ClinicalTrials.gov NCT00973492). Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  1. The geo-spatial information infrastructure at the Centre for Control and Prevention of Zoonoses, University of Ibadan, Nigeria: an emerging sustainable One-Health pavilion.

    PubMed

    Olugasa, B O

    2014-12-01

    The World-Wide-Web as a contemporary means of information sharing offers a platform for geo-spatial information dissemination to improve education about spatio-temporal patterns of disease spread at the human-animal-environment interface in developing countries of West Africa. In assessing the quality of exposure to geospatial information applications among students in five purposively selected institutions in West Africa, this study reviewed course contents and postgraduate programmes in zoonoses surveillance. Geospatial information content and associated practical exercises in zoonoses surveillance were scored.. Seven criteria were used to categorize and score capability, namely, spatial data capture; thematic map design and interpretation; spatio-temporal analysis; remote sensing of data; statistical modelling; the management of spatial data-profile; and web-based map sharing operation within an organization. These criteria were used to compute weighted exposure during training at the institutions. A categorical description of institution with highest-scoring of computed Cumulative Exposure Point Average (CEPA) was based on an illustration with retrospective records of rabies cases, using data from humans, animals and the environment, that were sourced from Grand Bassa County, Liberia to create and share maps and information with faculty, staff, students and the neighbourhood about animal bite injury surveillance and spatial distribution of rabies-like illness. Uniformly low CEPA values (0-1.3) were observed across academic departments. The highest (3.8) was observed at the Centre for Control and Prevention of Zoonoses (CCPZ), University of Ibadan, Nigeria, where geospatial techniques were systematically taught, and thematic and predictive maps were produced and shared online with other institutions in West Africa. In addition, a short course in zoonosis surveillance, which offers inclusive learning in geospatial applications, is taught at CCPZ. The paper presents a graded capability for geospatial data capture, analysis and an emerging sustainable map pavilion dedicated to zoonoses disease surveillance training among collaborating institutions in West Africa.

  2. Australian midwives knowledge, attitude and perceived learning needs around perinatal mental health.

    PubMed

    Hauck, Yvonne L; Kelly, Georgina; Dragovic, Milan; Butt, Janice; Whittaker, Pamela; Badcock, Johanna C

    2015-01-01

    a cross sectional survey was undertaken to explore midwives' knowledge of, and attitudes towards, mental health disorders in childbearing women vis-à-vis their perceived mental health learning needs. a 50.1% response rate included 238 midwives employed in the only public tertiary maternity hospital in Western Australia from March to June 2013. The survey comprised a mixture of custom-designed questions and vignettes presenting various disorders. Only 37.6% of midwives felt well-equipped to support women, whilst 50.2% reported insufficient access to information. Demand was highest for education on: personality disorders (77.8%); the impact of childbearing on mental health disorders (74.2%); and skills for handling stress and aggression (57.8%). Knowledge scores were variable: on average eight out of a maximum 13 questions were answered correctly, but few (2.7%) answered more than 11 correctly, and 3.7% scored ≤4 correct. Across disorders, recognition from vignettes was highest for depression (93.9%), and lowest for schizophrenia (65.6%). Surprisingly, there were no associations between general knowledge scores and previous mental health experience, recent professional development, or access to information around mental health. The majority endorsed positive beliefs about midwives' role in mental health assessment, and belief in women's recovery (83.5%), however, cluster analysis of warmth and competence ratings revealed negative stereotyping of mental health disorders. Midwives accept it is their role to assess the mental health status of women but many feel ill-equipped to do so and express a strong desire for further knowledge and skills across a range of perinatal mental health topics. Attitudes to recovery are positive but negative stereotypes exist; therefore awareness of potential bias is important to negate their influence on care. Learning needs may change due to trends in clinical practice. Strategies are needed to recognise negative beliefs and to ensure education is responsive to local contexts. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Teachers' knowledge concerning dental trauma and its management in primary schools in Riyadh, Saudi Arabia.

    PubMed

    Alsadhan, Salwa A; Alsayari, Najla F; Abuabat, Mashael F

    2018-02-22

    The main aim of this cross-sectional study was to assess knowledge concerning traumatic dental injuries and their management among primary schoolteachers in Riyadh, Saudi Arabia. The secondary objective was to evaluate the effect of gender, nationality, marital status, school type, geographical area, age group, level of education and years of experience on teachers' knowledge. Data were collected, through a self-administered questionnaire, from both male and female teachers employed in public and private primary schools in the five geographical areas of Riyadh City. The total sample size was 1,520 teachers. Data were entered into the Statistical Package for the Social Sciences. Frequencies and percentages were calculated. An independent t-test and a one-way analysis of variance (ANOVA) were used to calculate significance. The total score for the questions assessing knowledge was calculated out of 9, and the highest score was 7 with an average score of 2.85. Over half of the sampled participants stated that they did not know how to manage soft-tissue injuries. Regarding the management of fractured teeth, 38.8% believed that the fractured part is useless; and for the management of an avulsed permanent tooth, only 6.2% of the respondents selected the correct answer. For the question regarding suitable storage medium of an avulsed tooth, only 19.7% chose milk and 3.2% chose the injured person's saliva. Teachers between 41 and 50 years of age and those with longer years of experience had the highest level of knowledge. Teachers in the north area of Riyadh had a higher level of knowledge than teachers in other areas. There was a lack of knowledge among primary schoolteachers in Riyadh concerning traumatic dental injuries and their management. Statistically significant differences were found among geographical areas, age groups and years of experience; no statistically significant differences were found regarding gender, nationality, marital status, level of education and school type (public/private). © 2018 FDI World Dental Federation.

  4. WE-H-BRC-09: Simulated Errors in Mock Radiotherapy Plans to Quantify the Effectiveness of the Physics Plan Review

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

    Gopan, O; Kalet, A; Smith, W

    2016-06-15

    Purpose: A standard tool for ensuring the quality of radiation therapy treatments is the initial physics plan review. However, little is known about its performance in practice. The goal of this study is to measure the effectiveness of physics plan review by introducing simulated errors into “mock” treatment plans and measuring the performance of plan review by physicists. Methods: We generated six mock treatment plans containing multiple errors. These errors were based on incident learning system data both within the department and internationally (SAFRON). These errors were scored for severity and frequency. Those with the highest scores were included inmore » the simulations (13 errors total). Observer bias was minimized using a multiple co-correlated distractor approach. Eight physicists reviewed these plans for errors, with each physicist reviewing, on average, 3/6 plans. The confidence interval for the proportion of errors detected was computed using the Wilson score interval. Results: Simulated errors were detected in 65% of reviews [51–75%] (95% confidence interval [CI] in brackets). The following error scenarios had the highest detection rates: incorrect isocenter in DRRs/CBCT (91% [73–98%]) and a planned dose different from the prescribed dose (100% [61–100%]). Errors with low detection rates involved incorrect field parameters in record and verify system (38%, [18–61%]) and incorrect isocenter localization in planning system (29% [8–64%]). Though pre-treatment QA failure was reliably identified (100%), less than 20% of participants reported the error that caused the failure. Conclusion: This is one of the first quantitative studies of error detection. Although physics plan review is a key safety measure and can identify some errors with high fidelity, others errors are more challenging to detect. This data will guide future work on standardization and automation. Creating new checks or improving existing ones (i.e., via automation) will help in detecting those errors with low detection rates.« less

  5. Analysis of the American Society of Anesthesiologists Physical Status Classification System and Caprini Risk Assessment Model in Predicting Venous Thromboembolic Outcomes in Plastic Surgery Patients.

    PubMed

    Shaikh, Mohammad-Ali; Jeong, Haneol S; Mastro, Andrew; Davis, Kathryn; Lysikowski, Jerzy; Kenkel, Jeffrey M

    2016-04-01

    Venous thromboembolism (VTE) can be a fatal outcome of plastic surgery. Risk assessment models attempt to determine a patient's risk, yet few studies have compared different models in plastic surgery patients. The authors investigated preoperative ASA physical status and 2005 Caprini scores to determine which model was more predictive of VTE. A retrospective chart review examined 1801 patients undergoing contouring and reconstructive procedures from January 2008 to January 2012. Patients were grouped into risk tiers for ASA scores (1-2 = low, 3+ = high) with 2 cutoffs for Caprini scores (1-4 = low, 5+ high; 1-5 = low, 6+ = high), then re-stratified into 3 tiers using Caprini score cutoffs (1-4 = low, 5-8 = high, 9+ = highest; 1-5 = low, 6-8 = high, 9+ = highest). Median scores of VTE patients were compared to those without VTE. Odds ratio and chi-squared analyses were performed. Of the 1598 patients included in the study, 1.50% developed VTE. Median ASA scores differed significantly between comparison groups but Caprini scores did not vary regardless of cutoff. When examining the 2-tiered Caprini scores, using low risk = 1-5 showed a significant relationship between risk tier and DVT development (P = 0.0266). The ASA system yielded the highest odds ratio of VTE development between low and high-risk patients. The Caprini model captured more patients with VTE in its high-risk category. Combining the two models for a more heuristic approach to preoperative care may identify patients at higher risk. 4 Risk. © 2015 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

  6. Determination of the diagnostic value of the Modified Mallampati Score, Upper Lip Bite Test and Facial Angle in predicting difficult intubation: A prospective descriptive study.

    PubMed

    Mahmoodpoor, Ata; Soleimanpour, Hassan; Golzari, Samad Ej; Nejabatian, Arezoo; Pourlak, Tannaz; Amani, Masoumeh; Hajmohammadi, Saeed; Hosseinzadeh, Hamzeh; Esfanjani, Robab Mehdizadeh

    2017-02-01

    Difficult intubation is a significant cause of mortality and morbidity related to anesthesia. We decided to evaluate the value of Modified Mallampati Score, Upper Lip Bite Test and Facial Angle in the prediction of difficult intubation. In a prospective descriptive study, data from 132 patients who were candidates for elective maxillofacial surgeries under general anesthesia were gathered. Facial Angles were measured by a maxillofacial surgeon according to cephalometry. The Modified Mallampati Score and Upper Lip Bite Test were first measured by an anesthesiologist and then another anesthesiologist was assigned to record the Cormack and Lehane score during the intubation. Grades 3 and 4 were considered as difficult intubation. Sensitivity, specificity, positive predictive value, negative predictive value and Youden index were calculated for all tests. Difficult intubation was reported in 12% of the patients. Facial Angle≤82.5° can predict difficult intubation with 87.5% sensitivity and 88.8% specificity. Among the three tests, a high Modified Mallampati Score had the highest specificity (94.5%) and a high Modified Mallampati Score and Facial Angle (FA≤82.5°) had the highest sensitivity (87.5%). The highest NPV, sensitivity and Youden index were observed when using Facial Angle with the Modified Mallampati Score or with Upper Lip Bite Test. Facial Angle has a high sensitivity, NPV and Youden index for the prediction of difficult intubation, but the best result is achieved when Facial Angle is used in combination with either the Modified Mallampati Score or Upper Lip Bit Test. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. The Persisting Racial Scoring Gap on Graduate and Professional School Admission Tests.

    ERIC Educational Resources Information Center

    Journal of Blacks in Higher Education, 2003

    2003-01-01

    Discusses the racial scoring gap on tests for admission to medical, business, law, and other graduate programs, noting that in the highest-scoring brackets on the Medical College Admission Test (MCAT), the racial gap is even larger. Whites are five times, twelve times, and seven times more likely, respectively, to score higher on the MCAT, Law…

  8. Customer care. Patient satisfaction in the prehospital setting.

    PubMed

    Doering, G T

    1998-09-01

    The focus of the study was to prioritize six emergency medical service treatment factors in terms of their impact upon patient satisfaction in the prehospital setting. The six treatment areas analyzed were: EMS response time; medical care provided on scene; explanation of care by the provider; the provider's ability to reduce patient anxiety; the provider's ability to meet the patient's non-medical needs; and the level of courtesy/politeness shown by the EMS provider toward the patient. Telephone interviews were conducted with both patients and bystanders to obtain their perception of how well the system met their needs. The study analyzed how the six issues were rated and then evaluated the impact an individual's low score in a category had on that person's overall rating of the service provided. The overall satisfaction rating is not a calculated score, but an overall score specified by the respondent. The effect each issue had on the respondent's overall rating was determined by averaging the overall ratings for a category's low scorers, averaging the overall ratings for high scorers and then measuring the difference. Results of the study indicate that the factor with the greatest negative impact on patient satisfaction came from a perceived lack of crew courtesy and politeness. Respondents who indicated a fair to poor score in this category decreased their overall score by 60.2%. Ratings in other categories yielded the following results: When respondents rated the response time as fair to poor, their average overall rating showed an 18.4% decrease. When respondents rated the quality of medical care as fair to poor, their average overall rating showed a decrease of 22.6%. When the crew's ability to explain what was happening to the patient was rated as fair to poor, the average overall score dropped 33.6%. When the EMT's and medic's ability to reduce the patient's anxiety was rated fair to poor, average overall score declined by 32.6%. Finally, when the crew's ability to satisfy a patient's non-medical needs was rated as fair to poor, the average overall score diminished by 37.4%.

  9. Communication skills in pediatrics – the relationship between pediatrician and child

    PubMed Central

    Mărginean, Cristina Oana; Meliţ, Lorena Elena; Chinceşan, Mihaela; Mureşan, Simona; Georgescu, Anca Meda; Suciu, Nicoleta; Pop, Anisoara; Azamfirei, Leonard

    2017-01-01

    Abstract Interpersonal and communication skills are 2 essential qualities of every physician. These are separate and distinct parts of the professional character of every physician. In pediatrics these abilities present even a higher impact. We performed a survey-type prospective study based on questionnaires on 100 subjects, equally divided into 4 groups: 25 children, 25 pediatricians, 25 care-givers (parents, tutors, and relatives), and 25 health care staff, in a Tertiary Pediatric Clinic from Romania, between January 2017 and April 2017. We included 100 participants in our study, equally divided into 4 groups: pediatric patients, pediatricians, care-givers, and health care staff. The 1st group comprised 25 children diagnosed with different chronic conditions, presenting the age between 5 and 14 years. The male gender predominated among the children (57%). The lowest general average score for “Communication” section was encountered among pediatricians group, 3.8, while the other 3 groups presented the same average score for this section, that is, 4.6. The children and the health care staff offered the same average score for “Transparency,” that is, 4.6, while the pediatricians offered a score of 4.5, and the care-givers of 4.7. The lowest average score for the item “Hospital environment” was given by the doctors, that is, 3.3, followed by care-givers with a score of 3.6, health care staff 3.7, and children with an average score of 3.8. All the 4 groups included in the study offered a general average of 4.9 out of 5 for the “Intercultural issues” section. The lowest average score for “Time management” section was offered by both children and pediatricians, that is, 4.1, while care-givers and health care staff had a slightly better perception regarding this item, offering 4.2 and 4.3, respectively. The opinion among the 4 groups included in the study was generally similar regarding the 5 items assessed by our questionnaires. Therefore, the main aspects that need to be improved in the health care system in downward order are the following: hospital environment, time management, communication, transparency, and intercultural issues. PMID:29069036

  10. Communication skills in pediatrics - the relationship between pediatrician and child.

    PubMed

    Mărginean, Cristina Oana; Meliţ, Lorena Elena; Chinceşan, Mihaela; Mureşan, Simona; Georgescu, Anca Meda; Suciu, Nicoleta; Pop, Anisoara; Azamfirei, Leonard

    2017-10-01

    Interpersonal and communication skills are 2 essential qualities of every physician. These are separate and distinct parts of the professional character of every physician. In pediatrics these abilities present even a higher impact.We performed a survey-type prospective study based on questionnaires on 100 subjects, equally divided into 4 groups: 25 children, 25 pediatricians, 25 care-givers (parents, tutors, and relatives), and 25 health care staff, in a Tertiary Pediatric Clinic from Romania, between January 2017 and April 2017.We included 100 participants in our study, equally divided into 4 groups: pediatric patients, pediatricians, care-givers, and health care staff. The 1st group comprised 25 children diagnosed with different chronic conditions, presenting the age between 5 and 14 years. The male gender predominated among the children (57%). The lowest general average score for "Communication" section was encountered among pediatricians group, 3.8, while the other 3 groups presented the same average score for this section, that is, 4.6. The children and the health care staff offered the same average score for "Transparency," that is, 4.6, while the pediatricians offered a score of 4.5, and the care-givers of 4.7. The lowest average score for the item "Hospital environment" was given by the doctors, that is, 3.3, followed by care-givers with a score of 3.6, health care staff 3.7, and children with an average score of 3.8. All the 4 groups included in the study offered a general average of 4.9 out of 5 for the "Intercultural issues" section. The lowest average score for "Time management" section was offered by both children and pediatricians, that is, 4.1, while care-givers and health care staff had a slightly better perception regarding this item, offering 4.2 and 4.3, respectively.The opinion among the 4 groups included in the study was generally similar regarding the 5 items assessed by our questionnaires. Therefore, the main aspects that need to be improved in the health care system in downward order are the following: hospital environment, time management, communication, transparency, and intercultural issues.

  11. The effects of postharvest application of lecithin to improve storage potential and quality of fresh goji (Lycium barbarum L.) berries.

    PubMed

    Jatoi, Mushtaque Ahmed; Jurić, Slaven; Vidrih, Rajko; Vinceković, Marko; Vuković, Marko; Jemrić, Tomislav

    2017-09-01

    To enhance storage life and post-storage quality of fresh goji berries, three treatments with lecithin (1, 5, 10g·L -1 ) and two storage times (8, 16days) were evaluated. The significant effects on the physiological and biochemical parameters were varied. 1g·L -1 lecithin showed its main effects after 8days of storage by reduction in total weight loss and decay, SSC/TA ratio (also at 16days), and chlorophyll content and with highest scores of sensory attributes (also at 16days). 5g·L -1 lecithin showed its main effects after 16days of storage: highest SSC, highest TA (also at 8days), highest TPC, only significant reduction in DPPH antioxidant activity, and highest total flavonoid content. 10g·L -1 lecithin showed its main effects after 8days of storage with highest SSC, chlorophyll content, total flavonoid, DPPH, and ABTS antioxidant activity (also at 16days), but with least scores of sensory attributes. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Department of Defense HIV/AIDS Prevention Program (DHAPP): 2010 Annual Report

    DTIC Science & Technology

    2011-04-01

    training sessions that took place in FY10 to assess the program’s effectiveness. MEASURES OF EFFECTIVENESS Pretest and posttests have been developed with...competence level among the trainees. Pretest scores ranged from 32.5% to 67.5%, while posttest scores ranged from 65.0% to 75.0%, making it clear that...it was a valuable training. The average pretest score went from approximately 50% to a posttest average of 70%. Below is a table of scores, followed

  13. The Apgar score has survived the test of time.

    PubMed

    Finster, Mieczyslaw; Wood, Margaret

    2005-04-01

    In 1953, Virginia Apgar, M.D. published her proposal for a new method of evaluation of the newborn infant. The avowed purpose of this paper was to establish a simple and clear classification of newborn infants which can be used to compare the results of obstetric practices, types of maternal pain relief and the results of resuscitation. Having considered several objective signs pertaining to the condition of the infant at birth she selected five that could be evaluated and taught to the delivery room personnel without difficulty. These signs were heart rate, respiratory effort, reflex irritability, muscle tone and color. Sixty seconds after the complete birth of the baby a rating of zero, one or two was given to each sign, depending on whether it was absent or present. Virginia Apgar reviewed anesthesia records of 1025 infants born alive at Columbia Presbyterian Medical Center during the period of this report. All had been rated by her method. Infants in poor condition scored 0-2, infants in fair condition scored 3-7, while scores 8-10 were achieved by infants in good condition. The most favorable score 1 min after birth was obtained by infants delivered vaginally with the occiput the presenting part (average 8.4). Newborns delivered by version and breech extraction had the lowest score (average 6.3). Infants delivered by cesarean section were more vigorous (average score 8.0) when spinal was the method of anesthesia versus an average score of 5.0 when general anesthesia was used. Correlating the 60 s score with neonatal mortality, Virginia found that mature infants receiving 0, 1 or 2 scores had a neonatal death rate of 14%; those scoring 3, 4, 5, 6 or 7 had a death rate of 1.1%; and those in the 8-10 score group had a death rate of 0.13%. She concluded that the prognosis of an infant is excellent if he receives one of the upper three scores, and poor if one of the lowest three scores.

  14. Development of a method for classification of hospitals based on results of the diagnosis-related groups and the principle of case-mix index.

    PubMed

    Shelf, Louay

    2016-08-18

    This research used DRGs and CMI to adjust medical waste production through the calculation of DRGs and CMI scores. These scores were used to assess the performances of teaching hospitals in Damascus. The linear correlations between these scores and the annual amount of waste and DRGs values were studied. The differences between the daily waste generations before and after the adjustment process were determined. Accordingly, the highest values of DRGs and CMI Scores were for the pediatric and Al Assad hospitals respectively. Among the teaching hospitals in Damascus, Al Assad has achieved the highest performance. Based on the results, the accuracy and homogeneity of medical waste generation rates were improved, which in turn leads to continuous improvement in the management of medical wastes.

  15. Ranking prediction model using the competition record of Ladies Professional Golf Association players.

    PubMed

    Chae, Jin Seok; Park, Jin; So, Wi-Young

    2017-07-28

    The purpose of this study was to suggest a ranking prediction model using the competition record of the Ladies Professional Golf Association (LPGA) players. The top 100 players on the tour money list from the 2013-2016 US Open were analyzed in this model. Stepwise regression analysis was conducted to examine the effect of performance and independent variables (i.e., driving accuracy, green in regulation, putts per round, driving distance, percentage of sand saves, par-3 average, par-4 average, par-5 average, birdies average, and eagle average) on dependent variables (i.e., scoring average, official money, top-10 finishes, winning percentage, and 60-strokes average). The following prediction model was suggested:Y (Scoring average) = 55.871 - 0.947 (Birdies average) + 4.576 (Par-4 average) - 0.028 (Green in regulation) - 0.012 (Percentage of sand saves) + 2.088 (Par-3 average) - 0.026 (Driving accuracy) - 0.017 (Driving distance) + 0.085 (Putts per round)Y (Official money) = 6628736.723 + 528557.907 (Birdies average) - 1831800.821 (Par-4 average) + 11681.739 (Green in regulation) + 6476.344 (Percentage of sand saves) - 688115.074 (Par-3 average) + 7375.971 (Driving accuracy)Y (Top-10 finish%) = 204.462 + 12.562 (Birdies average) - 47.745 (Par-4 average) + 1.633 (Green in regulation) - 5.151 (Putts per round) + 0.132 (Percentage of sand saves)Y (Winning percentage) = 49.949 + 3.191 (Birdies average) - 15.023 (Par-4 average) + 0.043 (Percentage of sand saves)Y (60-strokes average) = 217.649 + 13.978 (Birdies average) - 44.855 (Par-4 average) - 22.433 (Par-3 average) + 0.16 (Green in regulation)Scoring of the above five prediction models and the prediction of golf ranking in the 2016 Women's Golf Olympic competition in Rio revealed a significant correlation between the predicted and real ranking (r = 0.689, p < 0.001) and between the predicted and the real average score (r = 0.653, p < 0.001). Our ranking prediction model using LPGA data may help coaches and players to identify which players are likely to participate in Olympic and World competitions, based on their performance.

  16. A randomized controlled trial of a brief intervention for illicit drugs linked to the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in clients recruited from primary health-care settings in four countries.

    PubMed

    Humeniuk, Rachel; Ali, Robert; Babor, Thomas; Souza-Formigoni, Maria Lucia O; de Lacerda, Roseli Boerngen; Ling, Walter; McRee, Bonnie; Newcombe, David; Pal, Hemraj; Poznyak, Vladimir; Simon, Sara; Vendetti, Janice

    2012-05-01

    This study evaluated the effectiveness of a brief intervention (BI) for illicit drugs (cannabis, cocaine, amphetamine-type stimulants and opioids) linked to the World Health Organization (WHO) Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). The ASSIST screens for problem or risky use of 10 psychoactive substances, producing a score for each substance that falls into either a low-, moderate- or high-risk category. Prospective, randomized controlled trial in which participants were either assigned to a 3-month waiting-list control condition or received brief motivational counselling lasting an average of 13.8 minutes for the drug receiving the highest ASSIST score. Primary health-care settings in four countries: Australia, Brazil, India and the United States. A total of 731 males and females scoring within the moderate-risk range of the ASSIST for cannabis, cocaine, amphetamine-type stimulants or opioids. ASSIST-specific substance involvement scores for cannabis, stimulants or opioids and ASSIST total illicit substance involvement score at baseline and 3 months post-randomization. Omnibus analyses indicated that those receiving the BI had significantly reduced scores for all measures, compared with control participants. Country-specific analyses showed that, with the exception of the site in the United States, BI participants had significantly lower ASSIST total illicit substance involvement scores at follow-up compared with the control participants. The sites in India and Brazil demonstrated a very strong brief intervention effect for cannabis scores (P < 0.005 for both sites), as did the sites in Australia (P < 0.005) and Brazil (P < 0.01) for stimulant scores and the Indian site for opioid scores (P < 0.01). The Alcohol, Smoking and Substance Involvement Screening Test-linked brief intervention aimed at reducing illicit substance use and related risks is effective, at least in the short term, and the effect generalizes across countries. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

  17. Preliminary results demonstrating the impact of Mediterranean diet on bone health.

    PubMed

    Savanelli, Maria Cristina; Barrea, Luigi; Macchia, Paolo Emidio; Savastano, Silvia; Falco, Andrea; Renzullo, Andrea; Scarano, Elisabetta; Nettore, Immacolata Cristina; Colao, Annamaria; Di Somma, Carolina

    2017-04-24

    Nutrition is an environmental factor affecting bone health. Nutrition is considered essential to achieve and maintain optimal bone mass. Mediterranean diet (MD) has shown to prevent bone disease. Aim of this study is to investigate the relationship between bone health status and adherence the MD. Four-hundred eighteen healthy people (105 males and 313 females, age 50 ± 14 years) were recruited in the outdoor hospital of the "Campus Salute Onlus" held in Piazza del Plebiscito in Naples, October 17-20th 2013 and 09-11th October 2014. All subjects underwent clinical assessment, calcaneal quantitative ultrasound (QUS) scanner and PREvención con DIeta MEDiterránea (PREDIMED) questionnaire. Globally, prevalence of osteoporosis and osteopenia were 7.7 and 46.0%, respectively. The majority of subjects (60.5%) had an average score (score 6-9) of adherence to MD. The T-score showed positive correlation with PREDIMED score (r = 0.250, p < 0.001). The higher T-scores were positively associated with a higher consumption of extra-virgin olive oil (EVOO), vegetables, fruits, legumes, and fish and negatively associated with consumption of red meat. The higher T-scores were positively associated with the highest odds of PREDIMED scores (higher adherence) (OR 6.91, IC 6.27-7.61, p < 0.001). Multiple regression analysis models indicated that, among the single food items investigated, high T-score can be predicted by consumption of EVOO (p < 0.001), fish (p < 0.001) and fruit (p = 0.002) intake. A PREDIMED score of 3 was found to be predictive for a low T-score (α = 0.05, R-squared index = 0.417). The results demonstrate a positive correlation between bone health status and adherence to MD, suggesting that a high adherence to MD promotes bone health. The observations here reported confirmed that a specific dietary approach, such as MD, can represent a modifiable environmental factor for osteoporosis' prevention.

  18. Medical students perception of test anxiety triggered by different assessment modalities.

    PubMed

    Guraya, Salman Y; Guraya, Shaista S; Habib, Fawzia; AlQuiliti, Khalid W; Khoshhal, Khalid I

    2018-05-06

    Test anxiety is well known among medical students. However, little is known about test anxiety produced by different components of exam individually. This study aimed to stratify varying levels of test anxiety provoked by each exam modality and to explore the students perceptions about confounding factors. A self-administered questionnaire was administered to medical students. The instrument contained four main themes; lifestyle, psychological and specific factors of information needs, learning styles, and perceived difficulty level of each assessment tool. A highest test anxiety score of 5 was ranked for "not scheduling available time" and "insufficient exercise" by 28.8 and 28.3% students, respectively. For "irrational thoughts about exam" and "fear to fail", a highest test anxiety score of 5 was scored by 28.8 and 25.7% students, respectively. The highest total anxiety score of 1255 was recorded for long case exam, followed by 975 for examiner-based objective structured clinical examination. Excessive course load and course not well covered by faculty were thought to be the main confounding factors. The examiner-based assessment modalities induced high test anxiety. Faculty is urged to cover core contents within stipulated time and to rigorously reform and update existing curricula to prepare relevant course material.

  19. The SAT® Essay and College Performance: Understanding What Essay Scores Add to HSGPA and SAT. Research Report 2012-9 (REV: 4-2013)

    ERIC Educational Resources Information Center

    Shaw, Emily J.; Kobrin, Jennifer L.

    2013-01-01

    This study examines the relationship between students' SAT essay scores and college outcomes, including first-year grade point average (FYGPA) and first-year English course grade average (FY EngGPA), overall and by various demographic and academic performance subgroups. Results showed that the SAT essay score has a positive relationship with both…

  20. The impact of coping on the somatic and mental status of patients with COPD: a cross-sectional study.

    PubMed

    Papava, Ion; Oancea, Cristian; Enatescu, Virgil Radu; Bredicean, Ana Cristina; Dehelean, Liana; Romosan, Radu Stefan; Timar, Bogdan

    2016-01-01

    Chronic obstructive pulmonary disease (COPD) is one of the most debilitating somatic diseases, having anxiety and depression frequently as comorbidities. The coping style, the way in which the subject manages to control the difficult and stressful situations of life, can influence its evolution and also the existence of the comorbidities. In this study, coping styles in a group of subjects with COPD and their association with the intensity of depressive and anxiety symptoms as well as medical determinants were identified. In this cross-sectional study, 28 male patients with COPD risk class D were enrolled. The patients performed spirometry tests, Borg scale, 6-minute walking test, Hospital Anxiety and Depression Scale, and COPE Inventory were recorded. According to their higher coping subscale score, the depression score was the highest in patients with avoidance-type coping and the lowest in patients with problem-focused coping (11.0 vs 5.6; P=0.042), respectively, patients with social support-focused coping having the highest anxiety score in contrast to patients with emotion-focused coping, which had the lowest anxiety score (11.6 vs 5.0; P=0.006). Regarding respiratory parameters, significant differences were present for the variation of the medians between the four groups only for forced vital capacity (FVC%) (the lowest FVC% was in patients with predominant social support-focused coping and the highest in patients with problem-focused coping) and 6-minute walking test (%) (the lowest score for patients with social support-focused coping and the highest value in patients with avoidance-type coping). Problem-coping score was significantly and positively associated with FVC% (Spearman's r=0.400; P=0.035), emotion-focused coping score was significantly and positively associated with FVC% (Spearman's r=0.395; P=0.038), and social support-focused coping score was negatively and significantly correlated with forced expiratory volume in 1 second/FVC% ratio (Spearman's r=0.389; P=0.041). A significant, negative correlation was found only between depression score and forced expiratory volume in 1 second (Spearman's r=-0.435; P=0.026) with respect to psychiatric symptoms. Coping styles in patients with COPD affect the intensity of associated depressive and anxiety symptoms as well as medical determinants, thus the coping style should be considered an important part in the multidisciplinary approach of these patients.

  1. Lifestyle Cardiovascular Risk Score, Genetic Risk Score, and Myocardial Infarction in Hispanic/Latino Adults Living in Costa Rica.

    PubMed

    Sotos-Prieto, Mercedes; Baylin, Ana; Campos, Hannia; Qi, Lu; Mattei, Josiemer

    2016-12-20

    A lifestyle cardiovascular risk score (LCRS) and a genetic risk score (GRS) have been independently associated with myocardial infarction (MI) in Hispanics/Latinos. Interaction or joint association between these scores has not been examined. Thus, our aim was to assess interactive and joint associations between LCRS and GRS, and each individual lifestyle risk factor, on likelihood of MI. Data included 1534 Costa Rican adults with nonfatal acute MI and 1534 matched controls. The LCRS used estimated coefficients as weights for each factor: unhealthy diet, physical inactivity, smoking, elevated waist:hip ratio, low/high alcohol intake, low socioeconomic status. The GRS included 14 MI-associated risk alleles. Conditional logistic regressions were used to calculate adjusted odds ratios. The odds ratios for MI were 2.72 (2.33, 3.17) per LCRS unit and 1.13 (95% CI 1.06, 1.21) per GRS unit. A significant joint association for highest GRS tertile and highest LCRS tertile and odds of MI was detected (odds ratio=5.43 [3.71, 7.94]; P<1.00×10 -7 ), compared to both lowest tertiles. The odds ratios were 1.74 (1.22, 2.49) under optimal lifestyle and unfavorable genetic profile, and 5.02 (3.46, 7.29) under unhealthy lifestyle but advantageous genetic profile. Significant joint associations were observed for the highest GRS tertile and the highest of each lifestyle component risk category. The interaction term was nonsignificant (P=0.33). Lifestyle risk factors and genetics are jointly associated with higher odds of MI among Hispanics/Latinos. Individual and combined lifestyle risk factors showed stronger associations. Efforts to improve lifestyle behaviors could help prevent MI regardless of genetic susceptibility. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  2. Prediction of Brugia malayi antigenic peptides: candidates for synthetic vaccine design against lymphatic filariasis.

    PubMed

    Gomase, Virendra S; Chitlange, Nikhilkumar R; Changbhale, Smruti S; Kale, Karbhari V

    2013-08-01

    Brugia malayi is a threadlike nematode cause's swelling of lymphatic organs, condition well known as lymphatic filariasis; till date no invention made to effectively address lymphatic filariasis. In this analysis we a have predicted suitable antigenic peptides from Brugia malayi antigen protein for peptide vaccine design against lymphatic filariasis based on cross protection phenomenon as, an ample immune response can be generated with a single protein subunit. We found MHC class II binding peptides of Brugia malayi antigen protein are important determinant against the diseased condition. The analysis shows Brugia malayi antigen protein having 505 amino acids, which shows 497 nonamers. In this assay, we have predicted MHC-I binding peptides for 8mer_H2_Db (optimal score- 15.966), 9mer_H2_Db (optimal score- 15.595), 10mer_H2_Db (optimal score- 19.405), 11mer_H2_Dballeles (optimal score- 23.801). We also predicted the SVM based MHCII-IAb nonamers, 51-FQQIDPLDA, 442-FAAIACLVH, 206-YLNPFGHQF, 167-WYVIMAACY, 367-YAMIVIRLL, 434- LVITTAANF, 176-LDSYCLWKP, 435-VITTAANFA, 364-WPGYAMIVI (optimal score- 13.963); MHCII-IAd nonamers, 52-QQIDPLDAE, 171-MAACYLDSY, 239-QWRSVILCN, 168-YVIMAACYL, 3-QYLSVHSLS, 322-EILLHAKVV, 417- LGIIASFVS, 396-KAIFLAHFG, 167-WYVIMAACY, 269-LALHCINVI, 93-FINKAAPKQ, 259-NCIIVLKAF, 79- QGVLLIIPR, 22-TILQRSQAI, 63-RGFVYGNVS, 109-NISSLAFET,(optimal score- 16.748); and MHCII-IAg7 nonamers 171-MAACYLDSY, 73-KIVNGAQGV, 259-NCIIVLKAF, 209-PFGHQFSFE, 102-SCDTLLKNI, 25-QRSQAIRIV, 444- AIACLVHLF, 88-SLVNGFINK, 252-FPRHQLLNC, 471-RFVLANDNE, 52-QQIDPLDAE, 469-HRRFVLAND, 457- SNRHYFLAD, 362-KSWPGYAMI, 476-NDNEGEDFE, 370-IVIRLLQAL (optimal score- 19.847) which represents potential binders from Brugia malayi antigen protein. The method integrates prediction of MHC class I binding proteasomal C-terminal cleavage peptides and Eighteen potential antigenic peptides at average propensity 1.063 having highest local hydrophilicity. Thus a small antigen fragment can induce immune response against whole antigen. This approach can be applied for designing subunit and synthetic peptide vaccines.

  3. Evaluation of a pretest scoring system (4Ts) for the diagnosis of heparin-induced thrombocytopenia in a university hospital setting.

    PubMed

    Vatanparast, Rodina; Lantz, Sarah; Ward, Kristine; Crilley, Pamela Ann; Styler, Michael

    2012-11-01

    The initial diagnosis of heparin-induced thrombocytopenia (HIT) is made on clinical grounds because the assays with the highest sensitivity (eg, heparin-platelet factor 4 antibody enzyme-linked immunosorbent assay [ELISA]) and specificity (eg, serotonin release assay) may not be readily available. The clinical utility of the pretest scoring system, the 4Ts, was developed and validated by Lo et al in the Journal of Thrombosis and Haemostasis in 2006. The pretest scoring system looks at the degree and timing of thrombocytopenia, thrombosis, and the possibility of other etiologies. Based on the 4T score, patients can be categorized as having a high, intermediate, or low probability of having HIT. We conducted a retrospective study of 100 consecutive patients who were tested for HIT during their hospitalization at Hahnemann University Hospital (Philadelphia, PA) in 2009. Of the 100 patients analyzed, 72, 23, and 5 patients had 4T pretest probability scores of low, intermediate, and high, respectively. A positive HIT ELISA (optical density > 1.0 unit) was detected in 0 of 72 patients (0%) in the low probability group, in 5 of 23 patients (22%) in the intermediate probability group, and in 2 of 5 patients (40%) in the high probability group. The average turnaround time for the HIT ELISA was 4 to 5 days. Fourteen (19%) of the 72 patients with a low pretest probability of HIT were treated with a direct thrombin inhibitor. Ten (71%) of the 14 patients in the low probability group treated with a direct thrombin inhibitor had a major complication of bleeding requiring blood transfusion support. In this retrospective study, a low 4T score showed 100% correlation with a negative HIT antibody assay. We recommend incorporating the 4T scoring system into institutional core measures when assessing a patient with suspected HIT, selecting only patients with intermediate to high probability for therapeutic intervention, which may translate into reduced morbidity and lower health care costs.

  4. Comparison and integration of deleteriousness prediction methods for nonsynonymous SNVs in whole exome sequencing studies

    PubMed Central

    Dong, Chengliang; Wei, Peng; Jian, Xueqiu; Gibbs, Richard; Boerwinkle, Eric; Wang, Kai; Liu, Xiaoming

    2015-01-01

    Accurate deleteriousness prediction for nonsynonymous variants is crucial for distinguishing pathogenic mutations from background polymorphisms in whole exome sequencing (WES) studies. Although many deleteriousness prediction methods have been developed, their prediction results are sometimes inconsistent with each other and their relative merits are still unclear in practical applications. To address these issues, we comprehensively evaluated the predictive performance of 18 current deleteriousness-scoring methods, including 11 function prediction scores (PolyPhen-2, SIFT, MutationTaster, Mutation Assessor, FATHMM, LRT, PANTHER, PhD-SNP, SNAP, SNPs&GO and MutPred), 3 conservation scores (GERP++, SiPhy and PhyloP) and 4 ensemble scores (CADD, PON-P, KGGSeq and CONDEL). We found that FATHMM and KGGSeq had the highest discriminative power among independent scores and ensemble scores, respectively. Moreover, to ensure unbiased performance evaluation of these prediction scores, we manually collected three distinct testing datasets, on which no current prediction scores were tuned. In addition, we developed two new ensemble scores that integrate nine independent scores and allele frequency. Our scores achieved the highest discriminative power compared with all the deleteriousness prediction scores tested and showed low false-positive prediction rate for benign yet rare nonsynonymous variants, which demonstrated the value of combining information from multiple orthologous approaches. Finally, to facilitate variant prioritization in WES studies, we have pre-computed our ensemble scores for 87 347 044 possible variants in the whole-exome and made them publicly available through the ANNOVAR software and the dbNSFP database. PMID:25552646

  5. 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.

  6. Readability, complexity, and suitability analysis of online lymphedema resources.

    PubMed

    Tran, Bao Ngoc N; Singh, Mansher; Lee, Bernard T; Rudd, Rima; Singhal, Dhruv

    2017-06-01

    Over 72% of Americans use online health information to assist in health care decision-making. Previous studies of lymphedema literature have focused only on reading level of patient-oriented materials online. Findings indicate they are too advanced for most patients to comprehend. This, more comprehensive study, expands the previous analysis to include critical elements of health materials beyond readability using assessment tools to report on the complexity and density of data as well as text design, vocabulary, and organization. The top 10 highest ranked websites on lymphedema were identified using the most popular search engine (Google). Website content was analyzed for readability, complexity, and suitability using Simple Measure of Gobbledygook, PMOSE/iKIRSCH, and Suitability Assessment of Materials (SAM), respectively. PMOSE/iKIRSCH and SAM were performed by two independent raters. Fleiss' kappa score was calculated to ensure inter-rater reliability. Online lymphedema literature had a reading grade level of 14.0 (SMOG). Overall complexity score was 6.7 (PMOSE/iKIRSCH) corresponding to "low" complexity and requiring a 8th-12th grade education. Fleiss' kappa score was 80% (P = 0.04, "substantial" agreement). Overall suitability score was 45% (SAM) correlating to the lowest level of "adequate" suitability. Fleiss' kappa score was 76% (P = 0.06, "substantial" agreement). Online resources for lymphedema are above the recommended levels for readability and complexity. The suitability level is barely adequate for the intended audience. Overall, these materials are too sophisticated for the average American adult, whose literacy skills are well documented. Further efforts to revise these materials are needed to improve patient comprehension and understanding. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Prevalence of female sexual dysfunction during pregnancy among Egyptian women.

    PubMed

    Ahmed, Magdy R; Madny, Elham H; Sayed Ahmed, Waleed A

    2014-04-01

    The aim of this study was to assess the prevalence of female sexual dysfunction (FSD) during pregnancy in a sample of women from Egypt. This prospective cohort study was conducted among pregnant women who presented to the Obstetrics Outpatient Clinic - Suez Canal University Hospital for routine antenatal care between February 2012 and February 2013. The 451 women who completed the study attended during their first trimester with a singleton pregnancy and were in a stable relationship with their partners for the last 6 months. Sexual function was assessed using the Female Sexual Function Index (FSFI) questionnaire during the 4 weeks preceding pregnancy and then in each trimester during the antenatal visits. Prevalence of FSD during pregnancy was estimated to be 68.8%. According to the FSFI, scores of all domains and total score were significantly reduced during the whole period of pregnancy (average 22.5 ± 3.7) compared to the pre-conception period (30.5 ± 5.6). However, there was significant increase of all domains and total score during the second trimester (26.6 ± 3.9) in comparison to the first and third trimesters (22.4 ± 4.1 and 18.6 ± 3.8, respectively). Total FSFI score was found to be positively correlated to pre-conception total FSFI score. However, age, parity and duration of marriage were negatively correlated. FSD is a prevalent problem during pregnancy among Egyptian women. The magnitude of the problem is highest during the third trimester while the second trimester represents the peak of sexual function during pregnancy. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.

  8. Screening of alcohol use disorders in psychiatric outpatients: influence of gender, age, and psychiatric diagnosis.

    PubMed

    Sánchez Autet, Mónica; Garriga, Marina; Zamora, Francisco Javier; González, Idilio; Usall, Judith; Tolosa, Leticia; Benítez, Concepción; Puertas, Raquel; Arranz, Belén

    2017-07-14

    Alcohol use disorders (AUD) are 2 times higher among psychiatric patients than in the general population. The under-recognition of this dual diagnosis can entail several negative outcomes. Early assessment with a screening tool like the CAGE questionnaire could be an opportunity to improve patients' prognoses. The objective of this study is to assess AUD risk in an outpatient psychiatric sample with a modified CAGE, considering the influence of age, gender and clinical psychiatric diagnosis. An observational, multicentric, descriptive study was carried out. The 4-item CAGE scale, camouflaged in a healthy lifestyle questionnaire, was implemented, using a cut-off point of one. 559 outpatients were assessed. 54% were female and the average age was 50.07 years. 182 patients presented a CAGE score ≥1 (45.1% of men and 21.9% of women). Gender was the strongest predictor of a positive result in CAGE, as men were 3.03 times more likely to score ≥1 on the CAGE questionnaire (p < .001, 95% CI: 0.22-0.49). Patients with bipolar and personality disorders had the highest rates of CAGE scores ≥1 (45.2 and 44.9%, respectively), with a significant association between diagnosis and a positive score (p = .002). Patients above 60 years were 2.5 times less likely to score ≥1 on the CAGE (p = .017, 95% CI: 0.19-0.85). Specific screening questionnaires, like the CAGE scale, can be an easy and useful tool in the assessment of AUD risk in psychiatric outpatients. Male patients with a bipolar or personality disorder present a higher risk of AUD.

  9. Effect-site concentration of remifentanil during patient-controlled analgesia in labour.

    PubMed

    Jost, A; Blagus, R; Ban, B; Kamenik, M

    2015-08-01

    Intravenous remifentanil has been described for patient-controlled analgesia in labour. Recently, the application of target-controlled infusion pumps with Minto's pharmacokinetic/pharmacodynamic model has been reported. Hypothetical effect-site remifentanil concentration during patient-controlled analgesia for labour has yet to be examined. The aim of this concept study was to explore characteristics of this parameter. We performed a historical cohort study based on our previous randomised cross-over clinical trial and analysed hypothetical effect-site remifentanil concentration. Values at spontaneous vaginal delivery and Apgar scores were tested for correlation. The association between pain score and the corresponding effect-site remifentanil concentration before and after bolus administration, and their relative difference, was examined with a linear mixed-effects model, adjusted for other variables. A series of 23 parturients with uncomplicated singleton pregnancies were included. On average, effect-site remifentanil concentration was highest during the third quarter throughout our recordings (5.5ng/mL; maximum 15.8ng/mL). The mean (median) {IQR} [range] at spontaneous vaginal delivery (n=14) was 2.52 (1.32) {0.95-4.28} [0.65-6.88] ng/mL, all Apgar scores were >7, and no correlation was confirmed. A negative association between effect-site remifentanil concentration before bolus administration and pain score (scale 0-100) was observed (-3.9, 95% CI -5.16 to -2.61, P <0.01). The residual value of hypothetical effect-site remifentanil concentration before uterine contraction, at the beginning of bolus administration, predicted lower pain scores. Monitoring effect-site remifentanil concentration may be potentially useful when remifentanil is administered for labour analgesia. However, our results need to be confirmed with a pharmacokinetic model optimized for pregnant patients. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Impact of intratumoural heterogeneity on the assessment of Ki67 expression in breast cancer.

    PubMed

    Aleskandarany, M A; Green, A R; Ashankyty, I; Elmouna, A; Diez-Rodriguez, M; Nolan, C C; Ellis, I O; Rakha, E A

    2016-07-01

    In breast cancer (BC), the prognostic value of Ki67 expression is well-documented. Intratumoural heterogeneity (ITH) of Ki67 expression is amongst the several technical issues behind the lag of its inclusion into BC prognostic work-up. The immunohistochemical (IHC) expression of anti-Ki67 antibody (MIB1 clone) was assessed in four full-face (FF) sections from different primary tumour blocks and their matched axillary nodal (LN) metastases in a series of 55 BC. Assessment was made using the highest expression hot spots (HS), lowest expression (LS), and overall/average expression scores (AS) in each section. Heterogeneity score (Hes), co-efficient of variation, and correlation co-efficient were used to assess the levels of Ki67 ITH. Ki67 HS, LS, and AS scores were highly variable within the same section and between different sections of the primary tumour, with maximal variation observed in the LS (P < 0.001). The least variability between the different slides was observed with HS scoring. Although the associations between Ki67 and clinicopathological and molecular variables were similar when using HS or AS, the best correlation between AS and HS was observed in tumours with high Ki67 expression only. Ki67 expression in LN deposits was less heterogeneous than in the primary tumours and was perfectly correlated with the HS Ki67 expression in the primary tumour sections (r = 0.98, P < 0.001). In conclusion, assessment of Ki67 expression using HS scoring method on a full-face BC tissue section can represent the primary tumour growth fraction that is likely to metastasise. The association between Ki67 expression pattern in the LN metastasis and the HS in the primary tumour may reflect the temporal heterogeneity through clonal expansion.

  11. i-Assess: Evaluating the impact of electronic data capture for OSCE.

    PubMed

    Monteiro, Sandra; Sibbald, Debra; Coetzee, Karen

    2018-04-01

    Tablet-based assessments offer benefits over scannable-paper assessments; however, there is little known about the impact to the variability of assessment scores. Two studies were conducted to evaluate changes in rating technology. Rating modality (paper vs tablets) was manipulated between candidates (Study 1) and within candidates (Study 2). Average scores were analyzed using repeated measures ANOVA, Cronbach's alpha and generalizability theory. Post-hoc analyses included a Rasch analysis and McDonald's omega. Study 1 revealed a main effect of modality (F (1,152) = 25.06, p < 0.01). Average tablet-based scores were higher, (3.39/5, 95% CI = 3.28 to 3.51), compared with average scan-sheet scores (3.00/5, 95% CI = 2.90 to 3.11). Study 2 also revealed a main effect of modality (F (1, 88) = 15.64, p < 0.01), however, the difference was reduced to 2% with higher scan-sheet scores (3.36, 95% CI = 3.30 to 3.42) compared with tablet scores (3.27, 95% CI = 3.21 to 3.33). Internal consistency (alpha and omega) remained high (>0.8) and inter-station reliability remained constant (0.3). Rasch analyses showed no relationship between station difficulty and rating modality. Analyses of average scores may be misleading without an understanding of internal consistency and overall reliability of scores. Although updating to tablet-based forms did not result in systematic variations in scores, routine analyses ensured accurate interpretation of the variability of assessment scores. This study demonstrates the importance of ongoing program evaluation and data analysis.

  12. Impact of Long-Term Serum Platinum Concentrations on Neuro- and Ototoxicity in Cisplatin-Treated Survivors of Testicular Cancer

    PubMed Central

    Sprauten, Mette; Darrah, Thomas H.; Peterson, Derick R.; Campbell, M. Ellen; Hannigan, Robyn E.; Cvancarova, Milada; Beard, Clair; Haugnes, Hege S.; Fosså, Sophie D.; Oldenburg, Jan; Travis, Lois B.

    2012-01-01

    Purpose Cisplatin-induced neurotoxicity and ototoxicity (NTX) are important adverse effects after chemotherapy for testicular cancer (TC). Although serum platinum is measurable years after therapy, its impact on NTX has not been evaluated. Patients and Methods In all, 169 cisplatin-treated survivors of TC provided blood samples at Survey I and reported NTX during Survey I (1998-2002) and Survey II (2007-2008). Serum platinum was quantified by inductively coupled plasma mass spectrometry. Patient-reported outcomes were evaluated with the Scale for Chemotherapy-Induced Neurotoxicity (SCIN), regarding the extent of symptom bother as 0, “not at all”; 1, “a little”; 2, “quite a bit”; or 3, “very much.” Summing the six symptom scores yielded a total SCIN score of 0 to 18. Categorizing total SCIN scores into quartiles yielded similar-sized groups with increasing symptoms. Multivariate ordinal logistic regression analyses evaluated associations between NTX and long-term serum platinum levels, adjusting for cisplatin dose, dosing schedule, and age. Results At Survey I, a significant four- to five-fold association with total SCIN score emerged for the highest serum platinum quartile (odds ratio [OR], 4.69; 95% CI, 1.82 to 12.08). Paresthesias and Raynaud's syndrome (hands and feet) showed significant two- to four-fold increased risks with the highest platinum quartile. At Survey II, total SCIN score remained significantly associated with the highest platinum quartile (OR, 4.28; 95% CI, 1.36 to 13.48). Paresthesias (hands and feet) and tinnitus showed significant three- to four-fold increased risks for the highest platinum quartile. Cumulative cisplatin dose was not associated with total SCIN score or individual SCIN symptoms in multivariate analyses. Conclusion Here we document a significant relationship between increasing levels of residual serum platinum and NTX severity after adjusting for initial cisplatin dose. PMID:22184390

  13. Vocational interests by gender and race 10 years after spinal cord injury.

    PubMed

    Clark, Jillian M R; Krause, James S

    2017-11-01

    To examine and compare vocational interests as a function of gender and race among 247 participants with spinal cord injury (SCI) approximately 10 years after SCI onset utilizing the 2004 edition of the Strong Interest Inventory (SII). For this cross-sectional analysis nested within a prospective cohort study, data were collected via mail and analyzed at a medical university in the Southeastern United States. Among the 563 adults with traumatic SCI initially enrolled during inpatient rehabilitation at a specialty hospital, 247 met current study eligibility criteria and completed the SII approximately 10 years postinjury. The SII is a 291-item measure of vocational interests. Male participants scored highest on the Realistic theme and females scored highest on the Social theme. White participants scored highest on the Realistic theme, whereas Black participants scored highest on the Conventional theme. Differences in vocational interests by gender were seen on two of the six General Occupational Themes (GOT; Realistic and Social) and 12 of the 30 Basic Interest Scales (BIS). Race differences were observed on the Enterprising and Conventional GOT and 11 of 30 BIS. For both female and Black participants, interests are more physically compatible with employment post-SCI than male and White participants. Yet, employment rates in White males with SCI are greater than those of female and Black individuals with SCI. These data suggest further research on factors influencing gender and racial disparities in employment among those with SCI is indicated. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  14. Medical Students’ Perception of Their Educational Environment

    PubMed Central

    Pai, Preethi G; Menezes, Vishma; Srikanth; Subramanian, Atreya M.; Shenoy, Jnaneshwara P.

    2014-01-01

    Background: Students’ perception of the environment within which they study has shown to have a significant impact on their behavior, academic progress and sense of well-being. This study was undertaken to evaluate the students’ perception of their learning environment in an Indian medical school following traditional curricula and to study differences, if any, between the students according to the stages of medical education, i.e., the pre-clinical and clinical stages. Methodology: In the present study, the Dundee Ready Education Environment Measure (DREEM) inventory was administered to undergraduate medical students of first (n = 227), third (n = 175), fifth (n = 171) and seventh (n = 123) semesters. Scores obtained were expressed as mean ± Standard Deviation (SD) and analyzed using one-way ANOVA and Dunnett’s test. P-value < 0.05 was considered as significant. Results: The mean DREEM score for our medical school was 123/200.The first-year students were found to be more satisfied with learning environment (indicated by their higher DREEM score) compared to other semester students. Progressive decline in scores with each successive semester was observed. Evaluating the sub-domains of perception, the registrars in all semesters had a more positive perception of learning (Average mean score: 29.44), their perception of course organizers moved in the right direction (Average mean score: 26.86), their academic self-perception was more on the positive side (Average mean score: 20.14), they had a more positive perception of atmosphere (Average mean score: 29.07) and their social self-perception could be graded as not too bad (Average mean score: 17.02). Conclusion: The present study revealed that all the groups of students perceived their learning environment positively. However, a few problematic areas of learning environment were perceived such as: students were stressed more often; they felt that the course organizers were authoritarian and emphasized factual learning. Implementing more problem-based learning, student counseling and workshops on teaching-learning for educators might enable us to remedy and enrich our learning environment. PMID:24596737

  15. Counselling on breastfeeding: assessing knowledge and skills.

    PubMed Central

    Rea, M. F.; Venancio, S. I.; Martines, J. C.; Savage, F.

    1999-01-01

    Reported are the results of a randomized controlled trial to assess the effectiveness of the WHO/UNICEF 40-hour course "Breastfeeding counselling: a training course". The course was conducted in a maternity hospital which provides care to a low-income population in a metropolitan area in São Paulo, Brazil. Health workers from 60 health units were randomly assigned to be either participants (20) or controls (40), and their breastfeeding knowledge and skills were assessed before and immediately after the course, as well as 3 months later. Immediately after the course the participants' knowledge of breastfeeding had increased significantly compared to controls. Both their clinical and counselling skills also improved significantly. When assessed 3 months later, the scores remained high with only a small decrease. The implementation of the course was also evaluated. The methods used were participatory observation, key interviews and focus group discussion. In the 33 sessions of the course, the average score was 8.43 out of 10. Scores were highest for content and methodology of the theory sessions, and lowest for "use of time", "clinical management of lactation", and "discussion of clinical practice". "Breastfeeding counselling: a training course" therefore effectively increases health workers' knowledge and their clinical and counselling skills for the support of breastfeeding. The course can be conducted adequately using the material and methodology proposed, but could be more satisfactory if the time allocated to exercises and clinical practice sessions were increased. PMID:10427934

  16. Prevalence of Internalized HIV-Related Stigma Among HIV-Infected Adults in Care, United States, 2011-2013.

    PubMed

    Baugher, Amy R; Beer, Linda; Fagan, Jennifer L; Mattson, Christine L; Freedman, Mark; Skarbinski, Jacek; Shouse, R Luke

    2017-09-01

    HIV-infected U.S. adults have reported internalized HIV-related stigma; however, the national prevalence of stigma is unknown. We sought to determine HIV-related stigma prevalence among adults in care, describe which socio-demographic groups bear the greatest stigma burden, and assess the association between stigma and sustained HIV viral suppression. The Medical Monitoring Project measures characteristics of U.S. HIV-infected adults receiving care using a national probability sample. We used weighted data collected from June 2011 to May 2014 and assessed self-reported internalized stigma based on agreement with six statements. Overall, 79.1% endorsed ≥1 HIV-related stigma statements (n = 13,841). The average stigma score was 2.4 (out of a possible high score of six). White males had the lowest stigma scores while Hispanic/Latina females and transgender persons who were multiracial or other race had the highest. Although stigma was associated with viral suppression, it was no longer associated after adjusting for age. Stigma was common among HIV-infected adults in care. Results suggest individual and community stigma interventions may be needed, particularly among those who are <50 years old or Hispanic/Latino. Stigma was not independently associated with viral suppression; however, this sample was limited to adults in care. Examining HIV-infected persons not in care may elucidate stigma's association with viral suppression.

  17. Multidimensional fatigue in pulmonary hypertension: prevalence, severity and predictors.

    PubMed

    Tartavoulle, Todd M; Karpinski, Aryn C; Aubin, Andrew; Kluger, Benzi M; Distler, Oliver; Saketkoo, Lesley Ann

    2018-01-01

    Pulmonary hypertension is a potentially fatal disease. Despite pharmacological advances in pulmonary hypertension, fatigue remains common in patients with pulmonary hypertension. A convenience sample of 120 participants at an international patient conference completed the Multidimensional Fatigue Inventory (MFI)-20 scale. Data on New York Heart Association Functional Class, body mass index, oxygen use and medication type/use were also collected. There was a high prevalence of "severe" to "very severe" fatigue for each dimension: General Fatigue (60%), Physical Fatigue (55.8%), Reduced Activity (41.7%), Reduced Motivation (32.5%) and Mental Fatigue (27.5%). The mean±sd overall MFI-20 score was 58±5.1. Dimensions with the highest averaged levels were General Fatigue (13.40±3.61), Physical Fatigue (13.23±3.67) and Reduced Activity (11.33±4.16). Body mass index correlated with higher fatigue scores. Phosphodiesterase inhibitor plus endothelin receptor antagonist combination negatively predicted General Fatigue, Physical Fatigue, Reduced Motivation and Reduced Activity. Triple therapy was a significant predictor of General Fatigue, Physical Fatigue and Reduced Activity. There were no significant predictors of Mental Fatigue. Multidimensional fatigue is common and severe in patients with pulmonary hypertension. Phosphodiesterase inhibitor plus endothelin receptor antagonist combination resulted in lower scores in most fatigue dimensions. Comprehensive assessment of fatigue should be considered in the clinical care of patients with pulmonary hypertension and clinical research to develop formal interventions that target this disabling symptom.

  18. Early prediction of intensive care unit-acquired weakness using easily available parameters: a prospective observational study.

    PubMed

    Wieske, Luuk; Witteveen, Esther; Verhamme, Camiel; Dettling-Ihnenfeldt, Daniela S; van der Schaaf, Marike; Schultz, Marcus J; van Schaik, Ivo N; Horn, Janneke

    2014-01-01

    An early diagnosis of Intensive Care Unit-acquired weakness (ICU-AW) using muscle strength assessment is not possible in most critically ill patients. We hypothesized that development of ICU-AW can be predicted reliably two days after ICU admission, using patient characteristics, early available clinical parameters, laboratory results and use of medication as parameters. Newly admitted ICU patients mechanically ventilated ≥2 days were included in this prospective observational cohort study. Manual muscle strength was measured according to the Medical Research Council (MRC) scale, when patients were awake and attentive. ICU-AW was defined as an average MRC score <4. A prediction model was developed by selecting predictors from an a-priori defined set of candidate predictors, based on known risk factors. Discriminative performance of the prediction model was evaluated, validated internally and compared to the APACHE IV and SOFA score. Of 212 included patients, 103 developed ICU-AW. Highest lactate levels, treatment with any aminoglycoside in the first two days after admission and age were selected as predictors. The area under the receiver operating characteristic curve of the prediction model was 0.71 after internal validation. The new prediction model improved discrimination compared to the APACHE IV and the SOFA score. The new early prediction model for ICU-AW using a set of 3 easily available parameters has fair discriminative performance. This model needs external validation.

  19. Health knowledge, attitude and practice among Iranian pilgrims.

    PubMed

    Tabatabaei, Aminreza; Mortazavi, Seyyed Mostafa; Shamspour, Navvab; Shushtarizadeh, Naser

    2015-02-01

    Iran has the highest number of Umrah pilgrims among Islamic countries. Health care plays a major role in fulfilling the Umrah rites. Pilgrims' health situation depends on their health knowledge, attitude, and practice (KAP). In this study, we aimed to determine the health KAP among Iranian Umrah pilgrims. In this cross-sectional study, 157 Iranian Umrah pilgrims were randomly selected in Mecca, Saudi Arabia in June 2011. Data were collected using a questionnaire. The questionnaire consisted of demographic information (sex, age, degree of education, and resource of health knowledge), health knowledge (5 questions), health attitude (5 questions) and health practice (10 questions). Level of knowledge were very low in 12.1%, low in 25.2%, average in 38.1%, good in 20.4% and very good in 4.2% of respondents. Mean and standard deviation of attitude score was 18.58 ± 2.20 out of 25 (ranged between 13.00 and 25.00). The pilgrims were given 74.2 % out of total score. The Mean and standard deviation of practice score was 8.19 ± 1.32 out of 10 (ranged between 3 and 10). Although the old and low educated pilgrims had little knowledge of health tips, they had a good health attitude and practice. Educational strategy to improve knowledge regarding health-related problems and to develop health practices among pilgrims is needed.

  20. State Test Score Trends through 2008-09, Part 1: Rising Scores on State Tests and NAEP. Nevada

    ERIC Educational Resources Information Center

    Center on Education Policy, 2010

    2010-01-01

    This paper profiles Nevada's test score trends through 2008-09. Between 2005 and 2009, the percentages of students reaching the proficient level on the state test and the basic level on NAEP increased in grade 8 reading and math. Average annual gains were larger on the state test than on NAEP in both subjects. Trends in average (mean) test scores…

  1. Analysis of 2009-10 WCPSS SAT Scores. Measuring Up. E&R Report No. 10.25

    ERIC Educational Resources Information Center

    Holdzkom, David; Gilleland, Kevin

    2010-01-01

    Wake County Public School System (WCPSS) students continue to fare well on the SAT test as compared with students in the state and nation. While there was a decline in average test scores in 2009-10 as compared with the prior year, the posted scores continue a trend of measurable improvement over time. Over the past 20 years, the average SAT…

  2. Collaborative learning and testing in introductory general chemistry

    NASA Astrophysics Data System (ADS)

    Amaral, Katie Elizabeth

    Students taking General chemistry at the University of Florida are either well-prepared or under-prepared. To meet the needs of the under-prepared students, an introductory course (CHM 1025) was developed. An accurate method of placement into CHM 1025 or the mainstream course (CHM 2045) was needed. The Chemistry Readiness Assessment Exam was written and tested and students are advised to take either course based upon their scores. The accuracy of the cutoff scores was examined, with the minimum passing chemistry score lowered to six correct out of 18, and the math score raised to six correct out of eight. Collaborative problem-solving sessions were held during every CHM 1025 class. These sessions were shown to increase student achievement in CHM 1025. Group placement was also shown to have an effect on student achievement in the course. Students placed randomly into collaborative groups had the highest average GPA, while students placed by achievement had the lowest average GPA. The efficacy of CHM 1025 was examined to determine if the students who required the course do as well in CHM 2045 as those students who did not need it. Students who had taken CHM 1025 had a higher GPA in CHM 2045 than the students who went directly into CHM 2045. Students in the spring semester of 2004 took collaborative exams. Achievement levels of students who had collaborative exams were compared to students who took traditional exams to determine if collaborative testing had an effect on student achievement and retention in CHM 1025. There was no significant difference in achievement although the collaborative exams were harder. Percentages of students taking each exam were also compared, with more students taking the collaborative exams. Finally, undergraduate students called peer mentors, who had taken CHM 1025, were recruited to assist with the course. Mentors helped CHM 1025 students with the collaborative problems. The mentors' presence helped lower students' withdrawal rates in the class. The mentors also benefited from the program, as evidenced by their higher GPA in CHM 2045.

  3. A 2-year study of Gram stain competency assessment in 40 clinical laboratories.

    PubMed

    Goodyear, Nancy; Kim, Sara; Reeves, Mary; Astion, Michael L

    2006-01-01

    We used a computer-based competency assessment tool for Gram stain interpretation to assess the performance of 278 laboratory staff from 40 laboratories on 40 multiple-choice questions. We report test reliability, mean scores, median, item difficulty, discrimination, and analysis of the highest- and lowest-scoring questions. The questions were reliable (KR-20 coefficient, 0.80). Overall mean score was 88% (range, 63%-98%). When categorized by cell type, the means were host cells, 93%; other cells (eg, yeast), 92%; gram-positive, 90%; and gram-negative, 88%. When categorized by type of interpretation, the means were other (eg, underdecolorization), 92%; identify by structure (eg, bacterial morphologic features), 91%; and identify by name (eg, genus and species), 87%. Of the 6 highest-scoring questions (mean scores, > or = 99%) 5 were identify by structure and 1 was identify by name. Of the 6 lowest-scoring questions (mean scores, < 75%) 5 were gram-negative and 1 was host cells. By type of interpretation, 2 were identify by structure and 4 were identify by name. Computer-based Gram stain competency assessment examinations are reliable. Our analysis helps laboratories identify areas for continuing education in Gram stain interpretation and will direct future revisions of the tests.

  4. The discriminatory capability of existing scores to predict advanced colorectal neoplasia: a prospective colonoscopy study of 5,899 screening participants.

    PubMed

    Wong, Martin C S; Ching, Jessica Y L; Ng, Simpson; Lam, Thomas Y T; Luk, Arthur K C; Wong, Sunny H; Ng, Siew C; Ng, Simon S M; Wu, Justin C Y; Chan, Francis K L; Sung, Joseph J Y

    2016-02-03

    We evaluated the performance of seven existing risk scoring systems in predicting advanced colorectal neoplasia in an asymptomatic Chinese cohort. We prospectively recruited 5,899 Chinese subjects aged 50-70 years in a colonoscopy screening programme(2008-2014). Scoring systems under evaluation included two scoring tools from the US; one each from Spain, Germany, and Poland; the Korean Colorectal Screening(KCS) scores; and the modified Asia Pacific Colorectal Screening(APCS) scores. The c-statistics, sensitivity, specificity, positive predictive values(PPVs), and negative predictive values(NPVs) of these systems were evaluated. The resources required were estimated based on the Number Needed to Screen(NNS) and the Number Needed to Refer for colonoscopy(NNR). Advanced neoplasia was detected in 364 (6.2%) subjects. The German system referred the least proportion of subjects (11.2%) for colonoscopy, whilst the KCS scoring system referred the highest (27.4%). The c-statistics of all systems ranged from 0.56-0.65, with sensitivities ranging from 0.04-0.44 and specificities from 0.74-0.99. The modified APCS scoring system had the highest c-statistics (0.65, 95% C.I. 0.58-0.72). The NNS (12-19) and NNR (5-10) were similar among the scoring systems. The existing scoring systems have variable capability to predict advanced neoplasia among asymptomatic Chinese subjects, and further external validation should be performed.

  5. Diet quality is associated with obesity and hypertension in Australian adults: a cross sectional study.

    PubMed

    Livingstone, Katherine M; McNaughton, Sarah A

    2016-10-01

    Poor diet, characterized by a low diet quality score, has been associated with greater prevelence of obesity and hypertension. However, the evidence is inconsistent across diet quality scores and by sex. The aim was to investigate the relationship between diet quality and obesity and hypertension. Adults (n = 4908; age 45.2 ± 0.24 years) were included from the cross-sectional Australian Health Survey 2011-2013. Two 24-h dietary recalls were used to derive the dietary guideline index (DGI) and recommended food score (RFS). Logistic regression investigated relationships between diet quality score and odds ratio of obesity, hypertension and obesity-associated hypertension. In the highest tertile of DGI, but not RFS, individuals were less likely to be obese (men: OR 0.64, CI: 0.45, 0.92, P-trend = 0.014; women: 0.68, 0.48, 0.96, P-trend = 0.025) and to have central adiposity (men: 0.68, 0.48, 0.97, P-trend = 0.030; women: 0.53, 0.37, 0.77, P-trend = 0.001) compared with the lowest tertile. Men, but not women, in the highest tertile of DGI and RFS were less likely to be hypertensive (DGI: 0.56, 0.37, 0.85, P-trend = 0.006; RFS: 0.62, 0.41, 0.94, P-trend = 0.021) compared with the lowest tertile. In men with obesity, but not normal weight men or women, those in the highest tertile of DGI were less likely to be hypertensive (0.53, 0.36, 0.78, P-trend = 0.001) compared with the highest tertile. Higher diet quality, as estimated using DGI, was associated with lower odds ratio of obesity in men and women. Odds ratio of hypertension was lower in men, but not women, with a high diet quality score compared with a low score, while obesity-associated hypertension was only associated with diet quality score in men with obesity. Longitudinal studies are needed to evaluate whether diet quality predicts risk of obesity and hypertension.

  6. Effect of knee osteoarthritis on the perception of quality of life in Venezuelan patients.

    PubMed

    Chacón, José G; González, Nancy E; Véliz, Aleida; Losada, Benito R; Paul, Hernando; Santiago, Luís G; Antúnez, Ana; Finol, Yelitza; González, María E; Granados, Isabel; Maldonado, Irama; Maldonado, Teolinda; Marín, Francisco; Zambrano, Gisela; Rodríguez, Martín A

    2004-06-15

    To measure the perception of quality of life in Venezuelan patients with knee osteoarthritis and to identify those variables that may influence it. A multicenter, cross-sectional study of 126 mestizo patients with knee osteoarthritis recruited from 8 rheumatology centers in Venezuela. We used a Spanish-translated version of the Arthritis Impact Measurement Scales (AIMS), as adapted in Venezuela. One-way analysis of variance was used to compare the AIMS mean total score among subgroups of knee pain, anatomic stage, and socioeconomic status (SES); a post-hoc test was performed to identify significant intragroup differences. Pearson's correlation coefficient was used to examine correlations between age, body mass index (BMI), disease duration, knee pain, and AIMS score. Associations between radiologic stage, SES, and AIMS scores were examined using Spearman's rank correlation. Multiple regression analysis was used to estimate predictor factors of AIMS scores. A significant correlation was found between total AIMS scores and knee pain, age, and socioeconomic status, but not with BMI, disease duration, or anatomic stage. Patients with severe knee pain differed from those with mild and moderate pain, and the highest AIMS mean total score was seen in patients within the severe knee pain subset. Patients in the highest socioeconomic levels differed from those within lowest categories. Patients classified as being at the levels of relative and critical poverty showed the highest AIMS scores. Multiple regression analysis showed that knee pain was the only variable that exerted an independent effect on the quality of life in our patients. The perception of quality of life is negatively affected by increasing levels of joint pain, old age, and low socioeconomic status in Venezuelan patients with knee osteoarthritis. Our study supports the need for an early and vigorous approach to treat pain in this group of patients.

  7. Clinical practice guidelines in hypertension: a review.

    PubMed

    Álvarez-Vargas, Mayita Lizbeth; Galvez-Olortegui, José Kelvin; Galvez-Olortegui, Tomas Vladimir; Sosa-Rosado, José Manuel; Camacho-Saavedra, Luis Arturo

    2015-10-23

    The aim of this study is the methodological evaluation of Clinical Practice Guidelines (CPG) in hypertension. This is the first in a series of review articles, analysis, assessment in methodology and content of clinical practice guidelines in Cardiology. Of all clinical practice guidelines, three were selected and the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument was used to assess each guide. The guidelines obtained the lowest score in the domain of applicability (mean 43.8%); while the highest score was for clarity of presentation (mean 81.5%). The lowest percentage was found in the applicability domain (European guideline) and the highest of all scores was found in two domains: scope and purpose, and clarity of presentation (Canadian guideline). Assessing the quality of the clinical practice guidelines analyzed, the Canadian is one with the best scores obtained by applying the AGREE II instrument, and it is advised to be used without modifications.

  8. Quality of online health information about oral contraceptives from Hebrew-language websites.

    PubMed

    Neumark, Yehuda; Flum, Lior; Lopez-Quintero, Catalina; Shtarkshall, Ronny

    2012-09-24

    The Internet is a frequently used source of health information. Adolescents in particular seem to be receptive to online health information (OHI) and often incorporate such information in their decision-making processes. Yet, OHI is often incomplete, inaccurate, or unreliable. This study assessed the quality of Hebrew online (non-user-generated) content on oral contraceptives (OC), with regard to accuracy/completeness, credibility, and usability. Twenty-nine websites in Hebrew, including those of the four Israeli HMOs, were identified and evaluated. The websites were categorized as: HMO, health portal, contraception-specific, promotional-commercial, and life style and women's health. A set of established content parameters was selected by a family planning expert to assess accuracy/completeness. The Health on the Net Foundation Code of Conduct (HONcode) principles were used to assess the websites' reliability. Usability was assessed by applying items selected from the Minervation Validation and the University of Michigan's 'Website Evaluation checklist' scale. Mean scores, standard deviations (SD), and ranges were calculated for all websites and for category-specific websites. Correlation between dimensions and Inter-rater reliability were also examined. The mean score for accuracy/completeness was 50.9% for all websites (SD=30.1%, range 8-100%). Many websites failed to provide complete information, or provided inaccurate information regarding what to do when a pill is missed and when to use back-up methods. The average credibility score for all websites was 70.6% (SD=15.1, range=38=98%). The credibility parameters that were most commonly absent were funding source, authoring, date of content creation and last modification, explicit reference to evidence-based information, and references and citations. The average usability score for all websites was 94.5% (SD=6.9%, range 79-100%). A weak correlation was found between the three quality parameters assessed. Wide variation was noted in the quality of Hebrew-language OC websites. HMOs' websites scored highest on credibility and usability, and contraceptive-specific websites exhibited the greatest accuracy/completeness. The findings highlight the need to establish quality guidelines for health website content, train health care providers in assisting their patients to seek high quality OHI, and strengthen e-health literacy skills among online-information seekers, including perhaps health professionals.

  9. Predicting the admission into medical school of African American college students who have participated in summer academic enrichment programs.

    PubMed

    Hesser, A; Cregler, L L; Lewis, L

    1998-02-01

    To identify cognitive and noncognitive variables as predictors of the admission into medical school of African American college students who have participated in summer academic enrichment programs (SAEPs). The study sample comprised 309 African American college students who participated in SAEPs at the Medical College of Georgia School of Medicine from 1980 to 1989 and whose educational and occupational statuses were determined by follow-up tracking. A three-step logistic regression was used to analyze the data (with alpha = .05); the criterion variable was admission to medical school. The 17 predictor variables studied were one of two types, cognitive and noncognitive. The cognitive variables were (1) Scholastic Aptitude Test mathematics (SAT-M) score, (2) SAT verbal score, (3) college grade-point average (GPA), (4) college science GPA, (5) SAEP GPA, and (6) SAEP basic science GPA (BSGPA). The noncognitive variables were (1) gender, (2) highest college level at the time of the last SAEP application, (3) type of college attended (historically African American or predominately white), (4) number of SAEPs attended, (5) career aspiration (physician or another health science option) (6) parents who were professionals, (7) parents who were health care role models, (8) evidence of leadership, (9) evidence of community service, (10) evidence of special motivation, and (11) strength of letter of recommendation in the SAEP application. For each student the rating scores for the last four noncognitive variables were determined by averaging the ratings of two judges who reviewed relevant information in each student's file. In step 1, which explained 20% of the admission decision variance, SAT-M score, SAEP BSGPA, and college GPA were the three significant cognitive predictors identified. In step 2, which explained 31% of the variance, the three cognitive predictors identified in step 1 were joined by three noncognitive predictors: career aspiration, type of college, and number of SAEPs attended. In step 3, which explained 29% of the variance, two cognitive variables (SAT-M score and SAEP BSGPA) and two noncognitive variables (career aspiration and strength of recommendation letter) were identified. The results support the concept of using both cognitive and noncognitive variables when selecting African American students for pre-medical school SAEPs.

  10. Quality of online health information about oral contraceptives from Hebrew-language websites

    PubMed Central

    2012-01-01

    Background The Internet is a frequently used source of health information. Adolescents in particular seem to be receptive to online health information (OHI) and often incorporate such information in their decision-making processes. Yet, OHI is often incomplete, inaccurate, or unreliable. This study assessed the quality of Hebrew online (non-user-generated) content on oral contraceptives (OC), with regard to accuracy/completeness, credibility, and usability. Methods Twenty-nine websites in Hebrew, including those of the four Israeli HMOs, were identified and evaluated. The websites were categorized as: HMO, health portal, contraception-specific, promotional-commercial, and life style and women’s health. A set of established content parameters was selected by a family planning expert to assess accuracy/completeness. The Health on the Net Foundation Code of Conduct (HONcode) principles were used to assess the websites’ reliability. Usability was assessed by applying items selected from the Minervation Validation and the University of Michigan’s ′Website Evaluation checklist′ scale. Mean scores, standard deviations (SD), and ranges were calculated for all websites and for category-specific websites. Correlation between dimensions and Inter-rater reliability were also examined. Results The mean score for accuracy/completeness was 50.9% for all websites (SD=30.1%, range 8–100%). Many websites failed to provide complete information, or provided inaccurate information regarding what to do when a pill is missed and when to use back–up methods. The average credibility score for all websites was 70.6% (SD=15.1, range=38=98%). The credibility parameters that were most commonly absent were funding source, authoring, date of content creation and last modification, explicit reference to evidence-based information, and references and citations. The average usability score for all websites was 94.5% (SD=6.9%, range 79–100%). A weak correlation was found between the three quality parameters assessed. Conclusions Wide variation was noted in the quality of Hebrew-language OC websites. HMOs’ websites scored highest on credibility and usability, and contraceptive-specific websites exhibited the greatest accuracy/completeness. The findings highlight the need to establish quality guidelines for health website content, train health care providers in assisting their patients to seek high quality OHI, and strengthen e-health literacy skills among online-information seekers, including perhaps health professionals. PMID:23006798

  11. Tobacco control environment: cross-sectional survey of policy implementation, social unacceptability, knowledge of tobacco health harms and relationship to quit ratio in 17 low-income, middle-income and high-income countries

    PubMed Central

    Corsi, Daniel J; Gilmore, Anna B; Kruger, Annamarie; Igumbor, Ehimario; Chifamba, Jephat; Yang, Wang; Wei, Li; Iqbal, Romaina; Mony, Prem; Gupta, Rajeev; Vijayakumar, Krishnapillai; Mohan, V; Kumar, Rajesh; Rahman, Omar; Yusoff, Khalid; Ismail, Noorhassim; Zatonska, Katarzyna; Altuntas, Yuksel; Rosengren, Annika; Bahonar, Ahmad; Yusufali, AfzalHussein; Dagenais, Gilles; Lear, Scott; Diaz, Rafael; Avezum, Alvaro; Lopez-Jaramillo, Patricio; Lanas, Fernando; Rangarajan, Sumathy; Teo, Koon; McKee, Martin; Yusuf, Salim

    2017-01-01

    Objectives This study examines in a cross-sectional study ‘the tobacco control environment’ including tobacco policy implementation and its association with quit ratio. Setting 545 communities from 17 high-income, upper-middle, low-middle and low-income countries (HIC, UMIC, LMIC, LIC) involved in the Environmental Profile of a Community's Health (EPOCH) study from 2009 to 2014. Participants Community audits and surveys of adults (35–70 years, n=12 953). Primary and secondary outcome measures Summary scores of tobacco policy implementation (cost and availability of cigarettes, tobacco advertising, antismoking signage), social unacceptability and knowledge were associated with quit ratios (former vs ever smokers) using multilevel logistic regression models. Results Average tobacco control policy score was greater in communities from HIC. Overall 56.1% (306/545) of communities had >2 outlets selling cigarettes and in 28.6% (154/539) there was access to cheap cigarettes (<5cents/cigarette) (3.2% (3/93) in HIC, 0% UMIC, 52.6% (90/171) LMIC and 40.4% (61/151) in LIC). Effective bans (no tobacco advertisements) were in 63.0% (341/541) of communities (81.7% HIC, 52.8% UMIC, 65.1% LMIC and 57.6% LIC). In 70.4% (379/538) of communities, >80% of participants disapproved youth smoking (95.7% HIC, 57.6% UMIC, 76.3% LMIC and 58.9% LIC). The average knowledge score was >80% in 48.4% of communities (94.6% HIC, 53.6% UMIC, 31.8% LMIC and 35.1% LIC). Summary scores of policy implementation, social unacceptability and knowledge were positively and significantly associated with quit ratio and the associations varied by gender, for example, communities in the highest quintile of the combined scores had 5.0 times the quit ratio in men (Odds ratio (OR) 5·0, 95% CI 3.4 to 7.4) and 4.1 times the quit ratio in women (OR 4.1, 95% CI 2.4 to 7.1). Conclusions This study suggests that more focus is needed on ensuring the tobacco control policy is actually implemented, particularly in LMICs. The gender-related differences in associations of policy, social unacceptability and knowledge suggest that different strategies to promoting quitting may need to be implemented in men compared to women. PMID:28363924

  12. The ESMO-Magnitude of Clinical Benefit Scale for novel oncology drugs: correspondence with three years of reimbursement decisions in Israel.

    PubMed

    Hammerman, Ariel; Greenberg-Dotan, Sari; Feldhamer, Ilan; Birnbaum, Yair; Cherny, Nathan I

    2018-02-01

    The European Society for Medical Oncology published in 2015 its Magnitude of Clinical Benefit Scale (ESMO-MCBS) for cancer medicines. Our objective was to evaluate the association between Israel's national reimbursement decisions regarding novel cancer drugs, prior to the availability of ESMO-MCBS, and the later published ESMO-MCBS scores. ESMO-MCBS scores were obtained retrospectively for the cancer drugs that were candidates for reimbursement in Israel in 2013-2015 and were categorized to 'highest benefit' (ESMO-MCBS 4-5 or A) 'medium benefit' (3 or B) and 'lowest benefit' (0-2 or C). The reimbursement decisions were accessed and compared with the categorized ESMO scores. ESMO-MCBS score was available for 19/22 drugs approved for reimbursement and 15/16 non-approved drugs. 58% of the approved drugs gained a 'highest benefit' score and 37% were 'medium benefit'. 87% of the non-approved drugs had 'lowest benefit' scores. Median score for approved drugs was 4 vs. 1 for the non-approved (p < 0.05). The Israeli decisions regarding reimbursement of novel cancer drugs, demonstrated concordance with ESMO-MCBS scores. Incorporation of ESMO-MCBS data in reimbursement deliberations could assist in framing the appropriate use of the limited resources to deliver effective and affordable cancer care.

  13. Predictive value of the APACHE II, SAPS II, SOFA and GCS scoring systems in patients with severe purulent bacterial meningitis.

    PubMed

    Pietraszek-Grzywaczewska, Iwona; Bernas, Szymon; Łojko, Piotr; Piechota, Anna; Piechota, Mariusz

    2016-01-01

    Scoring systems in critical care patients are essential for predicting of the patient outcome and evaluating the therapy. In this study, we determined the value of the Acute Physiology and Chronic Health Evaluation II (APACHE II), Simplified Acute Physiology Score II (SAPS II), Sequential Organ Failure Assessment (SOFA) and Glasgow Coma Scale (GCS) scoring systems in the prediction of mortality in adult patients admitted to the intensive care unit (ICU) with severe purulent bacterial meningitis. We retrospectively analysed data from 98 adult patients with severe purulent bacterial meningitis who were admitted to the single ICU between March 2006 and September 2015. Univariate logistic regression identified the following risk factors of death in patients with severe purulent bacterial meningitis: APACHE II, SAPS II, SOFA, and GCS scores, and the lengths of ICU stay and hospital stay. The independent risk factors of patient death in multivariate analysis were the SAPS II score, the length of ICU stay and the length of hospital stay. In the prediction of mortality according to the area under the curve, the SAPS II score had the highest accuracy followed by the APACHE II, GCS and SOFA scores. For the prediction of mortality in a patient with severe purulent bacterial meningitis, SAPS II had the highest accuracy.

  14. Predicting Long-Term College Success through Degree Completion Using ACT[R] Composite Score, ACT Benchmarks, and High School Grade Point Average. ACT Research Report Series, 2012 (5)

    ERIC Educational Resources Information Center

    Radunzel, Justine; Noble, Julie

    2012-01-01

    This study compared the effectiveness of ACT[R] Composite score and high school grade point average (HSGPA) for predicting long-term college success. Outcomes included annual progress towards a degree (based on cumulative credit-bearing hours earned), degree completion, and cumulative grade point average (GPA) at 150% of normal time to degree…

  15. Lung transplantation in the most critically-III: forging ahead.

    PubMed

    Mulvihill, Michael S; Hartwig, Matthew G; Daneshmand, Mani A

    2017-09-01

    Lung transplantation is the gold standard therapy for patients with end-stage lung disease. The use of the lung allocation score (LAS) has permitted improved allocation of scarce pulmonary allografts. Recently, Crawford et al. examined the experience in the United States in lung transplantation in candidates with the highest LAS, demonstrating that outcomes for candidates with the highest LAS scores have improved significantly. This editorial places these data in the broader context of thoracic transplantation, and highlights the critical need for ongoing examination of this critically-ill patient population.

  16. A Correlational Study on Cerebral Microbleeds and Carotid Atherosclerosis in Patients with Ischemic Stroke.

    PubMed

    Zhao, Fang-Fang; Gao, Hao-Yuan; Gao, Yuan; Zhao, Zhuan; Li, Juan; Ning, Fang-Bo; Zhang, Xin-Na; Wang, Zhi-Gao; Yu, Ai-Ling; Guo, Yan-Yong; Sun, Bao-Liang

    2018-05-11

    This study aimed to investigate the correlation between cerebral microbleeds and carotid atherosclerosis in patients with ischemic stroke. Patients with ischemic stroke treated in a hospital in China from 2016 to 2017 were enrolled in the study. Based on the results from susceptibility-weighted imaging, the patients were divided into cerebral microbleed and noncerebral microbleed groups. The degree of carotid atherosclerosis was assessed with carotid intima-media thickness (CIMB) and Crouse score of carotid plaque. The details of patients' demographic information, cerebrovascular disease-related risk factors, carotid atherosclerosis indices, cerebral microbleed distribution, and grading were recorded, compared, and analyzed. Logistic regression analysis of the 198 patients showed that CIMB and Crouse score were significantly correlated with the occurrence of cerebral microbleeds. The CIMB thickening group (P = .03) and the plaque group (P = .01) were more susceptible to cerebral microbleeds. In the distribution of cerebral microbleed sites, Crouse scores were the highest in the mixed group and showed a statistically significant difference (P < .01). As the degree of carotid atherosclerosis increased, the average number of cerebral microbleeds also increased (P < .01). The receiver operating characteristic curve analysis of the carotid atherosclerosis indices showed a statistically significant difference. The CIMB value combined with the Crouse score was the best indicator (P < .01). In patients with ischemic stroke, cerebral microbleeds are closely related to carotid atherosclerosis. Active control of carotid atherosclerosis is important to prevent cerebral microbleeds in patients with ischemic stroke. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  17. Subjective Mental Workload and Its Correlation With Musculoskeletal Disorders in Bank Staff.

    PubMed

    Darvishi, Ebrahim; Maleki, Afshin; Giahi, Omid; Akbarzadeh, Arash

    2016-01-01

    The purpose of this study was to evaluate the rate of subjective mental workload (SMWL) and its correlation with musculoskeletal disorders among bank staff members in Kurdistan Province located in western Iran. This cross-sectional study was conducted among 200 bank staff members in Kurdistan Province, Iran. The mental workload was assessed using the National Aeronautics and Space Administration-Task Load Index (NASA-TLX) computerized version. NASA-TLX is a multidimensional rating procedure that derives an overall workload score based on a weighted average of ratings on 6 subscales. These subscales include Mental Demands, Physical Demands, Temporal Demands, Performance, Effort, Effectiveness, and Frustration. The musculoskeletal disorders (MSDs) were documented with the Nordic Musculoskeletal Questionnaire and generic body diagram. Of the staff members, 78.5% experienced pain at least once during the past year in 1 of their 9 musculoskeletal body regions. The highest frequencies of pain were in the neck and lower back. The NASA-TLX estimated the Effort and Performance scales with mean ± SD of 72.8 ± 25.2 and 36 ± 22.6, respectively, as the maximal and minimal scores among the 6 subscales of SMWL. The statistical analysis of the data revealed that there was a significant correlation between the overall mental workload score and also among the 6 subscales of SMWL separately with MSDs (P < .05). SMWL appears to be a risk factor in the incidence of MSDs, so that the odds of MSDs increased by 11% with each additional 1-point increase in SMWL score. Copyright © 2016. Published by Elsevier Inc.

  18. Hypercortisolemia is associated with severity of bone loss and depression in hypothalamic amenorrhea and anorexia nervosa.

    PubMed

    Lawson, Elizabeth A; Donoho, Daniel; Miller, Karen K; Misra, Madhusmita; Meenaghan, Erinne; Lydecker, Janet; Wexler, Tamara; Herzog, David B; Klibanski, Anne

    2009-12-01

    Anorexia nervosa (AN) and functional hypothalamic amenorrhea (HA) are associated with low bone density, anxiety, and depression. Women with AN and HA have elevated cortisol levels. Significant hypercortisolemia, as in Cushing's disease, causes bone loss. It is unknown whether anxiety and depression and/or cortisol dysregulation contribute to low bone density in AN or HA. Our objective was to investigate whether hypercortisolemia is associated with bone loss and mood disturbance in women with HA and AN. We conducted a cross-sectional study in a clinical research center. We studied 52 women [21 healthy controls (HC), 13 normal-weight women with functional HA, and 18 amenorrheic women with AN]. Serum samples were measured every 20 min for 12 h overnight and pooled for average cortisol levels. Bone mineral density (BMD) was assessed by dual-energy x-ray absorptiometry (DXA) at anteroposterior and lateral spine and hip. Hamilton Rating Scales for Anxiety (HAM-A) and Depression (HAM-D) were administered. BMD was lower in AN and HA than HC at all sites and lower in AN than HA at the spine. On the HAM-D and HAM-A, AN scored higher than HA, and HA scored higher than HC. Cortisol levels were highest in AN, intermediate in HA, and lowest in HC. HAM-A and HAM-D scores were associated with decreased BMD. Cortisol levels were positively associated with HAM-A and HAM-D scores and negatively associated with BMD. Hypercortisolemia is a potential mediator of bone loss and mood disturbance in these disorders.

  19. Identity development in adolescents with mental problems

    PubMed Central

    2013-01-01

    Background In the revision of the Diagnostic and Statistical Manual (DSM-5), “Identity” is an essential diagnostic criterion for personality disorders (self-related personality functioning) in the alternative approach to the diagnosis of personality disorders in Section III of DSM-5. Integrating a broad range of established identity concepts, AIDA (Assessment of Identity Development in Adolescence) is a new questionnaire to assess pathology-related identity development in healthy and disturbed adolescents aged 12 to 18 years. Aim of the present study is to investigate differences in identity development between adolescents with different psychiatric diagnoses. Methods Participants were 86 adolescent psychiatric in- and outpatients aged 12 to 18 years. The test set includes the questionnaire AIDA and two semi-structured psychiatric interviews (SCID-II, K-DIPS). The patients were assigned to three diagnostic groups (personality disorders, internalizing disorders, externalizing disorders). Differences were analyzed by multivariate analysis of variance MANOVA. Results In line with our hypotheses, patients with personality disorders showed the highest scores in all AIDA scales with T>70. Patients with externalizing disorders showed scores in an average range compared to population norms, while patients with internalizing disorders lay in between with scores around T=60. The AIDA total score was highly significant between the groups with a remarkable effect size of f= 0.44. Conclusion Impairment of identity development differs between adolescent patients with different forms of mental disorders. The AIDA questionnaire is able to discriminate between these groups. This may help to improve assessment and treatment of adolescents with severe psychiatric problems. PMID:23899433

  20. Patients with lower activation associated with higher costs; delivery systems should know their patients' 'scores'.

    PubMed

    Hibbard, Judith H; Greene, Jessica; Overton, Valerie

    2013-02-01

    Patient activation is a term that describes the skills and confidence that equip patients to become actively engaged in their health care. Health care delivery systems are turning to patient activation as yet another tool to help them and their patients improve outcomes and influence costs. In this article we examine the relationship between patient activation levels and billed care costs. In an analysis of 33,163 patients of Fairview Health Services, a large health care delivery system in Minnesota, we found that patients with the lowest activation levels had predicted average costs that were 8 percent higher in the base year and 21 percent higher in the first half of the next year than the costs of patients with the highest activation levels, both significant differences. What's more, patient activation was a significant predictor of cost even after adjustment for a commonly used "risk score" specifically designed to predict future costs. As health care delivery systems move toward assuming greater accountability for costs and outcomes for defined patient populations, knowing patients' ability and willingness to manage their health will be a relevant piece of information integral to health care providers' ability to improve outcomes and lower costs.

  1. [Characteristics and determinants of informal care in chronic diseases in Hungary: a comparative analysis].

    PubMed

    Beretzky, Zsuzsanna; Péntek, Márta

    2017-12-01

    Informal care plays an important role in ageing societies. To analyse informal care use and its determinants among patients with chronic diseases in Hungary. Patient level data from previous studies in 14 diagnoses were analysed including patients' EQ-5D-3L health status. Descriptive statistics were performed and a linear regression model was built to analyse determinants of informal care time. 2047 patients (female: 58%) with mean age of 58.9 (SD = 16.3) years and EQ-5D-3L index score of 0.64 (SD = 0.33) were involved. 27% received informal care, the average time of care was 7.54 (SD = 26.36) hours/week. Both the rate of informal care use and its time differed significantly between the diagnoses (p<0.05), the highest were in dementia, Parkinsons' disease and in chronic inflammatory immunological diseases. Significant determinants were age, EQ-5D-3L scores, gender and certain diagnosis dummys (R 2 = 0.111). Informal care use is significant in chronic debilitating conditions. Future studies are encouraged to reveal unmet needs, preferences and further explanatory factors. Orv Hetil. 2017; 158(52): 2068-2078.

  2. Cognitive Behavioral Therapy for insomnia with Veterans: evaluation of effectiveness and correlates of treatment outcomes.

    PubMed

    Trockel, Mickey; Karlin, Bradley E; Taylor, C Barr; Manber, Rachel

    2014-02-01

    This paper examines the effectiveness of Cognitive Behavioral Therapy for insomnia (CBT-I) in Veterans and the effects of two process measures on CBT-I outcomes: 1) therapist ratings of patient adherence and 2) patient ratings of therapeutic alliance. Data are from 316 therapists in the Department of Veterans Affairs CBT-I Training Program and 696 patients receiving CBT-I from therapists undergoing training. Mixed effects model results indicate Insomnia Severity Index scores decreased from 20.7 at baseline to 10.9 (d = 2.3) during a typical course of CBT-I. Patients with highest tercile compared to those with lowest tercile adherence achieved, on average, 4.1 points greater reduction in ISI scores (d = 0.95). The effect of therapeutic alliance on change in insomnia severity was not significant after adjusting for adherence to CBT-I. These results support the effectiveness and feasibility of large-scale training in and implementation of CBT-I and indicate that greater focus on patient adherence may lead to enhanced outcomes. The current findings suggest that CBT-I therapists and training programs place greater emphasis on attending to and increasing patient adherence. Published by Elsevier Ltd.

  3. Desire for autonomy in health care decisions: a general population survey.

    PubMed

    Cullati, Stéphane; Courvoisier, Delphine S; Charvet-Bérard, Agathe I; Perneger, Thomas V

    2011-04-01

    To examine factors associated with desire for autonomy in health care decisions in the general population. Mailed survey of 2348 residents of Geneva, Switzerland. Participants answered questions on a scale measuring their desire for autonomy in health care decisions. The scale was scored between 0 (lowest desire for autonomy) and 100 (highest desire for autonomy). On average the respondents favoured shared or active involvement in medical decisions (mean score 62.0, SD 20.9), but attitudes varied considerably. In the multivariate model, factors associated with a higher desire for autonomy included female gender, younger age, higher education, living alone, reporting an excellent global health and - a new observation compared to previous studies - having made several medical decisions in the past 6 months. The attitudes of the general public appear to be consistent with the model of shared decision making. However, people vary considerably in their desire for autonomy. An explicit assessment of each individual's desire for autonomy may improve the decision-making process. Such an assessment should be repeated regularly, as familiarity with medical decisions may increase the desire for autonomy. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  4. Usability analysis of indoor map application in a shopping centre

    NASA Astrophysics Data System (ADS)

    Dewi, R. S.; Hadi, R. K.

    2018-04-01

    Although indoor navigation is still new in Indonesia, its future development is very promising. Similar to the outdoor one, the indoor navigation technology provides several important functions to support route and landmark findings. Furthermore, there is also a need that indoor navigation can support the public safety especially during disaster evacuation process in a building. It is a common that the indoor navigation technologies are built as applications where users can access this technology using their smartphones, tablets, or personal computers. Therefore, a usability analysis is important to ensure the indoor navigation applications can be operated by users with highest functionality. Among several indoor map applications which were available in the market, this study chose to analyse indoor Google Maps due to its availability and popularity in Indonesia. The experiments to test indoor Google Maps was conducted in one of the biggest shopping centre building in Surabaya, Indonesia. The usability was measured by employing System Usability Scale (SUS) questionnaire. The result showed that the SUS score of indoor Google Maps was below the average score of other cellular applications to indicate the users still had high difficulty in operating and learning the features of indoor Google Maps.

  5. IQ variations across time, race, and nationality: an artifact of differences in literacy skills.

    PubMed

    Marks, David F

    2010-06-01

    A body of data on IQ collected over 50 years has revealed that average population IQ varies across time, race, and nationality. An explanation for these differences may be that intelligence test performance requires literacy skills not present in all people to the same extent. In eight analyses, population mean full scale IQ and literacy scores yielded correlations ranging from .79 to .99. In cohort studies, significantly larger improvements in IQ occurred in the lower half of the IQ distribution, affecting the distribution variance and skewness in the predicted manner. In addition, three Verbal subscales on the WAIS show the largest Flynn effect sizes and all four Verbal subscales are among those showing the highest racial IQ differences. This pattern of findings supports the hypothesis that both secular and racial differences in intelligence test scores have an environmental explanation: secular and racial differences in IQ are an artifact of variation in literacy skills. These findings suggest that racial IQ distributions will converge if opportunities are equalized for different population groups to achieve the same high level of literacy skills. Social justice requires more effective implementation of policies and programs designed to eliminate inequities in IQ and literacy.

  6. Environmental contamination in an Australian mining community and potential influences on early childhood health and behavioural outcomes.

    PubMed

    Dong, Chenyin; Taylor, Mark Patrick; Kristensen, Louise Jane; Zahran, Sammy

    2015-12-01

    Arsenic, cadmium and lead in aerosols, dusts and surface soils from Australia's oldest continuous lead mining town of Broken Hill were compared to standardised national childhood developmental (year 1) and education performance measures (years 3,5,7,9). Contaminants close to mining operations were elevated with maximum lead levels in soil: 8900 mg/kg; dust wipe: 86,061 μg/m(2); dust deposition: 2950 μg/m(2)/day; aerosols: 0.707 μg/m(3). The proportion of children from Broken Hill central, the area with the highest environmental contamination, presented with vulnerabilities in two or more developmental areas at 2.6 times the national average. Compared with other school catchments of Broken Hill, children in years 3 and 5 from the most contaminated school catchment returned consistently the lowest educational scores. By contrast, children living and attending schools associated with lower environmental contamination levels recorded higher school scores and lower developmental vulnerabilities. Similar results were identified in Australia's two other major lead mining and smelting cities of Port Pirie and Mount Isa. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. An Evaluation on Iran International Public Health Summer School in Relation to its Efficacy Based on Participants' Experience and Opinions.

    PubMed

    Parnia, Aidin; Yamani, Nikoo; Zamani, Ahmadreza; Badihian, Shervin; Manouchehri, Navid; Fakhri, Maryam

    2017-01-01

    A serious challenge to educate health staff for public health is to appear encouraging enough to persuade them for learning issues on this field and implementing new educational methods and innovative ways. Iran International Public Health Summer School (IPHS) made an effort to provide medical sciences students with a fortune to get familiar with and involved in public health. This study intended to evaluate the efficacy of this event. This cross-sectional study was performed in March-April 2015 by the help of an electronic self-administered questionnaire filled out by 49 Iranian participants 6 months after IPHS2014. The questionnaire assessed the main goals in seven main domains: Interest, activities, and general knowledge in the field of public health, general skills, educational methods, educational and executive schedules, and general satisfaction. Average scores of all domains were >3 (the mean), and all were statistically significant. The highest average score belonged to educational methods (3.92) and the lowest was calculated for the item regarding participants' activities on public health (3.5). No significant difference was found between positive answers of individuals who were interested or active in public health prior to the event and those who had no background. We believe IPHS was a unique instance in Public Health Education in Iran. Considering the level of success of this program to reach its goals for both students' with or without any previous background on public health, it is recommended as a general model to be simulated in other developing countries.

  8. Retrospective Assessment of Occupational Exposures for the GENEVA Study of ALS among Military Veterans

    PubMed Central

    Woskie, Susan R.; Gore, Rebecca; Sandler, Dale P.; Schmidt, Silke; Kamel, Freya

    2017-01-01

    Abstract Objective: This paper describes the retrospective exposure assessment conducted to assess occupational exposures for the Genes and Environmental Exposures in Veterans (GENEVA) study, a case–control study investigating the joint contribution of genetics and environmental exposures to the risk of amyotrophic lateral sclerosis (ALS) among military veterans. Methods: Occupational histories for 1597 study participants collected as part of the GENEVA study were the basis for this retrospective exposure assessment. The data set included 15528 jobs held from 1924 to 2010, representing 4539 unique industry and occupation (I&O) combinations. Three industrial hygiene experts were recruited to independently rate occupational exposures to specific agents previously associated with an increased risk of ALS. Utilizing information on industry, job title, tasks performed, and materials used for each job held, raters assigned exposures associated with each I&O for the ‘current time’ defined as the period after 1995 (post-1995). The exposure assessment targeted agents identified as potential occupational risk factors for ALS. Experts rated semi-quantitatively exposure intensity in five exposure categories (0–4) for Group A agents (lead, formaldehyde, hydrocarbon solvents, and chlorinated solvents) and qualitatively as yes/no (1/0) exposed for Group B agents (mercury, selenium, arsenic, polychlorinated biphenyls, electromagnetic field, pesticides, and viral agents). Confidence scores (0–3) were reported for every I&O rated based on raters’ experience with that industry and/or job. Each I&O was assigned an average exposure score of the raters and an alternative exposure rating was developed for each I&O by excluding low confidence (<2) scores before averaging. Exposure reconstruction for jobs held pre-1995 was done by comparing exposure data extracted from the OSHA Chemical Exposure and Health Database (CEHD) during pre-1995 and post-1995. For agents with limited exposure data in the CEHD, pre-1995 exposures were determined based on raters’ judgment. Results: The proportion of I&O combinations determined to be ‘exposed’ ranged from 0.1 to 26% across different agents, with the highest values corresponding to hydrocarbon solvents and the lowest to selenium. Industries with the highest proportion of exposed records include manufacturing, utilities, healthcare, and military with non-combat jobs. Analyses for raters’ reliability showed the best agreement between the raters when rating exposure to viral agents (kappa = 0.67), hydrocarbon solvents (kappa = 0.53), and lead (kappa = 0.50). The proportion of ‘exposed’ I&O combinations increased for hydrocarbon solvents, chlorinated solvents, and pesticides when exposure ratings were adjusted by raters’ confidence. Compared to post-1995, exposures in the earlier period (pre-1995) were deemed higher or the same for most of the agents and lower for formaldehyde and electromagnetic field exposures. Conclusions: Our results indicate that using raters’ confidence assessment in determining exposure scores increases both the proportion of I&O combinations regarded as exposed and the intensity scores, suggesting raters tend to be conservative in their assessment when they lack detailed knowledge of an industry or job. PMID:28355414

  9. Youth Sport-Related Concussions: Perceived and Measured Baseline Knowledge of Concussions Among Community Coaches, Athletes, and Parents.

    PubMed

    Nanos, Katherine N; Franco, John M; Larson, Dirk; Mara, Kristin; Laskowski, Edward R

    2017-12-01

    To assess concussion knowledge of athletes, coaches, and parents/guardians in a community setting and to understand trends/gaps in knowledge among subgroups to tailor efforts toward creating educational interventions. This prospective cross-sectional study involved 262 individuals (142 [55%] female): 115 athletes participating in noncontact and contact sports (ages 13-19 years), 15 coaches, and 132 parents. Recruitment occurred from August 30, 2015, through August 30, 2016, at 3 local high schools. Participants completed a questionnaire developed by the investigators to assess concussion experience and basic knowledge. Females, health care employees, and parents showed stronger concern for potential long-term sequelae of concussion, whereas athletes were most concerned about not being able to return to sport. Those with higher perceived concussion knowledge were slightly older (median age, 42.5 vs 33 years), more educated (college or higher: 42 [70%] vs 100 [50%]), and more likely to be health care workers (22 [37.9%] vs 34 [17.7%]) and scored higher on knowledge questions (average correct: 75.5% vs 60%). Most participants could identify potential concussion sequelae, but only 86 (34.3%) identified a concussion as a brain injury. Of the subgroups, coaches scored highest on knowledge questions. Those with a concussion history tended to consider themselves more knowledgeable but were also less concerned about sequelae. Overall, those with a concussion history scored slightly higher on knowledge questions (average correct: 69.8% vs 61.9%). Participants involved in contact sports were more likely to have had a concussion vs those in noncontact sports (57 [26%] vs 4 [10.3%]). Significant differences in perceived and actual concussion knowledge across different subgroups of study participants involved in high school sports were identified. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  10. Lactate Parameters Predict Clinical Outcomes in Patients with Nonvariceal Upper Gastrointestinal Bleeding.

    PubMed

    Lee, Seung Hoon; Min, Yang Won; Bae, Joohwan; Lee, Hyuk; Min, Byung Hoon; Lee, Jun Haeng; Rhee, Poong Lyul; Kim, Jae J

    2017-11-01

    The predictive role of lactate in patients with nonvariceal upper gastrointestinal bleeding (NVUGIB) has been suggested. This study evaluated several lactate parameters in terms of predicting outcomes of bleeding patients and sought to establish a new scoring model by combining lactate parameters and the AIMS65 score. A total of 114 patients with NVUGIB who underwent serum lactate level testing at least twice and endoscopic hemostasis within 24 hours after admission were retrospectively analyzed. The associations between five lactate parameters and clinical outcomes were evaluated and the predictive power of lactate parameter combined AIMS65s (L-AIMS65s) and AIMS56 scoring was compared. The most common cause of bleeding was gastric ulcer (48.2%). Lactate clearance rate (LCR) was associated with 30-day rebleeding (odds ratio [OR], 0.931; 95% confidence interval [CI], 0.872-0.994; P = 0.033). Initial lactate (OR, 1.313; 95% CI, 1.050-1.643; P = 0.017), maximal lactate (OR, 1.277; 95% CI, 1.037-1.573; P = 0.021), and average lactate (OR, 1.535; 95% CI, 1.137-2.072; P = 0.005) levels were associated with 30-day mortality. Initial lactate (OR, 1.213; 95% CI, 1.027-1.432; P = 0.023), maximal lactate (OR, 1.271; 95% CI, 1.074-1.504; P = 0.005), and average lactate (OR, 1.501; 95% CI, 1.150-1.959; P = 0.003) levels were associated with admission over 7 days. Although L-AIMS65s showed the highest area under the curve for prediction of each outcome, differences between L-AIMS65s and AIMS65 did not reach statistical significance. In conclusion, lactate parameters have a prognostic role in patients with NVUGIB. However, they do not increase the predictive power of AIMS65 when combined. © 2017 The Korean Academy of Medical Sciences.

  11. Use of the Measure of Processes of Care (MPOC-20) to evaluate health service delivery for children with cerebral palsy and their families in Jordan: validation of Arabic-translated version (AR-MPOC-20).

    PubMed

    Saleh, M; Almasri, N A

    2014-09-01

    Family-centred service (FCS) is widely accepted now as best practice in paediatric rehabilitation. The Measure of Processes of Care-20 items set (MPOC-20) is a valid and reliable self-report measure of parents' perceptions of the extent to which health services are family-centred. Arabic-translated and validated version of the MPOC-20 (AR-MPOC-20) is used to examine Jordanian families' perception of service providers' caregiving behaviours as they receive rehabilitation services for their children with cerebral palsy (CP). Parents of 114 children with CP who are receiving services at different settings in Jordan were interviewed using the AR-MPOC-20. Participating children aged 4.1 ± 4.4 years, 53.5% were males. Children varied across gross motor functional classification system (GMFCS). Parents were mostly mothers (76.3%), with at least high school education (71.9%). Factor analyses of the AR-MPOC-20 yielded a five-factor solution with items loaded differently from the original measure. All items correlated best and significantly with their own Arabic scale score (rs: 0.91-0.26, P < 0.01). Internal consistency values of AR-MPOC-20 scales were acceptable (Cronbach's α: 0.69-0.82). Scale 'Providing Written Information' has the lowest average score (1.9 ± 1.6), while scale 'Respectful & Coordinated Care' has the highest average score (5.2 ± 1.5). The AR-MPOC-20 is found to be a valid and reliable measure for use with Arabic-Jordanian families of children with CP. FCS is not yet well implemented in Jordan, with parents reporting more need for information about their children's health and available services. Service providers are encouraged to apply FCS in paediatric rehabilitation, and giving more attention to effective communication and information exchange with families. AR-MPOC-20 is recommended for use for program evaluation.

  12. Middle School Student Factors as Predictors of College Readiness

    ERIC Educational Resources Information Center

    Karnick, Kelley

    2013-01-01

    In this study, several middle school factors of students from two consecutive graduating classes were analyzed to determine what relation they had to college readiness, as measured by ACT subtest scores. The academic factors included: 8th grade EXPLORE composite score, 7th grade spring reading and math MAP scores, highest math course completed in…

  13. 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.

  14. Written Comments Made by Anesthesia Residents When Providing Below Average Scores for the Supervision Provided by the Faculty Anesthesiologist.

    PubMed

    Dexter, Franklin; Szeluga, Debra; Masursky, Danielle; Hindman, Bradley J

    2016-06-01

    Anesthesia residents in our department evaluate the supervision provided by the faculty anesthesiologist with whom they worked the previous day. What advice managers can best provide to the faculty who receive below-average supervision scores is unknown. The residents provided numerical answers (1 "never," 2 "rarely," 3 "frequently," or 4 "always") to each of the 9 supervision questions, resulting in a total supervision score. A written comment could also be provided. Over 2.5 years, the response rate to requests for evaluation was 99.1%. There were 13,664 evaluations of 76 faculty including 1387 comments. There were 25 evaluations with a comment of disrespectful behavior. For all 25, the question evaluating whether "the faculty treated me respectfully" was answered <4 (i.e., not "always"). The supervision scores were less than for the other evaluations with comments (P < 0.0001). Each increase in the faculty's number of comments of being disrespectful was associated with a lesser mean score (P = 0.0002). A low supervision score (<3.00; i.e., less than "frequent") had an odds ratio of 85 for disrespectful faculty behavior (P < 0.0001). The predictive value of the supervision score not being low for absence of a comment of disrespectful behavior was 99%. That finding was especially useful because 94% of scores below average (<3.80) were not low (≥3.00). There were 6 evaluations with a comment of insufficient faculty presence. Those evaluations had lesser scores than the other evaluations with comments (P < 0.0001). The 6 faculty with 1 such comment had lesser mean scores than the other faculty (P = 0.0071). There were 34 evaluations with a comment about poor-quality teaching. The evaluations related to poor teaching had lesser scores than the other evaluations with comments (P < 0.0001). The faculty who each received such a comment had lesser mean scores than the other faculty (P < 0.0001). Each increase in the faculty's number of comments of poor-quality teaching was associated with a lesser mean score (P = 0.0002). The 9 supervision questions were internally consistent (Cronbach α = 0.948). A faculty with a comment about poor-quality teaching had significant odds of also having a comment about insufficient presence (P = 0.0044). A comment with negative sentiment had significant odds of being about poor-quality teaching rather than being about insufficient presence (odds ratio, 6.00; P < 0.0001). A faculty who has insufficient presence cannot be providing good teaching. Furthermore, there was negligible correlation between supervision scores and faculty clinical assignments. Thus, insufficient faculty presence accounted for a small proportion of below-average supervision scores and low-quality supervision. Furthermore, scores ≥3 have a predictive value for the absence of disrespectful behavior ≅99%. Approximately 94% of the faculty supervision scores that were below average were still ≥3. Consequently, for the vast majority of the faculty-resident-days, quality of teaching distinguished between below- versus above-average supervision scores. This result is consistent with our prior finding of a strong correlation between 6-month supervision scores and assessments of teaching effectiveness. Taken together, when individual faculty anesthesiologists are counseled about their clinical supervision scores, the attribute to emphasize is quality of clinical teaching.

  15. Predicting occupational personality test scores.

    PubMed

    Furnham, A; Drakeley, R

    2000-01-01

    The relationship between students' actual test scores and their self-estimated scores on the Hogan Personality Inventory (HPI; R. Hogan & J. Hogan, 1992), an omnibus personality questionnaire, was examined. Despite being given descriptive statistics and explanations of each of the dimensions measured, the students tended to overestimate their scores; yet all correlations between actual and estimated scores were positive and significant. Correlations between self-estimates and actual test scores were highest for sociability, ambition, and adjustment (r = .62 to r = .67). The results are discussed in terms of employers' use and abuse of personality assessment for job recruitment.

  16. Half-peroneus-longus-tendon graft augmentation for unqualified hamstring tendon graft of anterior cruciate ligament reconstruction.

    PubMed

    Liu, Chung-Ting; Lu, Yung-Chang; Huang, Chang-Hung

    2015-09-01

    In some situations, harvested hamstring tendon grafts are not qualified for anterior cruciate ligament (ACL) reconstruction. This study aimed to present a reinforcing method with additional half peroneus longus tendon (half-PLT) graft augmentation. Eight cases underwent ACL reconstruction with unqualified hamstring tendon grafts (diameter <7 mm) and were salvaged by additional half-PLT graft augmentation. The pivot shift test and KT-1000 tests were performed 3 years after surgery. Functional evaluation of subjective International Knee Documentation Committee (IKDC) and Lysholm scores was also done. In addition, Foot and Ankle Disability Index (FADI) scores were used to evaluate the function of the ankle donor site. The diameter of unqualified four-strand hamstring tendon grafts was 6.2 mm on average (range, 6.0-6.5 mm). The average diameter of hamstring grafts with half-PLT augmentation was 9.6 mm (range, 9.5-10.0 mm). The pivot shift test was negative in all patients. No significant differences between normal and abnormal knees were found by KT-1000. The average IKDC score was 86.0 (range, 83 to 89), and the average Lysholm score was 84.4 (range, 80-90). The average FADI score for the donor sites of half-PLT was 135.8 (range, 134-136). Additional half-PLT can successfully and safely reinforce unqualified hamstring tendon grafts for ACL reconstruction.

  17. An examination of anxiety levels of nursing students caring for patients in terminal period

    PubMed Central

    Sancar, Behire; Yalcin, Ayse Saba; Acikgoz, Inci

    2018-01-01

    Objective: To investigate the anxiety levels of the nursing students who are caring for the patients in the terminal period and to determine whether there is a difference between 3rd, 4th grade in this direction. Methods: A 40-item “State and Trait Anxiety Scale” was used together with the questionnaire on “Determining the Level of Anxiety Levels of Nursing Students Caring for the Patient at the Terminal Period” for determining the data. Results: The mean scores and standard deviations of all students from the state and trait anxiety scales were respectively 41.95±5.06, 48.15±5.44. Averages of 3rd state anxiety scale score was 42.03 ± 5.26, trait anxiety scale averages were 48.08 ± 5.59; Averages of 4th state anxiety scale score was 41.85 ± 4.83, trait anxiety scale averages were 48.24 ± 5.30. Conclusion: In our study, it was found that there wasn't significant difference between the 3rd, 4th grade students related to ill patient care in terms of high level of state and trait anxiety during communication and patient care. The state and trait anxiety scores of the students in both grades were found to be higher than the average scores of the scale's previous applications. PMID:29643886

  18. Clinical use of the ABO-Scoring Index: reliability and subtraction frequency.

    PubMed

    Lieber, William S; Carlson, Sean K; Baumrind, Sheldon; Poulton, Donald R

    2003-10-01

    This study tested the reliability and subtraction frequency of the study model-scoring system of the American Board of Orthodontists (ABO). We used a sample of 36 posttreatment study models that were selected randomly from six different orthodontic offices. Intrajudge and interjudge reliability was calculated using nonparametric statistics (Spearman rank coefficient, Wilcoxon, Kruskal-Wallis, and Mann-Whitney tests). We found differences ranging from 3 to 6 subtraction points (total score) for intrajudge scoring between two sessions. For overall total ABO score, the average correlation was .77. Intrajudge correlation was greatest for occlusal relationships and least for interproximal contacts. Interjudge correlation for ABO score averaged r = .85. Correlation was greatest for buccolingual inclination and least for overjet. The data show that some judges, on average, were much more lenient than others and that this resulted in a range of total scores between 19.7 and 27.5. Most of the deductions were found in the buccal segments and most were related to the second molars. We present these findings in the context of clinicians preparing for the ABO phase III examination and for orthodontists in their ongoing evaluation of clinical results.

  19. 160 W 800 fs Yb:YAG single crystal fiber amplifier without CPA.

    PubMed

    Markovic, Vesna; Rohrbacher, Andreas; Hofmann, Peter; Pallmann, Wolfgang; Pierrot, Simonette; Resan, Bojan

    2015-10-05

    We demonstrate a compact and simple two-stage Yb:YAG single crystal fiber amplifier which delivers 160 W average power, 800 fs pulses without chirped pulse amplification. This is the highest average power of femtosecond laser based on SCF. Additionally, we demonstrate the highest small signal gain of 32.5 dB from the SCF in the first stage and the highest extraction efficiency of 42% in the second stage. The excellent performance of the second stage was obtained using the bidirectional pumping scheme, which is applied to SCF for the first time.

  20. Value of the SYNTAX score for periprocedural myocardial infarction according to WHO and the third universal definition of myocardial infarction: insights from the TWENTE trial.

    PubMed

    Tandjung, Kenneth; Lam, Ming Kai; Sen, Hanim; de Man, Frits H A F; Louwerenburg, J Hans W; Stoel, Martin G; van Houwelingen, K Gert; Linssen, Gerard C M; van der Palen, Job; Doggen, Carine J M; von Birgelen, Clemens

    2016-07-20

    The SYNTAX score is a tool to quantify the complexity of coronary artery disease. We investigated the relation between the SYNTAX score and the occurrence of a periprocedural myocardial infarction (PMI) according to the historical definition of the World Health Organization (WHO) and the recently updated universal definition of MI. The SYNTAX score was calculated in 1,243 patients enrolled in TWENTE, a randomised trial which assessed second-generation drug-eluting stents. PMI was defined by the WHO definition and the third universal definition of MI. Patients were divided into tertiles of the SYNTAX score: ≤7 (n=430); >7 and <15 (n=390); ≥15 (n=423). PMI according to the WHO definition occurred more frequently in patients in the highest SYNTAX score tertile (7.3% vs. 3.1% vs. 1.6%, p<0.001) compared to the mid and lowest tertile. Similar findings were seen for universal PMI (9.9% vs. 7.7% vs. 3.7%, p<0.01). After multivariate analysis, SYNTAX score was a significant independent correlate of PMI for both definitions: the highest SYNTAX score tertile had an almost five times higher risk for WHO PMI, and a three times higher risk for universal PMI. In a broad patient population treated with second-generation DES, the SYNTAX score was able to stratify the risk of PMI.

  1. Assessing pharmacy residents' knowledge of biostatistics and research study design.

    PubMed

    Bookstaver, P Brandon; Miller, April D; Felder, Tisha M; Tice, Danielle L; Norris, LeAnn B; Sutton, S Scott

    2012-01-01

    Historically, clinicians have demonstrated a lack of confidence and poor aptitude for biostatistics as a tool for medical literature interpretation. Evaluation of pharmacy residents' ability to interpret biostatistics commonly used in peer-reviewed literature has not been previously conducted. To evaluate the level of understanding and perception of biostatistics concepts among pharmacy residents. A survey of postgraduate year 1 (PGY1) residents in American Society of Health-System Pharmacists-accredited residency programs was conducted in May 2009. The survey instrument consisted of 27 items, including 10 knowledge-based questions, and was distributed to residency programs for anonymous reporting via SurveyMonkey. The primary outcome of interest was biostatistics knowledge, defined as the percent total score of correct knowledge items. Statistical attitude and confidence questions were rated on a 5-point Likert-type scale (1 = strongly disagree, 5 = strongly agree). The t-test or 1-way analysis of variance was conducted, as appropriate, to assess for differences in mean biostatistics knowledge scores by respondent characteristics. Forward stepwise regression was used to identify which characteristics were independently associated with biostatistics knowledge. A total of 214 PGY1 residents responded to the online survey assessment, and a subset of respondents (n = 166) answered 1 or more of the biostatistics knowledge questions. Of those who responded to at least 1 knowledge assessment, the overall mean (SD) biostatistics knowledge score was 47.3% (18.50%; range 0-90). Overall, respondents were predominantly female (74%) and younger than 30 years (81%). Residents scored highest in the recognition of the purpose of a double-blind study (92.6%; 95% CI 88.52 to 96.67), interpretation of relative risk (75.8%; 95% CI 69.02 to 82.57), and identification of the appropriate analytic method for a nominal variable (69.4%; 95% CI 62.16 to 76.59). Bivariate analyses showed that there were statistically significant mean differences in knowledge scores by attitude (p = 0.001) and confidence (p < 0.001). The multivariate model showed that above-average confidence ratings were associated with an absolute increase of 7.6% in biostatistics knowledge score (p < 0.019) compared to those whose confidence rating was at or below average. Overall, pharmacy residents' perception and understanding of biostatistics were poor in this assessment, which correlates with previous reports. Enhanced training in biostatistics and literature evaluation of both mentors and trainees should be incorporated in PharmD programs and residency training sites.

  2. Large-Scale Evaluation of Quality of Care in 6 Countries of Eastern Europe and Central Asia Using Clinical Performance and Value Vignettes.

    PubMed

    Peabody, John W; DeMaria, Lisa; Smith, Owen; Hoth, Angela; Dragoti, Edmond; Luck, Jeff

    2017-09-27

    A significant determinant of population health outcomes is the quality of care provided for noncommunicable diseases, obstetric, and pediatric care. We present results on clinical practice quality in these areas as measured among nearly 4,000 providers working at more than 1,000 facilities in 6 Eastern European and Central Asian countries. This study was conducted between March 2011 and April 2013 in Albania, Armenia, Georgia, Kazakhstan, Kirov Province in Russia, and Tajikistan. Using a probability proportional-to-size sampling technique, based on number of hospital beds, we randomly selected within each country 42 hospitals and their associated primary health care clinics. Physicians and midwives within each clinical area of interest were randomly selected from each hospital and clinic and asked how they would care for simulated patients using Clinical Performance and Value (CPV) vignettes. Facility administrators were also asked to complete a facility survey to collect structural measures of quality. CPV vignettes were scored on a scale of 0% to 100% for each provider. We used descriptive statistics and t tests to identify significant differences in CPV scores between hospitals and clinics and rural vs. urban facilities, and ANOVA to identify significant differences in CPV scores across countries. We found that quality of care, as concurrently measured by performance on CPV vignettes, was generally poor and widely variable within and between countries. Providers in Kirov Province, Russia, had the highest overall performance, with an average score of 70.8%, while providers in Albania and Tajikistan had the lowest average score, each at 50.8%. The CPV vignettes with the lowest scores were for multiple noncommunicable disease risk factors and birth asphyxia. A considerable proportion (11%) of providers performed well on the CPV vignettes, regardless of country, facility, or structural resources available to them. Countries of Eastern Europe and Central Asia are challenged by poor performance as measured by clinical care vignettes, but there is potential for provision of high-quality care by a sizable proportion of providers. Large-scale assessments of quality of care have been hampered by the lack of effective measurement tools that provide generalizable and reliable results across diverse economic, cultural, and social settings. The feasibility of quality measurement using CPV vignettes in these 6 countries and the ability to combine results with individual feedback could significantly enhance strategies to improve quality of care, and ultimately population health. © Peabody et al.

  3. Low agreement of visual rating for detailed quantification of pulmonary emphysema in whole-lung CT.

    PubMed

    Mascalchi, Mario; Diciotti, Stefano; Sverzellati, Nicola; Camiciottoli, Gianna; Ciccotosto, Cesareo; Falaschi, Fabio; Zompatori, Maurizio

    2012-02-01

    Multidetector spiral computed tomography (CT) has opened the possibility of quantitative evaluation of emphysema extent in the whole lung. Visual assessment can be used for such a purpose, but its reproducibility has not been established. To assess agreement of detailed assessment of pulmonary emphysema on whole-lung CT using a visual scale. Thirty patients with chronic obstructive pulmonary disease underwent whole-lung inspiratory CT. Four chest radiologists rated the same 22 ± 2 thin sections using a visual scale which defines a range of emphysema extent between 0 and 100. Two of them repeated the rating two months later. Inter- and intra-operator agreement was evaluated with the Bland and Altman method. In addition, the percentage of emphysema at -950 Hounsfield units in the whole lung was determined using fully automated commercially available software for 3D densitometry. In three of six operator pairs and in one of two intra-operator pairs the Kendall τ test showed a significant correlation between the difference and the average magnitude of visual scores. Among different operators the half-width of 95% limits of agreement (95% LoA) was wide ranging between a score of 14.2-27.7 for an average visual score of 20 and between 18.5-36.8 for an average visual score of 80. Within the same operator the half-width of 95% LoA ranged between a score of 10.9-21.0 for an average visual score of 20 and between 25.1-30.1 for an average visual score of 80. The visual scores of the four radiologists were correlated with the results of densitometry (P < 0.001; r = 0.65-0.81). The inter- and intra-operator agreement of detailed assessment of emphysema in the whole lung using a visual scale is low and decreases with increasing emphysema extent.

  4. A practical 3D printed simulator for endoscopic endonasal transsphenoidal surgery to improve basic operational skills.

    PubMed

    Wen, Guodao; Cong, ZiXiang; Liu, KaiDong; Tang, Chao; Zhong, Chunyu; Li, Liwen; Dai, XuJie; Ma, Chiyuan

    2016-06-01

    We aimed to present a practical three-dimensional (3D) printed simulator to comprehensively and effectively accelerate the learning curve of endoscopic endonasal transsphenoidal surgery (EETS). The 3D printed simulator consists of three parts: (1) skull frame, (2) the nasal passage and the nasal alar of the face, and (3) a modified sella turcica. We aimed to improve three basic operational skills of surgeons: drilling, curetting, and aspirating. Eighteen neurosurgeons and five post-graduates were recruited and consented for the training. For trainees, (1) as the training progressed, the scores increased gradually, (2) a significant increase in the average scores was observed in the tenth training compared to the first training, and (3) there is a significant decrease in trainee variability in the shortening of the gap. The 18 neurosurgeons were divided into three groups: experts, assistants, and observers. For all three basic operations, (1) the average score of experts was obviously higher than that of the assistants, observers, and trainees' tenth training and (2) the average scores of assistants and observers were obviously higher than that of trainees' first training. A significant high in the average score between the assistants and the observers was seen for aspirating, but not for drilling or curetting. For curetting and aspirating, the tenth training average score of trainees was obviously higher than that of assistants and observers. This 3D printed simulator allows different endoscopic basic operations to be simulated and improves the EETS techniques of surgeons. We believed it to be a practical, simple, and low-cost simulator.

  5. Influence of gender equity awareness on women's reproductive healthcare in rural areas of midwest China.

    PubMed

    Wang, Lei; Cui, Ying; Zhang, Li; Wang, Chao; Jiang, Yan; Shi, Wei

    2013-11-01

    To investigate the impact of married women's gender equity awareness on use of reproductive healthcare services in rural China. The questionnaire-based study recruited 1500 married women who were aged 15-49years, had at least 1 pregnancy, and were living in rural Gansu, Qinghai, Shanxi, or Xinjiang, China, between October and December 2010. "Gender equity awareness" was quantified by responses to 7 statements, graded in accordance with a system scoring the strength of overall belief (≥19, strong; 15-18, moderate; and ≤14, weak). Only 383 women (26.3%) demonstrated high gender equity awareness. The percentage of women who received consistent prenatal care was highest in the group scoring 15 points or more (P<0.001); the percentage of women with hospital delivery and gynecologic examination (P<0.001) was highest in the group scoring 19 points or more; and the percentage of women with reproductive tract infections was highest in the group with the lowest scores (P<0.001). Women's gender equity awareness is not strong in rural midwest China. There was a positive correlation between gender equity awareness and use of reproductive healthcare services. There should be an emphasis on various activities to educate women so that they can fully access reproductive healthcare. © 2013.

  6. The countermovement jump to monitor neuromuscular status: A meta-analysis.

    PubMed

    Claudino, João Gustavo; Cronin, John; Mezêncio, Bruno; McMaster, Daniel Travis; McGuigan, Michael; Tricoli, Valmor; Amadio, Alberto Carlos; Serrão, Julio Cerca

    2017-04-01

    The primary objective of this meta-analysis was to compare countermovement jump (CMJ) performance in studies that reported the highest value as opposed to average value for the purposes of monitoring neuromuscular status (i.e., fatigue and supercompensation). The secondary aim was to determine the sensitivity of the dependent variables. Systematic review with meta-analysis. The meta-analysis was conducted on the highest or average of a number of CMJ variables. Multiple literature searches were undertaken in Pubmed, Scopus, and Web of Science to identify articles utilizing CMJ to monitor training status. Effect sizes (ES) with 95% confidence interval (95% CI) were calculated using the mean and standard deviation of the pre- and post-testing data. The coefficient of variation (CV) with 95% CI was also calculated to assess the level of instability of each variable. Heterogeneity was assessed using a random-effects model. 151 articles were included providing a total of 531 ESs for the meta-analyses; 85.4% of articles used highest CMJ height, 13.2% used average and 1.3% used both when reporting changes in CMJ performance. Based on the meta-analysis, average CMJ height was more sensitive than highest CMJ height in detecting CMJ fatigue and supercompensation. Furthermore, other CMJ variables such as peak power, mean power, peak velocity, peak force, mean impulse, and power were sensitive in tracking the supercompensation effects of training. The average CMJ height was more sensitive than highest CMJ height in monitoring neuromuscular status; however, further investigation is needed to determine the sensitivity of other CMJ performance variables. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  7. Total mercury in canned tuna sold in Canada in 2006.

    PubMed

    Dabeka, Robert W; Mckenzie, Arthur D; Forsyth, Donald S

    2014-01-01

    Total mercury was measured in 156 composites prepared from 936 samples of canned tuna sold in Canada in 2006. Each composite comprised a single brand. Yellowfin tuna contained the lowest concentrations, averaging 0.066 mg/kg. Skipjack tuna contained slightly higher concentrations, averaging 0.132 mg/kg. The highest average concentration was found in the Albacore tuna: mean 0.325 mg/kg, range 0.174-0.507 mg/kg. The second highest concentration among the 49 albacore composites was 0.469 mg/kg. There were 72 composites for which the type of tuna was not specified. The mercury in these averaged 0.095 mg/kg and ranged from 0.016 to 0.237 mg/kg.

  8. Motor ability and inhibitory processes in children with ADHD: a neuroelectric study.

    PubMed

    Hung, Chiao-Ling; Chang, Yu-Kai; Chan, Yuan-Shuo; Shih, Chia-Hao; Huang, Chung-Ju; Hung, Tsung-Min

    2013-06-01

    The purpose of the current study was to examine the relationship between motor ability and response inhibition using behavioral and electrophysiological indices in children with ADHD. A total of 32 participants were recruited and underwent a motor ability assessment by administering the Basic Motor Ability Test-Revised (BMAT) as well as the Go/No-Go task and event-related potential (ERP) measurements at the same time. The results indicated that the BMAT scores were positively associated with the behavioral and ERP measures. Specifically, the BMAT average score was associated with a faster reaction time and higher accuracy, whereas higher BMAT subset scores predicted a shorter P3 latency in the Go condition. Although the association between the BMAT average score and the No-Go accuracy was limited, higher BMAT average and subset scores predicted a shorter N2 and P3 latency and a larger P3 amplitude in the No-Go condition. These findings suggest that motor abilities may play roles that benefit the cognitive performance of ADHD children.

  9. Selection criteria of residents for residency programs in Kuwait

    PubMed Central

    2013-01-01

    Background In Kuwait, 21 residency training programs were offered in the year 2011; however, no data is available regarding the criteria of selecting residents for these programs. This study aims to provide information about the importance of these criteria. Methods A self-administered questionnaire was used to collect data from members (e.g. chairmen, directors, assistants …etc.) of residency programs in Kuwait. A total of 108 members were invited to participate. They were asked to rate the importance level (scale from 1 to 5) of criteria that may affect the acceptance of an applicant to their residency programs. Average scores were calculated for each criterion. Results Of the 108 members invited to participate, only 12 (11.1%) declined to participate. Interview performance was ranked as the most important criteria for selecting residents (average score: 4.63/5.00), followed by grade point average (average score: 3.78/5.00) and honors during medical school (average score: 3.67/5.00). On the other hand, receiving disciplinary action during medical school and failure in a required clerkship were considered as the most concerning among other criteria used to reject applicants (average scores: 3.83/5.00 and 3.54/5.00 respectively). Minor differences regarding the importance level of each criterion were noted across different programs. Conclusions This study provided general information about the criteria that are used to accept/reject applicants to residency programs in Kuwait. Future studies should be conducted to investigate each criterion individually, and to assess if these criteria are related to residents' success during their training. PMID:23331670

  10. Articular Cartilage: Evaluation with Fluid-suppressed 7.0-T Sodium MR Imaging in Subjects with and Subjects without Osteoarthritis

    PubMed Central

    Babb, James; Xia, Ding; Chang, Gregory; Krasnokutsky, Svetlana; Abramson, Steven B.; Jerschow, Alexej; Regatte, Ravinder R.

    2013-01-01

    Purpose: To assess the potential use of sodium magnetic resonance (MR) imaging of cartilage, with and without fluid suppression by using an adiabatic pulse, for classifying subjects with versus subjects without osteoarthritis at 7.0 T. Materials and Methods: The study was approved by the institutional review board and was compliant with HIPAA. The knee cartilage of 19 asymptomatic (control subjects) and 28 symptomatic (osteoarthritis patients) subjects underwent 7.0-T sodium MR imaging with use of two different sequences: one without fluid suppression (radial three-dimensional sequence) and one with fluid suppression (inversion recovery [IR] wideband uniform rate and smooth truncation [WURST]). Fluid suppression was obtained by using IR with an adiabatic inversion pulse (WURST pulse). Mean sodium concentrations and their standard deviations were measured in the patellar, femorotibial medial, and lateral cartilage regions over four consecutive sections for each subject. The minimum, maximum, median, and average means and standard deviations were calculated over all measurements for each subject. The utility of these measures in the detection of osteoarthritis was evaluated by using logistic regression and the area under the receiver operating characteristic curve (AUC). Bonferroni correction was applied to the P values obtained with logistic regression. Results: Measurements from IR WURST were found to be significant predicators of all osteoarthritis (Kellgren-Lawrence score of 1–4) and early osteoarthritis (Kellgren-Lawrence score of 1 or 2). The minimum standard deviation provided the highest AUC (0.83) with the highest accuracy (>78%), sensitivity (>82%), and specificity (>74%) for both all osteoarthritis and early osteoarthritis groups. Conclusion: Quantitative sodium MR imaging at 7.0 T with fluid suppression by using adiabatic IR is a potential biomarker for osteoarthritis. © RSNA, 2013 PMID:23468572

  11. Modelling the impact of new patient visits on risk adjusted access at 2 clinics.

    PubMed

    Kolber, Michael A; Rueda, Germán; Sory, John B

    2018-06-01

    To evaluate the effect new outpatient clinic visits has on the availability of follow-up visits for established patients when patient visit frequency is risk adjusted. Diagnosis codes for patients from 2 Internal Medicine Clinics were extracted through billing data. The HHS-HCC risk adjusted scores for each clinic were determined based upon the average of all clinic practitioners' profiles. These scores were then used to project encounter frequencies for established patients, and for new patients entering the clinic based on risk and time of entry into the clinics. A distinct mean risk frequency distribution for physicians in each clinic could be defined providing model parameters. Within the model, follow-up visit utilization at the highest risk adjusted visit frequencies would require more follow-up slots than currently available when new patient no-show rates and annual patient loss are included. Patients seen at an intermediate or lower visit risk adjusted frequency could be accommodated when new patient no-show rates and annual patient clinic loss are considered. Value-based care is driven by control of cost while maintaining quality of care. In order to control cost, there has been a drive to increase visit frequency in primary care for those patients at increased risk. Adding new patients to primary care clinics limits the availability of follow-up slots that accrue over time for those at highest risk, thereby limiting disease and, potentially, cost control. If frequency of established care visits can be reduced by improved disease control, closing the practice to new patients, hiring health care extenders, or providing non-face to face care models then quality and cost of care may be improved. © 2018 John Wiley & Sons, Ltd.

  12. Effect of Pre-cooking Conditions on the Quality Characteristics of Ready-To-Eat Samgyetang

    PubMed Central

    2015-01-01

    The aim of this study was to examine the effectiveness of pre-cooking conditions on the quality characteristics of ready-to-eat (RTE) Samgyetang. Raw chickens were steamed under the different conditions of 50℃/30 min (T1), 65℃/30 min (T2), 85℃/30 min (T3), and 90℃/10 min (T4) prior to retorting at 120℃ for 65 min. The results showed that pre-cooking conditions in all treated samples could reduce fat contents in breast and leg meats by 8.5-11.7% and 10.0-11.0% compared to the control, even though there were no significant differences among treatments (p>0.05). The L* and b* values of breast and leg meats treated with the higher temperature and longer time conditions were significantly higher than the control (p<0.05), while a* values tended to decrease despite of not to a significant extent (p>0.05). Moreover, apparent viscosity and water soluble protein showed insignificant differences (p>0.05) among the samples as a result of the retorting process, which might have more negative influences on the quality. T2 samples obtained significantly the highest average Quantitative Descriptive Analysis (QDA) score and transmittance value, representing the most clear broth among the samples, compared to the control. On the other hand, T3 showed the highest cooking loss among the treatments and the lowest QDA scores among the samples. In conclusion, pre-cooking treatment prior to retorting in manufacturing Samgyetang is a plausible way to reduce its fat content. A pre-cooking condition at either 65℃ for 30 min, or 90℃ for 10 min are recommended for producing Samgyetang with optimum quality. PMID:26761871

  13. Life satisfaction and cardiovascular disease risk in Poland

    PubMed Central

    Szklarska, Alicja; Lipowicz, Anna; Jankowska, Ewa Anita; Kozieł, Sławomir

    2013-01-01

    Introduction Cardiovascular disease is the most common cause of death. Life satisfaction is a predictor of morbidity and mortality, irrespectively of objective measures of health status. The aim of the study was to evaluate the relationship between life satisfaction (LS) and cardiovascular disease risk (CVD) assessed with the Framingham Risk Score (FRS) in Polish adults. Material and methods Past, present and projected LS were estimated. The FRS reflecting 10-year CVD risk was calculated from health indices and lifestyle parameters. Relationships between LS and FRS were tested by two-way analysis of variance in 489 men and 591 women, 40–50 years of age. Results Subjects with a reduction in LS over time had a higher FRS compared to peers with an improvement in LS. The relationship between current LS and FRS had a J-shape in men; FRS was lowest in men with an LS of 5–7 (average LS), slightly higher in men with an LS of 8–10 (highest LS), and highest in men with an LS of 1–4 (lowest LS). Among women, there was an inverse linear relationship between LS and FRS: the higher the LS, the lower FRS. There was a strong linear relationship between predicted LS and CVD risk. Highest risk was evident in subjects with low LS in whom low LS was predicted over the next five years. Conclusions Low LS (dissatisfaction) thus has a long-term negative effect on CVD risk in Polish adults of both sexes. PMID:24049521

  14. Quality of Life in Cardiovascular Patients in Iran and Factors Affecting It: A Systematic Review

    PubMed Central

    Yaghoubi, Alireza; Tabrizi, Jafar-Sadegh; Mirinazhad, Mir-Mousa; Azami, Saber; Naghavi-Behzad, Mohammad; Ghojazadeh, Morteza

    2012-01-01

    Introduction Cardiovascular diseases are always one of the major causes of mortality in the world affecting all aspects of patients’ lives. Therefore, this study was conducted to summarize and provide a clear view of quality of life in these patients in Iran through a systematic review on the results of previously conducted studies. Methods In a systematic review, required information was collected by searching keywords of Iran, quality of life, heart failure, cardiac, heart, and their Persian equivalents in databases of Science Direct, Pubmed, IRAN doc, SID, Medlib and Magiran. The selected time period for searching articles was since 2000 to 2012. Inclusion criteria were: releasing of article during 2000 to 2012, articles reporting patients’ quality of life in any domains of heart diseases, and articles published in Persian and English. Extracted results first were summarized in Extraction Table, and then analyzed manually. Results Finally 18 of 1592 found articles were included in the study. A total of 3,797 cardiac patients' quality of life was measured using six different tools, the most important one of which was SF36 questionnaire. Among eight dimensions of SF36 questionnaire, the highest mean was for social role functioning with average score of 58.37 and the lowest for physical limitation (physical role functioning) with score of 42.95. Overall, mean of eight dimensions was 53.19. Among 4 general domains of quality of life, physical activity had the lowest average of 43.63 and average of general dimensions of quality of life was 47.65. The most important factors affecting quality of life were sex, age, education, marital status, occupational status, suffering duration, number of hospitalizations etc. Conclusion The results of the studies showed relatively low quality of life of cardiovascular patients in general. Therefore, according to the introduced effective factors in this study, it is necessary to consider regular programs for improving quality of life in these patients and providing suitable and qualitative services. PMID:24250995

  15. Contingent association between the size of the social support network and osteoporosis among Korean elderly women

    PubMed Central

    Seo, Da Hea; Kim, Kyoung Min; Lee, Eun Young; Kim, Hyeon Chang; Kim, Chang Oh; Youm, Yoosik; Rhee, Yumie

    2017-01-01

    Objective To investigate the association between the number of personal ties (or the size of the social support network) and the incidence of osteoporosis among older women in Korea. Methods Data from the Korean Urban Rural Elderly Study were used. Bone density was measured by dual-energy X-ray absorptiometry at the lumbar spine (L1–L4) and femur neck. T-score, the standardized bone density compared with what is normally expected in a healthy young adult, was measured and the presence of osteoporosis was determined, if the T-score was < -2.5. The social support network size was measured by self-responses (number of confidants and spouse). Results Of the 1,846 participants, 44.9% were diagnosed with osteoporosis. The association between the social support network size and the incidence of osteoporosis was curvilinear in both bivariate and multivariate analyses. Having more people in one’s social support network size was associated with lower risk of osteoporosis until it reached around four. Increasing the social support network size beyond four, in contrast, was associated with a higher risk of osteoporosis. This association was contingent on the average intimacy level of the social network. At the highest average intimacy level (“extremely close”), increasing the number of social support network members from one to six was associated with linear decrease in the predicted probability of osteoporosis from 45% to 30%. However, at the lowest average intimacy level (“not very close”), the predicted probability of osteoporosis dramatically increased from 48% to 80% as the size of the social network increased from one to six. Conclusion Our results show that maintaining a large and intimate social support network is associated with a lower risk of osteoporosis among elderly Korean women, while a large but less-intimate social relationship is associated with a higher risk. PMID:28700637

  16. Evaluate the Usability of the Mobile Instant Messaging Software in the Elderly.

    PubMed

    Wen, Tzu-Ning; Cheng, Po-Liang; Chang, Po-Lun

    2017-01-01

    Instant messaging (IM) is one kind of online chat that provides real-time text transmission over the Internet. It becomes one of the popular communication tools. Even it is currnetly an era of smartphones, it still a great challenge to teach and promote the elderly to use smart phone. Besides, the acceptance of the elderly to use IM remains unknown. This study describes the usability and evaluates the acceptance of the IM in the elderly, who use the smartphone for the first time. This study is a quasi-experimental design study. The study period started from October, 2012 to December, 2013. There were totally 41 elderly recruited in the study. All of them were the first time to use LINE app on the smartphones. The usability was evaluated by using the Technology Acceptance Model which consisted of four constructs: cognitive usability, cognitive ease of use, attitude and willingness to use. Overall, the elderly had the best "attitude" for LINE APP communication software, with the highest rating averaging 4.07 points on four constructs, followed by an average of 4 points on "cognitive usefulness". The socres of "cognitive ease of use" and "willingness to use" scores were equal which are an average score of 3.86. It can be interpreted that (1) the elders thought that the LINE APP as an excellent communication tool for them; (2) they found the software is useful (3) it was convenient for them to communicate. However, it was necessary to additionally assist and explain the certain functions such as the options. It would play a great role in the "willingness to use". The positive acceptance of LINE APP in elderly refer to the probable similar acceptance for them to use other communication software. Encouraging the willingness the elderly to explore more technology products and understanding their behavior will be the basic knowledge to develop further software.

  17. Eating disorders, menstrual dysfunction, weight change and DMPA use predict bone density change in college-aged women.

    PubMed

    Nieves, Jeri W; Ruffing, Jamie A; Zion, Marsha; Tendy, Susan; Yavorek, Trudy; Lindsay, Robert; Cosman, Felicia

    2016-03-01

    There are limited longitudinal studies that have evaluated bone mineral density (BMD) changes in college-aged women. Our objective was to simultaneously evaluate factors influencing 4-year BMD change. This was a longitudinal cohort study of healthy, physically active women in the US Military Academy (n=91; average age=18.4years). Assessments over four years included: height, weight, calcium intake, physical fitness, menstrual function (annual number cycles), oral contraceptives (OCs) or depot-medroxyprogesterone acetate (DMPA) use, and eating disorder behavior (Eating Disorder Inventory; (EDI)). BMD was measured annually at the lumbar spine and total hip by dual X-ray absorptiometry and calcaneal BMD by PIXI. Slope of 4year BMD change at each skeletal site (spine total hip and calcaneus) was calculated for each woman. BMD gains occurred at the spine in 50% and the hip in 36% of women. In unadjusted analyses, spine bone gain was positively related to menstrual cycle frequency (p=0.04). Spine and hip BMD loss occurred in those using DMPA (p<0.01) and those with the highest EDI quartile scores (p<0.05). BMD change was unrelated to OC use. Hip and calcaneus BMD decreased with weight loss (average 4.8+2.2lb/year) as compared to those with stable weight/weight gain (p<0.05). In multivariable analysis, spine BMD increase was significantly related to African American (AA) race, normal EDI score and normal menses. Hip BMD increase was related to AA race, weight increase and normal menses. DMPA use was associated with spine, hip, and calcaneus bone loss. On average, BMD may modestly increase in college-aged women, in the absence of risk factors. However, risk factors including subclinical eating disorders, weight loss, menstrual dysfunction and DMPA use can have significant detrimental effects on BMD in young healthy physically active women. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Contingent association between the size of the social support network and osteoporosis among Korean elderly women.

    PubMed

    Lee, Seungwon; Seo, Da Hea; Kim, Kyoung Min; Lee, Eun Young; Kim, Hyeon Chang; Kim, Chang Oh; Youm, Yoosik; Rhee, Yumie

    2017-01-01

    To investigate the association between the number of personal ties (or the size of the social support network) and the incidence of osteoporosis among older women in Korea. Data from the Korean Urban Rural Elderly Study were used. Bone density was measured by dual-energy X-ray absorptiometry at the lumbar spine (L1-L4) and femur neck. T-score, the standardized bone density compared with what is normally expected in a healthy young adult, was measured and the presence of osteoporosis was determined, if the T-score was < -2.5. The social support network size was measured by self-responses (number of confidants and spouse). Of the 1,846 participants, 44.9% were diagnosed with osteoporosis. The association between the social support network size and the incidence of osteoporosis was curvilinear in both bivariate and multivariate analyses. Having more people in one's social support network size was associated with lower risk of osteoporosis until it reached around four. Increasing the social support network size beyond four, in contrast, was associated with a higher risk of osteoporosis. This association was contingent on the average intimacy level of the social network. At the highest average intimacy level ("extremely close"), increasing the number of social support network members from one to six was associated with linear decrease in the predicted probability of osteoporosis from 45% to 30%. However, at the lowest average intimacy level ("not very close"), the predicted probability of osteoporosis dramatically increased from 48% to 80% as the size of the social network increased from one to six. Our results show that maintaining a large and intimate social support network is associated with a lower risk of osteoporosis among elderly Korean women, while a large but less-intimate social relationship is associated with a higher risk.

  19. METAL MIXTURES AND CHILDREN&RSQUO;S NEURODEVELOPMENT

    EPA Science Inventory

    Since manganese is an essential nutrient, it is expected that children who were exposed to the highest and lowest levels of manganese will have lower neurodevelopmental scores than children who were exposed to moderate levels of manganese. Neurodevelopmental scores are also...

  20. The Effect of Buzz Group Technique and Clustering Technique in Teaching Writing at the First Class of SMA HKBP I Tarutung

    ERIC Educational Resources Information Center

    Pangaribuan, Tagor; Manik, Sondang

    2018-01-01

    This research held at SMA HKBP 1 Tarutung North Sumatra on the research result of test XI[superscript 2] and XI[superscript 2] students, after they got treatment in teaching writing in recount text by using buzz group and clustering technique. The average score (X) was 67.7 and the total score buzz group the average score (X) was 77.2 and in…

  1. 2009 Department of Defense HIV/AIDS Prevention Program (DHAPP)

    DTIC Science & Technology

    2010-05-01

    FY08 to assess the program’s effectiveness. MEASURES OF EFFECTIVENESS Pretest and posttests have been developed with the expertise of the physicians...among the trainees. Pretest scores ranged from 55.0% to 80.0%, while posttest scores ranged from 72.5% to 82.5%, making it clear that it was a...valuable training for all participants. The average pretest score ranged from approximately 67.5% to a posttest average of 79.0%, showing clear

  2. 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.

  3. The key incident monitoring and management system - history and role in quality improvement.

    PubMed

    Badrick, Tony; Gay, Stephanie; Mackay, Mark; Sikaris, Ken

    2018-01-26

    The determination of reliable, practical Quality Indicators (QIs) from presentation of the patient with a pathology request form through to the clinician receiving the report (the Total Testing Process or TTP) is a key step in identifying areas where improvement is necessary in laboratories. The Australasian QIs programme Key Incident Monitoring and Management System (KIMMS) began in 2008. It records incidents (process defects) and episodes (occasions at which incidents may occur) to calculate incident rates. KIMMS also uses the Failure Mode Effects Analysis (FMEA) to assign quantified risk to each incident type. The system defines risk as incident frequency multiplied by both a harm rating (on a 1-10 scale) and detection difficulty score (also a 1-10 scale). Between 2008 and 2016, laboratories participating rose from 22 to 69. Episodes rose from 13.2 to 43.4 million; incidents rose from 114,082 to 756,432. We attribute the rise in incident rate from 0.86% to 1.75% to increased monitoring. Haemolysis shows the highest incidence (22.6% of total incidents) and the highest risk (26.68% of total risk). "Sample is suspected to be from the wrong patient" has the second lowest frequency, but receives the highest harm rating (10/10) and detection difficulty score (10/10), so it is calculated to be the 8th highest risk (2.92%). Similarly, retracted (incorrect) reports QI has the 10th highest frequency (3.9%) but the harm/difficulty calculation confers the second highest risk (11.17%). TTP incident rates are generally low (less than 2% of observed episodes), however, incident risks, their frequencies multiplied by both ratings of harm and discovery difficulty scores, concentrate improvement attention and resources on the monitored incident types most important to manage.

  4. Focus on Teacher Salaries: What Teacher Salary Averages Don't Show.

    ERIC Educational Resources Information Center

    Gaines, Gale

    Traditional comparisons of teacher salary averages fail to consider factors beyond pay raises that affect those averages. Salary averages do not show: regional and national variations among states' average salaries; the variation of salaries within an individual state; variations in the cost of living; the highest degree earned by teachers and the…

  5. Sex and Employment-Setting Differences in Work-Family Conflict in Athletic Training.

    PubMed

    Mazerolle, Stephanie M; Eason, Christianne M; Pitney, William A; Mueller, Megan N

    2015-09-01

    Work-family conflict (WFC) has received much attention in athletic training, yet several factors related to this phenomenon have not been examined, specifically a practitioner's sex, occupational setting, willingness to leave the profession, and willingness to use work-leave benefits. To examine how sex and occupational differences in athletic training affect WFC and to examine willingness to leave the profession and use work-leave benefits. Cross-sectional study. Multiple occupational settings, including clinic/outreach, education, collegiate, industrial, professional sports, secondary school, and sales. A total of 246 athletic trainers (ATs) (men = 110, women = 136) participated. Of these, 61.4% (n = 151) were between 20 and 39 years old. Participants responded to a previously validated and reliable WFC instrument. We created and validated a 3-item instrument that assessed willingness to use work-leave benefits, which demonstrated good internal consistency (Cronbach α = 0.88), as well as a single question about willingness to leave the profession. The mean (± SD) WFC score was 16.88 ± 4.4 (range = 5 [least amount of conflict] to 25 [highest amount of conflict]). Men scored 17.01 ± 4.5, and women scored 16.76 ± 4.36, indicating above-average WFC. We observed no difference between men and women based on conflict scores (t244 = 0.492, P = .95) or their willingness to leave the profession (t244 = -1.27, P = .21). We noted differences among ATs in different practice settings (F8,245 = 5.015, P <.001); those in collegiate and secondary school settings had higher reported WFC scores. A negative relationship existed between WFC score and comfort using work-leave benefits (2-tailed r = -0.533, P < .001). Comfort with using work-leave benefits was different among practice settings (F8,245 = 3.01, P = .003). The ATs employed in traditional practice settings reported higher levels of WFC. Male and female ATs had comparable experiences of WFC and willingness to leave the profession.

  6. Analysing collaboration among HIV agencies through combining network theory and relational coordination.

    PubMed

    Khosla, Nidhi; Marsteller, Jill Ann; Hsu, Yea Jen; Elliott, David L

    2016-02-01

    Agencies with different foci (e.g. nutrition, social, medical, housing) serve people living with HIV (PLHIV). Serving needs of PLHIV comprehensively requires a high degree of coordination among agencies which often benefits from more frequent communication. We combined Social Network theory and Relational Coordination theory to study coordination among HIV agencies in Baltimore. Social Network theory implies that actors (e.g., HIV agencies) establish linkages amongst themselves in order to access resources (e.g., information). Relational Coordination theory suggests that high quality coordination among agencies or teams relies on the seven dimensions of frequency, timeliness and accuracy of communication, problem-solving communication, knowledge of agencies' work, mutual respect and shared goals. We collected data on frequency of contact from 57 agencies using a roster method. Response options were ordinal ranging from 'not at all' to 'daily'. We analyzed data using social network measures. Next, we selected agencies with which at least one-third of the sample reported monthly or more frequent interaction. This yielded 11 agencies whom we surveyed on seven relational coordination dimensions with questions scored on a Likert scale of 1-5. Network density, defined as the proportion of existing connections to all possible connections, was 20% when considering monthly or higher interaction. Relational coordination scores from individual agencies to others ranged between 1.17 and 5.00 (maximum possible score 5). The average scores for different dimensions across all agencies ranged between 3.30 and 4.00. Shared goals (4.00) and mutual respect (3.91) scores were highest, while scores such as knowledge of each other's work and problem-solving communication were relatively lower. Combining theoretically driven analyses in this manner offers an innovative way to provide a comprehensive picture of inter-agency coordination and the quality of exchange that underlies collaborative ties. These methods together can identify areas that could be targeted to promote closer ties. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Using a Math Pre-Test in a Large General Education Geoscience Course: How Effective?

    NASA Astrophysics Data System (ADS)

    Richardson, R. M.

    2006-12-01

    Teaching large (150 or more students) General Education Geoscience courses presents many challenges, but one of the most important is how to effectively incorporate quantitative literacy. Many students are math phobic, and will run to General Education courses that minimize quantitative aspects. I will present results from one approach that we have used successfully for at least two years: a math pre-test. Our General Education Geoscience course has no prerequisites other than admission to the University, and is designed for first and second year non-science students. Fortunately, with limited exceptions, all entering students at the University of Arizona take a Math Readiness Test (MRT) for math placement. With the cooperation of the Mathematics Department, we have used old MRT exams to selectively use questions that are of the highest utility for the course material `understanding graphs, linear equations and extrapolations, scientific notation and large numbers, word problems, and scaling/unit conversions. We administer the exam in the first discussion section. Students receive full credit for a `serious effort', and we score the exam. In recent semesters the percentage of correct answers has varied from just under 50% to nearly 90% on individual questions. The pre-test has several important benefits. First, it lets students know clearly up front that there will be mathematics in the class. Second, it lets students know the range of skills expected to be successful. Third, because the average score is between 70-80% it gives students confidence that they can do the math in the course. Fourth, we contact all students who score less than 50%, and offer help, including referral to tutoring service in Mathematics. Feedback from students has been positive. Unfortunately, when we compared scores on the math pre-test to final grades in the course, we found essentially no correlation. We are exploring a number of possible explanations. We are also seeing if our math pre-test scores correlate with the initial MRT score, and overall student success.

  8. Characteristics of perceived parenting styles in Japan using the EMBU scale.

    PubMed

    Someya, T; Uehara, T; Kadowaki, M; Tang, S W; Takahashi, S

    1999-10-01

    The EMBU (Egna Minnen av Barndoms Uppfostran) is a self-report questionnaire for the assessment of one's memory of parental rearing experiences. We are interested in using this scale to determine the characteristics of perceived parenting styles in Japan. The study subjects consisted of 1320 healthy Japanese volunteers, comprising 687 males (52%) and 633 females (48%). We investigated the relationship between demographics and the EMBU scale. ANCOVA revealed that the subject's gender had a significant effect on paternal rejection scores (male > female), and both gender and birth-order position had significant effects on emotional warmth scores for both parents (female > male, and only-child > middle or last-born child). Birth-order position had significant effects on maternal over-protection, with the highest score being that of only children, and on the aspect of favouritism (favouring subjects), scores for both parents were highest from the last-born children. Rejection scores for the mother were significantly higher than those for the father from female subjects. Among both male and female subjects, emotional warmth scores and overprotection scores for the mother were significantly higher than those for the father. Among male subjects, scores for the mother on favouritism of the subject were significantly higher than those for the father. On the other hand, among female subjects, scores for the father on favouritism of the subject were higher than scores for the mother. Our results suggest that parenting styles have significant interrelationships with the gender and birth-order position of the subject.

  9. A minimally invasive methodology based on morphometric parameters for day 2 embryo quality assessment.

    PubMed

    Molina, Inmaculada; Lázaro-Ibáñez, Elisa; Pertusa, Jose; Debón, Ana; Martínez-Sanchís, Juan Vicente; Pellicer, Antonio

    2014-10-01

    The risk of multiple pregnancy to maternal-fetal health can be minimized by reducing the number of embryos transferred. New tools for selecting embryos with the highest implantation potential should be developed. The aim of this study was to evaluate the ability of morphological and morphometric variables to predict implantation by analysing images of embryos. This was a retrospective study of 135 embryo photographs from 112 IVF-ICSI cycles carried out between January and March 2011. The embryos were photographed immediately before transfer using Cronus 3 software. Their images were analysed using the public program ImageJ. Significant effects (P < 0.05), and higher discriminant power to predict implantation were observed for the morphometric embryo variables compared with morphological ones. The features for successfully implanted embryos were as follows: four cells on day 2 of development; all blastomeres with circular shape (roundness factor greater than 0.9), an average zona pellucida thickness of 13 µm and an average of 17695.1 µm² for the embryo area. Embryo size, which is described by its area and the average roundness factor for each cell, provides two objective variables to consider when predicting implantation. This approach should be further investigated for its potential ability to improve embryo scoring. Copyright © 2014 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  10. Variation in Educational Outcomes and Policies across Countries and of Schools within Countries. NBER Working Paper No. 16293

    ERIC Educational Resources Information Center

    Freeman, Richard B.; Machin, Stephen; Viarengo, Martina

    2010-01-01

    This study examines the variation in educational outcomes across and within countries using the TIMSS mathematics tests. It documents the wide cross-country variation in the level and dispersion of test scores. Countries with the highest test scores are those with the least inequality in scores, which suggests a "virtuous" equity-efficiency…

  11. Analysis of micromineral contents of school meals.

    PubMed

    Shin, Dongsoon

    2014-08-01

    Korean ordinary diets are referred to be good for human health in worldwide. However it is uncertain whether they provide microminerals enough for growth and health of teenagers. A main purpose of this study was to identify micromineral contents in school meals. The fifty cuisines were collected from elementary schools and middle schools in Gyeongnam area. The contents of Fe, Zn, Cu and Mn among microminerals were analyzed by using ICP-OES method. Data were expressed as mean, standard deviation and range value and linear regression analysis performed. Fe level of Pangibuseotpaprika-salad was the highest among side-dishes (average 346.6 µg) and Zn level of Sullung-tang was highest among soups (average 229.1 µg). Cu level of Buchu-kimchi was the highest among kimchies (average 217.5 µg) and Mn level of Gumeunkongyangnyum-gui was highest among side-dishes (average 198.4 µg). Generally cooked-rices as main dish had relative smaller amounts of microminerals than the other cuisines. The results showed that the ratio of Cu : Fe : Zn was approximately 12 : 4 : 1 and the relationship between Fe versus Zn or Fe versus Cu was significantly positive. Comparing to Korean Dietary Recommended Intakes (KDRI) level, school meals provided not sufficient amount (<25% DRI) of Fe, Zn or Mn, while they did excessive amount (>125% DRI) of Cu.

  12. Comparison of the Framingham Risk Score, UKPDS Risk Engine, and SCORE for Predicting Carotid Atherosclerosis and Peripheral Arterial Disease in Korean Type 2 Diabetic Patients.

    PubMed

    Ahn, Hye-Ran; Shin, Min-Ho; Yun, Woo-Jun; Kim, Hye-Yeon; Lee, Young-Hoon; Kweon, Sun-Seog; Rhee, Jung-Ae; Choi, Jin-Su; Choi, Seong-Woo

    2011-03-01

    To compare the predictability of the Framingham Risk Score (FRS), United Kingdom Prospective Diabetes Study (UKPDS) risk engine, and the Systematic Coronary Risk Evaluation (SCORE) for carotid atherosclerosis and peripheral arterial disease in Korean type 2 diabetic patients. Among 1,275 registered type 2 diabetes patients in the health center, 621 subjects with type 2 diabetes participated in the study. Well-trained examiners measured the carotid intima-media thickness (IMT), carotid plaque, and ankle brachial index (ABI). The subject's 10-year risk of coronary heart disease was calculated according to the FRS, UKPDS, and SCORE risk scores. These three risk scores were compared to the areas under the curve (AUC). The odds ratios (ORs) of all risk scores increased as the quartiles increased for plaque, IMT, and ABI. For plaque and IMT, the UKPDS risk score provided the highest OR (95% confidence interval) at 3.82 (2.36, 6.17) and at 6.21 (3.37, 11.45). For ABI, the SCORE risk estimation provided the highest OR at 7.41 (3.20, 17.18). However, no significant difference was detected for plaque, IMT, or ABI (P = 0.839, 0.313, and 0.113, respectively) when the AUCs of the three risk scores were compared. When we graphed the Kernel density distribution of these three risk scores, UKPDS had a higher distribution than FRS and SCORE. No significant difference was observed when comparing the predictability of the FRS, UKPDS risk engine, and SCORE risk estimation for carotid atherosclerosis and peripheral arterial disease in Korean type 2 diabetic patients.

  13. Cynicism about organizational change: an attribution process perspective.

    PubMed

    Wanous, John P; Reichers, Arnon E; Austin, James T

    2004-06-01

    The underlying attribution process for cynicism about organizational change is examined with six samples from four different organizations. The samples include hourly (n=777) and salaried employees (n= 155) from a manufacturing plant, faculty (n=293) and staff (n=302) from a large university, managers from a utility company (n=97), and young managers (n=65) from various organizations who were attending an evening MBA program. This form of cynicism is defined as the combination of Pessimism (about future change efforts) and a Dispositional attribution (why past efforts to change failed). Three analyses support this definition. First, an exploratory factor analysis (from the largest sample) produced two factors, one composed of Pessimism and the Dispositional attribution items and the second of the Situational attribution items. Second, the average correlation (across several samples) between Pessimism and Dispositional attribution is much higher (.59) than the average correlation between Pessimism and Situational attribution (.17). Third, scores on two different trait-based measures of cynicism correlate highest with the Dispositional attribution component of cynicism. A practical implication is that organizational leaders may minimize cynicism by managing both employees' pessimism about organizational change and employees' attributions about it. Specific suggestions for how this might be done are offered.

  14. The Association Between Dietary Quality and Overall and Cancer-Specific Mortality Among Cancer Survivors, NHANES III.

    PubMed

    Deshmukh, Ashish A; Shirvani, Shervin M; Likhacheva, Anna; Chhatwal, Jagpreet; Chiao, Elizabeth Y; Sonawane, Kalyani

    2018-04-01

    Given the recent emphasis on the totality of the diet by national guidelines, we examined the relationship between the quality of diet and overall and cancer-specific mortality among cancer survivors. From the Third National Health and Nutrition Examination Survey (NHANES III), 1191 participants diagnosed with cancer were identified. Healthy Eating Index (HEI) scores were utilized; higher HEI score indicated better adherence to dietary recommendations. During a median follow-up of 17.2 years, a total of 607 cancer-specific deaths occurred. A high-quality diet (highest-quartile HEI score) was associated with decreased risk of overall (hazard ratio [HR] = 0.59, 95% confidence interval [CI] = 0.45 to 0.77) and cancer-specific (HR = 0.35, 95% CI = 0.19 to 0.63) mortality when compared with a poor-quality diet (lowest-quartile HEI score). Among individual dietary components, the highest-quartile score for saturated fat intake was associated decreased cancer-specific mortality (HR = 0.55, 95% CI = 0.36 to 0.86). Our results highlight the importance of a "total diet" approach to improving survival among cancer patients.

  15. Gender and Ethnicity Differences in HIV-related Stigma Experienced by People Living with HIV in Ontario, Canada

    PubMed Central

    Loutfy, Mona R.; Logie, Carmen H.; Zhang, Yimeng; Blitz, Sandra L.; Margolese, Shari L.; Tharao, Wangari E.; Rourke, Sean B.; Rueda, Sergio; Raboud, Janet M.

    2012-01-01

    This study aimed to understand gender and ethnicity differences in HIV-related stigma experienced by 1026 HIV-positive individuals living in Ontario, Canada that were enrolled in the OHTN Cohort Study. Total and subscale HIV-related stigma scores were measured using the revised HIV-related Stigma Scale. Correlates of total stigma scores were assessed in univariate and multivariate linear regression. Women had significantly higher total and subscale stigma scores than men (total, median = 56.0 vs. 48.0, p<0.0001). Among men and women, Black individuals had the highest, Aboriginal and Asian/Latin-American/Unspecified people intermediate, and White individuals the lowest total stigma scores. The gender-ethnicity interaction term was significant in multivariate analysis: Black women and Asian/Latin-American/Unspecified men reported the highest HIV-related stigma scores. Gender and ethnicity differences in HIV-related stigma were identified in our cohort. Findings suggest differing approaches may be required to address HIV-related stigma based on gender and ethnicity; and such strategies should challenge racist and sexist stereotypes. PMID:23300514

  16. An analysis of key environmental and social risks in the development of concentrated solar power projects

    NASA Astrophysics Data System (ADS)

    Otieno, George A.; Loosen, Alexander E.

    2016-05-01

    Concentrated Solar Power projects have impacts on local environment and social conditions. This research set out to investigate the environmental and social risks in the development of such projects and rank these risks from highest to lowest. The risks were analysed for parabolic trough and tower technologies only. A literature review was undertaken, identifying seventeen risks that were then proposed to six CSP experts for scoring. The risks were scored based of five factors on a five tier scale. The scores from the experts were compiled to develop an overall rank of the identified risks. The risk of disruption of local water resources was found to represent the highest risk before and after mitigation with a score of moderate-high and moderate respectively. This score is linked to the importance of water in water scarce regions typified by the best regions for CSP. The risks to avian species, to worker health and safety, due to noise on the environment, to visual and recreational resources completed the top five risks after mitigation.

  17. Gender and ethnicity differences in HIV-related stigma experienced by people living with HIV in Ontario, Canada.

    PubMed

    Loutfy, Mona R; Logie, Carmen H; Zhang, Yimeng; Blitz, Sandra L; Margolese, Shari L; Tharao, Wangari E; Rourke, Sean B; Rueda, Sergio; Raboud, Janet M

    2012-01-01

    This study aimed to understand gender and ethnicity differences in HIV-related stigma experienced by 1026 HIV-positive individuals living in Ontario, Canada that were enrolled in the OHTN Cohort Study. Total and subscale HIV-related stigma scores were measured using the revised HIV-related Stigma Scale. Correlates of total stigma scores were assessed in univariate and multivariate linear regression. Women had significantly higher total and subscale stigma scores than men (total, median = 56.0 vs. 48.0, p<0.0001). Among men and women, Black individuals had the highest, Aboriginal and Asian/Latin-American/Unspecified people intermediate, and White individuals the lowest total stigma scores. The gender-ethnicity interaction term was significant in multivariate analysis: Black women and Asian/Latin-American/Unspecified men reported the highest HIV-related stigma scores. Gender and ethnicity differences in HIV-related stigma were identified in our cohort. Findings suggest differing approaches may be required to address HIV-related stigma based on gender and ethnicity; and such strategies should challenge racist and sexist stereotypes.

  18. Estimation of Uncertainties in the Global Distance Test (GDT_TS) for CASP Models.

    PubMed

    Li, Wenlin; Schaeffer, R Dustin; Otwinowski, Zbyszek; Grishin, Nick V

    2016-01-01

    The Critical Assessment of techniques for protein Structure Prediction (or CASP) is a community-wide blind test experiment to reveal the best accomplishments of structure modeling. Assessors have been using the Global Distance Test (GDT_TS) measure to quantify prediction performance since CASP3 in 1998. However, identifying significant score differences between close models is difficult because of the lack of uncertainty estimations for this measure. Here, we utilized the atomic fluctuations caused by structure flexibility to estimate the uncertainty of GDT_TS scores. Structures determined by nuclear magnetic resonance are deposited as ensembles of alternative conformers that reflect the structural flexibility, whereas standard X-ray refinement produces the static structure averaged over time and space for the dynamic ensembles. To recapitulate the structural heterogeneous ensemble in the crystal lattice, we performed time-averaged refinement for X-ray datasets to generate structural ensembles for our GDT_TS uncertainty analysis. Using those generated ensembles, our study demonstrates that the time-averaged refinements produced structure ensembles with better agreement with the experimental datasets than the averaged X-ray structures with B-factors. The uncertainty of the GDT_TS scores, quantified by their standard deviations (SDs), increases for scores lower than 50 and 70, with maximum SDs of 0.3 and 1.23 for X-ray and NMR structures, respectively. We also applied our procedure to the high accuracy version of GDT-based score and produced similar results with slightly higher SDs. To facilitate score comparisons by the community, we developed a user-friendly web server that produces structure ensembles for NMR and X-ray structures and is accessible at http://prodata.swmed.edu/SEnCS. Our work helps to identify the significance of GDT_TS score differences, as well as to provide structure ensembles for estimating SDs of any scores.

  19. Establishing the minimal clinically important difference for the Questionnaire of Olfactory Disorders.

    PubMed

    Mattos, Jose L; Schlosser, Rodney J; Mace, Jess C; Smith, Timothy L; Soler, Zachary M

    2018-05-02

    Olfactory-specific quality of life (QOL) can be measured using the Questionnaire of Olfactory Disorders Negative Statements (QOD-NS). Changes in the QOD-NS after treatment can be difficult to interpret since there is no standardized definition of clinically meaningful improvement. Patients with chronic rhinosinusitis (CRS) completed the QOD-NS. Four distribution-based methods were used to calculate the minimal clinically important difference (MCID): (1) one-half standard deviation (SD); (2) standard error of the mean (SEM); (3) Cohen's effect size (d) of the smallest unit of change; and (4) minimal detectable change (MDC). We also averaged all 4 of the scores together. Finally, the likelihood of achieving a MCID after sinus surgery using these methods, as well as average QOD-NS scores, was stratified by normal vs abnormal baseline QOD-NS scores. Outcomes were examined on 128 patients. The mean ± SD improvement in QOD-NS score after surgery was 4.3 ± 11.0 for the entire cohort and 9.6 ± 12.9 for those with abnormal baseline scores (p < 0.001). The MCID values using the different techniques were: (1) SD = 6.5; (2) SEM = 3.1; (3) d = 2.6; and (4) MDC = 8.6. The MCID score was 5.2 on average. For the total cohort analysis, the likelihood of reporting a MCID ranged from 26% to 51%, and 49% to 70% for patients reporting preoperative abnormal olfaction. Distribution-based MCID values of the QOD-NS range between 2.6 and 8.6 points, with an average of 5.2. When stratified by preoperative QOD-NS scores the majority of patients reporting abnormal preoperative QOD-NS scores achieved a MCID. © 2018 ARS-AAOA, LLC.

  20. Exploring the Gender Gap in the Conceptual Survey of Electricity and Magnetism

    ERIC Educational Resources Information Center

    Henderson, Rachel; Stewart, Gay; Stewart, John; Michaluk, Lynnette; Traxler, Adrienne

    2017-01-01

    The "gender gap" on various physics conceptual evaluations has been extensively studied. Men's average pretest scores on the Force Concept Inventory and Force and Motion Conceptual Evaluation are 13% higher than women's, and post-test scores are on average 12% higher than women's. This study analyzed the gender differences within the…

  1. ViVaMBC: estimating viral sequence variation in complex populations from illumina deep-sequencing data using model-based clustering.

    PubMed

    Verbist, Bie; Clement, Lieven; Reumers, Joke; Thys, Kim; Vapirev, Alexander; Talloen, Willem; Wetzels, Yves; Meys, Joris; Aerssens, Jeroen; Bijnens, Luc; Thas, Olivier

    2015-02-22

    Deep-sequencing allows for an in-depth characterization of sequence variation in complex populations. However, technology associated errors may impede a powerful assessment of low-frequency mutations. Fortunately, base calls are complemented with quality scores which are derived from a quadruplet of intensities, one channel for each nucleotide type for Illumina sequencing. The highest intensity of the four channels determines the base that is called. Mismatch bases can often be corrected by the second best base, i.e. the base with the second highest intensity in the quadruplet. A virus variant model-based clustering method, ViVaMBC, is presented that explores quality scores and second best base calls for identifying and quantifying viral variants. ViVaMBC is optimized to call variants at the codon level (nucleotide triplets) which enables immediate biological interpretation of the variants with respect to their antiviral drug responses. Using mixtures of HCV plasmids we show that our method accurately estimates frequencies down to 0.5%. The estimates are unbiased when average coverages of 25,000 are reached. A comparison with the SNP-callers V-Phaser2, ShoRAH, and LoFreq shows that ViVaMBC has a superb sensitivity and specificity for variants with frequencies above 0.4%. Unlike the competitors, ViVaMBC reports a higher number of false-positive findings with frequencies below 0.4% which might partially originate from picking up artificial variants introduced by errors in the sample and library preparation step. ViVaMBC is the first method to call viral variants directly at the codon level. The strength of the approach lies in modeling the error probabilities based on the quality scores. Although the use of second best base calls appeared very promising in our data exploration phase, their utility was limited. They provided a slight increase in sensitivity, which however does not warrant the additional computational cost of running the offline base caller. Apparently a lot of information is already contained in the quality scores enabling the model based clustering procedure to adjust the majority of the sequencing errors. Overall the sensitivity of ViVaMBC is such that technical constraints like PCR errors start to form the bottleneck for low frequency variant detection.

  2. Correlates of disease-specific knowledge in Chinese patients with COPD.

    PubMed

    Wong, Carlos Kh; Yu, W C

    2016-01-01

    This study aimed to determine the associations of various sociodemographic factors with the level of disease-specific knowledge among Hong Kong Chinese patients with COPD. A cross-sectional survey of 100 Chinese adults with COPD recruited from outpatient clinics was conducted from September 2009 to September 2010. Data on the knowledge specific to COPD and patients' sociodemographics were collected from face-to-face interviews. Primary outcome of disease-specific knowledge was measured using 65-item Bristol COPD Knowledge Questionnaire (BCKQ), summing up the 65 items as the BCKQ overall score. Associations of sociodemographic factors with the BCKQ overall score were evaluated using the linear regression model. The mean BCKQ overall score of our patients was 41.01 (SD: 10.64). The knowledge in topics of "Smoking" and "Phlegm" achieved the first (3.97, SD: 0.82) and second (3.91, SD: 1.17) highest mean scores, respectively, while the topic of "Oral steroids" returned the lowest mean score of 1.89 (SD: 1.64). The BCKQ overall score progressively declined ( P <0.001) with increase in education level, with the highest BCKQ overall score of 46.71 at no formal education among all subgroups. Compared to nondrinkers, current drinkers were associated with lower total BCKQ score. We found that among COPD patients in outpatient clinics, impairments in the level of COPD knowledge were evident in patients who were current drinkers or had higher level of education.

  3. The utility of diabetes risk score items as predictors of incident type 2 diabetes in Asian populations: An evidence-based review.

    PubMed

    Hu, Pei Lin; Koh, Yi Ling Eileen; Tan, Ngiap Chuan

    2016-12-01

    The prevalence of type 2 diabetes mellitus is rising, with many Asian countries featured in the top 10 countries with the highest numbers of persons with diabetes. Reliable diabetes risk scores enable the identification of individuals at risk of developing diabetes for early intervention. This article aims to identify common risk factors in the risk scores with the highest discrimination; factors with the most influence on the risk score in Asian populations, and to propose a set of factors translatable to the multi-ethnic Singapore population. A systematic search of PubMed and EMBASE databases was conducted to identify studies published before August 2016 that developed risk prediction models for incident diabetes. 12 studies were identified. Risk scores that included laboratory measurements had better discrimination. Coefficient analysis showed fasting glucose and HbA1c having the greatest impact on the risk score. A proposed Asian risk score would include: family history of diabetes, age, gender, smoking status, body mass index, waist circumference, hypertension, fasting plasma glucose, HbA1c, HDL-cholesterol and triglycerides. Future research is required on the influence of ethnicity in Singapore. The risk score may potentially be used to stratify individuals for enrolment into diabetes prevention programmes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  4. Automated Quantification of the Landing Error Scoring System With a Markerless Motion-Capture System.

    PubMed

    Mauntel, Timothy C; Padua, Darin A; Stanley, Laura E; Frank, Barnett S; DiStefano, Lindsay J; Peck, Karen Y; Cameron, Kenneth L; Marshall, Stephen W

    2017-11-01

      The Landing Error Scoring System (LESS) can be used to identify individuals with an elevated risk of lower extremity injury. The limitation of the LESS is that raters identify movement errors from video replay, which is time-consuming and, therefore, may limit its use by clinicians. A markerless motion-capture system may be capable of automating LESS scoring, thereby removing this obstacle.   To determine the reliability of an automated markerless motion-capture system for scoring the LESS.   Cross-sectional study.   United States Military Academy.   A total of 57 healthy, physically active individuals (47 men, 10 women; age = 18.6 ± 0.6 years, height = 174.5 ± 6.7 cm, mass = 75.9 ± 9.2 kg).   Participants completed 3 jump-landing trials that were recorded by standard video cameras and a depth camera. Their movement quality was evaluated by expert LESS raters (standard video recording) using the LESS rubric and by software that automates LESS scoring (depth-camera data). We recorded an error for a LESS item if it was present on at least 2 of 3 jump-landing trials. We calculated κ statistics, prevalence- and bias-adjusted κ (PABAK) statistics, and percentage agreement for each LESS item. Interrater reliability was evaluated between the 2 expert rater scores and between a consensus expert score and the markerless motion-capture system score.   We observed reliability between the 2 expert LESS raters (average κ = 0.45 ± 0.35, average PABAK = 0.67 ± 0.34; percentage agreement = 0.83 ± 0.17). The markerless motion-capture system had similar reliability with consensus expert scores (average κ = 0.48 ± 0.40, average PABAK = 0.71 ± 0.27; percentage agreement = 0.85 ± 0.14). However, reliability was poor for 5 LESS items in both LESS score comparisons.   A markerless motion-capture system had the same level of reliability as expert LESS raters, suggesting that an automated system can accurately assess movement. Therefore, clinicians can use the markerless motion-capture system to reliably score the LESS without being limited by the time requirements of manual LESS scoring.

  5. Biological assessment of streams in the Indianapolis Metropolitan Area, Indiana, 1999-2001

    USGS Publications Warehouse

    Voelker, David C.

    2004-01-01

    During 1999?2001, benthic invertebrates and fish were sampled to describe biological communities in the White River and selected tributaries in the Indianapolis Metropolitan Area in Indiana. Twelve sites (six on the White River and six on tributaries) were sampled biannually for benthic invertebrates and annually for fish. The information complements water-chemistry data collected by the Indianapolis Department of Public Works in the study area. Evaluation of the habitat for sites in the study area was done, using a Qualitative Habitat Evaluation Index (QHEI) developed by the Ohio Environmental Protection Agency. The QHEI scores basin and habitat characteristics for each site, with a maximum possible score of 100. Higher scores indicate better habitat conditions for biotic communities. The QHEI scores for sites on the White River ranged from 55 at the Harding site to 71 at the Waverly site; scores on the tributaries ranged from 45 on Pogues Run to 82 on Williams Creek. A total of 151 taxa were identified from the benthic-invertebrate samples. The Ephemeroptera, Plecoptera, and Trichoptera (EPT) Index scores for sites on the White River ranged from 0 at the Harding site to 15 at the Nora site. The Nora site, which is upstream from Indianapolis, generally scored the highest of all White River sites. Sites in the immediate vicinity of Indianapolis scored the lowest and indicate a negative effect on benthic-invertebrate communities in that reach. EPT Index scores increased in the farthest downstream reaches, which indicate that water-quality conditions had improved in comparison to sites in Indianapolis. For the tributary sites, EPT Index values ranged from 0 at Pogues Run to 16 at Buck Creek. Tributary sites on Fall Creek, Pleasant Run, and Pogues Run consistently scored 7 or lower; sites on Buck Creek, Eagle Creek, and Williams Creek scored 7 or higher. Hilsenhoff Biotic Index (HBI) scores ranged from 4.9 (good) to 9.6 (very poor) for the White River sites and from 5.2 (good) to 8.0 (poor) for the tributary sites. The lowest scores among the White River sites were at the Nora site, indicating the best water-quality conditions were where the White River enters Marion County. The highest HBI scores were at the Morris and Harding sites, indicating the least-favorable water-quality conditions of all the White River sites. Of the tributary sites, HBI scores for Buck, Eagle, and Williams Creeks indicate fair water-quality conditions; HBI scores for Pleasant Run and Pogues Run were the highest, indicating relatively poor water-quality conditions. On the White River, the highest Invertebrate Community Index (ICI) scores, which indicate the best benthic-invertebrate conditions, were at the Nora site. Conditions were fair to poor in the downtown Indianapolis area; ICI scores indicate slight improvement in the downstream reaches of the study area. Of the tributary sites, Buck Creek was the only site with ICI scores indicating exceptional water quality. Williams Creek ICI scores indicate good water quality; the remaining tributary-site scores reflect fair conditions. A total of 74 species and 3 hybrids of fish were identified during the study period. The Cyprinidae (carps and minnows) was the largest group of fish identified and consisted of more than half of all fish collected. The most numerous species was the central stoneroller (Campostoma anomalum), which accounted for almost 25 percent of the fish identified. Two nonnative species, the koi carp (Cyprinus carpio) and the western mosquitofish (Gambusia affinis), and one species classified as an Indiana species of special concern, the northern studfish (Fundulus catenatus), also were collected during the study. Indiana Index of Biotic Integrity (IBI) and Ohio Index of Biotic Integrity scores were calculated to show the condition of the fish communities at each site. Results of the Indiana IBI calculations showed no apparent differences in scores among the Wh

  6. Hyper-parenting is negatively associated with physical activity among 7-12year olds.

    PubMed

    Janssen, Ian

    2015-04-01

    To explore associations between helicopter, little emperor, tiger mom, and concerted cultivation hyper-parenting styles with child physical activity. 724 North American parents of 7-12 year olds completed a survey (May, 2014) that assessed their engagement in the hyper-parenting styles and the frequency that their child played outdoors, walked/bicycled, and played organized sports. Z-scores were generated for each hyper-parenting style and four groups were created: low (<-1 SD), below average (-1 to -0.49 SD), average (-0.50 to 0.50 SD), above average (0.51 to 0.1.0 SD), and high (>1 SD). Outdoor play, active transportation, and organized sport did not differ across helicopter parenting groups. Children in the low little emperor group had higher (P<0.005) outdoor play and active transportation scores than children in the average, above average, and high groups (exception: high group for outdoor play). Children in the low tiger mom and concerted cultivation groups had higher (P<0.005) outdoor play, active transportation, and organized sport scores than children in the average, above average, and high groups (exceptions: average and high tiger mom groups for organized sport). Little emperor, tiger mom, and concerted cultivation parenting styles were associated with lower physical activity among 7-12 year olds. Copyright © 2015. Published by Elsevier Inc.

  7. Academic status and progress of deaf and hard-of-hearing students in general education classrooms.

    PubMed

    Antia, Shirin D; Jones, Patricia B; Reed, Susanne; Kreimeyer, Kathryn H

    2009-01-01

    The study participants were 197 deaf or hard-of-hearing students with mild to profound hearing loss who attended general education classes for 2 or more hours per day. We obtained scores on standardized achievement tests of math, reading, and language/writing, and standardized teacher's ratings of academic competence annually, for 5 years, together with other demographic and communication data. Results on standardized achievement tests indicated that, over the 5-year period, 63%-79% of students scored in the average or above-average range in math, 48%-68% in reading, and 55%-76% in language/writing. The standardized test scores for the group were, on average, half an SD below hearing norms. Average student progress in each subject area was consistent with or better than that made by the norm group of hearing students, and 79%-81% of students made one or more year's progress annually. Teachers rated 69%-81% of students as average or above average in academic competence over the 5 years. The teacher's ratings also indicated that 89% of students made average or above-average progress. Students' expressive and receptive communication, classroom participation, communication mode, and parental participation in school were significantly, but moderately, related to academic outcomes.

  8. Effect of dyad training on medical students' cardiopulmonary resuscitation performance.

    PubMed

    Wang, Candice; Huang, Chin-Chou; Lin, Shing-Jong; Chen, Jaw-Wen

    2017-03-01

    We investigated the effects of dyadic training on medical students' resuscitation performance during cardiopulmonary resuscitation (CPR) training.We provided students with a 2-hour training session on CPR for simulated cardiac arrest. Student teams were split into double groups (Dyad training groups: Groups A and B) or Single Groups. All groups received 2 CPR simulation rounds. CPR simulation training began with peer demonstration for Group A, and peer observation for Group B. Then the 2 groups switched roles. Single Groups completed CPR simulation without peer observation or demonstration. Teams were then evaluated based on leadership, teamwork, and team member skills.Group B had the highest first simulation round scores overall (P = 0.004) and in teamwork (P = 0.001) and team member skills (P = 0.031). Group B also had the highest second simulation round scores overall (P < 0.001) and in leadership (P = 0.033), teamwork (P < 0.001), and team member skills (P < 0.001). In the first simulation, there were no differences between Dyad training groups with those of Single Groups in overall scores, leadership scores, teamwork scores, and team member scores. In the second simulation, Dyad training groups scored higher in overall scores (P = 0.002), leadership scores (P = 0.044), teamwork scores (P = 0.005), and team member scores (P = 0.008). Dyad training groups also displayed higher improvement in overall scores (P = 0.010) and team member scores (P = 0.022).Dyad training was effective for CPR training. Both peer observation and demonstration for peers in dyad training can improve student resuscitation performance.

  9. Effect of dyad training on medical students’ cardiopulmonary resuscitation performance

    PubMed Central

    Wang, Candice; Huang, Chin-Chou; Lin, Shing-Jong; Chen, Jaw-Wen

    2017-01-01

    Abstract We investigated the effects of dyadic training on medical students’ resuscitation performance during cardiopulmonary resuscitation (CPR) training. We provided students with a 2-hour training session on CPR for simulated cardiac arrest. Student teams were split into double groups (Dyad training groups: Groups A and B) or Single Groups. All groups received 2 CPR simulation rounds. CPR simulation training began with peer demonstration for Group A, and peer observation for Group B. Then the 2 groups switched roles. Single Groups completed CPR simulation without peer observation or demonstration. Teams were then evaluated based on leadership, teamwork, and team member skills. Group B had the highest first simulation round scores overall (P = 0.004) and in teamwork (P = 0.001) and team member skills (P = 0.031). Group B also had the highest second simulation round scores overall (P < 0.001) and in leadership (P = 0.033), teamwork (P < 0.001), and team member skills (P < 0.001). In the first simulation, there were no differences between Dyad training groups with those of Single Groups in overall scores, leadership scores, teamwork scores, and team member scores. In the second simulation, Dyad training groups scored higher in overall scores (P = 0.002), leadership scores (P = 0.044), teamwork scores (P = 0.005), and team member scores (P = 0.008). Dyad training groups also displayed higher improvement in overall scores (P = 0.010) and team member scores (P = 0.022). Dyad training was effective for CPR training. Both peer observation and demonstration for peers in dyad training can improve student resuscitation performance. PMID:28353555

  10. Variations in a university subject pool as a function of earlier or later participation and self-report: a replication and extension.

    PubMed

    Bernard, Larry C; Walsh, R Patricia

    2002-10-01

    The present study replicated and extended earlier research on temporal sampling effects in university subject pools. Data were obtained from 236 participants, 79 men and 157 women, in a university subject pool during a 15-wk. semester. Without knowing the purpose of the study, participants self-selected to participate earlier (Weeks 4 and 5; n = 105) or later (Weeks 14 and 15; n = 131). Three hypotheses were investigated: (1) that the personality patterns of earlier and later participants on the NEO Personality Inventory-Revised and the Personality Research Form differ significantly, with earlier participants scoring higher on the latter scales reflecting social responsibility and higher on former Conscientiousness and Neuroticism scales; (2) that there are similar significant differences between participants in the earlier and later groups compared to the male and female college normative samples for the two tests: and (3) that earlier participants will have higher actual Scholastic Assessment Test scores and Grade Point Averages. Also investigated was whether participants' foreknowledge that their actual Scholastic Assessment Test scores and Grade Point Averages would be obtained would affect their accuracy of self-report. In contrast to prior research, neither the first nor second hypothesis was supported by the current study; there do not appear to be consistent differences on personality variables. However, the third hypothesis was supported. Earlier participants had higher actual high school Grade Point Average, college Grade Point Average, and Scholastic Assessment Test Verbal scores. Foreknowledge that actual Scholastic Assessment Test scores and Grade Point Averages would be obtained did not affect the accuracy of self-report. In addition, later participants significantly over-reported their scores, and significantly more women than men and more first-year than senior-year subjects participated in the early group.

  11. Quality of Life among Breast Cancer Patients In Malaysia.

    PubMed

    Ganesh, Sri; Lye, Munn-Sann; Lau, Fen Nee

    2016-01-01

    Among the factors reported to determine the quality of life of breast cancer patients are socio- demographic background, clinical stage, type of treatment received, and the duration since diagnosis. The objective of this study was to determine the quality of life (QOL) scores among breast cancer patients at a Malaysian public hospital. This cross-sectional study of breast cancer patients was conducted between March to June 2013. QOL scores were determined using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and its breast cancer supplementary measure (QLQ-BR23). Both the QLQ-C30 and QLQ-BR23 assess items from functional and symptom scales. The QLQ-C30 in addition also measures the Global Health Status (GHS). Systematic random sampling was used to recruit patients. 223 breast cancer patients were recruited with a response rate of 92.1%. The mean age of the patients was 52.4 years (95% CI = 51.0, 53.7, SD=10.3). Majority of respondents are Malays (60.5%), followed by Chinese (19.3%), Indians (18.4%), and others (1.8%). More than 50% of respondents are at stage III and stage IV of malignancy. The mean Global Health Status was 65.7 (SD = 21.4). From the QLQ-C30, the mean score in the functioning scale was highest for 'cognitive functioning' (84.1, SD=18.0), while the mean score in the symptom scale was highest for 'financial difficulties' (40.1, SD=31.6). From the QLQ-BR23, the mean score for functioning scale was highest for 'body image' (80.0, SD=24.6) while the mean score in the symptom scale was highest for 'upset by hair loss' (36.2, SD=29.4). Two significant predictors for Global Health Status were age and employment. The predictors explained 10.6% of the variation of global health status (R2=0.106). Age and employment were found to be significant predictors for Global Health Status (GHS). The Quality of Life among breast cancer patients reflected by the GHS improves as age and employment increases.

  12. Differentiation of homicidal child molesters, nonhomicidal child molesters, and nonoffenders by phallometry.

    PubMed

    Firestone, P; Bradford, J M; Greenberg, D M; Nunes, K L

    2000-11-01

    The purpose of this study was to examine the ability of phallometry to discriminate among homicidal child molesters, nonhomicidal child molesters, and a comparison group of nonoffenders. Twenty-seven child molesters who had committed or had attempted a sexually motivated homicide, 189 nonhomicidal child molesters, and 47 nonoffenders were compared on demographic variables and psychometrically determined responses to aural descriptions of sexual vignettes. Two phallometric indexes were used: the pedophile index and the pedophile assault index. The pedophile index was computed by dividing the subject's highest response to an aural description of sex with a "consenting" child by his highest response to description of sex with a consenting adult. The pedophile assault index was computed by dividing the subject's highest response to an aural description of assault involving a child victim by his highest response to description of sex with a "consenting" child. Homicidal child molesters, nonhomicidal child molesters, and nonoffenders were not significantly different in age or IQ. Homicidal and nonhomicidal child molesters had significantly higher pedophile index scores than nonoffenders. Significantly more homicidal child molesters (14 [52%] of 27) and nonhomicidal child molesters (82 [46%] of 180) than nonoffenders (13 [28%] of 47) had pedophile index scores equal to or greater than 1.0, but homicidal and nonhomicidal child molesters did not differ from each other. Significantly more homicidal child molesters (17 [63%] of 27) than either nonhomicidal child molesters (71 [40%] of 178) or nonoffenders (17 [36%] of 47) had pedophile assault index scores equal to or greater than 1.0, and nonhomicidal child molesters and nonoffenders were not significantly different from each other. Within-group analyses revealed that of the three groups, only the nonhomicidal child molesters exhibited a significant difference between their pedophile index scores and their pedophile assault index scores; their pedophile index scores were higher. Consistent with past research, the authors found that the pedophile index is useful in differentiating homicidal and nonhomicidal child molesters from nonoffenders and that the pedophile assault index is able to differentiate homicidal child molesters from nonhomicidal child molesters and nonoffenders.

  13. [Research barometer: how is research activity monitored and how is it compared?].

    PubMed

    Djurhuus, Jens Chr

    2003-01-20

    Recent analyses place Danish health science with the highest scientific impact per investment and the greatest share of most-cited papers globally. Several fields have international top score impact implying that they achieve more frequent citing than the average (Matthew effect). This appears paradoxical in view of the drastic reductions in Danish research budgets through the last 20 years--and the concomitant switch from long-term government grants to short-term external/private funding implying that continuity is replaced by demands for prompt results. Danish health research has thus proved remarkably robust under the steady downward tendency, but it is doubtful how far it will withstand current policy without irreversible damage. The methodologies applied in assessment of the excellence of research become increasingly sophisticated. They are still not completely reliable. At present they are primarily retrospective. It is imperative that future instruments monitor the actual research position.

  14. Reading Level and Length of Written Research Consent Forms

    PubMed Central

    Foe, Gabriella; Lally, Rachel

    2015-01-01

    Abstract In 100 Institutional Review Board approved consent forms (CFs), we assessed pages, reading levels, and whether they included essential elements. CF page numbers ranged from 3 to 28 (mean, 10.3) and readability ranged from grades 5.6 to 28.9 (mean, 11.6). The CF mean score for including essential elements was 90.8% (range: 63.5–100%). There were no significant differences by specialty in number of pages (p = 0.053), but surgical specialties had the highest readability (mean, 13.1), and pediatrics the lowest (10.5), p = 0.008. While approved CFs generally included the Office for Human Research Protections recommended essential elements, they were very long, and even pediatric forms, which had the lowest reading levels, were written on average at a tenth grade level. Researchers need guidance to resolve pressure between regulatory mandates and guidelines and “keeping it simple and clear.” PMID:25580939

  15. The effects of self-esteem and ego threat on interpersonal appraisals of men and women: a naturalistic study.

    PubMed

    Vohs, Kathleen D; Heatherton, Todd F

    2003-11-01

    A naturalistic study examined the effects of self-esteem and threats to the self on interpersonal appraisals. Self-esteem scores, ego threat (operationalized as a substantial decrease in self-esteem across an average of 9 months), and their interaction were used to predict likability and personality perceptions of college men and women. The results revealed a curvilinear function explaining likability: Moderate to low self-esteem men and women were higher in likability when threatened, whereas high self-esteem men were seen as less likable when threatened. Personality ratings indicated that high self-esteem men and women who were threatened were rated highest on Antagonism (i.e., fake, arrogant, unfriendly, rude, and uncooperative). Mediational analyses revealed that differences in Antagonism statistically accounted for differences in likability. These patterns are interpreted with respect to gender and time in interpersonal perceptions as well as naturalistic versus laboratory investigations.

  16. Joint Patch and Multi-label Learning for Facial Action Unit Detection

    PubMed Central

    Zhao, Kaili; Chu, Wen-Sheng; De la Torre, Fernando; Cohn, Jeffrey F.; Zhang, Honggang

    2016-01-01

    The face is one of the most powerful channel of nonverbal communication. The most commonly used taxonomy to describe facial behaviour is the Facial Action Coding System (FACS). FACS segments the visible effects of facial muscle activation into 30+ action units (AUs). AUs, which may occur alone and in thousands of combinations, can describe nearly all-possible facial expressions. Most existing methods for automatic AU detection treat the problem using one-vs-all classifiers and fail to exploit dependencies among AU and facial features. We introduce joint-patch and multi-label learning (JPML) to address these issues. JPML leverages group sparsity by selecting a sparse subset of facial patches while learning a multi-label classifier. In four of five comparisons on three diverse datasets, CK+, GFT, and BP4D, JPML produced the highest average F1 scores in comparison with state-of-the art. PMID:27382243

  17. The relationship between quality of life and methods of delivery: A systematic review and meta-analysis.

    PubMed

    Rezaei, Nazanin; Tavalaee, Zahra; Sayehmiri, Kourosh; Sharifi, Nasibeh; Daliri, Salman

    2018-04-01

    Some physical, emotional and social changes arise in mothers during the postpartum periods which can affect the quality of life (QOL) of the mother and family. Given the importance of the quality of life in the postpartum period and its influencing factors such as method of delivery, the present study aimed at investigating the relationship between the quality of life and methods of delivery in the world, using a systematic review and meta-analysis method. The present study is a systematic review and meta-analysis on the relationship between aspects of quality of life and method of delivery in the world conducted in Persian and English language articles published by the end of 2015. For this purpose, the databases of Medlib, SID, Scopus, ISI Web of Science, PubMed, Google scholar, Irandoc, Magiran and Iranmedex were searched using key words and their compounds. The results of studies were combined using the random effects model in the meta-analysis. Heterogeneity of studies was assessed using I2 index and Cochran test and data were analyzed using STATA Version 11.1 and SPSS Version 16. Based on the results of the meta-analysis of studies, the aspect of physical functioning had the highest quality of life mean score in women with vaginal delivery: 74.37 (95% CI: 67.7-81) and mental health had the highest QOL mean score in women with cesarean delivery: 65.8 (95% CI: 62.7-69). Also, based on the time elapsed since delivery, mental health had the highest mean score in less than 1 month, 2 months and 4 months' postpartum. Physical pain had the highest mean score 6 months after giving birth, and mental functioning in 8 months after giving birth. The results of the present meta-analysis showed that the mean scores for most dimensions of quality of life in women with vaginal delivery were higher than in women with cesarean delivery.

  18. Impact of Residency Training Redesign on Residents' Clinical Knowledge.

    PubMed

    Waller, Elaine; Eiff, M Patrice; Dexter, Eve; Rinaldo, Jason C B; Marino, Miguel; Garvin, Roger; Douglass, Alan B; Phillips, Robert; Green, Larry A; Carney, Patricia A

    2017-10-01

    The In-training Examination (ITE) is a frequently used method to evaluate family medicine residents' clinical knowledge. We compared family medicine ITE scores among residents who trained in the 14 programs that participated in the Preparing the Personal Physician for Practice (P4) Project to national averages over time, and according to educational innovations. The ITE scores of 802 consenting P4 residents who trained in 2007 through 2011 were obtained from the American Board of Family Medicine. The primary analysis involved comparing scores within each academic year (2007 through 2011), according to program year (PGY) for P4 residents to all residents nationally. A secondary analysis compared ITE scores among residents in programs that experimented with length of training and compared scores among residents in programs that offered individualized education options with those that did not. Release of ITE scores was consented to by 95.5% of residents for this study. Scores of P4 residents were higher compared to national scores in each year. For example, in 2011, the mean P4 score for PGY1 was 401.2, compared to the national average of 386. For PGY2, the mean P4 score was 443.1, compared to the national average of 427, and for PGY3, the mean P4 score was 477.0, compared to the national PGY3 score of 456. Scores of residents in programs that experimented with length of training were similar to those in programs that did not. Scores were also similar between residents in programs with and without individualized education options. Family medicine residency programs undergoing substantial educational changes, including experiments in length of training and individualized education, did not appear to experience a negative effect on resident's clinical knowledge, as measured by ITE scores. Further research is needed to study the effect of a wide range of residency training innovations on ITE scores over time.

  19. Dietary risk ranking for residual antibiotics in cultured aquatic products around Tai Lake, China.

    PubMed

    Song, Chao; Li, Le; Zhang, Cong; Qiu, Liping; Fan, Limin; Wu, Wei; Meng, Shunlong; Hu, Gengdong; Chen, Jiazhang; Liu, Ying; Mao, Aimin

    2017-10-01

    Antibiotics are widely used in aquaculture and therefore may be present as a dietary risk in cultured aquatic products. Using the Tai Lake Basin as a study area, we assessed the presence of 15 antibiotics in 5 widely cultured aquatic species using a newly developed dietary risk ranking approach. By assigning scores to each factor involved in the ranking matrices, the scores of dietary risks per antibiotic and per aquatic species were calculated. The results indicated that fluoroquinolone antibiotics posed the highest dietary risk in all aquatic species. Then, the total scores per aquatic species were summed by all 15 antibiotic scores of antibiotics, it was found that Crab (Eriocheir sinensis) had the highest dietary risks. Finally, the most concerned antibiotic category and aquatic species were selected. This study highlighted the importance of dietary risk ranking in the production and consumption of cultured aquatic products around Tai Lake. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Willingness to pay and quality of life in patients with rosacea.

    PubMed

    Beikert, F C; Langenbruch, A K; Radtke, M A; Augustin, M

    2013-06-01

    Rosacea is a chronic inflammatory dermatosis affecting >2% of the population. Willingness to pay (WTP) is a well established method which reflects the individual burden of disease. Evaluation of WTP and quality of life (QoL) in patients with rosacea. Nationwide postal survey on adult patients with rosacea affiliated with the German rosacea patient advocacy group. WTP was evaluated by three standardized items and compared to historical data on vitiligo (n = 1023). QoL was assessed using the Dermatology Life Quality Index (DLQI). Data from n = 475 rosacea patients (79.9% women, mean age 56.3, range 26-90) were analysed. On average, patients were willing to pay € 2880 (median € 500) for complete healing compared with € 7360 (median € 3000) in vitiligo. Relative WTP was higher in women; the highest sums were registered for the age group 21-30 years. The extent of facial involvement predicted a higher relative WTP, whereas WTP decreased with the duration of symptoms and age. Mean DLQI total score was 4.3 compared to 7.0 in vitiligo. In rosacea, the highest values were observed in patients <30 years. Severe QoL reductions (DLQI>10) were less frequent (11%) than in vitiligo (24.6%). The correlation between WTP and DLQI was significant (e.g. r = 0.249, P = 0.000 for relative WTP). Rosacea patients show a moderate WTP and average QoL reduction is mild. WTP proved to be a valid tool to assess patients' burden of disease. Patient education and the development of effective treatment options might still improve patients' satisfaction. © 2012 The Authors. Journal of the European Academy of Dermatology and Venereology © 2012 European Academy of Dermatology and Venereology.

  1. Anxiety and depression symptoms in the 2 years following diagnosis of breast or gynaecologic cancer: prevalence, course and determinants of outcome.

    PubMed

    Stafford, Lesley; Judd, Fiona; Gibson, Penny; Komiti, Angela; Mann, G Bruce; Quinn, Michael

    2015-08-01

    The purposes of this study are to examine the course and prevalence of anxiety and depression over 24 months in women with newly diagnosed breast and gynaecologic cancer and, controlling for demographic and clinical confounders, to test the role of neuroticism and psychiatric history in determining outcome 6, 12, 18 and 24 months post-diagnosis. Participants completed the Hospital Anxiety and Depression Scale-anxiety subscale and Centre for Epidemiological Studies Depression Scale on an 8-weekly basis from diagnosis until 96 weeks. Changes over time were analyzed with repeated measures ANOVA. Hierarchical linear regression, adjusted a priori for age, chemotherapy and radiation treatment, living alone, education and tumour stream were used to predict anxiety and depression. Participants were 105 women (66 breast, 39 gynaecologic). Rates of anxiety (18.1 %) and depression (33.3 %) were highest at diagnosis. Average rates of anxiety and depression were 5.9 and 22.4 %, respectively. Average scores of anxiety and depression were highest at diagnosis, with improvement at 8 and 40 weeks, respectively, subsequently maintained. Morbidity at diagnosis was particularly acute among women with a treatment history of anxiety/depression or with high neuroticism. These three variables were the best and only predictors over 24 months. Women are most vulnerable to anxiety and depression at diagnosis, with improvement over time. Morbidity rates are lower than reported elsewhere. Women with high neuroticism and a psychiatric history are at greatest risk for future morbidity after adjusting for confounders. Early identification of these women plus heightened surveillance or early referral to psychosocial services may protect against longer-term morbidity.

  2. Evaluation of Relationship Between Body Dysmorphic Disorder and Self-Esteem in Rhinoplasty Candidates.

    PubMed

    Baykal, Bahadir; Erdim, Ibrahim; Ozbay, Isa; Oghan, Fatih; Oncu, Fatih; Erdogdu, Zeynep; Kayhan, Fatma Tulin

    2015-11-01

    To investigate the relationship between body dysmorphic syndrome and self-esteem in rhinoplasty candidates. A negative statistical correlation was evident between Rosenberg Self-Esteem Scale (RSES) and Body Dysmorphic Disorder Examination-Self Report (BDDE-SR) scores. In terms of responses to the first Body Dysmorphic Disorder Questionnaire (BDDQ) question, which focuses on general attitude toward body dysmorphic syndrome, the average RSES "YES" score was significantly less than the "NO" score. No significant differences appeared between RSES scores and scores for the 4th subgroup of BDDQ questions (subgroups A, B, and C; these questions explore how much time is spent daily on maintenance of bodily appearance). However, significant differences appeared between scores for the 4th subgroup of BDDQ questions and BDDE-SR scores. The average BDD-SR score of subgroup A (less than 1 hour spent on bodily maintenance) was significantly lower than those of group B (1-3 hours) and group C (more than 3 hours). However, no significant differences appeared in average BDD-SR scores between subgroups B and C. In this prospective study, 56 patients (31 females and 25 males) were evaluated preoperatively using the BDDQ, the BDDE-SR, and the RSES. Patients younger than 15 years and those with deformities caused by trauma were excluded. Rhinoplasty candidates had higher levels of body dysmorphic disorder (BDD). Although patients with low RSES scores were more likely to have BDD, rhinoplasty candidates were not notably deficient in self-esteem. However, in rhinoplasty candidates with low RSES scores, the frequency of BDD was elevated. Therefore, the authors suggest that rhinoplasty candidates with low RSES scores should be investigated carefully in terms of BDD.

  3. Care and Justice orientations to moral decision making in veterinary students.

    PubMed

    Quinn, C; Kinnison, T; May, S A

    2012-11-03

    An adapted version of the Moral Justification Scale was used to assess moral decision-making orientation in veterinary students, comparing sex and year of study. The Scale consists of vignettes and related statements, each of which was classified as Justice, Care for People or Care for Animals. The importance of each statement in the decision-making process was rated by 204 students on a 10-point Likert Scale. An average score of importance for Justice, Care for People and Care for Animals related statements were calculated for each individual. General inclination scores were calculated by subtracting an individual's average Care score from their average Justice score. Inclination scores suggested that two-thirds of students have a balanced approach, using Justice and Care almost equally in approaching ethical dilemmas. The majority of students, however, show an overall Justice orientation. The attitude towards the importance of Justice did not vary between students of different years or sexes. Students' attitudes towards the importance of Care for People in their decision making were, however, significantly lower for final-year students. Reasons hypothesised include the start of placements. Care for Animals scores were affected by sex, whereby females give more importance to such statements than males.

  4. Clinic research on the treatment for humeral shaft fracture with minimal invasive plate osteosynthesis: a retrospective study of 128 cases.

    PubMed

    Chen, H; Hu, X; Yang, G; Xiang, M

    2017-04-01

    Minimal invasive plate osteosynthesis (MIPO) is one of the most important techniques in the treatment for humeral shaft fractures. This study was performed to evaluate the efficacy of MIPO technique for the treatment for humeral shaft fractures. We retrospectively evaluated 128 cases with humeral shaft fractures that were treated with MIPO technique from March 2005 to August 2008. All the patients were followed up by routine radiological imaging and clinical examinations. Constant-Murley score and HSS elbow joint score were used to evaluate the treatment outcome. The average duration of the surgery was 60 min (range 40-95 min) without blood transfusion. All fractures healed without infection. All cases recovered carrying angle except four cases with 10°-15° cubitus varus. After the average follow-up of 23 (13-38) months, satisfactory function was achieved according to Constant-Murley score and HSS elbow joint score. Constant-Murley score was 80 on average (range 68-91). According to HSS elbow joint score, there were 123 cases of excellent clinical outcome and five cases of effective outcome. It seems to be a safe and effective method for managing humeral shaft fractures with MIPO technique.

  5. [Prediction of the total Japanese cedar pollen counts based on male flower-setting conditions of standard trees].

    PubMed

    Yuta, Atsushi; Ukai, Kotaro; Sakakura, Yasuo; Tani, Hideshi; Matsuda, Fukiko; Yang, Tian-qun; Majima, Yuichi

    2002-07-01

    We made a prediction of the Japanese cedar (Cryptomeria japonica) pollen counts at Tsu city based on male flower-setting conditions of standard trees. The 69 standard trees from 23 kinds of clones, planted at Mie Prefecture Science and Technology Promotion Center (Hakusan, Mie) in 1964, were selected. Male flower-setting conditions for 276 faces (69 trees x 4 points of the compass) were scored from 0 to 3. The average of scores and total pollen counts from 1988 to 2000 was analyzed. As the results, the average scores from standard trees and total pollen counts except two mass pollen-scattered years in 1995 and 2000 had a positive correlation (r = 0.914) by linear function. On the mass pollen-scattered years, pollen counts were influenced from the previous year. Therefore, the score of the present year minus that of the previous year were used for analysis. The average scores from male flower-setting conditions and pollen counts had a strong positive correlation (r = 0.994) when positive scores by taking account of the previous year were analyzed. We conclude that prediction of pollen counts are possible based on the male flower-setting conditions of standard trees.

  6. A new plan-scoring method using normal tissue complication probability for personalized treatment plan decisions in prostate cancer

    NASA Astrophysics Data System (ADS)

    Kim, Kwang Hyeon; Lee, Suk; Shim, Jang Bo; Yang, Dae Sik; Yoon, Won Sup; Park, Young Je; Kim, Chul Yong; Cao, Yuan Jie; Chang, Kyung Hwan

    2018-01-01

    The aim of this study was to derive a new plan-scoring index using normal tissue complication probabilities to verify different plans in the selection of personalized treatment. Plans for 12 patients treated with tomotherapy were used to compare scoring for ranking. Dosimetric and biological indexes were analyzed for the plans for a clearly distinguishable group ( n = 7) and a similar group ( n = 12), using treatment plan verification software that we developed. The quality factor ( QF) of our support software for treatment decisions was consistent with the final treatment plan for the clearly distinguishable group (average QF = 1.202, 100% match rate, n = 7) and the similar group (average QF = 1.058, 33% match rate, n = 12). Therefore, we propose a normal tissue complication probability (NTCP) based on the plan scoring index for verification of different plans for personalized treatment-plan selection. Scoring using the new QF showed a 100% match rate (average NTCP QF = 1.0420). The NTCP-based new QF scoring method was adequate for obtaining biological verification quality and organ risk saving using the treatment-planning decision-support software we developed for prostate cancer.

  7. Sealant retention is better assessed through colour photographs than through the replica and the visual examination methods.

    PubMed

    Hu, Xuan; Fan, Mingwan; Rong, Wensheng; Lo, Edward C M; Bronkhorst, Ewald; Frencken, Jo E

    2014-08-01

    The aim of this study was to test the hypothesis that the colour photograph method has a higher level of validity for assessing sealant retention than the visual clinical examination and replica methods. Sealed molars were assessed by two evaluators. The scores for the three methods were compared against consensus scores derived through assessing retention from scanning electron microscopy images (reference standard). The presence/absence (survival) of retained sealants on occlusal surfaces was determined according to the traditional and modified categorizations of retention. Sensitivity, specificity, and Youden-index scores were calculated. Sealant retention assessment scores for visual clinical examinations and for colour photographs were compared with those of the reference standard on 95 surfaces, and sealant retention assessment scores for replicas were compared with those of the reference standard on 33 surfaces. The highest mean Youden-index score for the presence/absence of sealant material was observed for the colour photograph method, followed by that for the replica method; the visual clinical examination method scored lowest. The mean Youden-index score for the survival of retained sealants was highest for the colour photograph method for both the traditional (0.882) and the modified (0.768) categories of sealant retention, whilst the visual clinical examination method had the lowest Youden-index score for these categories (0.745 and 0.063, respectively). The colour photograph method had a higher validity than the replica and the visual examination methods for assessing sealant retention. © 2014 Eur J Oral Sci.

  8. The Dental Hygiene Aptitude Tests and the American College Testing Program Tests as Predictors of Scores on the National Board Dental Hygiene Examination.

    ERIC Educational Resources Information Center

    Longenbecker, Sueann; Wood, Peter H.

    1984-01-01

    Scores from the National Board Dental Hygiene Examination (NBDHE) served as the criterion variable in a comparison of the predictive validity of the Dental Hygiene Aptitude Tests (DHAT) and the ACT Assessment tests. The DHAT-Science and Verbal tests combined to produce the highest multiple correlation with NBDHE scores. (Author/DWH)

  9. The effect of benzocaine and ketoprofen gels on pain during fixed orthodontic appliance treatment: a randomised, double-blind, crossover trial.

    PubMed

    Eslamian, Ladan; Borzabadi-Farahani, Ali; Gholami, Hadi

    2016-05-01

    To compare the analgesic effect of topical benzocaine (5%) and ketoprofen (1.60 mg/mL) after 2 mm activation of 7 mm long delta loops used for maxillary en-masse orthodontic space closure. Twenty patients (seven males, 13 females, 15-25 years of age, mean age of 19.5 years) participated in a randomised crossover, double-blind trial. After appliance activation, participants were instructed to use analgesic gels and record pain perception at 2, 6, 24 hours and 2, 3 and 7 days (at 18.00 hrs), using a visual analogue scale ruler (VAS, 0-4). Each patient received all three gels (benzocaine, ketoprofen, and a control (placebo)) randomly, but at three different appliance activation visits following a wash-over gap of one month. After the first day, the patients were instructed to repeat gel application twice a day at 10:00 and 18:00 hrs for three days. The recorded pain scores were subjected to non-parametric analysis. The highest pain was recorded at 2 and 6 hours. Pain scores were significantly different between the three groups (Kruskal-Wallis test, p < 0.01). The overall mean (SD) pain scores for the benzocaine 5%, ketoprofen, and control (placebo) groups were 0.89 (0.41), 0.68 (0.34), and 1.15 (0.81), respectively. The pain scores were significantly different between the ketoprofen and control groups (mean difference = 0.47, p = 0.005). All groups demonstrated significant differences in pain scores at the six different time intervals (p < 0.05) and there was no gender difference (p > 0.05). A significant pain reduction was observed following the use of ketoprofen when tested against a control gel (placebo). The highest pain scores were experienced in patients administered the placebo and the lowest scores in patients who applied ketoprofen gel. Benzocaine had an effect mid-way between ketoprofen and the placebo. The highest pain scores were recorded 2 hours following force application, which decreased to the lowest scores after 7 days.

  10. Segmentation schema for enhancing land cover identification: A case study using Sentinel 2 data

    NASA Astrophysics Data System (ADS)

    Mongus, Domen; Žalik, Borut

    2018-04-01

    Land monitoring is performed increasingly using high and medium resolution optical satellites, such as the Sentinel-2. However, optical data is inevitably subjected to the variable operational conditions under which it was acquired. Overlapping of features caused by shadows, soft transitions between shadowed and non-shadowed regions, and temporal variability of the observed land-cover types require radiometric corrections. This study examines a new approach to enhancing the accuracy of land cover identification that resolves this problem. The proposed method constructs an ensemble-type classification model with weak classifiers tuned to the particular operational conditions under which the data was acquired. Iterative segmentation over the learning set is applied for this purpose, where feature space is partitioned according to the likelihood of misclassifications introduced by the classification model. As these are a consequence of overlapping features, such partitioning avoids the need for radiometric corrections of the data, and divides land cover types implicitly into subclasses. As a result, improved performance of all tested classification approaches were measured during the validation that was conducted on Sentinel-2 data. The highest accuracies in terms of F1-scores were achieved using the Naive Bayes Classifier as the weak classifier, while supplementing original spectral signatures with normalised difference vegetation index and texture analysis features, namely, average intensity, contrast, homogeneity, and dissimilarity. In total, an F1-score of nearly 95% was achieved in this way, with F1-scores of each particular land cover type reaching above 90%.

  11. Multidimensional fatigue in pulmonary hypertension: prevalence, severity and predictors

    PubMed Central

    Tartavoulle, Todd M.; Karpinski, Aryn C.; Aubin, Andrew; Kluger, Benzi M.; Distler, Oliver; Saketkoo, Lesley Ann

    2018-01-01

    Pulmonary hypertension is a potentially fatal disease. Despite pharmacological advances in pulmonary hypertension, fatigue remains common in patients with pulmonary hypertension. A convenience sample of 120 participants at an international patient conference completed the Multidimensional Fatigue Inventory (MFI)-20 scale. Data on New York Heart Association Functional Class, body mass index, oxygen use and medication type/use were also collected. There was a high prevalence of “severe” to “very severe” fatigue for each dimension: General Fatigue (60%), Physical Fatigue (55.8%), Reduced Activity (41.7%), Reduced Motivation (32.5%) and Mental Fatigue (27.5%). The mean±sd overall MFI-20 score was 58±5.1. Dimensions with the highest averaged levels were General Fatigue (13.40±3.61), Physical Fatigue (13.23±3.67) and Reduced Activity (11.33±4.16). Body mass index correlated with higher fatigue scores. Phosphodiesterase inhibitor plus endothelin receptor antagonist combination negatively predicted General Fatigue, Physical Fatigue, Reduced Motivation and Reduced Activity. Triple therapy was a significant predictor of General Fatigue, Physical Fatigue and Reduced Activity. There were no significant predictors of Mental Fatigue. Multidimensional fatigue is common and severe in patients with pulmonary hypertension. Phosphodiesterase inhibitor plus endothelin receptor antagonist combination resulted in lower scores in most fatigue dimensions. Comprehensive assessment of fatigue should be considered in the clinical care of patients with pulmonary hypertension and clinical research to develop formal interventions that target this disabling symptom. PMID:29577043

  12. Impact of early human milk on sepsis and health-care costs in very low birth weight infants.

    PubMed

    Patel, A L; Johnson, T J; Engstrom, J L; Fogg, L F; Jegier, B J; Bigger, H R; Meier, P P

    2013-07-01

    To study the incidence of sepsis and neonatal intensive care unit (NICU) costs as a function of the human milk (HM) dose received during the first 28 days post birth for very low birth weight (VLBW) infants. Prospective cohort study of 175 VLBW infants. The average daily dose of HM (ADDHM) was calculated from daily nutritional data for the first 28 days post birth (ADDHM-Days 1-28). Other covariates associated with sepsis were used to create a propensity score, combining multiple risk factors into a single metric. The mean gestational age and birth weight were 28.1 ± 2.4 weeks and 1087 ± 252 g, respectively. The mean ADDHM-Days 1-28 was 54 ± 39 ml kg(-1) day(-1) (range 0-135). Binary logistic regression analysis controlling for propensity score revealed that increasing ADDHM-Days 1-28 was associated with lower odds of sepsis (odds ratio 0.981, 95% confidence interval 0.967-0.995, P=0.008). Increasing ADDHM-Days 1-28 was associated with significantly lower NICU costs. A dose-response relationship was demonstrated between ADDHM-Days 1-28 and a reduction in the odds of sepsis and associated NICU costs after controlling for propensity score. For every HM dose increase of 10 ml kg(-1) day(-1), the odds of sepsis decreased by 19%. NICU costs were lowest in the VLBW infants who received the highest ADDHM-Days 1-28.

  13. Comparative analysis of online patient education material pertaining to hepatitis and its complications.

    PubMed

    Gulati, Rishabh; Nawaz, Mohammad; Pyrsopoulos, Nikolaos T

    2016-05-01

    Approximately 50% of patients leave the doctor's office with a poor understanding of their diagnosis. Online patient education websites are becoming a major source of information for many of the patients. Here, we determine the reading grade level of online patient education materials on hepatitis B, hepatitis C, cirrhosis, and hepatocellular cancer and compare it with the National Institutes of Health-recommended reading grade level of sixth to seventh grade or under. A Google search was performed to retrieve patient reading materials. Text was modified to remove medical terms that were defined within the article. Documents were then divided into categories of introduction, risk factors, symptoms, diagnosis, treatment, and prevention. Each document was then analyzed using six validated readability tests to determine the grade level and complexity on the basis of the number of words, syllables, or number of uncommon words. Modified documents had a mean readability score of 10.23, although the recommended score is less than 7.0. Cirrhosis had the highest reading grade level, with a median of 11.3, whereas hepatitis B and hepatocellular carcinoma had the easiest readability, with a median of 9.5. Furthermore, treatment subsection was the most difficult, with a median score of 10.8. Patient reading materials reviewed in this study were written well above the recommended reading grade level. These findings suggest review of patient education materials in an effort to close the gap between the average reading level and the reading materials.

  14. Impact of Early Human Milk on Sepsis and Health Care Costs in Very Low Birth Weight Infants

    PubMed Central

    Patel, Aloka L.; Johnson, Tricia J.; Engstrom, Janet L.; Fogg, Louis F.; Jegier, Briana J.; Bigger, Harold R.; Meier, Paula P.

    2013-01-01

    Objective To study the incidence of sepsis and neonatal intensive care unit (NICU) costs as a function of the human milk (HM) dose received during the first 28 days post-birth for very low birth weight (VLBW) infants. Study Design Prospective cohort study of 175 VLBW infants. Average daily dose of HM (ADDHM) was calculated from daily nutritional data for the first 28 days post-birth (ADDHM-Days1-28). Other covariates associated with sepsis were used to create a propensity score, combining multiple risk factors into a single metric. Result The mean gestational age and birth weight were 28.1 ± 2.4 wk and 1087 ± 252 g, respectively. The mean ADDHM-Days1-28 was 54 ± 39 mL/kg/d (range 0-135). Binary logistic regression analysis controlling for propensity score revealed that increasing ADDHM-Days1-28 was associated with lower odds of sepsis (OR .981, 95%CI .967-.995, p=.008). Increasing ADDHM-Days1-28 was associated with significantly lower NICU costs. Conclusion A dose-response relationship was demonstrated between ADDHM-Days1-28 and a reduction in the odds of sepsis and associated NICU costs after controlling for propensity score. For every HM dose increase of 10 mL/kg/d, the odds of sepsis decreased by 19%. NICU costs were lowest in the VLBW infants who received the highest ADDHM-Days1-28. PMID:23370606

  15. High-Quality Diets Associate With Reduced Risk of Colorectal Cancer: Analyses of Diet Quality Indexes in the Multiethnic Cohort.

    PubMed

    Park, Song-Yi; Boushey, Carol J; Wilkens, Lynne R; Haiman, Christopher A; Le Marchand, Loïc

    2017-08-01

    Healthy eating patterns assessed by diet quality indexes (DQIs) have been related to lower risk of colorectal cancer-mostly among whites. We investigated the associations between 4 DQI scores (the Healthy Eating Index 2010 [HEI-2010], the Alternative Healthy Eating Index 2010 [AHEI-2010], the alternate Mediterranean diet score [aMED], and the Dietary Approaches to Stop Hypertension score) and colorectal cancer risk in the Multiethnic Cohort. We analyzed data from 190,949 African American, Native Hawaiian, Japanese American, Latino, and white individuals, 45 to 75 years old, who entered the Multiethnic Cohort study from 1993 through 1996. During an average 16 years of follow-up, 4770 invasive colorectal cancer cases were identified. Scores from all 4 DQIs associated inversely with colorectal cancer risk; higher scores associated with decreasing colorectal cancer risk (all P's for trend ≤ .003). Associations were not significant for AHEI-2010 and aMED scores in women after adjustment for covariates: for the highest vs lowest quintiles, the hazard ratio for the HEI-2010 score in men was 0.69 (95% confidence interval [CI], 0.59-0.80) and in women was 0.82 (95% CI, 0.70-0.96); for the AHEI-2010 score the hazard ratio in men was 0.75 (95% CI, 0.65-0.85) and in women was 0.90 (95% CI, 0.78-1.04); for the aMED score the hazard ratio in men was 0.84 (95% CI, 0.73-0.97) and in women was 0.96 (95% CI, 0.82-1.13); for the Dietary Approaches to Stop Hypertension score the hazard ratio in men was 0.75 (95% CI, 0.66-0.86) and in women was 0.86 (95% CI, 0.75-1.00). Associations were limited to the left colon and rectum for all indexes. The inverse associations were less strong in African American individuals than in the other 4 racial/ethnic groups. Based on an analysis of data from the Multiethnic Cohort Study, high-quality diets are associated with a lower risk of colorectal cancer in most racial/ethnic subgroups. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

  16. Concurrent Validity Between a Shared Curriculum, the Internal Medicine In-Training Examination, and the American Board of Internal Medicine Certifying Examination.

    PubMed

    Sisson, Stephen D; Bertram, Amanda; Yeh, Hsin-Chieh

    2015-03-01

    A core objective of residency education is to facilitate learning, and programs need more curricula and assessment tools with demonstrated validity evidence. We sought to demonstrate concurrent validity between performance on a widely shared, ambulatory curriculum (the Johns Hopkins Internal Medicine Curriculum), the Internal Medicine In-Training Examination (IM-ITE), and the American Board of Internal Medicine Certifying Examination (ABIM-CE). A cohort study of 443 postgraduate year (PGY)-3 residents at 22 academic and community hospital internal medicine residency programs using the curriculum through the Johns Hopkins Internet Learning Center (ILC). Total and percentile rank scores on ILC didactic modules were compared with total and percentile rank scores on the IM-ITE and total scores on the ABIM-CE. The average score on didactic modules was 80.1%; the percentile rank was 53.8. The average IM-ITE score was 64.1% with a percentile rank of 54.8. The average score on the ABIM-CE was 464. Scores on the didactic modules, IM-ITE, and ABIM-CE correlated with each other (P < .05). Residents completing greater numbers of didactic modules, regardless of scores, had higher IM-ITE total and percentile rank scores (P < .05). Resident performance on modules covering back pain, hypertension, preoperative evaluation, and upper respiratory tract infection was associated with IM-ITE percentile rank. Performance on a widely shared ambulatory curriculum is associated with performance on the IM-ITE and the ABIM-CE.

  17. The Validity of Two Neuromotor Assessments for Predicting Motor Performance at 12 Months in Preterm Infants.

    PubMed

    Song, You Hong; Chang, Hyun Jung; Shin, Yong Beom; Park, Young Sook; Park, Yun Hee; Cho, Eun Sol

    2018-04-01

    To evaluate the validity of the Test of Infant Motor Performance (TIMP) and general movements (GMs) assessment for predicting Alberta Infant Motor Scale (AIMS) score at 12 months in preterm infants. A total of 44 preterm infants who underwent the GMs and TIMP at 1 month and 3 months of corrected age (CA) and whose motor performance was evaluated using AIMS at 12 months CA were included. GMs were judged as abnormal on basis of poor repertoire or cramped-synchronized movements at 1 month CA and abnormal or absent fidgety movement at 3 months CA. TIMP and AIMS scores were categorized as normal (average and low average and >5th percentile, respectively) or abnormal (below average and far below average or <5th percentile, respectively). Correlations between GMs and TIMP scores at 1 month and 3 months CA and the AIMS classification at 12 months CA were examined. The TIMP score at 3 months CA and GMs at 1 month and 3 months CA were significantly correlated with the motor performance at 12 months CA. However, the TIMP score at 1 month CA did not correlate with the AIMS classification at 12 months CA. For infants with normal GMs at 3 months CA, the TIMP score at 3 months CA correlated significantly with the AIMS classification at 12 months CA. Our findings suggest that neuromotor assessment using GMs and TIMP could be useful to identify preterm infants who are likely to benefit from intervention.

  18. The Nation's Report Card Reading 2011 State Snapshot Report. Oregon. Grade 8, Public Schools

    ERIC Educational Resources Information Center

    National Center for Education Statistics, 2011

    2011-01-01

    Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to other…

  19. The Nation's Report Card Reading 2011 State Snapshot Report. Oregon. Grade 4, Public Schools

    ERIC Educational Resources Information Center

    National Center for Education Statistics, 2011

    2011-01-01

    Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to other…

  20. The Nation's Report Card Mathematics 2011 State Snapshot Report. Oregon. Grade 4, Public Schools

    ERIC Educational Resources Information Center

    National Center for Education Statistics, 2011

    2011-01-01

    Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 mathematics assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to…

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