Comparison of the sensitivity of the UKCAT and A Levels to sociodemographic characteristics: a national study

PubMed Central

2014-01-01

Background The UK Clinical Aptitude Test (UKCAT) was introduced to facilitate widening participation in medical and dental education in the UK by providing universities with a continuous variable to aid selection; one that might be less sensitive to the sociodemographic background of candidates compared to traditional measures of educational attainment. Initial research suggested that males, candidates from more advantaged socioeconomic backgrounds and those who attended independent or grammar schools performed better on the test. The introduction of the A* grade at A level permits more detailed analysis of the relationship between UKCAT scores, secondary educational attainment and sociodemographic variables. Thus, our aim was to further assess whether the UKCAT is likely to add incremental value over A level (predicted or actual) attainment in the selection process. Methods Data relating to UKCAT and A level performance from 8,180 candidates applying to medicine in 2009 who had complete information relating to six key sociodemographic variables were analysed. A series of regression analyses were conducted in order to evaluate the ability of sociodemographic status to predict performance on two outcome measures: A level ‘best of three’ tariff score; and the UKCAT scores. Results In this sample A level attainment was independently and positively predicted by four sociodemographic variables (independent/grammar schooling, White ethnicity, age and professional social class background). These variables also independently and positively predicted UKCAT scores. There was a suggestion that UKCAT scores were less sensitive to educational background compared to A level attainment. In contrast to A level attainment, UKCAT score was independently and positively predicted by having English as a first language and male sex. Conclusions Our findings are consistent with a previous report; most of the sociodemographic factors that predict A level attainment also predict UKCAT performance. However, compared to A levels, males and those speaking English as a first language perform better on UKCAT. Our findings suggest that UKCAT scores may be more influenced by sex and less sensitive to school type compared to A levels. These factors must be considered by institutions utilising the UKCAT as a component of the medical and dental school selection process. PMID:24400861

A Comparison of Presentation Levels to Maximize Word Recognition Scores

PubMed Central

Guthrie, Leslie A.; Mackersie, Carol L.

2010-01-01

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

School Performance: A Matter of Health or Socio-Economic Background? Findings from the PIAMA Birth Cohort Study

PubMed Central

Ruijsbroek, Annemarie; Wijga, Alet H.; Gehring, Ulrike; Kerkhof, Marjan; Droomers, Mariël

2015-01-01

Background Performance in primary school is a determinant of children’s educational attainment and their socio-economic position and health inequalities in adulthood. We examined the relationship between five common childhood health conditions (asthma symptoms, eczema, general health, frequent respiratory infections, and overweight), health related school absence and family socio-economic status on children’s school performance. Methods We used data from 1,865 children in the Dutch PIAMA birth cohort study. School performance was measured as the teacher’s assessment of a suitable secondary school level for the child, and the child’s score on a standardized achievement test (Cito Test). Both school performance indicators were standardised using Z-scores. Childhood health was indicated by eczema, asthma symptoms, general health, frequent respiratory infections, overweight, and health related school absence. Children’s health conditions were reported repeatedly between the age of one to eleven. School absenteeism was reported at age eleven. Highest attained educational level of the mother and father indicated family socio-economic status. We used linear regression models with heteroskedasticity-robust standard errors for our analyses with adjustment for sex of the child. Results The health indicators used in our study were not associated with children’s school performance, independently from parental educational level, with the exception of asthma symptoms (-0.03 z-score / -0.04 z-score with Cito Test score after adjusting for respectively maternal and paternal education) and missing more than 5 schooldays due to illness (-0.18 z-score with Cito Test score and -0.17 z-score with school level assessment after adjustment for paternal education). The effect estimates for these health indicators were much smaller though than the effect estimates for parental education, which was strongly associated with children’s school performance. Conclusion Children’s school performance was affected only slightly by a number of common childhood health problems, but was strongly associated with parental education. PMID:26247468

School Performance: A Matter of Health or Socio-Economic Background? Findings from the PIAMA Birth Cohort Study.

PubMed

Ruijsbroek, Annemarie; Wijga, Alet H; Gehring, Ulrike; Kerkhof, Marjan; Droomers, Mariël

2015-01-01

Performance in primary school is a determinant of children's educational attainment and their socio-economic position and health inequalities in adulthood. We examined the relationship between five common childhood health conditions (asthma symptoms, eczema, general health, frequent respiratory infections, and overweight), health related school absence and family socio-economic status on children's school performance. We used data from 1,865 children in the Dutch PIAMA birth cohort study. School performance was measured as the teacher's assessment of a suitable secondary school level for the child, and the child's score on a standardized achievement test (Cito Test). Both school performance indicators were standardised using Z-scores. Childhood health was indicated by eczema, asthma symptoms, general health, frequent respiratory infections, overweight, and health related school absence. Children's health conditions were reported repeatedly between the age of one to eleven. School absenteeism was reported at age eleven. Highest attained educational level of the mother and father indicated family socio-economic status. We used linear regression models with heteroskedasticity-robust standard errors for our analyses with adjustment for sex of the child. The health indicators used in our study were not associated with children's school performance, independently from parental educational level, with the exception of asthma symptoms (-0.03 z-score / -0.04 z-score with Cito Test score after adjusting for respectively maternal and paternal education) and missing more than 5 schooldays due to illness (-0.18 z-score with Cito Test score and -0.17 z-score with school level assessment after adjustment for paternal education). The effect estimates for these health indicators were much smaller though than the effect estimates for parental education, which was strongly associated with children's school performance. Children's school performance was affected only slightly by a number of common childhood health problems, but was strongly associated with parental education.

From dV-Trainer to Real Robotic Console: The Limitations of Robotic Skill Training.

PubMed

Yang, Kun; Zhen, Hang; Hubert, Nicolas; Perez, Manuela; Wang, Xing Huan; Hubert, Jacques

To investigate operators' performance quality, mental stress, and ergonomic habits through a training curriculum on robotic simulators. Forty volunteers without robotic surgery experience were recruited to practice 2 exercises on a dV-Trainer (dVT) for 14 hours. The simulator software (M-score a ) provided an automatic evaluation of the overall score for the surgeons' performance. Each participant provided a subjective difficulty score (validity to be proven) for each exercise. Their ergonomic habits were evaluated based on the workspace range and armrest load-validated criteria for evaluating the proficiency of using the armrest. They then repeated the same tasks on a da Vinci Surgical Skill Simulator for a final-level test. Their final scores were compared with their initial scores and the scores of 5 experts on the da Vinci Surgical Skill Simulator. A total of 14 hours of training on the dVT significantly improved the surgeons' performance scores to the expert level with a significantly reduced workload, but their ergonomic score was still far from the expert level. Sufficient training on the dVT improves novices' performance, reduces psychological stress, and inculcates better ergonomic habits. Among the evaluated criteria, novices had the most difficulty in achieving expert levels of ergonomic skills. The training benefits of robotic surgery simulators should be determined with quantified variables. The detection of the limitations during robotic training curricula could guide the targeted training and improve the training effect. Copyright © 2017. Published by Elsevier Inc.

Process-Oriented Guided Inquiry Learning Strategy Enhances Students’ Higher Level Thinking Skills in a Pharmaceutical Sciences Course

PubMed Central

Verlinden, Nathan; Kruger, Nicholas; Carroll, Ailey; Trumbo, Tiffany

2015-01-01

Objective. To determine if the process-oriented guided inquiry learning (POGIL) teaching strategy improves student performance and engages higher-level thinking skills of first-year pharmacy students in an Introduction to Pharmaceutical Sciences course. Design. Overall examination scores and scores on questions categorized as requiring either higher-level or lower-level thinking skills were compared in the same course taught over 3 years using traditional lecture methods vs the POGIL strategy. Student perceptions of the latter teaching strategy were also evaluated. Assessment. Overall mean examination scores increased significantly when POGIL was implemented. Performance on questions requiring higher-level thinking skills was significantly higher, whereas performance on questions requiring lower-level thinking skills was unchanged when the POGIL strategy was used. Student feedback on use of this teaching strategy was positive. Conclusion. The use of the POGIL strategy increased student overall performance on examinations, improved higher-level thinking skills, and provided an interactive class setting. PMID:25741027

The Predictive Value of Ultrasound Learning Curves Across Simulated and Clinical Settings.

PubMed

Madsen, Mette E; Nørgaard, Lone N; Tabor, Ann; Konge, Lars; Ringsted, Charlotte; Tolsgaard, Martin G

2017-01-01

The aim of the study was to explore whether learning curves on a virtual-reality (VR) sonographic simulator can be used to predict subsequent learning curves on a physical mannequin and learning curves during clinical training. Twenty midwives completed a simulation-based training program in transvaginal sonography. The training was conducted on a VR simulator as well as on a physical mannequin. A subgroup of 6 participants underwent subsequent clinical training. During each of the 3 steps, the participants' performance was assessed using instruments with established validity evidence, and they advanced to the next level only after attaining predefined levels of performance. The number of repetitions and time needed to achieve predefined performance levels were recorded along with the performance scores in each setting. Finally, the outcomes were correlated across settings. A good correlation was found between time needed to achieve predefined performance levels on the VR simulator and the physical mannequin (Pearson correlation coefficient .78; P < .001). Performance scores on the VR simulator correlated well to the clinical performance scores (Pearson correlation coefficient .81; P = .049). No significant correlations were found between numbers of attempts needed to reach proficiency across the 3 different settings. A post hoc analysis found that the 50% fastest trainees at reaching proficiency during simulation-based training received higher clinical performance scores compared to trainees with scores placing them among the 50% slowest (P = .025). Performances during simulation-based sonography training may predict performance in related tasks and subsequent clinical learning curves. © 2016 by the American Institute of Ultrasound in Medicine.

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

PubMed

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

2014-06-01

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

A Continuity Principle for Calibration of Scores within Mastery Assessment Systems.

ERIC Educational Resources Information Center

Tucker, Ledyard R.

A continuity principle is suggested for scaling of assessment scores from different levels of a multilevel mastery training program. In such training programs students are self-paced and work at levels of tasks appropriate for their levels of performance. The problem addressed in this report concerns the scaling of assessment scores at different…

A comparative study of students' performance in preclinical physiology assessed by multiple choice and short essay questions.

PubMed

Oyebola, D D; Adewoye, O E; Iyaniwura, J O; Alada, A R; Fasanmade, A A; Raji, Y

2000-01-01

This study was designed to compare the performance of medical students in physiology when assessed by multiple choice questions (MCQs) and short essay questions (SEQs). The study also examined the influence of factors such as age, sex, O/level grades and JAMB scores on performance in the MCQs and SEQs. A structured questionnaire was administered to 264 medical students' four months before the Part I MBBS examination. Apart from personal data of each student, the questionnaire sought information on the JAMB scores and GCE O' Level grades of each student in English Language, Biology, Chemistry, Physics and Mathematics. The physiology syllabus was divided into five parts and the students were administered separate examinations (tests) on each part. Each test consisted of MCQs and SEQs. The performance in MCQs and SEQs were compared. Also, the effects of JAMB scores and GCE O/level grades on the performance in both the MCQs and SEQs were assessed. The results showed that the students performed better in all MCQ tests than in the SEQs. JAMB scores and O' level English Language grade had no significant effect on students' performance in MCQs and SEQs. However O' level grades in Biology, Chemistry, Physics and Mathematics had significant effects on performance in MCQs and SEQs. Inadequate knowledge of physiology and inability to present information in a logical sequence are believed to be major factors contributing to the poorer performance in the SEQs compared with MCQs. In view of the finding of significant association between performance in MCQs and SEQs and GCE O/level grades in science subjects and mathematics, it was recommended that both JAMB results and the GCE results in the four O/level subjects above may be considered when selecting candidates for admission into the medical schools.

Factors affecting dance exercise performance in students at a special needs school.

PubMed

Ito, Yukiko; Hiramoto, Izumi; Kodama, Hideya

2017-09-01

In Japan, dance exercise has been introduced as a compulsory element of health and physical education, but there is a considerable discrepancy in the levels of performance among students with intellectual disability (ID) at special needs schools. The aim of this study was therefore to identify the factors affecting the performance of dance exercise in students with ID. A 4 month dance exercise program was implemented for junior high school students at a special needs school, and the performance of 32 students at 22 sessions was assessed quantitatively according to calorie use during exercise and performance proficiency score. The measures were compared according to gender, age, body mass index, diagnosis, and development quotient (DQ) score. Performance in many students improved with repetition and reached the highest attainment level at around the third month. Male gender and older age had a significant positive impact on calorie use, whereas diagnosis of Down syndrome and higher DQ score had a significant positive impact on proficiency score. Four students with poor performance were all female students with autism. This study provides some possible explanations for differences in the levels of dance performance among students with ID. © 2017 Japan Pediatric Society.

Hispanics' SAT Scores: The Influences of Level of Parental Education, Performance-Avoidance Goals, and Knowledge about Learning

ERIC Educational Resources Information Center

Hannon, Brenda

2015-01-01

This study uncovers which learning (epistemic belief of learning), socioeconomic background (level of parental education, family income) or social-personality factors (performance-avoidance goals, test anxiety) mitigate the ethnic gap in SAT (Scholastic Assessment Test) scores. Measures assessing achievement motivation, test anxiety, socioeconomic…

Using an Accountability Program to Improve Psychiatry Resident Scores on In-Service Examinations.

PubMed

Ferrell, Brandon T; Tankersley, William E; Morris, Clayton D

2015-12-01

The Psychiatry Resident-In-Training Examination (PRITE) is a standardized examination that measures residents' educational progress during residency training. It also serves as a moderate-to-strong predictor of later performance on the board certification examination. This study evaluated the effectiveness of an accountability program used by a public psychiatric hospital to increase its residents' PRITE scores. A series of consequences and incentives were developed based on levels of PRITE performance. Poor performance resulted in consequences, including additional academic assignments. Higher performance led to residents earning external moonlighting privileges. Standardized PRITE scores for all residents (N = 67) over a 10-year period were collected and analyzed. The PRITE examination consists of 2 subscales-psychiatry and neurology. Change in the overall level of PRITE scores following the implementation of the accountability program was estimated using a discontinuous growth curve model for each subscale. Standardized scores on the psychiatry subscale were 51.09 points, approximately 0.50 SD change, which was higher after the accountability program was implemented. Standardized scores on the neurology subscale did not change. An accountability program that assigns consequences based on examination performance may be moderately successful in improving scores on the psychiatry subscale scores of the PRITE. This likely has longer-term benefits for residents due to the relationship between PRITE and board certification examination performance.

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

PubMed

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

2007-08-15

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

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.

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

PubMed

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

2002-10-01

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

Rater Expertise in a Second Language Speaking Assessment: The Influence of Training and Experience

ERIC Educational Resources Information Center

Davis, Lawrence Edward

2012-01-01

Speaking performance tests typically employ raters to produce scores; accordingly, variability in raters' scoring decisions has important consequences for test reliability and validity. One such source of variability is the rater's level of expertise in scoring. Therefore, it is important to understand how raters' performance is influenced by…

Comparison of Basic Science Knowledge Between DO and MD Students.

PubMed

Davis, Glenn E; Gayer, Gregory G

2017-02-01

With the coming single accreditation system for graduate medical education, medical educators may wonder whether knowledge in basic sciences is equivalent for osteopathic and allopathic medical students. To examine whether medical students' basic science knowledge is the same among osteopathic and allopathic medical students. A dataset of the Touro University College of Osteopathic Medicine-CA student records from the classes of 2013, 2014, and 2015 and the national cohort of National Board of Medical Examiners Comprehensive Basic Science Examination (NBME-CBSE) parameters for MD students were used. Models of the Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) Level 1 scores were fit using linear and logistic regression. The models included variables used in both osteopathic and allopathic medical professions to predict COMLEX-USA outcomes, such as Medical College Admission Test biology scores, preclinical grade point average, number of undergraduate science units, and scores on the NBME-CBSE. Regression statistics were studied to compare the effectiveness of models that included or excluded NBME-CBSE scores at predicting COMLEX-USA Level 1 scores. Variance inflation factor was used to investigate multicollinearity. Receiver operating characteristic curves were used to show the effectiveness of NBME-CBSE scores at predicting COMLEX-USA Level 1 pass/fail outcomes. A t test at 99% level was used to compare mean NBME-CBSE scores with the national cohort. A total of 390 student records were analyzed. Scores on the NBME-CBSE were found to be an effective predictor of COMLEX-USA Level 1 scores (P<.001). The pass/fail outcome on COMLEX-USA Level 1 was also well predicted by NBME-CBSE scores (P<.001). No significant difference was found in performance on the NBME-CBSE between osteopathic and allopathic medical students (P=.322). As an examination constructed to assess the basic science knowledge of allopathic medical students, the NBME-CBSE is effective at predicting performance on COMLEX-USA Level 1. In addition, osteopathic medical students performed the same as allopathic medical students on the NBME-CBSE. The results imply that the same basic science knowledge is expected for DO and MD students.

Congenital heart disease: interrelation between German diagnosis-related groups system and Aristotle complexity score.

PubMed

Sinzobahamvya, Nicodème; Photiadis, Joachim; Arenz, Claudia; Kopp, Thorsten; Hraska, Viktor; Asfour, Boulos

2010-06-01

The Disease-Related Groups (DRGs) system postulates that inpatient stays with similar levels of clinical complexity are expected to consume similar amounts of resources. This, applied to surgery of congenital heart disease, suggests that the higher the complexity of procedures as estimated by the Aristotle complexity score, the higher hospital reimbursement should be. This study analyses how much case-mix index (CMI) generated by German DRG 2009 version correlates with Aristotle score. A total of 456 DRG cases of year 2008 were regrouped according to German DRG 2009 and related cost-weight values and overall CMI evaluated. Corresponding Aristotle basic and comprehensive complexity scores (ABC and ACC) and levels were determined. Associated surgical performance (Aristotle score times hospital survival) was estimated. Spearman 'r' correlation coefficients were calculated between Aristotle scores and cost-weights. Goodness of fit 'r(2)' from derived regression was determined. Correlation was estimated to be optimal if Spearman 'r' and derived goodness of fit 'r(2)' approached 1 value. CMI was 8.787 while mean ABC and ACC scores were 7.64 and 9.27, respectively. Hospital survival was 98.5%: therefore, surgical performance attained 7.53 (ABC score) and 9.13 (ACC score). ABC and ACC scores and levels positively correlated with cost-weights. With Spearman 'r' of 1 and goodness of fit 'r(2)' of 0.9790, scores of the six ACC levels correlated at best. The equation was y = 0.5591 + 0.939x, in which y stands for cost-weight (CMI) and x for score of ACC level. ACC score correlates almost perfectly with corresponding cost-weights (CMI) generated by the German DRG 2009. It could therefore be used as the basis for hospital reimbursement to compensate in conformity with procedures' complexity. Extrapolated CMI in this series would be 9.264. Modulation of reimbursement according to surgical performance could be established and thus 'reward' quality in congenital heart surgery. Copyright 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

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

ERIC Educational Resources Information Center

Hennessy, James J.; Merrifield, Philip R.

1978-01-01

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

Enhancing the Interpretability of the Overall Results of an International Test of English-Language Proficiency

ERIC Educational Resources Information Center

Papageorgiou, Spiros; Morgan, Rick; Becker, Valerie

2015-01-01

The purpose of this study was to enhance the meaning of the scores of an English-language test by developing performance levels and descriptors for reporting overall test performance. The levels and descriptors were intended to accompany the total scale scores of TOEFL Junior® Standard, an international test of English as a second/foreign…

Serum Albumin and Disease Severity of Non-Cystic Fibrosis Bronchiectasis.

PubMed

Lee, Seung Jun; Kim, Hyo-Jung; Kim, Ju-Young; Ju, Sunmi; Lim, Sujin; Yoo, Jung Wan; Nam, Sung-Jin; Lee, Gi Dong; Cho, Hyun Seop; Kim, Rock Bum; Cho, Yu Ji; Jeong, Yi Yeong; Kim, Ho Cheol; Lee, Jong Deog

2017-08-01

A clinical classification system has been developed to define the severity and predict the prognosis of subjects with non-cystic fibrosis (CF) bronchiectasis. We aimed to identify laboratory parameters that are correlated with the bronchiectasis severity index (BSI) and FACED score. The medical records of 107 subjects with non-CF bronchiectasis for whom BSI and FACED scores could be calculated were retrospectively reviewed. The correlations between the laboratory parameters and BSI or FACED score were assessed, and multiple-linear regression analysis was performed to identify variables independently associated with BSI and FACED score. An additional subgroup analysis was performed according to sex. Among all of the enrolled subjects, 49 (45.8%) were male and 58 (54.2%) were female. The mean BSI and FACED scores were 9.43 ± 3.81 and 1.92 ± 1.59, respectively. The serum albumin level (r = -0.49), bilirubin level (r = -0.31), C-reactive protein level (r = 0.22), hemoglobin level (r = -0.2), and platelet/lymphocyte ratio (r = 0.31) were significantly correlated with BSI. Meanwhile, serum albumin (r = -0.37) and bilirubin level (r = -0.25) showed a significant correlation with the FACED score. Multiple-linear regression analysis showed that the serum bilirubin level was independently associated with BSI, and the serum albumin level was independently associated with both scoring systems. Subgroup analysis revealed that the level of uric acid was also a significant variable independently associated with the BSI in male bronchiectasis subjects. Several laboratory variables were identified as possible prognostic factors for non-CF bronchiectasis. Among them, the serum albumin level exhibited the strongest correlation and was identified as an independent variable associated with the BSI and FACED scores. Copyright © 2017 by Daedalus Enterprises.

Relationship Between Speech Intelligibility and Speech Comprehension in Babble Noise.

PubMed

Fontan, Lionel; Tardieu, Julien; Gaillard, Pascal; Woisard, Virginie; Ruiz, Robert

2015-06-01

The authors investigated the relationship between the intelligibility and comprehension of speech presented in babble noise. Forty participants listened to French imperative sentences (commands for moving objects) in a multitalker babble background for which intensity was experimentally controlled. Participants were instructed to transcribe what they heard and obey the commands in an interactive environment set up for this purpose. The former test provided intelligibility scores and the latter provided comprehension scores. Collected data revealed a globally weak correlation between intelligibility and comprehension scores (r = .35, p < .001). The discrepancy tended to grow as noise level increased. An analysis of standard deviations showed that variability in comprehension scores increased linearly with noise level, whereas higher variability in intelligibility scores was found for moderate noise level conditions. These results support the hypothesis that intelligibility scores are poor predictors of listeners' comprehension in real communication situations. Intelligibility and comprehension scores appear to provide different insights, the first measure being centered on speech signal transfer and the second on communicative performance. Both theoretical and practical implications for the use of speech intelligibility tests as indicators of speakers' performances are discussed.

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.

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

Construct Validity of Fresh Frozen Human Cadaver as a Training Model in Minimal Access Surgery

PubMed Central

Macafee, David; Pranesh, Nagarajan; Horgan, Alan F.

2012-01-01

Background: The construct validity of fresh human cadaver as a training tool has not been established previously. The aims of this study were to investigate the construct validity of fresh frozen human cadaver as a method of training in minimal access surgery and determine if novices can be rapidly trained using this model to a safe level of performance. Methods: Junior surgical trainees, novices (<3 laparoscopic procedure performed) in laparoscopic surgery, performed 10 repetitions of a set of structured laparoscopic tasks on fresh frozen cadavers. Expert laparoscopists (>100 laparoscopic procedures) performed 3 repetitions of identical tasks. Performances were scored using a validated, objective Global Operative Assessment of Laparoscopic Skills scale. Scores for 3 consecutive repetitions were compared between experts and novices to determine construct validity. Furthermore, to determine if the novices reached a safe level, a trimmed mean of the experts score was used to define a benchmark. Mann-Whitney U test was used for construct validity analysis and 1-sample t test to compare performances of the novice group with the benchmark safe score. Results: Ten novices and 2 experts were recruited. Four out of 5 tasks (nondominant to dominant hand transfer; simulated appendicectomy; intracorporeal and extracorporeal knot tying) showed construct validity. Novices’ scores became comparable to benchmark scores between the eighth and tenth repetition. Conclusion: Minimal access surgical training using fresh frozen human cadavers appears to have construct validity. The laparoscopic skills of novices can be accelerated through to a safe level within 8 to 10 repetitions. PMID:23318058

The Distribution of Thai Mental State Examination Scores among Non-Demented Elderly in Suburban Bangkok Metropolitan and Associated Factors.

PubMed

Muangpaisan, Weerasak; Assantachai, Prasert; Sitthichai, Kobkul; Richardson, Kathryn; Brayne, Carol

2015-09-01

To obtain the distribution of Thai Mental State Examination (TMSE) scores in the Thai population across different age groups and educational levels in men and women aged 50 years and older and its relationship with demographic factors. The different cutpoints in literate and illiterate participants and item performance in both groups were also determined. Community-dwelling participants aged 50 years and over were invited to join the study. Personal information, general health history, and specific illness questionnaires including the activities of daily living, designed by the Survey in Europe on Nutrition and the Elderly, a ConcertedAction (SENECA), and the Thai Mental State Examination (TMSE) were completed in the face-to-face interview. There were 4,459 participants with no specific reported conditions that could potentially influence cognitive performance. The mean (SD) age was 64.2 (7.9) years and mostparticipants were women (71.7%). The median (interquartile range) of the TMSE was 27 (25-29) and 23 (19-26) in literate and illiterate participants, respectively. The distribution of TMSE scores were reported here determined by age, gender and educational level. Percentage of correct response in each TMSE item was low in recall and calculation performance. TMSE score declined with age in both genders and had greater variation with increasing age. TMSE score also increased with increasing levels of education and better financial status. Gender was not associated with the TMSE score adjusting for age, educational level, and economic status. Age, education, and economic status have an influence on the TMSE performance. Controllingfor these three factors, genders does not contribute to significant differences in TMSE performance. Norms adjustedfor these factors should be considered before employing single cutpoints to identify impairment.

Emotion rendering in music: range and characteristic values of seven musical variables.

PubMed

Bresin, Roberto; Friberg, Anders

2011-10-01

Many studies on the synthesis of emotional expression in music performance have focused on the effect of individual performance variables on perceived emotional quality by making a systematical variation of variables. However, most of the studies have used a predetermined small number of levels for each variable, and the selection of these levels has often been done arbitrarily. The main aim of this research work is to improve upon existing methodologies by taking a synthesis approach. In a production experiment, 20 performers were asked to manipulate values of 7 musical variables simultaneously (tempo, sound level, articulation, phrasing, register, timbre, and attack speed) for communicating 5 different emotional expressions (neutral, happy, scary, peaceful, sad) for each of 4 scores. The scores were compositions communicating four different emotions (happiness, sadness, fear, calmness). Emotional expressions and music scores were presented in combination and in random order for each performer for a total of 5 × 4 stimuli. The experiment allowed for a systematic investigation of the interaction between emotion of each score and intended expressed emotions by performers. A two-way analysis of variance (ANOVA), repeated measures, with factors emotion and score was conducted on the participants' values separately for each of the seven musical factors. There are two main results. The first one is that musical variables were manipulated in the same direction as reported in previous research on emotional expressive music performance. The second one is the identification for each of the five emotions the mean values and ranges of the five musical variables tempo, sound level, articulation, register, and instrument. These values resulted to be independent from the particular score and its emotion. The results presented in this study therefore allow for both the design and control of emotionally expressive computerized musical stimuli that are more ecologically valid than stimuli without performance variations. Copyright © 2011 Elsevier Srl. All rights reserved.

Congenital heart surgery: surgical performance according to the Aristotle complexity score.

PubMed

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

2011-04-01

Aristotle score methodology defines surgical performance as 'complexity score times hospital survival'. We analysed how this performance evolved over time and in correlation with case volume. Aristotle basic and comprehensive complexity scores and corresponding basic and comprehensive surgical performances were determined for primary (main) procedures carried out from 2006 to 2009. Surgical case volume performance described as unit performance was estimated as 'surgical performance times the number of primary procedures'. Basic and comprehensive complexity scores for the whole cohort of procedures (n=1828) were 7.74±2.66 and 9.89±3.91, respectively. With an early survival of 97.5% (1783/1828), mean basic and comprehensive surgical performances reached 7.54±2.54 and 9.64±3.81, respectively. Basic surgical performance varied little over the years: 7.46±2.48 in 2006, 7.43±2.58 in 2007, 7.50±2.76 in 2008 and 7.79±2.54 in 2009. Comprehensive surgical performance decreased from 9.56±3.91 (2006) to 9.22±3.94 (2007), and then to 9.13±3.77 (2008), thereafter increasing up to 10.62±3.67 (2009). No significant change of performance was observed for low comprehensive complexity levels 1-3. Variation concerned level 4 (p=0.048) which involved the majority of procedures (746, or 41% of cases) and level 6 (p<0.0001) which included a few cases (20, or 1%), whereas for level 5, statistical significance was almost attained: p=0.079. With a mean annual number of procedures of 457, mean basic and comprehensive unit performance was estimated at 3447±362 and 4405±577, respectively. Basic unit performance increased year to year from 3036 (2006, 100%) to 3254 (2007, 107.2%), then 3720 (2008, 122.5%), up to 3793 (2009, 124.9%). Comprehensive unit performance also increased: from 3891 (2006, 100%) to 4038 (2007, 103.8%), 4528 (2008, 116.4%) and 5172 (2009, 132.9%). Aristotle scoring of surgical performance allows quality assessment of surgical management of congenital heart disease over time. The newly defined unit performance appears to well reflect the trend of activity and efficiency of a congenital heart surgery department. Copyright © 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

Patterns in Illinois educational school data

NASA Astrophysics Data System (ADS)

Stevens, Cacey S.; Marder, Michael; Nagel, Sidney R.

2015-06-01

We examine Illinois educational data from standardized exams and analyze primary factors affecting the achievement of public school students. We focus on the simplest possible models: representation of data through visualizations and regressions on single variables. Exam scores are shown to depend on school type, location, and poverty concentration. For most schools in Illinois, student test scores decline linearly with poverty concentration. However, Chicago must be treated separately. Selective schools in Chicago, as well as some traditional and charter schools, deviate from this pattern based on poverty. For any poverty level, Chicago schools perform better than those in the rest of Illinois. Selective programs for gifted students show high performance at each grade level, most notably at the high school level, when compared to other Illinois school types. The case of Chicago charter schools is more complex. Up to 2008, Chicago charter and neighborhood schools had similar performance scores. In the last few years, charter students' scores overtook those of students in traditional schools as the number of charter school locations increased.

Comparison of the goals and MISTELS scores for the evaluation of surgeons on training benches.

PubMed

Wolf, Rémi; Medici, Maud; Fiard, Gaëlle; Long, Jean-Alexandre; Moreau-Gaudry, Alexandre; Cinquin, Philippe; Voros, Sandrine

2018-01-01

Evaluation of surgical technical abilities is a major issue in minimally invasive surgery. Devices such as training benches offer specific scores to evaluate surgeons but cannot transfer in the operating room (OR). A contrario, several scores measure performance in the OR, but have not been evaluated on training benches. Our aim was to demonstrate that the GOALS score, which can effectively grade in the OR the abilities involved in laparoscopy, can be used for evaluation on a laparoscopic testbench (MISTELS). This could lead to training systems that can identify more precisely the skills that have been acquired or must still be worked on. 32 volunteers (surgeons, residents and medical students) performed the 5 tasks of the MISTELS training bench and were simultaneously video-recorded. Their performance was evaluated with the MISTELS score and with the GOALS score based on the review of the recording by two experienced, blinded laparoscopic surgeons. The concurrent validity of the GOALS score was assessed using Pearson and Spearman correlation coefficients with the MISTELS score. The construct validity of the GOALS score was assessed with k-means clustering and accuracy rates. Lastly, abilities explored by each MISTELS task were identified with multiple linear regression. GOALS and MISTELS scores are strongly correlated (Pearson correlation coefficient = 0.85 and Spearman correlation coefficient = 0.82 for the overall score). The GOALS score proves to be valid for construction for the tasks of the training bench, with a better accuracy rate between groups of level after k-means clustering, when compared to the original MISTELS score (accuracy rates, respectively, 0.75 and 0.56). GOALS score is well suited for the evaluation of the performance of surgeons of different levels during the completion of the tasks of the MISTELS training bench.

Comprehensive Osteopathic Medical Licensing Examination-USA level 1 and level 2-cognitive evaluation preparation and outcomes.

PubMed

Maholtz, Danielle E; Erickson, Michael J; Cymet, Tyler

2015-04-01

The Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) assesses the competence of osteopathic physicians in training. It is designed to protect the public by setting minimum competence standards. All osteopathic medical students must pass COMLEX-USA Level 1, Level 2-Cognitive Evaluation, and Level 2-Performance Evaluation before being allowed to graduate from an osteopathic medical school. Residency training programs use COMLEX-USA scores as a major factor in deciding whom they will interview and admit into their programs. In addition, colleges of osteopathic medicine use student COMLEX-USA scores as an external assessment of their success in educating students. Because COMLEX-USA is a high-stakes examination series, it is important to understand predictive factors for performance. The authors review the literature on the relationship between COMLEX-USA scores and correlated student variables. Results from the Council on Osteopathic Student Government Presidents' survey on students' preparation methods and performance are also provided.

Neurosurgical Skills Assessment: Measuring Technical Proficiency in Neurosurgery Residents Through Intraoperative Video Evaluations.

PubMed

Sarkiss, Christopher A; Philemond, Steven; Lee, James; Sobotka, Stanislaw; Holloway, Terrell D; Moore, Maximillian M; Costa, Anthony B; Gordon, Errol L; Bederson, Joshua B

2016-05-01

Although technical skills are fundamental in neurosurgery, there is little agreement on how to describe, measure, or compare skills among surgeons. The primary goal of this study was to develop a quantitative grading scale for technical surgical performance that distinguishes operator skill when graded by domain experts (residents, attendings, and nonsurgeons). Scores provided by raters should be highly reliable with respect to scores from other observers. Neurosurgery residents were fitted with a head-mounted video camera while performing craniotomies under attending supervision. Seven videos, 1 from each postgraduate year (PGY) level (1-7), were anonymized and scored by 16 attendings, 8 residents, and 7 nonsurgeons using a grading scale. Seven skills were graded: incision, efficiency of instrument use, cauterization, tissue handling, drilling/craniotomy, confidence, and training level. A strong correlation was found between skills score and PGY year (P < 0.001, analysis of variance). Junior residents (PGY 1-3) had significantly lower scores than did senior residents (PGY 4-7, P < 0.001, t test). Significant variation among junior residents was observed, and senior residents' scores were not significantly different from one another. Interrater reliability, measured against other observers, was high (r = 0.581 ± 0.245, Spearman), as was assessment of resident training level (r = 0.583 ± 0.278, Spearman). Both variables were strongly correlated (r = 0.90, Pearson). Attendings, residents, and nonsurgeons did not score differently (P = 0.46, analysis of variance). Technical skills of neurosurgery residents recorded during craniotomy can be measured with high interrater reliability. Surgeons and nonsurgeons alike readily distinguish different skill levels. This type of assessment could be used to coach residents, to track performance over time, and potentially to compare skill levels. Developing an objective tool to evaluate surgical performance would be useful in several areas of neurosurgery education. Copyright © 2016 Elsevier Inc. All rights reserved.

Long-term and within-day variability of working memory performance and EEG in individuals.

PubMed

Gevins, Alan; McEvoy, Linda K; Smith, Michael E; Chan, Cynthia S; Sam-Vargas, Lita; Baum, Cliff; Ilan, Aaron B

2012-07-01

Assess individual-subject long-term and within-day variability of a combined behavioral and EEG test of working memory. EEGs were recorded from 16 adults performing n-back working memory tasks, with 10 tested in morning and afternoon sessions over several years. Participants were also tested after ingesting non-prescription medications or recreational substances. Performance and EEG measures were analyzed to derive an Overall score and three constituent sub-scores characterizing changes in performance, cortical activation, and alertness from each individual's baseline. Long-term and within-day variability were determined for each score; medication effects were assessed by reference to each individual's normal day-to-day variability. Over the several year period, the mean Overall score and sub-scores were approximately zero with standard deviations less than one. Overall scores were lower and their variability higher in afternoon relative to morning sessions. At the group level, alcohol, diphenhydramine and marijuana produced significant effects, but there were large individual differences. Objective working memory measures incorporating performance and EEG are stable over time and sensitive at the level of individual subjects to interventions that affect neurocognitive function. With further research these measures may be suitable for use in individualized medical care by providing a sensitive assessment of incipient illness and response to treatment. Published by Elsevier Ireland Ltd.

Monitoring performance, pituitary-adrenal hormones and mood profiles: how to diagnose non-functional over-reaching in male elite junior soccer players.

PubMed

Schmikli, Sándor L; de Vries, Wouter R; Brink, Michel S; Backx, Frank Jg

2012-11-01

To verify if in male elite junior soccer players a minimum 1-month performance decrease is accompanied by a mood profile and hormone levels typical of non-functional over-reaching (NFOR). A prospective case-control study using a monthly performance monitor with a standardised field test to detect the performance changes. Players with a performance decrease lasting at least 1 month were compared with control players without a performance decrease on mood scores and pre-exercise and postexercise levels of stress hormones. Sporting field and sports medical laboratory. Ninety-four young elite soccer players were monitored during the 2006-2008 seasons. Twenty-one players were invited to the laboratory, seven of whom showed a significant performance decrease. Performance change over time, scores on the profile of mood states and premaximal and postmaximal exercise serum levels of adrenocorticotropic hormone (ACTH), growth hormone (GH) and cortisol. Players with a performance decrease showed psychological and hormonal changes typical of the non-functional state of over-reaching. Scores were higher on depression and anger, whereas the resting GH levels and ACTH levels after maximal exercise were reduced. ACTH and GH were capable of classifying all but one player correctly as either NFOR or control. Performance-related criteria in field tests are capable of identifying players with worsened mood and adaptations of the endocrine system that fit the definition of NFOR. Performance, mood and hormone levels may therefore be considered as valid instruments to diagnose NFOR in young elite soccer players.

CREOG In-Training Examination Results: Contemporary Use to Predict ABOG Written Examination Outcomes

PubMed Central

Lingenfelter, Brandon M.; Jiang, Xuezhi; Schnatz, Peter F.; O'Sullivan, David M.; Minassian, Shahab S.; Forstein, David A.

2016-01-01

Background The in-training examination (ITE) offers formative assessments of residents' developing medical knowledge. Identification of an ITE performance level associated with success on the specialty board examination allows identification of “at risk” residents. Objective This study sought to identify a threshold score for obstetrics and gynecology residents' performance on the Council on Resident Education in Obstetrics and Gynecology (CREOG) ITE that predicts successful performance on the American Board of Obstetrics and Gynecology (ABOG) written examination. Methods We analyzed ITE and ABOG results of 80 residents who completed 4 years of CREOG ITEs at 2 institutions between 2002 and 2012. We assessed the level of performance associated with successful performance on the ABOG written examination. Results Data analyzed included scores for 71 of 80 residents (89%), with an overall pass rate of 82%. A postgraduate year (PGY) 4 score of 200 on the CREOG ITE or twice in any of the PGY training years was associated with a 100% ABOG pass rate. Scoring ≥ 205 in any PGY also was associated with a 100% pass rate. Residents who did not attain a score of 200 had a 35% to 45% chance of failing the ABOG written examination, depending on the PGY of the ITE performance. Conclusions Our findings suggest that a CREOG ITE score of at least 200 twice, or as a PGY-4, offers assurance of successful performance on the ABOG examination. Scores lower than this threshold may be used to identify “at risk” residents for added learning and provide program elements in need of improvement. PMID:27413437

CREOG In-Training Examination Results: Contemporary Use to Predict ABOG Written Examination Outcomes.

PubMed

Lingenfelter, Brandon M; Jiang, Xuezhi; Schnatz, Peter F; O'Sullivan, David M; Minassian, Shahab S; Forstein, David A

2016-07-01

The in-training examination (ITE) offers formative assessments of residents' developing medical knowledge. Identification of an ITE performance level associated with success on the specialty board examination allows identification of "at risk" residents. This study sought to identify a threshold score for obstetrics and gynecology residents' performance on the Council on Resident Education in Obstetrics and Gynecology (CREOG) ITE that predicts successful performance on the American Board of Obstetrics and Gynecology (ABOG) written examination. We analyzed ITE and ABOG results of 80 residents who completed 4 years of CREOG ITEs at 2 institutions between 2002 and 2012. We assessed the level of performance associated with successful performance on the ABOG written examination. Data analyzed included scores for 71 of 80 residents (89%), with an overall pass rate of 82%. A postgraduate year (PGY) 4 score of 200 on the CREOG ITE or twice in any of the PGY training years was associated with a 100% ABOG pass rate. Scoring ≥ 205 in any PGY also was associated with a 100% pass rate. Residents who did not attain a score of 200 had a 35% to 45% chance of failing the ABOG written examination, depending on the PGY of the ITE performance. Our findings suggest that a CREOG ITE score of at least 200 twice, or as a PGY-4, offers assurance of successful performance on the ABOG examination. Scores lower than this threshold may be used to identify "at risk" residents for added learning and provide program elements in need of improvement.

Development of the TeamOBS-PPH - targeting clinical performance in postpartum hemorrhage.

PubMed

Brogaard, Lise; Hvidman, Lone; Hinshaw, Kim; Kierkegaard, Ole; Manser, Tanja; Musaeus, Peter; Arafeh, Julie; Daniels, Kay I; Judy, Amy E; Uldbjerg, Niels

2018-06-01

This study aimed to develop a valid and reliable TeamOBS-PPH tool for assessing clinical performance in the management of postpartum hemorrhage (PPH). The tool was evaluated using video-recordings of teams managing PPH in both real-life and simulated settings. A Delphi panel consisting of 12 obstetricians from the UK, Norway, Sweden, Iceland, and Denmark achieved consensus on (i) the elements to include in the assessment tool, (ii) the weighting of each element, and (iii) the final tool. The validity and reliability were evaluated according to Cook and Beckman. (Level 1) Four raters scored four video-recordings of in situ simulations of PPH. (Level 2) Two raters scored 85 video-recordings of real-life teams managing patients with PPH ≥1000 mL in two Danish hospitals. (Level 3) Two raters scored 15 video-recordings of in situ simulations of PPH from a US hospital. The tool was designed with scores from 0 to 100. (Level 1) Teams of novices had a median score of 54 (95% CI 48-60), whereas experienced teams had a median score of 75 (95% CI 71-79; p < 0.001). (Level 2) The intra-rater [intra-class correlation (ICC) = 0.96] and inter-rater (ICC = 0.83) agreements for real-life PPH were strong. The tool was applicable in all cases: atony, retained placenta, and lacerations. (Level 3) The tool was easily adapted to in situ simulation settings in the USA (ICC = 0.86). The TeamOBS-PPH tool appears to be valid and reliable for assessing clinical performance in real-life and simulated settings. The tool will be shared as the free TeamOBS App. © 2018 Nordic Federation of Societies of Obstetrics and Gynecology.

Performance of the Hack's Impairment Index Score: A Novel Tool to Assess Impairment from Alcohol in Emergency Department Patients.

PubMed

Hack, Jason B; Goldlust, Eric J; Ferrante, Dennis; Zink, Brian J

2017-10-01

Over 35 million alcohol-impaired (AI) patients are cared for in emergency departments (EDs) annually. Emergency physicians are charged with ensuring AI patients' safety by identifying resolution of alcohol-induced impairment. The most common standard evaluation is an extemporized clinical examination, as ethanol levels are not reliable or predictive of clinical symptoms. There is no standard assessment of ED AI patients. The objective was to evaluate a novel standardized ED assessment of alcohol impairment, Hack's Impairment Index (HII score), in a busy urban ED. A retrospective chart review was performed for all AI patients seen in our busy urban ED over 24 months. Trained nurses evaluated AI patients with both "usual" and HII score every 2 hours. Patients were stratified by frequency of visits for AI during this time: high (≥ 6), medium (2-5), and low (1). Within each category, comparisons were made between HII scores, measured ethanol levels, and usual nursing assessment of AI. Changes in HII scores over time were also evaluated. A total of 8,074 visits from 3,219 unique patients were eligible for study, including 7,973 (98.7%) with ethanol levels, 5,061 (62.7%) with complete HII scores, and 3,646 (45.2%) with health care provider assessments. Correlations between HII scores and ethanol levels were poor (Pearson's R 2  = 0.09, 0.09, and 0.17 for high-, medium-, and low-frequency strata). HII scores were excellent at discriminating nursing assessment of AI, while ethanol levels were less effective. Omitting extrema, HII scores fell consistently an average 0.062 points per hour, throughout patients' visits. The HII score applied a quantitative, objective assessment of alcohol impairment. HII scores were superior to ethanol levels as an objective clinical measure of impairment. The HII declines in a reasonably predictable manner over time, with serial evaluations corresponding well with health care provider evaluations. © 2017 by the Society for Academic Emergency Medicine.

Spatial task performance, sex differences, and motion sickness susceptibility.

PubMed

Levine, Max E; Stern, Robert M

2002-10-01

There are substantial individual differences in susceptibility to motion sickness, yet little is known about what mediates these differences. Spatial ability and sex have been suggested as possible factors in this relationship. 89 participants (57 women) were administered a Motion Sickness Questionnaire that assesses motion sickness susceptibility, a Water-level Task that gauges sensitivity to gravitational upright, and a Mental Rotation Task that tests an individual's awareness of how objects typically move in space. Significant sex differences were observed in performance of both the Water-level Task (p<.01), and the Mental Rotation Task (p<.005), with women performing less accurately than men. Women also had significantly higher scores on the Motion Sickness Questionnaire (p<.005). Among men, but not women, significant negative relationships were observed between Water-level Task performance and Motion Sickness Questionnaire score (p<.001) and between Mental Rotation Task performance and Motion Sickness Questionnaire score (p<.005). In conclusion, women performed significantly more poorly than men did on the spatial ability tasks and reported significantly more bouts of motion sickness. In addition, men showed a significant negative relationship between spatial ability and motion sickness susceptibility.

Teaching Children to Relax.

ERIC Educational Resources Information Center

Proeger, Charlene; Myrick, Robert D.

1980-01-01

Many elementary school students perform below their ability levels due to excessive anxiety and stress. Research reveals negative correlations between general anxiety and test anxiety, and scores on intelligence tests. Studies have shown that changes in anxiety level are related to changes in intelligence quotient scores. Further, anxiety affects…

The effects of individual differences, prior experience and cognitive load on the transfer of dynamic decision-making performance.

PubMed

Nicholson, Brad; O'Hare, David

2014-01-01

Situational awareness is recognised as an important factor in the performance of individuals and teams in dynamic decision-making (DDM) environments (Salmon et al. 2014 ). The present study was designed to investigate whether the scores on the WOMBAT™ Situational Awareness and Stress Tolerance Test (Roscoe and North 1980 ) would predict the transfer of DDM performance from training under different levels of cognitive load to a novel situation. Participants practised a simulated firefighting task under either low or high conditions of cognitive load and then performed a (transfer) test in an alternative firefighting environment under an intermediate level of cognitive load. WOMBAT™ test scores were a better predictor of DDM performance than scores on the Raven Matrices. Participants with high WOMBAT™ scores performed better regardless of their training condition. Participants with recent gaming experience who practised under low cognitive load showed better practice phase performance but worse transfer performance than those who practised under high cognitive load. The relationship between task experience, situational awareness ability, cognitive load and the transfer of dynamic decision-making (DDM) performance was investigated. Results showed that the WOMBAT™ test predicted transfer of DDM performance regardless of task cognitive load. The effects of cognitive load on performance varied according to previous task-relevant experience.

Facility-level outcome performance measures for nursing homes.

PubMed

Porell, F; Caro, F G

1998-12-01

Risk-adjusted nursing home performance scores were developed for four health outcomes and five quality indicators from resident-level longitudinal case-mix reimbursement data for Medicaid residents of more than 500 nursing homes in Massachusetts. Facility performance was measured by comparing actual resident outcomes with expected outcomes derived from quarterly predictions of resident-level econometric models over a 3-year period (1991-1994). Performance measures were tightly distributed among facilities in the state. The intercorrelations among the nine outcome performance measures were relatively low and not uniformly positive. Performance measures were not highly associated with various structural facility attributes. For most outcomes, longitudinal analyses revealed only modest correlations between a facility's performance score from one time period to the next. Relatively few facilities exhibited consistent superior or inferior performance over time. The findings have implications toward the practical use of facility outcome performance measures for quality assurance and reimbursement purposes in the near future.

Performance Assessment of IT Governance with Balanced Score Card and COBIT 4.1 of Universitas Pendidikan Indonesia

NASA Astrophysics Data System (ADS)

Wijayanti, N. Y.; Setiawan, W.; Sukamto, R. A.

2017-02-01

Information technology’s application has become an important daily support for all sectors. Educational institutions, including Universitas Pendidikan Indonesia (UPI), enable information technology as the main asset to increase its qualities and global’s competitive power. By the importances of using information technology for almost every scope, measurement is needed to identify how optimal the IT governance is. Based on these facts, the purposes of this reaseacrh are identify the IT governance’s performance assessment indicators, discover the scores based on the indicators, and analyse IT governance’s performance in UPI. This research is using the combination of Balanced Score Card (BSC) and COBIT 4.1 as the framework to establish assessment indicators in questionnaire’s form. By combining both methods, the final scores of IT governance’s performance will represent UPI’s business goals and objectives in all sectors. This research used 26 COBIT’s processes as assessment indicator of IT performance from the maping 15 IT and business goals of COBIT, and 17 UPI’s strategic plans. The final score are 3.80 for financial perspective, 3.63 for customer perspective, 3.62 for internal business process perspective, and 3.72 for learning and growth perspective. With these scores, then the final result is each perspectives of Balanced Score Card’s current maturity levels are at level 4, which is IT process criticality is regularly defined with full support and agreement from the relevant business process owners.

Timed activity performance in persons with upper limb amputation: A preliminary study.

PubMed

Resnik, Linda; Borgia, Mathew; Acluche, Frantzy

55 subjects with upper limb amputation were administered the T-MAP twice within one week. To develop a timed measure of activity performance for persons with upper limb amputation (T-MAP); examine the measure's internal consistency, test-retest reliability and validity; and compare scores by prosthesis use. Measures of activity performance for persons with upper limb amputation are needed The time required to perform daily activities is a meaningful metric that implication for participation in life roles. Internal consistency and test-retest reliability were evaluated. Construct validity was examined by comparing scores by amputation level. Exploratory analyses compared sub-group scores, and examined correlations with other measures. Scale alpha was 0.77, ICC was 0.93. Timed scores differed by amputation level. Subjects using a prosthesis took longer to perform all tasks. T-MAP was not correlated with other measures of dexterity or activity, but was correlated with pain for non-prosthesis users. The timed scale had adequate internal consistency and excellent test-retest reliability. Analyses support reliability and construct validity of the T-MAP. 2c "outcomes" research. Published by Elsevier Inc.

Crossing the Gender Gap: A Study of Female Participation and Performance in Advanced Maths and Sciences

NASA Astrophysics Data System (ADS)

Haseltine, Jessica

2006-10-01

A statistical analysis of enrollment in AP maths and sciences in the Abilene Independent School District, between 2000 and 2005, studied the relationship between gender, enrollment, and performance. Data suggested that mid-scoring females were less likely than their male counterparts to enroll in AP-level courses. AISD showed higher female : male score ratios than national and state averages but no improvement in enrollment comparisons. Several programs are suggested to improve both participation and performance of females in upper-level math and science courses.

Using Trauma and Injury Severity Score (TRISS)-based analysis in the development of regional risk adjustment tools to trend quality in a voluntary trauma system: the experience of the Trauma Foundation of Northeast Ohio.

PubMed

Mancuso, C; Barnoski, A; Tinnell, C; Fallon, W

2000-04-01

Presently, no trauma system exists in Ohio. Since 1993, all hospitals in Cuyahoga County (CUY), northeast Ohio (n = 22) provide data to a trauma registry. In return, each received hospital-specific data, comparison data by trauma care level and a county-wide aggregate summary. This report describes the results of this approach in our region. All cases were entered by paper abstract or electronic download. Interrater reliability audits and z score analysis was performed by using the Major Trauma Outcome Study and the CUY 1994 baseline groups. Risk adjustment of mortality data was performed using statistical modeling and logistic regression (Trauma and Injury Severity Score, Major Trauma Outcome Study, CUY). Trauma severity measures were defined. In 1995, 3,375 patients were entered. Two hundred ninety-one died (8.6%). Severity measures differed by level of trauma care, indicating differences in case mix. Probability of survival was lowest in the Level I centers, highest in the acute care hospitals. Outcomes z scores demonstrated survival differences for all levels. In a functioning trauma system, the most severely injured patients should be cared for at the trauma centers. A low volume at acute care hospitals is desirable. By using Trauma and Injury Severity Score with community-specific constants, NE Ohio is accomplishing these goals. The Level I performance data are an interesting finding compared with the data from the Level II centers in the region

Stress and academic performance among medical students.

PubMed

Sohail, Nudrat

2013-01-01

To determine the relationship of stress and academic performance in first year medical students and to identify sources of stress, levels of stress and relevant coping strategies. Mixed method sequential. Allama Iqbal Medical College, Lahore, from March to December 2010. Survey questionnaire and in-depth interviews were carried out in the first year students with their consent. Two hundred and fifty students were surveyed, out of whom 120 students responded. Twelve students with their consent were interviewed. Non-probability purposive sampling was employed for both types of data collection. SPSS version 20 was used. The qualitative data generated through structured in-depth interviews, were analyzed by content analysis. Low level of stress was found in 7.5% (score ‹150), moderate level of stress was present in 71.67% (score between 150 and 300), and high level of stress was observed in 20.83% (score ›300) of the students. There is moderate negative (-0.583) and significant (p < 0.01) correlation between academic performance and sources of stress. Similarly there is moderate negative (-0.478) and significant (p < 0.01) correlation between academic performance and levels of stress. There was strong positive (0.799) and significant (p < 0.01), correlation between stress level and number of stress sources. The study showed a diversity of stress sources and a high level of stress in the medical students. The results also show that higher level of stress is associated with poor academic performance.

Test anxiety and academic performance in chiropractic students.

PubMed

Zhang, Niu; Henderson, Charles N R

2014-01-01

Objective : We assessed the level of students' test anxiety, and the relationship between test anxiety and academic performance. Methods : We recruited 166 third-quarter students. The Test Anxiety Inventory (TAI) was administered to all participants. Total scores from written examinations and objective structured clinical examinations (OSCEs) were used as response variables. Results : Multiple regression analysis shows that there was a modest, but statistically significant negative correlation between TAI scores and written exam scores, but not OSCE scores. Worry and emotionality were the best predictive models for written exam scores. Mean total anxiety and emotionality scores for females were significantly higher than those for males, but not worry scores. Conclusion : Moderate-to-high test anxiety was observed in 85% of the chiropractic students examined. However, total test anxiety, as measured by the TAI score, was a very weak predictive model for written exam performance. Multiple regression analysis demonstrated that replacing total anxiety (TAI) with worry and emotionality (TAI subscales) produces a much more effective predictive model of written exam performance. Sex, age, highest current academic degree, and ethnicity contributed little additional predictive power in either regression model. Moreover, TAI scores were not found to be statistically significant predictors of physical exam skill performance, as measured by OSCEs.

Lumbopelvic control and pitching performance of professional baseball pitchers.

PubMed

Chaudhari, Ajit M W; McKenzie, Christopher S; Borchers, James R; Best, Thomas M

2011-08-01

This study assessed the correlation between lumbopelvic control during a single-leg balancing task and in-game pitching performance in Minor-League baseball pitchers. Seventy-five healthy professional baseball pitchers performed a standing lumbopelvic control test during the last week of spring training for the 2008 and 2009 seasons while wearing a custom-designed testing apparatus, the "Level Belt." With the Level Belt secured to the waist, subjects attempted to transition from a 2-leg to a single-leg pitching stance and balance while maintaining a stable pelvic position. Subjects were graded on the maximum sagittal pelvic tilt from a neutral position during the motion. Pitching performance, number of innings pitched (IP), and injuries were compared for all subjects who pitched at least 50 innings during a season. The median Level Belt score for the study group was 7°. Two-sample t-tests with equal variances were used to determine if pitchers with a Level Belt score <7° or ≥7° were more likely to perform differently during the baseball season, and chi-square analysis was used to compare injuries between groups. Subjects scoring <7° on the Level Belt test had significantly fewer walks plus hits per inning than subjects scoring ≥7° (walks plus hits per inning pitched, 1.352 ± 0.251 vs. 1.584 ± 0.360, p = 0.013) and significantly more IP during the season (IP, 78.89 ± 38.67 vs. 53.38 ± 42.47, p = 0.043). There was no significant difference in the number of pitchers injured between groups. These data suggest that lumbopelvic control influences overall performance for baseball pitchers and that a simple test of lumbopelvic control can potentially identify individuals who have a better chance of pitching success.

Validation of the Narrowing Beam Walking Test in Lower Limb Prosthesis Users.

PubMed

Sawers, Andrew; Hafner, Brian

2018-04-11

To evaluate the content, construct, and discriminant validity of the Narrowing Beam Walking Test (NBWT), a performance-based balance test for lower limb prosthesis users. Cross-sectional study. Research laboratory and prosthetics clinic. Unilateral transtibial and transfemoral prosthesis users (N=40). Not applicable. Content validity was examined by quantifying the percentage of participants receiving maximum or minimum scores (ie, ceiling and floor effects). Convergent construct validity was examined using correlations between participants' NBWT scores and scores or times on existing clinical balance tests regularly administered to lower limb prosthesis users. Known-groups construct validity was examined by comparing NBWT scores between groups of participants with different fall histories, amputation levels, amputation etiologies, and functional levels. Discriminant validity was evaluated by analyzing the area under each test's receiver operating characteristic (ROC) curve. No minimum or maximum scores were recorded on the NBWT. NBWT scores demonstrated strong correlations (ρ=.70‒.85) with scores/times on performance-based balance tests (timed Up and Go test, Four Square Step Test, and Berg Balance Scale) and a moderate correlation (ρ=.49) with the self-report Activities-specific Balance Confidence scale. NBWT performance was significantly lower among participants with a history of falls (P=.003), transfemoral amputation (P=.011), and a lower mobility level (P<.001). The NBWT also had the largest area under the ROC curve (.81) and was the only test to exhibit an area that was statistically significantly >.50 (ie, chance). The results provide strong evidence of content, construct, and discriminant validity for the NBWT as a performance-based test of balance ability. The evidence supports its use to assess balance impairments and fall risk in unilateral transtibial and transfemoral prosthesis users. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Predictive relationship of osteopathic manual medicine grades and COMLEX-USA Level 1 total scores and osteopathic principles and practice subscores.

PubMed

Lewis, Drew D; Johnson, Mary T; Finnerty, Edward P

2014-06-01

Osteopathic manual medicine (OMM) encompasses hands-on diagnosis and treatment as part of patient care. The area of osteopathic principles and practice (OPP) is considered a core competency for students and practitioners of this medical tradition. The Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) is a useful tool for assessing candidates' competency. To examine the relationship of COMLEX-USA Level 1 total scores and OPP subscores with OMM course grades, and to determine if these grades are predictive of COMLEX-USA Level 1 OPP performance. The authors collected data-COMLEX-USA Level 1 total and OPP subscores, OMM grades (written, practical, and total for first and second academic years), sex, and age-for a cohort of osteopathic medical students at a single institution, and these data were then analyzed by means of correlation analysis. Records were obtained from a second-year class of osteopathic medical students (N=217). The authors' analysis of total scores and OPP subscores on COMLEX-USA Level 1 yielded a statistically significant correlation with all variables. Although the correlations were moderate, second-year written examination grades showed the strongest association with the COMLEX-USA Level 1 OPP subscores (r=0.530) and total scores (r=0.566). Performance in the second-year OMM written examination could identify students potentially at risk for poor performance on COMLEX-USA Level 1. © 2014 The American Osteopathic Association.

[A school-level longitudinal study of clinical performance examination scores].

PubMed

Park, Jang Hee

2015-06-01

This school-level longitudinal study examined 7 years of clinical performance data to determine differences (effects) in students and annual changes within a school and between schools; examine how much their predictors (characteristics) influenced the variation in student performance; and calculate estimates of the schools' initial status and growth. A school-level longitudinal model was tested: level 1 (between students), level 2 (annual change within a school), and level 3 (between schools). The study sample comprised students who belonged to the CPX Consortium (n=5,283 for 2005~2008 and n=4,337 for 2009~2011). Despite a difference between evaluation domains, the performance outcomes were related to individual large-effect differences and small-effect school-level differences. Physical examination, clinical courtesy, and patient education were strongly influenced by the school effect, whereas patient-physician interaction was not affected much. Student scores are influenced by the school effect (differences), and the predictors explain the variation in differences, depending on the evaluation domain.

Automated Scoring of L2 Spoken English with Random Forests

ERIC Educational Resources Information Center

Kobayashi, Yuichiro; Abe, Mariko

2016-01-01

The purpose of the present study is to assess second language (L2) spoken English using automated scoring techniques. Automated scoring aims to classify a large set of learners' oral performance data into a small number of discrete oral proficiency levels. In automated scoring, objectively measurable features such as the frequencies of lexical and…

A Study of the Relationship between Levels of Technology Implementation (LoTi) and Student Performance on Texas Assessment of Knowledge and Skills (TAKS) Scores

ERIC Educational Resources Information Center

Berkeley-Jones, Catherine Spotswood

2012-01-01

The purpose of this study was to examine teacher Levels of Technology Implementation (LoTi) self-ratings and student Texas Assessment of Knowledge and Skills (TAKS) scores. The study assessed the relationship between LoTi ratings and TAKS scores of 6th, 7th, and 8th grade students as reported in student records at Alamo Heights Independent School…

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

PubMed

Gao, Zan; Podlog, Leslie

2012-10-01

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

Stroop performance, dissociation, and trauma exposure in a community sample of children.

PubMed

DePrince, Anne P; Weinzierl, Kristin M; Combs, Melody D

2008-01-01

Extending previous research with adults, the current study examined Stroop task performance under selective and divided attention demands in a community sample of school-age children (N = 97). Stroop interference scores in both attention conditions were calculated. Higher levels of child-reported dissociation were associated with better interference control under divided attention conditions and worse control under selective attention conditions; lower levels of dissociation were associated with the opposite pattern. Both family violence exposure and Stroop interaction scores explained unique variance in dissociation scores. Although research with adults has generally assumed or implied that cognitive correlates of dissociation are a consequence of dissociation, the current findings with school-age children suggest that future research should evaluate executive function performance (in this case, interference control) as a possible risk factor for dissociation.

Relationship between procrastination and academic performance among a group of undergraduate dental students in India.

PubMed

Lakshminarayan, Nagesh; Potdar, Shrudha; Reddy, Siddana Goud

2013-04-01

Procrastination, generally defined as a voluntary, irrational delay of behavior, is a prevalent phenomenon among college students throughout the world and occurs at alarmingly high rates. For this study, a survey was conducted of 209 second-, third-, and fourth-year undergraduate dental students of Bapuji Dental College and Hospital, Davangere, India, to identify the relationship between their level of procrastination and academic performance. A sixteen-item questionnaire was used to assess the level of procrastination among these students. Data related to their academic performance were also collected. Spearman's correlation coefficient test was used to assess the relationship between procrastination and academic performance. It showed a negative correlation of -0.63 with a significance level of p<0.01 (two-tailed test), indicating that students who showed high procrastination scores performed below average in their academics. In addition, analysis with the Mann-Whitney U test found a significant difference in procrastination scores between the two gender groups (p<0.05). Hence, among the Indian undergraduate dental students evaluated in this study, it appeared that individuals with above average and average academic performance had lower scores of procrastination and vice versa.

Increased Level of Interleukin 6 Associates With Increased 90-Day and 1-Year Mortality in Patients With End-Stage Liver Disease.

PubMed

Remmler, Johannes; Schneider, Christoph; Treuner-Kaueroff, Theresa; Bartels, Michael; Seehofer, Daniel; Scholz, Markus; Berg, Thomas; Kaiser, Thorsten

2018-05-01

Organ allocation for liver transplantation is based on prognosis, using the model for end-stage liver disease (MELD) or MELD including serum sodium (MELD-Na) score. These scores do not consider systemic inflammation and septic complications. Blood level of C-reactive protein (CRP), in addition to the MELD score, associates with mortality in patients with end-stage liver disease, whereas levels of interleukin 6 (IL6) have not been systematically studied. We performed a retrospective observational cohort study of 474 patients with end-stage liver disease (63.5% male; median age, 56.9 years), evaluated for liver transplantation in Germany, with at least 1 year of follow up. Data were collected on blood levels of CRP, IL6, and white blood cell count (WBC). Findings were analyzed in relation to mortality and compared with patients' MELD scores and MELD-Na scores. For survival analysis, the cohort was divided into quartiles of IL6, CRP, and WBC levels, as well as MELD scores. Log-rank test and the Cox proportional hazards regression model were used to compare the groups, and area under the receiver operating characteristic (AUROC) values were calculated. Blood levels of IL6 and MELD scores associated with mortality: none of the patients with levels of IL6 below the first quartile (below 5.3 pg/mL) died within 1 year. In contrast, 67.7% of the patients in the highest quartile of IL6 level (37.0 pg/mL or more) died within 1 year. MELD score also correlated with mortality: among patients with MELD scores below 8.7, 0.9% died within 1 year, whereas in patients with MELD scores of 18.0 or more, 67.4% died within 1 year. The predictive value of level of IL6 (AUROC, 0.940) was higher than level of CRP (AUROC, 0.866) (P = .009) or WBC (AUROC, 0.773) (P < .001) for 90-day mortality. MELD scores associated with 90-day mortality (AUROC, 0.933) (P = .756) as did MELD-Na score (AUROC, 0.946) (P = .771). Level of IL6 associated with 1-year mortality (AUROC, 0.916) to a greater extent than liver synthesis or detoxification markers international normalized ratio (AUROC, 0.839) (P = .007) or bilirubin (AUROC 0.846) (P = .007). Level of IL6 was an independent, significant risk factor for mortality after adjustment for MELD score, MELD-Na score, level of CRP, or WBC. In a retrospective analysis, we found high blood levels of IL6 to associate with 90-day and 1-year mortality in patients with end-stage liver disease; its predictive value was comparable to that of MELD or MELD-Na score, and was higher than that of level of CRP or WBC. Further studies should be performed to confirm the results in different cohorts. Copyright © 2018 AGA Institute. Published by Elsevier Inc. All rights reserved.

Assessment of numeracy in sports and exercise science students at an Australian university

NASA Astrophysics Data System (ADS)

Green, Simon; McGlynn, Susan; Stuart, Deidre; Fahey, Paul; Pettigrew, Jim; Clothier, Peter

2018-05-01

The effect of high school study of mathematics on numeracy performance of sports and exercise science (SES) students is not clear. To investigate this further, we tested the numeracy skills of 401 students enrolled in a Bachelor of Health Sciences degree in SES using a multiple-choice survey consisting of four background questions and 39 numeracy test questions. Background questions (5-point scale) focused on highest level of mathematics studied at high school, self-perception of mathematics proficiency, perceived importance of mathematics to SES and likelihood of seeking help with mathematics. Numeracy questions focused on rational number, ratios and rates, basic algebra and graph interpretation. Numeracy performance was based on answers to these questions (1 mark each) and represented by the total score (maximum = 39). Students from first (n = 212), second (n = 78) and third (n = 111) years of the SES degree completed the test. The distribution of numeracy test scores for the entire cohort was negatively skewed with a median (IQR) score of 27(11). We observed statistically significant associations between test scores and the highest level of mathematics studied (P < 0.05), being lowest in students who studied Year 10 Mathematics (20 (9)), intermediate in students who studied Year 12 General Mathematics (26 (8)) and highest in two groups of students who studied higher-level Year 12 Mathematics (31 (9), 31 (6)). There were statistically significant associations between test scores and level of self-perception of mathematics proficiency and also likelihood of seeking help with mathematics (P < 0.05) but not with perceived importance of mathematics to SES. These findings reveal that the level of mathematics studied in high school is a critical factor determining the level of numeracy performance in SES students.

School Budgeting and School Performance: The Impact of New York City's Performance Driven Budgeting Initiative.

ERIC Educational Resources Information Center

Stiefel, Leanna; Schwartz, Amy Ellen; Portas, Carole; Kim, Dae Yeop

2003-01-01

Analyzes the impact of Performance Driven Budgeting (PDB), a school-based budgeting initiative, on student test scores in the fourth and fifth grades and on spending patterns in selected New York City schools. Finds that PDB has a positive effect on some student test scores and leads to a change in the mix of spending, but not its level. (Contains…

US Medical Student Performance on the NBME Subject Examination in Internal Medicine: Do Clerkship Sequence and Clerkship Length Matter?

PubMed

Ouyang, Wenli; Cuddy, Monica M; Swanson, David B

2015-09-01

Prior to graduation, US medical students are required to complete clinical clerkship rotations, most commonly in the specialty areas of family medicine, internal medicine, obstetrics and gynecology (ob/gyn), pediatrics, psychiatry, and surgery. Within a school, the sequence in which students complete these clerkships varies. In addition, the length of these rotations varies, both within a school for different clerkships and between schools for the same clerkship. The present study investigated the effects of clerkship sequence and length on performance on the National Board of Medical Examiner's subject examination in internal medicine. The study sample included 16,091 students from 67 US Liaison Committee on Medical Education (LCME)-accredited medical schools who graduated in 2012 or 2013. Student-level measures included first-attempt internal medicine subject examination scores, first-attempt USMLE Step 1 scores, and five dichotomous variables capturing whether or not students completed rotations in family medicine, ob/gyn, pediatrics, psychiatry, and surgery prior to taking the internal medicine rotation. School-level measures included clerkship length and average Step 1 score. Multilevel models with students nested in schools were estimated with internal medicine subject examination scores as the dependent measure. Step 1 scores and the five dichotomous variables were treated as student-level predictors. Internal medicine clerkship length and average Step 1 score were used to predict school-to-school variation in average internal medicine subject examination scores. Completion of rotations in surgery, pediatrics and family medicine prior to taking the internal medicine examination significantly improved scores, with the largest benefit observed for surgery (coefficient = 1.58 points; p value < 0.01); completion of rotations in ob/gyn and psychiatry were unrelated to internal medicine subject examination performance. At the school level, longer internal medicine clerkships were associated with higher scores on the internal medicine examination (coefficient = 0.23 points/week; p value < 0.01). The order in which students complete clinical clerkships and the length of the internal medicine clerkship are associated with their internal medicine subject examination scores. Findings may have implications for curriculum re-design.

The impact of prematurity and maternal socioeconomic status and education level on achievement-test scores up to 8th grade.

PubMed

ElHassan, Nahed O; Bai, Shasha; Gibson, Neal; Holland, Greg; Robbins, James M; Kaiser, Jeffrey R

2018-01-01

The relative influence of prematurity vs. maternal social factors (socioeconomic status and education level) on academic performance has rarely been examined. To examine the impact of prematurity and maternal social factors on academic performance from 3rd through 8th grade. We conducted a retrospective cohort study of infants born in 1998 at the University of Arkansas for Medical Sciences. The study sample included 58 extremely low gestational age newborns (ELGANs, 23‒<28 weeks), 171 preterm (≥28‒<34 weeks), 228 late preterm (≥34‒<37 weeks), and 967 term ((≥37‒<42 weeks) infants. Neonatal and maternal variables were collected including maternal insurance status (proxy measure for socioeconomic status) and education level. The primary outcomes were literacy and mathematics achievement-test scores from 3rd through 8th grade. Linear mixed models were used to identify significant predictors of academic performance. All two-way interactions between grade level, gestational-age (GA) groups, and social factors were tested for statistical significance. Prematurity, social factors, gender, race, gravidity, and Apgar score at one minute were critical determinants of academic performance. Favorable social factors were associated with a significant increase in both literacy and mathematic scores, while prematurity was associated with a significant decrease in mathematic scores. Examination of GA categories and social factors interaction suggested that the impact of social factors on test scores was similar for all GA groups. Furthermore, the impact of social factors varied from grade to grade for literacy, while the influence of either GA groups or social factors was constant across grades for mathematics. For example, an ELGAN with favorable social factors had a predicted literacy score 104.1 (P <.001), 98.2 (P <.001), and 76.4 (P <.01) points higher than an otherwise similar disadvantaged term infant at grades 3, 5, and 8, respectively. The difference in their predicted mathematic scores was 33.4 points for all grades (P <.05). While there were significant deficits in academic performance for ELGANs compared to PT, LPT, and term infants, the deficit could be offset by higher SES and better-educated mothers. These favorable social factors were critical to a child's academic achievement. The role of socioeconomic factors should be incorporated in discussions on outcome with families of preterm infants.

Conditional Standard Errors, Reliability and Decision Consistency of Performance Levels Using Polytomous IRT.

ERIC Educational Resources Information Center

Wang, Tianyou; And Others

M. J. Kolen, B. A. Hanson, and R. L. Brennan (1992) presented a procedure for assessing the conditional standard error of measurement (CSEM) of scale scores using a strong true-score model. They also investigated the ways of using nonlinear transformation from number-correct raw score to scale score to equalize the conditional standard error along…

Impact of pandemic flu training on ability of medical personnel to recognize an index case of avian influenza.

PubMed

Adini, Bruria; Goldberg, Avishay; Cohen, Robert; Bar-Dayan, Yaron

2012-04-01

This study investigated the relationship between training programmes for pandemic flu and level of knowledge of health-care professionals with performance in an avian flu exercise. Training programmes of all general hospitals in Israel for managing a pandemic influenza were evaluated. Spearman's ρ correlation was used to analyse the relationship between training scores and level of knowledge of medical personnel with performance in an avian flu exercise. Hospital preparedness levels were evaluated at two time points and Wilcoxon signed-rank test was used to determine if overall preparedness scores improved over time. Evaluation of training programmes for pandemic influenza showed high to very high scores in most hospitals (mean 85, SD 22). Significant correlations between training and performance in the exercise were noted for: implementation of training programmes 0.91, P = 0.000; designating personnel for training 0.87, P = 0.000; content of training 0.61, P = 0.001; and training materials 0.36, P = 0.05. Overall reliability of the evaluation scores was 0.82 and reliability for two of the sub-scales was: implementation of the programme 0.78; and designating personnel for training 0.37. No significant correlation was found between level of knowledge and performance in the exercise. Training programmes for hospital personnel for pandemic flu have a significant role in improving performance in case of pandemic flu. The key component of the training programme appears to be the implementation of the programme. Use of knowledge tests should be further investigated, as they do not appear to correlate with the level of emergency preparedness for pandemic influenza.

Low aerobic fitness and obesity are associated with lower standardized test scores in children.

PubMed

Roberts, Christian K; Freed, Benjamin; McCarthy, William J

2010-05-01

To investigate whether aerobic fitness and obesity in school children are associated with standardized test performance. Ethnically diverse (n = 1989) 5th, 7th, and 9th graders attending California schools comprised the sample. Aerobic fitness was determined by a 1-mile run/walk test; body mass index (BMI) was obtained from state-mandated measurements. California standardized test scores were obtained from the school district. Students whose mile run/walk times exceeded California Fitnessgram standards or whose BMI exceeded Centers for Disease Control sex- and age-specific body weight standards scored lower on California standardized math, reading, and language tests than students with desirable BMI status or fitness level, even after controlling for parent education among other covariates. Ethnic differences in standardized test scores were consistent with ethnic differences in obesity status and aerobic fitness. BMI-for-age was no longer a significant multivariate predictor when covariates included fitness level. Low aerobic fitness is common among youth and varies among ethnic groups, and aerobic fitness level predicts performance on standardized tests across ethnic groups. More research is needed to uncover the physiological mechanisms by which aerobic fitness may contribute to performance on standardized academic tests.

The influence of critical thinking skills on performance and progression in a pre-registration nursing program.

PubMed

Pitt, Victoria; Powis, David; Levett-Jones, Tracy; Hunter, Sharyn

2015-01-01

The importance of developing critical thinking skills in preregistration nursing students is recognized worldwide. Yet, there has been limited exploration of how students' critical thinking skill scores on entry to pre-registration nursing education influence their academic and clinical performance and progression. The aim of this study was to: i) describe entry and exit critical thinking scores of nursing students enrolled in a three year bachelor of nursing program in Australia in comparison to norm scores; ii) explore entry critical thinking scores in relation to demographic characteristics, students' performance and progression. This longitudinal correlational study used the Health Sciences Reasoning Test (HSRT) to measure critical thinking skills in a sample (n=134) of students, at entry and exit (three years later). A one sample t-test was used to determine if differences existed between matched student critical thinking scores between entry and exit points. Academic performance, clinical performance and progression data were collected and correlations with entry critical thinking scores were examined. There was a significant relationship between critical thinking scores, academic performance and students' risk of failing, especially in the first semester of study. Critical thinking scores were predictive of program completion within three years. The increase in critical thinking scores from entry to exit was significant for the 28 students measured. In comparison to norm scores, entry level critical thinking scores were significantly lower, but exit scores were comparable. Critical thinking scores had no significant relationship to clinical performance. Entry critical thinking scores significantly correlate to academic performance and predict students risk of course failure and ability to complete a nursing degree in three years. Students' critical thinking scores are an important determinant of their success and as such can inform curriculum development and selection strategies. Copyright © 2014 Elsevier Ltd. All rights reserved.

Emotional intelligence, performance, and retention in clinical staff nurses.

PubMed

Codier, Estelle; Kamikawa, Cindy; Kooker, Barbara M; Shoultz, Jan

2009-01-01

Emotional intelligence has been correlated with performance, retention, and organizational commitment in professions other than nursing. A 2006 pilot study provided the first evidence of a correlation between emotional intelligence and performance in clinical staff nurses. A follow-up study was completed, the purpose of which was to explore emotional intelligence, performance level, organizational commitment, and retention. A convenience sample of 350 nurses in a large medical center in urban Hawaii participated in this study. This article reports the findings pertaining to the subset of 193 clinical staff nurses who responded. The Mayer-Salovey-Caruso Emotional Intelligence Test instrument was used to measure emotional intelligence abilities. Performance was defined as ranking on a clinical ladder. Commitment was scored on a Likert scale. The following variables measured retention: total years in nursing, years in current job, total years anticipated in current job, and total anticipated career length. Emotional intelligence scores in clinical staff nurses correlated positively with both performance level and retention variables. Clinical staff nurses with higher emotional intelligence scores demonstrated higher performance, had longer careers, and greater job retention.

Levels of mania and cognitive performance two years after ECT in patients with bipolar I disorder - results from a follow-up study.

PubMed

Haghighi, Mohammad; Barikani, Reza; Jahangard, Leila; Ahmadpanah, Mohammad; Bajoghli, Hafez; Sadeghi Bahmani, Dena; Holsboer-Trachsler, Edith; Brand, Serge

2016-08-01

There is limited evidence on the long-term outcomes for patients with bipolar I disorder (BP-I-D) and treated with ECT. Therefore, we asked whether mania scores and cognitive performance at the end of ECT treatment (baseline/BL) predicted mania scores, cognitive performance, recurrence, treatment adherence, and mood (depression; hypomania) two years later (follow-up/FU). 38 patients with BP-I-D undergoing ECT at baseline were followed up two years later. A brief psychiatric and cognitive assessment (Mini Mental State Examination; short-term verbal memory test) was performed; patients completed questionnaires covering recurrence, treatment adherence, and mood (depression; hypomania). High cognitive performance at BL predicted high cognitive performance at FU; low mania scores at BL predicted low mania scores at FU. By FU, cognitive performance had increased and mania scores decreased. Mania scores and cognitive performance at BL did not predict recurrence, or adherence to medication, or mood (depression; hypomania). The pattern of results suggests that after two years of successful treatment of acute mania with ECT, cognitive impairment, measured by MMSE and a short-term verbal memory test, is not impaired and mood symptom recurrence seems to be improved. Mania scores and cognitive performance at the end of ECT treatment predicted neither mood (depression; hypomania), nor recurrence, or adherence to medication two years later. Copyright © 2016 Elsevier Inc. All rights reserved.

A structural equation model of the relationship between muscle strength, balance performance, walking endurance and community integration in stroke survivors

PubMed Central

2017-01-01

Purpose To use structural equation modelling (SEM) to determine (1) the direct and indirect associations of strength of paretic lower limb muscles with the level of community integration, and (2) the direct association of walking endurance and balance performance with the level of community integration in community-dwelling stroke survivors. Materials and methods In this cross-sectional study of 105 stroke survivors, the Subjective Index of Physical and Social Outcome (SIPSO) was used to measure the level of community integration. Lower-limb strength measures included isometric paretic ankle strength and isokinetic paretic knee peak torque. The Berg Balance Scale (BBS) and the 6-minute walk test (6MWT) were used to evaluate balance performance and walking endurance, respectively. Results SEM revealed that the distance walked on the 6MWT had the strongest direct association with the SIPSO score (β = 0.41, p <0.001). An increase of one standard deviation in the 6MWT distance resulted in an increase of 0.41 standard deviations in the SIPSO score. Moreover, dorsiflexion strength (β = 0.18, p = 0.044) and the BBS score (β = 0.21, p = 0.021) had direct associations with the SIPSO score. Conclusions The results of the proposed model suggest that rehabilitation training of community-dwelling stroke survivors could focus on walking endurance, balance performance and dorsiflexor muscle strengthening if the aim is to augment the level of community integration. PMID:29049293

Document Level Assessment of Document Retrieval Systems in a Pairwise System Evaluation

ERIC Educational Resources Information Center

Rajagopal, Prabha; Ravana, Sri Devi

2017-01-01

Introduction: The use of averaged topic-level scores can result in the loss of valuable data and can cause misinterpretation of the effectiveness of system performance. This study aims to use the scores of each document to evaluate document retrieval systems in a pairwise system evaluation. Method: The chosen evaluation metrics are document-level…

Derivation and Cross-Validation of Cutoff Scores for Patients With Schizophrenia Spectrum Disorders on WAIS-IV Digit Span-Based Performance Validity Measures.

PubMed

Glassmire, David M; Toofanian Ross, Parnian; Kinney, Dominique I; Nitch, Stephen R

2016-06-01

Two studies were conducted to identify and cross-validate cutoff scores on the Wechsler Adult Intelligence Scale-Fourth Edition Digit Span-based embedded performance validity (PV) measures for individuals with schizophrenia spectrum disorders. In Study 1, normative scores were identified on Digit Span-embedded PV measures among a sample of patients (n = 84) with schizophrenia spectrum diagnoses who had no known incentive to perform poorly and who put forth valid effort on external PV tests. Previously identified cutoff scores resulted in unacceptable false positive rates and lower cutoff scores were adopted to maintain specificity levels ≥90%. In Study 2, the revised cutoff scores were cross-validated within a sample of schizophrenia spectrum patients (n = 96) committed as incompetent to stand trial. Performance on Digit Span PV measures was significantly related to Full Scale IQ in both studies, indicating the need to consider the intellectual functioning of examinees with psychotic spectrum disorders when interpreting scores on Digit Span PV measures. © The Author(s) 2015.

Relationship between job satisfaction and performance of primary care physicians after the family physician reform of east Azerbaijan province in Northwest Iran.

PubMed

Jabbari, Hossein; Pezeshki, Mohamad Zakarria; Naghavi-Behzad, Mohammad; Asghari, Mohammad; Bakhshian, Fariba

2014-01-01

Following the implementation of family physician program in 2004 in Iranian healthcare system, the understanding in changes in physicians' practice has become important. The objective of this study was to determine the level of family physicians' job satisfaction and its relationship with their performance level. A cross-sectional study was conducted among all 367 family physicians of East Azerbaijan province in during December 2009 to May 2011 using a self-administered, anonymous questionnaire for job satisfaction. The performance scores of primary care physicians were obtained from health deputy of Tabriz Medical University. In this study, overall response rate was 64.5%. The average score of job satisfaction was 42.10 (±18.46), and performance score was 87.52 (±5.74) out of 100. There was significant relationships between working history and job satisfaction (P = 0.014), marital status (P = 0.014), and sex (P = 0.018) with performance among different personal and organizational variables. However, there was no significant relationship between job satisfaction and performance, but satisfied people had about three times better performance than their counterparts (all P < 0.05). The low scores of family physicians in performance and job satisfaction are obvious indications for more extensive research in identifying causes and finding mechanisms to improve the situation, especially in payment methods and work condition, in existing health system.

Comparison of an expert system with other clinical scores for the evaluation of severity of asthma.

PubMed

Gautier, V; Rédier, H; Pujol, J L; Bousquet, J; Proudhon, H; Michel, C; Daurès, J P; Michel, F B; Godard, P

1996-01-01

"Asthmaexpert" was produced at the special request of several clinicians in order to obtain a better understanding of the medical decisions taken by clinical experts in the management of asthmatic patients. In order to assess the severity of asthma, a new score called Artificial Intelligence score (AI score), produced by Asthmaexpert, was compared with three other scores (Aas, Hargreave and Brooks). One hundred patients were enrolled prospectively in the study during their first consultation in the out-patient clinic. Distribution of severity level according to the different scores was studied, and the reliability between AI and other scores was evaluated by Kappa and MacNemar tests. Correlations with functional parameters were performed. The AI score assessed higher levels of severity than the other scores (Kappa = 18, 28 and 10% for Aas, Hargreave and Brooks, respectively) with significant MacNemar test in all cases. There was a significant correlation between AI score and forced expiratory volume in one second (FEV1) (r = 0.73). These data indicate that the AI score is a severity score which defines higher levels of severity than the chosen scores. Correlations for functional parameters are good. This score appears easy to use for the first consultation of an asthmatic patient.

Transforming Biology Assessment with Machine Learning: Automated Scoring of Written Evolutionary Explanations

NASA Astrophysics Data System (ADS)

Nehm, Ross H.; Ha, Minsu; Mayfield, Elijah

2012-02-01

This study explored the use of machine learning to automatically evaluate the accuracy of students' written explanations of evolutionary change. Performance of the Summarization Integrated Development Environment (SIDE) program was compared to human expert scoring using a corpus of 2,260 evolutionary explanations written by 565 undergraduate students in response to two different evolution instruments (the EGALT-F and EGALT-P) that contained prompts that differed in various surface features (such as species and traits). We tested human-SIDE scoring correspondence under a series of different training and testing conditions, using Kappa inter-rater agreement values of greater than 0.80 as a performance benchmark. In addition, we examined the effects of response length on scoring success; that is, whether SIDE scoring models functioned with comparable success on short and long responses. We found that SIDE performance was most effective when scoring models were built and tested at the individual item level and that performance degraded when suites of items or entire instruments were used to build and test scoring models. Overall, SIDE was found to be a powerful and cost-effective tool for assessing student knowledge and performance in a complex science domain.

The Validity of ITBS Reading Comprehension Test Scores for Learning Disabled and Non Learning Disabled Students under Extended-Time Conditions.

ERIC Educational Resources Information Center

Huesman, Ronald L., Jr.; Frisbie, David A.

This study investigated the effect of extended-time limits in terms of performance levels and score comparability for reading comprehension scores on the Iowa Tests of Basic Skills (ITBS). The first part of the study compared the average reading comprehension scores on the ITBS of 61 sixth-graders with learning disabilities and 397 non learning…

Variability in Percentage above Cut Scores Due to Discreteness in Score Scale. Research Report. ETS RR-17-32

ERIC Educational Resources Information Center

Lu, Ying

2017-01-01

For standard- or criterion-based assessments, the use of cut scores to indicate mastery, nonmastery, or different levels of skill mastery is very common. As part of performance summary, it is of interest to examine the percentage of examinees at or above the cut scores (PAC) and how PAC evolves across administrations. This paper shows that…

Conflict resolution abilities in children with Specific Language Impairment.

PubMed

Paula, Erica Macêdo de; Befi-Lopes, Debora Maria

2013-01-01

To investigate the conflict resolution abilities of children with Specific Language Impairment, and to verify whether the time of speech-language therapy correlates to the performance on the conflict resolution task. Participants included 20 children with Specific Language Impairment (Research Group) and 40 children with normal language development (Control Group), with ages ranging from 7 years to 8 years and 11 months. To assess the conflict resolution abilities, five hypothetical contexts of conflict were presented. The strategies used by the children were classified and scored by the following levels: level 0 (solutions that do not match the other levels), level 1 (physical solutions), level 2 (unilateral solutions), level 3 (cooperative solutions), and level 4 (mutual solutions). Statistical analysis showed group effect for the variable total score. There was a difference between the groups for modal development level, with higher level of modal development observed in the Control Group. There was no correlation between the period of speech-language therapy attendance and the total score. Children with Specific Language Impairment present difficulties in solving problems, in view of the fact that they mainly use physical and unilateral strategies. There was no correlation between the time of speech-language therapy and performance in the task.

High-fidelity, low-cost, automated method to assess laparoscopic skills objectively.

PubMed

Gray, Richard J; Kahol, Kanav; Islam, Gazi; Smith, Marshall; Chapital, Alyssa; Ferrara, John

2012-01-01

We sought to define the extent to which a motion analysis-based assessment system constructed with simple equipment could measure technical skill objectively and quantitatively. An "off-the-shelf" digital video system was used to capture the hand and instrument movement of surgical trainees (beginner level = PGY-1, intermediate level = PGY-3, and advanced level = PGY-5/fellows) while they performed a peg transfer exercise. The video data were passed through a custom computer vision algorithm that analyzed incoming pixels to measure movement smoothness objectively. The beginner-level group had the poorest performance, whereas those in the advanced group generated the highest scores. Intermediate-level trainees scored significantly (p < 0.04) better than beginner trainees. Advanced-level trainees scored significantly better than intermediate-level trainees and beginner-level trainees (p < 0.04 and p < 0.03, respectively). A computer vision-based analysis of surgical movements provides an objective basis for technical expertise-level analysis with construct validity. The technology to capture the data is simple, low cost, and readily available, and it obviates the need for expert human assessment in this setting. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Ocular dominance stability and reading skill: a controversial relationship.

PubMed

Zeri, Fabrizio; De Luca, Maria; Spinelli, Donatella; Zoccolotti, Pierluigi

2011-11-01

Evidence is mixed concerning the relationship between stability of ocular dominance and reading deficits. Contrasting results may be due to the use of different tests of dominance, different samples of readers, and different scoring methods. The aim of this study was to investigate the relationship among ocular dominance, general visual abilities, and reading performance, and to evaluate the consistency and reliability of different tests of ocular dominance and the effects of different types of eye dominance scoring. In a group of young adults, we measured: (a) main optometric parameters; (b) reading time and accuracy; and (c) ocular dominance in two sighting and four motor tests. Dominance was determined using different scoring methods (relative, absolute, and binary scores). All dominance tests showed good levels of internal reliability. Sighting tests were consistent regardless of the scoring method, and all participants had stable dominance. Three of four motor tests were moderately consistent when dominance was measured with relative scores but not when it was measured with absolute or binary scores. No relationship was found between stability of dominance and reading performance, regardless of the type of test or scoring method. No systematic pattern of correlation was found between binocular vision variables and dominance measures. Choosing the type of motor test to measure ocular dominance is crucial, because the level of consistency among tests is low to moderate. Furthermore, motor tests were not correlated with reading performances. Present results suggest caution when trying to link reading difficulties with specific profiles of ocular dominance.

Performance Evaluation of Fusing Protected Fingerprint Minutiae Templates on the Decision Level

PubMed Central

Yang, Bian; Busch, Christoph; de Groot, Koen; Xu, Haiyun; Veldhuis, Raymond N. J.

2012-01-01

In a biometric authentication system using protected templates, a pseudonymous identifier is the part of a protected template that can be directly compared. Each compared pair of pseudonymous identifiers results in a decision testing whether both identifiers are derived from the same biometric characteristic. Compared to an unprotected system, most existing biometric template protection methods cause to a certain extent degradation in biometric performance. Fusion is therefore a promising way to enhance the biometric performance in template-protected biometric systems. Compared to feature level fusion and score level fusion, decision level fusion has not only the least fusion complexity, but also the maximum interoperability across different biometric features, template protection and recognition algorithms, templates formats, and comparison score rules. However, performance improvement via decision level fusion is not obvious. It is influenced by both the dependency and the performance gap among the conducted tests for fusion. We investigate in this paper several fusion scenarios (multi-sample, multi-instance, multi-sensor, multi-algorithm, and their combinations) on the binary decision level, and evaluate their biometric performance and fusion efficiency on a multi-sensor fingerprint database with 71,994 samples. PMID:22778583

Attention during functional tasks is associated with motor performance in children with developmental coordination disorder

PubMed Central

Fong, Shirley S.M.; Chung, Joanne W.Y.; Cheng, Yoyo T.Y.; Yam, Timothy T.T.; Chiu, Hsiu-Ching; Fong, Daniel Y.T.; Cheung, C.Y.; Yuen, Lily; Yu, Esther Y.T.; Hung, Yeung Sam; Macfarlane, Duncan J.; Ng, Shamay S.M.

2016-01-01

Abstract This cross-sectional and exploratory study aimed to compare motor performance and electroencephalographic (EEG) attention levels in children with developmental coordination disorder (DCD) and those with typical development, and determine the relationship between motor performance and the real-time EEG attention level in children with DCD. Eighty-six children with DCD [DCD: n = 57; DCD and attention deficit hyperactivity disorder (ADHD): n = 29] and 99 children with typical development were recruited. Their motor performance was assessed with the Movement Assessment Battery for Children (MABC) and attention during the tasks of the MABC was evaluated by EEG. All children with DCD had higher MABC impairment scores and lower EEG attention scores than their peers (P < 0.05). After accounting for age, sex, body mass index, and physical activity level, the attention index remained significantly associated with the MABC total impairment score and explained 14.1% of the variance in children who had DCD but not ADHD (P = 0.009) and 17.5% of the variance in children with both DCD and ADHD (P = 0.007). Children with DCD had poorer motor performance and were less attentive to movements than their peers. Their poor motor performance may be explained by inattention. PMID:27631272

Validation of a Dry Model for Assessing the Performance of Arthroscopic Hip Labral Repair.

PubMed

Phillips, Lisa; Cheung, Jeffrey J H; Whelan, Daniel B; Murnaghan, Michael Lucas; Chahal, Jas; Theodoropoulos, John; Ogilvie-Harris, Darrell; Macniven, Ian; Dwyer, Tim

2017-07-01

Arthroscopic hip labral repair is a technically challenging and demanding surgical technique with a steep learning curve. Arthroscopic simulation allows trainees to develop these skills in a safe environment. The purpose of this study was to evaluate the use of a combination of assessment ratings for the performance of arthroscopic hip labral repair on a dry model. Cross-sectional study; Level of evidence, 3. A total of 47 participants including orthopaedic surgery residents (n = 37), sports medicine fellows (n = 5), and staff surgeons (n = 5) performed arthroscopic hip labral repair on a dry model. Prior arthroscopic experience was noted. Participants were evaluated by 2 orthopaedic surgeons using a task-specific checklist, the Arthroscopic Surgical Skill Evaluation Tool (ASSET), task completion time, and a final global rating scale. All procedures were video-recorded and scored by an orthopaedic fellow blinded to the level of training of each participant. The internal consistency/reliability (Cronbach alpha) using the total ASSET score for the procedure was high (intraclass correlation coefficient > 0.9). One-way analysis of variance for the total ASSET score demonstrated a difference between participants based on the level of training ( F 3,43 = 27.8, P < .001). A good correlation was seen between the ASSET score and previous exposure to arthroscopic procedures ( r = 0.52-0.73, P < .001). The interrater reliability for the ASSET score was excellent (>0.9). The results of this study demonstrate that the use of dry models to assess the performance of arthroscopic hip labral repair by trainees is both valid and reliable. Further research will be required to demonstrate a correlation with performance on cadaveric specimens or in the operating room.

Face recognition performance of individuals with Asperger syndrome on the Cambridge Face Memory Test.

PubMed

Hedley, Darren; Brewer, Neil; Young, Robyn

2011-12-01

Although face recognition deficits in individuals with Autism Spectrum Disorder (ASD), including Asperger syndrome (AS), are widely acknowledged, the empirical evidence is mixed. This in part reflects the failure to use standardized and psychometrically sound tests. We contrasted standardized face recognition scores on the Cambridge Face Memory Test (CFMT) for 34 individuals with AS with those for 42, IQ-matched non-ASD individuals, and age-standardized scores from a large Australian cohort. We also examined the influence of IQ, autistic traits, and negative affect on face recognition performance. Overall, participants with AS performed significantly worse on the CFMT than the non-ASD participants and when evaluated against standardized test norms. However, while 24% of participants with AS presented with severe face recognition impairment (>2 SDs below the mean), many individuals performed at or above the typical level for their age: 53% scored within +/- 1 SD of the mean and 9% demonstrated superior performance (>1 SD above the mean). Regression analysis provided no evidence that IQ, autistic traits, or negative affect significantly influenced face recognition: diagnostic group membership was the only significant predictor of face recognition performance. In sum, face recognition performance in ASD is on a continuum, but with average levels significantly below non-ASD levels of performance. Copyright © 2011, International Society for Autism Research, Wiley-Liss, Inc.

The H-Impairment Index (HII): a standardized assessment of alcohol-induced impairment in the Emergency Department.

PubMed

Hack, Jason B; Goldlust, Eric J; Gibbs, Frantz; Zink, Brian

2014-03-01

Emergency Departments (EDs) care for thousands of alcohol-intoxicated patients annually. No clinically relevant bedside measures currently exist to describe degree of impairment. To assess a group of bedside tests ("Hack's Impairment Index [HII] score") that applies a numerical value to the degree of alcohol-induced impairment in ED patients. A six-month retrospective review of HII score data was performed in a convenience sample of 293 intoxicated ED patients. Patients were scored 0-4 on five tasks, divided by the maximum score (20 if all tasks completed), every 2 hours; and classified by the number of visits: Low-frequency (1 visit); Medium-frequency (2 visits); High-frequency (≥3 visits). Correlations were assessed between HII score, healthcare provider judgment of intoxication, and measured alcohol levels. Study patients had 513 visits; 236 were low-frequency, 26 middle-frequency and 31 high-frequency. Clinical assessment and HII score were strongly correlated (Spearman's rho = 0.82, p < 0.001); clinical assessment and alcohol level less strongly so (rho = 0.49, p < 0.001). Among low-frequency patients, HII score and alcohol level were weakly correlated (r = 0.324, p < 0.001), with no such correlation among high-frequency visitors (r = -0.04, p = 0.89). The mean decline between serial HII scores was 0.126 (95% CI: 0.098-0.154). This pilot study shows the HII score can be performed at the bedside of alcohol-intoxicated patients. The HII declines in a reasonably predictable manner over time; and applies a quantitative, objective assessment of alcohol impairment.

Investigation of Remedial Education Course Scores as a Predictor of Introduction-Level Course Performances

ERIC Educational Resources Information Center

Ulmer, Ward; Means, Darris R.; Cawthon, Tony W.; Kristensen, Sheryl A.

2016-01-01

This study explores whether performance in remedial English and remedial math is a predictor of success in a college-level introduction English or college-level math class; and whether demographic variables increase the likelihood of remedial English and remedial math as a predictor of success in a college-level introduction English or…

Surgical management of congenital heart disease: evaluation according to the Aristotle score.

PubMed

Heinrichs, Jutta; Sinzobahamvya, Nicodème; Arenz, Claudia; Kallikourdis, Antonios; Photiadis, Joachim; Schindler, Ehrenfried; Hraska, Vicktor; Asfour, Boulos

2010-01-01

The Aristotle basic complexity (ABC) score (1.5-15 points) is the sum of potentials for early mortality, morbidity and anticipated surgical technique difficulty. The Aristotle comprehensive complexity (ACC) score (1.5-25 points) is the sum of ABC score and patient-adjusted complexity score; it comprises six complexity levels. We used the ACC score to evaluate quality in surgical management of congenital heart disease. Procedures performed in year 2002 and 2007 were analysed. Proportion of procedures requiring at least 1 week of stay in the intensive care unit was chosen as the marker of morbidity. We adopted threshold duration of 120 min for cardio-pulmonary bypass (CPB) cases and the same duration for operations without CPB as surrogate of surgical technical difficulty. The ACC scores were correlated to mortality, morbidity and technical difficulty. This study included 758 patients who underwent 787 primary procedures. The mean ABC and ACC scores amounted to 7.61+/-2.46 and 9.51+/-3.84. Early mortality was 3.05% (24/787), 95% confidence interval (CI): 1.97-4.51%. Zero at ACC levels 1 and 2, it increased from 1.2% (2/161) for level 3 up to 22.2% (2/9) for level 6. Morbidity index was evaluated at 25.9% (204/787), 95% CI: 22.9-29.1%. 1.9% at level 1, it escalated up to 77.8% at level 6. Index of technique difficulty was estimated at 35.2% (277/787), 95% CI: 31.8-38.6%, ranging from 4.8% for level 1 to 66.7% for level 6. A high correlation was found between the ACC scores and mortality, indices of morbidity and technique difficulty, Spearman's correlation coefficient r being 0.9856, 1 and 0.9429, respectively. Mortality (p=0.037) and morbidity (p=0.041) were lower in year 2007 than in 2002 with ABC (p=0.18) and ACC (p=0.37) surgical performance being not significantly different. The Aristotle score is still under development. Morbidity evaluation should be ideally based on observed postoperative complications; estimation of surgical technical difficulty chosen in this study may not be generalised. Nevertheless, the actual Aristotle comprehensive complexity score, as evaluated in its three components, accurately determined the outcome of surgical management of congenital heart disease. It appears to be an adequate tool to evaluate quality in paediatric cardiac surgery, over time. Copyright 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

A Robust Outlier Approach to Prevent Type I Error Inflation in Differential Item Functioning

ERIC Educational Resources Information Center

Magis, David; De Boeck, Paul

2012-01-01

The identification of differential item functioning (DIF) is often performed by means of statistical approaches that consider the raw scores as proxies for the ability trait level. One of the most popular approaches, the Mantel-Haenszel (MH) method, belongs to this category. However, replacing the ability level by the simple raw score is a source…

The readability and suitability of sexual health promotion leaflets.

PubMed

Corcoran, Nova; Ahmad, Fatuma

2016-02-01

To investigate the readability and suitability of sexual health promotion leaflets. Application of SMOG, FRY and SAM tests to assess the readability and suitability of a selection of sexual health leaflets. SMOG and FRY scores illustrate an average reading level of grade 9. SAM scores indicate that 59% of leaflets are superior in design and 41% are average in design. Leaflets generally perform well in the categories of content, literacy demand, typography and layout. They perform poorly in use of graphics, learning stimulation/motivation and cultural appropriateness. Sexual health leaflets have a reading level that is too high. Leaflets perform well on the suitability scores indicating they are reasonably suitable. There are a number of areas where sexual health leaflets could improve their design. Numerous practical techniques are suggested for improving the readability and suitability of sexual health leaflets. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Subsequent Vertebral Fractures Post Cement Augmentation of the Thoracolumbar Spine: Does it Correlate With Level-specific Bone Mineral Density Scores?

PubMed

Hey, Hwee Weng Dennis; Hwee Weng, Dennis Hey; Tan, Jun Hao; Jun, Hao Tan; Tan, Chuen Seng; Chuen, Seng Tan; Tan, Hsi Ming Bryan; Ming, Bryan Tan Hsi; Lau, Puang Huh Bernard; Huh, Bernard Lau Puang; Hee, Hwan Tak; Hwan, Tak Hee

2015-12-01

A case-control study. In this study, we investigated the correlation between level-specific preoperative bone mineral density and subsequent vertebral fractures. We also identified factors associated with subsequent vertebral fractures. Complications of cement augmentation of the spine include subsequent vertebral fractures, leading to unnecessary morbidity and more treatment. Ability to predict at-risk vertebra will help guide management. We studied all patients with osteoporotic compression fractures who underwent cement augmentation in a single institution from November 2001 to December 2010 by a single surgeon. Association between level-specific bone mineral density T-scores and subsequent fractures was assessed. Multivariable analysis was performed to identify significant factors associated with subsequent vertebral fractures. 93 patients followed up for a mean duration of 25.1 months (12-96) had a mean age of 76.8 years (47-99). Vertebroplasty was performed in 58 patients (62.4%) on 68 levels and kyphoplasty in 35 patients (37.6%) on 44 levels. Refracture was seen in 16 patients (17.2%). The time to subsequent fracture post cement augmentation was 20.5 months (2-90). For refracture cases, 43.8% (7/16) fractured in the adjacent vertebrae. Subsequently fractured vertebra had a mean T-score of -2.860 (95% confidence interval -3.268 to -2.452) and nonfractured vertebra had a mean T-score of -2.180 (95% confidence interval -2.373 to -1.986). A T-score of -2.2 or lower is predictive of refracture at that vertebra (P = 0.047). Odds ratio increases with decreasing T-scores from -2.2 or lower to -2.6 or lower. A T-score of -2.6 or lower gives no additional predictive advantage. After multivariable analysis, age (P = 0.049) and loss of preoperative anterior vertebral height (P = 0.017) are associated with refracture. Level-specific T-scores are predictive of subsequent fractures and the odds ratio increases with lower T-scores from -2.2 or less to -2.6 or less. They have a low positive predictive value, but a high negative predictive value for subsequent fractures. Other significant associations with subsequent refractures include age and anterior vertebral height. 4.

Heterogeneity of Cognitive Anosognosia and its Variation with the Severity of Dementia in Patients with Alzheimer's Disease.

PubMed

Avondino, Emilie; Antoine, Pascal

2016-01-01

Currently, the lack of awareness of deficits, i.e., anosognosia, is a major obstacle in the healthcare circuit that delays the diagnosis of Alzheimer's disease (AD). However, a clear framework is lacking in the literature related to this phenomenon in terms of its definition, mechanisms, and objects. The aim of this study is to assess the different levels of cognitive anosognosia using a prediction-performance procedure and to identify the potential correlates of these levels. A sample of patients with probable AD was divided into three groups according to the severity of dementia (mild (MiD), moderate (MoD), and moderately severe (MSD) dementia), ranked according to the results of the Mini-Mental State Examination. We observed the following three scores: the real score, the prediction score, and the anosognosia score. These scores were calculated based on the prediction-performance task MISAwareness from the Dementia Rating Scale for cognitive processes (i.e., Attention, Initiation, Conceptualization, Construction, and Memory). We obtained a strong plateau effect between the MiD and MoD groups for anosognosia scores for actual performance or prediction for both the level of overall functioning and for specific processes. The sole exception was the result for memory processes. Moreover, the profiles of the patients' responses on the Memory subscale were substantially different and, indeed, opposite from those for the other processes. The main results confirm the multidimensionality of anosognosia and its variability with the stage of dementia and specifically implicate memory processes that indicate a cleavage between memory and other cognitive functions.

Recovery in Level 7-10 Women's USA Artistic Gymnastics.

PubMed

Buckner, Stephen B; Bacon, Nicholas T; Bishop, Phillip A

2017-01-01

This study assessed physical performance in women's artistic gymnastics following three variable recovery periods. Participants included fifteen female gymnasts (mean age = 13.5 ± 1.1) who had competed at USA Gymnastics (USAG) levels 7 - 10 within at least one year prior to the study. Each testing session consisted of a warm-up followed by four muscular endurance tests and one explosive maximal test. Assessments included pull-ups, leg lifts, handstand push-ups, vertical jump, and push-ups. After the performance assessments, the participants completed a typical practice session. The performance measures were reassessed at the beginning of each of the recovery periods of 24, 48, and 72 hours in a counterbalanced design. Performance assessments were converted into Z-scores and then averaged for a composite session Z-score. The composite session Z-scores were compared to evaluate the recovery duration. Composite Z's were significantly lower (p=0.000), after the 24 (z=-1.10) and the 48 hour (z=-0.71) recovery periods compared to baseline (z=0.00). However, there was no difference in scores (p=1.00) between the baseline and 72 hours (z=0.004) recovery. Full recovery required 72 hours under the conditions of this study.

Do Differential Response Rates to Patient Surveys Between Organizations Lead to Unfair Performance Comparisons?: Evidence From the English Cancer Patient Experience Survey.

PubMed

Saunders, Catherine L; Elliott, Marc N; Lyratzopoulos, Georgios; Abel, Gary A

2016-01-01

Patient surveys typically have variable response rates between organizations, leading to concerns that such differences may affect the validity of performance comparisons. To explore the size and likely sources of associations between hospital-level survey response rates and patient experience. Cross-sectional mail survey including 60 patient experience items sent to 101,771 cancer survivors recently treated by 158 English NHS hospitals. Age, sex, race/ethnicity, socioeconomic status, clinical diagnosis, hospital type, and region were available for respondents and nonrespondents. The overall response rate was 67% (range, 39% to 77% between hospitals). Hospitals with higher response rates had higher scores for all items (Spearman correlation range, 0.03-0.44), particularly questions regarding hospital-level administrative processes, for example, procedure cancellations or medical note availability.From multivariable analysis, associations between individual patient experience and hospital-level response rates were statistically significant (P<0.05) for 53/59 analyzed questions, decreasing to 37/59 after adjusting for case-mix, and 25/59 after further adjusting for hospital-level characteristics.Predicting responses of nonrespondents, and re-estimating hypothetical hospital scores assuming a 100% response rate, we found that currently low performing hospitals would have attained even lower scores. Overall nationwide attainment would have decreased slightly to that currently observed. Higher response rate hospitals have more positive experience scores, and this is only partly explained by patient case-mix. High response rates may be a marker of efficient hospital administration, and higher quality that should not, therefore, be adjusted away in public reporting. Although nonresponse may result in slightly overestimating overall national levels of performance, it does not appear to meaningfully bias comparisons of case-mix-adjusted hospital results.

Is Cognitive Test-Taking Anxiety Associated With Academic Performance Among Nursing Students?

PubMed

Duty, Susan M; Christian, Ladonna; Loftus, Jocelyn; Zappi, Victoria

2016-01-01

The cognitive component of test anxiety was correlated with academic performance among nursing students. Modest but statistically significant lower examination grade T scores were observed for students with high compared with low levels of cognitive test anxiety (CTA). High levels of CTA were associated with reduced academic performance.

Analyzing Musical Self-Esteem and Performance Anxiety Levels of Students Receiving Professional Music Education at Different Institutions in Turkey

ERIC Educational Resources Information Center

Otacioglu, Sena Gürsen

2016-01-01

The study was conducted to establish which variables cause the interrelations between musical self-esteem and performance-anxiety levels of students receiving professional music education at different institutions to vary. In relation to this framework, "musical self-esteem" and "performance anxiety" scores of students…

Neyman-Pearson biometric score fusion as an extension of the sum rule

NASA Astrophysics Data System (ADS)

Hube, Jens Peter

2007-04-01

We define the biometric performance invariance under strictly monotonic functions on match scores as normalization symmetry. We use this symmetry to clarify the essential difference between the standard score-level fusion approaches of sum rule and Neyman-Pearson. We then express Neyman-Pearson fusion assuming match scores defined using false acceptance rates on a logarithmic scale. We show that by stating Neyman-Pearson in this form, it reduces to sum rule fusion for ROC curves with logarithmic slope. We also introduce a one parameter model of biometric performance and use it to express Neyman-Pearson fusion as a weighted sum rule.

Results of arthroscopic repair of type II superior labral anterior posterior lesions in overhead athletes: assessment of return to preinjury playing level and satisfaction.

PubMed

Neuman, Brian J; Boisvert, C Brittany; Reiter, Brian; Lawson, Kevin; Ciccotti, Michael G; Cohen, Steven B

2011-09-01

The majority of the literature on surgical outcomes of superior labral anterior posterior (SLAP) repairs has focused on short-term follow-up of 1 to 2 years, not allowing adequate time for full rehabilitation and return to maximum level of competition for all types of athletes. Also, previous studies have concentrated on using questionnaires that primarily evaluate patients' activities of daily living, which do not focus on sport-specific performance. To determine the midterm results of type II SLAP repairs in overhead athletes, focusing primarily on athletic performance as well as activities of daily living. Case series; Level of evidence, 4. A retrospective review of 30 overhead athletes, who underwent an arthroscopic superior labral repair for a symptomatic type II SLAP tear between 2002 and 2007, was performed. Our study population included 22 male and 8 female patients with a mean age at the time of surgery of 24 years. Twenty-one patients participated in baseball or softball, and the remainder of patients were involved in javelin throwing or tennis. The average follow-up was 3.5 years. The outcome of treatment was evaluated using the American Shoulder and Elbow Society (ASES) scoring system, assessing activities of daily living, and the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow (KJOC) score, assessing sport-specific performance. In addition, the length of time to return to sport and the degree of successful performance were evaluated. Repairs resulted in ASES scores comparable with those from prior published studies (average ASES score, 87.9). The KJOC score averaged 73.6. The athletes' perception was that they returned to approximately 84.1% of their preinjury level of function with a mean time to return to play of 11.7 months. There was a significant drop in the ASES to KJOC score for the baseball/softball players (87.9 ± 14.94 and 72 ± 19.24, respectively; P = .006). Patients reported an overall satisfaction rate of 93.3% with the procedure, with the majority being very satisfied. Arthroscopic SLAP repairs show excellent results and a high rate of overall satisfaction; however, the outcomes are less reliable in throwers. The KJOC score provides a more stringent assessment of overhead athletes' function after SLAP repair than the ASES score. Our findings also indicate that SLAP repairs lead to improved shoulder function during routine daily activities but that consistent return to elite throwing sports may still remain somewhat problematic.

Parameters for screening music performance anxiety.

PubMed

Barbar, Ana E; Crippa, José A; Osório, Flávia L

2014-09-01

To assess the discriminative capacity of the Kenny Music Performance Anxiety Inventory (K-MPAI), in its version adapted for Brazil, in a sample of 230 Brazilian adult musicians. The Social Phobia Inventory (SPIN) was used to assess the presence of social anxiety indicators, adopting it as the gold standard. The Mann-Whitney U test and the receiver operating characteristic (ROC) curve were used for statistical analysis, with p ≤ 0.05 set as the significance level. Subjects with social anxiety indicators exhibited higher mean total K-MPAI scores, as well as higher individual scores on 62% of its items. The area under the ROC curve was 0.734 (p = 0.001), and considered appropriate. Within the possible cutoff scores presented, the score -15 had the best balance of sensitivity and specificity values. However, the score -7 had greater specificity and accuracy. The K-MPAI showed appropriate discriminant validity, with a marked association between music performance anxiety and social anxiety. The cutoff scores presented in the study have both clinical and research value, allowing screening for music performance anxiety and identification of possible cases.

A core competency-based objective structured clinical examination (OSCE) can predict future resident performance.

PubMed

Wallenstein, Joshua; Heron, Sheryl; Santen, Sally; Shayne, Philip; Ander, Douglas

2010-10-01

This study evaluated the ability of an objective structured clinical examination (OSCE) administered in the first month of residency to predict future resident performance in the Accreditation Council for Graduate Medical Education (ACGME) core competencies. Eighteen Postgraduate Year 1 (PGY-1) residents completed a five-station OSCE in the first month of postgraduate training. Performance was graded in each of the ACGME core competencies. At the end of 18 months of training, faculty evaluations of resident performance in the emergency department (ED) were used to calculate a cumulative clinical evaluation score for each core competency. The correlations between OSCE scores and clinical evaluation scores at 18 months were assessed on an overall level and in each core competency. There was a statistically significant correlation between overall OSCE scores and overall clinical evaluation scores (R = 0.48, p < 0.05) and in the individual competencies of patient care (R = 0.49, p < 0.05), medical knowledge (R = 0.59, p < 0.05), and practice-based learning (R = 0.49, p < 0.05). No correlation was noted in the systems-based practice, interpersonal and communication skills, or professionalism competencies. An early-residency OSCE has the ability to predict future postgraduate performance on a global level and in specific core competencies. Used appropriately, such information can be a valuable tool for program directors in monitoring residents' progress and providing more tailored guidance. © 2010 by the Society for Academic Emergency Medicine.

A comparison of FibroMeter™ NAFLD Score, NAFLD fibrosis score, and transient elastography as noninvasive diagnostic tools for hepatic fibrosis in patients with biopsy-proven non-alcoholic fatty liver disease.

PubMed

Aykut, Umut Emre; Akyuz, Umit; Yesil, Atakan; Eren, Fatih; Gerin, Fatma; Ergelen, Rabia; Celikel, Cigdem Ataizi; Yilmaz, Yusuf

2014-11-01

Noninvasive markers that purport to distinguish patients with non-alcoholic fatty liver disease (NAFLD) with fibrosis from those without must be evaluated rigorously for their classification accuracy. Herein, we seek to compare the diagnostic performances of three different noninvasive methods (FibroMeter™ NAFLD score, NAFLD Fibrosis score (NFSA), and Transient Elastrography [TE]) for the detection of liver fibrosis in NAFLD patients. A total of 88 patients with biopsy-proven NAFLD were included. The Kleiner system was used for grading fibrosis in liver biopsies. The FibroMeter™ NAFLD score was determined using a proprietary algorithm (regression score). The NFSA score was calculated based on age, hyperglycemia, body mass index, platelets, albumin and serum aminotransferase levels. TE was performed using the Fibroscan apparatus. The sensitivities/specificities for the FibroMeter™ NAFLD score, NFSA, and TE for the diagnosis of significant fibrosis (F2 + F3 + F4 fibrosis) were 38.6%/86.4%, 52.3%/88.6%, and 75.0%/93.2%, respectively. The areas under the receiver operating characteristic curves of TE were significantly higher than those of both the FibroMeter™ NAFLD score and NFSA. No significant differences were found between the FibroMeter™ NAFLD score and NFSA for the detection of significant and severe fibrosis, although the diagnostic performance of the FibroMeter™ NAFLD score was higher than that of the NFSA score for cirrhosis. In summary, TE showed the best diagnostic performance for the noninvasive assessment of liver fibrosis in NAFLD patients. The diagnostic performances of the FibroMeter™ NAFLD score and NFSA did not differ significantly for the detection of both significant and severe fibrosis.

Evaluation of affective temperament and anxiety-depression levels of patients with polycystic ovary syndrome.

PubMed

Asik, Mehmet; Altinbas, Kursat; Eroglu, Mustafa; Karaahmet, Elif; Erbag, Gokhan; Ertekin, Hulya; Sen, Hacer

2015-10-01

Women with polycystic ovary syndrome (PCOS) are reported to experience depressive episodes at a higher rate than healthy controls (HC). Affective temperament features are psychiatric markers that may help to predict and identify vulnerability to depression in women with PCOS. Our aim was to evaluate the affective temperaments of women with PCOS and to investigate the association with depression and anxiety levels and laboratory variables in comparison with HC. The study included 71 women with PCOS and 50 HC. Hormonal evaluations were performed for women with PCOS. Physical examination, clinical history, Hospital Anxiety and Depression Scale (HADS) and TEMPS-A were performed for all subjects. Differences between groups were evaluated using Student's t-tests and Mann-Whitney U tests. Correlations and logistic regression tests were performed. All temperament subtype scores, except hyperthymic, and HADS anxiety, depression, and total scores were significantly higher in patients with PCOS compared to HC. A statistically significant positive correlation was found between BMI and irritable temperament, and insulin and HADS depression scores in patients with PCOS. Additionally, hirsutism score and menstrual irregularity were correlated with HADS depression, anxiety and total scores in PCOS patients. In logistic regression analysis, depression was not affected by PCOS, hirsutism score or menstrual irregularity. However, HADS anxiety score was associated with hirsutism score. Our study is the first to evaluate the affective temperament features of women with PCOS. Consequently, establishing affective temperament properties for women with PCOS may help clinicians predict those patients with PCOS who are at risk for depressive and anxiety disorders. Copyright © 2015 Elsevier B.V. All rights reserved.

Development of an Itemwise Efficiency Scoring Method: Concurrent, Convergent, Discriminant, and Neuroimaging-Based Predictive Validity Assessed in a Large Community Sample

PubMed Central

Moore, Tyler M.; Reise, Steven P.; Roalf, David R.; Satterthwaite, Theodore D.; Davatzikos, Christos; Bilker, Warren B.; Port, Allison M.; Jackson, Chad T.; Ruparel, Kosha; Savitt, Adam P.; Baron, Robert B.; Gur, Raquel E.; Gur, Ruben C.

2016-01-01

Traditional “paper-and-pencil” testing is imprecise in measuring speed and hence limited in assessing performance efficiency, but computerized testing permits precision in measuring itemwise response time. We present a method of scoring performance efficiency (combining information from accuracy and speed) at the item level. Using a community sample of 9,498 youths age 8-21, we calculated item-level efficiency scores on four neurocognitive tests, and compared the concurrent, convergent, discriminant, and predictive validity of these scores to simple averaging of standardized speed and accuracy-summed scores. Concurrent validity was measured by the scores' abilities to distinguish men from women and their correlations with age; convergent and discriminant validity were measured by correlations with other scores inside and outside of their neurocognitive domains; predictive validity was measured by correlations with brain volume in regions associated with the specific neurocognitive abilities. Results provide support for the ability of itemwise efficiency scoring to detect signals as strong as those detected by standard efficiency scoring methods. We find no evidence of superior validity of the itemwise scores over traditional scores, but point out several advantages of the former. The itemwise efficiency scoring method shows promise as an alternative to standard efficiency scoring methods, with overall moderate support from tests of four different types of validity. This method allows the use of existing item analysis methods and provides the convenient ability to adjust the overall emphasis of accuracy versus speed in the efficiency score, thus adjusting the scoring to the real-world demands the test is aiming to fulfill. PMID:26866796

Social Performance Cues Induce Behavioral Flexibility in Humans

PubMed Central

Toelch, Ulf; Bruce, Matthew J.; Meeus, Marius T. H.; Reader, Simon M.

2011-01-01

Behavioral flexibility allows individuals to react to environmental changes, but changing established behavior carries costs, with unknown benefits. Individuals may thus modify their behavioral flexibility according to the prevailing circumstances. Social information provided by the performance level of others provides one possible cue to assess the potential benefits of changing behavior, since out-performance in similar circumstances indicates that novel behaviors (innovations) are potentially useful. We demonstrate that social performance cues, in the form of previous players’ scores in a problem-solving computer game, influence behavioral flexibility. Participants viewed only performance indicators, not the innovative behavior of others. While performance cues (high, low, or no scores) had little effect on innovation discovery rates, participants that viewed high scores increased their utilization of innovations, allowing them to exploit the virtual environment more effectively than players viewing low or no scores. Perceived conspecific performance can thus shape human decisions to adopt novel traits, even when the traits employed cannot be copied. This simple mechanism, social performance feedback, could be a driver of both the facultative adoption of innovations and cumulative cultural evolution, processes critical to human success. PMID:21811477

Emotional intelligence in surgery is associated with resident job satisfaction.

PubMed

Hollis, Robert H; Theiss, Lauren M; Gullick, Allison A; Richman, Joshua S; Morris, Melanie S; Grams, Jayleen M; Porterfield, John R; Chu, Daniel I

2017-03-01

Emotional intelligence (EI) has been associated with improved work performance and job satisfaction in several industries. We evaluated whether EI was associated with higher measures of work performance and job satisfaction in surgical residents. We distributed the validated Trait EI Questionnaire and job satisfaction survey to all general surgery residents at a single institution in 2015. EI and job satisfaction scores were compared with resident performance using faculty evaluations of clinical competency-based surgical milestones and standardized test scores including the United States Medical Licensing Examination (USMLE) and American Board of Surgery In-Training Examination (ABSITE). Statistical comparison was made using Pearson correlation and simple linear regression adjusting for postgraduate year level. The survey response rate was 68.9% with 31 resident participants. Global EI was associated with scores on USMLE Step 2 (r = 0.46, P = 0.01) and Step 3 (r = 0.54, P = 0.01) but not ABSITE percentile scores (r = 0.06, P = 0.77). None of the 16 surgical milestone scores were significantly associated with global EI or EI factors before or after adjustment for postgraduate level. Global EI was associated with overall job satisfaction (r = 0.37, P = 0.04). Of the facets of job satisfaction, global EI was significantly associated with views of supervision (r = 0.42, P = 0.02) and nature of work (r = 0.41, P = 0.02). EI was associated with job satisfaction and USMLE performance but not ACGME competency-based milestones or ABSITE scores. EI may be an important factor for fulfillment in surgical training that is not currently captured with traditional in-training performance measures. Published by Elsevier Inc.

Performance Measurement and Accommodation: Students with Visual Impairments on Pennsylvania's Alternate Assessment

ERIC Educational Resources Information Center

Zebehazy, Kim T.; Zigmond, Naomi; Zimmerman, George J.

2012-01-01

Introduction: This study investigated the use of accommodations and the performance of students with visual impairments and severe cognitive disabilities on the Pennsylvania Alternate System of Assessment (PASA)yCoan alternate performance-based assessment. Methods: Differences in test scores on the most basic level (level A) of the PASA of 286…

Holistic rubric vs. analytic rubric for measuring clinical performance levels in medical students.

PubMed

Yune, So Jung; Lee, Sang Yeoup; Im, Sun Ju; Kam, Bee Sung; Baek, Sun Yong

2018-06-05

Task-specific checklists, holistic rubrics, and analytic rubrics are often used for performance assessments. We examined what factors evaluators consider important in holistic scoring of clinical performance assessment, and compared the usefulness of applying holistic and analytic rubrics respectively, and analytic rubrics in addition to task-specific checklists based on traditional standards. We compared the usefulness of a holistic rubric versus an analytic rubric in effectively measuring the clinical skill performances of 126 third-year medical students who participated in a clinical performance assessment conducted by Pusan National University School of Medicine. We conducted a questionnaire survey of 37 evaluators who used all three evaluation methods-holistic rubric, analytic rubric, and task-specific checklist-for each student. The relationship between the scores on the three evaluation methods was analyzed using Pearson's correlation. Inter-rater agreement was analyzed by Kappa index. The effect of holistic and analytic rubric scores on the task-specific checklist score was analyzed using multiple regression analysis. Evaluators perceived accuracy and proficiency to be major factors in objective structured clinical examinations evaluation, and history taking and physical examination to be major factors in clinical performance examinations evaluation. Holistic rubric scores were highly related to the scores of the task-specific checklist and analytic rubric. Relatively low agreement was found in clinical performance examinations compared to objective structured clinical examinations. Meanwhile, the holistic and analytic rubric scores explained 59.1% of the task-specific checklist score in objective structured clinical examinations and 51.6% in clinical performance examinations. The results show the usefulness of holistic and analytic rubrics in clinical performance assessment, which can be used in conjunction with task-specific checklists for more efficient evaluation.

Comparative study of multimodal biometric recognition by fusion of iris and fingerprint.

PubMed

Benaliouche, Houda; Touahria, Mohamed

2014-01-01

This research investigates the comparative performance from three different approaches for multimodal recognition of combined iris and fingerprints: classical sum rule, weighted sum rule, and fuzzy logic method. The scores from the different biometric traits of iris and fingerprint are fused at the matching score and the decision levels. The scores combination approach is used after normalization of both scores using the min-max rule. Our experimental results suggest that the fuzzy logic method for the matching scores combinations at the decision level is the best followed by the classical weighted sum rule and the classical sum rule in order. The performance evaluation of each method is reported in terms of matching time, error rates, and accuracy after doing exhaustive tests on the public CASIA-Iris databases V1 and V2 and the FVC 2004 fingerprint database. Experimental results prior to fusion and after fusion are presented followed by their comparison with related works in the current literature. The fusion by fuzzy logic decision mimics the human reasoning in a soft and simple way and gives enhanced results.

Comparative Study of Multimodal Biometric Recognition by Fusion of Iris and Fingerprint

PubMed Central

Benaliouche, Houda; Touahria, Mohamed

2014-01-01

This research investigates the comparative performance from three different approaches for multimodal recognition of combined iris and fingerprints: classical sum rule, weighted sum rule, and fuzzy logic method. The scores from the different biometric traits of iris and fingerprint are fused at the matching score and the decision levels. The scores combination approach is used after normalization of both scores using the min-max rule. Our experimental results suggest that the fuzzy logic method for the matching scores combinations at the decision level is the best followed by the classical weighted sum rule and the classical sum rule in order. The performance evaluation of each method is reported in terms of matching time, error rates, and accuracy after doing exhaustive tests on the public CASIA-Iris databases V1 and V2 and the FVC 2004 fingerprint database. Experimental results prior to fusion and after fusion are presented followed by their comparison with related works in the current literature. The fusion by fuzzy logic decision mimics the human reasoning in a soft and simple way and gives enhanced results. PMID:24605065

Mapping Direct Observations From Objective Structured Clinical Examinations to the Milestones Across Specialties.

PubMed

Baker-Genaw, Kimberly; Kokas, Maria S; Ahsan, Syed F; Darnley-Fisch, Deborah; Drake, Sean; Goyal, Nikhil; Inamdar, Kedar; Moutzouros, Vasilios; Prabhakar, Deepak; Rolland, Laurie; Sangha, Roopina; Shreve, Maria; Woodward, Ann

2016-07-01

Little is known about residents' performance on the milestones at the institutional level. Our institution formed a work group to explore this using an institutional-level curriculum and residents' evaluation of the milestones. We assessed whether beginner-level milestones for interpersonal and communication skills (ICS) related to observable behaviors in ICS-focused objective structured clinical examinations (OSCEs) for postgraduate year (PGY) 1 residents across specialties. The work group compared ICS subcompetencies across 12 programs to identify common beginner-level physician-patient communication milestones. The selected ICS milestone sets were compared for common language with the ICS-OSCE assessment tool-the Kalamazoo Essential Elements of Communication Checklist-Adapted (KEECC-A). To assess whether OSCE scores related to ICS milestone scores, all PGY-1 residents from programs that were part of Next Accreditation System Phase 1 were identified; their OSCE scores from July 2013 to June 2014 and ICS subcompetency scores from December 2014 were compared. The milestones for 10 specialties and the transitional year had at least 1 ICS subcompetency that related to physician-patient communication. The language of the ICS beginner-level milestones appears similar to behaviors outlined in the KEECC-A. All 60 residents with complete data received at least a beginner-level ICS subcompetency score and at least a satisfactory score on all 3 OSCEs. The ICS-OSCE scores for PGY-1 residents appear to relate to beginner-level milestones for physician-patient communication across multiple specialties.

Measuring Reading Performance Informally.

ERIC Educational Resources Information Center

Powell, William R.

To improve the accuracy of the informal reading inventory (IRI), a differential set of criteria is necessary for both word recognition and comprehension scores for different levels and reading conditions. In initial evaluation, word recognition scores should reflect only errors of insertions, omissions, mispronunciations, substitiutions, unkown…

Autism-relevant traits interact with temporoparietal junction stimulation effects on social cognition: a high-definition transcranial direct current stimulation and electroencephalography study.

PubMed

Donaldson, Peter H; Kirkovski, Melissa; Rinehart, Nicole J; Enticott, Peter G

2018-03-01

The temporoparietal junction (TPJ) is implicated in mental and emotional state attribution, processes associated with autism-relevant traits. Transcranial direct current stimulation (tDCS) to the TPJ can influence social-cognitive performance. However, associations with electrophysiology and autism-relevant traits remain relatively unexamined. This study had two aims: first, exploring links between Autism-Spectrum Quotient (AQ) scores and social-cognitive performance; second, examining interactions between AQ scores and high-definition-tDCS (HD-tDCS) applied to the right TPJ in terms of mental/emotional state attribution and neurophysiological outcomes. Fifty-three participants completed mental/emotional state attribution tasks before and after HD-tDCS. Pre-stimulation mental state attribution accuracy was reduced in participants with higher AQ Switching scores. Cathodal stimulation was associated with reduced emotion attribution performance in participants with higher AQ Switching and AQ Social scores (the latter at trend-level). Anodal stimulation more frequently interacted with AQ Social scores in terms of neurophysiology, in particular regarding reduced delta power in the left compared to right TPJ, and trend-level positive interactions with P100 and P300 latencies during the emotion recognition task. Elements of attention/switching (AQ Switching) may subserve or underpin elements of social cognition (AQ Social), and cathodal and anodal stimulation may have differing effects depending on trait levels in these domains. This study makes an important and original contribution in terms of increasing understanding of how such trait-level variation might interact with the effects of tDCS and also extending previous studies with regard to understanding potential roles of the rTPJ in both attention and social cognition and how autism-relevant traits might influence TPJ function. © 2017 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

The relation among steroid hormone levels, lipid profile and menopausal symptom severity.

PubMed

Kaya, Cihan; Cengiz, Hüseyin; Yeşil, Ali; Ekin, Murat; Yaşar, Levent

2017-12-01

Many postmenopausal women experience hot flashes, night sweats, non-specific emotional and psychological distresses. Our aim was to investigate the relation among steroid hormone levels, lipid profile and menopausal symptom severity using the menopause rating scale (MRS). A cross-sectional study was performed at our outpatient clinic with natural postmenopausal women. A total of 444 women were included in this study. The basic characteristics of the study population, such as age, gravidity, parity, time to menopause onset and body mass index (BMI) were recorded. Venous blood samples were collected from subjects after overnight fasting. The levels of high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, total cholesterol, triglyceride (TG), fasting plasma glucose, C-reactive protein, thyroid-stimulating hormone (TSH), cortisol, estradiol (E2), progesterone, testosterone and dehydroepiandrostenedione sulfate (DHEA-S) were analyzed. The MRS questionnaire validated for the Turkish population was used to assess the menopausal symptoms. There was a statistically significant difference between mild and severe total symptom scores for TG, and elevated TG levels were observed in the severe group (p = 0.04). Elevated testosterone levels were observed with severe psychological symptom and total symptom scores. There were significant differences in progesterone level in psychological, urogenital, and total scores and lower levels were seen in severe symptom groups. There was a significant negative correlation between urogenital symptom scores and progesterone levels (p < 0.001). Elevated levels of testosterone were related to severe psychological symptom and total menopausal symptom scores. A decrease in progesterone levels was related to high psychological, urogenital and total menopausal symptom scores. Elevated TG levels were also related to the total severe symptom scores.

HDL-cholesterol and physical performance: results from the ageing and longevity study in the sirente geographic area (ilSIRENTE Study).

PubMed

Landi, Francesco; Russo, Andrea; Cesari, Matteo; Pahor, Marco; Bernabei, Roberto; Onder, Graziano

2007-09-01

High-density lipoprotein (HDL) cholesterol has been hypothesised to be a reliable marker of frailty and poor prognosis among the oldest elderly. We evaluate the relationship of HDL-cholesterol with measures of physical performance, muscle strength, and functional status in older persons aged 80years or older. Data are from baseline evaluation of the ageing and longevity study in the Sirente geographic area (ilSIRENTE study) (n = 364). Physical performance was assessed using the physical performance battery score [short physical performance battery (SPPB)], which is based on three-timed tests: 4-m walking-speed, balance, and chair-stand tests. Muscle strength was measured by hand-grip strength. Analyses of covariance were performed to evaluate the relationship of different HDL-cholesterol levels with physical function. In the unadjusted analyses, physical function (as measured by the 4-m walking-speed, theSPPB score, the basic and instrumental activities of daily living scales scores), but not hand-grip strength, improved significantly as HDL-cholesterol tertiles increased. After adjustment for potential confounders, which included age, gender, living alone, alcohol abuse, physical activity, congestive heart failure, diabetes, cerebrovascular diseases, osteoarthritis, albumin, urea, C-reactive protein and LDL cholesterol, the association of HDL-cholesterol tertiles with the 4-m walking-speed and the SPPB score was still consistent. The present study suggests that among very old subjects living in the community the higher levels of HDL-cholesterol are associated with better functional performance.

Factors contributing to speech perception scores in long-term pediatric cochlear implant users.

PubMed

Davidson, Lisa S; Geers, Ann E; Blamey, Peter J; Tobey, Emily A; Brenner, Christine A

2011-02-01

The objectives of this report are to (1) describe the speech perception abilities of long-term pediatric cochlear implant (CI) recipients by comparing scores obtained at elementary school (CI-E, 8 to 9 yrs) with scores obtained at high school (CI-HS, 15 to 18 yrs); (2) evaluate speech perception abilities in demanding listening conditions (i.e., noise and lower intensity levels) at adolescence; and (3) examine the relation of speech perception scores to speech and language development over this longitudinal timeframe. All 112 teenagers were part of a previous nationwide study of 8- and 9-yr-olds (N = 181) who received a CI between 2 and 5 yrs of age. The test battery included (1) the Lexical Neighborhood Test (LNT; hard and easy word lists); (2) the Bamford Kowal Bench sentence test; (3) the Children's Auditory-Visual Enhancement Test; (4) the Test of Auditory Comprehension of Language at CI-E; (5) the Peabody Picture Vocabulary Test at CI-HS; and (6) the McGarr sentences (consonants correct) at CI-E and CI-HS. CI-HS speech perception was measured in both optimal and demanding listening conditions (i.e., background noise and low-intensity level). Speech perception scores were compared based on age at test, lexical difficulty of stimuli, listening environment (optimal and demanding), input mode (visual and auditory-visual), and language age. All group mean scores significantly increased with age across the two test sessions. Scores of adolescents significantly decreased in demanding listening conditions. The effect of lexical difficulty on the LNT scores, as evidenced by the difference in performance between easy versus hard lists, increased with age and decreased for adolescents in challenging listening conditions. Calculated curves for percent correct speech perception scores (LNT and Bamford Kowal Bench) and consonants correct on the McGarr sentences plotted against age-equivalent language scores on the Test of Auditory Comprehension of Language and Peabody Picture Vocabulary Test achieved asymptote at similar ages, around 10 to 11 yrs. On average, children receiving CIs between 2 and 5 yrs of age exhibited significant improvement on tests of speech perception, lipreading, speech production, and language skills measured between primary grades and adolescence. Evidence suggests that improvement in speech perception scores with age reflects increased spoken language level up to a language age of about 10 yrs. Speech perception performance significantly decreased with softer stimulus intensity level and with introduction of background noise. Upgrades to newer speech processing strategies and greater use of frequency-modulated systems may be beneficial for ameliorating performance under these demanding listening conditions.

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

PubMed

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

2015-02-01

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

Complex dynamics in the distribution of players’ scoring performance in Rugby Union world cups

NASA Astrophysics Data System (ADS)

Seuront, Laurent

2013-09-01

The evolution of the scoring performance of Rugby Union players is investigated over the seven rugby world cups (RWC) that took place from 1987 to 2011, and a specific attention is given to how they may have been impacted by the switch from amateurism to professionalism that occurred in 1995. The distribution of the points scored by individual players, Ps, ranked in order of performance were well described by the simplified canonical law Ps∝(, where r is the rank, and ϕ and α are the parameters of the distribution. The parameter α did not significantly change from 1987 to 2007 (α=0.92±0.03), indicating a negligible effect of professionalism on players’ scoring performance. In contrast, the parameter ϕ significantly increased from ϕ=1.32 for 1987 RWC, ϕ=2.30 for 1999 to 2003 RWC and ϕ=5.60 for 2007 RWC, suggesting a progressive decrease in the relative performance of the best players. Finally, the sharp decreases observed in both α(α=0.38) and ϕ(ϕ=0.70) in the 2011 RWC indicate a more even distribution of the performance of individuals among scorers, compared to the more heterogeneous distributions observed from 1987 to 2007, and suggest a sharp increase in the level of competition leading to an increase in the average quality of players and a decrease in the relative skills of the top players. Note that neither α nor ϕ significantly correlate with traditional performance indicators such as the number of points scored by the best players, the number of games played by the best players, the number of points scored by the team of the best players or the total number of points scored over each RWC. This indicates that the dynamics of the scoring performance of Rugby Union players is influenced by hidden processes hitherto inaccessible through standard performance metrics; this suggests that players’ scoring performance is connected to ubiquitous phenomena such as anomalous diffusion.

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

ERIC Educational Resources Information Center

Floría, Pablo; Harrison, Andrew J.

2013-01-01

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

Identifying the influence of gender on motivation and engagement levels in student physiotherapists.

PubMed

Edgar, Susan

2015-04-01

There is an increasing focus in higher education on the role of learner characteristics and their influence on academic performance. Educators are interested in how students engage with learning activities as they progress through the curriculum. A previous study highlighted gender effects in academic performance in student physiotherapists, despite comparable entry scores. The aim of this study was to determine variation in student motivation and engagement, across the four year levels of the physiotherapy program at The University of Notre Dame Australia while considering gender and age. A cross-sectional design was adopted surveying 233 students utilising the Motivation and Engagement Scale - University/College (MES-UC), to review motivational thoughts and behaviours influencing learning. RESULTS identified gender effects with males having on average significantly lower scores for planning, task management and persistence; and higher scores for disengagement from their studies. Females displayed higher average scores for anxiety particularly in their first year and final clinical year. RESULTS were consistent with gender effects noted in academic performance throughout the program for previous student cohorts. The application of the MES-UC early in course would highlight to educators the areas where intervention can be targeted. Early individualized intervention is recommended to address learner characteristics influencing performance.

Declining blood lead levels and cognitive changes in moderately lead-poisoned children.

PubMed

Ruff, H A; Bijur, P E; Markowitz, M; Ma, Y C; Rosen, J F

1993-04-07

To determine whether chelation therapy or biochemical changes during a lead-lowering intervention was associated with changes in cognitive functioning of moderately lead-poisoned children. It was hypothesized that cognitive performance would improve as blood lead level declined over time. Short-term intervention study with measures obtained before and after intervention. Hospital specialty clinic and university research center. A total of 154 previously untreated children referred to clinic with blood lead levels between 1.21 and 2.66 mumol/L (25 and 55 micrograms/dL) at time of enrollment. Ages ranged from 13 to 87 months. Enrolled children were treated with edetate calcium disodium (EDTA) if eligible and/or with orally administered iron supplement if iron deficient. For all children, housing inspections and abatement procedures were performed as necessary. Score on Bayley Mental Development Scale or Stanford-Binet Intelligence Scale (4th edition). There was no effect of edetate calcium disodium treatment per se. In the short term (7 weeks), changes in blood lead levels were not related to changes in cognitive scores. In the long term (6 months), however, changes in performance were significantly related to changes in blood lead level, even after controlling for confounding variables. The standardized score increased 1 point for every decrease of 0.14 mumol/L (3 micrograms/dL) in blood lead level. The results suggest an association between decreases in blood lead level and cognitive improvements in moderately lead-poisoned children.

Modified combination of platelet count and neutrophil "to" lymphocyte ratio as a prognostic factor in patients with advanced head and neck cancer.

PubMed

Nakayama, Masahiro; Gosho, Masahiko; Hirose, Yuki; Nishimura, Bungo; Tanaka, Shuho; Tabuchi, Keiji; Okubo, Hideki; Wada, Tetsuro; Hara, Akira

2018-06-01

We evaluated the prognostic potential of the combination of platelet count and neutrophil to lymphocyte ratio (COP-NLR) in patients with advanced head and neck cancer. We proposed a modified COP-NLR scoring system defined as follows: score 0 (platelet count level <300 × 10 9 /L and NLR <3); score 1 (platelet count level ≥300 × 10 9 /L and NLR <3); and score 2 (NLR ≥3). We assessed whether the modified scoring system had better performance as an indicator of prognosis than the existing COP-NLR scoring system (original and 4-group scores). A total of 248 patients were enrolled. The Akaike Information Criterion value with the modified COP-NLR score was the smallest among the 3 models. The 3-year survival rates according to the modified COP-NLR scores of 0, 1, and 2 were 80.6%, 59.9%, and 23.8%, respectively. The modified COP-NLR score is a useful prognostic marker in patients with advanced head and neck cancer. © 2018 Wiley Periodicals, Inc.

Emotional intelligence, perceived stress and academic performance of Sri Lankan medical undergraduates.

PubMed

Ranasinghe, P; Wathurapatha, W S; Mathangasinghe, Y; Ponnamperuma, G

2017-02-20

Previous research has shown that higher Emotional Intelligence (EI) is associated with better academic and work performance. The present study intended to explore the relationship between EI, perceived stress and academic performance and associated factors among medical undergraduates. This descriptive cross-sectional research study was conducted among 471 medical undergraduates of 2nd, 4th and final years of University of Colombo, Sri Lanka. Students were rated on self administered Perceived Stress Scale (PSS) and Schutte Self-Report Emotional Intelligence Test (SEIT). Examination results were used as the dichotomous outcome variable in a logistic regression analysis. Females had higher mean EI scores (p = 0.014). A positive correlation was found between the EI score and the number of extracurricular activities (r = 0.121, p = 0.008). Those who were satisfied regarding their choice to study medicine, and who were planning to do postgraduate studies had significantly higher EI scores and lower PSS scores (p <0.001). Among final year undergraduates, those who passed the Clinical Sciences examination in the first attempt had a higher EI score (p <0.001) and a lower PSS score (p <0.05). Results of the binary logistic-regression analysis in the entire study population indicated that female gender (OR:1.98) and being satisfied regarding their choice of the medical undergraduate programme (OR:3.69) were significantly associated with passing the examinations. However, PSS Score and engagement in extracurricular activities were not associated with 'Examination Results'. Higher EI was associated with better academic performance amongst final year medical students. In addition a higher EI was observed in those who had a higher level of self satisfaction. Self-perceived stress was lower in those with a higher EI. Enhancing EI might help to improve academic performance among final year medical student and also help to reduce the stress levels and cultivate better coping during professional life in the future.

Baseline serum level of matrix metalloproteinase-3 as a biomarker of progressive joint damage in rheumatoid arthritis patients.

PubMed

Galil, Sahar Mahfouz Abdel; El-Shafey, Abeer Mohamed; Hagrass, Hoda A; Fawzy, Faten; Sammak, Ahmed El

2016-04-01

Matrix metalloproteinase-3 (MMP-3) plays a pivotal role in the destruction of bone and degradation of cartilage components in rheumatoid arthritis (RA). We aimed in this study to analyze the relation between baseline levels of MMP-3 and the progression of joint damage in RA. Eighty-one untreated RA patients with joint symptoms for <1 year were evaluated at baseline and after 12 months as regards erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP) and plain X-ray of both hands and wrists. Baseline levels of MMP-3 were measured by enzyme-linked immunosorbent assay and magnetic resonance imaging (MRI) of hands/wrists was performed. Disease Activity Score (DAS28) and Health Assessment Questionnaire (HAQ) were performed at baseline evaluation and after 12 months. The baseline MMP-3 levels were significantly higher in the high-progression group compared with the low-progression one (95.75 ± 42.84 vs. 50.45 ± 12.83, P < 0.001). There was a positive correlation between baseline levels of MMP-3 and MRI erosion score and other baseline clinical parameters, except for HAQ and the van der Heijde modification of the Sharp scoring system (SvdH) scores, while after 12 months, there were high positive correlations between MMP-3 and SvdH score, as well as all parameters except for ESR. Serum baseline levels of MMP-3 are strong prognostic markers of disease activity, and act well as an early predictor of progressive joint damage in recent-onset RA disease. © 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

Deaf college students' mathematical skills relative to morphological knowledge, reading level, and language proficiency.

PubMed

Kelly, Ronald R; Gaustad, Martha G

2007-01-01

This study of deaf college students examined specific relationships between their mathematics performance and their assessed skills in reading, language, and English morphology. Simple regression analyses showed that deaf college students' language proficiency scores, reading grade level, and morphological knowledge regarding word segmentation and meaning were all significantly correlated with both the ACT Mathematics Subtest and National Technical Institute for the Deaf (NTID) Mathematics Placement Test scores. Multiple regression analyses identified the best combination from among these potential independent predictors of students' performance on both the ACT and NTID mathematics tests. Additionally, the participating deaf students' grades in their college mathematics courses were significantly and positively associated with their reading grade level and their knowledge of morphological components of words.

Item Response Theory Analysis of the Psychopathic Personality Inventory-Revised.

PubMed

Eichenbaum, Alexander E; Marcus, David K; French, Brian F

2017-06-01

This study examined item and scale functioning in the Psychopathic Personality Inventory-Revised (PPI-R) using an item response theory analysis. PPI-R protocols from 1,052 college student participants (348 male, 704 female) were analyzed. Analyses were conducted on the 131 self-report items comprising the PPI-R's eight content scales, using a graded response model. Scales collected a majority of their information about respondents possessing higher than average levels of the traits being measured. Each scale contained at least some items that evidenced limited ability to differentiate between respondents with differing levels of the trait being measured. Moreover, 80 items (61.1%) yielded significantly different responses between men and women presumably possessing similar levels of the trait being measured. Item performance was also influenced by the scoring format (directly scored vs. reverse-scored) of the items. Overall, the results suggest that the PPI-R, despite identifying psychopathic personality traits in individuals possessing high levels of those traits, may not identify these traits equally well for men and women, and scores are likely influenced by the scoring format of the individual item and scale.

Prognostic value of inflammation-based scores in patients with osteosarcoma

PubMed Central

Liu, Bangjian; Huang, Yujing; Sun, Yuanjue; Zhang, Jianjun; Yao, Yang; Shen, Zan; Xiang, Dongxi; He, Aina

2016-01-01

Systemic inflammation responses have been associated with cancer development and progression. C-reactive protein (CRP), Glasgow prognostic score (GPS), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR), and neutrophil-platelet score (NPS) have been shown to be independent risk factors in various types of malignant tumors. This retrospective analysis of 162 osteosarcoma cases was performed to estimate their predictive value of survival in osteosarcoma. All statistical analyses were performed by SPSS statistical software. Receiver operating characteristic (ROC) analysis was generated to set optimal thresholds; area under the curve (AUC) was used to show the discriminatory abilities of inflammation-based scores; Kaplan-Meier analysis was performed to plot the survival curve; cox regression models were employed to determine the independent prognostic factors. The optimal cut-off points of NLR, PLR, and LMR were 2.57, 123.5 and 4.73, respectively. GPS and NLR had a markedly larger AUC than CRP, PLR and LMR. High levels of CRP, GPS, NLR, PLR, and low level of LMR were significantly associated with adverse prognosis (P < 0.05). Multivariate Cox regression analyses revealed that GPS, NLR, and occurrence of metastasis were top risk factors associated with death of osteosarcoma patients. PMID:28008988

A study of time management: the correlation between video game usage and academic performance markers.

PubMed

Anand, Vivek

2007-08-01

This study analyzes the correlation between video game usage and academic performance. Scholastic Aptitude Test (SAT) and grade-point average (GPA) scores were used to gauge academic performance. The amount of time a student spends playing video games has a negative correlation with students' GPA and SAT scores. As video game usage increases, GPA and SAT scores decrease. A chi-squared analysis found a p value for video game usage and GPA was greater than a 95% confidence level (0.005 < p < 0.01). This finding suggests that dependence exists. SAT score and video game usage also returned a p value that was significant (0.01 < p < 0.05). Chi-squared results were not significant when comparing time spent studying and an individual's SAT score. This research suggests that video games may have a detrimental effect on an individual's GPA and possibly on SAT scores. Although these results show statistical dependence, proving cause and effect remains difficult, since SAT scores represent a single test on a given day. The effects of video games maybe be cumulative; however, drawing a conclusion is difficult because SAT scores represent a measure of general knowledge. GPA versus video games is more reliable because both involve a continuous measurement of engaged activity and performance. The connection remains difficult because of the complex nature of student life and academic performance. Also, video game usage may simply be a function of specific personality types and characteristics.

Relationships of anxiety scores to academy and field training performance of air traffic control specialists.

DOT National Transportation Integrated Search

1989-05-01

State-trait anxiety scores were used prior to the 1981 strike of air traffic control specialists (ATCSs) to estimate perceived levels of job stress in field studies of this occupational group. The present study assessed the relationship between anxie...

Examining the Relationship between Math Scores and English Language Proficiency

ERIC Educational Resources Information Center

Henry, Denfield L.; Nistor, Nicolae; Baltes, Beate

2016-01-01

Multiple studies propose that English proficiency dictates English language learners' (ELLs) performances on mathematics assessments. The current study investigates the predictive power of English proficiency on mathematics scores, while controlling for gender, socioeconomic status (SES), and grade level among ELLs at a south Florida elementary…

General surgery training and robotics: Are residents improving their skills?

PubMed

Finnerty, Brendan M; Afaneh, Cheguevara; Aronova, Anna; Fahey, Thomas J; Zarnegar, Rasa

2016-02-01

While robotic-assisted operations have become more prevalent, many general surgery residencies do not have a formal robotic training curriculum. We sought to ascertain how well current general surgery training permits acquisition of robotic skills by comparing robotic simulation performance across various training levels. Thirty-six participants were categorized by level of surgical training: eight medical students (MS), ten junior residents (JR), ten mid-level residents (MLR), and eight senior residents (SR). Participants performed three simulation tasks on the da Vinci (®) Skills Simulator (MatchBoard, EnergyDissection, SutureSponge). Each task's scores (0-100) and cumulative scores (0-300) were compared between groups. There were no differences in sex, hand dominance, video gaming history, or prior robotic experience between groups; however, SR was the oldest (p < 0.001). The median overall scores did not differ: 188 (84-201) for MS, 183 (91-234) for JR, 197 (153-218) for MLR, and 205 (169-229) for SR (p = 0.14). The median SutureSponge score was highest for SR (61, range 39-81) compared to MS (43, range 26-61), JR (43, range 11-72), and MLR (55, range 36-68) (p = 0.039). However, there were no significant differences in MatchBoard (p = 0.27) or EnergyDissection (p = 0.99) scores between groups. There was a positive correlation between SutureSponge score and number of laparoscopic cases logged (p = 0.005, r(2) = 0.21), but this correlation did not exist for the MatchBoard or EnergyDissection tasks. Lastly, there was no correlation between total lifetime hours of video gaming and overall score (p = 0.89, R(2) = 0.0006). Robotic skillsets acquired during general surgery residency show minimal improvement during the course of training, although laparoscopic experience is correlated with advanced robotic task performance. Changes in residency curricula or pursuit of fellowship training may be warranted for surgeons seeking proficiency.

Norms of the Mini-Mental state Examination for Japanese subjects that underwent comprehensive brain examinations: the Kashima Scan Study.

PubMed

Yakushiji, Yusuke; Horikawa, Etsuo; Eriguchi, Makoto; Nanri, Yusuke; Nishihara, Masashi; Hirotsu, Tatsumi; Hara, Hideo

2014-01-01

The distribution of the Mini-Mental State Examination (MMSE) scores by age and educational level was investigated in subjects that underwent comprehensive brain examinations. This cross-sectional study included 1,414 adults without neurological disorders who underwent health-screening tests of the brain, referred to as the "Brain Dock," in our center. The MMSE scores were compared between age groups (40-44, 45-49, 50-54, 55-59, 60-64, 65-69, or ≥70 years) and educational levels [the low education level group (6-12 years) and the high education level group (≥13 years)]. The median age was 59 years, and 763 (54%) were women. There was no significant difference in the MMSE total score between women and men. The stepwise method of the multiple linear regression analysis confirmed that a higher age [β value, -0.129; standard error (S.E.), 0.020; p<0.001], low education level (6-12 years) (β value, -0.226; S.E., 0.075; p=0.003), and women (β values, 0.148; S.E., 0.066; p=0.024) was significantly associated with decreased MMSE score. In general, both the percentile scores and mean scores decreased with aging and were lower in the low education level group than in the high education level group. The degree of decrement in scores with age was stronger in the low education level group than in the high education level group. The provided data for age- and education-specific reference norms will be useful for both clinicians and investigators who perform comprehensive brain examinations to assess the cognitive function of subjects.

Measuring Medical Housestaff Teamwork Performance Using Multiple Direct Observation Instruments: Comparing Apples and Apples.

PubMed

Weingart, Saul N; Yaghi, Omar; Wetherell, Matthew; Sweeney, Megan

2018-04-10

To examine the composition and concordance of existing instruments used to assess medical teams' performance. A trained observer joined 20 internal medicine housestaff teams for morning work rounds at Tufts Medical Center, a 415-bed Boston teaching hospital, from October through December 2015. The observer rated each team's performance using 9 teamwork observation instruments that examined domains including team structure, leadership, situation monitoring, mutual support, and communication. Observations recorded on paper forms were stored electronically. Scores were normalized from 1 (low) to 5 (high) to account for different rating scales. Overall mean scores were calculated and graphed; weighted scores adjusted for the number of items in each teamwork domain. Teamwork scores were analyzed using t-tests, pair-wise correlations, and the Kruskal-Wallis statistic, and team performance was compared across instruments by domain. The 9 tools incorporated 5 major domains, with 5-35 items per instrument for a total of 161 items per observation session. In weighted and unweighted analyses, the overall teamwork performance score for a given team on a given day varied by instrument. While all of the tools identified the same low outlier, high performers on some instruments were low performers on others. Inconsistent scores for a given team across instruments persisted in domain-level analyses. There was substantial variation in the rating of individual teams assessed concurrently by a single observer using multiple instruments. Since existing teamwork observation tools do not yield concordant assessments, researchers should create better tools for measuring teamwork performance.

Fine-motor skills testing and prediction of endovascular performance.

PubMed

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

2013-12-01

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

Challenges in performance of food safety management systems: a case of fish processing companies in Tanzania.

PubMed

Kussaga, Jamal B; Luning, Pieternel A; Tiisekwa, Bendantunguka P M; Jacxsens, Liesbeth

2014-04-01

This study provides insight for food safety (FS) performance in light of the current performance of core FS management system (FSMS) activities and context riskiness of these systems to identify the opportunities for improvement of the FSMS. A FSMS diagnostic instrument was applied to assess the performance levels of FSMS activities regarding context riskiness and FS performance in 14 fish processing companies in Tanzania. Two clusters (cluster I and II) with average FSMS (level 2) operating under moderate-risk context (score 2) were identified. Overall, cluster I had better (score 3) FS performance than cluster II (score 2 to 3). However, a majority of the fish companies need further improvement of their FSMS and reduction of context riskiness to assure good FS performance. The FSMS activity levels could be improved through hygienic design of equipment and facilities, strict raw material control, proper follow-up of critical control point analysis, developing specific sanitation procedures and company-specific sampling design and measuring plans, independent validation of preventive measures, and establishing comprehensive documentation and record-keeping systems. The risk level of the context could be reduced through automation of production processes (such as filleting, packaging, and sanitation) to restrict people's interference, recruitment of permanent high-skilled technological staff, and setting requirements on product use (storage and distribution conditions) on customers. However, such intervention measures for improvement could be taken in phases, starting with less expensive ones (such as sanitation procedures) that can be implemented in the short term to more expensive interventions (setting up assurance activities) to be adopted in the long term. These measures are essential for fish processing companies to move toward FSMS that are more effective.

45 CFR 2522.520 - What special terms are used in this subpart?

Code of Federal Regulations, 2011 CFR

2011-10-01

... their reading scores to grade-level, or other specific measures of academic achievement. (g) Grantee includes subgrantees, programs, and projects. (h) National performance measures are performance measures...

45 CFR 2522.520 - What special terms are used in this subpart?

Code of Federal Regulations, 2010 CFR

2010-10-01

... their reading scores to grade-level, or other specific measures of academic achievement. (g) Grantee includes subgrantees, programs, and projects. (h) National performance measures are performance measures...

Further Simplification of the Simple Erosion Narrowing Score With Item Response Theory Methodology.

PubMed

Oude Voshaar, Martijn A H; Schenk, Olga; Ten Klooster, Peter M; Vonkeman, Harald E; Bernelot Moens, Hein J; Boers, Maarten; van de Laar, Mart A F J

2016-08-01

To further simplify the simple erosion narrowing score (SENS) by removing scored areas that contribute the least to its measurement precision according to analysis based on item response theory (IRT) and to compare the measurement performance of the simplified version to the original. Baseline and 18-month data of the Combinatietherapie Bij Reumatoide Artritis (COBRA) trial were modeled using longitudinal IRT methodology. Measurement precision was evaluated across different levels of structural damage. SENS was further simplified by omitting the least reliably scored areas. Discriminant validity of SENS and its simplification were studied by comparing their ability to differentiate between the COBRA and sulfasalazine arms. Responsiveness was studied by comparing standardized change scores between versions. SENS data showed good fit to the IRT model. Carpal and feet joints contributed the least statistical information to both erosion and joint space narrowing scores. Omitting the joints of the foot reduced measurement precision for the erosion score in cases with below-average levels of structural damage (relative efficiency compared with the original version ranged 35-59%). Omitting the carpal joints had minimal effect on precision (relative efficiency range 77-88%). Responsiveness of a simplified SENS without carpal joints closely approximated the original version (i.e., all Δ standardized change scores were ≤0.06). Discriminant validity was also similar between versions for both the erosion score (relative efficiency = 97%) and the SENS total score (relative efficiency = 84%). Our results show that the carpal joints may be omitted from the SENS without notable repercussion for its measurement performance. © 2016, American College of Rheumatology.

Sentence level auditory comprehension treatment program for aphasic adults.

PubMed

Naeser, M A; Haas, G; Mazurski, P; Laughlin, S

1986-06-01

The purpose of this study was to investigate whether a newly developed sentence level auditory comprehension (SLAC) treatment program could be used to improve language comprehension test scores in adults with chronic aphasia. Results indicate that the SLAC treatment program can be used with chronic patients; performance on a standardized test (the Token Test) was improved after treatment; and improved performance could not be predicted from either anatomic CT scan lesion sites or pretreatment test scores. One advantage to the SLAC treatment program is that the patient can practice listening independently with a tape recorder device (Language Master) and earphones either in the hospital or at home.

Elevated cortisol levels in Cushing's disease are associated with cognitive decrements.

PubMed

Starkman, M N; Giordani, B; Berent, S; Schork, M A; Schteingart, D E

2001-01-01

The objective of this study was to use Cushing's disease as a unique human model to elucidate the cognitive deficits resulting from exposure to chronic stress-level elevations of endogenous cortisol. Forty-eight patients with a first episode of acute, untreated Cushing's disease and 38 healthy control subjects were studied. Scores for four of five verbal IQ subtests were significantly lower in patients with Cushing's disease; their scores were significantly lower for only one nonverbal performance IQ subtest (block design). Verbal, but not visual, learning and delayed recall at 30 minutes were significantly decreased among patients with Cushing's disease. Although verbal delayed recall was significantly lower in these patients, the retention index (percentage), which compares the amount of initially learned material to that recalled after the delay, was not significantly decreased. There was no significant association between depression scores and cognitive performance. A higher degree of cortisol elevation was associated with poorer performance on several subtests of learning, delayed recall, and visual-spatial ability. Chronically elevated levels of glucocorticoids have deleterious effects on particular domains of cognition. Verbal learning and other verbal functions seem more vulnerable than nonverbal functions. The results suggest that both the neocortex and hippocampus are affected.

Games as Formative Assessment Environments: Examining the Impact of Explanations of Scoring and Incentives on Math Learning, Game Performance, and Help Seeking. CRESST Report 796

ERIC Educational Resources Information Center

Delacruz, Girlie C.

2011-01-01

Due to their motivational nature, there has been growing interest in the potential of games to help teach academic content and skills. This report examines how different levels of detail about a game's scoring rules affect math learning and performance. Data were collected from 164 students in the fourth to sixth grades at five after-school…

Universality, correlations, and rankings in the Brazilian universities national admission examinations

NASA Astrophysics Data System (ADS)

da Silva, Roberto; Lamb, Luis C.; Barbosa, Marcia C.

2016-09-01

We analyze the scores obtained by students who have taken the ENEM examination, The Brazilian High School National Examination which is used in the admission process at Brazilian universities. The average high schools scores from different disciplines are compared through the Pearson correlation coefficient. The results show a very large correlation between the performance in the different school subjects. Even though the students' scores in the ENEM form a Gaussian due to the standardization, we show that the high schools' scores form a bimodal distribution that cannot be used to evaluate and compare students performance over time. We also show that this high schools distribution reflects the correlation between school performance and the economic level (based on the average family income) of the students. The ENEM scores are compared with a Brazilian non standardized exam, the entrance examination from the Universidade Federal do Rio Grande do Sul. The analysis of the performance of the same individuals in both tests shows that the two tests not only select different abilities, but also lead to the admission of different sets of individuals. Our results indicate that standardized tests might be an interesting tool to compare performance of individuals over the years, but not of institutions.

Grip form and graphomotor control in preschool children.

PubMed

Burton, A W; Dancisak, M J

2000-01-01

The purpose of this study was to examine the utility of the grip scale presented by Schneck and Henderson, the effect of grip form on drawing accuracy, and the effect of implement diameter on grip form and drawing accuracy. Sixty boys and girls who were 3, 4, and 5 years of age performed 20 trials of a precision drawing task, 4 trials each with five implements of varying diameters (4.7, 7.9, 11.1, 14.3, and 17.5 mm). First, all 1,200 grips could be coded according to Schneck and Henderson's 10-grip whole-configuration assessment system, but the interrater reliability was lower than expected (.67 proportion of perfect agreement). Second, using Schneck's five-level scoring system, the level of grip significantly affected drawing accuracy, with the highest grip level used most often with the highest accuracy scores and the lowest observed grip level used most often with the lowest accuracy scores. Third, increasing implement diameter led to significantly lower level grips but did not significantly affect accuracy. Therapists are recommended to use Schneck and Henderson's 10-grip scale only for documenting the persons' grips and changes in their grips, but if comparisons between individual persons are desired, then Schneck's five-level scale, which affords greater generalizability, should be used. Further, children with graphomotor performance deficits are not likely to benefit from grip manipulations because such strategies were shown to make better only performance that is already good.

Video self-assessment of basic suturing and knot tying skills by novice trainees.

PubMed

Hu, Yinin; Tiemann, Debbie; Michael Brunt, L

2013-01-01

Self-assessment is important to learning but few studies have utilized video self-assessment of basic surgical skills. We compared a video self-assessment of suturing and knot tying skills by novice trainees to the assessment by a senior attending surgeon. Sixteen senior medical students and 7 beginner surgical interns were video-recorded while performing five suturing and knot tying tasks. All videos were analyzed using an objective structured assessment of technical skills (OSATS) metrics (1-5 scale; 1 = novice, 5 = expert). Video self-assessment was carried out within 4 weeks of an instructional session and subsequently by one senior surgery instructor (blinded to the individual). Both a Global score and total combined OSATS scores were analyzed. Total possible OSATS scores were: interrupted suture-30, subcuticular closure-30, one and two-handed knot tying-25 each, tying in a restricted space 20; maximum combined score-130 points). Confidence levels in performing the tasks pre-test and the value of video self-assessment were rated on a 1-5 Likert scale (1 = low and 5 = high). Data are mean±SD and statistical significance was evaluated using Friedman's test. Self-assessment scoring was significantly higher than the assessment by a senior instructor for three tasks by global score and all five tasks by combined OSATS score (self-assessment 71.8±16.7 vs attending assessment 56.7±11.0, p = 0.007). Mean self-assessment Global scores ranged from 2.5 to 2.8 for all tasks performed compared to 1.8-2.3 for attending surgeon assessment (p<0.05). Confidence levels demonstrated no correlation to performance speed or proficiency. The video self-assessment was rated as a highly valuable (mean 4.3±0.8) component to skills training. Novice trainees over-estimate their basic technical skills performance compared to the assessment by a senior surgeon. Video self-assessment may be a valuable addition to a pre-residency and surgical internship preparatory curriculum in basic suturing and knot tying. Copyright © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Anthropometric and Athletic Performance Combine Test Results Among Positions Within Grade Levels of High School-Aged American Football Players.

PubMed

Leutzinger, Todd J; Gillen, Zachary M; Miramonti, Amelia M; McKay, Brianna D; Mendez, Alegra I; Cramer, Joel T

2018-05-01

Leutzinger, TJ, Gillen, ZM, Miramonti, AM, McKay, BD, Mendez, AI, and Cramer, JT. Anthropometric and athletic performance combine test results among positions within grade levels of high school-aged American football players. J Strength Cond Res 32(5): 1288-1296, 2018-The purpose of this study was to investigate differences among player positions at 3 grade levels in elite, collegiate-prospective American football players. Participants' data (n = 7,160) were analyzed for this study (mean height [Ht] ± SD = 178 ± 7 cm, mass [Bm] = 86 ± 19 kg). Data were obtained from 12 different high school American football recruiting combines hosted by Zybek Sports (Boulder, Colorado). Eight 2-way (9 × 3) mixed factorial analysis of variances {position (defensive back [DB], defensive end, defensive lineman, linebacker, offensive lineman [OL], quarterback, running back, tight end, and wide receiver [WR]) × grade (freshmen, sophomores, and juniors)} were used to test for differences among the mean test scores for each combine measure (Ht, Bm, 40-yard [40 yd] dash, proagility [PA] drill, L-cone [LC] drill, vertical jump [VJ], and broad jump [BJ]). There were position-related differences (p ≤ 0.05) for Ht, 40 yd dash, and BJ, within each grade level and for Bm, PA, LC, and VJ independent of grade level. Generally, the results showed that OL were the tallest, weighed the most, and exhibited the lowest performance scores among positions. Running backs were the shortest, whereas DBs and WRs weighed the least and exhibited the highest performance scores among positions. These results demonstrate the value of classifying high school-aged American football players according to their specific position rather than categorical groupings such as "line" vs. "skill" vs. "big skill" when evaluating anthropometric and athletic performance combine test results.

Competition-Level Differences on the Lower Quarter Y-Balance Test in Baseball Players

PubMed Central

Butler, Robert J.; Bullock, Garrett; Arnold, Todd; Plisky, Phillip; Queen, Robin

2016-01-01

Context: Decreased performance in dynamic balance has previously been associated with a history of ulnar collateral ligament injury in baseball players. Previous research on dynamic balance in soccer players has shown that test performance depends on competition level. However, dynamic balance has yet to be examined in baseball players. Objective: To understand normative values and determine differences in dynamic balance, as measured by the Lower Quarter Y-Balance Test, across competition levels in baseball players. Design: Cross-sectional study. Setting: Preseason physical examinations. Patients or Other Participants: Dynamic balance was measured in 88 high school (HS), 78 collegiate (COL), and 90 professional (PRO) baseball players. Main Outcome Measure(s): All participants completed the Lower Quarter Y-Balance Test using the standard protocol. In unilateral stance, they reached with 1 foot in the anterior, posteromedial, and posterolateral directions. We calculated 1-way analyses of variance to compare performance, composite score, and reach asymmetry for each direction as well as the sum of the asymmetry values (P < .05). Composite score was calculated by averaging the maximum normalized reach scores. Reach asymmetry was determined by calculating bilateral differences in reach ability. Results: In comparison with the HS and COL groups, the PRO players exhibited greater posteromedial (P < .01; effect size index [ESI]HS = 1.06, ESICOL = 0.95) and posterolateral reach (P < .01; ESIHS = 0.82, ESICOL = 0.84) as well as a greater composite score (P < .01; ESIHS = 0.60, ESICOL = 0.87). In contrast, HS baseball players exhibited increased anterior reach (P < .01; ESICOL = 0.60, ESIPRO = 0.39) compared with the COL and PRO cohorts. No significant differences in reach asymmetry were observed among groups. Conclusions: Lower extremity dynamic balance performance differed based on the baseball players' competition level. These baseline data may be helpful in identifying low-performing athletes who might benefit from neuromuscular interventions. PMID:27849388

Competition-Level Differences on the Lower Quarter Y-Balance Test in Baseball Players.

PubMed

Butler, Robert J; Bullock, Garrett; Arnold, Todd; Plisky, Phillip; Queen, Robin

2016-12-01

Decreased performance in dynamic balance has previously been associated with a history of ulnar collateral ligament injury in baseball players. Previous research on dynamic balance in soccer players has shown that test performance depends on competition level. However, dynamic balance has yet to be examined in baseball players. To understand normative values and determine differences in dynamic balance, as measured by the Lower Quarter Y-Balance Test, across competition levels in baseball players. Cross-sectional study. Preseason physical examinations. Dynamic balance was measured in 88 high school (HS), 78 collegiate (COL), and 90 professional (PRO) baseball players. All participants completed the Lower Quarter Y-Balance Test using the standard protocol. In unilateral stance, they reached with 1 foot in the anterior, posteromedial, and posterolateral directions. We calculated 1-way analyses of variance to compare performance, composite score, and reach asymmetry for each direction as well as the sum of the asymmetry values (P < .05). Composite score was calculated by averaging the maximum normalized reach scores. Reach asymmetry was determined by calculating bilateral differences in reach ability. In comparison with the HS and COL groups, the PRO players exhibited greater posteromedial (P < .01; effect size index [ESI] HS = 1.06, ESI COL = 0.95) and posterolateral reach (P < .01; ESI HS = 0.82, ESI COL = 0.84) as well as a greater composite score (P < .01; ESI HS = 0.60, ESI COL = 0.87). In contrast, HS baseball players exhibited increased anterior reach (P < .01; ESI COL = 0.60, ESI PRO = 0.39) compared with the COL and PRO cohorts. No significant differences in reach asymmetry were observed among groups. Lower extremity dynamic balance performance differed based on the baseball players' competition level. These baseline data may be helpful in identifying low-performing athletes who might benefit from neuromuscular interventions.

Evaluating Middle School Students' Spatial-scientific Performance in Earth-space Science

NASA Astrophysics Data System (ADS)

Wilhelm, Jennifer; Jackson, C.; Toland, M. D.; Cole, M.; Wilhelm, R. J.

2013-06-01

Many astronomical concepts cannot be understood without a developed understanding of four spatial-mathematics domains defined as follows: a) Geometric Spatial Visualization (GSV) - Visualizing the geometric features of a system as it appears above, below, and within the system’s plane; b) Spatial Projection (SP) - Projecting to a different location and visualizing from that global perspective; c) Cardinal Directions (CD) - Distinguishing directions (N, S, E, W) in order to document an object’s vector position in space; and d) Periodic Patterns - (PP) Recognizing occurrences at regular intervals of time and/or space. For this study, differences were examined between groups of sixth grade students’ spatial-scientific development pre/post implementation of an Earth/Space unit. Treatment teachers employed a NASA-based curriculum (Realistic Explorations in Astronomical Learning), while control teachers implemented their regular Earth/Space units. A 2-level hierarchical linear model was used to evaluate student performance on the Lunar Phases Concept Inventory (LPCI) and four spatial-mathematics domains, while controlling for two variables (gender and ethnicity) at the student level and one variable (teaching experience) at the teacher level. Overall LPCI results show pre-test scores predicted post-test scores, boys performed better than girls, and Whites performed better than non-Whites. We also compared experimental and control groups’ by spatial-mathematics domain outcomes. For GSV, it was found that boys, in general, tended to have higher GSV post-scores. For domains CD and SP, no statistically significant differences were observed. PP results show Whites performed better than non-Whites. Also for PP, a significant cross-level interaction term (gender-treatment) was observed, which means differences in control and experimental groups are dependent on students’ gender. These findings can be interpreted as: (a) the experimental girls scored higher than the control girls and/or (b) the control group displayed a gender gap in favor of boys while no gender gap was displayed within the experimental group.

Tailored instructor feedback leads to more effective virtual-reality laparoscopic training.

PubMed

Paschold, M; Huber, T; Zeißig, S R; Lang, H; Kneist, Werner

2014-03-01

Laparoscopic novices begin at different performance levels, and studies on tailored training concepts are warranted. The effect of verbal instructor feedback has been investigated with varying results, and its effectiveness in virtual-reality laparoscopic (VRL) simulations still is unclear. This study aimed to determine whether laparoscopic novices with lower initial performance statuses may profit from training with intensive instructor feedback. A prospective, single-blinded study was performed within a week-long curricular course. In this study, 20 medical students performed a complex bimanual maneuver on a VRL simulator. There was a division in performance levels, with a high-performer group (HPG) that received a better median score and a low-performer group (LPG). During the training phase, only the initial LPG received standardized instructor feedback in a one-to-one setting. The final assessment of skills for both groups involved performing the task without feedback at the end of the course. The HPG and LPG showed significantly different initial performance levels according global and categorized (time, economics, error) scores (p < 0.005). This difference disappeared quickly throughout the instructor feedback phase. The final assessment demonstrated that both groups were at the same level of performance. This is the first study to use a tailored training concept with instructor feedback limited to the LPG. The tailored training was effective and economic for the laparoscopic novices and their teachers.

Do Accountability and Voucher Threats Improve Low-Performing Schools? NBER Working Paper No. 11597

ERIC Educational Resources Information Center

Figlio, David N.; Rouse, Cecilia

2005-01-01

In this paper we study the effects of the threat of school vouchers and school stigma in Florida on the performance of "low-performing" schools using student-level data from a subset of districts. Estimates of the change in school-level high-stakes test scores from the first year of the reform are consistent with the early results used…

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

PubMed

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

2017-11-01

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

On combining multi-normalization and ancillary measures for the optimal score level fusion of fingerprint and voice biometrics

NASA Astrophysics Data System (ADS)

Mohammed Anzar, Sharafudeen Thaha; Sathidevi, Puthumangalathu Savithri

2014-12-01

In this paper, we have considered the utility of multi-normalization and ancillary measures, for the optimal score level fusion of fingerprint and voice biometrics. An efficient matching score preprocessing technique based on multi-normalization is employed for improving the performance of the multimodal system, under various noise conditions. Ancillary measures derived from the feature space and the score space are used in addition to the matching score vectors, for weighing the modalities, based on their relative degradation. Reliability (dispersion) and the separability (inter-/intra-class distance and d-prime statistics) measures under various noise conditions are estimated from the individual modalities, during the training/validation stage. The `best integration weights' are then computed by algebraically combining these measures using the weighted sum rule. The computed integration weights are then optimized against the recognition accuracy using techniques such as grid search, genetic algorithm and particle swarm optimization. The experimental results show that, the proposed biometric solution leads to considerable improvement in the recognition performance even under low signal-to-noise ratio (SNR) conditions and reduces the false acceptance rate (FAR) and false rejection rate (FRR), making the system useful for security as well as forensic applications.

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

PubMed

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

2015-03-01

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

Conference attendance does not correlate with emergency medicine residency in-training examination scores.

PubMed

Gene Hern, H; Wills, Charlotte; Alter, Harrison; Bowman, Steven H; Katz, Eric; Shayne, Philip; Vahidnia, Farnaz

2009-12-01

The residency review committee for emergency medicine (EM) requires residents to have greater than 70% attendance of educational conferences during residency training, but it is unknown whether attendance improves clinical competence or scores on the American Board of Emergency Medicine (ABEM) in-training examination (ITE). This study examined the relationship between conference attendance and ITE scores. The hypothesis was that greater attendance would correlate to a higher examination score. This was a multi-center retrospective cohort study using conference attendance data and examination results from residents in four large county EM residency training programs. Longitudinal multi-level models, adjusting for training site, U.S. Medical Licensing Examination (USMLE) Step 1 score, and sex were used to explore the relationship between conference attendance and in-training examination scores according to year of training. Each year of training was studied, as well as the overall effect of mean attendance as it related to examination score. Four training sites reported data on 405 residents during 2002 to 2008; 386 residents had sufficient data to analyze. In the multi-level longitudinal models, attendance at conference was not a significant predictor of in-training percentile score (coefficient = 0.005, 95% confidence interval [CI] = -0.053 to 0.063, p = 0.87). Score on the USMLE Step 1 examination was a strong predictor of ITE score (coefficient = 0.186, 95% CI = 0.155 to 0.217; p < 0.001), as was female sex (coefficient = 2.117, 95% CI = 0.987 to 3.25; p < 0.001). Greater conference attendance does not correlate with performance on an individual's ITE scores. Conference attendance may represent an important part of EM residency training but perhaps not of ITE performance. (c) 2009 by the Society for Academic Emergency Medicine.

Hospital performance measures and 30-day readmission rates.

PubMed

Stefan, Mihaela S; Pekow, Penelope S; Nsa, Wato; Priya, Aruna; Miller, Lauren E; Bratzler, Dale W; Rothberg, Michael B; Goldberg, Robert J; Baus, Kristie; Lindenauer, Peter K

2013-03-01

Lowering hospital readmission rates has become a primary target for the Centers for Medicare & Medicaid Services, but studies of the relationship between adherence to the recommended hospital care processes and readmission rates have provided inconsistent and inconclusive results. To examine the association between hospital performance on Medicare's Hospital Compare process quality measures and 30-day readmission rates for patients with acute myocardial infarction (AMI), heart failure and pneumonia, and for those undergoing major surgery. We assessed hospital performance on process measures using the 2007 Hospital Inpatient Quality Reporting Program. The process measures for each condition were aggregated in two separate measures: Overall Measure (OM) and Appropriate Care Measure (ACM) scores. Readmission rates were calculated using Medicare claims. Risk-standardized 30-day all-cause readmission rate was calculated as the ratio of predicted to expected rate standardized by the overall mean readmission rate. We calculated predicted readmission rate using hierarchical generalized linear models and adjusting for patient-level factors. Among patients aged ≥ 66 years, the median OM score ranged from 79.4 % for abdominal surgery to 95.7 % for AMI, and the median ACM scores ranged from 45.8 % for abdominal surgery to 87.9 % for AMI. We observed a statistically significant, but weak, correlation between performance scores and readmission rates for pneumonia (correlation coefficient R = 0.07), AMI (R = 0.10), and orthopedic surgery (R = 0.06). The difference in the mean readmission rate between hospitals in the 1st and 4th quartiles of process measure performance was statistically significant only for AMI (0.25 percentage points) and pneumonia (0.31 percentage points). Performance on process measures explained less than 1 % of hospital-level variation in readmission rates. Hospitals with greater adherence to recommended care processes did not achieve meaningfully better 30-day hospital readmission rates compared to those with lower levels of performance.

Intellectual development in Noonan syndrome: a longitudinal study.

PubMed

Roelofs, Renée L; Janssen, Nikki; Wingbermühle, Ellen; Kessels, Roy P C; Egger, Jos I M

2016-07-01

Although cognitive impairments in adults with Noonan syndrome seem to be limited to a low-average intelligence and slower processing speed, studies in children with Noonan syndrome have demonstrated more extensive cognitive problems. These include deficits in language skills, memory, attention, and executive functioning. This longitudinal study is the first to investigate intellectual development in a group of individuals with Noonan syndrome. Sixteen patients with Noonan syndrome underwent intelligence assessment both in childhood and in adulthood, using Wechsler's intelligence scales. IQ scores and Wechsler standard scores achieved in childhood and adulthood were compared. Subsequently, verbal and performance IQ in childhood were used as predictors for adult IQ and index scores. Compared with childhood scores, adult full-scale IQ and performance IQ significantly increased. Adult performance IQ was higher than verbal IQ. Childhood performance IQ and verbal IQ together predicted all adult IQ and index scores, except for the processing speed index. Childhood IQ was a significant predictor of adult intelligence in patients with Noonan syndrome. Performance IQ advanced to a normal level in adulthood, while verbal IQ did not develop proportionately, resulting in a discrepancy between adult performance IQ and verbal IQ. This finding could suggest a delay in the development of executive functioning in patients with Noonan syndrome, which seems to be outgrown in adulthood.

Learning and Study Strategies Inventory subtests and factors as predictors of National Board of Chiropractic Examiners Part 1 examination performance.

PubMed

Schutz, Christine M; Dalton, Leanne; Tepe, Rodger E

2013-01-01

This study was designed to extend research on the relationship between chiropractic students' learning and study strategies and national board examination performance. Sixty-nine first trimester chiropractic students self-administered the Learning and Study Strategies Inventory (LASSI). Linear trends tests (for continuous variables) and Mantel-Haenszel trend tests (for categorical variables) were utilized to determine if the 10 LASSI subtests and 3 factors predicted low, medium and high levels of National Board of Chiropractic Examiners (NBCE) Part 1 scores. Multiple regression was performed to predict overall mean NBCE examination scores using the 3 LASSI factors as predictor variables. Four LASSI subtests (Anxiety, Concentration, Selecting Main Ideas, Test Strategies) and one factor (Goal Orientation) were significantly associated with NBCE examination levels. One factor (Goal Orientation) was a significant predictor of overall mean NBCE examination performance. Learning and study strategies are predictive of NBCE Part 1 examination performance in chiropractic students. The current study found LASSI subtests Anxiety, Concentration, Selecting Main Ideas, and Test Strategies, and the Goal-Orientation factor to be significant predictors of NBCE scores. The LASSI may be useful to educators in preparing students for academic success. Further research is warranted to explore the effects of learning and study strategies training on GPA and NBCE performance.

Veterans Affairs facility performance on Washington Circle indicators and casemix-adjusted effectiveness.

PubMed

Harris, Alex H S; Humphreys, Keith; Finney, John W

2007-12-01

Self-administered Addiction Severity Index (ASI) data were collected on 5,723 patients who received substance abuse treatment in 1 of 110 programs located at 73 Veterans Affairs facilities. The associations between each of three Washington Circle (WC) performance indicator scores (identification, initiation, and engagement) and their casemix-adjusted facility-level improvement in ASI drug and alcohol composites 7 months after intake were estimated. Higher initiation rates were not associated with facility-level improvement in ASI alcohol composite scores but were modestly associated with greater improvements in ASI drug composite scores. Identification and engagement rates were unrelated to 7-month outcomes. WC indicators focused on the early stages of treatment may tap necessary but insufficient processes for patients with substance use disorder to achieve good posttreatment outcomes. Ideally, the WC indicators would be supplemented with other measures of treatment quality.

Home advantage and player nationality in international club football.

PubMed

Poulter, Damian R

2009-06-01

The home advantage effect was investigated at a team and player level in Union of European Football Associations (UEFA) Champions League football using in-depth performance and disciplinary variables. Performance analysis revealed that the home team scored more goals, had more shots on and off target, had a greater share of possession, and won more corners than the away team. There was an opposite trend for disciplinary variables, with the home team committing less fouls than the away team, and receiving less yellow and red cards. There were home advantage effects at player level for goals, total shots, shots on target, assists, and yellow cards, as found in the team analysis. In addition, foreign players demonstrated a home advantage effect for goals scored, whereas domestic players scored an equivalent number of goals at home and away venues. Results are discussed in relation to the home advantage literature and wider implications for the sport.

Pharmacy students' test-taking motivation-effort on a low-stakes standardized test.

PubMed

Waskiewicz, Rhonda A

2011-04-11

To measure third-year pharmacy students' level of motivation while completing the Pharmacy Curriculum Outcomes Assessment (PCOA) administered as a low-stakes test to better understand use of the PCOA as a measure of student content knowledge. Student motivation was manipulated through an incentive (ie, personal letter from the dean) and a process of statistical motivation filtering. Data were analyzed to determine any differences between the experimental and control groups in PCOA test performance, motivation to perform well, and test performance after filtering for low motivation-effort. Incentivizing students diminished the need for filtering PCOA scores for low effort. Where filtering was used, performance scores improved, providing a more realistic measure of aggregate student performance. To ensure that PCOA scores are an accurate reflection of student knowledge, incentivizing and/or filtering for low motivation-effort among pharmacy students should be considered fundamental best practice when the PCOA is administered as a low-stakes test.

Test anxiety in mathematics among early undergraduate students in a British university in Malaysia

NASA Astrophysics Data System (ADS)

Karjanto, Natanael; Yong, Su Ting

2013-03-01

The level of test anxiety in mathematics subjects among early undergraduate students at the University of Nottingham Malaysia Campus is studied in this article. The sample consists of 206 students taking several mathematics modules who completed the questionnaires on test anxiety just before they entered the venue for midterm examinations. The sample data include the differences in the context of academic levels, gender groups and nationality backgrounds. The level of test anxiety in mathematics is measured using seven Likert questionnaire statements adapted from the Test Anxiety Inventory describing one's emotional feeling before the start of an examination. In general, the result shows that the students who had a lower score expectation were more anxious than those who had a higher score expectation, but that they obtained a better score than the expected score. In the context of academic levels, gender groups and nationality backgrounds, there were no significant correlations between the level of test anxiety and the students' academic performance. The effect size of the correlation values ranged from extremely small to moderate.

Executive functions in adolescents with spina bifida: relations with autonomy development and parental intrusiveness.

PubMed

Tuminello, Elizabeth R; Holmbeck, Grayson N; Olson, Rick

2012-01-01

The current study was part of a larger longitudinal investigation and examined the relation of parent-report and performance measures of executive functioning (EF) with measures of behavioral and emotional autonomy and parental intrusiveness in adolescents with and without spina bifida (SB; n=65 in a comparison sample and 61 in an SB sample; M age=14.55, SD=0.63). For both groups, higher levels of parent-reported EF problems predicted higher levels of observed child dependency and lower levels of teacher-reported intrinsic motivation. Higher scores on performance EF measures predicted lower levels of observed child dependency and observed maternal intrusiveness for both groups. In adolescents with SB only, higher performance EF scores predicted higher intrinsic motivation and emotional autonomy from both mother and father and predicted lower levels of observed paternal intrusiveness. While causal conclusions cannot be drawn, EFs appear to be closely related to autonomy development and parental intrusiveness, particularly for adolescents with SB. These results suggest that the inclusion of EF training in interventions targeting adolescents with SB may be beneficial for autonomy development.

Speech perception in noise in the elderly: interactions between cognitive performance, depressive symptoms, and education.

PubMed

de Carvalho, Laura Maria Araújo; Gonsalez, Elisiane Crestani de Miranda; Iorio, Maria Cecília Martineli

The difficulty the elderly experience in understanding speech may be related to several factors including cognitive and perceptual performance. To evaluate the influence of cognitive performance, depressive symptoms, and education on speech perception in noise of elderly hearing aids users. The sample consisted of 25 elderly hearing aids users in bilateral adaptation, both sexes, mean age 69.7 years. Subjects underwent cognitive assessment using the Mini-Mental State Examination and the Alzheimer's Disease Assessment Scale-cognitive and depressive symptoms evaluation using the Geriatric Depression Scale. The assessment of speech perception in noise (S/N ratio) was performed in free field using the Portuguese Sentence List test. Statistical analysis included the Spearman correlation calculation and multiple linear regression model, with 95% confidence level and 0.05 significance level. In the study of speech perception in noise (S/N ratio), there was statistically significant correlation between education scores (p=0.018), as well as with the Mini-Mental State Examination (p=0.002), Alzheimer's Disease Assessment Scale-cognitive (p=0.003), and Geriatric Depression Scale (p=0.022) scores. We found that for a one-unit increase in Alzheimer's Disease Assessment Scale-cognitive score, the S/N ratio increased on average 0.15dB, and for an increase of one year in education, the S/N ratio decreased on average 0.40dB. Level of education, cognitive performance, and depressive symptoms influence the speech perception in noise of elderly hearing aids users. The better the cognitive level and the higher the education, the better is the elderly communicative performance in noise. Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

The objective structured clinical examination revisited for postgraduate trainees in general practice.

PubMed

Schoenmakers, Birgitte; Wens, Johan

2014-03-04

To investigate if the psychometric qualities of an OSCE consisting of more complex simulated patient encounters remain valid and reliable in the assessment of postgraduate trainees in general practice. In this intervention study without control group, the traditional OSCE was formally replaced by the new, complex version. The study population was composed by all postgraduate trainees (second and third phase) in general practice during the ongoing academic year. Data were handled and collected as part of the formal assessment program. Univariate analyses, the variance of scores and multivariate analyses were performed to assess the test qualities. A total of 340 students participated. Average final scores were slightly higher for third-phase students (t-test, p =0.05). Overall test scores were equally distributed on station level, circuit level and phase level. A multiple regression analysis revealed that test scores were dependent on the stations and circuits, but not on the master phase. In a changing learning environment, assessment and evaluation strategies require reorientation. The reliability and validity of the OSCE remain subject to discussion. In particular, when it comes to content and design, the traditional OSCE might underestimate the performance level of postgraduate trainees in general practice. A reshaping of this OSCE to a more sophisticated design with more complex patient encounters appears to restore the validity of the test results.

Use of the MoCA in Detecting Early Alzheimer's Disease in a Spanish-Speaking Population with Varied Levels of Education

PubMed Central

Zhou, Yan; Ortiz, Freddy; Nuñez, Christopher; Elashoff, David; Woo, Ellen; Apostolova, Liana G.; Wolf, Sheldon; Casado, Maria; Caceres, Nenette; Panchal, Hemali; Ringman, John M.

2015-01-01

Background/Aims Performance on the Montreal Cognitive Assessment (MoCA) has been demonstrated to be dependent on the educational level. The purpose of this study was to identify how to best adjust MoCA scores and to identify MoCA items most sensitive to cognitive decline in incipient Alzheimer's disease (AD) in a Spanish-speaking population with varied levels of education. Methods We analyzed data from 50 Spanish-speaking participants. We examined the pattern of diagnosis-adjusted MoCA residuals in relation to education and compared four alternative score adjustments using bootstrap sampling. Sensitivity and specificity analyses were performed for the raw and each adjusted score. The interval reliability of the MoCA as well as item discrimination and item validity were examined. Results We found that with progressive compensation added for those with lower education, unexplained residuals decreased and education-residual association moved to zero, suggesting that more compensation was necessary to better adjust MoCA scores in those with a lower educational level. Cube copying, sentence repetition, delayed recall, and orientation were most sensitive to cognitive impairment due to AD. Conclusion A compensation of 3-4 points was needed for <6 years of education. Overall, the Spanish version of the MoCA maintained adequate psychometric properties in this population. PMID:25873930

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

PubMed

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

2014-02-01

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

Cognitive predictors of skilled performance with an advanced upper limb multifunction prosthesis: a preliminary analysis.

PubMed

Hancock, Laura; Correia, Stephen; Ahern, David; Barredo, Jennifer; Resnik, Linda

2017-07-01

Purpose The objectives were to 1) identify major cognitive domains involved in learning to use the DEKA Arm; 2) specify cognitive domain-specific skills associated with basic versus advanced users; and 3) examine whether baseline memory and executive function predicted learning. Method Sample included 35 persons with upper limb amputation. Subjects were administered a brief neuropsychological test battery prior to start of DEKA Arm training, as well as physical performance measures at the onset of, and following training. Multiple regression models controlling for age and including neuropsychological tests were developed to predict physical performance scores. Prosthetic performance scores were divided into quartiles and independent samples t-tests compared neuropsychological test scores of advanced scorers and basic scorers. Baseline neuropsychological test scores were used to predict change in scores on physical performance measures across time. Results Cognitive domains of attention and processing speed were statistically significantly related to proficiency of DEKA Arm use and predicted level of proficiency. Conclusions Results support use of neuropsychological tests to predict learning and use of a multifunctional prosthesis. Assessment of cognitive status at the outset of training may help set expectations for the duration and outcomes of treatment. Implications for Rehabilitation Cognitive domains of attention and processing speed were significantly related to level of proficiencyof an advanced multifunctional prosthesis (the DEKA Arm) after training. Results provide initial support for the use of neuropsychological tests to predict advanced learningand use of a multifunctional prosthesis in upper-limb amputees. Results suggest that assessment of patients' cognitive status at the outset of upper limb prosthetictraining may, in the future, help patients, their families and therapists set expectations for theduration and intensity of training and may help set reasonable proficiency goals.

Training improves laparoscopic tasks performance and decreases operator workload.

PubMed

Hu, Jesse S L; Lu, Jirong; Tan, Wee Boon; Lomanto, Davide

2016-05-01

It has been postulated that increased operator workload during task performance may increase fatigue and surgical errors. The National Aeronautics and Space Administration-Task Load Index (NASA-TLX) is a validated tool for self-assessment for workload. Our study aims to assess the relationship of workload and performance of novices in simulated laparoscopic tasks of different complexity levels before and after training. Forty-seven novices without prior laparoscopic experience were recruited in a trial to investigate whether training improves task performance as well as mental workload. The participants were tested on three standard tasks (ring transfer, precision cutting and intracorporeal suturing) in increasing complexity based on the Fundamentals of Laparoscopic Surgery (FLS) curriculum. Following a period of training and rest, participants were tested again. Test scores were computed from time taken and time penalties for precision errors. Test scores and NASA-TLX scores were recorded pre- and post-training and analysed using paired t tests. One-way repeated measures ANOVA was used to analyse differences in NASA-TLX scores between the three tasks. NASA-TLX score was lowest with ring transfer and highest with intracorporeal suturing. This was statistically significant in both pre-training (p < 0.001) and post-training (p < 0.001). NASA-TLX scores mirror the changes in test scores for the three tasks. Workload scores decreased significantly after training for all three tasks (ring transfer = 2.93, p < 0.001, precision cutting = 3.74, p < 0.001, intracorporeal suturing = 2.98, p < 0.001). NASA-TLX score is an accurate reflection of the complexity of simulated laparoscopic tasks in the FLS curriculum. This also correlates with the relationship of test scores between the three tasks. Simulation training improves both performance score and workload score across the tasks.

Systems Engineering Management Guide,

DTIC Science & Technology

1990-01-01

6•’-&-S- A -i-2-- -4-$-6-7-6-I SPEED AN0 INDURA6Ca CARGO CAPACITY ,- .- ,-,-,-$-- -,-$-4-,-,-7-,-U LOOISTICSR&M CARGO CAPACITY -- - - - -3.2- - 3-4...only subjective and to predict a level of performance with ( high , medium, low) evaluation is possible. respect to each attribute for each alternative For...criterion; evaluated as having an expected speed of however, some fixed plan for scoring 31.5 knots would receive a score of .50, while performance

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

NASA Astrophysics Data System (ADS)

Jensen-Ruopp, Helga Spitko

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

Impact of Personality Traits, Anxiety, Depression and Hopelessness Levels on Quality of Life in the Patients with Breast Cancer.

PubMed

İzci, Filiz; Sarsanov, Dauren; Erdogan, Zeynep İyigün; İlgün, Ahmet Serkan; Çelebi, Esra; Alço, Gül; Kocaman, Nazmiye; Ordu, Çetin; Öztürk, Alper; Duymaz, Tomris; Pilavcı, Kezban Nur; Elbüken, Filiz; Ağaçayak, Filiz; Aktepe, Fatma; Ünveren, Gizem; Özdem, Gözdem; Eralp, Yeşim; Özmen, Vahit

2018-04-01

The aim of this study was to investigate the impacts of personality traits, anxiety, depression and hopelessness levels on quality of life in the patients with breast cancer. The study was performed on 90 patients diagnosed with breast cancer and 90 healthy women. Sociodemographic and Clinical Data Collection Form designed by us, Beck Hopelessness Scale (BHS), Beck Anxiety Scale (BAS), Beck Depression Scale (BDS), Eysenck Personality Inventory (EPI) and Quality of Life Scale-Short Form (SF-36) were administered to patients and to control group. The patients with breast cancer were found to indicate higher levels of anxiety and depression, lower levels of quality of life, and higher scores of personality inventory subscales as compared to the healthy control group. In the patient group, it was identified that the quality of life subscale scores were found to be negatively correlated with anxiety, depression, hopelessness and neurotic personality scores; there was a positive correlation between neurotic personality scores and depression, anxiety and hopelessness scores. It can be concluded that the breast cancer patients with extraversion personality traits have lower levels of anxiety and depression, keeping their quality of life better, whereas the patients with higher neuroticism scores may have more impaired quality of life. Therefore, the psychiatric evaluation of the breast cancer patients during and after the treatment cannot be ruled out.

Physician groups' use of data from patient experience surveys.

PubMed

Friedberg, Mark W; SteelFisher, Gillian K; Karp, Melinda; Schneider, Eric C

2011-05-01

In Massachusetts, physician groups' performance on validated surveys of patient experience has been publicly reported since 2006. Groups also receive detailed reports of their own performance, but little is known about how physician groups have responded to these reports. To examine whether and how physician groups are using patient experience data to improve patient care. During 2008, we conducted semi-structured interviews with the leaders of 72 participating physician groups (out of 117 groups receiving patient experience reports). Based on leaders' responses, we identified three levels of engagement with patient experience reporting: no efforts to improve (level 1), efforts to improve only the performance of low-scoring physicians or practice sites (level 2), and efforts to improve group-wide performance (level 3). Groups' level of engagement and specific efforts to improve patient care. Forty-four group leaders (61%) reported group-wide improvement efforts (level 3), 16 (22%) reported efforts to improve only the performance of low-scoring physicians or practice sites (level 2), and 12 (17%) reported no performance improvement efforts (level 1). Level 3 groups were more likely than others to have an integrated medical group organizational model (84% vs. 31% at level 2 and 33% at level 1; P < 0.005) and to employ the majority of their physicians (69% vs. 25% and 20%; P < 0.05). Among level 3 groups, the most common targets for improvement were access, communication with patients, and customer service. The most commonly reported improvement initiatives were changing office workflow, providing additional training for nonclinical staff, and adopting or enhancing an electronic health record. Despite statewide public reporting, physician groups' use of patient experience data varied widely. Integrated organizational models were associated with greater engagement, and efforts to enhance clinicians' interpersonal skills were uncommon, with groups predominantly focusing on office workflow and support staff.

[Circadian rhythm : Influence on Epworth Sleepiness Scale score].

PubMed

Herzog, M; Bedorf, A; Rohrmeier, C; Kühnel, T; Herzog, B; Bremert, T; Plontke, S; Plößl, S

2017-02-01

The Epworth Sleepiness Scale (ESS) is frequently used to determine daytime sleepiness in patients with sleep-disordered breathing. It is still unclear whether different levels of alertness induced by the circadian rhythm influence ESS score. The aim of this study is to investigate the influence of circadian rhythm-dependent alertness on ESS performance. In a monocentric prospective noninterventional observation study, 97 patients with suspected sleep-disordered breathing were investigated with respect to daytime sleepiness in temporal relationship to polysomnographic examination and treatment. The Karolinska Sleepiness Scale (KSS) and the Stanford Sleepiness Scale (SSS) served as references for the detection of present sleepiness at three different measurement times (morning, noon, evening), prior to and following a diagnostic polysomnography night as well as after a continuous positive airway pressure (CPAP) titration night (9 measurements in total). The KSS, SSS, and ESS were performed at these times in a randomized order. The KSS and SSS scores revealed a circadian rhythm-dependent curve with increased sleepiness at noon and in the evening. Following a diagnostic polysomnography night, the scores were increased compared to the measurements prior to the night. After the CPAP titration night, sleepiness in the morning was reduced. KSS and SSS reflect the changes in alertness induced by the circadian rhythm. The ESS score war neither altered by the intra-daily nor by the inter-daily changes in the level of alertness. According to the present data, the ESS serves as a reliable instrument to detect the level of daytime sleepiness independently of the circadian rhythm-dependent level of alertness.

A Study on the Correlation between Cord Blood Glucose Level and the Apgar Score.

PubMed

Khan, Kalyan; Saha, Ashis Ranjan

2013-02-01

The study of the biochemical parameters of cord blood acts as a mirror, which usually reflects the neonatal status. The widely used system for the evaluation of a neonate is the Apgar score. There is no comprehensive published data which has established the association between the cord blood glucose level and the Apgar score. Similarly, there is also no well accepted reference range of the cord blood glucose level. The main objectives of the present study was to ascertain any adverse effects of an abnormal cord blood glucose level on the neonatal status and to find out a standard reference level of glucose in cord blood. The cord blood glucose estimation was done by using the glucose oxidase peroxidase method and the statistical analysis was performed by using the SPSS, version 16 software. In the present study, the cord blood glucose level was found to have no correlation with the Apgar scores which were calculated at both one minute and five minutes after birth. It was also found that for the foetus to be free from any obvious complication, the cord blood glucose level had to be around 87 mg/dl. The fluctuations in the maternal glucose levels are weakly associated with the glucose level in the cord blood.

The test-retest reliability of the latent construct of executive function depends on whether tasks are represented as formative or reflective indicators.

PubMed

Willoughby, Michael T; Kuhn, Laura J; Blair, Clancy B; Samek, Anya; List, John A

2017-10-01

This study investigates the test-retest reliability of a battery of executive function (EF) tasks with a specific interest in testing whether the method that is used to create a battery-wide score would result in differences in the apparent test-retest reliability of children's performance. A total of 188 4-year-olds completed a battery of computerized EF tasks twice across a period of approximately two weeks. Two different approaches were used to create a score that indexed children's overall performance on the battery-i.e., (1) the mean score of all completed tasks and (2) a factor score estimate which used confirmatory factor analysis (CFA). Pearson and intra-class correlations were used to investigate the test-retest reliability of individual EF tasks, as well as an overall battery score. Consistent with previous studies, the test-retest reliability of individual tasks was modest (rs ≈ .60). The test-retest reliability of the overall battery scores differed depending on the scoring approach (r mean  = .72; r factor_ score  = .99). It is concluded that the children's performance on individual EF tasks exhibit modest levels of test-retest reliability. This underscores the importance of administering multiple tasks and aggregating performance across these tasks in order to improve precision of measurement. However, the specific strategy that is used has a large impact on the apparent test-retest reliability of the overall score. These results replicate our earlier findings and provide additional cautionary evidence against the routine use of factor analytic approaches for representing individual performance across a battery of EF tasks.

Ability-performance relationships in education and employment settings: critical tests of the more-is-better and the good-enough hypotheses.

PubMed

Arneson, Justin J; Sackett, Paul R; Beatty, Adam S

2011-10-01

The nature of the relationship between ability and performance is of critical importance for admission decisions in the context of higher education and for personnel selection. Although previous research has supported the more-is-better hypothesis by documenting linearity of ability-performance relationships, such research has not been sensitive enough to detect deviations at the top ends of the score distributions. An alternative position receiving considerable attention is the good-enough hypothesis, which suggests that although higher levels of ability may result in better performance up to a threshold, above this threshold greater ability does not translate to better performance. In this study, the nature of the relationship between cognitive ability and performance was examined throughout the score range in four large-scale data sets. Monotonicity was maintained in all instances. Contrary to the good-enough hypothesis, the ability-performance relationship was commonly stronger at the top end of the score distribution than at the bottom end.

Improvement of Immediate Performance in Neonatal Resuscitation Through Rapid Cycle Deliberate Practice Training.

PubMed

Magee, Maclain J; Farkouh-Karoleski, Christiana; Rosen, Tove S

2018-04-01

Simulation training is an effective method to teach neonatal resuscitation (NR), yet many pediatrics residents do not feel comfortable with NR. Rapid cycle deliberate practice (RCDP) allows the facilitator to provide debriefing throughout the session. In RCDP, participants work through the scenario multiple times, eventually reaching more complex tasks once basic elements have been mastered. We determined if pediatrics residents have improved observed abilities, confidence level, and recall in NR after receiving RCDP training compared to the traditional simulation debriefing method. Thirty-eight pediatrics interns from a large academic training program were randomized to a teaching simulation session using RCDP or simulation debriefing methods. The primary outcome was the intern's cumulative score on the initial Megacode Assessment Form (MCAF). Secondary outcome measures included surveys of confidence level, recall MCAF scores at 4 months, and time to perform critical interventions. Thirty-four interns were included in analysis. Interns in the RCDP group had higher initial MCAF scores (89% versus 84%, P  < .026), initiated positive pressure ventilation within 1 minute (100% versus 71%, P  < .05), and administered epinephrine earlier (152 s versus 180 s, P  < .039). Recall MCAF scores were not different between the 2 groups. Immediately following RCDP interns had improved observed abilities and decreased time to perform critical interventions in NR simulation as compared to those trained with the simulation debriefing. RCDP was not superior in improving confidence level or retention.

A Comparison of Robotic Simulation Performance on Basic Virtual Reality Skills: Simulator Subjective Versus Objective Assessment Tools.

PubMed

Dubin, Ariel K; Smith, Roger; Julian, Danielle; Tanaka, Alyssa; Mattingly, Patricia

To answer the question of whether there is a difference between robotic virtual reality simulator performance assessment and validated human reviewers. Current surgical education relies heavily on simulation. Several assessment tools are available to the trainee, including the actual robotic simulator assessment metrics and the Global Evaluative Assessment of Robotic Skills (GEARS) metrics, both of which have been independently validated. GEARS is a rating scale through which human evaluators can score trainees' performances on 6 domains: depth perception, bimanual dexterity, efficiency, force sensitivity, autonomy, and robotic control. Each domain is scored on a 5-point Likert scale with anchors. We used 2 common robotic simulators, the dV-Trainer (dVT; Mimic Technologies Inc., Seattle, WA) and the da Vinci Skills Simulator (dVSS; Intuitive Surgical, Sunnyvale, CA), to compare the performance metrics of robotic surgical simulators with the GEARS for a basic robotic task on each simulator. A prospective single-blinded randomized study. A surgical education and training center. Surgeons and surgeons in training. Demographic information was collected including sex, age, level of training, specialty, and previous surgical and simulator experience. Subjects performed 2 trials of ring and rail 1 (RR1) on each of the 2 simulators (dVSS and dVT) after undergoing randomization and warm-up exercises. The second RR1 trial simulator performance was recorded, and the deidentified videos were sent to human reviewers using GEARS. Eight different simulator assessment metrics were identified and paired with a similar performance metric in the GEARS tool. The GEARS evaluation scores and simulator assessment scores were paired and a Spearman rho calculated for their level of correlation. Seventy-four subjects were enrolled in this randomized study with 9 subjects excluded for missing or incomplete data. There was a strong correlation between the GEARS score and the simulator metric score for time to complete versus efficiency, time to complete versus total score, economy of motion versus depth perception, and overall score versus total score with rho coefficients greater than or equal to 0.70; these were significant (p < .0001). Those with weak correlation (rho ≥0.30) were bimanual dexterity versus economy of motion, efficiency versus master workspace range, bimanual dexterity versus master workspace range, and robotic control versus instrument collisions. On basic VR tasks, several simulator metrics are well matched with GEARS scores assigned by human reviewers, but others are not. Identifying these matches/mismatches can improve the training and assessment process when using robotic surgical simulators. Copyright © 2017 American Association of Gynecologic Laparoscopists. Published by Elsevier Inc. All rights reserved.

The Somatic Marker Hypothesis and Sexual Decision Making: Understanding the Role of Iowa Gambling Task Performance and Daily Sexual Arousal on the Sexual Behavior of Gay and Bisexual Men.

PubMed

Rendina, H Jonathon; Millar, Brett M; Dash, Genevieve; Feldstein Ewing, Sarah W; Parsons, Jeffrey T

2018-04-19

The sexual decision-making literature suggests that sexual arousal and behavior are associated. The somatic marker hypothesis suggests that individual neuropsychological differences in decision making, as measured by the Iowa Gambling Task (IGT), may moderate these associations; however, this hypothesis has yet to be tested with event-level sexual behavior data. We hypothesized that (a) daily sexual arousal would be positively associated with likelihood of engaging in sex and condomless anal sex (CAS) and (b) IGT scores would moderate these associations such that the associations would be stronger among those with higher IGT scores. We used daily diary data from 334 highly sexually active gay and bisexual men to examine the main and interaction effects of sexual arousal and IGT scores on sexual engagement and CAS. As hypothesized, daily sexual arousal was positively associated with greater odds of both sexual engagement and CAS with casual male partners. Individual-level IGT performance significantly moderated the day-level association between arousal and sexual engagement, which was stronger for men with higher IGT scores. There was no main effect of IGT scores on either sexual behavior outcome, nor did it moderate the association between arousal and CAS. These findings highlight the influence of sexual arousal on sexual engagement, which differed by IGT scores; the effect of arousal on CAS was much less variable and may not be moderated by neurocognitive factors. This study supports the importance of exploring integrated behavioral/biomedical interventions to improve individual decision making to prevent HIV infection.

Age and expertise effects in aviation decision making and flight control in a flight simulator.

PubMed

Kennedy, Quinn; Taylor, Joy L; Reade, Gordon; Yesavage, Jerome A

2010-05-01

Age (due to declines in cognitive abilities necessary for navigation) and level of aviation expertise are two factors that may affect aviation performance and decision making under adverse weather conditions. We examined the roles of age, expertise, and their relationship on aviation decision making and flight control performance during a flight simulator task. Seventy-two IFR-rated general aviators, aged 19-79 yr, made multiple approach, holding pattern entry, and landing decisions while navigating under Instrument Flight Rules weather conditions. Over three trials in which the fog level varied, subjects decided whether or not to land the aircraft. They also completed two holding pattern entries. Subjects' flight control during approaches and holding patterns was measured. Older pilots (41+ yr) were more likely than younger pilots to land when visibility was inadequate (older pilots' mean false alarm rate: 0.44 vs 0.25). They also showed less precise flight control for components of the approach, performing 0.16 SD below mean approach scores. Expertise attenuated an age-related decline in flight control during holding patterns: older IFR/CFI performed 0.73 SD below mean score; younger IFR/CFI, younger CFII/ATP, older CFII/ATP: 0.32, 0.26, 0.03 SD above mean score. Additionally, pilots with faster processing speed (by median split) had a higher mean landing decision false alarm rate (0.42 vs 0.28), yet performed 0.14 SD above the mean approach control score. Results have implications regarding specialized training for older pilots and for understanding processes involved in older adults' real world decision making and performance.

Effects of vitamin D supplementation on strength, physical function, and health perception in older, community-dwelling men.

PubMed

Kenny, Anne M; Biskup, Bradley; Robbins, Bertha; Marcella, Glenn; Burleson, Joseph A

2003-12-01

To study the effects of vitamin D supplementation in healthier populations of men. : Randomized, controlled trial. General clinical research center. Sixty-five healthy, community-dwelling men (mean age+/-standard deviation=76+/-4, range 65-87). Cholecalciferol (1,000 IU/d) or placebo supplementation for 6 months; all received 500 mg supplemental calcium. Upper and lower extremity muscle strength and power, physical performance and activity, health perception, calcium and vitamin D intake, and biochemical assessment, including 25-hydroxyvitamin D (25OHD), parathyroid hormone (PTH), and ionized calcium levels. The levels of 25OHD increased and PTH decreased in the cholecalciferol group, whereas there were no significant changes in the control group (P<.001). Baseline 25OHD levels correlated with baseline single-leg stance time and physical activity score. Baseline PTH levels correlated with baseline 8-foot walk time and physical activity score. No significant difference in strength, power, physical performance, or health perception was found between groups. The 25OHD or PTH levels correlated with physical activity and physical performance in older, community-dwelling men with normal 25OHD status. Vitamin D supplementation increased 25OHD levels and decreased PTH levels but did not increase muscle strength or improve physical performance or health perception in this group of healthy, older men. Further investigations of the effects of vitamin D supplementation should focus on individuals with low levels of vitamin D.

Using a visual plate waste study to monitor menu performance.

PubMed

Connors, Priscilla L; Rozell, Sarah B

2004-01-01

Two visual plate waste studies were conducted in 1-week phases over a 1-year period in an acute care hospital. A total of 383 trays were evaluated in the first phase and 467 in the second. Food items were ranked for consumption from a low (1) to high (6) score, with a score of 4.0 set as the benchmark denoting a minimum level of acceptable consumption. In the first phase two entrees, four starches, all of the vegetables, sliced white bread, and skim milk scored below the benchmark. As a result six menu items were replaced and one was modified. In the second phase all entrees scored at or above 4.0, as did seven vegetables, and a dinner roll that replaced sliced white bread. Skim milk continued to score below the benchmark. A visual plate waste study assists in benchmarking performance, planning menu changes, and assessing effectiveness.

Factors related to student performance in statistics courses in Lebanon

NASA Astrophysics Data System (ADS)

Naccache, Hiba Salim

The purpose of the present study was to identify factors that may contribute to business students in Lebanese universities having difficulty in introductory and advanced statistics courses. Two statistics courses are required for business majors at Lebanese universities. Students are not obliged to be enrolled in any math courses prior to taking statistics courses. Drawing on recent educational research, this dissertation attempted to identify the relationship between (1) students’ scores on Lebanese university math admissions tests; (2) students’ scores on a test of very basic mathematical concepts; (3) students’ scores on the survey of attitude toward statistics (SATS); (4) course performance as measured by students’ final scores in the course; and (5) their scores on the final exam. Data were collected from 561 students enrolled in multiple sections of two courses: 307 students in the introductory statistics course and 260 in the advanced statistics course in seven campuses across Lebanon over one semester. The multiple regressions results revealed four significant relationships at the introductory level: between students’ scores on the math quiz with their (1) final exam scores; (2) their final averages; (3) the Cognitive subscale of the SATS with their final exam scores; and (4) their final averages. These four significant relationships were also found at the advanced level. In addition, two more significant relationships were found between students’ final average and the two subscales of Effort (5) and Affect (6). No relationship was found between students’ scores on the admission math tests and both their final exam scores and their final averages in both the introductory and advanced level courses. On the other hand, there was no relationship between students’ scores on Lebanese admissions tests and their final achievement. Although these results were consistent across course formats and instructors, they may encourage Lebanese universities to assess the effectiveness of prerequisite math courses. Moreover, these findings may lead the Lebanese Ministry of Education to make changes to the admissions exams, course prerequisites, and course content. Finally, to enhance the attitude of students, new learning techniques, such as group work during class meetings can be helpful, and future research should aim to test the effectiveness of these pedagogical techniques on students’ attitudes toward statistics.

The impact of using standardized patients in psychiatric cases on the levels of motivation and perceived learning of the nursing students.

PubMed

Sarikoc, Gamze; Ozcan, Celale Tangul; Elcin, Melih

2017-04-01

The use of standardized patients is not very common in psychiatric nursing education and there has been no study conducted in Turkey. This study evaluated the impact of using standardized patients in psychiatric cases on the levels of motivation and perceived learning of the nursing students. This manuscript addressed the quantitative aspect of a doctoral thesis study in which both quantitative and qualitative methods were used. A pre-test and post-test were employed in the quantitative analysis in a randomized and controlled study design. The motivation scores, and interim and post-test scores for perceived learning were higher in the experimental group compared to pre-test scores and the scores of the control group. The students in the experimental group reported that they felt more competent about practical training in clinical psychiatry, as well as in performing interviews with patients having mental problems, and reported less anxiety about performing an interview when compared to students in the control group. It is considered that the inclusion of standardized patient methodology in the nursing education curriculum in order to improve the knowledge level and skills of students would be beneficial in the training of mental health nurses. Copyright © 2017 Elsevier Ltd. All rights reserved.

The person's conception of the structures of developing intellect: early adolescence to middle age.

PubMed

Demetriou, A; Efklides, A

1989-08-01

According to experiential structuralism, thought abilities have six capacity spheres: experimental, propositional, quantitative, imaginal, qualitative, and metacognitive. The first five are applied to the environment. The metacognitive capacity is applied to the others, serving as the interface between reality and the cognitive system or between any of the other capacities. To test this postulate, 648 subjects aged 12 to 40 years, solved eight tasks that were addressed, in pairs, to the first four capacity spheres. One of the tasks in each pair tapped the first and the other the third formal level of the sphere. Having solved the tasks, the subjects were required to rate each pair of tasks in terms of similarity of operations, difficulty, and success of solution. Factor analysis of difficulty and success evaluation scores revealed the same capacity-specific factors as the analysis of performance scores. Factor analysis of similarity scores differentiated between same- and different-sphere pairs. Analysis of variance showed that difficulty and success evaluation scores preserved performance differences between the first and the third formal tasks. Cognitive level, age, socioeconomic status, and sex were related to the metacognitive measures in ways similar to their relations to performance measures. These findings were integrated into a model aimed at capturing real-time metacognitive functioning.

CE verbal episodic memory impairment in schizophrenia: a comparison with frontal lobe lesion patients.

PubMed

Christensen, Bruce K; Patrick, Regan E; Stuss, Donald T; Gillingham, Susan; Zipursky, Robert B

2013-01-01

Schizophrenia (SCZ)-related verbal memory impairment is hypothesized to be mediated, in part, by frontal lobe (FTL) dysfunction. However, little research has contrasted the performance of SCZ patients with that of patients exhibiting circumscribed frontal lesions. The current study compared verbal episodic memory in patients with SCZ and focal FTL lesions (left frontal, LF; right frontal, RF; and bi-frontal, BF) on a four-trial list learning task consisting of three lists of varying semantic organizational structure. Each dependent variable was examined at two levels: scores collapsed across all four trials and learning scores (i.e., trial 4-trial 1). Performance deficits were observed in each patient group across most dependent measures at both levels. Regarding patient group differences, SCZ patients outperformed LF/BF patients (i.e., either learning scores or scores collapsed across trial) on free recall, primacy, primary memory, secondary memory, and subjective organization, whereas they only outperformed RF patients on the semantically blocked list on recency and primary memory. Collectively, these results indicate that the pattern of memory performance is largely similar between patients with SCZ and those with RF lesions. These data support tentative arguments that verbal episodic memory deficits in SCZ may be mediated by frontal dysfunction in the right hemisphere.

Assessment of photoselective vaporization of prostate skills during Urology Objective Structured Clinical Examinations (OSCE)

PubMed Central

Noureldin, Yasser A.; Elkoushy, Mohamed A.; Fahmy, Nader; Carrier, Serge; Elhilali, Mostafa M.; Andonian, Sero

2015-01-01

Introduction: We evaluated the use of the GreenLight Simulator (GL-SIM) (American Medical Systems, Guelph, ON) in the skill assessment of postgraduate trainees (PGTs) in photoselective vaporization of the prostate (PVP). We also sought to determine whether previous PVP experience or GL-SIM practice improved performance. Methods: PGTs in postgraduate years (PGY-3 to PGY-5) from all 4 Quebec urology training programs were recruited during 2 annual Objective Structured Clinical Examinations (OSCEs). During a 20-minute OSCE station, PGTs were asked to perform 2 exercises: (1) identification of endoscopic landmarks and (2) a PVP of a 30-g normal prostate. Grams vaporized, global scores, and number of correct anatomical landmarks were recorded and correlated with PGY level, practice on the GL-SIM, and previous PVP experience. Results: In total, 25 PGTs were recruited at each OSCE, with 13 PGTs participating in both OSCEs. When comparing scores from the first and second OSCEs, there was a significant improvement in the number of grams vaporized (2.9 vs. 4.3 g; p = 0.003) and global score (100 vs. 165; p = 0.03). There was good correlation between the number of previously performed PVPs and the global score (r = 0.4, p = 0.04). Similarly, PGTs with previous practice on the GL-SIM had significantly higher global score (100.6 vs. 162.6; p = 0.04) and grams vaporized (3.1 vs. 4.1 g; p = 0.04) when compared with those who did not practice on GL-SIM. Furthermore, there were significantly more competent PGTs among those who had previously practiced on the GL-SIM (32.7% vs. 10.2%; p = 0.009). PGY level did not significantly affect grams vaporized or global score (p > 0.05). Conclusion: Performance on the GL-SIM at OSCEs significantly correlated with previous practice on the GL-SIM and previous PVP experience rather than PGY level. Furthermore, there were significantly more competent PGTs among those who had previously practiced on the GL-SIM. PMID:25737763

Deficits in Physical Function Among Young Childhood Cancer Survivors

PubMed Central

Hoffman, Megan C.; Mulrooney, Daniel A.; Steinberger, Julia; Lee, Jill; Baker, K. Scott; Ness, Kirsten K.

2013-01-01

Purpose Childhood cancer survivors (CCSs) are at risk for physical disability. The aim of this investigation was to characterize and compare physical performance among CCSs and a group of siblings age < 18 years and determine if diagnosis, treatment, and physical activity levels were associated with lower performance scores. Methods CCSs ≥ 5 years from diagnosis and a sibling comparison group were recruited and evaluated for strength, mobility, and fitness. Physical performance measures were compared in regression models between survivors and siblings by diagnosis and among survivors by treatment exposures and physical activity levels. Results CCSs (n = 183; mean age ± standard deviation [SD], 13.5 ± 2.5 years; 53% male) scored lower than siblings (n = 147; mean age ± SD, 13.4 ± 2.4 years; 50% male) on lower-extremity strength testing, the timed up-and-go (TUG) test, and the 6-minute walk (6MW) test, despite reporting similar levels and types of habitual physical activity. The lowest scores were prevalent among survivors of CNS tumors and bone and soft tissue sarcomas on strength testing (score ± SD: CNS tumors, 76.5 ± 4.7; sarcoma 67.1 ± 7.2 v siblings, 87.3 ± 2.4 Newton-meters quadricep strength at 90° per second; P = .04 and .01, respectively) and among CNS tumor survivors on the TUG (score ± SD: 5.1 ± 0.1 v siblings, 4.4 ± 0.1 seconds; P < .001) and 6MW tests (score ± SD: 533.3 ± 15.6 v siblings, 594.1 ± 8.3 m; P < .001). Conclusion CCSs may have underlying physiologic deficits that interfere with function that cannot be completely overcome by participation in regular physical activity. These survivors may need referral for specialized exercise interventions in addition to usual counseling to remain physically active. PMID:23796992

Association of Ego Defense Mechanisms with Academic Performance, Anxiety and Depression in Medical Students: A Mixed Methods Study.

PubMed

Waqas, Ahmed; Rehman, Abdul; Malik, Aamenah; Muhammad, Umer; Khan, Sarah; Mahmood, Nadia

2015-09-30

 Ego defense mechanisms are unconscious psychological processes that help an individual to prevent anxiety when exposed to a stressful situation. These mechanisms are important in psychiatric practice to assess an individual's personality dynamics, psychopathologies, and modes of coping with stressful situations, and hence, to design appropriate individualized treatment. Our study delineates the relationship of ego defense mechanisms with anxiety, depression, and academic performance of Pakistani medical students.  This cross-sectional study was done at CMH Lahore Medical College and Fatima Memorial Hospital Medical and Dental College, both in Lahore, Pakistan, from December 1, 2014 to January 15, 2015. Convenience sampling was used and only students who agreed to take part in this study were included. The questionnaire consisted of three sections: 1) Demographics, documenting demographic data and academic scores on participants' most recent exams; 2) Hospital Anxiety and Depression Scale (HADS); and 3) Defense Style Questionnaire-40 (DSQ-40). The data were analyzed with SPSS v. 20. Mean scores and frequencies were calculated for demographic variables and ego defense mechanisms. Bivariate correlations, one-way ANOVA, and multiple linear regression were used to identify associations between academic scores, demographics, ego defense mechanisms, anxiety, and depression.  A total of 409 medical students participated, of whom 286 (70%) were females and 123 (30%) were males. Mean percentage score on the most recent exams was 75.6% in medical students. Bivariate correlation revealed a direct association between mature and neurotic ego defense mechanisms and academic performance, and an indirect association between immature mechanisms and academic performance. One-way ANOVA showed that moderate levels of anxiety (P < .05) and low levels of depression (P < .05) were associated with higher academic performance.  There was a significant association between academic performance and ego defense mechanisms, anxiety, and depression levels in our sample of Pakistani medical students.

Association of Ego Defense Mechanisms with Academic Performance, Anxiety and Depression in Medical Students: A Mixed Methods Study

PubMed Central

Waqas, Ahmed; Malik, Aamenah; Muhammad, Umer; Khan, Sarah; Mahmood, Nadia

2015-01-01

Background: Ego defense mechanisms are unconscious psychological processes that help an individual to prevent anxiety when exposed to a stressful situation. These mechanisms are important in psychiatric practice to assess an individual’s personality dynamics, psychopathologies, and modes of coping with stressful situations, and hence, to design appropriate individualized treatment. Our study delineates the relationship of ego defense mechanisms with anxiety, depression, and academic performance of Pakistani medical students. Methods: This cross-sectional study was done at CMH Lahore Medical College and Fatima Memorial Hospital Medical and Dental College, both in Lahore, Pakistan, from December 1, 2014 to January 15, 2015. Convenience sampling was used and only students who agreed to take part in this study were included. The questionnaire consisted of three sections: 1) Demographics, documenting demographic data and academic scores on participants’ most recent exams; 2) Hospital Anxiety and Depression Scale (HADS); and 3) Defense Style Questionnaire-40 (DSQ-40). The data were analyzed with SPSS v. 20. Mean scores and frequencies were calculated for demographic variables and ego defense mechanisms. Bivariate correlations, one-way ANOVA, and multiple linear regression were used to identify associations between academic scores, demographics, ego defense mechanisms, anxiety, and depression. Results: A total of 409 medical students participated, of whom 286 (70%) were females and 123 (30%) were males. Mean percentage score on the most recent exams was 75.6% in medical students. Bivariate correlation revealed a direct association between mature and neurotic ego defense mechanisms and academic performance, and an indirect association between immature mechanisms and academic performance. One-way ANOVA showed that moderate levels of anxiety (P < .05) and low levels of depression (P < .05) were associated with higher academic performance. Conclusion: There was a significant association between academic performance and ego defense mechanisms, anxiety, and depression levels in our sample of Pakistani medical students. PMID:26543695

A new method for determining levels of sedation in dogs: A pilot study with propofol and a novel neuroactive steroid anesthetic.

PubMed

Youngblood, B L; Ueyama, Y; Muir, W W; Belfort, G M; Hammond, R H; Dai, J; Salituro, F G; Robichaud, A J; Doherty, J J

2018-05-22

Different levels of consciousness are required in order to perform different medical procedures. Sedation scales established to objectively define various levels of sedation in humans have not been thoroughly characterized in non-human species. Postural changes in rats or dogs are useful as gross measures of sedation but are inadequate for quantitative assessment since graded levels of sedation are difficult to delineate and obscured by movement abnormalities. A new canine sedation scoring (CSS) method was developed based on the modified observer's assessment of alertness and sedation score (MOAA/S) used in humans. The method employed a combination of physical, auditory and somatosensory stimuli of increasing intensity. Cardiovascular, respiratory, and a neurophysiological measure of sedation (bispectral index: BIS) data were recorded. Validation studies were performed following intravenous loading and constant rate infusion of propofol or a novel synthetic neuroactive steroid (SGE-746). Four levels of consciousness were identified: 1) Awake, 2) Moderate Sedation (MS), 3) Deep Sedation (DS) and 4) General Anesthesia (GA). Cardiorespiratory measurements obtained after bolus administration of propofol and SGE-746 and at the end of each CRI remained within normal limits. Canine sedation scores correlated with BIS for SGE-746. SGE-746 exhibited a more gradual exposure-response relationship than propofol. Larger increases in the plasma concentration from awake values were required to achieve different levels of sedation with SGE-746 compared to propofol. No other canine sedation scoring methods are widely accepted. A CSS method, based on the human MOAA/S scale defined four levels of consciousness in dogs and provided better resolution of sedation depth than BIS alone. Copyright © 2018 Elsevier B.V. All rights reserved.

Subjective and objective quantification of physician's workload and performance during radiation therapy planning tasks.

PubMed

Mazur, Lukasz M; Mosaly, Prithima R; Hoyle, Lesley M; Jones, Ellen L; Marks, Lawrence B

2013-01-01

To quantify, and compare, workload for several common physician-based treatment planning tasks using objective and subjective measures of workload. To assess the relationship between workload and performance to define workload levels where performance could be expected to decline. Nine physicians performed the same 3 tasks on each of 2 cases ("easy" vs "hard"). Workload was assessed objectively throughout the tasks (via monitoring of pupil size and blink rate), and subjectively at the end of each case (via National Aeronautics and Space Administration Task Load Index; NASA-TLX). NASA-TLX assesses the 6 dimensions (mental, physical, and temporal demands, frustration, effort, and performance); scores > or ≈ 50 are associated with reduced performance in other industries. Performance was measured using participants' stated willingness to approve the treatment plan. Differences in subjective and objective workload between cases, tasks, and experience were assessed using analysis of variance (ANOVA). The correlation between subjective and objective workload measures were assessed via the Pearson correlation test. The relationships between workload and performance measures were assessed using the t test. Eighteen case-wise and 54 task-wise assessments were obtained. Subjective NASA-TLX scores (P < .001), but not time-weighted averages of objective scores (P > .1), were significantly lower for the easy vs hard case. Most correlations between the subjective and objective measures were not significant, except between average blink rate and NASA-TLX scores (r = -0.34, P = .02), for task-wise assessments. Performance appeared to decline at NASA-TLX scores of ≥55. The NASA-TLX may provide a reasonable method to quantify subjective workload for broad activities, and objective physiologic eye-based measures may be useful to monitor workload for more granular tasks within activities. The subjective and objective measures, as herein quantified, do not necessarily track each other, and more work is needed to assess their utilities. From a series of controlled experiments, we found that performance appears to decline at subjective workload levels ≥55 (as measured via NASA-TLX), which is consistent with findings from other industries. Copyright © 2013 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

1H-MR spectroscopy metabolite levels correlate with executive function in vascular cognitive impairment

PubMed Central

Gasparovic, Charles; Prestopnik, Jillian; Thompson, Jeffrey; Taheri, Saeid; Huisa, Branko; Schrader, Ronald; Adair, John C; Rosenberg, Gary A

2013-01-01

Background White matter hyperintensities (WMHs) are associated with vascular cognitive impairment (VCI) but fail to correlate with neuropsychological measures. As proton MR spectroscopy (1H-MRS) can identify ischaemic tissue, we hypothesised that MRS detectable brain metabolites would be superior to WMHs in predicting performance on neuropsychological tests. Methods 60 patients with suspected VCI underwent clinical, neuropsychological, MRI and CSF studies. They were diagnosed as having subcortical ischaemic vascular disease (SIVD), multiple infarcts, mixed dementia and leukoaraiosis. We measured brain metabolites in a white matter region above the lateral ventricles with 1H-MRS and WMH volume in this region and throughout the brain. Results We found a significant correlation between both total creatine (Cr) and N-acetylaspartyl compounds (NAA) and standardised neuropsychological test scores. Cr levels in white matter correlated significantly with executive function (p=0.001), attention (p=0.03) and overall T score (p=0.007). When lesion volume was added as a covariate, NAA also showed a significant correlation with executive function (p=0.003) and overall T score (p=0.015). Furthermore, while metabolite levels also correlated with total white matter lesion volume, adjusting the Cr levels for lesion volume did not diminish the strength of the association between Cr levels and neuropsychological scores. The lowest metabolite levels and neuropsychological scores were found in the SIVD group. Finally, lesion volume alone did not correlate significantly with any neuropsychological test score. Conclusion These results suggest that estimates of neurometabolite levels provide additional and useful information concerning cognitive function in VCI not obtainable by measurements of lesion load. PMID:23418212

A National Study of the Relationship between Home Access to a Computer and Academic Performance Scores of Grade 12 U.S. Science Students: An Analysis of the 2009 NAEP Data

NASA Astrophysics Data System (ADS)

Coffman, Mitchell Ward

The purpose of this dissertation was to examine the relationship between student access to a computer at home and academic achievement. The 2009 National Assessment of Educational Progress (NAEP) dataset was probed using the National Data Explorer (NDE) to investigate correlations in the subsets of SES, Parental Education, Race, and Gender as it relates to access of a home computer and improved performance scores for U.S. public school grade 12 science students. A causal-comparative approach was employed seeking clarity on the relationship between home access and performance scores. The influence of home access cannot overcome the challenges students of lower SES face. The achievement gap, or a second digital divide, for underprivileged classes of students, including minorities does not appear to contract via student access to a home computer. Nonetheless, in tests for significance, statistically significant improvement in science performance scores was reported for those having access to a computer at home compared to those not having access. Additionally, regression models reported evidence of correlations between and among subsets of controls for the demographic factors gender, race, and socioeconomic status. Variability in these correlations was high; suggesting influence from unobserved factors may have more impact upon the dependent variable. Having access to a computer at home increases performance scores for grade 12 general science students of all races, genders and socioeconomic levels. However, the performance gap is roughly equivalent to the existing performance gap of the national average for science scores, suggesting little influence from access to a computer on academic achievement. The variability of scores reported in the regression analysis models reflects a moderate to low effect, suggesting an absence of causation. These statistical results are accurate and confirm the literature review, whereby having access to a computer at home and the predictor variables were found to have a significant impact on performance scores, although the data presented suggest computer access at home is less influential upon performance scores than poverty and its correlates.

The effects of academic grouping on student performance in science

NASA Astrophysics Data System (ADS)

Scoggins, Sally Smykla

The current action research study explored how student placement in heterogeneous or homogeneous classes in seventh-grade science affected students' eighth-grade Science State of Texas Assessment of Academic Readiness (STAAR) scores, and how ability grouping affected students' scores based on race and socioeconomic status. The population included all eighth-grade students in the target district who took the regular eighth-grade science STAAR over four academic school years. The researcher ran three statistical tests: a t-test for independent samples, a one-way between subjects analysis of variance (ANOVA) and a two-way between subjects ANOVA. The results showed no statistically significant difference between eighth-grade Pre-AP students from seventh-grade Pre-AP classes and eighth-grade Pre-AP students from heterogeneous seventh-grade classes and no statistically significant difference between Pre-AP students' scores based on socioeconomic status. There was no statistically significant interaction between socioeconomic status and the seventh-grade science classes. The scores between regular eighth-grade students who were in heterogeneous seventh-grade classes were statistically significantly higher than the scores of regular eighth-grade students who were in regular seventh-grade classes. The results also revealed that the scores of students who were White were statistically significantly higher than the scores of students who were Black and Hispanic. Black and Hispanic scores did not differ significantly. Further results indicated that the STAAR Level II and Level III scores were statistically significantly higher for the Pre-AP eighth-grade students who were in heterogeneous seventh-grade classes than the STAAR Level II and Level III scores of Pre-AP eighth-grade students who were in Pre-AP seventh-grade classes.

Neurofilament Subunit L Levels in the Cerebrospinal Fluid and Serum of Patients with Amyotrophic Lateral Sclerosis.

PubMed

Gong, Zhong-Ying; Lv, Gao-Peng; Gao, Li-Na; Lu, Yi; Guo, Jie; Zang, Da-Wei

2018-06-13

There are no reliable biomarkers that could evaluate the disease burden in amyotrophic lateral sclerosis (ALS). The aim of our study is to evaluate the changes in cerebrospinal fluid (CSF) and serum neurofilament subunit L (NF-L) in patients with ALS and to analyze the correlations between the levels of NF-L and clinical parameters. CSF and serum samples were obtained from 80 ALS patients and 40 controls. The levels of NF-L in CSF and serum were assessed, and disease progression parameters including duration, revised ALS Functional Rating Scale (ALSFRS-r) score, disease progression rate (DPR), upper motor neuron (UMN) score, and survival were analyzed by registered neurologists. All samples were measured using a commercial enzyme-linked immunosorbent assay. Statistical analyses were performed using Prism software. Compared to the controls, the ALS patients displayed significantly increased levels of NF-L; these values were negatively correlated with the ALSFRS-r score and positively correlated with the decrease in ALSFRS-r score, DPR, and UMN score. There was no correlation between levels of NF-L and duration. In addition, the cumulative survival rate in ALS patients with a low level of NF-L was higher than in patients with a high level of NF-L. NF-L levels increased in CSF and serum of patients with ALS. NF-L may thus be a neurodegenerative biomarker for predicting ALS severity and progression, and the survival of patients with this disease. © 2018 S. Karger AG, Basel.

The level and nature of autistic intelligence II: what about Asperger syndrome?

PubMed

Soulières, Isabelle; Dawson, Michelle; Gernsbacher, Morton Ann; Mottron, Laurent

2011-01-01

A distinctively uneven profile of intelligence is a feature of the autistic spectrum. Within the spectrum, Asperger individuals differ from autistics in their early speech development and in being less likely to be characterized by visuospatial peaks. While different specific strengths characterize different autistic spectrum subgroups, all such peaks of ability have been interpreted as deficits: isolated, aberrant, and irreconcilable with real human intelligence. This view has recently been challenged by findings of autistic strengths in performance on Raven's Progressive Matrices (RPM), an important marker of general and fluid intelligence. We investigated whether these findings extend to Asperger syndrome, an autistic spectrum subgroup characterized by verbal peaks of ability, and whether the cognitive mechanisms underlying autistic and Asperger RPM performance differ. Thirty-two Asperger adults displayed a significant advantage on RPM over Wechsler Full-Scale and Performance scores relative to their typical controls, while in 25 Asperger children an RPM advantage was found over Wechsler Performance scores only. As previously found with autistics, Asperger children and adults achieved RPM scores at a level reflecting their Wechsler peaks of ability. Therefore, strengths in RPM performance span the autistic spectrum and imply a common mechanism advantageously applied to different facets of cognition. Autistic spectrum intelligence is atypical, but also genuine, general, and underestimated.

The Level and Nature of Autistic Intelligence II: What about Asperger Syndrome?

PubMed Central

Soulières, Isabelle; Dawson, Michelle; Gernsbacher, Morton Ann; Mottron, Laurent

2011-01-01

A distinctively uneven profile of intelligence is a feature of the autistic spectrum. Within the spectrum, Asperger individuals differ from autistics in their early speech development and in being less likely to be characterized by visuospatial peaks. While different specific strengths characterize different autistic spectrum subgroups, all such peaks of ability have been interpreted as deficits: isolated, aberrant, and irreconcilable with real human intelligence. This view has recently been challenged by findings of autistic strengths in performance on Raven's Progressive Matrices (RPM), an important marker of general and fluid intelligence. We investigated whether these findings extend to Asperger syndrome, an autistic spectrum subgroup characterized by verbal peaks of ability, and whether the cognitive mechanisms underlying autistic and Asperger RPM performance differ. Thirty-two Asperger adults displayed a significant advantage on RPM over Wechsler Full-Scale and Performance scores relative to their typical controls, while in 25 Asperger children an RPM advantage was found over Wechsler Performance scores only. As previously found with autistics, Asperger children and adults achieved RPM scores at a level reflecting their Wechsler peaks of ability. Therefore, strengths in RPM performance span the autistic spectrum and imply a common mechanism advantageously applied to different facets of cognition. Autistic spectrum intelligence is atypical, but also genuine, general, and underestimated. PMID:21991394

Massive Transfusion: The Revised Assessment of Bleeding and Transfusion (RABT) Score.

PubMed

Joseph, Bellal; Khan, Muhammad; Truitt, Michael; Jehan, Faisal; Kulvatunyou, Narong; Azim, Asad; Jain, Arpana; Zeeshan, Muhammad; Tang, Andrew; O'Keeffe, Terence

2018-05-21

Massive transfusion (MT) is a lifesaving treatment for trauma patients with hemorrhagic shock, assessed by Assessment of Blood Consumption (ABC) Score based on mechanism of injury, systolic blood pressure (SBP), tachycardia, and FAST exam. The aim of this study was to assess the performance of ABC score by replacing hypotension and tachycardia; with Shock Index (SI) > 1.0 and including pelvic fractures. We performed a 2-year (2014-2015) analysis of all high-level trauma activations and excluded patients dead on arrival. The ABC score was calculated using the 4-point score [blunt (0)/penetrating trauma (1), HR ≥ 120 (1), SBP ≤ 90 mmHg (1), and FAST positive (1)]. The Revised Assessment of Bleeding and Transfusion (RABT) score also included 4 points, calculated by replacing HR and SBP with SI > 1.0 and including pelvic fracture. AUROC compared performances of the two scores. A total of 380 patients were included. The overall MT was 27%. Patients receiving MT had higher median ABC scores [1.1 (0-2) vs. 1 (0-2), p = 0.15] and RABT scores [2 (1-3) vs. 1 (0-2), p < 0.001]. The RABT score had better discriminative power (AUROC = 0.828) compared to ABC score (AUROC = 0.617) for predicting the need for MT. Cutoff of RABT score ≥ 2 had a sensitivity of 84% and specificity of 77% for predicting need for MT compared to ABC score with 39% sensitivity and 72% specificity. Replacement of hypotension and tachycardia with a SI > 1.0 and inclusion of pelvic fracture enhanced discrimination of ABC score for predicting the need for MT. The current ABC score would benefit from revision to more appropriately identify patients requiring MT.

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.

Relationship between meaningful work and job performance in nurses.

PubMed

Tong, Ling

2018-04-01

The present study was designed to determine the relationship between meaningful work and job performance, and the impact of meaningful work on nursing care quality. Meaningful work has been suggested as a significant factor affecting job performance, but the relationship has never been studied in nurses in China. A descriptive correlational study was designed to assess the level of meaningful work, tasks, and contextual performance as well as their relationships. We used a stratified random-sampling approach to enrol nurses from hospitals. Multivariate regression analysis was applied to determine the relationship between meaningful work and their demographic data. There were significant, positive relationships between meaningful work and task performance and contextual performance. Education level, work unit, and employment type influenced meaningful work. The work motivation score of the nurses was lower than that of the other 2 dimensions, and a negative work motivation score negatively influenced job performance. Improving meaningful work and providing more support and assistance could improve nurse performance, thereby improving the quality of nursing care. © 2018 John Wiley & Sons Australia, Ltd.

Rorschach cognitive developmental indices of mentally retarded persons: a comparison with scores on Wechsler Intelligence Scale for children-revised.

PubMed

Di Nuovo, S F; Colucci, G; Pellicciotta, A; Buono, S

1997-08-01

In a sample of 55 mentally retarded subjects (M age = 14 yr., 1 mo.) the relations between some perceptual and cognitive Rorschach indices, including the Becker's Genetic Level Score, and Wechsler Scale scores were studied. The mean Developmental Score did not increase across ages and was higher for girls than for boys, while Verbal and Performance IQs were lower for girls. The correlations confirm the hypothesis that for mentally retarded persons WISC-R scaled scores and Rorschach cognitive indices are different measures of intellective functioning. The findings are discussed with reference to the assessment and rehabilitation of retarded subjects.

Exploring the role of task performance and learning style on prefrontal hemodynamics during a working memory task.

PubMed

Anderson, Afrouz A; Parsa, Kian; Geiger, Sydney; Zaragoza, Rachel; Kermanian, Riley; Miguel, Helga; Dashtestani, Hadis; Chowdhry, Fatima A; Smith, Elizabeth; Aram, Siamak; Gandjbakhche, Amir H

2018-01-01

Existing literature outlines the quality and location of activation in the prefrontal cortex (PFC) during working memory (WM) tasks. However, the effects of individual differences on the underlying neural process of WM tasks are still unclear. In this functional near infrared spectroscopy study, we administered a visual and auditory n-back task to examine activation in the PFC while considering the influences of task performance, and preferred learning strategy (VARK score). While controlling for age, results indicated that high performance (HP) subjects (accuracy > 90%) showed task dependent lower activation compared to normal performance subjects in PFC region Specifically HP groups showed lower activation in left dorsolateral PFC (DLPFC) region during performance of auditory task whereas during visual task they showed lower activation in the right DLPFC. After accounting for learning style, we found a correlation between visual and aural VARK score and level of activation in the PFC. Subjects with higher visual VARK scores displayed lower activation during auditory task in left DLPFC, while those with higher visual scores exhibited higher activation during visual task in bilateral DLPFC. During performance of auditory task, HP subjects had higher visual VARK scores compared to NP subjects indicating an effect of learning style on the task performance and activation. The results of this study show that learning style and task performance can influence PFC activation, with applications toward neurological implications of learning style and populations with deficits in auditory or visual processing.

Exploring the role of task performance and learning style on prefrontal hemodynamics during a working memory task

PubMed Central

Anderson, Afrouz A.; Parsa, Kian; Geiger, Sydney; Zaragoza, Rachel; Kermanian, Riley; Miguel, Helga; Chowdhry, Fatima A.; Smith, Elizabeth; Aram, Siamak; Gandjbakhche, Amir H.

2018-01-01

Existing literature outlines the quality and location of activation in the prefrontal cortex (PFC) during working memory (WM) tasks. However, the effects of individual differences on the underlying neural process of WM tasks are still unclear. In this functional near infrared spectroscopy study, we administered a visual and auditory n-back task to examine activation in the PFC while considering the influences of task performance, and preferred learning strategy (VARK score). While controlling for age, results indicated that high performance (HP) subjects (accuracy > 90%) showed task dependent lower activation compared to normal performance subjects in PFC region Specifically HP groups showed lower activation in left dorsolateral PFC (DLPFC) region during performance of auditory task whereas during visual task they showed lower activation in the right DLPFC. After accounting for learning style, we found a correlation between visual and aural VARK score and level of activation in the PFC. Subjects with higher visual VARK scores displayed lower activation during auditory task in left DLPFC, while those with higher visual scores exhibited higher activation during visual task in bilateral DLPFC. During performance of auditory task, HP subjects had higher visual VARK scores compared to NP subjects indicating an effect of learning style on the task performance and activation. The results of this study show that learning style and task performance can influence PFC activation, with applications toward neurological implications of learning style and populations with deficits in auditory or visual processing. PMID:29870536

[Influence of education level on self-evaluation and control of patients with bronchial asthma].

PubMed

Zhao, Hai-jin; Cai, Shao-xi; Tong, Wan-cheng; Li, Wen-jun; Fu, Liang

2008-05-01

To investigate the effect of education on self-evaluation and control level in patients with bronchial asthma. Seventy-five asthmatic patients with the initial diagnosis in line with the American Thoracic Society criteria, including 46 with junior high school education or below (group A) and 29 with senior high school education or above (group B), were asked to complete a survey to assess their symptoms and asthma attacks. Asthma control test (ACT) and peak expiratory flow rate (PEFR) evaluation were performed 8, 12 and 24 weeks after salmeterol/fluticasone therapy. Step-down treatment was administered according to GINA guidelines. The self-evaluation of the patients was assessed according to ACT score, physical signs and pulmonary function. An ACT score over 19 indicate well controlled condition. The effect of education on the self-evaluation and control level of bronchial asthma was assessed. The two groups had similar basal level of pulmonary function (FEV1). Eight weeks after the therapy, 29 patients in group A had ACT score over 19, including 11 with high control level; in group B, 17 had ACT score over 19, of whom 4 showed high control level. There was no significant difference between the two groups in control levels and self-evaluation (P>0.05). At 12 weeks, 37 patients in group A had ACT score over 19, with 17 having high control level; 22 patients in group B had ACT score over 19, 4 showing high control level; the two groups were similar in the control levels (P>0.05) but showed significant difference in self-evaluation (P<0.05). At the time of 24 weeks, 42 and 26 patients had ACT score over 19 in the two groups, with 19 and 5 having high control level, respectively. The two groups differed significantly in the control levels (P<0.05) and self-evaluation (P<0.05). The patients' education level may play a role in self-evaluation and control level of bronchial asthma, but its impact differs in the course of the treatment.

Does the "office nurse" level of training matter in the family medicine office?

PubMed

Erickson, Rodney A; Erickson, Richard A; Targonski, Paul V; Cox, Stephen B; Deming, James R; Mold, James W

2012-01-01

The "office nurse" or clinical associate (registered nurse [RN], licensed practical nurse[LPN], or medical assistant [MA]) is a key member of the family medicine care team, but little is known about the influence of their level of training on team performance. The performance of the clinical dyad (clinician and associate) was studied in relation to the level of training of the nurse. The dyad's performance was measured by the performance indicators of diabetes scores, patient satisfaction, and productivity. Dyads with a RN scored higher in meeting all 5 of the diabetes quality indicators (27.8%) than those with a LPN (19.3%) or an MA (14.7%). For patient satisfaction, the RN dyads also scored higher than the other dyad groups (positive responses: RN, 96.8%; LPN, 95.5%; MA, 94.6%). Productivity was the same in all groups. Better diabetes performance was seen in those practices with fewer competing demands: nonrural versus rural (22.2% vs 15.1%, respectively), and those not doing obstetrics versus those doing obstetrics (20.3% vs 15.1%, respectively), and for physicians versus associate providers (18.8% vs 15.1%, respectively). Higher patient satisfaction was observed in those dyads who were nonrural verus rural (96.6 vs 94.1%), among those doing obstetrics (96.0% vs 94.9%), and in physicians verus associate providers (95.7% vs 93.2%). The number of years working with the same clinician was twice as high for RNs (6.63) and LPNs (6.57) than for MAs (3.29). A higher level of education of the clinical associate seems to confer skills that enhance the care team's management of chronic illness such as diabetes. This could potentially decrease the practice burden on other team members while facilitating the team's objectives in meeting quality indicators.

Same But Different: FIM Summary Scores May Mask Variability in Physical Functioning Profiles.

PubMed

Fisher, Steve R; Middleton, Addie; Graham, James E; Ottenbacher, Kenneth J

2018-02-08

To examine how similar summary scores of physical functioning using the FIM can represent different patient clinical profiles. Retrospective cohort study. Inpatient rehabilitation facilities. Medicare fee-for-service beneficiaries (N=765,441) discharged from inpatient rehabilitation. Not applicable. We used patients' scores on items of the FIM to quantify their level of independence on both self-care and mobility domains. We then identified patients as requiring "no physical assistance" at discharge from inpatient rehabilitation by using a rule and score-based approach. In those patients with FIM self-care and mobility summary scores suggesting no physical assistance needed, we found that physical assistance was in fact needed frequently in bathroom-related activities (eg, continence, toilet and tub transfers, hygiene, clothes management) and with stairs. It was not uncommon for actual performance to be lower than what may be suggested by a summary score of those domains. Further research is needed to create clinically meaningful descriptions of summary scores from combined performances on individual items of physical functioning. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

[The study of establishment of the " Chinese provincial Blindness prevention technical guidance group performance evaluation system"].

PubMed

Lu, L N; He, X G; Zhu, J F; Xu, X; Zhang, R; Hu, X; Zou, H D

2016-11-11

Objective: To establish an assessment system, including indexes and scoring methods, that can be used for performance evaluation of the provincial blindness prevention technical guidance group properly and effectively . Methods: The indexes and scoring methods were set based on the core content of The " National Plan of Prevention and Treatment of Blindness (2012-2015)" , the specific requirement and target of the World Health Organization (WHO) "For the General Eye Health: Global plan of Action (2014-2019)" , and the current situation of the China's provinces and autonomous regions. These indexes should be of effectiveness, feasibility, comparability, guidance and advancing. Formed by a literature review of candidate indicators, the framework of the system is built by qualitative assessment. With the Delphi method, the system was further revised and improved. Empirical pilot study was then used to prove the feasibility, followed by the final qualitative analysis that establish the " Chinese provincial Blindness prevention technical guidance group performance evaluation system" . Results: Through the literature review and qualitative assessment, a six dimensional system framework was built, including 6 first-level indicators, 16 second-level indicators, and 29 third-level indicators through Delphi method evaluation. With the variation coefficient method, the coeffiences of the first-level index weight were calculated as: Organization and management 0.15, Development and implementation of blindness prevention plans 0.15, Implementation of blindness prevention projects 0.14, Training 0.17, Health education 0.18, and Cooperation and exchanges 0.21. The specific scoring method for this system is confirmed as: data and files check, field interview, and record interview, sampling investigation. Empirical pilot study was conducted in the Jilin, Guizhou and Gansu provinces, and the self-assessment results from local experts were consistent with the scores from the systems. Conclusion: This system established is appropriate at current time, and it can effectively evaluate the performance of the Chinese provincial Blindness prevention technical guidance group. (Chin J Ophthalmol, 2016, 52:814-824) .

Procedure-specific assessment tool for flexible pharyngo-laryngoscopy: gathering validity evidence and setting pass-fail standards.

PubMed

Melchiors, Jacob; Petersen, K; Todsen, T; Bohr, A; Konge, Lars; von Buchwald, Christian

2018-06-01

The attainment of specific identifiable competencies is the primary measure of progress in the modern medical education system. The system, therefore, requires a method for accurately assessing competence to be feasible. Evidence of validity needs to be gathered before an assessment tool can be implemented in the training and assessment of physicians. This evidence of validity must according to the contemporary theory on validity be gathered from specific sources in a structured and rigorous manner. The flexible pharyngo-laryngoscopy (FPL) is central to the otorhinolaryngologist. We aim to evaluate the flexible pharyngo-laryngoscopy assessment tool (FLEXPAT) created in a previous study and to establish a pass-fail level for proficiency. Eighteen physicians with different levels of experience (novices, intermediates, and experienced) were recruited to the study. Each performed an FPL on two patients. These procedures were video recorded, blinded, and assessed by two specialists. The score was expressed as the percentage of a possible max score. Cronbach's α was used to analyze internal consistency of the data, and a generalizability analysis was performed. The scores of the three different groups were explored, and a pass-fail level was determined using the contrasting groups' standard setting method. Internal consistency was strong with a Cronbach's α of 0.86. We found a generalizability coefficient of 0.72 sufficient for moderate stakes assessment. We found a significant difference between the novice and experienced groups (p < 0.001) and strong correlation between experience and score (Pearson's r = 0.75). The pass/fail level was established at 72% of the maximum score. Applying this pass-fail level in the test population resulted in half of the intermediary group receiving a failing score. We gathered validity evidence for the FLEXPAT according to the contemporary framework as described by Messick. Our results support a claim of validity and are comparable to other studies exploring clinical assessment tools. The high rate of physicians underperforming in the intermediary group demonstrates the need for continued educational intervention. Based on our work, we recommend the use of the FLEXPAT in clinical assessment of FPL and the application of a pass-fail level of 72% for proficiency.

Using Concurrent Verbalization to Measure Math Comprehension

ERIC Educational Resources Information Center

Lambeth, Cathryn Colley

2012-01-01

The current study investigated variability in student performance on a concurrent verbalization measure based on a grade-level sample math word problem and sought to determine to what extent the variability in verbalization scores is related to scores on a reliable measure of reading (DIBELS Next) and math (easyCBM) and to student factors (e.g.…

A Study of Factors Affecting Student Performance in Community College General Chemistry Courses.

ERIC Educational Resources Information Center

Sanchez, Karen; Betkouski, Marianne

High risk students in college chemistry are often identified by low mathematics SAT scores, low American Chemical Society Toledo scores, and secondary school chemistry grades. This study was designed to identify additional variables that can be used at the community college level as predictors of success in chemistry. The study compared students'…

External Validation of European System for Cardiac Operative Risk Evaluation II (EuroSCORE II) for Risk Prioritization in an Iranian Population

PubMed Central

Atashi, Alireza; Amini, Shahram; Tashnizi, Mohammad Abbasi; Moeinipour, Ali Asghar; Aazami, Mathias Hossain; Tohidnezhad, Fariba; Ghasemi, Erfan; Eslami, Saeid

2018-01-01

Introduction The European System for Cardiac Operative Risk Evaluation II (EuroSCORE II) is a prediction model which maps 18 predictors to a 30-day post-operative risk of death concentrating on accurate stratification of candidate patients for cardiac surgery. Objective The objective of this study was to determine the performance of the EuroSCORE II risk-analysis predictions among patients who underwent heart surgeries in one area of Iran. Methods A retrospective cohort study was conducted to collect the required variables for all consecutive patients who underwent heart surgeries at Emam Reza hospital, Northeast Iran between 2014 and 2015. Univariate and multivariate analysis were performed to identify covariates which significantly contribute to higher EuroSCORE II in our population. External validation was performed by comparing the real and expected mortality using area under the receiver operating characteristic curve (AUC) for discrimination assessment. Also, Brier Score and Hosmer-Lemeshow goodness-of-fit test were used to show the overall performance and calibration level, respectively. Results Two thousand five hundred eight one (59.6% males) were included. The observed mortality rate was 3.3%, but EuroSCORE II had a prediction of 4.7%. Although the overall performance was acceptable (Brier score=0.047), the model showed poor discriminatory power by AUC=0.667 (sensitivity=61.90, and specificity=66.24) and calibration (Hosmer-Lemeshow test, P<0.01). Conclusion Our study showed that the EuroSCORE II discrimination power is less than optimal for outcome prediction and less accurate for resource allocation programs. It highlights the need for recalibration of this risk stratification tool aiming to improve post cardiac surgery outcome predictions in Iran. PMID:29617500

Parent's confidence as a caregiver.

PubMed

Raines, Deborah A; Brustad, Judith

2012-06-01

The purpose of this study was to describe the parent's self-reported confidence as a caregiver. The specific research questions were as follows: • What is the parent's perceived level of confidence when performing infant caregiving activities in the neonatal intensive care unit (NICU)? • What is the parent's projected level of confidence about performing infant caregiving activities on the first day at home? Participants were parents of infants with an anticipated discharge date within 5 days. Inclusion criteria were as follows: parent at least 18 years of age, infant's discharge destination is home with the parent, parent will have primary responsibility for the infant after discharge, and the infant's length of stay in the NICU was a minimum of 10 days. Descriptive, survey research. Participants perceived themselves to be confident in all but 2 caregiving activities when caring for their infants in the NICU, but parents projected a change in their level of confidence in their ability to independently complete infant care activities at home. When comparing the self-reported level of confidence in the NICU and the projected level of confidence at home, the levels of confidence decreased for 5 items, increased for 8 items, and remained unchanged for 2 items. All of the items with a decrease in score were the items with the lowest score when performed in the NICU. All of these low-scoring items are caregiving activities that are unique to the post-NICU status of the infant. Interestingly, the parent's projected level of confidence increased for the 8 items focused on handling and interacting with the infant. The findings of this research provide evidence that nurses may need to rethink when parents become active participants in their infant's medical-based caregiving activities.

The relationship between temperamental traits and the level of performance of an eye-hand co-ordination task in jet pilots.

PubMed

Biernacki, Marcin; Tarnowski, Adam

2008-01-01

When assessing the psychological suitability for the profession of a pilot, it is important to consider personality traits and psychomotor abilities. Our study aimed at estimating the role of temperamental traits as components of pilots' personality in eye-hand co-ordination. The assumption was that differences in the escalation of the level of temperamental traits, as measured with the Formal Characteristic of Behaviour-Temperament Inventory (FCB-TI), will significantly influence eye-hand co-ordination. At the level of general scores, enhanced briskness proved to be the most important trait for eye-hand co-ordination. An analysis of partial scores additionally underlined the importance of sensory sensitivity, endurance and activity. The application of eye-hand co-ordination tasks, which involve energetic and temporal dimensions of performance, helped to disclose the role of biologically-based personality traits in psychomotor performance. The implication of these findings for selecting pilots is discussed.

Assessment of levels of otoacoustic emission response in neonates with perinatal asphyxia☆

PubMed Central

Ribeiro, Georgea Espindola; da Silva, Daniela Polo Camargo; Montovani, Jair Cortez

2014-01-01

Objective: To evaluate the effects of perinatal asphyxia on the level of the response to transient otoacoustic emissions in infants. Methods: Otoacoustic emissions in 154 neonates were performed: 54 infants who suffered asphyxia at birth, measured by Apgar score and medical diagnosis, and 100 infants without risk were compared. Scores less than 4 in the first minute and/or less than 6 in the fifth minute were considered as "low Apgar". Statistical analysis of the data was performed using the Kruskal, Wilcoxon, and Mann-Whitney nonparametric tests. Results: Lower levels of response were observed in transient otoacoustic emission in the group that suffered perinatal asphyxia, with significant values for the frequencies 2,000, 3,000, and 4,000 Hz in the right ear, and 2,000 and 4,000 Hz in the left ear. Conclusions: The analysis of the intrinsic characteristics of the otoacoustic emissions evidenced low performance of outer hair cells in neonates who had perinatal asphyxia, which may affect the development of listening skills in this population. PMID:25479848

Student performance on levels 1 and 2-CE of COMLEX-USA: do elective upper-level undergraduate science courses matter?

PubMed

Wong, Stanley K; Ramirez, Juan R; Helf, Scott C

2009-11-01

The effect of a variety of preadmission variables, including the number of elective preadmission upper-level science courses, on academic achievement is not well established. To investigate the relationship between number of preadmission variables and overall student academic achievement in osteopathic medical school. Academic records of osteopathic medical students in the 2008 and 2009 graduating classes of Western University of Health Sciences College of Osteopathic Medicine of the Pacific in Pomona, California, were analyzed. Multivariate linear regression analyses were performed to identify predictors of academic achievement based on Medical College Admission Test (MCAT) subscores, undergraduate grade point average (GPA), GPA in medical school basic science (preclinical GPA) and clinical clerkship (clinical GPA), and scores on the Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) Level 1 and Level 2-Cognitive Evaluation (CE). Records of 358 osteopathic medical students were evaluated. Analysis of beta coefficients suggested that undergraduate science GPA was the most important predictor of overall student academic achievement (P<.01). Biological sciences MCAT subscore was a more modest but still statistically significant predictor of preclinical GPA and COMLEX-USA Level 1 score (P<.01). Physical sciences MCAT subscore was also a statistically significant predictor of preclinical GPA, and verbal reasoning MCAT subscore was a statistically significant predictor of COMLEX-USA Level 2-CE score (both P<.01). Women had statistically significantly higher preclinical GPA and COMLEX-USA Level 2-CE scores than men (P<.05). Differences in some outcome variables were also associated with racial-ethnic background and age. Number of preadmission elective upper-level science courses taken by students before matriculation was not significantly correlated with any academic achievement variable. Although undergraduate science GPA and MCAT biological sciences subscore were significant predictors of overall academic achievement for osteopathic medical students, the number of elective upper-level science courses taken preadmission had no predictive value.

Mathematics-Related Emotions among Finnish Adolescents across Different Performance Levels

ERIC Educational Resources Information Center

Holm, Marja Eliisa; Hannula, Markku Sakari; Björn, Piia Maria

2017-01-01

This study examined the relation of mathematics performance and gender with seven mathematics-related emotions (enjoyment, pride, anger, anxiety, shame, hopelessness and boredom) among adolescents. Using strict and lenient mathematics performance cut-off scores, respective groups of adolescents with mathematics difficulties (MD, n = 136), low (LA,…

Comparing five depression measures in depressed Chinese patients using item response theory: an examination of item properties, measurement precision and score comparability.

PubMed

Zhao, Yue; Chan, Wai; Lo, Barbara Chuen Yee

2017-04-04

Item response theory (IRT) has been increasingly applied to patient-reported outcome (PRO) measures. The purpose of this study is to apply IRT to examine item properties (discrimination and severity of depressive symptoms), measurement precision and score comparability across five depression measures, which is the first study of its kind in the Chinese context. A clinical sample of 207 Hong Kong Chinese outpatients was recruited. Data analyses were performed including classical item analysis, IRT concurrent calibration and IRT true score equating. The IRT assumptions of unidimensionality and local independence were tested respectively using confirmatory factor analysis and chi-square statistics. The IRT linking assumptions of construct similarity, equity and subgroup invariance were also tested. The graded response model was applied to concurrently calibrate all five depression measures in a single IRT run, resulting in the item parameter estimates of these measures being placed onto a single common metric. IRT true score equating was implemented to perform the outcome score linking and construct score concordances so as to link scores from one measure to corresponding scores on another measure for direct comparability. Findings suggested that (a) symptoms on depressed mood, suicidality and feeling of worthlessness served as the strongest discriminating indicators, and symptoms concerning suicidality, changes in appetite, depressed mood, feeling of worthlessness and psychomotor agitation or retardation reflected high levels of severity in the clinical sample. (b) The five depression measures contributed to various degrees of measurement precision at varied levels of depression. (c) After outcome score linking was performed across the five measures, the cut-off scores led to either consistent or discrepant diagnoses for depression. The study provides additional evidence regarding the psychometric properties and clinical utility of the five depression measures, offers methodological contributions to the appropriate use of IRT in PRO measures, and helps elucidate cultural variation in depressive symptomatology. The approach of concurrently calibrating and linking multiple PRO measures can be applied to the assessment of PROs other than the depression context.

Improved score statistics for meta-analysis in single-variant and gene-level association studies.

PubMed

Yang, Jingjing; Chen, Sai; Abecasis, Gonçalo

2018-06-01

Meta-analysis is now an essential tool for genetic association studies, allowing them to combine large studies and greatly accelerating the pace of genetic discovery. Although the standard meta-analysis methods perform equivalently as the more cumbersome joint analysis under ideal settings, they result in substantial power loss under unbalanced settings with various case-control ratios. Here, we investigate the power loss problem by the standard meta-analysis methods for unbalanced studies, and further propose novel meta-analysis methods performing equivalently to the joint analysis under both balanced and unbalanced settings. We derive improved meta-score-statistics that can accurately approximate the joint-score-statistics with combined individual-level data, for both linear and logistic regression models, with and without covariates. In addition, we propose a novel approach to adjust for population stratification by correcting for known population structures through minor allele frequencies. In the simulated gene-level association studies under unbalanced settings, our method recovered up to 85% power loss caused by the standard methods. We further showed the power gain of our methods in gene-level tests with 26 unbalanced studies of age-related macular degeneration . In addition, we took the meta-analysis of three unbalanced studies of type 2 diabetes as an example to discuss the challenges of meta-analyzing multi-ethnic samples. In summary, our improved meta-score-statistics with corrections for population stratification can be used to construct both single-variant and gene-level association studies, providing a useful framework for ensuring well-powered, convenient, cross-study analyses. © 2018 WILEY PERIODICALS, INC.

Memory awareness profiles differentiate mild cognitive impairment from early-stage dementia: evidence from assessments of performance monitoring and evaluative judgement.

PubMed

Clare, Linda; Whitaker, Christopher J; Roberts, Judith L; Nelis, Sharon M; Martyr, Anthony; Marková, Ivana S; Roth, Ilona; Woods, Robert T; Morris, Robin G

2013-01-01

Measures of memory awareness based on evaluative judgement and performance monitoring are often regarded as equivalent, but the Levels of Awareness Framework suggests they reflect different awareness phenomena. Examination of memory awareness among groups with differing degrees of impairment provides a test of this proposition. Ninety-nine people with dementia (PwD), 30 people with mild cognitive impairment (PwMCI), and their relatives completed isomorphic performance monitoring and evaluative judgement measures of memory awareness and were followed up at 12 and (PwD only) 20 months. In addition to the resulting awareness indices, comparative accuracy scores were calculated using the relatives' data to establish whether any inaccuracy was specific to self-ratings. When making evaluative judgements about their memory in general, both PwD and PwMCI tended to overestimate their own functioning relative to informant ratings made by relatives. When monitoring performance on memory tests, PwD again overestimated performance relative to test scores, but PwMCI were much more accurate. Comparative accuracy scores indicated that, unlike PwD, PwMCI do not show a specific inaccuracy in self-related appraisals. The results support the proposition that awareness indices at the levels of evaluative judgement and performance monitoring should be regarded as reflecting distinct awareness phenomena. Copyright © 2013 S. Karger AG, Basel.

Simulation-Based Laparoscopic Surgery Crisis Resource Management Training-Predicting Technical and Nontechnical Skills.

PubMed

Goldenberg, Mitchell G; Fok, Kai H; Ordon, Michael; Pace, Kenneth T; Lee, Jason Y

2017-12-19

To develop a unique simulation-based assessment using a laparoscopic inferior vena cava (IVC) injury scenario that allows for the safe assessment of urology resident's technical and nontechnical skills, and investigate the effect of personality traits performance in a surgical crisis. Urology residents from our institution were recruited to participate in a simulation-based training laparoscopic nephrectomy exercise. Residents completed demographic and multidimensional personality questionnaires and were instructed to play the role of staff urologist. A vasovagal response to pneumoperitoneum and an IVC injury event were scripted into the scenario. Technical and nontechnical skills were assessed by expert laparoscopic surgeons using validated tools (task checklist, GOALS, and NOTSS). Ten junior and five senior urology residents participated. Five residents were unable to complete the exercise safely. Senior residents outperformed juniors on technical (checklist score 15.1 vs 9.9, p < 0.01, GOALS score 18.0 vs 13.3, p < 0.01) and nontechnical performance (NOTSS score 13.8 vs 10.1, p = 0.03). Technical performance scores correlated with NOTSS scores (p < 0.01) and pass/fail rating correlated with technical performance (p < 0.01 for both checklist and GOALS), NOTSS score (p = 0.02), and blood loss (p < 0.01). Only the conscientiousness dimension of the big five inventory correlated with technical score (p = 0.03) and pass/fail rating (p = 0.04). Resident level of training and laparoscopic experience correlated with technical performance during a simulation-based laparoscopic IVC injury crisis management scenario, as well as multiple domains of nontechnical performance. Personality traits of our surgical residents are similar and did not predict technical skill. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Impact of Personality Traits, Anxiety, Depression and Hopelessness Levels on Quality of Life in the Patients with Breast Cancer

PubMed Central

Sarsanov, Dauren; Erdogan, Zeynep İyigün; İlgün, Ahmet Serkan; Çelebi, Esra; Alço, Gül; Kocaman, Nazmiye; Ordu, Çetin; Öztürk, Alper; Duymaz, Tomris; Pilavcı, Kezban Nur; Elbüken, Filiz; Ağaçayak, Filiz; Aktepe, Fatma; Ünveren, Gizem; Özdem, Gözdem; Eralp, Yeşim; Özmen, Vahit

2018-01-01

Objective The aim of this study was to investigate the impacts of personality traits, anxiety, depression and hopelessness levels on quality of life in the patients with breast cancer. Materials and methods The study was performed on 90 patients diagnosed with breast cancer and 90 healthy women. Sociodemographic and Clinical Data Collection Form designed by us, Beck Hopelessness Scale (BHS), Beck Anxiety Scale (BAS), Beck Depression Scale (BDS), Eysenck Personality Inventory (EPI) and Quality of Life Scale–Short Form (SF-36) were administered to patients and to control group. Results The patients with breast cancer were found to indicate higher levels of anxiety and depression, lower levels of quality of life, and higher scores of personality inventory subscales as compared to the healthy control group. In the patient group, it was identified that the quality of life subscale scores were found to be negatively correlated with anxiety, depression, hopelessness and neurotic personality scores; there was a positive correlation between neurotic personality scores and depression, anxiety and hopelessness scores. Conclusions It can be concluded that the breast cancer patients with extraversion personality traits have lower levels of anxiety and depression, keeping their quality of life better, whereas the patients with higher neuroticism scores may have more impaired quality of life. Therefore, the psychiatric evaluation of the breast cancer patients during and after the treatment cannot be ruled out. PMID:29774319

Best practices for level-up patching operation.

DOT National Transportation Integrated Search

2012-12-01

Level-up patching is a common corrective maintenance activity in Texas performed by most districts. It involves laying down a thin asphalt mix layer over an existing pavement in areas of sagging or rutting to improve the ride score and reduce pavemen...

Confounding adjustment in comparative effectiveness research conducted within distributed research networks.

PubMed

Toh, Sengwee; Gagne, Joshua J; Rassen, Jeremy A; Fireman, Bruce H; Kulldorff, Martin; Brown, Jeffrey S

2013-08-01

A distributed research network (DRN) of electronic health care databases, in which data reside behind the firewall of each data partner, can support a wide range of comparative effectiveness research (CER) activities. An essential component of a fully functional DRN is the capability to perform robust statistical analyses to produce valid, actionable evidence without compromising patient privacy, data security, or proprietary interests. We describe the strengths and limitations of different confounding adjustment approaches that can be considered in observational CER studies conducted within DRNs, and the theoretical and practical issues to consider when selecting among them in various study settings. Several methods can be used to adjust for multiple confounders simultaneously, either as individual covariates or as confounder summary scores (eg, propensity scores and disease risk scores), including: (1) centralized analysis of patient-level data, (2) case-centered logistic regression of risk set data, (3) stratified or matched analysis of aggregated data, (4) distributed regression analysis, and (5) meta-analysis of site-specific effect estimates. These methods require different granularities of information be shared across sites and afford investigators different levels of analytic flexibility. DRNs are growing in use and sharing of highly detailed patient-level information is not always feasible in DRNs. Methods that incorporate confounder summary scores allow investigators to adjust for a large number of confounding factors without the need to transfer potentially identifiable information in DRNs. They have the potential to let investigators perform many analyses traditionally conducted through a centralized dataset with detailed patient-level information.

A comparison of educational strategies for the acquisition of nursing student's performance and critical thinking: simulation-based training vs. integrated training (simulation and critical thinking strategies).

PubMed

Zarifsanaiey, Nahid; Amini, Mitra; Saadat, Farideh

2016-11-16

There is a need to change the focus of nursing education from traditional teacher-centered training programs to student-centered active methods. The integration of the two active learning techniques will improve the effectiveness of training programs. The objective of this study is to compare the effects of the integrated training (simulation and critical thinking strategies) and simulation-based training on the performance level and critical thinking ability of nursing students. The present quasi-experimental study was performed in 2014 on 40 students who were studying practical nursing principles and skills course in the first half of the academic year in Shiraz University of Medical Sciences. Students were randomly divided into control (n = 20) and experimental (n = 20) groups. After training students through simulation and integrated education (simulation and critical thinking strategies), the students' critical thinking ability and performance were evaluated via the use of California Critical Thinking Ability Questionnaire B (CCTST) and Objective Structured Clinical Examination (OSCE) comprising 10 stations, respectively. The external reliability of the California Critical Thinking questionnaire was reported by Case B.to be between 0.78 and 0.80 and the validity of OSCE was approved by 5 members of the faculty. Furthermore, by using Split Half method (the correlation between odd and even stations), the reliability of the test was approved with correlation coefficient of 0.66. Data were analyzed using t-test and Mann-Whitney test. A significance level of 0.05 was considered to be statistically significant. The mean scores of the experimental group performance level were higher than the mean score of the control group performance level. This difference was statistically significant and students in the experimental group in OSCE stations had significantly higher performance than the control group (P <0.001). However, the mean scores obtained for the critical thinking did not increase before and after the intervention. The results showed that, the students' performance level was increased by the application of integrated training (simulation and critical thinking strategies).

Psychological impact on dispatched local lay rescuers performing bystander cardiopulmonary resuscitation.

PubMed

Zijlstra, Jolande A; Beesems, Stefanie G; De Haan, Rob J; Koster, Rudolph W

2015-07-01

We studied the short-term psychological impact and post-traumatic stress disorder (PTSD)-related symptoms in lay rescuers performing cardiopulmonary resuscitation (CPR) after a text message (TM)-alert for out-of-hospital-cardiac arrest, and assessed which factors contribute to a higher level of PTSD-related symptoms. The lay rescuers received a TM-alert and simultaneously an email with a link to an online questionnaire. We analyzed all questionnaires from February 2013 until October 2014 measuring the short-term psychological impact. We interviewed by telephone all first arriving lay rescuers performing bystander CPR and assessed PTSD-related symptoms with the Impact of Event Scale (IES) 4-6 weeks after the resuscitation. IES-scores 0-8 reflected no stress, 9-25 mild, 26-43 moderate, and 44-75 severe stress. A score ≥ 26 indicated PTSD symptomatology. Of all alerted lay rescuers, 6572 completed the online questionnaire. Of these, 1955 responded to the alert and 507 assisted in the resuscitation. We interviewed 203 first arriving rescuers of whom 189 completed the IES. Of these, 41% perceived no/mild short-term impact, 46% bearable impact and 13% severe impact. On the IES, 81% scored no stress and 19% scored mild stress. None scored moderate or severe stress. Using a multivariable logistic regression model we identified three factors with an independent impact on mild stress level: no automated external defibrillator connected by the lay rescuer, severe short-term impact, and no (very) positive experience. Lay rescuers alerted by text messages, do not show PTSD-related symptoms 4-6 weeks after performing bystander CPR, even if they perceive severe short-term psychological impact. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Longitudinal associations between physical activity and depression scores in Swedish women followed 32 years.

PubMed

Gudmundsson, P; Lindwall, M; Gustafson, D R; Östling, S; Hällström, T; Waern, M; Skoog, I

2015-12-01

Physical activity is negatively associated with depressive symptoms. However, few studies consider dynamic associations of changes in physical activity and reciprocal relationships. This study aimed to perform comprehensive evaluations of relationships between physical activity and depression scores in women followed from mid- to late life. The Prospective Population Study of Women in Gothenburg, Sweden, provided repeated measures of self-reported physical activity and depressive symptoms between 1974 and 2005 (baseline N = 676, 84.5% response rate). Depressive symptoms were assessed using the Montgomery-Åsberg Depression Rating Scale, and physical activity was evaluated by the Saltin-Grimby Physical Activity Level Scale. Latent growth curve analyses were used to evaluate associations of change, and cross-lagged models were used to study the reciprocal relationship between physical activity and depression scores. At baseline, lower levels of physical activity were related to higher depression scores. Individuals with decreasing physical activity over time evidenced higher depression scores at 32-year follow-up. Higher average baseline depression score was related to declining levels of physical activity at subsequent examinations. Reduced physical activity may be a long-term consequence of depression. It is important to address individual changes in physical activity and not merely absolute levels of physical activity in relationship to depression. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Agreement in the assessment of metastatic spine disease using scoring systems.

PubMed

Arana, Estanislao; Kovacs, Francisco M; Royuela, Ana; Asenjo, Beatriz; Pérez-Ramírez, Ursula; Zamora, Javier

2015-04-01

To assess variability in the use of Tomita and modified Bauer scores in spine metastases. Clinical data and imaging from 90 patients with biopsy-proven spinal metastases, were provided to 83 specialists from 44 hospitals. Spinal levels involved and the Tomita and modified Bauer scores for each case were determined twice by each clinician, with a minimum of 6-week interval. Clinicians were blinded to every evaluation. Kappa statistic was used to assess intra and inter-observer agreement. Subgroup analyses were performed according to clinicians' specialty (medical oncology, neurosurgery, radiology, orthopedic surgery and radiation oncology), years of experience (⩽7, 8-13, ⩾14), and type of hospital (four levels). For metastases identification, intra-observer agreement was "substantial" (0.600.80) at the other levels. Inter-observer agreement was "almost perfect" at lumbar spine, and "substantial" at the other levels. Intra-observer agreement for the Tomita and Bauer scores was almost perfect. Inter-observer agreement was almost perfect for the Tomita score and substantial for the Bauer one. Results were similar across specialties, years of experience and type of hospital. Agreement in the assessment of metastatic spine disease is high. These scoring systems can improve communication among clinicians involved in oncology care. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Correlation between safety climate and contractor safety assessment programs in construction

PubMed Central

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

2015-01-01

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

Validity and Reliability of Baseline Testing in a Standardized Environment.

PubMed

Higgins, Kathryn L; Caze, Todd; Maerlender, Arthur

2017-08-11

The Immediate Postconcussion Assessment and Cognitive Testing (ImPACT) is a computerized neuropsychological test battery commonly used to determine cognitive recovery from concussion based on comparing post-injury scores to baseline scores. This model is based on the premise that ImPACT baseline test scores are a valid and reliable measure of optimal cognitive function at baseline. Growing evidence suggests that this premise may not be accurate and a large contributor to invalid and unreliable baseline test scores may be the protocol and environment in which baseline tests are administered. This study examined the effects of a standardized environment and administration protocol on the reliability and performance validity of athletes' baseline test scores on ImPACT by comparing scores obtained in two different group-testing settings. Three hundred-sixty one Division 1 cohort-matched collegiate athletes' baseline data were assessed using a variety of indicators of potential performance invalidity; internal reliability was also examined. Thirty-one to thirty-nine percent of the baseline cases had at least one indicator of low performance validity, but there were no significant differences in validity indicators based on environment in which the testing was conducted. Internal consistency reliability scores were in the acceptable to good range, with no significant differences between administration conditions. These results suggest that athletes may be reliably performing at levels lower than their best effort would produce. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The effect of routine hoof trimming on locomotion score, ruminating time, activity, and milk yield of dairy cows.

PubMed

Van Hertem, T; Parmet, Y; Steensels, M; Maltz, E; Antler, A; Schlageter-Tello, A A; Lokhorst, C; Romanini, C E B; Viazzi, S; Bahr, C; Berckmans, D; Halachmi, I

2014-01-01

The objective of this study was to quantify the effect of hoof trimming on cow behavior (ruminating time, activity, and locomotion score) and performance (milk yield) over time. Data were gathered from a commercial dairy farm in Israel where routine hoof trimming is done by a trained hoof trimmer twice per year on the entire herd. In total, 288 cows spread over 6 groups with varying production levels were used for the analysis. Cow behavior was measured continuously with a commercial neck activity logger and a ruminating time logger (HR-Tag, SCR Engineers Ltd., Netanya, Israel). Milk yield was recorded during each milking session with a commercial milk flow sensor (Free Flow, SCR Engineers Ltd.). A trained observer assigned on the spot 5-point locomotion scores during 19 nighttime milking occasions between 22 October 2012 and 4 February 2013. Behavioral and performance data were gathered from 1wk before hoof trimming until 1wk after hoof trimming. A generalized linear mixed model was used to statistically test all main and interactive effects of hoof trimming, parity, lactation stage, and hoof lesion presence on ruminating time, neck activity, milk yield, and locomotion score. The results on locomotion scores show that the proportional distribution of cows in the different locomotion score classes changes significantly after trimming. The proportion of cows with a locomotion score ≥3 increases from 14% before to 34% directly after the hoof trimming. Two months after the trimming, the number of cows with a locomotion score ≥3 reduced to 20%, which was still higher than the baseline values 2wk before the trimming. The neck activity level was significantly reduced 1d after trimming (380±6 bits/d) compared with before trimming (389±6 bits/d). Each one-unit increase in locomotion score reduced cow activity level by 4.488 bits/d. The effect of hoof trimming on ruminating time was affected by an interaction effect with parity. The effect of hoof trimming on locomotion scores was affected by an interaction effect with lactation stage and tended to be affected by interaction effects with hoof lesion presence, indicating that cows with a lesion reacted different to the trimming than cows without a lesion did. The results show that the routine hoof trimming affected dairy cow behavior and performance in this farm. Copyright © 2014 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

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

NASA Astrophysics Data System (ADS)

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

2008-03-01

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

Quality dependent fusion of intramodal and multimodal biometric experts

NASA Astrophysics Data System (ADS)

Kittler, J.; Poh, N.; Fatukasi, O.; Messer, K.; Kryszczuk, K.; Richiardi, J.; Drygajlo, A.

2007-04-01

We address the problem of score level fusion of intramodal and multimodal experts in the context of biometric identity verification. We investigate the merits of confidence based weighting of component experts. In contrast to the conventional approach where confidence values are derived from scores, we use instead raw measures of biometric data quality to control the influence of each expert on the final fused score. We show that quality based fusion gives better performance than quality free fusion. The use of quality weighted scores as features in the definition of the fusion functions leads to further improvements. We demonstrate that the achievable performance gain is also affected by the choice of fusion architecture. The evaluation of the proposed methodology involves 6 face and one speech verification experts. It is carried out on the XM2VTS data base.

Relationship Between Cognitive Assessment and Balance Measures in Adolescents Referred for Vestibular Physical Therapy After Concussion

PubMed Central

Alsalaheen, Bara A.; Whitney, Susan L.; Marchetti, Gregory F.; Furman, Joseph M.; Kontos, Anthony P.; Collins, Michael W.; Sparto, Patrick J.

2016-01-01

Objective To examine the relationship between cognitive and balance performance in adolescents with concussion. Design Retrospective case series. Setting Tertiary. Patients Sixty patients. Interventions Correlation analyses were performed to describe the relationship between symptoms, cognitive measure, and balance measure at the time of initiation of vestibular physical therapy. Main Outcome Measures Cognitive performance was assessed using the Immediate Post-concussion Assessment and Cognitive Testing (ImPACT). The dizziness and balance function measures included dizziness severity rating, Activities-specific Balance Confidence scale (ABC), Dizziness Handicap Inventory (DHI), Functional Gait Assessment, gait speed, Timed “UP and GO,” Five Times Sit to Stand, and Sensory Organization Test (SOT). To account for multiple comparisons, the False Discovery Rate method was used. Results Performance measures of balance were significantly correlated with cognitive measures. Greater total symptom scores were related to greater impairment in the ABC and DHI (r = 0.35-0.39, P ≤ 0.008) and worse performance in condition 2 of the SOT (r = −0.48, P = 0.004). Among the ImPACT composite scores, lower memory scores were correlated with impaired balance performance measures (r = 0.37-0.59, P ≤ 0.012). Lower visual memory was also correlated with worse ABC scores. Conclusions The significant relationships reported between the cognitive performance scores and balance measures may reflect that similar levels of functioning exist across domains in individuals with protracted recovery who receive vestibular physical therapy. PMID:25706663

Associating Physical Activity Levels with Motor Performance and Physical Function in Childhood Survivors of Acute Lymphoblastic Leukemia.

PubMed

Hung, Stanley H; Rankin, Anne; Virji-Babul, Naznin; Pritchard, Sheila; Fryer, Christopher; Campbell, Kristin L

2017-01-01

Purpose: This cross-sectional, observational study investigated whether physical activity (PA) levels are associated with motor performance and physical function in children after treatment for acute lymphoblastic leukemia (ALL). Method: Participants aged 8-13 years who had completed treatment for ALL (3-36 months post-treatment) were tested at their oncology long-term follow-up appointment at the British Columbia Children's Hospital. PA level was measured using the Physical Activity Questionnaire for Older Children (PAQ-C). Motor performance was measured using the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition, Short Form (BOT-2 SF), and physical function was measured using the 6-minute walk test (6MWT). Results: Thirteen children completed testing. PAQ-C scores were not associated with BOT-2 SF or 6MWT performance. Eleven children (85%) performed below the norm for the 6MWT. Children with elevated body mass index had poorer 6MWT but similar PAQ-C scores. Conclusion: PA was not found to be associated with motor performance and physical function. Participants who were overweight or obese had poorer 6MWT performance, which may indicate the need for closer monitoring of post-treatment weight status and physical function in the oncology follow-up setting.

Associating Physical Activity Levels with Motor Performance and Physical Function in Childhood Survivors of Acute Lymphoblastic Leukemia

PubMed Central

Hung, Stanley H.; Rankin, Anne; Virji-Babul, Naznin; Pritchard, Sheila; Fryer, Christopher

2017-01-01

Purpose: This cross-sectional, observational study investigated whether physical activity (PA) levels are associated with motor performance and physical function in children after treatment for acute lymphoblastic leukemia (ALL). Method: Participants aged 8–13 years who had completed treatment for ALL (3–36 months post-treatment) were tested at their oncology long-term follow-up appointment at the British Columbia Children's Hospital. PA level was measured using the Physical Activity Questionnaire for Older Children (PAQ-C). Motor performance was measured using the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition, Short Form (BOT-2 SF), and physical function was measured using the 6-minute walk test (6MWT). Results: Thirteen children completed testing. PAQ-C scores were not associated with BOT-2 SF or 6MWT performance. Eleven children (85%) performed below the norm for the 6MWT. Children with elevated body mass index had poorer 6MWT but similar PAQ-C scores. Conclusion: PA was not found to be associated with motor performance and physical function. Participants who were overweight or obese had poorer 6MWT performance, which may indicate the need for closer monitoring of post-treatment weight status and physical function in the oncology follow-up setting. PMID:28154445

Corpus and Method for Identifying Citations in Non-Academic Text (Open Access, Publisher’s Version)

DTIC Science & Technology

2014-05-31

patents, train a CRF classifier to find new citations, and apply a reranker to incorporate non-local information. Our best system achieves 0.83 F -score on...report precision, recall, and F -scores on chunk level. CRF training and decoding is performed with the CRF++ package7 using its default setting. 5.1...only obtain a very small number of training examples for statistical rerankers. 7http://crfpp.sourceforge.net Precision Recall F -score TEXT 0.7997 0.7805

Age and Expertise Effects in Aviation Decision Making and Flight Control in a Flight Simulator

PubMed Central

Kennedy, Quinn; Taylor, Joy L.; Reade, Gordon; Yesavage, Jerome A.

2010-01-01

Introduction Age (due to declines in cognitive abilities necessary for navigation) and level of aviation expertise are two factors that may affect aviation performance and decision making under adverse weather conditions. We examined the roles of age, expertise, and their relationship on aviation decision making and flight control performance during a flight simulator task. Methods Seventy-two IFR-rated general aviators, aged 19–79 yr, made multiple approach, holding pattern entry, and landing decisions while navigating under Instrument Flight Rules weather conditions. Over three trials in which the fog level varied, subjects decided whether or not to land the aircraft. They also completed two holding pattern entries. Subjects’ flight control during approaches and holding patterns was measured. Results Older pilots (41+ yr) were more likely than younger pilots to land when visibility was inadequate (older pilots’ mean false alarm rate: 0.44 vs 0.25). They also showed less precise flight control for components of the approach, performing 0.16 SD below mean approach scores. Expertise attenuated an age-related decline in flight control during holding patterns: older IFR/CFI performed 0.73 SD below mean score; younger IFR/CFI, younger CFII/ATP, older CFII/ATP: 0.32, 0.26, 0.03 SD above mean score. Additionally, pilots with faster processing speed (by median split) had a higher mean landing decision false alarm rate (0.42 vs 0.28), yet performed 0.14 SD above the mean approach control score. Conclusions Results have implications regarding specialized training for older pilots and for understanding processes involved in older adults’ real world decision making and performance. PMID:20464816

Organizational Leadership and Adaptive Reserve in Blood Pressure Control: The Heart Health NOW Study.

PubMed

Henderson, Kamal H; DeWalt, Darren A; Halladay, Jacquie; Weiner, Bryan J; Kim, Jung I; Fine, Jason; Cykert, Samuel

2018-04-01

Our purpose was to assess whether a practice's adaptive reserve and high leadership capability in quality improvement are associated with population blood pressure control. We divided practices into quartiles of blood pressure control performance and considered the top quartile as the benchmark for comparison. Using abstracted clinical data from electronic health records, we performed a cross-sectional study to assess the association of top quartile hypertension control and (1) the baseline practice adaptive reserve (PAR) scores and (2) baseline practice leadership scores, using modified Poisson regression models adjusting for practice-level characteristics. Among 181 practices, 46 were in the top quartile, which averaged 68% or better blood pressure control. Practices with higher PAR scores compared with lower PAR scores were not more likely to reside in the top quartile of performance (prevalence ratio [PR] = 1.92 for highest quartile; 95% CI, 0.9-4.1). Similarly, high quality improvement leadership capability compared with lower capability did not predict better blood pressure control performance (PR = 0.94; 95% CI, 0.57-1.56). Practices with higher proportions of commercially insured patients were more likely than practices with lower proportions of commercially insured patients to have top quartile performance (37% vs 26%, P =.002), whereas lower proportions of the uninsured (8% vs 14%, P =.055) were associated with better performance. Our findings show that adaptive reserve and leadership capability in quality improvement implementation are not statistically associated with achieving top quartile practice-level hypertension control at baseline in the Heart Health NOW project. Our findings, however, may be limited by a lack of patient-related factors and small sample size to preclude strong conclusions. © 2018 Annals of Family Medicine, Inc.

Sustainability of quality improvement following removal of pay-for-performance incentives.

PubMed

Benzer, Justin K; Young, Gary J; Burgess, James F; Baker, Errol; Mohr, David C; Charns, Martin P; Kaboli, Peter J

2014-01-01

Although pay-for-performance (P4P) has become a central strategy for improving quality in US healthcare, questions persist about the effectiveness of these programs. A key question is whether quality improvement that occurs as a result of P4P programs is sustainable, particularly if incentives are removed. To investigate sustainability of performance levels following removal of performance-based incentives. Observational cohort study that capitalized on a P4P program within the Veterans Health Administration (VA) that included adoption and subsequent removal of performance-based incentives for selected inpatient quality measures. The study sample comprised 128 acute care VA hospitals where performance was assessed between 2004 and 2010. VA system managers set annual performance goals in consultation with clinical leaders, and report performance scores to medical centers on a quarterly basis. These scores inform performance-based incentives for facilities and their managers. Bonuses are distributed based on the attainment of these performance goals. Seven quality of care measures for acute coronary syndrome, heart failure, and pneumonia linked to performance-based incentives. Significant improvements in performance were observed for six of seven quality of care measures following adoption of performance-based incentives and were maintained up to the removal of the incentive; subsequently, the observed performance levels were sustained. This is a quasi-experimental study without a comparison group; causal conclusions are limited. The maintenance of performance levels after removal of a performance-based incentive has implications for the implementation of Medicare's value-based purchasing initiative and other P4P programs. Additional research is needed to better understand human and system-level factors that mediate sustainability of performance-based incentives.

Application of Physiological Self-Regulation and Adaptive Task Allocation Techniques for Controlling Operator Hazardous States of Awareness

NASA Technical Reports Server (NTRS)

Prinzel, Lawrence J., III; Pope, Alan T.; Freeman, Frederick G.

2001-01-01

Prinzel, Hadley, Freeman, and Mikulka found that adaptive task allocation significantly enhanced performance only when used at the endpoints of the task workload continuum (i.e., very low or high workload), but that the technique degraded performance if invoked during other levels of task demand. These researchers suggested that other techniques should be used in conjunction with adaptive automation to help minimize the onset of hazardous states of awareness (HSA) and keep the operator 'in-the-loop.' The paper reports on such a technique that uses psychophysiological self-regulation to modulate the level of task engagement. Eighteen participants were assigned to three groups (self-regulation, false feedback, and control) and performed a compensatory tracking task that was cycled between three levels of task difficulty on the basis of the electroencephalogram (EEG) record. Those participants who had received self-regulation training performed significantly better and reported lower NASA-TLX scores than participants in the false feedback and control groups. Furthermore, the false feedback and control groups had significantly more task allocations resulting in return-to-manual performance decrements and higher EEG difference scores. Theoretical and practical implications of these results for adaptive automation are discussed.

Label reading, numeracy and Food&Nutrition involvement.

PubMed

Mulders, Maria Dgh; Corneille, O; Klein, O

2018-06-07

The purpose of this study was to investigate objective performance on a nutrition label comprehension task, and the influence of numeracy and food-related involvement on this performance level. A pilot study (n = 45) was run to prepare the scales in French. For the main study (n = 101), participants provided demographic information and answered the nutrition label survey, the short numeracy scale and two different food-related involvement scales (i.e. the food involvement scale and the nutrition involvement scale). Both studies were conducted online, and consent was obtained from all participants. Participants answered correctly only two-thirds of the nutrition label task items. Numeracy and food involvement scores were positively correlated with performance on this task. Finally, food involvement interacted with numeracy. Specifically, people scoring low in numeracy performed generally more poorly on the task, but if they had high food involvement scores, their performance increased. This suggests that high food-related motivation may compensate for poor numeracy skills when dealing with nutrition labels. Copyright © 2018. Published by Elsevier Ltd.

Pharmacy Students' Test-Taking Motivation-Effort on a Low-Stakes Standardized Test

PubMed Central

2011-01-01

Objective To measure third-year pharmacy students' level of motivation while completing the Pharmacy Curriculum Outcomes Assessment (PCOA) administered as a low-stakes test to better understand use of the PCOA as a measure of student content knowledge. Methods Student motivation was manipulated through an incentive (ie, personal letter from the dean) and a process of statistical motivation filtering. Data were analyzed to determine any differences between the experimental and control groups in PCOA test performance, motivation to perform well, and test performance after filtering for low motivation-effort. Results Incentivizing students diminished the need for filtering PCOA scores for low effort. Where filtering was used, performance scores improved, providing a more realistic measure of aggregate student performance. Conclusions To ensure that PCOA scores are an accurate reflection of student knowledge, incentivizing and/or filtering for low motivation-effort among pharmacy students should be considered fundamental best practice when the PCOA is administered as a low-stakes test PMID:21655395

The effects of primary reward on the I.Q. performance of grade-school children as a function of initial I.Q. level1

PubMed Central

Clingman, Joy; Fowler, Robert L.

1976-01-01

The effect of candy reward on I.Q. scores was investigated in 72 first- and second-grade children. All subjects were administered Form A of the Peabody Picture Vocabulary Test and, based upon these scores, were divided into three blocks: low, middle, and high. From each block, subjects were randomly assigned to one of three conditions (contingent reward, noncontingent reward, or no reward) that were in effect during administration of Form B. Results showed that candy given contingent upon each correct response increased I.Q. scores for the initially low scoring subjects, but had no influence on the scores of middle and high scoring subjects. PMID:16795514

Analysis of the Sheltered Instruction Observation Protocol Model on Academic Performance of English Language Learners

NASA Astrophysics Data System (ADS)

Ingram, Sandra W.

This quantitative comparative descriptive study involved analyzing archival data from end-of-course (EOC) test scores in biology of English language learners (ELLs) taught or not taught using the sheltered instruction observation protocol (SIOP) model. The study includes descriptions and explanations of the benefits of the SIOP model to ELLs, especially in content area subjects such as biology. Researchers have shown that ELLs in high school lag behind their peers in academic achievement in content area subjects. Much of the research on the SIOP model took place in elementary and middle school, and more research was necessary at the high school level. This study involved analyzing student records from archival data to describe and explain if the SIOP model had an effect on the EOC test scores of ELLs taught or not taught using it. The sample consisted of 527 Hispanic students (283 females and 244 males) from Grades 9-12. An independent sample t-test determined if a significant difference existed in the mean EOC test scores of ELLs taught using the SIOP model as opposed to ELLs not taught using the SIOP model. The results indicated that a significant difference existed between EOC test scores of ELLs taught using the SIOP model and ELLs not taught using the SIOP model (p = .02). A regression analysis indicated a significant difference existed in the academic performance of ELLs taught using the SIOP model in high school science, controlling for free and reduced-price lunch (p = .001) in predicting passing scores on the EOC test in biology at the school level. The data analyzed for free and reduced-price lunch together with SIOP data indicated that both together were not significant (p = .175) for predicting passing scores on the EOC test in high school biology. Future researchers should repeat the study with student-level data as opposed to school-level data, and data should span at least three years.

Assessing Arthroscopic Skills Using Wireless Elbow-Worn Motion Sensors.

PubMed

Kirby, Georgina S J; Guyver, Paul; Strickland, Louise; Alvand, Abtin; Yang, Guang-Zhong; Hargrove, Caroline; Lo, Benny P L; Rees, Jonathan L

2015-07-01

Assessment of surgical skill is a critical component of surgical training. Approaches to assessment remain predominantly subjective, although more objective measures such as Global Rating Scales are in use. This study aimed to validate the use of elbow-worn, wireless, miniaturized motion sensors to assess the technical skill of trainees performing arthroscopic procedures in a simulated environment. Thirty participants were divided into three groups on the basis of their surgical experience: novices (n = 15), intermediates (n = 10), and experts (n = 5). All participants performed three standardized tasks on an arthroscopic virtual reality simulator while wearing wireless wrist and elbow motion sensors. Video output was recorded and a validated Global Rating Scale was used to assess performance; dexterity metrics were recorded from the simulator. Finally, live motion data were recorded via Bluetooth from the wireless wrist and elbow motion sensors and custom algorithms produced an arthroscopic performance score. Construct validity was demonstrated for all tasks, with Global Rating Scale scores and virtual reality output metrics showing significant differences between novices, intermediates, and experts (p < 0.001). The correlation of the virtual reality path length to the number of hand movements calculated from the wireless sensors was very high (p < 0.001). A comparison of the arthroscopic performance score levels with virtual reality output metrics also showed highly significant differences (p < 0.01). Comparisons of the arthroscopic performance score levels with the Global Rating Scale scores showed strong and highly significant correlations (p < 0.001) for both sensor locations, but those of the elbow-worn sensors were stronger and more significant (p < 0.001) than those of the wrist-worn sensors. A new wireless assessment of surgical performance system for objective assessment of surgical skills has proven valid for assessing arthroscopic skills. The elbow-worn sensors were shown to achieve an accurate assessment of surgical dexterity and performance. The validation of an entirely objective assessment of arthroscopic skill with wireless elbow-worn motion sensors introduces, for the first time, a feasible assessment system for the live operating theater with the added potential to be applied to other surgical and interventional specialties. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

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

ERIC Educational Resources Information Center

Francis, Charles E.

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

Effectiveness of Essence of Chicken in Improving Cognitive Function in Young People Under Work-Related Stress

PubMed Central

Chan, Lung; Wang, Hsuan-Min; Chen, Kuan-Yu; Lin, Ying-Chin; Wu, Pei-Jung; Hsieh, Wan-Lin; Chen, Ying-Ru; Liu, Cheung-Pin; Tsai, Han-Yin; Chen, Yun-Ru; Chang, Hsiu-Hui; Hsieh, Yi-Chen; Hu, Chaur-Jong

2016-01-01

Abstract Work-related stress (WS) can result in considerable and extensive changes in physiological and psychological performance. WS beyond the optimal levels induces anxiety, confusion, exhaustion, and burnout. Chronic WS affects neurocognitive performance, particularly attention and visuospatial memory. Essence of chicken (EC) has been reported to improve neurocognitive function after mental stress. To investigate the beneficial effects of EC in improving neurocognitive performance under WS, we conducted a randomized, double blind trial. Total 102 young workers in New Taipei City with high WS, evaluated using the Individual Subjective Perception Job Stress Scale scores (>36 for job leaders and 33 for nonleaders) were recruited. Fifty-one participants received 70 mL of EC and 51 received a placebo daily for 2 weeks. Blood tests and neurocognitive assessment were performed before treatment, at the end of treatment, and 2 weeks after treatment. EC improved the performance of participants with high depression scores in the form-color associative memory test, used for assessing short-term memory. Although creatinine and glutamic-pyruvic transaminase (GPT) levels increased in week 2, but the levels returned to the baseline in week 4. Blood urea nitrogen (BUN) levels decreased in week 4. EC significantly improved short-term memory in participants with high WS and concomitant depressive mood, although it slightly increased GPT and creatinine levels and reduced BUN levels. The long-term treatment effects of EC warrant further investigation. PMID:27175681

Effectiveness of Essence of Chicken in Improving Cognitive Function in Young People Under Work-Related Stress: A Randomized Double-Blind Trial.

PubMed

Chan, Lung; Wang, Hsuan-Min; Chen, Kuan-Yu; Lin, Ying-Chin; Wu, Pei-Jung; Hsieh, Wan-Lin; Chen, Ying-Ru; Liu, Cheung-Pin; Tsai, Han-Yin; Chen, Yun-Ru; Chang, Hsiu-Hui; Hsieh, Yi-Chen; Hu, Chaur-Jong

2016-05-01

Work-related stress (WS) can result in considerable and extensive changes in physiological and psychological performance. WS beyond the optimal levels induces anxiety, confusion, exhaustion, and burnout. Chronic WS affects neurocognitive performance, particularly attention and visuospatial memory. Essence of chicken (EC) has been reported to improve neurocognitive function after mental stress.To investigate the beneficial effects of EC in improving neurocognitive performance under WS, we conducted a randomized, double blind trial. Total 102 young workers in New Taipei City with high WS, evaluated using the Individual Subjective Perception Job Stress Scale scores (>36 for job leaders and 33 for nonleaders) were recruited. Fifty-one participants received 70 mL of EC and 51 received a placebo daily for 2 weeks. Blood tests and neurocognitive assessment were performed before treatment, at the end of treatment, and 2 weeks after treatment.EC improved the performance of participants with high depression scores in the form-color associative memory test, used for assessing short-term memory. Although creatinine and glutamic-pyruvic transaminase (GPT) levels increased in week 2, but the levels returned to the baseline in week 4. Blood urea nitrogen (BUN) levels decreased in week 4.EC significantly improved short-term memory in participants with high WS and concomitant depressive mood, although it slightly increased GPT and creatinine levels and reduced BUN levels. The long-term treatment effects of EC warrant further investigation.

Differentiating the levels of risk for muscle dysmorphia among Hungarian male weightlifters: a factor mixture modeling approach.

PubMed

Babusa, Bernadett; Czeglédi, Edit; Túry, Ferenc; Mayville, Stephen B; Urbán, Róbert

2015-01-01

Muscle dysmorphia (MD) is a body image disturbance characterized by a pathological preoccupation with muscularity. The study aimed to differentiate the levels of risk for MD among weightlifters and to define a tentative cut-off score for the Muscle Appearance Satisfaction Scale (MASS) for the identification of high risk MD cases. Hungarian male weightlifters (n=304) completed the MASS, the Exercise Addiction Inventory, and specific exercise and body image related questions. For the differentiation of MD, factor mixture modeling was performed, resulting in three independent groups: low-, moderate-, and high risk MD groups. The estimated prevalence of high risk MD in this sample of weightlifters was 15.1%. To determine a cut-off score for the MASS, sensitivity and specificity analyses were performed and a cut-off point of 63 was suggested. The proposed cut-off score for the MASS can be useful for the early detection of high risk MD. Copyright © 2014 Elsevier Ltd. All rights reserved.

Emergency in the clinic: a simulation curriculum to improve outpatient safety.

PubMed

Espey, Eve; Baty, Gillian; Rask, John; Chungtuyco, Michelle; Pereda, Brenda; Leeman, Lawrence

2017-12-01

Emergency response skills are essential when events such as seizure, anaphylaxis, or hemorrhage occur in the outpatient setting. As services and procedures increasingly move outside the hospital, training to manage complications may improve outcomes. The objective of this study was to evaluate a simulation-based curriculum in outpatient emergency management skills with the outcome measures of graded objective performance and learner self-efficacy. This pre- and postcurriculum study enrolled residents and fellows in Obstetrics and Gynecology and Family Medicine in a simulation-based, outpatient emergency management curriculum. Learners completed self-efficacy questionnaires and were videotaped managing 3 medical emergency scenarios (seizure, over-sedation/cardiopulmonary arrest, and hemorrhage) in the simulation laboratory both before and after completion of the curriculum. Evaluators who were blinded to training level scored the simulation performance videotapes using a graded rubric with critical action checklists. Scenario scores were assigned in 5 domains and globally. Paired t-tests were used to determine differences pre- and postcurriculum. Thirty residents completed the curriculum and pre- and postcurriculum testing. Subjects' objective performance scores improved in all 5 domains (P<.05) in all scenarios. When scores were stratified by level of training, all participants demonstrated global improvement. When scores were stratified by previous outpatient simulation experience, subjects with previous experience improved in all but management of excess sedation. Pre- and postcurriculum self-efficacy evaluations demonstrated improvement in all 7 measured areas: confidence, use of appropriate resources, communication skills, complex airway management, bag mask ventilation, resuscitation, and hemorrhage management. Self-efficacy assessment showed improvement in confidence managing outpatient emergencies (P=.001) and ability to communicate well in emergency situations (P<.001). A simulation-based curriculum improved both self-efficacy and objectively rated performance scores in management of outpatient medical emergencies. Simulation-based curricula should be incorporated into residency education. Copyright © 2017 Elsevier Inc. All rights reserved.

Predictors of Responses to Corticosteroids for Cancer-Related Fatigue in Advanced Cancer Patients: A Multicenter, Prospective, Observational Study.

PubMed

Matsuo, Naoki; Morita, Tatsuya; Matsuda, Yoshinobu; Okamoto, Kenichiro; Matsumoto, Yoshihisa; Kaneishi, Keisuke; Odagiri, Takuya; Sakurai, Hiroki; Katayama, Hideki; Mori, Ichiro; Yamada, Hirohide; Watanabe, Hiroaki; Yokoyama, Taro; Yamaguchi, Takashi; Nishi, Tomohiro; Shirado, Akemi; Hiramoto, Shuji; Watanabe, Toshio; Kohara, Hiroyuki; Shimoyama, Satofumi; Aruga, Etsuko; Baba, Mika; Sumita, Koki; Iwase, Satoru

2016-07-01

Although corticosteroids are widely used to relieve cancer-related fatigue (CRF), information regarding the factors predicting responses to corticosteroids remains limited. The aim of this study was to identify potential factors predicting responses to corticosteroids for CRF in advanced cancer patients. Inclusion criteria for this multicenter, prospective, observational study were patients who had metastatic or locally advanced cancer and had a fatigue intensity score of 4 or more on a 0-10 Numerical Rating Scale (NRS). Univariate and multivariate analyses were conducted to identify the factors predicting two-point reduction or more in NRS on day 3. Among 179 patients who received corticosteroids, 86 (48%; 95% CI 41%-56%) had a response with two-point reduction or more. Factors that significantly predicted responses were performance status score of 3 or more, Palliative Performance Scale score more than 40, absence of ascites, absence of drowsiness, absence of depression, serum albumin level greater than 3 mg/dL, serum sodium level greater than 135 mEq/L, and baseline NRS score greater than 5. A multivariate analysis showed that the independent factors predicting responses were baseline NRS score greater than 5 (odds ratio [OR] 6.6, 95% CI 2.8-15.4), Palliative Performance Scale score more than 40 (OR 4.4, 95% CI 2.1-9.3), absence of drowsiness (OR 3.4, 95% CI 1.7-6.9), absence of ascites (OR 2.3, 95% CI 1.1-4.7), and absence of pleural effusion (OR 2.2, 95% CI 1.0-5.0). Treatment responses to corticosteroids for CRF may be predicted by baseline symptom intensity, performance status, drowsiness, and severity of fluid retention symptoms. Larger prospective studies are needed to confirm these results. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

The predictive validity of the MCAT exam in relation to academic performance through medical school: a national cohort study of 2001-2004 matriculants.

PubMed

Dunleavy, Dana M; Kroopnick, Marc H; Dowd, Keith W; Searcy, Cynthia A; Zhao, Xiaohui

2013-05-01

Most research examining the predictive validity of the Medical College Admission Test (MCAT) has focused on the relationship between MCAT scores and scores on the United States Medical Licensing Examination Step exams. This study examined whether MCAT scores predict students' unimpeded progress toward graduation (UP), which the authors defined as not withdrawing or being dismissed for academic reasons, graduating within five years of matriculation, and passing the Step 1, Step 2 Clinical Knowledge, and Step 2 Clinical Skills exams on the first attempt. Students who matriculated during 2001-2004 at 119 U.S. medical schools were included in the analyses. Logistic regression analyses were used to estimate the relationships between UP and MCAT total scores alone, undergraduate grade point averages (UGPAs) alone, and UGPAs and MCAT total scores together. All analyses were conducted at the school level and were considered together to evaluate relationships across schools. The majority of matriculants experienced UP. Together, UGPAs and MCAT total scores predicted UP well. MCAT total scores alone were a better predictor than UGPAs alone. Relationships were similar across schools; however, there was more variability across schools in the relationship between UP and UGPAs than between UP and MCAT total scores. The combination of UGPAs and MCAT total scores performs well as a predictor of UP. Both UGPAs and MCAT total scores are strong predictors of academic performance in medical school through graduation, not just the first two years. Further, these relationships generalize across medical schools.

Factors associated with simulator-assessed laparoscopic surgical skills of veterinary students.

PubMed

Kilkenny, Jessica J; Singh, Ameet; Kerr, Carolyn L; Khosa, Deep K; Fransson, Boel A

2017-06-01

OBJECTIVE To determine whether simulator-assessed laparoscopic skills of veterinary students were associated with training level and prior experience performing nonlaparoscopic veterinary surgery and other activities requiring hand-eye coordination and manual dexterity. DESIGN Experiment. SAMPLE 145 students without any prior laparoscopic surgical or fundamentals of laparoscopic surgery (FLS) simulator experience in years 1 (n = 39), 2 (34), 3 (39), and 4 (33) at a veterinary college. PROCEDURES A questionnaire was used to collect data from participants regarding experience performing veterinary surgery, playing video games, and participating in other activities. Participants performed a peg transfer, pattern cutting, and ligature loop-placement task on an FLS simulator, and FLS scores were assigned by an observer. Scores were compared among academic years, and correlations between amounts of veterinary surgical experience and FLS scores were assessed. A general linear model was used to identify predictors of FLS scores. RESULTS Participants were predominantly female (75%), right-hand dominant (92%), and between 20 and 29 years of age (98%). No significant differences were identified among academic years in FLS scores for individual tasks or total FLS score. Scores were not significantly associated with prior surgical or video game experience. Participants reporting no handicraft experience had significantly lower total FLS scores and FLS scores for task 2 than did participants reporting a lot of handicraft experience. CONCLUSIONS AND CLINICAL RELEVANCE Prior veterinary surgical and video game experience had no influence on FLS scores in this group of veterinary students, suggesting that proficiency of veterinary students in FLS may require specific training.

Intensive care nurses' knowledge of pressure ulcers: development of an assessment tool and effect of an educational program.

PubMed

Tweed, Carol; Tweed, Mike

2008-07-01

Critically ill patients are at high risk for pressure ulcers. Successful prevention of pressure ulcers requires that caregivers have adequate knowledge of this complication. To assess intensive care nurses' knowledge of pressure ulcers and the impact of an educational program on knowledge levels. A knowledge assessment test was developed. A cohort of registered nurses in a tertiary referral hospital in New Zealand had knowledge assessed 3 times: before an educational program, within 2 weeks after the program, and 20 weeks later. Multivariate analysis was performed to determine if attributes such as length of time since qualifying or level of intensive care unit experience were associated with test scores. The content and results of the assessment test were evaluated. Completion of the educational program resulted in improved levels of knowledge. Mean scores on the assessment test were 84% at baseline and 89% following the educational program. The mean baseline score did not differ significantly from the mean 20-week follow-up score of 85%. No association was detected between demographic data and test scores. Content validity and standard setting were verified by using a variety of methods. Levels of knowledge to prevent and manage pressure ulcers were good initially and improved with an educational program, but soon returned to baseline.

Climbing Bloom's taxonomy pyramid: Lessons from a graduate histology course.

PubMed

Zaidi, Nikki B; Hwang, Charles; Scott, Sara; Stallard, Stefanie; Purkiss, Joel; Hortsch, Michael

2017-09-01

Bloom's taxonomy was adopted to create a subject-specific scoring tool for histology multiple-choice questions (MCQs). This Bloom's Taxonomy Histology Tool (BTHT) was used to analyze teacher- and student-generated quiz and examination questions from a graduate level histology course. Multiple-choice questions using histological images were generally assigned a higher BTHT level than simple text questions. The type of microscopy technique (light or electron microscopy) used for these image-based questions did not result in any significant differences in their Bloom's taxonomy scores. The BTHT levels for teacher-generated MCQs correlated positively with higher discrimination indices and inversely with the percent of students answering these questions correctly (difficulty index), suggesting that higher-level Bloom's taxonomy questions differentiate well between higher- and lower-performing students. When examining BTHT scores for MCQs that were written by students in a Multiple-Choice Item Development Assignment (MCIDA) there was no significant correlation between these scores and the students' ability to answer teacher-generated MCQs. This suggests that the ability to answer histology MCQs relies on a different skill set than the aptitude to construct higher-level Bloom's taxonomy questions. However, students significantly improved their average BTHT scores from the midterm to the final MCIDA task, which indicates that practice, experience and feedback increased their MCQ writing proficiency. Anat Sci Educ 10: 456-464. © 2017 American Association of Anatomists. © 2017 American Association of Anatomists.

Objective assessment of operator performance during ultrasound-guided procedures.

PubMed

Tabriz, David M; Street, Mandie; Pilgram, Thomas K; Duncan, James R

2011-09-01

Simulation permits objective assessment of operator performance in a controlled and safe environment. Image-guided procedures often require accurate needle placement, and we designed a system to monitor how ultrasound guidance is used to monitor needle advancement toward a target. The results were correlated with other estimates of operator skill. The simulator consisted of a tissue phantom, ultrasound unit, and electromagnetic tracking system. Operators were asked to guide a needle toward a visible point target. Performance was video-recorded and synchronized with the electromagnetic tracking data. A series of algorithms based on motor control theory and human information processing were used to convert raw tracking data into different performance indices. Scoring algorithms converted the tracking data into efficiency, quality, task difficulty, and targeting scores that were aggregated to create performance indices. After initial feasibility testing, a standardized assessment was developed. Operators (N = 12) with a broad spectrum of skill and experience were enrolled and tested. Overall scores were based on performance during ten simulated procedures. Prior clinical experience was used to independently estimate operator skill. When summed, the performance indices correlated well with estimated skill. Operators with minimal or no prior experience scored markedly lower than experienced operators. The overall score tended to increase according to operator's clinical experience. Operator experience was linked to decreased variation in multiple aspects of performance. The aggregated results of multiple trials provided the best correlation between estimated skill and performance. A metric for the operator's ability to maintain the needle aimed at the target discriminated between operators with different levels of experience. This study used a highly focused task model, standardized assessment, and objective data analysis to assess performance during simulated ultrasound-guided needle placement. The performance indices were closely related to operator experience.

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

PubMed

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

2010-01-01

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

Effects of Cooperative Learning Approach on Biology Mean Achievement Scores of Secondary School Students' in Machakos District, Kenya

ERIC Educational Resources Information Center

Muraya, Daniel Ngaru; Kimamo, Githui

2011-01-01

Performance in Biology at secondary school level in Kenya remains poor and one reason is the teaching approach adopted by teachers with teacher-centered approaches being pre-dominant. This study sought to determine the effect of cooperative learning approach on mean achievement scores in Biology of secondary school students.…

The Impact of the Stanford Math Intervention Program and School Climate on Mathematics Achievement Levels of Female Middle School Students

ERIC Educational Resources Information Center

Carwell, Tamika L.

2012-01-01

The study's focus was to determine whether or not there was a significant statistical relationship between improved student performance scores from the Education Program for Gifted Youth (EPGY) Stanford Math Intervention Program and Discovery Formative Assessment mathematics mean scores of female middle school students. An additional focus of…

Assessment of higher level cognitive-communication functions in adolescents with ABI: Standardization of the student version of the functional assessment of verbal reasoning and executive strategies (S-FAVRES).

PubMed

MacDonald, Sheila

2016-01-01

Childhood acquired brain injuries can disrupt communication functions needed for success in school, work and social interaction. Cognitive-communication difficulties may not be apparent until adolescence, when academic, environmental and social-emotional demands increase. The Functional Assessment of Verbal Reasoning and Executive Strategies for Students (S-FAVRES) is a new activity-level measure of cognitive-communication skills in complex, contextual and integrative tasks that simulate real world communication challenges. It is hypothesized that S-FAVRES performance would differentiate adolescents with and without acquired brain injury (ABI) on scores for Accuracy, Rationale, Reasoning Subskills and Time. S-FAVRES was administered to 182 typically-developing (TD) and 57 adolescents with mild-to-severe ABI aged 12-19. Group differences, internal consistency, sensitivity, specificity, reliability and contributing factors to performance (age, gender, brain injury) were examined statistically. Those with ABI attained statistically lower Accuracy, Rationale and Reasoning sub-skills scores than their TD peers. Time scores were not significantly different. Performance trends were consistent across tasks, administrations, gender and age groups. Inter-rater reliability for scoring was acceptable. The S-FAVRES provides a reliable, functional and quantifiable measure of subtle cognitive-communication difficulties in adolescents that can assist speech-language pathologists in planning treatment and integration to school and real world communication.

Racial bias and the MCMI.

PubMed

Choca, J P; Shanley, L A; Peterson, C A; Van Denburg, E

1990-01-01

We studied the scores obtained on the Millon Clinical Multiaxial Inventory (MCMI) by Black and White male psychiatric inpatients to determine the presence or absence of racial bias. In predicting psychopathology for the two races, comparisons of MCMI performance indicated significant differences for all diagnoses except the personality disorders. The subjects were then matched into two groups of 209 patients each, according to DSM-III psychiatric diagnoses. The data were analyzed at the item, scale, and structural levels. At the item level, application of the Mantel-Haenszel Procedure revealed that 45 of the 175 items of the inventory were answered significantly different by the two racial groups. Because this number was higher than what could be expected by chance, the finding suggested possible deficiencies in terms of the culture-fairness of the items used in the test. At the scale level, an analysis of variance (ANOVA) demonstrated that the scores obtained by the Black and White groups were significantly different in 9 of the 20 scales (Histrionic, Narcissistic, Antisocial, Paraphrenia, Hypomania, Dysthymia, Alcohol Abuse, Drug Abuse, and Psychotic Delusion). With the exception of the Dysthymic scale, all of the differences were in the direction of the Blacks obtaining a higher score than the Whites. At the structural level, however, a principal components factor analysis performed on each group resulted in factor structures that looked identical.

Interleukin-6 is associated with cognitive function: the Northern Manhattan Study

PubMed Central

Wright, C.B.; Sacco, R.L.; Rundek, T.R.; Delman, J.B.; Rabbani, L.E.; Elkind, M.S.V.

2006-01-01

Background and purpose Inflammation has been linked to cognitive decline and dementia but the mechanism is not clear and few studies have included Hispanic and black subjects that may be at increased risk of these disorders. Methods We performed a cross-sectional analysis of the association between inflammatory marker levels and cognition in the stroke-free population-based cohort of the Northern Manhattan Study. Mini Mental State Exam (MMSE) scores were the continuous outcome and we adjusted for sociodemographic and vascular risk factors as well as subclinical atherosclerosis. Results Of the inflammatory markers, only interleukin (IL)-6 levels were associated with the MMSE. In univariate analysis age, hypertension, diabetes, smoking, moderate alcohol use, total homocysteine, carotid intima media thickness, and body mass index were positively associated with IL-6 levels. Hispanics compared to whites, those with less than a high school education, hypertension, cardiac disease, and total homocysteine were associated with lower MMSE scores. In a multivariate linear regression model, IL-6 was negatively associated with MMSE score adjusting for sociodemographic and vascular risk factors. Conclusions IL-6 levels were negatively associated with performance on the MMSE in this multiethnic cohort. Adjusting for vascular disease and subclinical atherosclerosis did not attenuate the association, suggesting a direct effect on the brain. PMID:16501663

A comparison of global rating scale and checklist scores in the validation of an evaluation tool to assess performance in the resuscitation of critically ill patients during simulated emergencies (abbreviated as "CRM simulator study IB").

PubMed

Kim, John; Neilipovitz, David; Cardinal, Pierre; Chiu, Michelle

2009-01-01

Crisis resource management (CRM) skills are a set of nonmedical skills required to manage medical emergencies. There is currently no gold standard for evaluation of CRM performance. A prior study examined the use of a global rating scale (GRS) to evaluate CRM performance. This current study compared the use of a GRS and a checklist as formal rating instruments to evaluate CRM performance during simulated emergencies. First-year and third-year residents participated in two simulator scenarios each. Three raters then evaluated resident performance in CRM using edited video recordings using both a GRS and a checklist. The Ottawa GRS provides a seven-point anchored ordinal scale for performance in five categories of CRM, and an overall performance score. The Ottawa CRM checklist provides 12 items in the five categories of CRM, with a maximum cumulative score of 30 points. Construct validity was measured on the basis of content validity, response process, internal structure, and response to other variables. T-test analysis of Ottawa GRS scores was conducted to examine response to the variable of level of training. Intraclass correlation coefficient (ICC) scores were used to measure inter-rater reliability for both scenarios. Thirty-two first-year and 28 third-year residents participated in the study. Third-year residents produced higher mean scores for overall CRM performance than first-year residents (P < 0.05), and in all individual categories within the Ottawa GRS (P < 0.05) and the Ottawa CRM checklist (P < 0.05). This difference was noted for both scenarios and for each individual rater (P < 0.05). No statistically significant difference in resident scores was observed between scenarios for both instruments. ICC scores of 0.59 and 0.61 were obtained for Scenarios 1 and 2 with the Ottawa GRS, whereas ICC scores of 0.63 and 0.55 were obtained with the Ottawa CRM checklist. Users indicated a strong preference for the Ottawa GRS given ease of scoring, presence of an overall score, and the potential for formative evaluation. Construct validity seems to be present when using both the Ottawa GRS and CRM checklist to evaluate CRM performance during simulated emergencies. Data also indicate the presence of moderate inter-rater reliability when using both the Ottawa GRS and CRM checklist.

Emotional intelligence and clinical performance/retention of nursing students

PubMed Central

Marvos, Chelsea; Hale, Frankie B.

2015-01-01

Objective: This exploratory, quantitative, descriptive study was undertaken to explore the relationship between clinical performance and anticipated retention in nursing students. Methods: After approval by the university's Human Subjects Committee, a sample of 104 nursing students were recruited for this study, which involved testing with a valid and reliable emotional intelligence (EI) instrument and a self-report survey of clinical competencies. Results: Statistical analysis revealed that although the group average for total EI score and the 6 score subsets were in the average range, approximately 30% of the individual total EI scores and 30% of two branch scores, identifying emotions correctly and understanding emotions, fell in the less than average range. This data, as well as the analysis of correlation with clinical self-report scores, suggest recommendations applicable to educators of clinical nursing students. Conclusions: Registered nurses make-up the largest segment of the ever-growing healthcare workforce. Yet, retention of new graduates has historically been a challenge for the profession. Given the projected employment growth in nursing, it is important to identify factors which correlate with high levels of performance and job retention among nurses. There is preliminary evidence that EI a nontraditional intelligence measure relates positively not only with retention of clinical staff nurses, but with overall clinical performance as well. PMID:27981096

Emotional intelligence and clinical performance/retention of nursing students.

PubMed

Marvos, Chelsea; Hale, Frankie B

2015-01-01

This exploratory, quantitative, descriptive study was undertaken to explore the relationship between clinical performance and anticipated retention in nursing students. After approval by the university's Human Subjects Committee, a sample of 104 nursing students were recruited for this study, which involved testing with a valid and reliable emotional intelligence (EI) instrument and a self-report survey of clinical competencies. Statistical analysis revealed that although the group average for total EI score and the 6 score subsets were in the average range, approximately 30% of the individual total EI scores and 30% of two branch scores, identifying emotions correctly and understanding emotions, fell in the less than average range. This data, as well as the analysis of correlation with clinical self-report scores, suggest recommendations applicable to educators of clinical nursing students. Registered nurses make-up the largest segment of the ever-growing healthcare workforce. Yet, retention of new graduates has historically been a challenge for the profession. Given the projected employment growth in nursing, it is important to identify factors which correlate with high levels of performance and job retention among nurses. There is preliminary evidence that EI a nontraditional intelligence measure relates positively not only with retention of clinical staff nurses, but with overall clinical performance as well.

Efficacy of a novel educational curriculum using a simulation laboratory on resident performance of hysteroscopic sterilization.

PubMed

Chudnoff, Scott G; Liu, Connie S; Levie, Mark D; Bernstein, Peter; Banks, Erika H

2010-09-01

To assess whether a novel educational curriculum using a simulation teaching laboratory improves resident knowledge, comfort with, and surgical performance of hysteroscopic sterilization. An educational prospective, pretest/posttest study. The Montefiore Institute of Minimally Invasive Surgery Laboratory. PATIENT(S)/SUBJECT(S): Thirty-four OB/GYN residents in an academic medical center. Hysteroscopic sterilization simulation laboratory and a brief didactic lecture. Differences in scores on validated skill assessment tools: Task specific checklist, Global Rating Scale (GRS), pass fail assessment, and a multiple-choice examination to evaluate knowledge and attitude. In the entire cohort improvements were observed on all evaluation tools after the simulation laboratory, with 31% points (SD+/-11.5, 95% confidence interval [CI] 27.3-35.3) higher score on the written evaluation; 63% points (SD+/-15.7, 95% CI 57.8-68.8) higher score on the task specific checklist; and 54% points (SD+/-13.6, 95% CI 48.8-58.3) higher score on the GRS. Higher PGY status was correlated with better pretest performance, but was not statistically significant in posttest scores. Residents reported an improvement in comfort performing the procedure after the laboratory. Simulation laboratory teaching significantly improved resident knowledge, comfort level, and technical skill performance of hysteroscopic sterilization. Copyright (c) 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Neuroprotective effects of Ganoderma lucidum polysaccharides against traumatic spinal cord injury in rats.

PubMed

Gokce, Emre Cemal; Kahveci, Ramazan; Atanur, Osman Malik; Gürer, Bora; Aksoy, Nurkan; Gokce, Aysun; Sargon, Mustafa Fevzi; Cemil, Berker; Erdogan, Bulent; Kahveci, Ozan

2015-11-01

Ganoderma lucidum (G. lucidum) is a mushroom belonging to the polyporaceae family of Basidiomycota and has widely been used as a traditional medicine for thousands of years. G. lucidum has never been studied in traumatic spinal cord injury. The aim of this study is to investigate whether G. lucidum polysaccharides (GLPS) can protect the spinal cord after experimental spinal cord injury. Rats were randomized into five groups of eight animals each: control, sham, trauma, GLPS, and methylprednisolone. In the control group, no surgical intervention was performed. In the sham group, only a laminectomy was performed. In all the other groups, the spinal cord trauma model was created by the occlusion of the spinal cord with an aneurysm clip. In the spinal cord tissue, caspase-3 activity, tumour necrosis factor-alpha levels, myeloperoxidase activity, malondialdehyde levels, nitric oxide levels, and superoxide dismutase levels were analysed. Histopathological and ultrastructural evaluations were also performed. Neurological evaluation was performed using the Basso, Beattie, and Bresnahan locomotor scale and the inclined-plane test. After traumatic spinal cord injury, increases in caspase-3 activity, tumour necrosis factor-alpha levels, myeloperoxidase activity, malondialdehyde levels, and nitric oxide levels were detected. After the administration of GLPS, decreases were observed in tissue caspase-3 activity, tumour necrosis factor-alpha levels, myeloperoxidase activity, malondialdehyde levels, and nitric oxide levels. Furthermore, GLPS treatment showed improved results in histopathological scores, ultrastructural scores, and functional tests. Biochemical, histopathological, and ultrastructural analyses and functional tests reveal that GLPS exhibits meaningful neuroprotective effects against spinal cord injury. Copyright © 2015 Elsevier Ltd. All rights reserved.

A Quantitative Assessment of Classroom Teaching and Learning in Engineering Education

ERIC Educational Resources Information Center

Agrawal, D. K.; Khan, Q. M.

2008-01-01

All stakeholders are aware of the importance of measuring performance in higher education at the university/college level. Generally the performance indicators used for this purpose have focused on graduation rates and/or final examination scores, rather than the performance-enabling processes. Further, the most commonly used method for knowledge…

Age, alcohol, and simulated altitude : effects on performance and breathalyzer scores.

DOT National Transportation Integrated Search

1988-01-01

Trained men in two groups, 30-39 (n=12) and 60-69 (n=13), each performed at the Multiple Task Performance Battery (MTPB) in four separate full-day sessions with and without alcohol (2.2 mL of 100-proof vodka per kg of body weight) at ground level and...

Burnout and occupational participation among dentists with teaching responsibilities in universities.

PubMed

Huri, Meral; Bağiş, Nilsun; Eren, Hakan; Başibüyük, Onur; Şahin, Sedef; Umaroğlu, Mutlu; Orhan, Kaan

2017-07-01

The aim of this study was to investigate the levels of burnout and explore the relationships between burnout and occupational participation among dentists with teaching responsibilities. Canadian Occupational Performance Measure (COPM) was used to evaluate occupational participation with questions on demographic information among 155 dentists with teaching responsibilities. Age, gender, years of experience, academic position were the factors affecting level of burnout and occupational participation. Occupational performance score was negatively correlated with emotional exhausment (r = -.731) and depersonalization (r = -.693) while positively correlated with personal accomplishment (r = .611). Occupational satisfaction scores were negatively correlated with emotional exhausment (r = -.631) and depersonalization (r = -.625) while positively correlated with personal accomplishment (r = .614). Occupational participation level can effect burnout among dentists with teaching responsibilities. Further studies with a larger sample are needed to investigate these preliminary results deeply.

The relationship between communication scores from the USMLE Step 2 Clinical Skills examination and communication ratings for first-year internal medicine residents.

PubMed

Winward, Marcia L; Lipner, Rebecca S; Johnston, Mary M; Cuddy, Monica M; Clauser, Brian E

2013-05-01

This study extends available evidence about the relationship between scores on the Step 2 Clinical Skills (CS) component of the United States Medical Licensing Examination and subsequent performance in residency. It focuses on the relationship between Step 2 CS communication and interpersonal skills scores and communication skills ratings that residency directors assign to residents in their first postgraduate year of internal medicine training. It represents the first large-scale evaluation of the extent to which Step 2 CS communication and interpersonal skills scores can be extrapolated to examinee performance in supervised practice. Hierarchical linear modeling techniques were used to examine the relationships among examinee characteristics, residency program characteristics, and residency-director-provided ratings. The sample comprised 6,306 examinees from 238 internal medicine residency programs who completed Step 2 CS for the first time in 2005 and received ratings during their first year of internal medicine residency training. Although the relationship is modest, Step 2 CS communication and interpersonal skills scores predict communication skills ratings for first-year internal medicine residents after accounting for other factors. The results of this study make a reasonable case that Step 2 CS communication and interpersonal skills scores provide useful information for predicting the level of communication skill that examinees will display in their first year of internal medicine residency training. This finding demonstrates some level of extrapolation from the testing context to behavior in supervised practice, thus providing validity-related evidence for using Step 2 CS communication and interpersonal skills scores in high-stakes decisions.

Uncovering curvilinear relationships between conscientiousness and job performance: how theoretically appropriate measurement makes an empirical difference.

PubMed

Carter, Nathan T; Dalal, Dev K; Boyce, Anthony S; O'Connell, Matthew S; Kung, Mei-Chuan; Delgado, Kristin M

2014-07-01

The personality trait of conscientiousness has seen considerable attention from applied psychologists due to its efficacy for predicting job performance across performance dimensions and occupations. However, recent theoretical and empirical developments have questioned the assumption that more conscientiousness always results in better job performance, suggesting a curvilinear link between the 2. Despite these developments, the results of studies directly testing the idea have been mixed. Here, we propose this link has been obscured by another pervasive assumption known as the dominance model of measurement: that higher scores on traditional personality measures always indicate higher levels of conscientiousness. Recent research suggests dominance models show inferior fit to personality test scores as compared to ideal point models that allow for curvilinear relationships between traits and scores. Using data from 2 different samples of job incumbents, we show the rank-order changes that result from using an ideal point model expose a curvilinear link between conscientiousness and job performance 100% of the time, whereas results using dominance models show mixed results, similar to the current state of the literature. Finally, with an independent cross-validation sample, we show that selection based on predicted performance using ideal point scores results in more favorable objective hiring outcomes. Implications for practice and future research are discussed.

Estimating verbal fluency and naming ability from the test of premorbid functioning and demographic variables: Regression equations derived from a regional UK sample.

PubMed

Jenkinson, Toni-Marie; Muncer, Steven; Wheeler, Miranda; Brechin, Don; Evans, Stephen

2018-06-01

Neuropsychological assessment requires accurate estimation of an individual's premorbid cognitive abilities. Oral word reading tests, such as the test of premorbid functioning (TOPF), and demographic variables, such as age, sex, and level of education, provide a reasonable indication of premorbid intelligence, but their ability to predict other related cognitive abilities is less well understood. This study aimed to develop regression equations, based on the TOPF and demographic variables, to predict scores on tests of verbal fluency and naming ability. A sample of 119 healthy adults provided demographic information and were tested using the TOPF, FAS, animal naming test (ANT), and graded naming test (GNT). Multiple regression analyses, using the TOPF and demographics as predictor variables, were used to estimate verbal fluency and naming ability test scores. Change scores and cases of significant impairment were calculated for two clinical samples with diagnosed neurological conditions (TBI and meningioma) using the method in Knight, McMahon, Green, and Skeaff (). Demographic variables provided a significant contribution to the prediction of all verbal fluency and naming ability test scores; however, adding TOPF score to the equation considerably improved prediction beyond that afforded by demographic variables alone. The percentage of variance accounted for by demographic variables and/or TOPF score varied from 19 per cent (FAS), 28 per cent (ANT), and 41 per cent (GNT). Change scores revealed significant differences in performance in the clinical groups, particularity the TBI group. Demographic variables, particularly education level, and scores on the TOPF should be taken into consideration when interpreting performance on tests of verbal fluency and naming ability. © 2017 The British Psychological Society.

Comparative neurobehavioral study of a polybrominated biphenyl-exposed population in Michigan and a nonexposed group in Wisconsin.

PubMed Central

Valciukas, J A; Lilis, R; Wolff, M S; Anderson, H A

1978-01-01

An analysis of findings regarding the prevalence and time course of symptoms and the results of neurobehavioral testing among Michigan and Wisconsin dairy farmers, is reported. Reviewed are: (1) differences in the prevalence of neurological symptoms at the time of examination; (2) differences in the incidence and time course of symptoms for the period 1972--1976; (3) differences among populations and subgroups (sex and age) regarding performance test scores; (4) correlations between performance test scores and neurological symptoms; and (5) correlations between serum PBB levels as indicators of exposure and performance tests and neurological symptoms. PMID:209977

Discover cervical disc arthroplasty versus anterior cervical discectomy and fusion in symptomatic cervical disc diseases: A meta-analysis.

PubMed

Shangguan, Lei; Ning, Guang-Zhi; Tang, Yu; Wang, Zhe; Luo, Zhuo-Jing; Zhou, Yue

2017-01-01

Symptomatic cervical disc disease (SCDD) is a common degenerative disease, and Discover artificial cervical disc, a new-generation nonconstrained artificial disk, has been developed and performed gradually to treat it. We performed this meta-analysis to compare the efficacy and safety between Discover cervical disc arthroplasty (DCDA) and anterior cervical discectomy and fusion (ACDF) for SCDD. An exhaustive literature search of PubMed, EMBASE, and the Cochrane Library was conducted to identify randomized controlled trials that compared DCDA with ACDF for patients suffering SCDD. A random-effect model was used. Results were reported as standardized mean difference or risk ratio with 95% confidence interval. Of 33 articles identified, six studies were included. Compared with ACDF, DCDA demonstrated shorter operation time (P < 0.0001), and better range of motion (ROM) at the operative level (P < 0.00001). But no significant differences were observed in blood loss, neck disability index (NDI) scores, neck and arm pain scores, Japanese orthopaedic association (JOA) scores, secondary surgery procedures and adverse events (P > 0.05). Subgroup analyses did not demonstrated significant differences. In conclusion, DCDA presented shorter operation time, and better ROM at the operative level. However, no significant differences were observed in blood loss, NDI scores, neck and arm pain scores, JOA scores, secondary surgery procedures and adverse events between the two groups. Additionally, more studies of high quality with mid- to long-term follow-up are required in future.

Does gender and experience influence shade matching quality?

PubMed

Haddad, Helene J; Jakstat, Holger A; Arnetzl, Gerwin; Borbely, Judit; Vichi, Alessandro; Dumfahrt, Herbert; Renault, Patrick; Corcodel, Nicoleta; Pohlen, Bostjan; Marada, Gyula; de Parga, Juan A Martinez Vazquez; Reshad, Mamaly; Klinke, Thomas U; Hannak, Wolfgang B; Paravina, Rade D

2009-01-01

To evaluate the influence of gender and level of experience on shade matching quality. A study was simultaneously performed at 15 universities located in 9 countries. A total of 614 color normal participants completed all phases of the experiment. Among them, there were 305 females and 309 males, 319 dental students and 295 dental professionals. A lecture on color matching in dentistry was given to all participants. Initial training was performed using Toothguide Trainer software (TT), while Toothguide Training Box (TTB) was used for both training and testing of participants' shade matching results. The test task was to successively match 15 shade guide tabs with the corresponding shade guide. The shade matching score for each participant was computed as a sum of color differences (SigmaDeltaE(ab)(*) score) between target tabs and selected tabs. Lower scores corresponded to better shade matching results and vice versa. Means and standard deviations were calculated. Mann-Whitney U test was used for statistical analysis of the data (alpha=0.05). The mean shade matching score (S.D.) for all participants was 41 (21). The score for female and male participants was 38 (20) and 44 (21), respectfully (p<0.001). The difference in scores between dental students, 42 (20), and dental professionals, 39 (21), was not statistically significant. Within the limitations of this study, females achieved significantly better shade matching results than males, indicating that gender plays an important role in shade matching. The level of experience was not found to be significant factor in shade matching.

The role of self-regulated learning in explaining examination performance of college students in first-semester general chemistry

NASA Astrophysics Data System (ADS)

Beckley, Scott

Many college students struggle with first-semester general chemistry. Prior studies have shown that a student's prior knowledge of chemistry, a cognitive factor, does not account for the total variance when measured by examination scores. This study explored the role of self-regulated learning (SRL) to identify the degree of success or failure of students with two outcome variables (i.e., American Chemical Society Comprehensive First-Term General Chemistry Examination (Form 2009) and hour-examination averages). The SRL construct consists of three interrelated components (i.e., cognitive, metacognitive, and motivational). SRL theory focuses on the idea of reciprocal determinism, in which the impact of one component of self-regulation affects the other two components. In the quantitative portion of this mixed methods study, eight measures of SRL were used to determine the `level' of self-regulation for each student. SRL variables were used in regression analysis and provided additional and unique variances. Cluster analysis techniques identified two distinct groups of students (i.e., adaptive and maladaptive). Generally, adaptive learners were associated with higher levels of SRL and success in the course; maladaptive learners had lower levels of SRL and struggled with the course demands. For the qualitative portion of the study, student volunteers (n = 8) were interviewed to gauge their views on the role of instruction in influencing their examination performances. The findings indicated that perceptions of teaching methods, demands of the course, course structure, feedback, and assessments were associated with the students' levels of self-regulation. Interviews revealed four SRL styles. Rote memorizers tended to fragment instruction and then memorize each fragment, while algorithmic memorizers tended to imitate the step-by-step problem-solving strategies of the instructor or the textbook. Globalizers were intrinsically motivated to learn the material but tended to focus on learning topics that were of practical interest to them, while conceptualizers tended to use flexible problem-solving approaches. The interviewees' actual outcome scores were compared to their predicted scores as generated from the regression models. In general, the actual scores of rote and algorithmic memorizers were lower than their predicted scores, while the actual scores for globalizers and conceptualizers were higher than predicted. From a teaching perspective, this study provided direct relationships between SRL and academic performance. This study also identified SRL styles and found evidence to support that differences in these styles influence students' performances.

Adjusting for Confounding in Early Postlaunch Settings: Going Beyond Logistic Regression Models.

PubMed

Schmidt, Amand F; Klungel, Olaf H; Groenwold, Rolf H H

2016-01-01

Postlaunch data on medical treatments can be analyzed to explore adverse events or relative effectiveness in real-life settings. These analyses are often complicated by the number of potential confounders and the possibility of model misspecification. We conducted a simulation study to compare the performance of logistic regression, propensity score, disease risk score, and stabilized inverse probability weighting methods to adjust for confounding. Model misspecification was induced in the independent derivation dataset. We evaluated performance using relative bias confidence interval coverage of the true effect, among other metrics. At low events per coefficient (1.0 and 0.5), the logistic regression estimates had a large relative bias (greater than -100%). Bias of the disease risk score estimates was at most 13.48% and 18.83%. For the propensity score model, this was 8.74% and >100%, respectively. At events per coefficient of 1.0 and 0.5, inverse probability weighting frequently failed or reduced to a crude regression, resulting in biases of -8.49% and 24.55%. Coverage of logistic regression estimates became less than the nominal level at events per coefficient ≤5. For the disease risk score, inverse probability weighting, and propensity score, coverage became less than nominal at events per coefficient ≤2.5, ≤1.0, and ≤1.0, respectively. Bias of misspecified disease risk score models was 16.55%. In settings with low events/exposed subjects per coefficient, disease risk score methods can be useful alternatives to logistic regression models, especially when propensity score models cannot be used. Despite better performance of disease risk score methods than logistic regression and propensity score models in small events per coefficient settings, bias, and coverage still deviated from nominal.

Differences in swallow physiology in patients with left and right hemispheric strokes.

PubMed

Wilmskoetter, Janina; Martin-Harris, Bonnie; Pearson, William G; Bonilha, Leonardo; Elm, Jordan J; Horn, Janet; Bonilha, Heather S

2018-05-11

We sought to determine the impact of lesion lateralization and lesion volume on swallow impairment on group-level by comparing patients with left and right hemisphere strokes and on patient-level by analyzing patients individually. We performed a retrospective, observational, cross-sectional study of 46 patients with unilateral (22 left, 24 right), acute, first-ever, ischemic strokes who received a diffusion weighted MRI (DW-MRI) and modified barium swallow study (MBSS) during their acute hospital stay. We determined lesion side on the DW-MRI and measured swallow physiology using the Modified Barium Swallow Impairment Profile (MBSImP™©), Penetration-Aspiration Scale (PAS), swallow timing, distance, area, and speed measures. We performed Pearson's Chi-Square and Wilcoxon Rank-Sum tests to compare patients with left and right hemisphere strokes, and Pearson or Spearman correlation, simple logistic regression, linear, and logistic multivariable regression modeling to assess the relationship between variables. At the group-level, there were no differences in MBSImP oral swallow impairment scores between patients with left and right hemisphere stroke. In adjusted analyses, patients with right hemisphere strokes showed significantly worse MBSImP pharyngeal total scores (p = 0.02), worse MBSImP component specific scores for laryngeal vestibular closure (Bonferroni adjusted alpha p ≤ 0.0029), and worse PAS scores (p = 0.03). Patients with right hemisphere strokes showed worse timing, distance, area, and speed measures. Lesion volume was significantly associated with MBSImP pharyngeal residue (p = 0.03) and pharyngeal total scores (p = 0.04). At the patient-level, 24% of patients (4 left, 7 right) showed opposite patterns of MBSImP oral and pharyngeal swallow impairment than seen at group-level. Our study showed differences in swallow physiology between patients with right and left unilateral strokes with patients with right hemisphere strokes showing worse pharyngeal impairment. Lesion lateralization seems to be a valuable marker for the severity of swallowing impairment at the group-level but less informative at the patient-level. Copyright © 2018 Elsevier Inc. All rights reserved.

Association between ambient noise exposure and school performance of children living in an urban area: a cross-sectional population-based study.

PubMed

Pujol, Sophie; Levain, Jean-Pierre; Houot, Hélène; Petit, Rémy; Berthillier, Marc; Defrance, Jérôme; Lardies, Joseph; Masselot, Cyril; Mauny, Frédéric

2014-04-01

Most of the studies investigating the effects of the external noise on children's school performance have concerned pupils in schools exposed to high levels due to aircraft or freeway traffic noise. However, little is known about the consequences of the chronic ambient noise exposure at a level commonly encountered in residential urban areas. This study aimed to assess the relationship between the school performance of 8- to 9-year-old-children living in an urban environment and their chronic ambient noise exposure at home and at school. The children's school performances on the national standardized assessment test in French and mathematics were compared with the environmental noise levels. Children's exposure to ambient noise was calculated in front of their bedrooms (Lden) and schools (LAeq,day) using noise prediction modeling. Questionnaires were distributed to the families to collect potential confounding factors. Among the 746 respondent children, 586 were included in multilevel analyses. On average, the LAeq,day at school was 51.5 dB (SD= 4.5 dB; range = 38-58 dB) and the outdoor Lden at home was 56.4 dB (SD= 4.4 dB; range = 44-69 dB). LAeq,day at school was associated with impaired mathematics score (p = 0.02) or impaired French score (p = 0.01). For a + 10 dB gap, the French and mathematics scores were on average lower by about 5.5 points. Lden at home was significantly associated with impaired French performance when considered alone (p < 10(-3)) and was borderline significant when the combined home-school exposure was considered (p = 0.06). The magnitude of the observed effect on school performance may appear modest, but should be considered in light of the number of people who are potentially chronically exposed to similar environmental noise levels.

Key features of hip hop dance motions affect evaluation by judges.

PubMed

Sato, Nahoko; Nunome, Hiroyuki; Ikegami, Yasuo

2014-06-01

The evaluation of hip hop dancers presently lacks clearly defined criteria and is often dependent on the subjective impressions of judges. Our study objective was to extract hidden motion characteristics that could potentially distinguish the skill levels of hip hop dancers and to examine the relationship between performance kinematics and judging scores. Eleven expert, six nonexpert, and nine novice dancers participated in the study, where each performed the "wave" motion as an experimental task. The movements of their upper extremities were captured by a motion capture system, and several kinematic parameters including the propagation velocity of the wave were calculated. Twelve judges evaluated the performances of the dancers, and we compared the kinematic parameters of the three groups and examined the relationship between the judging scores and the kinematic parameters. We found the coefficient of variation of the propagation velocity to be significantly different among the groups (P < .01) and highly correlated with the judging scores (r = -0.800, P < .01). This revealed that the variation of propagation velocity was the most dominant variable representing the skill level of the dancers and that the smooth propagation of the wave was most closely related to the evaluation by judges.

The relative contribution of physical fitness to the technical execution score in youth rhythmic gymnastics.

PubMed

Donti, Olyvia; Bogdanis, Gregory C; Kritikou, Maria; Donti, Anastasia; Theodorakou, Kalliopi

2016-06-01

This study examined the association between physical fitness and a technical execution score in rhythmic gymnasts varying in the performance level. Forty-six young rhythmic gymnasts (age: 9.9 ±1.3 years) were divided into two groups (qualifiers, n=24 and non-qualifiers, n=22) based on the results of the National Championships. Gymnasts underwent a series of physical fitness tests and technical execution was evaluated in a routine without apparatus. There were significant differences between qualifiers and non-qualifiers in the technical execution score (p=0.01, d=1.0), shoulder flexion (p=0.01, d=0.8), straight leg raise (p=0.004, d=0.9), sideways leg extension (p=0.002, d=0.9) and body fat (p=.021, d=0.7), but no differences were found in muscular endurance and jumping performance. The technical execution score for the non-qualifiers was significantly correlated with shoulder extension (r=0.423, p<0.05), sideways leg extension (r=0.687, p<0.01), push ups (r=0.437, p<0.05) and body fat (r=0.642, p<0.01), while there was only one significant correlation with sideways leg extension (r=0.467, p<0.05) for the qualifiers. Multiple regression analysis revealed that sideways leg extension, body fat, and push ups accounted for a large part (62.9%) of the variance in the technical execution score for the non-qualifiers, while for the qualifiers, only 37.3% of the variance in the technical execution score was accounted for by sideways leg extension and spine flexibility. In conclusion, flexibility and body composition can effectively discriminate between qualifiers and non-qualifiers in youth rhythmic gymnastics. At the lower level of performance (non-qualifiers), physical fitness seems to have a greater effect on the technical execution score.

Oral Assessment Kit, Levels II & III. Draft.

ERIC Educational Resources Information Center

Agrelo-Gonzalez, Maria; And Others

The assessment packet includes a series of oral tests to help develop speaking as an integral part of second language instruction at levels II and III. It contains: 8 mini-tests for use at level II; 9 mini-tests for use at level III; a rating scale and score sheet masters for evaluating performance on these tests; and a collection of suggested…

Physical fitness as an indicator of health status and its relationship to academic performance during the prepubertal period.

PubMed

Fonseca Del Pozo, Francisco Javier; Alonso, Joaquín Valle; Álvarez, Manuel Vaquero; Orr, Siobhan; Cantarero, Francisco Jesús Llorente

2017-01-01

Background: Physical activity (PA) is considered one of the most important determinants of the health status in children, and predictor of morbidity/mortality in adults. The aim is to examine the relationship between physical fitness (PF), PA, obesity and academic performance (AP) in primary school children. Methods: Cross-sectional studies including 91 primary school students, aged 9 to 12 years, from the province of Córdoba. Data was collected from April to June 2014. We measured PF using part of the EUROFIT fitness testing battery. The level of PA was measured as low or high PF and the level of obesity was measured using body mass index, waist circumference, percentage of fat mass, lean body mass, percentage of lean mass and basal metabolism. AP by scores on the second quarter was based on the total average of scores of basic subjects and other subjects, including physical education. Cognitive performance was assessed by the Spanish overall and factorial intelligence test. Results: The results of AP were positively related to levels of PF. Students who achieve better PF score better in Maths, (P=0.019), Natural Sciences (P=0.024), Religion (P=0.018) and Physical Education (P<0.001). A direct association between maximal aerobic capacity with Mathematics (r=0.325, P=0.02), AP (r=0.349, P=0.001) and cognitive performance (CP)(r=0.312, P=0.003) was observed. There was also a direct association of better jump tests with higher AP (r=0.328, P=0.002). Conclusion: The AP is associated with higher levels of fitness. Therefore, the education system should consider implementing curriculum strategies favouring the improvement of the PF, and therefore the health and AP of students.

A study of low scores in Canadian children and adolescents on the Wechsler Intelligence Scale For Children, Fourth Edition (WISC-IV).

PubMed

Brooks, Brian L

2011-01-01

Knowing the prevalence of low neurocognitive scores for the WISC-IV Canadian normative sample (WISC-IV(CDN)) is an important supplement for clinical interpretation of test performance. On the WISC-IV(CDN), it is uncommon for children and adolescents to have 4 or more subtest scores or 2 or more Index scores ≤ 9th percentile when all scores on the battery are considered simultaneously. As the level of the child's intelligence increases or the number of years of parental education increases, the prevalence of low scores decreases. These results are consistent with existing studies of the base rates of low scores in children and adolescents on pediatric cognitive batteries, including the WISC-IV American normative sample. Tables provided are ready for clinical use.

Dental caries, contact with dental services and deprivation in young children: their relationship at a small area level.

PubMed

Tickle, M; Moulding, G; Milsom, K; Blinkhorn, A

2000-10-14

To measure the relationship between tooth decay, contact with dental services and deprivation at electoral ward level. The study was carried out in 1998 in Ellesmere Port in the North West of England. All children younger than six years resident in Ellesmere Port registered with GDS services and those using CDS services were matched against the HA population register to identify unregistered children. Rates for children aged 3-5 years 'in contact' with primary dental care services, whether CDS or GDS, were calculated at ward level. One calibrated examiner examined all 5-year-old children in Ellesmere Port and dmft scores were calculated at ward level. Ward deprivation was measured using the Jarman score. Bivariate linear regressions at ward level were performed in turn between: dmft and Jarman score; rates for 3-5-year-olds in contact with dental services and Jarman score; and dmft and rates for 3-5-year-olds in contact with dental services. A significant linear relationship was observed between dmft and Jarman score (P=0.02, R2 = 0.43). Significant inverse relationships were found between rates for 3-5-year-olds in contact with dental services and Jarman score (P=0.001, R2 = 0.67), and also between dmft and rates for 3-5-year-olds in contact with dental services (P=0.002, R2 = 0.65). A strong inverse relationship was found between dental caries and contact with primary dental care services at electoral ward level. This relationship needs to be explored over a wider geographical area to establish if it is consistent and independent of deprivation.

Relationships between high-stakes clinical skills exam scores and program director global competency ratings of first-year pediatric residents

PubMed Central

Langenau, Erik E.; Pugliano, Gina; Roberts, William L.

2011-01-01

Background Responding to mandates from the Accreditation Council for Graduate Medical Education (ACGME) and American Osteopathic Association (AOA), residency programs have developed competency-based assessment tools. One such tool is the American College of Osteopathic Pediatricians (ACOP) program directors’ annual report. High-stakes clinical skills licensing examinations, such as the Comprehensive Osteopathic Medical Licensing Examination Level 2-Performance Evaluation (COMLEX-USA Level 2-PE), also assess competency in several clinical domains. Objective The purpose of this study is to investigate the relationships between program director competency ratings of first-year osteopathic residents in pediatrics and COMLEX-USA Level 2-PE scores from 2005 to 2009. Methods The sample included all 94 pediatric first-year residents who took COMLEX-USA Level 2-PE and whose training was reviewed by the ACOP for approval of training between 2005 and 2009. Program director competency ratings and COMLEX-USA Level 2-PE scores (domain and component) were merged and analyzed for relationships. Results Biomedical/biomechanical domain scores were positively correlated with overall program director competency ratings. Humanistic domain scores were not significantly correlated with overall program director competency ratings, but did show moderate correlation with ratings for interpersonal and communication skills. The six ACGME or seven AOA competencies assessed empirically by the ACOP program directors’ annual report could not be recovered by principal component analysis; instead, three factors were identified, accounting for 86% of the variance between competency ratings. Discussion A few significant correlations were noted between COMLEX-USA Level 2-PE scores and program director competency ratings. Exploring relationships between different clinical skills assessments is inherently difficult because of the heterogeneity of tools used and overlap of constructs within the AOA and ACGME core competencies. PMID:21927550

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

PubMed

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

2012-01-01

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

The influence of IQ stratification on WAIS-III/WMS-III FSIQ-general memory index discrepancy base-rates in the standardization sample.

PubMed

Hawkins, K A; Tulsky, D S

2001-11-01

Since memory performance expectations may be IQ-based, unidirectional base rate data for IQ-Memory Score discrepancies are provided in the WAIS-III/WMS-III Technical Manual. The utility of these data partially rests on the assumption that discrepancy base rates do not vary across ability levels. FSIQ stratified base rate data generated from the standardization sample, however, demonstrate substantial variability across the IQ spectrum. A superiority of memory score over FSIQ is typical at lower IQ levels, whereas the converse is true at higher IQ levels. These data indicate that the use of IQ-memory score unstratified "simple difference" tables could lead to erroneous conclusions for clients with low or high IQ. IQ stratified standardization base rate data are provided as a complement to the "predicted difference" method detailed in the Technical Manual.

Comparison of parameters of bone profile and homocysteine in physically active and non-active postmenopausal females.

PubMed

Tariq, Sundus; Lone, Khalid Parvez; Tariq, Saba

2016-01-01

Optimal physical activity is important in attaining a peak bone mass. Physically active women have better bone mineral density and reduce fracture risk as compared to females living a sedentary life. The objective of this study was to compare parameters of bone profile and serum homocysteine levels in physically active and non-active postmenopausal females. In this cross sectional study postmenopausal females between 50-70 years of age were recruited and divided into two groups: Physically inactive (n=133) performing light physical activity and Physically active (n=34) performing moderate physical activity. Physical activity (in metabolic equivalents), bone mineral density and serum homocysteine levels were assessed. Spearman's rho correlation was applied to observe correlations. Two independent sample t test and Mann Whitney U test were applied to compare groups. P-value ≤ 0.05 was taken statistically significant. Parameters of bone profile were significantly higher and serum homocysteine levels were significantly lower in postmenopausal females performing moderate physical activity as compared to females performing light physical activity. Homocysteine was not significantly related to T-score and Z-score in both groups. Improving physical activity could be beneficial for improving the quality of bone, decreasing fracture risk and decreasing serum homocysteine levels.

A Patient-Assessed Morbidity to Evaluate Outcome in Surgically Treated Vestibular Schwannomas.

PubMed

Al-Shudifat, Abdul Rahman; Kahlon, Babar; Höglund, Peter; Lindberg, Sven; Magnusson, Måns; Siesjo, Peter

2016-10-01

Outcome after treatment of vestibular schwannomas can be evaluated by health providers as mortality, recurrence, performance, and morbidity. Because mortality and recurrence are rare events, evaluation has to focus on performance and morbidity. The latter has mostly been reported by health providers. In the present study, we validate 2 new scales for patient-assessed performance and morbidity in comparison with different outcome tools, such as quality of life (QOL) (European Quality of Life-5 dimensions [EQ-5D]), facial nerve score, and work capacity. There were 167 total patients in a retrospective (n = 90) and prospective (n = 50) cohort of surgically treated vestibular schwannomas. A new patient-assessed morbidity score (paMS), a patient-assessed Karnofsky score (paKPS), the patient-assessed QOL (EQ-5D) score, work capacity, and the House-Brackmann facial nerve score were used as outcome measures. Analysis of paMS components and their relation to other outcomes was done as uni- and multivariate analysis. All outcome instruments, except EQ-5D and paKPS, showed a significant decrease postoperatively. Only the facial nerve score (House-Brackmann facial nerve score) differed significantly between the retrospective and prospective cohorts. Out of the 16 components of the paMS, hearing dysfunction, tear dysfunction, balance dysfunction, and eye irritation were most often reported. Both paMS and EQ-5D correlated significantly with work capacity. Standard QOL and performance instruments may not be sufficiently sensitive or specific to measure outcome at the cohort level after surgical treatment of vestibular schwannomas. A morbidity score may yield more detailed information on symptoms that can be relevant for rehabilitation and occupational training after surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

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

PubMed

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

2013-12-01

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

Assessment of construct validity of a virtual reality laparoscopy simulator.

PubMed

Rosenthal, Rachel; Gantert, Walter A; Hamel, Christian; Hahnloser, Dieter; Metzger, Juerg; Kocher, Thomas; Vogelbach, Peter; Scheidegger, Daniel; Oertli, Daniel; Clavien, Pierre-Alain

2007-08-01

The aim of this study was to assess whether virtual reality (VR) can discriminate between the skills of novices and intermediate-level laparoscopic surgical trainees (construct validity), and whether the simulator assessment correlates with an expert's evaluation of performance. Three hundred and seven (307) participants of the 19th-22nd Davos International Gastrointestinal Surgery Workshops performed the clip-and-cut task on the Xitact LS 500 VR simulator (Xitact S.A., Morges, Switzerland). According to their previous experience in laparoscopic surgery, participants were assigned to the basic course (BC) or the intermediate course (IC). Objective performance parameters recorded by the simulator were compared to the standardized assessment by the course instructors during laparoscopic pelvitrainer and conventional surgery exercises. IC participants performed significantly better on the VR simulator than BC participants for the task completion time as well as the economy of movement of the right instrument, not the left instrument. Participants with maximum scores in the pelvitrainer cholecystectomy task performed the VR trial significantly faster, compared to those who scored less. In the conventional surgery task, a significant difference between those who scored the maximum and those who scored less was found not only for task completion time, but also for economy of movement of the right instrument. VR simulation provides a valid assessment of psychomotor skills and some basic aspects of spatial skills in laparoscopic surgery. Furthermore, VR allows discrimination between trainees with different levels of experience in laparoscopic surgery establishing construct validity for the Xitact LS 500 clip-and-cut task. Virtual reality may become the gold standard to assess and monitor surgical skills in laparoscopic surgery.

Factors in seventh grade academics associated with performance levels on the tenth grade biology end of course test in selected middle and high schools in northwest Georgia

NASA Astrophysics Data System (ADS)

Ward, Jennifer Henry

This study attempted to identify factors in seventh grade academics that are associated with overall success in tenth grade biology. The study addressed the following research questions: Are there significant differences in performance levels in seventh grade Criterion Referenced Competency Test (CRCT) scores in science, math, reading, and language arts associated with performance categories in tenth grade biology End of Course Test (EOCT) and the following demographic variables : gender, ethnicity, socioeconomic status, disability category, and English language proficiency level? Is there a relationship among the categorical variables on the tenth grade biology EOCT and the same five demographic variables? Retrospective causal comparative research was used on a representative sample from the middle schools in three North Georgia counties who took the four CRCTs in the 2006-2007 school year, and took the biology EOCT in the 2009-2010 school year. Chi square was used to determine the relationships of the various demographic variables on three biology EOCT performance categories. Twoway ANOVA determined relationships between the seventh grade CRCT scores of students in the various demographic groups and their performance levels on the biology EOCT. Students' performance levels on the biology EOCT matched their performance levels on the seventh grade CRCTs consistently. Females performed better than males on all seventh grade CRCTs. Black and Hispanic students did worse than White and Asian/Asian Indian students on the math CRCT. Students living in poverty did worse on reading and language arts CRCTs than students who were better off. Special education students did worse on science, reading, and language arts CRCTs than students not receiving special education services. English language learners did worse than native English speakers on all seventh grade CRCTs. These findings suggest that remedial measures may be taken in the seventh grade that could impact performance levels on the biology EOCT.

British isles lupus assessment group 2004 index is valid for assessment of disease activity in systemic lupus erythematosus

PubMed Central

Yee, Chee-Seng; Farewell, Vernon; Isenberg, David A; Rahman, Anisur; Teh, Lee-Suan; Griffiths, Bridget; Bruce, Ian N; Ahmad, Yasmeen; Prabu, Athiveeraramapandian; Akil, Mohammed; McHugh, Neil; D'Cruz, David; Khamashta, Munther A; Maddison, Peter; Gordon, Caroline

2007-01-01

Objective To determine the construct and criterion validity of the British Isles Lupus Assessment Group 2004 (BILAG-2004) index for assessing disease activity in systemic lupus erythematosus (SLE). Methods Patients with SLE were recruited into a multicenter cross-sectional study. Data on SLE disease activity (scores on the BILAG-2004 index, Classic BILAG index, and Systemic Lupus Erythematosus Disease Activity Index 2000 [SLEDAI-2K]), investigations, and therapy were collected. Overall BILAG-2004 and overall Classic BILAG scores were determined by the highest score achieved in any of the individual systems in the respective index. Erythrocyte sedimentation rates (ESRs), C3 levels, C4 levels, anti–double-stranded DNA (anti-dsDNA) levels, and SLEDAI-2K scores were used in the analysis of construct validity, and increase in therapy was used as the criterion for active disease in the analysis of criterion validity. Statistical analyses were performed using ordinal logistic regression for construct validity and logistic regression for criterion validity. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Results Of the 369 patients with SLE, 92.7% were women, 59.9% were white, 18.4% were Afro-Caribbean and 18.4% were South Asian. Their mean ± SD age was 41.6 ± 13.2 years and mean disease duration was 8.8 ± 7.7 years. More than 1 assessment was obtained on 88.6% of the patients, and a total of 1,510 assessments were obtained. Increasing overall scores on the BILAG-2004 index were associated with increasing ESRs, decreasing C3 levels, decreasing C4 levels, elevated anti-dsDNA levels, and increasing SLEDAI-2K scores (all P < 0.01). Increase in therapy was observed more frequently in patients with overall BILAG-2004 scores reflecting higher disease activity. Scores indicating active disease (overall BILAG-2004 scores of A and B) were significantly associated with increase in therapy (odds ratio [OR] 19.3, P < 0.01). The BILAG-2004 and Classic BILAG indices had comparable sensitivity, specificity, PPV, and NPV. Conclusion These findings show that the BILAG-2004 index has construct and criterion validity. PMID:18050213

Residency factors that influence pediatric in-training examination score improvement.

PubMed

Chase, Lindsay H; Highbaugh-Battle, Angela P; Buchter, Susie

2012-10-01

The goal of this study was to determine which measurable factors of resident training experience contribute to improvement of in-training examination (ITE) and certifying examination (CE) scores. This is a descriptive retrospective study analyzing data from July 2003 through June 2006 at a large academic pediatric training program. Pediatric categorical residents beginning residency in July 2003 were included. Regression analyses were used to determine if the number of admissions performed, core lectures attended, acute care topics heard, grand rounds attended, continuity clinic patients encountered, or procedures performed correlated with improvement of ITE scores. These factors were then analyzed in relation to CE scores. Seventeen residents were included in this study. The number of general pediatric admissions was the only factor found to correlate with an increase in ITE score (P = .04). Scores for the ITE at pediatric levels 1 and 3 were predictive of CE scores. No other factors measured were found to influence CE scores. Although all experiences of pediatric residents likely contribute to professional competence, some experiences may have more effect on ITE and CE scores. In this study, only general pediatric admissions correlated significantly with an improvement in ITE scores from year 1 to year 3. Further study is needed to identify which elements of the residency experience contribute most to CE success. This would be helpful in optimizing residency program structure and curriculum within the limitations of duty hour regulations.

Communication Skills in Candidates for Accreditation in Rheumatology Are Correlated With Candidate's Performance in the Objective Structured Clinical Examination.

PubMed

Pascual-Ramos, Virginia; Flores-Alvarado, Diana Elsa; Portela-Hernández, Margarita; Maldonado-Velázquez, María Del Rocío; Amezcua-Guerra, Luis Manuel; López-Zepeda, Judith; Álvarez, Everardo; Rubio, Nadina; Lastra, Olga Vera; Saavedra, Miguel Ángel; Arce-Salinas, César Alejandro

2017-07-26

The Mexican Accreditation Council for Rheumatology annually certifies trainees in Rheumatology using a multiple-choice test and an objective structured clinical examination (OSCE). Since 2015, candidate's communication skills (CS) have been rated by both patients and by physician examiners and correlated with results on the OSCE. This study compared the CS from candidates to annual accreditation in Rheumatology as rated by patients and by physician examiners, and assessed whether these correlated with candidate's performance in the OSCE. From 2015 to 2017, 8areas of CS were evaluated using a Likert scale, in each OSCE station that involved a patient. Both patient and physician evaluators were trained annually and their evaluations were performed blindly. The associations were calculated using the Pearson correlation coefficient. In general, candidates were given high CS scores; the scores from patients of the candidate's CS were better than those of physician examiners; within the majority of the stations, both scores were found to correlate moderately. In addition, the scoring of CS correlated with trainee performance at the corresponding OSCE station. Interestingly, better correlations were found when the skills were rated by the patients compared to physician scores. The average CS score was correlated with the overall OSCE performance for each trainee, but not with the multiple-choice test, except in the 2017 accreditation process, when a weak correlation was found. CS assessed during a national accreditation process correlated with the candidate's performance at the station level and with the overall OSCE. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

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

PubMed

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

2012-01-01

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

The Simple View, Instructional Level, and the Plight of Struggling Fifth-/Sixth-Grade Readers

ERIC Educational Resources Information Center

Morris, Darrell; Meyer, Carla; Trathen, Woodrow; McGee, Jennifer; Vines, Nora; Stewart, Trevor; Gill, Tom; Schlagal, Robert

2017-01-01

This study explored print-processing and vocabulary differences among a group of 5th- and 6th-grade students who had scored below the 50th percentile on a standardized reading test. Guided by the simple view of reading, we applied cut scores (low/high) to the students' performance on print-processing and vocabulary tasks. The design allowed for…

Separating the Signal from the Noise: An Examination of Student and Teacher Scores Based on Student Learning Objectives (SLOs) in One State

ERIC Educational Resources Information Center

Buckley, Katie Hills

2015-01-01

Despite the prevalence of student learning objectives (SLOs) in teacher evaluation systems throughout the United States, research on the validity of student and teacher SLO scores used for high-stakes decisions is lacking. For this reason, this dissertation is comprised of two chapters that examine student and teacher-level SLO performance data…

Rotating night shifts too quickly may cause anxiety and decreased attentional performance, and impact prolactin levels during the subsequent day: a case control study.

PubMed

Chang, Yu-San; Chen, Hsiang-Lan; Wu, Yu-Hsuan; Hsu, Chung-Yao; Liu, Ching-Kuan; Hsu, Chin

2014-08-05

We investigated circadian changes and effects on mood, sleep-related hormones and cognitive performance when nurses worked consecutive night shifts in a rapidly rotating shift system. Daytime cognitive function, sleep propensity and sleep-related hormones (growth hormone, cortisol, prolactin, thyrotropin) were compared after participants worked two and four consecutive night shifts. Twenty-three off-duty nurses, 20 nurses working two consecutive night shifts and 16 nurses working four consecutive night shifts were enrolled. All participants completed the Maintenance of Wakefulness Test, State-Trait Anxiety Inventory, Stanford Sleepiness Scale, visual attention tasks (VAT), Wisconsin Card Sorting Test, and modified Multiple Sleep Latency Test. Hormone levels were also measured four times throughout the day, at 2-h intervals. During the day, the participants in the night shift groups were less able to maintain wakefulness, had poor performance on VAT, and higher thyrotropin levels than did those in the off-duty group. Participants who worked two night shifts were better able to maintain wakefulness, had higher anxiety scale scores, poorer initial performance and lack of learning effect on VAT, and higher prolactin levels compared with those who worked four night shifts. There were no differences in cortisol levels between the two- and four- shift groups. Rotating night shifts too quickly may cause anxiety and decreased attentional performance, and may impact daytime prolactin levels after night shifts. It is possible that the two-shift group had a higher cortisol level than did the four-shift group, which would be consistent with the group's higher state anxiety scores. The negative findings may be due to the small sample size. Further studies on the effects of consecutive night shifts on mood and cortisol levels during the daytime after sleep restriction would be valuable.

Effects of methylphenidate on acute math performance in children with attention-deficit hyperactivity disorder.

PubMed

Grizenko, Natalie; Cai, Emmy; Jolicoeur, Claude; Ter-Stepanian, Mariam; Joober, Ridha

2013-11-01

Examine the short-term (acute) effects of methylphenidate (MPH) on math performance in children with attention-deficit hyperactivity disorder (ADHD) and what factors predict improvement in math performance. One hundred ninety-eight children with ADHD participated in a double-blind, placebo-controlled, randomized crossover MPH trial. Math response to MPH was determined through administration of math problems adjusted to their academic level during the Restricted Academic Situation Scale (RASS). Student t tests were conducted to assess change in math performance with psychostimulants. Correlation between change on the RASS and change on the math performance was also examined. Linear regression was performed to determine predictor variables. Children with ADHD improved significantly in their math with MPH (P < 0.001). The degree of improvement on the RASS (which evaluates motor activity and orientation to task) and on math performance on MPH was highly correlated. A child's age at baseline and Wechsler Individual Achievement Test (WIAT)-Numerical Operations standard scores at baseline accounted for 15% of variances for acute math improvement. MPH improves acute math performance in children with ADHD. Younger children with lower math scores (as assessed by the WIAT) improved most on math scores when given psychostimulants. NCT00483106.

Risk screening for ADHD in a college population: is there a relationship with academic performance?

PubMed

Burlison, Jonathan D; Dwyer, William O

2013-01-01

The present study examines the relationship between self-reported levels of ADHD and academic outcomes, as well as aptitude. A total of 523 college students took the Adult Self-Report Scale-Version 1.1 (ASRS-V1.1), and their scores were compared with course performance and ACT (American College Test) composite scores. The measure identified 70 students (13.4%) as being in the "highly likely" category for an ADHD diagnosis. Course exam and ACT scores for the 70 "highly likely" students were statistically identical to the remaining 453 students in the sample and the 77 students identified as "highly unlikely" as well. Only 4 of the "highly likely" 70 students were registered with the university's Office of Student Disability Services as having been diagnosed with ADHD. The ASRS-V1.1 failed to discriminate academic performance and aptitude differences between ADHD "highly likely" and "highly unlikely" individuals. The use of self-report screeners of ADHD is questioned in contexts relating ADHD to academic performance.

The development of a virtual reality training programme for ophthalmology: repeatability and reproducibility (part of the International Forum for Ophthalmic Simulation Studies).

PubMed

Saleh, G M; Theodoraki, K; Gillan, S; Sullivan, P; O'Sullivan, F; Hussain, B; Bunce, C; Athanasiadis, I

2013-11-01

To evaluate the variability of performance among novice ophthalmic trainees in a range of repeated tasks using the Eyesi virtual reality (VR) simulator. Eighteen subjects undertook three attempts of five cataract specific and generic three-dimensional tasks: continuous curvilinear capsulorhexis, cracking and chopping, cataract navigation, bimanual cataract training, anti-tremor. Scores for each attempt were out of a maximum of 100 points. A non-parametric test was used to analyse the data, where a P-value of <0.05 was considered statistically significant. Highly significant differences were found between the scores achieved in the first attempt and that during the second (P<0.0001) and third (P<0.0001) but not between the second and third attempt (P=0.65). There was no significant variability in the overall score between the users (P=0.1104) or in the difference between their highest and lowest score (P=0.3878). Highly significant differences between tasks were shown both in the overall score (P=0.0001) and in the difference between highest and lowest score (P=0.003). This study, which is the first to quantify reproducibility of performance in entry level trainees using a VR tool, demonstrated significant intra-novice variability. The cohort of subjects performed equally overall in the range of tasks (no inter-novice variability) but each showed that performance varies significantly with the complexity of the task when using this high-fidelity instrument.

Objective evaluation of minimally invasive surgical skills for transplantation. Surgeons using a virtual reality simulator.

PubMed

Dănilă, R; Gerdes, B; Ulrike, H; Domínguez Fernández, E; Hassan, I

2009-01-01

The learning curve in laparoscopic surgery may be associated with higher patient risk, which is unacceptable in the setting of kidney donation. Virtual reality simulators may increase the safety and efficiency of training in laparoscopic surgery. The aim of this study was to investigate if the results of a training session reflect the actual skill level of transplantation surgeons and whether the simulator could differentiate laparoscopic experienced transplantation surgeon from advanced trainees. 16 subjects were assigned to one of two groups: 5 experienced transplantation surgeon and 11 advanced residents, with only assistant role during transplantation. The level of performance was measured by a relative scoring system that combines single parameters assessed by the computer. The higher the level of transplantation experience of a participant, the higher the laparoscopic performance. Experienced transplantation surgeons showed statistically significant better scores than the advanced group for time and precision parameters. Our results show that performance of the various tasks on the simulator corresponds to the respective level of experience in transplantation surgery in our research groups. This study confirms construct validity for the LapSim. It thus measures relevant skills and can be integrated in an endoscopic training and assessment curriculum for transplantations surgeons.

Association between obesity-related biomarkers and cognitive and motor development in infants.

PubMed

Camargos, Ana Cristina R; Mendonça, Vanessa A; Oliveira, Katherine S C; de Andrade, Camila Alves; Leite, Hércules Ribeiro; da Fonseca, Sueli Ferreira; Vieira, Erica Leandro Marciano; Teixeira Júnior, Antônio Lúcio; Lacerda, Ana Cristina Rodrigues

2017-05-15

This study aimed to verify the association between obesity-related biomarkers and cognitive and motor development in infants between 6 and 24 months of age. A cross-sectional study was conducted with 50 infants and plasma levels of leptin, adiponectin, resistin, soluble tumor necrosis factor receptors 1 and 2 (sTNFR1 and sTNFR2), chemokines, brain-derived neurotrophic factor (BDNF), serum cortisol and redox status were measured. The Bayley-III test was utilized to evaluate cognitive and motor development, and multiple linear stepwise regression models were performed to verify the association between selected biomarkers and cognitive and motor development. A significant association was found among plasma leptin and sTNFR1 levels with cognitive composite scores, and these two independents variables together explained 37% of the variability of cognitive composite scores (p=0.001). Only plasma sTNFR1 levels were associated and explained 24% of the variability of motor composite scores (p=0.003). Plasma levels of sTNFR1 were associated with the increase in cognitive and motor development scores in infants between 6 and 24 months of age through a mechanism not directly related to excess body weight. Moreover, increase in plasma levels of leptin reduced the cognitive development in this age range. Copyright © 2017 Elsevier B.V. All rights reserved.

The Effects of an Intervention Strategy on Children's Heart Rates and Skill Performance

ERIC Educational Resources Information Center

Ignico, Arlene; Corson, Arleen; Vidoni, Carla

2006-01-01

The purpose of this project was to examine the effectiveness of a fitness infusion instructional strategy (FI) on children's activity levels and skill performance scores. This strategy included aerobic activity within the skill practice tasks and game play. In other words, students performed short bouts of activity between the practice and…

Measuring What High-Achieving Students Know and Can Do on Entry to School: PIPS 2002-2008

ERIC Educational Resources Information Center

Wildy, Helen; Styles, Irene

2011-01-01

Anecdotal evidence from teachers in Western Australia suggested that increasing numbers of on-entry students have been performing at high levels over recent years on the Performance Indicators in Primary Schools Baseline Assessment (PIPS-BLA). This paper reports the results of an investigation into the performance of high-scoring students. Data…

Physical Performance and Serum 25(OH)vitamin D Status in Community Dwelling Old Mobility Limited Adults: A Cross-Sectional Study.

PubMed

von Berens, Å; Cederholm, T; Fielding, R A; Gustafsson, T; Kirn, D; Laussen, J; Nydahl, M; Travison, T G; Reid, K; Koochek, A

2018-01-01

To examine the potential association between serum 25(OH) vitamin D and the performance on the Short Physical Performance Battery (SPPB) including the sub-components; five repeated chair stands test, 4 meters walk test and balance in older mobility-limited community-dwelling men and women. A cross sectional study was performed in American and Swedish subjects who were examined for potential participation in a combined exercise and nutrition intervention trial. Logistic regression analysis and linear regression analyses were performed to evaluate the association for 25(OH)D with the overall score on the SBBP, chair stand, gait speed and balance. Community-dwelling (mean age 77.6 ± 5.3 years) mobility limited American (n=494) and Swedish (n=116) females (59%) and males. The SPPB (0-12 points) includes chair stand (s), gait speed (m/s) and a balance test. Mobility limitation i.e., SPPB score ≤ 9 was an inclusion criterion. A blood sample was obtained to measure serum 25(OH)vitamin D concentrations. No clear association of 25(OH)D with SPPB scores was detected either when 25(OH)D was assessed as a continuous variable or when categorized according to serum concentrations of <50, 50-75 or <75 nmol/L. However, when analyzing the relationship between 25(OH)D and seconds to perform the chair stands, a significant quadratic relationship was observed. Thus, at serum levels of 25(OH)D above 74 nmol/L, higher concentrations appeared to be advantageous for the chair stand test, whereas for serum levels below 74 nmol/L this association was not observed. This cross- sectional study lacked clear association between serum 25(OH)D and physical performance in mobility limited adults. A potentially interesting observation was that at higher serum levels of 25(OH)D a better performance on the chair stand test was indicated.

Women with breast cancer: self-reported distress in early survivorship.

PubMed

Lester, Joanne; Crosthwaite, Kara; Stout, Robin; Jones, Rachel N; Holloman, Christopher; Shapiro, Charles; Andersen, Barbara L

2015-01-01

To identify and compare levels of distress and sources of problems among patients with breast cancer in early survivorship. Descriptive, cross-sectional. A National Cancer Institute-designated comprehensive cancer center. 100 breast cancer survivors were selected to represent four time points in the cancer trajectory. Distress was self-reported using the Distress Thermometer and its 38-item problem list. Analysis of variance and chi-square analyses were performed as appropriate. Distress scores, problem reports, and time groups. Participants scored in range of the cutoff of more than 4 (range = 4.1-5.1) from treatment through three months post-treatment. At six months post-treatment, distress levels were significantly lower. Significant differences were found between groups on the total problem list score (p = 0.007) and emotional (p = 0.01) and physical subscale scores (p = 0.003). Comparison of groups at different points in the cancer trajectory found similar elevated levels from diagnosis through three months. Distress remained elevated in early survivorship but significantly decreased at six months post-treatment. Interventions to reduce or prevent distress may improve outcomes in early survivorship.

Examination of Substance Use, Risk Factors, and Protective Factors on Student Academic Test Score Performance.

PubMed

Arthur, Michael W; Brown, Eric C; Briney, John S; Hawkins, J David; Abbott, Robert D; Catalano, Richard F; Becker, Linda; Langer, Michael; Mueller, Martin T

2015-08-01

School administrators and teachers face difficult decisions about how best to use school resources to meet academic achievement goals. Many are hesitant to adopt prevention curricula that are not focused directly on academic achievement. Yet, some have hypothesized that prevention curricula can remove barriers to learning and, thus, promote achievement. We examined relationships among school levels of student substance use and risk and protective factors that predict adolescent problem behaviors and achievement test performance. Hierarchical generalized linear models were used to predict associations involving school-averaged levels of substance use and risk and protective factors and students' likelihood of meeting achievement test standards on the Washington Assessment of Student Learning, statistically controlling for demographic and economic factors known to be associated with achievement. Levels of substance use and risk/protective factors predicted the academic test score performance of students. Many of these effects remained significant even after controlling for model covariates. Implementing prevention programs that target empirically identified risk and protective factors has the potential to have a favorable effect on students' academic achievement. © 2015, American School Health Association.

Fitness profiling of elite level adolescent Gaelic football players.

PubMed

Cullen, Bryan D; Cregg, Cathal J; Kelly, David T; Hughes, Sarah M; Daly, Pat G; Moyna, Niall M

2013-08-01

The purpose of this study was to evaluate the anthropometric characteristics and fitness levels of elite level under 18 (U-18) Gaelic football players to establish normative centile scores for selected fitness parameters and to compare the physical and fitness characteristics relative to each playing position. A total of 265 male U-18 Gaelic football players (age: 16.96 ± 0.7 years; height: 178.11 ± 6.27 cm; weight: 72.07 ± 8.68 kg) participated in the study. According to positional roles, players were categorized as goalkeepers (n = 13), defenders (n = 113), midfielders (n = 30), and forwards (n = 109). Height and weight were measured, and skinfolds were taken before participants sequentially performed a sit and reach test (S&R), countermovement jump (CMJ), standing long jump (SLJ), 5- and 20-m speed test, and the Yo-Yo Intermittent Recovery Test Level 1 (YYIRT1). The percentage body fat was higher (p < 0.01) in goalkeepers than the other playing positions. Goalkeepers had a higher body mass index than defenders (p < 0.05) and forwards (p < 0.01). Midfielders and goalkeepers were taller (p < 0.01) and heavier (p < 0.01) than defenders and forwards. The total distance covered in the YYIRT1 was significantly lower (p < 0.01) in goalkeepers than the other playing positions. There was no significant positional difference in the performance scores in the S&R test, CMJ, SLJ, and 5- and 20-m running speed. The study findings indicate minimal differences in the anthropometric and physiological characteristics between playing positions in elite youth level Gaelic football players. The norm-referenced percentile scores will enable conditioning coaches to benchmark elite performance and design training programs.

Sleep disorder among medical students: relationship to their academic performance.

PubMed

Abdulghani, Hamza M; Alrowais, Norah A; Bin-Saad, Norah S; Al-Subaie, Nourah M; Haji, Alhan M A; Alhaqwi, Ali I

2012-01-01

Medical students are exposed to a significant level of pressure due to academic demands. Their sleep pattern is characterized by insufficient sleep duration, delayed sleep onset, and occurrence of napping episodes during the day. To examine the prevalence of sleep disorder among medical students and investigate any relationship between sleep disorder and academic performance. This is a cross-sectional self-administered questionnaire-based study. The participants were medical students of the first, second, and third academic years. The Epworth Sleepiness Scale (ESS) was also included to identify sleep disorder and grade point average was recorded for academic performance. There were 491 responses with a response rate of 55%. The ESS score demonstrated that 36.6% of participants were considered to have abnormal sleep habits, with a statistically significant increase in female students (p = 0.000). Sleeping between 6-10 h per day was associated with normal ESS scores (p = 0.019) as well as the academic grades ≥ 3.75. Abnormal ESS scores were associated with lower academic achievement (p = 0.002). A high prevalence of sleep disorder was found in this group of students, specifically female students. Analysis of the relationship between sleep disorder and academic performance indicates a significant relationship between abnormal ESS scores, total sleeping hours, and academic performance.

Continuous multiword recognition performance of young and elderly listeners in ambient noise

NASA Astrophysics Data System (ADS)

Sato, Hiroshi

2005-09-01

Hearing threshold shift due to aging is known as a dominant factor to degrade speech recognition performance in noisy conditions. On the other hand, cognitive factors of aging-relating speech recognition performance in various speech-to-noise conditions are not well established. In this study, two kinds of speech test were performed to examine how working memory load relates to speech recognition performance. One is word recognition test with high-familiarity, four-syllable Japanese words (single-word test). In this test, each word was presented to listeners; the listeners were asked to write the word down on paper with enough time to answer. In the other test, five continuous word were presented to listeners and listeners were asked to write the word down after just five words were presented (multiword test). Both tests were done in various speech-to-noise ratios under 50-dBA Hoth spectrum noise with more than 50 young and elderly subjects. The results of two experiments suggest that (1) Hearing level is related to scores of both tests. (2) Scores of single-word test are well correlated with those of multiword test. (3) Scores of multiword test are not improved as speech-to-noise ratio improves in the condition where scores of single-word test reach their ceiling.

Association of CRP gene polymorphism with CRP levels and Coronary Artery Disease in Type 2 Diabetes in Ahvaz, southwest of Iran

PubMed Central

Ghaffari, Mohammad Ali; Askari Sede, Saeed; Rashtchizadeh, Nadereh; Mohammadzadeh, Ghorban; Majidi, Shahla

2014-01-01

Introduction: We evaluated the association between four polymorphisms in the CRP gene with serum C-reactive protein (CRP) levels, prevalence and severity of coronary artery disease (CAD) in type 2 diabetes mellitus (T2DM) patients. Methods: We performed coronary angiography for 308 T2DM patients and classified them into two groups: T2DM with CAD and T2DM without CAD. All patients were from Ahvaz, Iran. serum levels of CRP, glucose and lipid profile were measured. Genotyping was performed by PCR/RFLP, and the severity of coronary artery disease was determined by Gensini score. Results: The GG genotype of SNP rs279421 was associated with the increased risk of CAD (OR= 2.38; 95% CI: 1.12- 5.8; p= 0.02) and CA, TT, TA genotypes and A allele of SNP rs3091244 and GA genotypes and A allele of SNP rs3093062 were significantly associated with increased CRP levels. None of genotypes or alleles was associated with Gensini score. We found that the haplotype 7 (AGCG) was associated with decreased risk of CAD (OR= 0.11; 95% CI: 0.02, 0.66; p= 0.017) and the Gensini score was correlated with increased levels of CRP, only in CAD group. Conclusion: Although genetic polymorphisms were influenced on serum RP levels, none of the alleles and genotypes raising or falling C-reactive protein levels was consistently associated with an increased prevalence of CAD or protected from that. PMID:25337466

Performance-based comparison of neonatal intubation training outcomes: simulator and live animal.

PubMed

Andreatta, Pamela B; Klotz, Jessica J; Dooley-Hash, Suzanne L; Hauptman, Joe G; Biddinger, Bea; House, Joseph B

2015-02-01

The purpose of this article was to establish psychometric validity evidence for competency assessment instruments and to evaluate the impact of 2 forms of training on the abilities of clinicians to perform neonatal intubation. To inform the development of assessment instruments, we conducted comprehensive task analyses including each performance domain associated with neonatal intubation. Expert review confirmed content validity. Construct validity was established using the instruments to differentiate between the intubation performance abilities of practitioners (N = 294) with variable experience (novice through expert). Training outcomes were evaluated using a quasi-experimental design to evaluate performance differences between 294 subjects randomly assigned to 1 of 2 training groups. The training intervention followed American Heart Association Pediatric Advanced Life Support and Neonatal Resuscitation Program protocols with hands-on practice using either (1) live feline or (2) simulated feline models. Performance assessment data were captured before and directly following the training. All data were analyzed using analysis of variance with repeated measures and statistical significance set at P < .05. Content validity, reliability, and consistency evidence were established for each assessment instrument. Construct validity for each assessment instrument was supported by significantly higher scores for subjects with greater levels of experience, as compared with those with less experience (P = .000). Overall, subjects performed significantly better in each assessment domain, following the training intervention (P = .000). After controlling for experience level, there were no significant differences among the cognitive, performance, and self-efficacy outcomes between clinicians trained with live animal model or simulator model. Analysis of retention scores showed that simulator trained subjects had significantly higher performance scores after 18 weeks (P = .01) and 52 weeks (P = .001) and cognitive scores after 52 weeks (P = .001). The results of this study demonstrate the feasibility of using valid, reliable assessment instruments to assess clinician competency and self-efficacy in the performance of neonatal intubation. We demonstrated the relative equivalency of live animal and simulation-based models as tools to support acquisition of neonatal intubation skills. Retention of performance abilities was greater for subjects trained using the simulator, likely because it afforded greater opportunity for repeated practice. Outcomes in each assessment area were influenced by the previous intubation experience of participants. This suggests that neonatal intubation training programs could be tailored to the level of provider experience to make efficient use of time and educational resources. Future research focusing on the uses of assessment in the applied clinical environment, as well as identification of optimal training cycles for performance retention, is merited.

Cross-cultural application of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS): performances of elderly Chinese Singaporeans.

PubMed

Lim, May-Li; Collinson, Simon Lowes; Feng, Lei; Ng, Tze-Pin

2010-01-01

There is a paucity of normative studies outside of North America and on elderly populations with very low education level. In the present study we examined the performance of poorly educated elderly on the Repeatable Battery Assessment of Neuropsychological Status (RBANS) with 352 cognitively normal elderly Chinese persons living in the community in Singapore who were enrolled in the Singapore Longitudinal Ageing Study (SLAS). Those with no formal education performed significantly less well than those with some years of formal education across four of five RBANS indices as well as the Total Scale score. Age- and education-adjusted normative data for the RBANS were established for the sample. The means and standard deviations of each of 12 subtests raw scores, five Index scores and the Total Scale score were calculated and stratified by age and education. Data from the present study should considerably advance the clinical utility of the RBANS in Chinese geriatric evaluations in Singapore, and can serve as a reference source for poorly educated elderly Chinese from around the region and beyond.

Vitamin D levels and perinatal depressive symptoms in women at risk: a secondary analysis of the mothers, omega-3, and mental health study.

PubMed

Williams, Jennifer Anne; Romero, Vivian C; Clinton, Chelsea M; Vazquez, Delia M; Marcus, Sheila M; Chilimigras, Julie L; Hamilton, Susan E; Allbaugh, Lucy J; Vahratian, Anjel M; Schrader, Ronald M; Mozurkewich, Ellen L

2016-08-03

Vitamin D insufficiency may be associated with depressive symptoms in non-pregnant adults. We performed this study to evaluate whether low maternal vitamin D levels are associated with depressive symptoms in pregnancy. This study was a secondary analysis of a randomized trial designed to assess whether prenatal omega-3 fatty acid supplementation would prevent depressive symptoms. Pregnant women from Michigan who were at risk for depression based on Edinburgh Postnatal Depression Scale Score or history of depression were enrolled. Participants completed the Beck Depression Inventory (BDI) and Mini International Neuropsychiatric Interview at 12-20 weeks, 26-28 weeks, 34-36 weeks, and 6-8 weeks postpartum. Vitamin D levels were measured at 12-20 weeks (N = 117) and 34-36 weeks (N = 112). Complete datasets were available on 105 subjects. Using regression analyses, we evaluated the relationship between vitamin D levels with BDI scores as well as with MINI diagnoses of major depressive disorder and generalized anxiety disorder. Our primary outcome measure was the association of maternal vitamin D levels with BDI scores during early and late pregnancy and postpartum. We found that vitamin D levels at 12-20 weeks were inversely associated with BDI scores both at 12-20 and at 34-36 weeks' gestation (P < 0.05, both). For every one unit increase in vitamin D in early pregnancy, the average decrease in the mean BDI score was .14 units. Vitamin D levels were not associated with diagnoses of major depressive disorder or generalized anxiety disorder. In women at risk for depression, early pregnancy low vitamin D levels are associated with higher depressive symptom scores in early and late pregnancy. Future investigations should study whether vitamin D supplementation in early pregnancy may prevent perinatal depressive symptoms. https://clinicaltrials.gov/ NCT00711971.

LD Hub: a centralized database and web interface to perform LD score regression that maximizes the potential of summary level GWAS data for SNP heritability and genetic correlation analysis.

PubMed

Zheng, Jie; Erzurumluoglu, A Mesut; Elsworth, Benjamin L; Kemp, John P; Howe, Laurence; Haycock, Philip C; Hemani, Gibran; Tansey, Katherine; Laurin, Charles; Pourcain, Beate St; Warrington, Nicole M; Finucane, Hilary K; Price, Alkes L; Bulik-Sullivan, Brendan K; Anttila, Verneri; Paternoster, Lavinia; Gaunt, Tom R; Evans, David M; Neale, Benjamin M

2017-01-15

LD score regression is a reliable and efficient method of using genome-wide association study (GWAS) summary-level results data to estimate the SNP heritability of complex traits and diseases, partition this heritability into functional categories, and estimate the genetic correlation between different phenotypes. Because the method relies on summary level results data, LD score regression is computationally tractable even for very large sample sizes. However, publicly available GWAS summary-level data are typically stored in different databases and have different formats, making it difficult to apply LD score regression to estimate genetic correlations across many different traits simultaneously. In this manuscript, we describe LD Hub - a centralized database of summary-level GWAS results for 173 diseases/traits from different publicly available resources/consortia and a web interface that automates the LD score regression analysis pipeline. To demonstrate functionality and validate our software, we replicated previously reported LD score regression analyses of 49 traits/diseases using LD Hub; and estimated SNP heritability and the genetic correlation across the different phenotypes. We also present new results obtained by uploading a recent atopic dermatitis GWAS meta-analysis to examine the genetic correlation between the condition and other potentially related traits. In response to the growing availability of publicly accessible GWAS summary-level results data, our database and the accompanying web interface will ensure maximal uptake of the LD score regression methodology, provide a useful database for the public dissemination of GWAS results, and provide a method for easily screening hundreds of traits for overlapping genetic aetiologies. The web interface and instructions for using LD Hub are available at http://ldsc.broadinstitute.org/ CONTACT: jie.zheng@bristol.ac.ukSupplementary information: Supplementary data are available at Bioinformatics online. © The Author 2016. Published by Oxford University Press.

Hospital for Special Surgery Pediatric Functional Activity Brief Scale predicts physical fitness testing performance.

PubMed

Fabricant, Peter D; Robles, Alex; McLaren, Son H; Marx, Robert G; Widmann, Roger F; Green, Daniel W

2014-05-01

An eight-item activity scale was recently developed and validated for use as a prognostic tool in clinical research in children and adolescents. It is unclear, however, if this brief questionnaire is predictive of quantitative metrics of physical activity and fitness. The purposes of this study were to prospectively administer the Hospital for Special Surgery Pediatric Functional Activity Brief Scale to a large cohort of healthy adolescents to determine (1) if the activity scale exhibits any floor or ceiling effects; (2) if scores on the activity scale are correlated with standardized physical fitness metrics; and if so, (3) to determine the discrimination ability of the activity scale to differentiate between adolescents with healthy or unhealthy levels of aerobic capacity and calculate an appropriate cutoff value for its use as a screening tool. One hundred eighty-two adolescents (mean, 15.3 years old) prospectively completed the activity scale and four standardized metrics of physical fitness: pushups, sit-ups, shuttle run exercise (Progressive Aerobic Cardiovascular Endurance Run), and calculated VO2-max. Age, sex, and body mass index were also recorded. Pearson correlations, regression analyses, and receiver operating characteristic analyses were used to evaluate activity scale performance. The activity scale did not exhibit any floor or ceiling effects. Pushups (ρ = 0.28), sit-ups (ρ = 0.23), performance on the Progressive Aerobic Cardiovascular Endurance Run (ρ = 0.44), and VO2-max (ρ = 0.43) were all positively correlated with the activity scale score (Pearson correlations, all p < 0.001). Receiver operating characteristic analysis revealed that those with an activity score of ≤ 14 were at higher risk of having low levels of aerobic capacity. In the current study, activity score was free of floor and ceiling effects and predictive of all four physical fitness metrics. An activity score of ≤ 14 was associated with at-risk aerobic capacity previously shown to be associated with an increased risk of metabolic syndrome. This study is the first to prospectively validate an activity questionnaire against quantitative physical fitness assessments and provides further evidence substantiating its use in outcomes research and screening for healthy levels of childhood activity and fitness. Level I, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.

The impact of patient autonomy on older adults with asthma.

PubMed

Karamched, Keerthi R; Hao, Wei; Song, Peter X; Carpenter, Laurie; Steinberg, Joel; Baptist, Alan P

2018-05-03

Understanding patient preferences and desire for involvement in making medical decisions is important when managing chronic conditions. Previous studies have utilized the Autonomy Preference Index (API) in younger asthmatic patients to evaluate these preferences. To identify factors associated with autonomy, and to determine if autonomy is related to asthma outcomes among older adults. 189 older adults (>55 yr) with persistent asthma were included. Preferences for autonomy were assessed using the API, with a higher score indicating higher desire for autonomy. Scores were separated into two domains of 'information seeking' and 'decision making' preferences. The separated scores were correlated with asthma outcomes and demographic variables. To control for confounding factors, a linear regression analysis was performed. Higher 'decision making' preference scores correlated with female gender (p=0.007), higher education level (p=0.01), and lower depression scores (p=0.04). Regarding outcomes, 'decision making' scores positively correlated with asthma quality of life questionnaire (AQLQ) scores (p=0.01). On linear regression analysis, the AQLQ score remained significantly associated with 'decision making' preference scores (p=0.03). There was no association with asthma control test scores, spirometry values, and healthcare utilization. 'Information seeking' preference scores correlated with education level (p=0.03), but there was no correlation with asthma outcomes. Older asthmatic adults with a greater desire for involvement in decision making have a higher asthma related quality of life. Future studies with the intention to increase patient autonomy may help establish a causal relationship. Copyright © 2018. Published by Elsevier Inc.

Predictors of laparoscopic simulation performance among practicing obstetrician gynecologists.

PubMed

Mathews, Shyama; Brodman, Michael; D'Angelo, Debra; Chudnoff, Scott; McGovern, Peter; Kolev, Tamara; Bensinger, Giti; Mudiraj, Santosh; Nemes, Andreea; Feldman, David; Kischak, Patricia; Ascher-Walsh, Charles

2017-11-01

While simulation training has been established as an effective method for improving laparoscopic surgical performance in surgical residents, few studies have focused on its use for attending surgeons, particularly in obstetrics and gynecology. Surgical simulation may have a role in improving and maintaining proficiency in the operating room for practicing obstetrician gynecologists. We sought to determine if parameters of performance for validated laparoscopic virtual simulation tasks correlate with surgical volume and characteristics of practicing obstetricians and gynecologists. All gynecologists with laparoscopic privileges (n = 347) from 5 academic medical centers in New York City were required to complete a laparoscopic surgery simulation assessment. The physicians took a presimulation survey gathering physician self-reported characteristics and then performed 3 basic skills tasks (enforced peg transfer, lifting/grasping, and cutting) on the LapSim virtual reality laparoscopic simulator (Surgical Science Ltd, Gothenburg, Sweden). The association between simulation outcome scores (time, efficiency, and errors) and self-rated clinical skills measures (self-rated laparoscopic skill score or surgical volume category) were examined with regression models. The average number of laparoscopic procedures per month was a significant predictor of total time on all 3 tasks (P = .001 for peg transfer; P = .041 for lifting and grasping; P < .001 for cutting). Average monthly laparoscopic surgical volume was a significant predictor of 2 efficiency scores in peg transfer, and all 4 efficiency scores in cutting (P = .001 to P = .015). Surgical volume was a significant predictor of errors in lifting/grasping and cutting (P < .001 for both). Self-rated laparoscopic skill level was a significant predictor of total time in all 3 tasks (P < .0001 for peg transfer; P = .009 for lifting and grasping; P < .001 for cutting) and a significant predictor of nearly all efficiency scores and errors scores in all 3 tasks. In addition to total time, there was at least 1 other objective performance measure that significantly correlated with surgical volume for each of the 3 tasks. Higher-volume physicians and those with fellowship training were more confident in their laparoscopic skills. By determining simulation performance as it correlates to active physician practice, further studies may help assess skill and individualize training to maintain skill levels as case volumes fluctuate. Copyright © 2017 Elsevier Inc. All rights reserved.

Tackle technique and tackle-related injuries in high-level South African Rugby Union under-18 players: real-match video analysis.

PubMed

Burger, Nicholas; Lambert, Michael I; Viljoen, Wayne; Brown, James C; Readhead, Clint; Hendricks, Sharief

2016-08-01

The high injury rate associated with rugby union is primarily due to the tackle, and poor contact technique has been identified as a risk factor for injury. We aimed to determine whether the tackle technique proficiency scores were different in injurious tackles versus tackles that did not result in injury using real-match scenarios in high-level youth rugby union. Injury surveillance was conducted at the under-18 Craven Week tournaments (2011-2013). Tackle-related injury information was used to identify injury events in the match video footage and non-injury events were identified for the injured player cohort. Injury and non-injury events were scored for technique proficiency and Cohen's effect sizes were calculated and the Student t test (p<0.05) was performed to compare injury versus non-injury scores. The overall mean score for front-on ball-carrier proficiency was 7.17±1.90 and 9.02±2.15 for injury and non-injury tackle events, respectively (effect size=moderate; p<0.05). The overall mean score for side/behind ball-carrier proficiency was 4.09±2.12 and 7.68±1.72 for injury and non-injury tackle events, respectively (effect size=large; p<0.01). The overall mean score for front-on tackler proficiency was 7.00±1.95 and 9.35±2.56 for injury and non-injury tackle events, respectively (effect size=moderate; p<0.05). The overall mean score for side/behind tackler proficiency was 5.47±1.60 and 8.14±1.75 for injury and non-injury tackle events, respectively (effect size=large; p<0.01). Higher overall mean and criterion-specific tackle-related technique scores were associated with a non-injury outcome. The ability to perform well during tackle events may decrease the risk of injury and may manifest in superior 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/

Deaf College Students' Mathematical Skills Relative to Morphological Knowledge, Reading Level, and Language Proficiency

ERIC Educational Resources Information Center

Kelly, Ronald R.; Gaustad, Martha G.

2007-01-01

This study of deaf college students examined specific relationships between their mathematics performance and their assessed skills in reading, language, and English morphology. Simple regression analyses showed that deaf college students' language proficiency scores, reading grade level, and morphological knowledge regarding word segmentation and…

Spelling and Learning Style in Children.

ERIC Educational Resources Information Center

Riding, R. J.; Tempest, J.

1986-01-01

Seventy-two 11-year-old students were tested on 32 dictated words containing two levels of both visual and phonemic complexity. Students were grouped within sexes on their extraversion scores on the Junior Eysenck Personality Inventory and quotients on the Raven's Matrices. Spelling performance was found to interact significantly with level of…

Students' perceived stress and perception of barriers to effective study: impact on academic performance in examinations.

PubMed

Turner, J; Bartlett, D; Andiappan, M; Cabot, L

2015-11-13

To identify students' perceptions of barriers to effective study and the relationship between these and demographic characteristics, levels of perceived stress and examination performance. A questionnaire was distributed to first (BDS1) and final year (BDS5) King's College London dental undergraduates, during Spring 2013. Data were collected on students' social and working environment using a Likert scale from zero to four. Levels of perceived stress and end-of-year examination results were collected. Statistical analyses were undertaken using SPSS® and Stata® software. A response rate of 83.0% (BDS1) and 82.9% (BDS5) was achieved. Social distractions were perceived to hinder study, with median scores of two and three for females and males respectively. The mean perceived stress score differed significantly (p=0.001) between males and females. Difficulties with journey was a significant predictor of perceived stress (p=0.03) as were family responsibilities (p=0.02). Social distractions were significantly related to examination performance (p=0.001). Social distractions were the barrier most highly rated as hindering effective study. Levels of perceived stress were high and were significantly associated with gender, a difficult journey to university and family responsibilities. Social distractions were significantly related to examination performance; students rating social distractions highly, performed less well.

Gross motor development in full-term Greek infants assessed by the Alberta Infant Motor Scale: reference values and socioeconomic impact.

PubMed

Syrengelas, Dimitrios; Kalampoki, Vassiliki; Kleisiouni, Paraskevi; Konstantinou, Dimitrios; Siahanidou, Tania

2014-07-01

The aims of this study were to investigate gross motor development in Greek infants and establish AIMS percentile curves and to examine possible association of AIMS scores with socioeconomic parameters. Mean AIMS scores of 1068 healthy Greek full-term infants were compared at monthly age level with the respective mean scores of the Canadian normative sample. In a subgroup of 345 study participants, parents provided, via interview, information about family socioeconomic status. Multiple linear regression analysis was performed to evaluate the relationship of infant motor development with socioeconomic parameters. Mean AIMS scores did not differ significantly between Greek and Canadian infants in any of the 19 monthly levels of age. In multiple linear regression analysis, the educational level of the mother and also whether the infant was being raised by grandparents/babysitter were significantly associated with gross motor development (p=0.02 and p<0.001, respectively), whereas there was no significant correlation of mean AIMS scores with gender, birth order, maternal age, paternal educational level and family monthly income. Gross motor development of healthy Greek full-term infants, assessed by AIMS during the first 19months of age, follows a similar course to that of the original Canadian sample. Specific socioeconomic factors are associated with the infants' motor development. Copyright © 2014 Elsevier Ltd. All rights reserved.

Association Between American Board of Surgery In-Training Examination Scores and Resident Performance.

PubMed

Ray, Juliet J; Sznol, Joshua A; Teisch, Laura F; Meizoso, Jonathan P; Allen, Casey J; Namias, Nicholas; Pizano, Louis R; Sleeman, Danny; Spector, Seth A; Schulman, Carl I

2016-01-01

The American Board of Surgery In-Training Examination (ABSITE) is designed to measure progress, applied medical knowledge, and clinical management; results may determine promotion and fellowship candidacy for general surgery residents. Evaluations are mandated by the Accreditation Council for Graduate Medical Education but are administered at the discretion of individual institutions and are not standardized. It is unclear whether the ABSITE and evaluations form a reasonable assessment of resident performance. To determine whether favorable evaluations are associated with ABSITE performance. Cross-sectional analysis of preliminary and categorical residents in postgraduate years (PGYs) 1 through 5 training in a single university-based general surgery program from July 1, 2011, through June 30, 2014, who took the ABSITE. Evaluation overall performance and subset evaluation performance in the following categories: patient care, technical skills, problem-based learning, interpersonal and communication skills, professionalism, systems-based practice, and medical knowledge. Passing the ABSITE (≥30th percentile) and ranking in the top 30% of scores at our institution. The study population comprised residents in PGY 1 (n = 44), PGY 2 (n = 31), PGY 3 (n = 26), PGY 4 (n = 25), and PGY 5 (n = 24) during the 4-year study period (N = 150). Evaluations had less variation than the ABSITE percentile (SD = 5.06 vs 28.82, respectively). Neither annual nor subset evaluation scores were significantly associated with passing the ABSITE (n = 102; for annual evaluation, odds ratio = 0.949; 95% CI, 0.884-1.019; P = .15) or receiving a top 30% score (n = 45; for annual evaluation, odds ratio = 1.036; 95% CI, 0.964-1.113; P = .33). There was no difference in mean evaluation score between those who passed vs failed the ABSITE (mean [SD] evaluation score, 91.77 [5.10] vs 93.04 [4.80], respectively; P = .14) or between those who received a top 30% score vs those who did not (mean [SD] evaluation score, 92.78 [4.83] vs 91.92 [5.11], respectively; P = .33). There was no correlation between annual evaluation score and ABSITE percentile (r(2) = 0.014; P = .15), percentage correct unadjusted for PGY level (r(2) = 0.019; P = .09), or percentage correct adjusted for PGY level (r(2) = 0.429; P = .91). Favorable evaluations do not correlate with ABSITE scores, nor do they predict passing. Evaluations do not show much discriminatory ability. It is unclear whether individual resident evaluations and ABSITE scores fully assess competency in residents or allow comparisons to be made across programs. Creation of a uniform evaluation system that encompasses the necessary subjective feedback from faculty with the objective measure of the ABSITE is warranted.

After-School Tutoring and the Distribution of Student Performance

ERIC Educational Resources Information Center

Huang, Min-Hsiung

2013-01-01

As more primary and secondary students worldwide seek after-school tutoring in academic subjects, concerns are being raised about whether after-school tutoring can raise average test scores without widening the variability in student performance, and whether students of certain ability levels may benefit more than others from after-school…

Collaborative Test Reviews: Student Performance

ERIC Educational Resources Information Center

Bhatia, Anuradha; Makela, Carole J.

2010-01-01

A group study method proved helpful in improving senior-level students' performance on unit tests through collaborative learning. Students of a History of Textiles course voluntarily attended study sessions to review course content and prepare for unit tests. The students who attended the group reviews scored better on tests than those who did…

CaPTHUS scoring model in primary hyperparathyroidism: can it eliminate the need for ioPTH testing?

PubMed

Elfenbein, Dawn M; Weber, Sara; Schneider, David F; Sippel, Rebecca S; Chen, Herbert

2015-04-01

The CaPTHUS model was reported to have a positive predictive value of 100 % to correctly predict single-gland disease in patients with primary hyperparathyroidism, thus obviating the need for intraoperative parathyroid hormone (ioPTH) testing. We sought to apply the CaPTHUS scoring model in our patient population and assess its utility in predicting long-term biochemical cure. We retrospective reviewed all parathyroidectomies for primary hyperparathyroidism performed at our university hospital from 2003 to 2012. We routinely perform ioPTH testing. Biochemical cure was defined as a normal calcium level at 6 months. A total of 1,421 patients met the inclusion criteria: 78 % of patients had a single adenoma at the time of surgery, 98 % had a normal serum calcium at 1 week postoperatively, and 96 % had a normal serum calcium level 6 months postoperatively. Using the CaPTHUS scoring model, 307 patients (22.5 %) had a score of ≥ 3, with a positive predictive value of 91 % for single adenoma. A CaPTHUS score of ≥ 3 had a positive predictive value of 98 % for biochemical cure at 1 week as well as at 6 months. In our population, where ioPTH testing is used routinely to guide use of bilateral exploration, patients with a preoperative CaPTHUS score of ≥ 3 had good long-term biochemical cure rates. However, the model only predicted adenoma in 91 % of cases. If minimally invasive parathyroidectomy without ioPTH testing had been done for these patients, the cure rate would have dropped from 98 % to an unacceptable 89 %. Even in these patients with high CaPTHUS scores, multigland disease is present in almost 10 %, and ioPTH testing is necessary.

Factors associated with IQ scores in long-term survivors of childhood acute lymphoblastic leukemia

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

Robison, L.L.; Nesbit, M.E. Jr.; Sather, H.N.

To identify factors which might be associated with intellectual function following treatment for childhood acute lymphoblastic leukemia, 50 long-term survivors were studied using the Wechsler Intelligence Scale for Children-Revised. All patients were diagnosed between 1972 and 1974 and were treated on a single clinical trial protocol with identical induction and maintenance chemotherapy plus central nervous system prophylaxis that included cranial radiation. The mean full scale IQ score for the group was 95 (SEM 2.0), with mean verbal IQ of 94.4 and mean performance IQ of 96.9. Factors which were found to be closely associated with a lower IQ score includedmore » female sex (in both verbal IQ and full-scale IQ), longer duration of chemotherapy (in performance IQ), and younger age at the time of radiation (in both verbal IQ and full-scale IQ). The age at the time of radiation was found to be significantly correlated with discrepancy between verbal and performance IQ, with younger age being associated with verbal IQ scores higher than performance IQ scores. When analyses were performed within specific subgroups of patients defined by sex and age at the time of radiation, dose of cranial radiation, concomitant intrathecal methotrexate therapy, and duration of therapy were all found to be correlated with a lower level of intellectual function. These preliminary findings provide direction for future studies to help identify high-risk patients.« less

Role of maca (Lepidium meyenii) consumption on serum interleukin-6 levels and health status in populations living in the Peruvian central Andes over 4000 m of altitude

PubMed Central

Gonzales, Gustavo F.; Gasco, Manuel; Lozada, Ivan

2013-01-01

Lepidium meyenii (Maca) is a plant that grows at over 4000 meters above sea level in the central Peruvian Andes. The hypocotyls of this plant are traditionally consumed for their nutritional and medicinal properties. The aim of this study was to determine the health status based on a health related quality of life (HRQL) questionnaire (SF-20) and serum levels of interleukin 6 (IL-6) in subjects that are maca consumers. For this, a cross-sectional study was designed to be performed in 50 subjects from Junin (4100 m): 27 subjects were maca consumers and 23 were non-consumers. The SF-20 survey is used to obtain a summary measure of health status. The stand up from a chair and sit down (SUCSD) test (to assess lower-extremity function), hemoglobin measurement, blood pressure, sexual hormone levels, serum IL-6 levels and the score of chronic mountain sickness (CMS) were evaluated. Testosterone/estradiol ratio (P≪0.05), IL-6 (P<0.05) and CMS score were lower, whereas the health status score was higher, in maca consumers when compared to non-consumers (P<0.01). A greater proportion of maca consumers successfully completed the SUCSD test compared to non-consumers (P<0.01), showing a significant association with lower values of serum IL-6 (P<0.05). In conclusion, consumption of maca was associated with low serum IL-6 levels and in turn with better health status scores in the SF-20 survey and low chronic mountain sickness scores. PMID:23934543

The impact of video games on training surgeons in the 21st century.

PubMed

Rosser, James C; Lynch, Paul J; Cuddihy, Laurie; Gentile, Douglas A; Klonsky, Jonathan; Merrell, Ronald

2007-02-01

Video games have become extensively integrated into popular culture. Anecdotal observations of young surgeons suggest that video game play contributes to performance excellence in laparoscopic surgery. Training benefits for surgeons who play video games should be quantifiable. There is a potential link between video game play and laparoscopic surgical skill and suturing. Cross-sectional analysis of the performance of surgical residents and attending physicians participating in the Rosser Top Gun Laparoscopic Skills and Suturing Program (Top Gun). Three different video game exercises were performed, and surveys were completed to assess past experience with video games and current level of play, and each subject's level of surgical training, number of laparoscopic cases performed, and number of years in medical practice. Academic medical center and surgical training program. Thirty-three residents and attending physicians participating in Top Gun from May 10 to August 24, 2002. The primary outcome measures were compared between participants' laparoscopic skills and suturing capability, video game scores, and video game experience. Past video game play in excess of 3 h/wk correlated with 37% fewer errors (P<.02) and 27% faster completion (P<.03). Overall Top Gun score (time and errors) was 33% better (P<.005) for video game players and 42% better (P<.01) if they played more than 3 h/wk. Current video game players made 32% fewer errors (P=.04), performed 24% faster (P<.04), and scored 26% better overall (time and errors) (P<.005) than their nonplaying colleagues. When comparing demonstrated video gaming skills, those in the top tertile made 47% fewer errors, performed 39% faster, and scored 41% better (P<.001 for all) on the overall Top Gun score. Regression analysis also indicated that video game skill and past video game experience are significant predictors of demonstrated laparoscopic skills. Video game skill correlates with laparoscopic surgical skills. Training curricula that include video games may help thin the technical interface between surgeons and screen-mediated applications, such as laparoscopic surgery. Video games may be a practical teaching tool to help train surgeons.

Relationship of executive function and educational status with functional balance in older adults.

PubMed

Voos, Mariana Callil; Custódio, Elaine Bazilio; Malaquias, Joel

2011-01-01

The Berg Balance Scale (BBS) is frequently used to assess functional balance in older adults. The relationship of executive function and level of education with the BBS performance has not been described. The aim of this study was to determine whether (1) the performance on a task requiring executive function (part B of the Trail Making Test, TMT-B) influences results of motor and cognitive tests and (2) the number of years of formal education could be related to performance on BBS in older adults. We also explored whether there would be differences, based on performance on TMT-B (high vs low) in motor function (BBS, the timed up and go [TUG]) or cognitive function (TMT-A and TMTDELTA), the Mini Mental State Examination (MMSE), as well as years of education. Participants included 101 older adults (age range, 60-80 years) residing in São Paulo, Brazil. Functional balance was assessed using BBS and TUG. Executive function was assessed using the TMT and MMSE. Educational status was determined by self-report of participant's total number of years of formal education. The BBS scores were inversely related to TMT-A time (r = -0.63, r = 0.40, P < .001) and TMT-B time (r = -0.56, r = 0.31, P < .001). There was a similar relationship with TMTDELTA (r = -0.47, r = 0.22, P < .001). The BBS scores were positively correlated to years of formal education (r = 0.48, r = 0.23, P < .001). There was a ceiling effect on the TMT-B, with many individuals reaching maximum score of 300 seconds. Participants with high levels of executive function had higher BBS and MMSE scores, more education, and lower TMT-A, TMTDELTA and TUG scores (P < .001) than the lower functioning group. Individuals with higher capacity on tasks requiring visuospatial abilities, psychomotor speed, and executive function, such as the TMT, had better performance on BBS. Individuals with a high executive function, measured by TMT-B, also performed better on other motor and cognitive tests.

Does the Level of Cervical Disc Herniation Surgery Affect Performance-based Outcomes in National Football League Athletes?

PubMed

Mai, Harry T; Burgmeier, Robert J; Mitchell, Sean M; Hecht, Andrew C; Maroon, Joseph C; Nuber, Gordon W; Hsu, Wellington K

2016-12-01

Retrospective cohort study. The aim of this study was to determine whether the level of a cervical disc herniation (CDH) procedure will uniquely impact performance-based outcomes in elite athletes of the National Football League (NFL). Comparative assessments of postsurgical outcomes in NFL athletes with CDH at different levels are unknown. Further, the surgical decision-making for these types of injuries in professional football athletes remains controversial. NFL players with a CDH injury at a definitive cervical level were identified through a review of publicly available archives. Injuries were divided into upper- (C2-C4) and lower-level (C4-T1) CDH. The impact on player outcomes was determined by comparing return to play statistics and calculating a "Performance Score" for each player on the basis of pertinent statistical data, both before and after surgery. A total of 40 NFL athletes met inclusion criteria. In the upper-level group, 10 of 15 (66.6%) players successfully returned to play an average of 44.6 games over 2.6 years. The lower-level cohort had 18 of 25 (72%) players return to play with an average of 44.1 games over 3.1 years. There was no significant difference in the rate of return to play (P = 0.71). Postsurgical performance scores of the upper and lower-level groups were 1.47 vs. 0.69 respectively, with no significant difference between these groups (P = 0.06). Adjacent segment disease requiring reoperation occurred in 10% of anterior cervical discectomy and fusion patients. In 50% of foraminotomy patients, a subsequent fusion was required. A uniquely high percentage of upper-level disc herniations develop in NFL athletes, and although CDH injuries present career threatening implications, an upper-level CDH does not preclude a player from successfully returning to play at a competitive level. In fact, these athletes showed comparable postsurgical performance to those athletes who underwent CDH procedures at lower cervical levels. 4.

Scoring annual earthquake predictions in China

NASA Astrophysics Data System (ADS)

Zhuang, Jiancang; Jiang, Changsheng

2012-02-01

The Annual Consultation Meeting on Earthquake Tendency in China is held by the China Earthquake Administration (CEA) in order to provide one-year earthquake predictions over most China. In these predictions, regions of concern are denoted together with the corresponding magnitude range of the largest earthquake expected during the next year. Evaluating the performance of these earthquake predictions is rather difficult, especially for regions that are of no concern, because they are made on arbitrary regions with flexible magnitude ranges. In the present study, the gambling score is used to evaluate the performance of these earthquake predictions. Based on a reference model, this scoring method rewards successful predictions and penalizes failures according to the risk (probability of being failure) that the predictors have taken. Using the Poisson model, which is spatially inhomogeneous and temporally stationary, with the Gutenberg-Richter law for earthquake magnitudes as the reference model, we evaluate the CEA predictions based on 1) a partial score for evaluating whether issuing the alarmed regions is based on information that differs from the reference model (knowledge of average seismicity level) and 2) a complete score that evaluates whether the overall performance of the prediction is better than the reference model. The predictions made by the Annual Consultation Meetings on Earthquake Tendency from 1990 to 2003 are found to include significant precursory information, but the overall performance is close to that of the reference model.

Retrieval of memories with the help of music in Alzheimer's disease.

PubMed

Chevreau, Priscilia; Nizard, Ingrid; Allain, Philippe

2017-09-01

This study focuses on music as a mediator facilitating access to autobiographical memory in Alzheimer's disease (AD). Studies on this topic are rare, but available data have shown a beneficial effect of music on autobiographical performance in AD patients. Based on the "index word" method, we developed the "index music" method for the evaluation of autobiographical memory. The subjects had to tell a memory of their choice from the words or music presented to them. The task was proposed to 54 patients with diagnosis of AD according to DSM IV and NINCDS-ADRDA criteria. All of them had a significant cognitive decline on the MMSE (mean score: 14.5). Patients were matched by age, sex and level of education with 48 control subjects without cognitive impairment (mean score on the MMSE: 28). Results showed that autobiographical memory quantity scores of AD patients were significantly lower than those of healthy control in both methods. However, autobiographical memory quality scores of AD patients increased with "index music" whereas autobiographical memory quality scores of healthy control decreased. Also, the autobiographical performance of patients with AD in condition index music was not correlated with cognitive performance in contrast to the autobiographical performances in index word. These results confirm that music improves access to personal memories in patients with AD. Personal memories could be preserved in patients with AD and music could constitute an interesting way to stimulate recollection.

Anxiety in the orthopedic patient: using PROMIS to assess mental health.

PubMed

Beleckas, Casey M; Prather, Heidi; Guattery, Jason; Wright, Melissa; Kelly, Michael; Calfee, Ryan P

2018-05-08

This study explored the performance of the Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety assessment relative to the Depression assessment in orthopedic patients, the relationship between Anxiety with self-reported Physical Function and Pain Interference, and to determine if Anxiety levels varied according to the location of orthopedic conditions. This cross-sectional evaluation analyzed 14,962 consecutive adult new-patient visits to a tertiary orthopedic practice between 4/1/2016 and 12/31/2016. All patients completed PROMIS Anxiety, Depression, Physical Function, and Pain Interference computer adaptive tests (CATs) as routine clinical intake. Patients were grouped by the orthopedic service providing care and categorized as either affected with Anxiety if scoring > 62 based on linkage to the Generalized Anxiety Disorder-7 survey. Spearman correlations between the PROMIS scores were calculated. Bivariate statistics assessed differences in Anxiety and Depression scores between patients of different orthopedic services. 20% of patients scored above the threshold to be considered affected by Anxiety. PROMIS Anxiety scores demonstrated a stronger correlation than Depression scores with Physical Function and Pain Interference scores. Patients with spine conditions reported the highest median Anxiety scores and were more likely to exceed the Anxiety threshold than patients presenting to sports or upper extremity surgeons. One in five new orthopedic patients reports Anxiety levels that may warrant intervention. This rate is heightened in patients needing spine care. Patient-reported Physical Function more strongly correlates with PROMIS Anxiety than Depression suggesting that the Anxiety CAT is a valuable addition to assess mental health among orthopedic patients. Diagnostic level III.

Construct validity of the ovine model in endoscopic sinus surgery training.

PubMed

Awad, Zaid; Taghi, Ali; Sethukumar, Priya; Tolley, Neil S

2015-03-01

To demonstrate construct validity of the ovine model as a tool for training in endoscopic sinus surgery (ESS). Prospective, cross-sectional evaluation study. Over 18 consecutive months, trainees and experts were evaluated in their ability to perform a range of tasks (based on previous face validation and descriptive studies conducted by the same group) relating to ESS on the sheep-head model. Anonymized randomized video recordings of the above were assessed by two independent and blinded assessors. A validated assessment tool utilizing a five-point Likert scale was employed. Construct validity was calculated by comparing scores across training levels and experts using mean and interquartile range of global and task-specific scores. Subgroup analysis of the intermediate group ascertained previous experience. Nonparametric descriptive statistics were used, and analysis was carried out using SPSS version 21 (IBM, Armonk, NY). Reliability of the assessment tool was confirmed. The model discriminated well between different levels of expertise in global and task-specific scores. A positive correlation was noted between year in training and both global and task-specific scores (P < .001). Experience of the intermediate group was variable, and the number of ESS procedures performed under supervision had the highest impact on performance. This study describes an alternative model for ESS training and assessment. It is also the first to demonstrate construct validity of the sheep-head model for ESS training. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

Case-Mix Adjustment of the Bereaved Family Survey.

PubMed

Kutney-Lee, Ann; Carpenter, Joan; Smith, Dawn; Thorpe, Joshua; Tudose, Alina; Ersek, Mary

2018-01-01

Surveys of bereaved family members are increasingly being used to evaluate end-of-life (EOL) care and to measure organizational performance in EOL care quality. The Bereaved Family Survey (BFS) is used to monitor EOL care quality and benchmark performance in the Veterans Affairs (VA) health-care system. The objective of this study was to develop a case-mix adjustment model for the BFS and to examine changes in facility-level scores following adjustment, in order to provide fair comparisons across facilities. We conducted a cross-sectional secondary analysis of medical record and survey data from veterans and their family members across 146 VA medical centers. Following adjustment using model-based propensity weighting, the mean change in the BFS-Performance Measure score across facilities was -0.6 with a range of -2.6 to 0.6. Fifty-five (38%) facilities changed within ±0.5 percentage points of their unadjusted score. On average, facilities that benefited most from adjustment cared for patients with greater comorbidity burden and were located in urban areas in the Northwest and Midwestern regions of the country. Case-mix adjustment results in minor changes to facility-level BFS scores but allows for fairer comparisons of EOL care quality. Case-mix adjustment of the BFS positions this National Quality Forum-endorsed measure for use in public reporting and internal quality dashboards for VA leadership and may inform the development and refinement of case-mix adjustment models for other surveys of bereaved family members.

The Level of Vision Necessary for Competitive Performance in Rifle Shooting: Setting the Standards for Paralympic Shooting with Vision Impairment.

PubMed

Allen, Peter M; Latham, Keziah; Mann, David L; Ravensbergen, Rianne H J C; Myint, Joy

2016-01-01

The aim of this study was to investigate the level of vision impairment (VI) that would reduce performance in shooting; to guide development of entry criteria to visually impaired (VI) shooting. Nineteen international-level shooters without VI took part in the study. Participants shot an air rifle, while standing, toward a regulation target placed at the end of a 10 m shooting range. Cambridge simulation glasses were used to simulate six different levels of VI. Visual acuity (VA) and contrast sensitivity (CS) were assessed along with shooting performance in each of seven conditions of simulated impairment and compared to that with habitual vision. Shooting performance was evaluated by calculating each individual's average score in every level of simulated VI and normalizing this score by expressing it as a percentage of the baseline performance achieved with habitual vision. Receiver Operating Characteristic curves were constructed to evaluate the ability of different VA and CS cut-off criteria to appropriately classify these athletes as achieving 'expected' or 'below expected' shooting results based on their performance with different levels of VA and CS. Shooting performance remained relatively unaffected by mild decreases in VA and CS, but quickly deteriorated with more moderate losses. The ability of visual function measurements to classify shooting performance was good, with 78% of performances appropriately classified using a cut-off of 0.53 logMAR and 74% appropriately classified using a cut-off of 0.83 logCS. The current inclusion criteria for VI shooting (1.0 logMAR) is conservative, maximizing the chance of including only those with an impairment that does impact performance, but potentially excluding some who do have a genuine impairment in the sport. A lower level of impairment would include more athletes who do have a genuine impairment but would potentially include those who do not actually have an impairment that impacts performance in the sport. An impairment to CS could impact performance in the sport and might be considered in determining eligibility to take part in VI competition.

The Level of Vision Necessary for Competitive Performance in Rifle Shooting: Setting the Standards for Paralympic Shooting with Vision Impairment

PubMed Central

Allen, Peter M.; Latham, Keziah; Mann, David L.; Ravensbergen, Rianne H. J. C.; Myint, Joy

2016-01-01

The aim of this study was to investigate the level of vision impairment (VI) that would reduce performance in shooting; to guide development of entry criteria to visually impaired (VI) shooting. Nineteen international-level shooters without VI took part in the study. Participants shot an air rifle, while standing, toward a regulation target placed at the end of a 10 m shooting range. Cambridge simulation glasses were used to simulate six different levels of VI. Visual acuity (VA) and contrast sensitivity (CS) were assessed along with shooting performance in each of seven conditions of simulated impairment and compared to that with habitual vision. Shooting performance was evaluated by calculating each individual’s average score in every level of simulated VI and normalizing this score by expressing it as a percentage of the baseline performance achieved with habitual vision. Receiver Operating Characteristic curves were constructed to evaluate the ability of different VA and CS cut-off criteria to appropriately classify these athletes as achieving ‘expected’ or ‘below expected’ shooting results based on their performance with different levels of VA and CS. Shooting performance remained relatively unaffected by mild decreases in VA and CS, but quickly deteriorated with more moderate losses. The ability of visual function measurements to classify shooting performance was good, with 78% of performances appropriately classified using a cut-off of 0.53 logMAR and 74% appropriately classified using a cut-off of 0.83 logCS. The current inclusion criteria for VI shooting (1.0 logMAR) is conservative, maximizing the chance of including only those with an impairment that does impact performance, but potentially excluding some who do have a genuine impairment in the sport. A lower level of impairment would include more athletes who do have a genuine impairment but would potentially include those who do not actually have an impairment that impacts performance in the sport. An impairment to CS could impact performance in the sport and might be considered in determining eligibility to take part in VI competition. PMID:27877150

Aerobic Fitness, Micronutrient Status, and Academic Achievement in Indian School-Aged Children

PubMed Central

Desai, Ishaan K.; Kurpad, Anura V.; Chomitz, Virginia R.; Thomas, Tinku

2015-01-01

Aerobic fitness has been shown to have several beneficial effects on child health. However, research on its relationship with academic performance has been limited, particularly in developing countries and among undernourished populations. This study examined the association between aerobic fitness and academic achievement in clinically healthy but nutritionally compromised Indian school-aged children and assessed whether micronutrient status affects this association. 273 participants, aged 7 to 10.5 years, were enrolled from three primary schools in Bangalore, India. Data on participants’ aerobic fitness (20-m shuttle test), demographics, anthropometry, diet, physical activity, and micronutrient status were abstracted. School-wide exam scores in mathematics and Kannada language served as indicators of academic performance and were standardized by grade level. The strength of the fitness/achievement association was analyzed using Spearman’s rank correlation, multiple variable logistic regression, and multi-level models. Significant positive correlations between aerobic capacity (VO2 peak) and academic scores in math and Kannada were observed (P < 0.05). After standardizing scores across grade levels and adjusting for school, gender, socioeconomic status, and weight status (BMI Z-score), children with greater aerobic capacities (mL * kg-1 * min-1) had greater odds of scoring above average on math and Kannada exams (OR=1.08, 95% CI: 1.02 to 1.15 and OR=1.11, 95% CI: 1.04 to 1.18, respectively). This association remained significant after adjusting for micronutrient deficiencies. These findings provide preliminary evidence of a fitness/achievement association in Indian children. While the mechanisms by which aerobic fitness may be linked to academic achievement require further investigation, the results suggest that educators and policymakers should consider the adequacy of opportunities for physical activity and fitness in schools for both their physical and potential academic benefits. PMID:25806824

Aerobic fitness, micronutrient status, and academic achievement in Indian school-aged children.

PubMed

Desai, Ishaan K; Kurpad, Anura V; Chomitz, Virginia R; Thomas, Tinku

2015-01-01

Aerobic fitness has been shown to have several beneficial effects on child health. However, research on its relationship with academic performance has been limited, particularly in developing countries and among undernourished populations. This study examined the association between aerobic fitness and academic achievement in clinically healthy but nutritionally compromised Indian school-aged children and assessed whether micronutrient status affects this association. 273 participants, aged 7 to 10.5 years, were enrolled from three primary schools in Bangalore, India. Data on participants' aerobic fitness (20-m shuttle test), demographics, anthropometry, diet, physical activity, and micronutrient status were abstracted. School-wide exam scores in mathematics and Kannada language served as indicators of academic performance and were standardized by grade level. The strength of the fitness/achievement association was analyzed using Spearman's rank correlation, multiple variable logistic regression, and multi-level models. Significant positive correlations between aerobic capacity (VO2 peak) and academic scores in math and Kannada were observed (P < 0.05). After standardizing scores across grade levels and adjusting for school, gender, socioeconomic status, and weight status (BMI Z-score), children with greater aerobic capacities (mL * kg(-1) * min(-1)) had greater odds of scoring above average on math and Kannada exams (OR=1.08, 95% CI: 1.02 to 1.15 and OR=1.11, 95% CI: 1.04 to 1.18, respectively). This association remained significant after adjusting for micronutrient deficiencies. These findings provide preliminary evidence of a fitness/achievement association in Indian children. While the mechanisms by which aerobic fitness may be linked to academic achievement require further investigation, the results suggest that educators and policymakers should consider the adequacy of opportunities for physical activity and fitness in schools for both their physical and potential academic benefits.

Role of Intracranial Pressure Monitoring in Management of Patients with Severe Traumatic Brain Injury: Results of a Large Level I Trauma Center in Southern Iran.

PubMed

Khalili, Hosseinali; Sadraei, Nazanin; Niakan, Amin; Ghaffarpasand, Fariborz; Sadraei, Amin

2016-10-01

To determine the role of intracranial pressure (ICP) monitoring in management of patients with severe traumatic brain injury (TBI) admitted to a large level I trauma center in Southern Iran. This was a cohort study performed during a 2-year period in a level I trauma center in Southern Iran including all adult patients (>16 years) with severe TBI (Glasgow Coma Scale [GCS] score, 3-8) who underwent ICP monitoring through ventriculostomy. The management was based on the recorded ICP values with threshold of 20 mm Hg. Decompressive craniectomy was performed in patients with intractable intracranial hypertension (persistent ICP ≥25 mm Hg). In unresponsive patients, barbiturate coma was induced. Patients were followed for 6 months and Glasgow Outcome Scale Extended was recorded. The determinants of favorable and unfavorable outcome were also determined. Overall, we included 248 patients with mean age of 34.6 ± 16.6 years, among whom there were 216 men (87.1%) and 32 women (12.9%). Eighty-five patients (34.2%) had favorable and 163 (65.8%) unfavorable outcomes. Those with favorable outcome had significantly lower age (P = 0.004), higher GCS score on admission (P < 0.001), lower Rotterdam score (P = 0.035), fewer episodes of intracranial hypertension (P < 0.001), and lower maximum recorded ICP (P = 0.041). These factors remained statistically significant after elimination of confounders by multivariate logistic regression model. Age, GCS score on admission, Rotterdam score, intracranial hypertension, and maximum recorded ICP are important determinants of outcome in patients with severe TBI. ICP monitoring assisted us in targeted therapy and management of patients with severe TBI. Copyright © 2016 Elsevier Inc. All rights reserved.

Effect of coccidia challenge and natural betaine supplementation on performance, nutrient utilization, and intestinal lesion scores of broiler chickens fed suboptimal level of dietary methionine

PubMed Central

Amerah, A. M.; Ravindran, V.

2015-01-01

The aim of the present experiment was to examine the effect of coccidia challenge and natural betaine supplementation on performance, nutrient utilization, and intestinal lesion scores of broiler chickens fed suboptimal level of dietary methionine. The experimental design was a 2 × 2 factorial arrangement of treatments evaluating two levels of betaine supplementation (0 and 960 g betaine/t of feed) without or with coccidia challenge. Each treatment was fed to 8 cages of 8 male broilers (Ross 308) for 1 to 21d. On d 14, birds in the 2 challenged groups received mixed inocula of Eimeria species from a recent field isolate, containing approximately 180,000 E. acervulina, 6,000 E. maxima, and 18,000 E. tenella oocysts. At 21d, digesta from the terminal ileum was collected for the determination of dry matter, energy, nitrogen, amino acids, starch, fat, and ash digestibilities. Lesion scores in the different segments of the small intestine were also measured on d 21. Performance and nutrient digestibility data were analyzed by two-way ANOVA. Lesion score data were analyzed using Pearson chi-square test to identify significant differences between treatments. Orthogonal polynomial contrasts were used to assess the significance of linear or quadratic models to describe the response in the dependent variable to total lesion scores. Coccidia challenge reduced (P < 0.0001) the weight gain and feed intake, and increased (P < 0.0001) the feed conversion ratio. Betaine supplementation had no effect (P > 0.05) on the weight gain or feed intake, but lowered (P < 0.05) the feed conversion ratio. No interaction (P > 0.05) between coccidia challenge and betaine supplementation was observed for performance parameters. Betaine supplementation increased (P < 0.05) the digestibility of dry matter, nitrogen, energy, fat, and amino acids only in birds challenged with coccidia as indicated by the significant interaction (P < 0.0001) between betaine supplementation and coccidia challenge. The main effect of coccidia challenge reduced (P < 0.05) starch digestibility. Betaine supplementation improved (P < 0.05) starch digestibility regardless of the coccidia challenge. For each unit increase in the total lesion score, there was a linear (P < 0.001) decrease in digestibility of mean amino acids, starch, and fat by 3.8, 3.4 and 16%, respectively. Increasing total lesion scores resulted in a quadratic (P < 0.05) decrease in dry matter digestibility and ileal digestible energy. No lesions were found in the intestine or ceca of the unchallenged treatments. In the challenged treatments, betaine supplementation reduced (P < 0.01) the lesion scores at the duodenum, lower jejunum, and total lesion scores compared to the treatment without supplements. In conclusion, coccidia challenge lowered the digestibility of energy and nutrients and increased the feed conversion ratio of broilers. However, betaine supplementation reduced the impact of coccidia challenge and positively affected nutrient digestibility and the feed conversion ratio. PMID:25691757

Characteristics and clinical correlates of prospective memory performance in first-episode schizophrenia.

PubMed

Zhou, Fu-Chun; Xiang, Yu-Tao; Wang, Chuan-Yue; Dickerson, Faith; Au, Raymond W C; Zhou, Jing-Jing; Zhou, Yan; Shum, David H K; Chiu, Helen F K; Man, David; Lee, Edwin H M; Yu, Xin; Chan, Raymond C K; Ungvari, Gabor S

2012-03-01

The aim of this study was to examine prospective memory (PM) and its socio-demographic, clinical, and neurocognitive correlates in first episode schizophrenia (FES). Fifty-one FES patients and 42 healthy controls formed the study sample. Time- and event-based PM (TBPM and EBPM) performance were measured with the Chinese version of the Cambridge Prospective Memory Test (C-CAMPROMPT). A battery of neuropsychological tests was also administered. Patients' clinical symptoms were evaluated with the Positive and Negative Symptom Scale (PANSS). Patients performed significantly worse in both TBPM (8.7 ± 5.3 vs. 14.8 ± 3.5) and EBPM (11.3 ± 4.7 vs. 15.7 ± 2.7) than the controls. After controlling for age, gender, education level and neurocognitive test score, the difference in performance on the two types of PM tasks between patients and controls was no longer present. In multiple linear regression analyses, longer duration of untreated psychosis (DUP), lower scores of the Hopkins Verbal Learning Test-Revised (HVLT-R) and the categories completed of the Wisconsin Card Sorting Test (WCST-CC) and higher score of the Color Trails Test-2 (CTT-2) contributed to poorer TBPM performance, while lower score of HVLT-R, higher score of the perseverative errors of the Wisconsin Card Sorting Test (WCST-PE) and longer DUP contributed to worse performance on EBPM. Both subtypes of PM are impaired in first-episode schizophrenia suggesting that PM deficits are an integral part of the cognitive dysfunction in the disease process. Copyright © 2011 Elsevier B.V. All rights reserved.

Validation of the da Vinci Surgical Skill Simulator across three surgical disciplines: A pilot study

PubMed Central

Alzahrani, Tarek; Haddad, Richard; Alkhayal, Abdullah; Delisle, Josée; Drudi, Laura; Gotlieb, Walter; Fraser, Shannon; Bergman, Simon; Bladou, Frank; Andonian, Sero; Anidjar, Maurice

2013-01-01

Objective: In this paper, we evaluate face, content and construct validity of the da Vinci Surgical Skills Simulator (dVSSS) across 3 surgical disciplines. Methods: In total, 48 participants from urology, gynecology and general surgery participated in the study as novices (0 robotic cases performed), intermediates (1–74) or experts (≥75). Each participant completed 9 tasks (Peg board level 2, match board level 2, needle targeting, ring and rail level 2, dots and needles level 1, suture sponge level 2, energy dissection level 1, ring walk level 3 and tubes). The Mimic Technologies software scored each task from 0 (worst) to 100 (best) using several predetermined metrics. Face and content validity were evaluated by a questionnaire administered after task completion. Wilcoxon test was used to perform pair wise comparisons. Results: The expert group comprised of 6 attending surgeons. The intermediate group included 4 attending surgeons, 3 fellows and 5 residents. The novices included 1 attending surgeon, 1 fellow, 13 residents, 13 medical students and 2 research assistants. The median number of robotic cases performed by experts and intermediates were 250 and 9, respectively. The median overall realistic score (face validity) was 8/10. Experts rated the usefulness of the simulator as a training tool for residents (content validity) as 8.5/10. For construct validity, experts outperformed novices in all 9 tasks (p < 0.05). Intermediates outperformed novices in 7 of 9 tasks (p < 0.05); there were no significant differences in the energy dissection and ring walk tasks. Finally, experts scored significantly better than intermediates in only 3 of 9 tasks (matchboard, dots and needles and energy dissection) (p < 0.05). Conclusions: This study confirms the face, content and construct validities of the dVSSS across urology, gynecology and general surgery. Larger sample size and more complex tasks are needed to further differentiate intermediates from experts. PMID:23914275

English language proficiency and academic performance: A study of a medical preparatory year program in Saudi Arabia

PubMed Central

Kaliyadan, Feroze; Thalamkandathil, Nazer; Parupalli, Srinivas Rao; Amin, Tarek Tawfik; Balaha, Magdy Hassan; Al Bu Ali, Waleed Hamad

2015-01-01

Introduction: All medical schools in Saudi Arabia have English as the primary official medium of instruction. Most of the high school education, however, is delivered in Arabic and hence the transition to an English based learning environment tends to be difficult for some students. Our study aims to correlate English language proficiency with academic performance among medical students in their preparatory year. Methods: A cross-sectional study design was used. Test scores of 103 preparatory year students (54 female and 49 male) were analyzed after the students completed an English language course and medical introductory course in their preparatory year. The total score obtained in the English course assessment was compared to each component of the medical content assessment. Results: A significantly positive correlation (Spearman's Rho, at 0.01 levels) was seen between the scores of the English exam and the written exam (P <0.001) and the oral exam (P = −0.003) parts respectively of the medical examination. Significant correlation with the English exam score was not obtained for the other components of the medical assessment, namely; student assignments, presentations and portfolios. Conclusion: English language proficiency is an important factor in determining academic proficiency of medical students in our college at the preparatory year level. PMID:26629471

English language proficiency and academic performance: A study of a medical preparatory year program in Saudi Arabia.

PubMed

Kaliyadan, Feroze; Thalamkandathil, Nazer; Parupalli, Srinivas Rao; Amin, Tarek Tawfik; Balaha, Magdy Hassan; Al Bu Ali, Waleed Hamad

2015-01-01

All medical schools in Saudi Arabia have English as the primary official medium of instruction. Most of the high school education, however, is delivered in Arabic and hence the transition to an English based learning environment tends to be difficult for some students. Our study aims to correlate English language proficiency with academic performance among medical students in their preparatory year. A cross-sectional study design was used. Test scores of 103 preparatory year students (54 female and 49 male) were analyzed after the students completed an English language course and medical introductory course in their preparatory year. The total score obtained in the English course assessment was compared to each component of the medical content assessment. A significantly positive correlation (Spearman's Rho, at 0.01 levels) was seen between the scores of the English exam and the written exam (P <0.001) and the oral exam (P = -0.003) parts respectively of the medical examination. Significant correlation with the English exam score was not obtained for the other components of the medical assessment, namely; student assignments, presentations and portfolios. English language proficiency is an important factor in determining academic proficiency of medical students in our college at the preparatory year level.

Nasal Histopathology and Intracage Ammonia Levels in Female Groups and Breeding Mice Housed in Static Isolation Cages

PubMed Central

Mexas, Angela M; Brice, Angela K; Caro, Adam C; Hillanbrand, Troy S

2015-01-01

Many factors influence ammonia levels in rodent cages, and high intracage ammonia has been associated with specific types of abnormal nasal pathology in mice. The use of autoclaved corncob bedding and the maintenance of low room humidity reduce the accumulation of ammonia in mouse cages. However, there are no engineering standards that define the limits of ammonia exposure for mice housed in static isolation cages. Regulatory guidance indicates that solid bottom cages must be sanitized at least weekly and that cage components in direct contact with animals must be sanitized at least every 2 wk. Common practice is to replace the bottoms and bedding of static isolation cages once weekly. To determine whether changing static isolation cages once weekly is an appropriate performance standard for mice, we prospectively evaluated the relationship between ammonia levels, nasal histopathology, and housing densities in various grouping strategies of mice housed in static isolation cages. Here, we report that the average nasal pathology score per cage and intracage ammonia levels were correlated, but nasal pathology scores did not differ among mice housed in breeding pairs, breeding trios, or female groups. In light of ammonia levels and histopathology scores as performance standards, these results suggest that a weekly cage-change frequency for static isolation cages does not result in adverse effects. Our results provide evidence to support current practices in the use of static isolation cages for housing laboratory mice in modern vivaria. PMID:26424245

Pig carcass tail lesions: the influence of record keeping through an advisory service and the relationship with farm performance parameters.

PubMed

van Staaveren, N; Teixeira, D L; Hanlon, A; Boyle, L A

2017-01-01

Tail lesions are important pig welfare indicators that could be recorded during meat inspection as they are more visible on the carcass than on the live animal. Tail biting is associated with reduced performance in the bitten pig, but it is not clear whether problems with tail biting are reflected in general farm performance figures. Farm advisory services aim to improve farm productivity which could be associated with improvements in pig welfare. Record keeping forms an integral part of such advisory services. The aim of this study was to examine the influence of record keeping in the Teagasc eProfit Monitor (ePM herds) on the prevalence of tail lesion severity scores in Irish slaughter pigs. In addition, we investigated associations between the prevalence of tail lesion scores and production parameters at farm level in ePM herds. Pigs were observed after scalding/dehairing and tail lesion score (0 to 4), sex and farm identification were recorded. Tail lesion scores were collapsed into none/mild lesions (score ⩽1), moderate lesions (score 2) and severe lesions (score ⩾3). The effect of record keeping (ePM herd) on the different tail lesion outcomes was analysed at batch level using the events/trials structure in generalized linear mixed models (PROC GLIMMIX). Spearman's rank correlations were calculated between average tail lesion score of a batch and production parameters. A total of 13 133 pigs were assessed from 73 batches coming from 61 farms. In all, 23 farms were identified as ePM herds. The average prevalence of moderate tail lesions was 26.8% and of severe tail lesions was 3.4% in a batch. Batches coming from ePM herds had a lower prevalence of moderate tail lesions than non-ePM herds (P<0.001). Average tail lesion score was negatively associated with age (P<0.05) and weight (P<0.05) at sale/transfer of weaners, and tended to be positively associated with the number of finishing days (P=0.06). In addition, the prevalence of severe tail lesions was negatively associated with average daily gain in weaners (P<0.05) and tended to do so with average daily gain in finishers (P=0.08). This study provides the first indication that record keeping through an advisory service may help to lower the risk of tail biting, which is associated with improved farm performance.

In vitro evaluation of a new iterative reconstruction algorithm for dose reduction in coronary artery calcium scoring

PubMed Central

Allmendinger, Thomas; Kunz, Andreas S; Veyhl-Wichmann, Maike; Ergün, Süleyman; Bley, Thorsten A; Petritsch, Bernhard

2017-01-01

Background Coronary artery calcium (CAC) scoring is a widespread tool for cardiac risk assessment in asymptomatic patients and accompanying possible adverse effects, i.e. radiation exposure, should be as low as reasonably achievable. Purpose To evaluate a new iterative reconstruction (IR) algorithm for dose reduction of in vitro coronary artery calcium scoring at different tube currents. Material and Methods An anthropomorphic calcium scoring phantom was scanned in different configurations simulating slim, average-sized, and large patients. A standard calcium scoring protocol was performed on a third-generation dual-source CT at 120 kVp tube voltage. Reference tube current was 80 mAs as standard and stepwise reduced to 60, 40, 20, and 10 mAs. Images were reconstructed with weighted filtered back projection (wFBP) and a new version of an established IR kernel at different strength levels. Calcifications were quantified calculating Agatston and volume scores. Subjective image quality was visualized with scans of an ex vivo human heart. Results In general, Agatston and volume scores remained relatively stable between 80 and 40 mAs and increased at lower tube currents, particularly in the medium and large phantom. IR reduced this effect, as both Agatston and volume scores decreased with increasing levels of IR compared to wFBP (P < 0.001). Depending on selected parameters, radiation dose could be lowered by up to 86% in the large size phantom when selecting a reference tube current of 10 mAs with resulting Agatston levels close to the reference settings. Conclusion New iterative reconstruction kernels may allow for reduction in tube current for established Agatston scoring protocols and consequently for substantial reduction in radiation exposure. PMID:28607763

The Automated Assessment of Postural Stability: Balance Detection Algorithm.

PubMed

Napoli, Alessandro; Glass, Stephen M; Tucker, Carole; Obeid, Iyad

2017-12-01

Impaired balance is a common indicator of mild traumatic brain injury, concussion and musculoskeletal injury. Given the clinical relevance of such injuries, especially in military settings, it is paramount to develop more accurate and reliable on-field evaluation tools. This work presents the design and implementation of the automated assessment of postural stability (AAPS) system, for on-field evaluations following concussion. The AAPS is a computer system, based on inexpensive off-the-shelf components and custom software, that aims to automatically and reliably evaluate balance deficits, by replicating a known on-field clinical test, namely, the Balance Error Scoring System (BESS). The AAPS main innovation is its balance error detection algorithm that has been designed to acquire data from a Microsoft Kinect ® sensor and convert them into clinically-relevant BESS scores, using the same detection criteria defined by the original BESS test. In order to assess the AAPS balance evaluation capability, a total of 15 healthy subjects (7 male, 8 female) were required to perform the BESS test, while simultaneously being tracked by a Kinect 2.0 sensor and a professional-grade motion capture system (Qualisys AB, Gothenburg, Sweden). High definition videos with BESS trials were scored off-line by three experienced observers for reference scores. AAPS performance was assessed by comparing the AAPS automated scores to those derived by three experienced observers. Our results show that the AAPS error detection algorithm presented here can accurately and precisely detect balance deficits with performance levels that are comparable to those of experienced medical personnel. Specifically, agreement levels between the AAPS algorithm and the human average BESS scores ranging between 87.9% (single-leg on foam) and 99.8% (double-leg on firm ground) were detected. Moreover, statistically significant differences in balance scores were not detected by an ANOVA test with alpha equal to 0.05. Despite some level of disagreement between human and AAPS-generated scores, the use of an automated system yields important advantages over currently available human-based alternatives. These results underscore the value of using the AAPS, that can be quickly deployed in the field and/or in outdoor settings with minimal set-up time. Finally, the AAPS can record multiple error types and their time course with extremely high temporal resolution. These features are not achievable by humans, who cannot keep track of multiple balance errors with such a high resolution. Together, these results suggest that computerized BESS calculation may provide more accurate and consistent measures of balance than those derived from human experts.

Measuring Inpatient Rehabilitation Facility Quality of Care: Discharge Self-Care Functional Status Quality Measure.

PubMed

Pardasaney, Poonam K; Deutsch, Anne; Iriondo-Perez, Jeniffer; Ingber, Melvin J; McMullen, Tara

2018-06-01

To describe the calculation and psychometric properties of the discharge self-care functional status quality measure implemented in the Centers for Medicare & Medicaid Services' (CMS) Inpatient Rehabilitation Facility (IRF) Quality Reporting Program on October 1, 2016. Medicare fee-for-service (FFS) patients from 38 IRFs that participated in the CMS Post-Acute Care Payment Reform Demonstration were included in this cohort study. Data came from the Continuity Assessment Record and Evaluation Item Set, IRF-Patient Assessment Instrument, and Medicare claims. For each patient, we calculated an expected discharge self-care score, risk-adjusted for demographic and baseline clinical characteristics. The performance score of each IRF equaled the percentage of patient stays where the observed discharge self-care score met or exceeded the expected score. We assessed the measure's discriminatory ability across IRFs and reliability. IRFs. Medicare FFS patients aged ≥21 years (N=4769). Not applicable. Facility-level discharge self-care quality measure performance score. A total of 4769 patient stays were included; 57% of stays were in women, and 12.1% were in patients aged <65 years. Stroke was the most common diagnosis (21.8%). The mean±SD performance score was 55.1%±16.6% (range, 25.8%-100%). About 54% of IRFs had scores significantly different from the percentage of stays that met or exceeded the expected discharge self-care score in the overall demonstration sample. The quality measure showed strong reliability, with intraclass correlation coefficients of .91. The discharge self-care quality measure showed strong discriminatory ability and reliability, representing an important initial step in evaluation of IRF self-care outcomes. A wide range in performance scores suggested a gap in quality of care across IRFs. Future work should include testing the measure with nationwide data from all IRFs. Published by Elsevier Inc.

Improving causal inference with a doubly robust estimator that combines propensity score stratification and weighting.

PubMed

Linden, Ariel

2017-08-01

When a randomized controlled trial is not feasible, health researchers typically use observational data and rely on statistical methods to adjust for confounding when estimating treatment effects. These methods generally fall into 3 categories: (1) estimators based on a model for the outcome using conventional regression adjustment; (2) weighted estimators based on the propensity score (ie, a model for the treatment assignment); and (3) "doubly robust" (DR) estimators that model both the outcome and propensity score within the same framework. In this paper, we introduce a new DR estimator that utilizes marginal mean weighting through stratification (MMWS) as the basis for weighted adjustment. This estimator may prove more accurate than treatment effect estimators because MMWS has been shown to be more accurate than other models when the propensity score is misspecified. We therefore compare the performance of this new estimator to other commonly used treatment effects estimators. Monte Carlo simulation is used to compare the DR-MMWS estimator to regression adjustment, 2 weighted estimators based on the propensity score and 2 other DR methods. To assess performance under varied conditions, we vary the level of misspecification of the propensity score model as well as misspecify the outcome model. Overall, DR estimators generally outperform methods that model one or the other components (eg, propensity score or outcome). The DR-MMWS estimator outperforms all other estimators when both the propensity score and outcome models are misspecified and performs equally as well as other DR estimators when only the propensity score is misspecified. Health researchers should consider using DR-MMWS as the principal evaluation strategy in observational studies, as this estimator appears to outperform other estimators in its class. © 2017 John Wiley & Sons, Ltd.

Trajectories of sleep disturbance and daytime sleepiness in women before and after surgery for breast cancer.

PubMed

Van Onselen, Christina; Paul, Steven M; Lee, Kathryn; Dunn, Laura; Aouizerat, Bradley E; West, Claudia; Dodd, Marylin; Cooper, Bruce; Miaskowski, Christine

2013-02-01

Sleep disturbance is a problem for oncology patients. To evaluate how sleep disturbance and daytime sleepiness (DS) changed from before to six months following surgery and whether certain characteristics predicted initial levels and/or the trajectories of these parameters. Patients (n=396) were enrolled prior to surgery and completed monthly assessments for six months following surgery. The General Sleep Disturbance Scale was used to assess sleep disturbance and DS. Using hierarchical linear modeling, demographic, clinical, symptom, and psychosocial adjustment characteristics were evaluated as predictors of initial levels and trajectories of sleep disturbance and DS. All seven General Sleep Disturbance Scale scores were above the cutoff for clinically meaningful levels of sleep disturbance. Lower performance status; higher comorbidity, attentional fatigue, and physical fatigue; and more severe hot flashes predicted higher preoperative levels of sleep disturbance. Higher levels of education predicted higher sleep disturbance scores over time. Higher levels of depressive symptoms predicted higher preoperative levels of sleep disturbance, which declined over time. Lower performance status; higher body mass index; higher fear of future diagnostic tests; not having had sentinel lymph node biopsy; having had an axillary lymph node dissection; and higher depression, physical fatigue, and attentional fatigue predicted higher DS prior to surgery. Higher levels of education, not working for pay, and not having undergone neo-adjuvant chemotherapy predicted higher DS scores over time. Sleep disturbance is a persistent problem for patients with breast cancer. The effects of interventions that can address modifiable risk factors need to be evaluated. Copyright © 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

Caregivers of patients with disorder of consciousness: burden, quality of life and social support.

PubMed

Giovannetti, A M; Covelli, V; Sattin, D; Leonardi, M

2015-10-01

To evaluate quality of life (QoL) and its predictors, psychological burden and level of perceived social support in caregivers of patients with disorder of consciousness. World Health Organization Quality of Life-Bref (WHOQOL-BREF), State Trait Anxiety Inventory-Y (STAI-Y), Beck Depression Inventory (BDI-II), Prolonged Grief Disorder Questionnaire, Coping Orientations to Problem Experiences, State-Trait Anger Expression Inventory-2 (STAXI-2), and the Medical Outcome Study Social Support Survey (MOS-SSS) were administered. One-sample t-tests were performed to compare WHOQOL-BREF, STAI-Y and STAXI-2 mean scores to the respective normative sample (NS). Pearson correlation was calculated between time dedicated to patient's care, WHOQOL-BREF, BDI-II, STAI-Y and MOS-SSS scores. Hierarchical multiple regression analyses were performed to evaluate which variables have predictive power on QoL. A total of 129 caregivers, 68.2% female, mean age 52.8 years, were enrolled. Three WHOQOL-BREF domains were significantly lower. Anxiety and anger were in line with NS. 28.7% of the sample reported high level of depressive symptoms; 20.9% satisfied the prolonged grief disorder criteria. No differences emerged between caregivers and chronic ill patients' scores at MOS-SSS. STAI-Y, BDI-II and WHOQOL-BREF scores positively correlated. MOS-SSS domains inversely correlate with BDI-II scores. BDI-II results the most relevant predictor of QoL. Study results provided innovative information about caregivers' poor QoL, difficulties in social support and high levels of burden. Time dedicated to care is not strictly related to burden, while social support perceived is highly associated with caregivers' depressive symptoms that are strong predictor of poor QoL. Supportive intervention able to integrate psychological, social and environmental levels is needed. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Step by Step Learning Using the I Diagram in the Systematic Qualitative Analyses of Cations within a Guided Inquiry Learning Approach

ERIC Educational Resources Information Center

Akkuzu, Nalan; Uyulgan, Melis Arzu

2017-01-01

The current study examines the performance and achievement of students in the Systematic Qualitative Analyses of Cations (SQACs). We sought answers to questions such as, "What are the students' levels of performance?" and "What is the relation between the average scores for performance and achievement?." This was done by using…

Who Repeats Algebra, and How Does Initial Performance Relate to Improvement When the Course Is Repeated?

ERIC Educational Resources Information Center

Fong, Anthony; Jaquet, Karina; Finkelstein, Neal

2016-01-01

The information provided in this report shows how students perform when they repeat algebra I and how the level of improvement varies depending on initial course performance and the academic measure (course grades or CST scores). This information can help inform decisions and policies regarding whether and under what circumstances students should…

Milestone-Based Assessments Are Superior to Likert-Type Assessments in Illustrating Trainee Progression

PubMed Central

Bartlett, Kathleen W.; Whicker, Shari A.; Bookman, Jack; Narayan, Aditee P.; Staples, Betty B.; Hering, Holly; McGann, Kathleen A.

2015-01-01

Background The Pediatrics Milestone Project uses behavioral anchors, narrative descriptions of observable behaviors, to describe learner progression through the Accreditation Council for Graduate Medical Education competencies. Starting June 2014, pediatrics programs were required to submit milestone reports for their trainees semiannually. Likert-type scale assessment tools were not designed to inform milestone reporting, creating a challenge for Clinical Competency Committees. Objective To determine if milestone-based assessments better stratify trainees by training level compared to Likert-type assessments. Methods We compared assessment results for 3 subcompetencies after changing from a 5-point Likert scale to milestone-based behavioral anchors in July 2013. Program leadership evaluated the new system by (1) comparing PGY-1 mean scores on Likert-type versus milestone-based assessments; and (2) comparing mean scores on the Likert-type versus milestone-based assessments across PGY levels. Results Mean scores for PGY-1 residents were significantly higher on the prior year's Likert-type assessments than milestone-based assessments for all 3 subcompetencies (P < .01). Stratification by PGY level was not observed with Likert-type assessments (eg, interpersonal and communication skills 1 [ICS1] mean score for PGY-1, 3.99 versus PGY-3, 3.98; P  =  .98). In contrast, milestone-based assessments demonstrated stratification by PGY level (eg, the ICS1 mean score was 3.06 for PGY-1, 3.83 for PGY-2, and 3.99 for PGY-3; P < .01 for PGY-1 versus PGY-3). Significantly different means by trainee level were noted across 21 subcompetencies on milestone-based assessments (P < .01 for PGY-1 versus PGY-3). Conclusions Initial results indicate milestone-based assessments stratify trainee performance by level better than Likert-type assessments. Average PGY-level scores from milestone-based assessments may ultimately provide guidance for determining whether trainees are progressing at the expected pace. PMID:26217427

An explorative study of school performance and antipsychotic medication.

PubMed

van der Schans, J; Vardar, S; Çiçek, R; Bos, H J; Hoekstra, P J; de Vries, T W; Hak, E

2016-09-21

Antipsychotic therapy can reduce severe symptoms of psychiatric disorders, however, data on school performance among children on such treatment are lacking. The objective was to explore school performance among children using antipsychotic drugs at the end of primary education. A cross-sectional study was conducted using the University Groningen pharmacy database linked to academic achievement scores at the end of primary school (Dutch Cito-test) obtained from Statistics Netherlands. Mean Cito-test scores and standard deviations were obtained for children on antipsychotic therapy and reference children, and statistically compared using analyses of covariance. In addition, differences in subgroups as boys versus girls, ethnicity, household income, and late starters (start date within 12 months of the Cito-test) versus early starters (start date > 12 months before the Cito-test) were tested. In all, data from 7994 children could be linked to Cito-test scores. At the time of the Cito-test, 45 (0.6 %) were on treatment with antipsychotics. Children using antipsychotics scored on average 3.6 points lower than the reference peer group (534.5 ± 9.5). Scores were different across gender and levels of household income (p < 0.05). Scores of early starters were significantly higher than starters within 12 months (533.7 ± 1.7 vs. 524.1 ± 2.6). This first exploration showed that children on antipsychotic treatment have lower school performance compared to the reference peer group at the end of primary school. This was most noticeable for girls, but early starters were less affected than later starters. Due to the observational cross-sectional nature of this study, no causality can be inferred, but the results indicate that school performance should be closely monitored and causes of underperformance despite treatment warrants more research.

Accuracy, calibration and clinical performance of the EuroSCORE: can we reduce the number of variables?

PubMed

Ranucci, Marco; Castelvecchio, Serenella; Menicanti, Lorenzo; Frigiola, Alessandro; Pelissero, Gabriele

2010-03-01

The European system for cardiac operative risk evaluation (EuroSCORE) is currently used in many institutions and is considered a reference tool in many countries. We hypothesised that too many variables were included in the EuroSCORE using limited patient series. We tested different models using a limited number of variables. A total of 11150 adult patients undergoing cardiac operations at our institution (2001-2007) were retrospectively analysed. The 17 risk factors composing the EuroSCORE were separately analysed and ranked for accuracy of prediction of hospital mortality. Seventeen models were created by progressively including one factor at a time. The models were compared for accuracy with a receiver operating characteristics (ROC) analysis and area under the curve (AUC) evaluation. Calibration was tested with Hosmer-Lemeshow statistics. Clinical performance was assessed by comparing the predicted with the observed mortality rates. The best accuracy (AUC 0.76) was obtained using a model including only age, left ventricular ejection fraction, serum creatinine, emergency operation and non-isolated coronary operation. The EuroSCORE AUC (0.75) was not significantly different. Calibration and clinical performance were better in the five-factor model than in the EuroSCORE. Only in high-risk patients were 12 factors needed to achieve a good performance. Including many factors in multivariable logistic models increases the risk for overfitting, multicollinearity and human error. A five-factor model offers the same level of accuracy but demonstrated better calibration and clinical performance. Models with a limited number of factors may work better than complex models when applied to a limited number of patients. Copyright (c) 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

Development of a new technique (ATP) for training visually impaired children in oral hygiene maintenance.

PubMed

Hebbal, M; Ankola, A V

2012-10-01

To develop a special oral health education technique and compare plaque scores before and after health education. Non-randomised before and after comparison trial without controls. The final study population comprised of 96 visually impaired children aged 6-18 years old. Silness and Loe plaque index scores were recorded at baseline. 'Audio tactile performance technique' (ATP Technique) a specially designed health education method was used to educate these children regarding oral hygiene maintenance. Periodic reinforcement of health education was performed at an interval of 9 months. Re-examination was carried out after 18 months of health education to assess plaque scores. Wilcoxon's sign rank test and paired t test was used to assess the difference between the scores before and after health education. There was increase in frequency of tooth brushing after health education. The mean plaque scores pre- and post-health education were 1.41 (+/-0.58) and 0.63 (+/-0.39) respectively. The difference was statistically significant (p<0.001). Visually impaired children could maintain an acceptable level of oral hygiene when taught using special customised methods.

Association of Practice-Level Social and Medical Risk With Performance in the Medicare Physician Value-Based Payment Modifier Program

PubMed Central

Epstein, Arnold M.; Orav, E. John; Filice, Clara E.; Samson, Lok Wong; Joynt Maddox, Karen E.

2017-01-01

Importance Medicare recently launched the Physician Value-Based Payment Modifier (PVBM) Program, a mandatory pay-for-performance program for physician practices. Little is known about performance by practices that serve socially or medically high-risk patients. Objective To compare performance in the PVBM Program by practice characteristics. Design, Setting, and Participants Cross-sectional observational study using PVBM Program data for payments made in 2015 based on performance of large US physician practices caring for fee-for-service Medicare beneficiaries in 2013. Exposures High social risk (defined as practices in the top quartile of proportion of patients dually eligible for Medicare and Medicaid) and high medical risk (defined as practices in the top quartile of mean Hierarchical Condition Category risk score among fee-for-service beneficiaries). Main Outcomes and Measures Quality and cost z scores based on a composite of individual measures. Higher z scores reflect better performance on quality; lower scores, better performance on costs. Results Among 899 physician practices with 5 189 880 beneficiaries, 547 practices were categorized as low risk (neither high social nor high medical risk) (mean, 7909 beneficiaries; mean, 320 clinicians), 128 were high medical risk only (mean, 3675 beneficiaries; mean, 370 clinicians), 102 were high social risk only (mean, 1635 beneficiaries; mean, 284 clinicians), and 122 were high medical and social risk (mean, 1858 beneficiaries; mean, 269 clinicians). Practices categorized as low risk performed the best on the composite quality score (z score, 0.18 [95% CI, 0.09 to 0.28]) compared with each of the practices categorized as high risk (high medical risk only: z score, −0.55 [95% CI, −0.77 to −0.32]; high social risk only: z score, −0.86 [95% CI, −1.17 to −0.54]; and high medical and social risk: −0.78 [95% CI, −1.04 to −0.51]) (P < .001 across groups). Practices categorized as high social risk only performed the best on the composite cost score (z score, −0.52 [95% CI, −0.71 to −0.33]), low risk had the next best cost score (z score, −0.18 [95% CI, −0.25 to −0.10]), then high medical and social risk (z score, 0.40 [95% CI, 0.23 to 0.57]), and then high medical risk only (z score, 0.82 [95% CI, 0.65 to 0.99]) (P < .001 across groups). Total per capita costs were $9506 for practices categorized as low risk, $13 683 for high medical risk only, $8214 for high social risk only, and $11 692 for high medical and social risk. These patterns were associated with fewer bonuses and more penalties for high-risk practices. Conclusions and Relevance During the first year of the Medicare Physician Value-Based Payment Modifier Program, physician practices that served more socially high-risk patients had lower quality and lower costs, and practices that served more medically high-risk patients had lower quality and higher costs. PMID:28763549

Clinical Association of Thyroid Stimulating Hormone Receptor Antibody Levels with Disease Severity in the Chronic Inactive Stage of Graves' Orbitopathy.

PubMed

Woo, Young Jae; Jang, Sun Young; Lim, Tyler Hyung Taek; Yoon, Jin Sook

2015-08-01

To investigate associations between serum thyroid stimulating hormone (TSH) receptor antibody (TRAb) levels and Graves' orbitopathy (GO) activity/severity in chronic-stage GO and compare the performance of two newly-developed TRAb assays (third-generation TSH-binding inhibition immunoglobulin [TBII] assay versus Mc4 thyroid-stimulating immunoglobulin [TSI] bioassay). This study is a retrospective review of medical charts and blood tests from Korean GO patients who first visited the departments of ophthalmology and endocrinology, Yonsei University College of Medicine from January 2008 to December 2011, were diagnosed with GO and Graves' hyperthyroidism, and were followed up for ≥18 months. Third-generation M22-TBII and Mc4-TSI assays were performed in the chronic-inactive GO patients in whom euthyroidism status was restored. Patients' GO activity/severity clinical activity scores (CAS), and modified NOSPECS scores were examined for a correlation with TRAb assays. Fifty patients (mean age, 41.3 years; 41 females) were analyzed. The mean duration of Graves' hyperthyroidism symptom was 63 months (range, 18 to 401 months) and that of GO was 46 months (range, 18 to 240 months). All patients had been treated previously with anti-thyroid drugs for a median period of 52.3 months, and two patients underwent either radioiodine therapy or total thyroidectomy. Mean CAS and NOSPECS scores were 0.5 ± 0.9 (standard deviation) and 4.8 ± 3.1, respectively. Mean M22-TBII and Mc4-TSI values were 7.5 ± 10.2 IL/L and 325.9 ± 210.1 specimen-to-reference control ratio. TSI was significantly correlated with NOSPECS score (R = 0.479, p < 0.001); however, TBII was not associated with NOSPECS score (p = 0.097). Neither TSI nor TBII correlated with CAS (p > 0.05), because GO inflammatory activity subsided in the chronic stages of GO. In chronic-inactive GO after euthyroid restoration, GO activity score did not associate with serum levels of TRAb or TBII. However, levels of the functional antibody Mc4-TSI did correlate with GO severity. Therefore, the TSI bioassay is a clinically relevant measure of disease severity even in chronic inactive GO.

Normative data for the Fototest from neurological patients with no cognitive impairment.

PubMed

Carnero Pardo, C; Carrera Muñoz, I; Triguero Cueva, L; López Alcalde, S; Vílchez Carrillo, R

2018-05-28

To contribute normative data for the Fototest from neurological patients with no cognitive impairment, including disaggregated data on each domain of the test (naming, free recall, total recall, and naming fluency). We performed a cross-sectional study in which neurological patients with no cognitive impairment were tested with the Fototest; we recorded total and domain scores. We performed a descriptive study of the total and domain scores, with data disaggregated by sex, age (over/under 65 years), and level of education (primary education completed/not completed; further study completed). We included a sample of 1,055 patients, who were mainly women (57.1%), aged over 65 (60.6%), and had a low level of education (38.6% had not completed primary education). Sex, age, and level of education influence total Fototest score (34.6 ± 5.3; P 10 : 28; P 5 : 27) and naming (5,9±0,3; 6; 5), free recall (8.5 ± 2.2; 6; 4), total recall (10.0 ± 1.5; 8; 7), and naming fluency scores (18.7 ± 4.9; 13; 12). For total score, the multivariate analysis revealed values of 1.5 ± 0.3 (ß ± SE) for sex (female), -2.4 ± 0.3 for age (> 65), and -1.6 ± 0.4 and 3.3 ± 0.4 for incomplete primary education and completed post-primary education, respectively (completed primary study was used as a reference). We provide normative data for total and domain Fototest results for each of the groups defined according to sex, age, and level of education. We also provide a percentile distribution of scores. We hope that these normative data will translate into increases in efficiency in Fototest administration in the clinical setting. Copyright © 2018 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Identifying factors associated with experiences of coronary heart disease patients receiving structured chronic care and counselling in European primary care

PubMed Central

2012-01-01

Background Primary care for chronic illness varies across European healthcare systems. In patients suffering from coronary heart disease (CHD), factors associated with patients’ experiences of receiving structured chronic care and counselling at the patient and practice level were investigated. Methods In an observational study comprising 140 general practices from five European countries (Austria, Germany, the Netherlands, Switzerland and the United Kingdom), 30 patients with Coronary Heart Disease (CHD) per practice were chosen at random to partake in this research. Patients were provided with a questionnaire and the Patient Assessment of Chronic Illness Care (PACIC-5A) - instrument. Practice characteristics were assessed through a practice questionnaire and face to face interviews. Data were aggregated to obtain two practice scores representing quality management and CHD care, respectively. A hierarchical multilevel analysis was performed to examine the impact of patient and practice characteristics on PACIC scores. Results The final sample included 1745 CHD-patients from 131 general practices with a mean age of 67.8 (SD 9.9) years. The overall PACIC score was 2.84 (95%CI: 2.79; 2.89) and the 5A score reflecting structured lifestyle counselling was 2.75 (95% CI: 2.69; 2.79). At the patient level, male gender, more frequent practice contact and fewer related or unrelated conditions were associated with higher PACIC scores. At the practice level, performance scores reflecting quality management (p = 0.013) and CHD care (p = 0.009) were associated with improved assessment of the structured chronic care and counselling received. Conclusions Patients’ perceived quality of care varies. However, good practice management and organisation of care were positively reflected in patients’ assessments of receiving structured chronic illness care. This highlights the importance of integrating patient experiences into quality measurements to provide feedback to health care professionals. PMID:22838403

Sports Activity After Reconstruction of Osteochondral Lesions of the Talus With Autologous Spongiosa Grafts and Autologous Matrix-Induced Chondrogenesis.

PubMed

Wiewiorski, Martin; Werner, Lorenzo; Paul, Jochen; Anderson, Andrew E; Barg, Alexej; Valderrabano, Victor

2016-10-01

For the treatment of osteochondral lesions of the talus (OCLTs), autologous matrix-induced chondrogenesis (AMIC) is a safe 1-step procedure with good clinical and radiological results. However, data regarding postoperative sports activity after AMIC are limited. To identify significant factors influencing the rate of postoperative sports and recreational activities. Case series; Level of evidence, 4. The sports and recreational activities of 60 patients (mean age, 34.9 ± 11.5 years) undergoing the AMIC procedure were retrospectively analyzed at a mean of 46.9 ± 17.8 months (range, 24.5-87.0 months) postoperatively. The visual analog scale (VAS) for pain score, Tegner activity scale score, activity rating scale (ARS) score, and satisfaction with surgery outcomes were assessed. Corrective calcaneal osteotomy was performed in 38 of 60 (63.3%) patients. Ligament repair was performed in 41 of 60 (68.3%) patients. The mean VAS score improved significantly from 6.9 ± 1.6 points (range, 5-10 points) preoperatively to 2.3 ± 1.9 points (range, 0-6 points) at latest follow-up (P < .001). No significant change in the mean Tegner activity scale score (3.3 ± 2.0 preoperatively to 3.4 ± 2.2 postoperatively; P = .526) and the mean ARS score (2.6 ± 4.3 preoperatively to 2.3 ± 3.4 postoperatively; P = .874) was noted. The percentage of patients involved in sports activity before the onset of symptoms became significantly lower at the time of surgery (from 95.0% to 53.3%; P < .001); no significant difference was noted postoperatively (from 53.3% to 58.3%; P = .663). No significant difference of the weekly sports frequency and the duration of sports activity was found postoperatively. Patients undergoing AMIC repair of an OCLT participate at a similar low postoperative sports and recreational activity level compared with the preoperative level. © 2016 The Author(s).

Clinical physical therapists research activity reality and barriers to their utilizing research findings

PubMed Central

Park, Kyungyeon; Choi, Boram; Han, Dongwook

2015-01-01

[Purpose] This research study was performed to investigate the barriers to using the research findings of physical therapists on evidence-based practice. [Subjects] The subjects of this research were physical therapists employed by hospitals that agreed to cooperate with the research in B city. [Methods] A questionnaire made up of 6 research items, 8 physical therapist items, 6 presentation items, and 8 setting items, for a total of 28 items, was distributed. The responses were scored so the higher result scores indicate a higher barrier level to using research findings. Differences in barrier levels related to the likelihood of therapists using research findings in their practice varied according to the general characteristics of the result as according to the t-test and ANOVA. Scheffe’s test was used as a post hoc test. [Results] The analysis of 158 returned questionnaires revealed that there were significant relationships between the age, educational level, and professional satisfaction of the therapists and the barriers to using research finding. Significant relationships were also found between the items of “Research participation in clinical research”, “Frequency of reading research articles”, and “Support of manager to use research” and the barrier level. No relationship was demonstrated between the recognition level of evidence-based practice and the performance level with the barrier score to using research findings. [Conclusion] This study demonstrated that to improve the utilization of research findings, there is a need to provide therapists with continual education and opportunities to participate in research, and environments and ways in which the research results can be given practical applications. PMID:26311932

Y-balance normative data for female collegiate volleyball players.

PubMed

Hudson, Christy; Garrison, J Craig; Pollard, Kalyssa

2016-11-01

The Lower Quarter Y Balance (YBT-LQ) Test performance varies depending on competitive level, sport, gender, and age; therefore, determining normative scores specific to a population may be helpful in identifying injury-risk thresholds and return-to-play criteria following an injury. The purpose of this study was to determine normative YBT-LQ scores by assessing a subset of female, Division I volleyball players. A descriptive analysis cohort study. Ninety healthy (19.6 ± 1.2 y/o), collegiate female volleyball players. YBT-LQ was measured in 3 distinct directions of anterior (ANT), posteromedial (PM) and posterolateral (PL) on both the dominant and non-dominant limbs. In addition, a one way ANOVA was performed to determine mean group differences of YBT-LQ dominant and non-dominant limb composite score across position. Baseline values for this population were 94.1 ± 6.6% on the dominant limb and 93.9 ± 6.2% on the non-dominant limb. There were no significant differences for YBT-LQ composite scores on dominant (P = 0.867) and non-dominant (P = 0.989) limbs between position. This study identified normative YBT-LQ composite scores for healthy, female, collegiate volleyball players. Participants performed similarly despite their position. Copyright © 2016 Elsevier Ltd. All rights reserved.

Mathematical literacy in undergraduates: role of gender, emotional intelligence and emotional self-efficacy

NASA Astrophysics Data System (ADS)

Tariq, Vicki N.; Qualter, Pamela; Roberts, Sian; Appleby, Yvon; Barnes, Lynne

2013-12-01

This empirical study explores the roles that Emotional Intelligence (EI) and Emotional Self-Efficacy (ESE) play in undergraduates' mathematical literacy, and the influence of EI and ESE on students' attitudes towards and beliefs about mathematics. A convenience sample of 93 female and 82 male first-year undergraduates completed a test of mathematical literacy, followed by an online survey designed to measure the students' EI, ESE and factors associated with mathematical literacy. Analysis of the data revealed significant gender differences. Males attained a higher mean test score than females and out-performed the females on most of the individual questions and the associated mathematical tasks. Overall, males expressed greater confidence in their mathematical skills, although both males' and females' confidence outweighed their actual mathematical proficiency. Correlation analyses revealed that males and females attaining higher mathematical literacy test scores were more confident and persistent, exhibited lower levels of mathematics anxiety and possessed higher mathematics qualifications. Correlation analyses also revealed that in male students, aspects of ESE were associated with beliefs concerning the learning of mathematics (i.e. that intelligence is malleable and that persistence can facilitate success), but not with confidence or actual performance. Both EI and ESE play a greater role with regard to test performance and attitudes/beliefs regarding mathematics amongst female undergraduates; higher EI and ESE scores were associated with higher test scores, while females exhibiting higher levels of ESE were also more confident and less anxious about mathematics, believed intelligence to be malleable, were more persistent and were learning goal oriented. Moderated regression analyses confirmed mathematics anxiety as a negative predictor of test performance in males and females, but also revealed that in females EI and ESE moderate the effects of anxiety on test performance, with the relationship between anxiety and test performance linked more to emotional management (EI) than to ESE.

Relationship of perceived physical self-concept and physical activity level and sex among young children.

PubMed

Planinsec, Jurij; Fosnaric, Samo

2005-04-01

The aim of this study was to investigate the relationship between level of physical activity and perceived physical self-concept of young children. The sample comprised 364 children from Slovenia, aged 6.4 yr. (SD = 0.3), of which 179 were boys and 185 girls. Parents and teachers reported children's physical activity using the Harro questionnaire. We divided children into Low and High Activity groups based on their mean scores. The children completed Stein's Children's Physical Self-concept Scale, which assesses Global Physical Self-concept and the subdomains of Physical Performance, Physical Appearance, and Weight Control behavior. Two-way analysis of variance with both sex and physical activity levels, and their interaction were used to examine differences in Physical Self-concept. There were significant differences between the Low and High Activity groups on scores for global Physical Self-concept Scale, Physical Performance, and Weight Control, on which children from the High Activity group scored higher; whereas on the subscale Physical Appearance, there were no significant differences. There were no significant sex differences on the Physical Self-concept Scale. The most important conclusion of this research indicates the theoretical assumptions that Physical Activity and perceived Physical Self-concept are related. Direction of the relationship remains unclarified.

The Effect of Art Therapy with Clay on Hopelessness Levels Among Neurology Patients.

PubMed

Akhan, Latife Utas; Kurtuncu, Meltem; Celik, Sevim

This study was performed to determine the effect of art therapy with clay on hopelessness levels of patients under treatment in departments of neurology. The study was of one group, pre- and posttest design. This study was performed on patients who were hospitalized in the neurology departments of a university and a state hospital between February and May 2012 in Turkey. The sample for the study comprised 50 neurology patients with diagnoses of epilepsy (17 patients) and stroke (33 patients). The patients in the study were asked to create objects of clay of any shape they desired. Data for the research were collected with a sociodemographic data form and by using the Beck Hopelessness Scale (BHS). While BHS scores of neurology patients before clay therapy were found higher compared to the scores after therapy with clay, there was also a statistically significant difference. After clay therapy, BHS scores were lower in women, in married patients, in patients who suffered from a stroke, people who had chronic disease, people without psychological illness, and in the case of children. The study showed that clay therapy had an impact on the hopelessness levels of neurology patients. Art therapy with clay may be used for rehabilitation purposes in neurology patients, both in the hospital and at home after discharge.

Relationships among gender, cognitive style, academic major, and performance on the Piaget water-level task.

PubMed

Hammer, R E; Hoffer, N; King, W L

1995-06-01

Many researchers have found that more college-age adults than would be expected fail Piaget's water-level task, with women failing more frequently than men. It has been hypothesized that differences in cognitive style may account for performance differences on the water-level task. In the present study, 27 male and 27 female architectural students and 27 male and 27 female liberal-arts students were assessed for their performance on both Piaget's Water-level Task and Witkin's Group Embedded Figures Test. No difference was found in performance of male and female architectural students on either task, but male liberal-arts students scored significantly higher than female liberal-arts students on both measures. A disembedding cognitive style predicted success on the water-level task for the architectural students but not for the liberal arts students.

Decisional conflict in asthma patients: a cross sectional study.

PubMed

Des Cormiers, Annick; Légaré, France; Simard, Serge; Boulet, Louis-Philippe

2015-01-01

This study aimed at determining the level of decisional conflict in asthmatic individuals facing recommendation-based decisions provided to improve asthma control. This was a cross-sectional study performed on a convenience sample of 50 adults aged between 18 and 65 years with a diagnosis of asthma. They completed a decisional conflict scale (possible range of 0-100%), asthma knowledge and control questionnaires (both 0% and 100%), and a general questionnaire on socio-demographic characteristics. A decisional conflict was considered clinically significant with a score greater than 37.5%. Simple descriptive statistics were used to investigate associations with decisional conflict. Participants were mainly women (76%) and diagnosed with mild asthma (72%). The median age (1st and 3rd quartile) was 25 years (22 and 42). The median score (1st and 3rd quartile) of decisional conflict was 33% (24 and 44). A clinically significant score (>37.5%) was obtained in 36% of subjects. A statistically significant negative correlation between the knowledge score and the decisional conflict score (r(p) = -0.38; p = 0.006) was observed. The level of knowledge was the only statistically independent variable associated with the decisional conflict score (p = 0.0043). A considerable proportion of patients with asthma have a clinically significant level of decisional conflict when facing decisions aimed at improving asthma control. Patients with poor knowledge of asthma are more at risk of clinically significant level of decisional conflict. These findings support the relevance of providing asthmatic patients with relevant information in decision aids.

Level of NICU Quality of Developmental Care and Neurobehavioral Performance in Very Preterm Infants

PubMed Central

Del Prete, Alberto; Bellù, Roberto; Tronick, Ed; Borgatti, Renato

2012-01-01

OBJECTIVE: To examine the relation between the neurobehavior of very preterm infants and the level of NICU quality of developmental care. METHODS: The neurobehavior of 178 very preterm infants (gestational age ≤29 weeks and/or birth weight ≤1500 g) from 25 NICUs participating in a large multicenter, longitudinal study (Neonatal Adequate Care for Quality of Life, NEO-ACQUA) was examined with a standardized neurobehavioral assessment, the NICU Network Neurobehavioral Scale (NNNS). A questionnaire, the NEO-ACQUA Quality of Care Checklist was used to evaluate the level of developmental care in each of the NICUs. A factor analyses applied to NEO-ACQUA Quality of Care Checklist produced 2 main factors: (1) the infant-centered care (ICC) index, which measures parents’ involvement in the care of their infant and other developmentally oriented care interventions, and (2) the infant pain management (IPM) index, which measures the NICU approach to and the procedures used for reducing infant pain. The relations between NNNS neurobehavioral scores and the 2 indexes were evaluated. RESULTS: Infants from NICUs with high scores on the ICC evidenced higher attention and regulation, less excitability and hypotonicity, and lower stress/abstinence NNNS scores than infants from low-care units. Infants from NICUs with high scores on the IPM evidenced higher attention and arousal, lower lethargy and nonoptimal reflexes NNNS scores than preterm infants from low-scoring NICUs. CONCLUSIONS: Very preterm infant neurobehavior was associated with higher levels of developmental care both in ICC and in IPM, suggesting that these practices support better neurobehavioral stability. PMID:22492762

Clinical characteristics classified by the serum KL-6 level in patients with organizing pneumonia.

PubMed

Yamaguchi, K; Tsushima, K; Kurita, N; Fujiwara, A; Soeda, S; Yamaguchi, A; Sugiyama, S; Togashi, Y; Kono, Y; Kasagi, S; Setoguchi, Y

2013-03-01

The serum Krebs von der Lungen-6 (KL-6) level is a useful marker correlated with the severity of various interstitial lung diseases. There have been few reports about the clinical characteristics of organizing pneumonia (OP) associated with the serum KL-6 levels. This study was performed to determine whether the serum KL-6 levels can help determine the optimal treatment for OP. Patients diagnosed with OP by clinical, radiological and histopathological findings were retrospectively reviewed. The OP patients were classified into two groups based on their serum KL-6 levels: normal KL-6 and high KL-6 groups. The two groups were compared with regard to their clinical and radiological data and therapeutic response one month after the start of treatment. The clinical records of twenty-two patients diagnosed with OP were reviewed. The serum KL-6 level was elevated in 11 of the 22 patients. There were no obvious differences in the clinical data between the two groups, although patients in the normal KL-6 group tended to have a fever. There were no significant differences in the chest X-ray (CXR) score or computed tomography (CT) score between the two groups. The CXR scores were correlated with the serum KL-6 levels. At 1 month after the diagnosis, 11 patients who needed treatment with prednisolone were included in the high KL-6 group. Patients with normal KL-6 levels showed lower CXR and CT scores. The serum KL-6 level on admission is a useful marker to judge the need for corticosteroid treatment in OP patients.

Mini-Mental State Exam performance of older African Americans: effect of age, gender, education, hypertension, diabetes, and the inclusion of serial 7s subtraction versus "world" backward on score.

PubMed

Hawkins, Keith A; Cromer, Jennifer R; Piotrowski, Andrea S; Pearlson, Godfrey D

2011-11-01

The Mini-Mental State Exam (MMSE) is a clinically ubiquitous yet incompletely standardized instrument. Though the test offers considerable examiner leeway, little data exist on the normative consequences of common administration variations. We sought to: (a) determine the effects of education, age, gender, health status, and a common administration variation (serial 7s subtraction vs. "world" spelled backward) on MMSE score within a minority sample, (b) provide normative data stratified on the most empirically relevant bases, and (c) briefly address item failure rates. African American citizens (N = 298) aged 55-87 living independently in the community were recruited by advertisement, community recruitment, and word of mouth. Total score with "world" spelled backward exceeded total score with serial 7s subtraction across all levels of education, replicating findings in Caucasian samples. Education is the primary source of variance on MMSE score, followed by age. In this cohort, women out-performed men when "world" spelled backward was included, but there was no gender effect when serial 7s subtraction was included in MMSE total score. To ensure an appropriate interpretation of MMSE scores, reports, whether clinical or in publications of research findings, should be explicit regarding the administration method. Stratified normative data are provided.

Failing to Prepare Is Preparing to Fail: A Single-Blinded, Randomized Controlled Trial to Determine the Impact of a Preoperative Instructional Video on the Ability of Residents to Perform Laparoscopic Right Colectomy.

PubMed

Crawshaw, Benjamin P; Steele, Scott R; Lee, Edward C; Delaney, Conor P; Mustain, W Conan; Russ, Andrew J; Shanmugan, Skandan; Champagne, Bradley J

2016-01-01

Laparoscopic colorectal resection is an index case for advanced skills training, yet many residents struggle to reach proficiency by graduation. Current methods to reduce the learning curve for residents remain expensive, time consuming, and poorly validated. The purpose of this study was to assess the impact of the addition of a preprocedural instructional video to improve the ability of a general surgery resident to perform laparoscopic right colectomy when compared with standard preparation. This was a single-blinded, randomized control study. Four university-affiliated teaching hospitals were included in the study. General surgery residents in postgraduation years 2 through 5 participated. Residents were randomly assigned to preparation with a narrated instructional video versus standard preparation. Resident performance, scored by a previously validated global assessment scale, was measured. Fifty-four residents were included. Half (n = 27) were randomly assigned to view the training video and half (n = 27) to standard preparation. There were no differences between groups in terms of training level or previous operative experience or in patient demographics (all p > 0.05). Groups were similar in the percentage of the case completed by residents (p = 0.39) and operative time (p = 0.74). Residents in the video group scored significantly higher in total score (mean: 46.8 vs 42.3; p = 0.002), as well as subsections directly measuring laparoscopic skill (vascular control mean: 11.3 vs 9.7, p < 0.001; mobilization mean: 7.6 vs. 7.0, p = 0.03) and overall performance score (mean: 4.0 vs 3.1; p < 0.001). Statistical significance persisted across training levels. There is potential for Hawthorne effect, and the study is underpowered at the individual postgraduate year level. The simple addition of a brief, narrated preprocedural video to general surgery resident case preparation significantly increased trainee ability to successfully perform a laparoscopic right colectomy. In an era of shortened hours and less exposure to cases, incorporating a brief but effective instructional video before surgery may improve the learning curve of trainees and ultimately improve safety.

Introduction of a paediatric anaesthesia comic information leaflet reduced preoperative anxiety in children.

PubMed

Kassai, B; Rabilloud, M; Dantony, E; Grousson, S; Revol, O; Malik, S; Ginhoux, T; Touil, N; Chassard, D; Pereira de Souza Neto, E

2016-07-01

The aim of the study was to determine whether the introduction of a paediatric anaesthesia comic information leaflet reduced preoperative anxiety levels of children undergoing major surgery. Secondary objectives were to determine whether the level of understanding of participants and other risk factors influence STAIC-S (State-Trait Anxiety Inventory for Children-State subscale) score in children. We performed a randomized controlled parallel-group trial comparing preoperative anxiety between two groups of children aged >6 and <17 yr. Before surgery, the intervention group received a comic information leaflet at home in addition to routine information given by the anaesthetist at least 1 day before surgery. The control group received the routine information only. The outcome measure was the difference between STAIC-S scores measured before any intervention and after the anaesthetist's visit. A multiple regression analysis was performed to explore the influence of the level of education, the anxiety of parents, and the childrens' intelligence quotient on STAIC-S scores. One hundred and fifteen children were randomized between April 2009 and April 2013. An intention-to-treat analysis on data from 111 patients showed a significant reduction (P=0.002) in STAIC-S in the intervention group (n=54, mean=-2.2) compared with the control group (n=57, mean=0.90). The multiple regression analysis did not show any influence on STAIC-S scores of the level of education, parental anxiety, or the intelligence quotient of the children. A paediatric anaesthesia comic information leaflet was a cheap and effective means of reducing preoperative anxiety, measured by STAIC-S, in children. NCT 00841022. © The Author 2016. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Introduction of a paediatric anaesthesia comic information leaflet reduced preoperative anxiety in children

PubMed Central

Kassai, B.; Rabilloud, M.; Dantony, E.; Grousson, S.; Revol, O.; Malik, S.; Ginhoux, T.; Touil, N.; Chassard, D.; Pereira de Souza Neto, E.

2016-01-01

Background The aim of the study was to determine whether the introduction of a paediatric anaesthesia comic information leaflet reduced preoperative anxiety levels of children undergoing major surgery. Secondary objectives were to determine whether the level of understanding of participants and other risk factors influence STAIC-S (State–Trait Anxiety Inventory for Children—State subscale) score in children. Methods We performed a randomized controlled parallel-group trial comparing preoperative anxiety between two groups of children aged >6 and <17 yr. Before surgery, the intervention group received a comic information leaflet at home in addition to routine information given by the anaesthetist at least 1 day before surgery. The control group received the routine information only. The outcome measure was the difference between STAIC-S scores measured before any intervention and after the anaesthetist's visit. A multiple regression analysis was performed to explore the influence of the level of education, the anxiety of parents, and the childrens' intelligence quotient on STAIC-S scores. Results One hundred and fifteen children were randomized between April 2009 and April 2013. An intention-to-treat analysis on data from 111 patients showed a significant reduction (P=0.002) in STAIC-S in the intervention group (n=54, mean=−2.2) compared with the control group (n=57, mean=0.90). The multiple regression analysis did not show any influence on STAIC-S scores of the level of education, parental anxiety, or the intelligence quotient of the children. Conclusions A paediatric anaesthesia comic information leaflet was a cheap and effective means of reducing preoperative anxiety, measured by STAIC-S, in children. Clinical trials registration NCT 00841022. PMID:27317708

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

PubMed Central

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

2012-01-01

Background: Growth and development in any country's national health system, without an efficient evaluation system, lacks the basic concepts and tools necessary for fulfilling the system's goals. The balanced scorecard (BSC) is a technique widely used to measure the performance of an organization. The basic core of the BSC is guided by the organization's vision and strategies, which are the bases for the formation of four perspectives of BSC. The goal of this research is the performance evaluation of Al-Zahra Academic Medical Center in Isfahan University of Medical Sciences, based on Iran BSC model. Materials and Methods: This is a combination (quantitative–qualitative) research which was done at Al-Zahra Academic Medical Center in Isfahan University of Medical Sciences in 2011. The research populations were hospital managers at different levels. Sampling method was purposive sampling in which the key informed personnel participated in determining the performance indicators of hospital as the BSC team members in focused discussion groups. After determining the conceptual elements in focused discussion groups, the performance objectives (targets) and indicators of hospital were determined and sorted in perspectives by the group discussion participants. Following that, the performance indicators were calculated by the experts according to the predetermined objectives; then, the score of each indicator and the mean score of each perspective were calculated. Results: Research findings included development of the organizational mission, vision, values, objectives, and strategies. The strategies agreed upon by the participants in the focus discussion group included five strategies, which were customer satisfaction, continuous quality improvement, development of human resources, supporting innovation, expansion of services and improving the productivity. Research participants also agreed upon four perspectives for the Al-Zahra hospital BSC. In the patients and community perspective (customer), two objectives and three indicators were agreed upon, with a mean score of 75.9%. In the internal process perspective, 4 objectives and 14 indicators were agreed upon, with a mean score of 79.37%. In the learning and growth perspective, four objectives and eight indicators were agreed upon, with a mean score of 81.11%. Finally, in the financial perspective, two objectives and five indicators were agreed upon, with a mean score of 67.15%. Conclusion: One way to create demand for hospital services is performance evaluation by paying close attention to all BSC perspectives, especially the non-financial perspectives such as customers and internal processes perspectives. In this study, the BSC showed the differences in performance level of the organization in different perspectives, which would assist the hospital managers improve their performance indicators. The learning and growth perspective obtained the highest score, and the financial perspective obtained the least score. Since the learning and growth perspective acts as a base for all other perspectives and they depend on it, hospitals must continuously improve the service processes and the quality of services by educating staff and updating their policies and procedures. This can increase customer satisfaction and productivity and finally improve the BSC in financial perspective. PMID:23555104

The impact of visual impairment on the ability to perform activities of daily living for persons with severe/profound intellectual disability.

PubMed

Dijkhuizen, Annemarie; Hilgenkamp, Thessa I M; Krijnen, Wim P; van der Schans, Cees P; Waninge, Aly

2016-01-01

The ability to perform activities of daily living (ADL) as a component of participation is one of the factors that contribute to quality of life. The ability to perform ADL for persons experiencing severe/profound intellectual disability (ID) may be reduced due to their cognitive and physical capacities. However, until recently, the impact of the significantly prevalent visual impairments on the performance of activities of daily living has not yet been revealed within this group. The purpose of this prospective cross-sectional study was to investigate the impact of visual impairment on the performance of activities of daily living for persons with a severe/profound intellectual disability. The Barthel Index (BI) and Comfortable Walking Speed (CWS) were used to measure the ability of performing activities of daily living (ADL) in 240 persons with severe/profound ID and having Gross Motor Functioning Classification System (GMFCS) levels I, II or III; this included 120 persons with visual impairment. The impact of visual impairment on ADL was analyzed with linear regression. The results of the study demonstrated that visual impairment slightly affects the ability of performing activities of daily living (BI) for persons experiencing a severe/profound intellectual disability. GMFCS Levels II or III, profound ID level, and visual impairment each have the effect of lowering BI scores. GMFCS Levels II or III, and profound ID level each have the effect of increasing CWS scores, which indicates a lower walking speed. A main effect of visual impairment is present on CWS, but our results do show a substantive interaction effect between GMFCS level III and visual impairment on Comfortable Walking Speed in persons with a severe/profound intellectual disability. Visual impairment has a slight effect on ability to perform ADL in persons experiencing severe/profound ID. Copyright © 2015 Elsevier Ltd. All rights reserved.

Stochastic Dominance and Analysis of ODI Batting Performance: the Indian Cricket Team, 1989-2005

PubMed Central

Damodaran, Uday

2006-01-01

Relative to other team games, the contribution of individual team members to the overall team performance is more easily quantifiable in cricket. Viewing players as securities and the team as a portfolio, cricket thus lends itself better to the use of analytical methods usually employed in the analysis of securities and portfolios. This paper demonstrates the use of stochastic dominance rules, normally used in investment management, to analyze the One Day International (ODI) batting performance of Indian cricketers. The data used span the years 1989 to 2005. In dealing with cricketing data the existence of ‘not out’ scores poses a problem while processing the data. In this paper, using a Bayesian approach, the ‘not-out’ scores are first replaced with a conditional average. The conditional average that is used represents an estimate of the score that the player would have gone on to score, if the ‘not out’ innings had been completed. The data thus treated are then used in the stochastic dominance analysis. To use stochastic dominance rules we need to characterize the ‘utility’ of a batsman. The first derivative of the utility function, with respect to runs scored, of an ODI batsman can safely be assumed to be positive (more runs scored are preferred to less). However, the second derivative needs not be negative (no diminishing marginal utility for runs scored). This means that we cannot clearly specify whether the value attached to an additional run scored is lesser at higher levels of scores. Because of this, only first-order stochastic dominance is used to analyze the performance of the players under consideration. While this has its limitation (specifically, we cannot arrive at a complete utility value for each batsman), the approach does well in describing player performance. Moreover, the results have intuitive appeal. Key Points The problem of dealing with ‘not out’ scores in cricket is tackled using a Bayesian approach. Stochastic dominance rules are used to characterize the utility of a batsman. Since the marginal utility of runs scored is not diminishing in nature, only first order stochastic dominance rules are used. The results, demonstrated using data for the Indian cricket team are intuitively appealing. The limitation of the approach is that it cannot arrive at a complete utility value for the batsman. PMID:24357944

Stochastic Dominance and Analysis of ODI Batting Performance: the Indian Cricket Team, 1989-2005.

PubMed

Damodaran, Uday

2006-01-01

Relative to other team games, the contribution of individual team members to the overall team performance is more easily quantifiable in cricket. Viewing players as securities and the team as a portfolio, cricket thus lends itself better to the use of analytical methods usually employed in the analysis of securities and portfolios. This paper demonstrates the use of stochastic dominance rules, normally used in investment management, to analyze the One Day International (ODI) batting performance of Indian cricketers. The data used span the years 1989 to 2005. In dealing with cricketing data the existence of 'not out' scores poses a problem while processing the data. In this paper, using a Bayesian approach, the 'not-out' scores are first replaced with a conditional average. The conditional average that is used represents an estimate of the score that the player would have gone on to score, if the 'not out' innings had been completed. The data thus treated are then used in the stochastic dominance analysis. To use stochastic dominance rules we need to characterize the 'utility' of a batsman. The first derivative of the utility function, with respect to runs scored, of an ODI batsman can safely be assumed to be positive (more runs scored are preferred to less). However, the second derivative needs not be negative (no diminishing marginal utility for runs scored). This means that we cannot clearly specify whether the value attached to an additional run scored is lesser at higher levels of scores. Because of this, only first-order stochastic dominance is used to analyze the performance of the players under consideration. While this has its limitation (specifically, we cannot arrive at a complete utility value for each batsman), the approach does well in describing player performance. Moreover, the results have intuitive appeal. Key PointsThe problem of dealing with 'not out' scores in cricket is tackled using a Bayesian approach.Stochastic dominance rules are used to characterize the utility of a batsman.Since the marginal utility of runs scored is not diminishing in nature, only first order stochastic dominance rules are used.The results, demonstrated using data for the Indian cricket team are intuitively appealing.The limitation of the approach is that it cannot arrive at a complete utility value for the batsman.

Propensity score matching with clustered data. An application to the estimation of the impact of caesarean section on the Apgar score.

PubMed

Arpino, Bruno; Cannas, Massimo

2016-05-30

This article focuses on the implementation of propensity score matching for clustered data. Different approaches to reduce bias due to cluster-level confounders are considered and compared using Monte Carlo simulations. We investigated methods that exploit the clustered structure of the data in two ways: in the estimation of the propensity score model (through the inclusion of fixed or random effects) or in the implementation of the matching algorithm. In addition to a pure within-cluster matching, we also assessed the performance of a new approach, 'preferential' within-cluster matching. This approach first searches for control units to be matched to treated units within the same cluster. If matching is not possible within-cluster, then the algorithm searches in other clusters. All considered approaches successfully reduced the bias due to the omission of a cluster-level confounder. The preferential within-cluster matching approach, combining the advantages of within-cluster and between-cluster matching, showed a relatively good performance both in the presence of big and small clusters, and it was often the best method. An important advantage of this approach is that it reduces the number of unmatched units as compared with a pure within-cluster matching. We applied these methods to the estimation of the effect of caesarean section on the Apgar score using birth register data. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Strategic planning processes and financial performance among hospitals in Lebanon.

PubMed

Saleh, Shadi; Kaissi, Amer; Semaan, Adele; Natafgi, Nabil Maher

2013-01-01

Strategic planning has been presented as a valuable management tool. However, evidence of its deployment in healthcare and its effect on organizational performance is limited in low-income and middle-income countries (LMICs). The study aimed to explore the use of strategic planning processes in Lebanese hospitals and to investigate its association with financial performance. The study comprised 79 hospitals and assessed occupancy rate (OR) and revenue-per-bed (RPB) as performance measures. The strategic planning process included six domains: having a plan, plan development, plan implementation, responsibility of planning activities, governing board involvement, and physicians' involvement. Approximately 90% of hospitals have strategic plans that are moderately developed (mean score of 4.9 on a 1-7 scale) and implemented (score of 4.8). In 46% of the hospitals, the CEO has the responsibility for the plan. The level of governing board involvement in the process is moderate to high (score of 5.1), whereas physician involvement is lower (score of 4.1). The OR and RPB amounted to respectively 70% and 59 304 among hospitals with a strategic plan as compared with 62% and 33 564 for those lacking such a plan. No statistical association between having a strategic plan and either of the two measures was detected. However, the findings revealed that among hospitals that had a strategic plan, higher implementation levels were associated with lower OR (p < 0.05). In an LMIC healthcare environment characterized by resource limitation, complexity, and political and economic volatility, flexibility rather than rigid plans allow organizations to better cope with environmental turbulence. Copyright © 2012 John Wiley & Sons, Ltd.

Differences Between Japanese and U.S. Children's Performance on "Zoo U": A Game-Based Social Skills Assessment.

PubMed

Craig, Ashley B; DeRosier, Melissa E; Watanabe, Yayoi

2015-08-01

The purpose of this study was to test whether and how performance on a digital game-based social skills assessment tool, "Zoo U" (3C Institute, Durham, NC), differed for children in the United States and Japan across six core social skills. "Zoo U" was administered to 497 third and fourth grade children from the United States and Japan (46 percent Japanese) by teachers and researchers, respectively. U.S. children received the original version of "Zoo U," and Japanese children received a fully translated Japanese version of the program. Scoring of each of the six social skills is built into the "Zoo U" software, with specific scoring algorithms for each grade level that provide both a continuous scale score and cutoffs for three distinct performance categories: high, average, and low. A multivariate analysis of variance (MANOVA) was conducted to assess differences by cultural group on each of the six continuous social skill scores, controlling for gender and grade level. Results revealed significant differences on four of the six skills in expected directions. Chi-squared and odds ratios analyses were then conducted on the assignment of children into each of the performance categories by cultural group, revealing additional nuance to the cultural differences identified in the MANOVA consistent with existing literature. We were able to replicate known cultural differences between U.S. and Japanese children with a simple direct translation of a Web-based social skills assessment game, "Zoo U." Our results provide preliminary support for the potential of game-based assessment methods to provide efficient and valid social skill assessments to children around the world.

An Evaluation of a Combat Conditioning Trial Program

DTIC Science & Technology

2008-11-20

rests on the weaker assumption that the pretest is correlated with the posttest score. The second reason was that ANCOVA would yield training effects...performance. cSignificant Unit x Time interaction in ANCOVA. Note. Pretest performance was a significant (p < .001) predictor of posttest performance for... Pretest fitness level was defined by splitting the pretest distribution for CV into quartiles. Posttest performance improved 7.2% for participants in

Self-reported assistive technology outcomes and personal characteristics in college students with less-apparent disabilities.

PubMed

Malcolm, Matt P; Roll, Marla C

2017-11-20

The impact of assistive technology (AT) services for college students with less-apparent disabilities is under-reported. Using the Canadian Occupational Performance Measure (COPM), we assessed student Performance and Satisfaction ratings of common academic tasks at the start and end of a semester during which 105 student-clients with less-apparent disabilities received AT services. We examined if COPM scores related to personal characteristics of gender, class-level (e.g., Sophomore), and STEM education; if personal characteristics predicted a student's follow-through with an AT service referral (n=231); and if personal characteristics and initial COPM scores predicted dropout from AT services (n=187). COPM ratings significantly increased in all academic tasks (p<.001). Gender predicted initial Satisfaction (male ratings > female ratings; p=.01), and Performance changes (females were more likely to have a service-meaningful change; p=.02). Higher class-level predicted better follow-through with a referral for AT services (p=.006). Increasing class-level (p=.05) and higher initial studying (p<.006) and reading (p<.029) ratings predicted a lower likelihood for dropout. These findings demonstrate that college students with less-apparent disabilities experience substantial improvements in their self-ratings of academic performance and satisfaction following AT services. Gender, class-level, and initial self-perceived reading and studying abilities may influence if and how the student participates with AT services.

Effects of Regulatory Self-Questioning on Secondary-Level Students' Problem-Solving Performance

ERIC Educational Resources Information Center

Pate, Michael L.; Miller, Greg

2011-01-01

A randomized posttest-only control group experimental design was used to determine the effects of regulatory self-questioning on secondary-level career and technical education students' electrical circuit theory test scores. Students who participated in the self-questioning group were asked to answer a list of regulatory questions as they solved…

Insulin-resistance and metabolic syndrome are related to executive function in women in a large family-based study.

PubMed

Schuur, M; Henneman, P; van Swieten, J C; Zillikens, M C; de Koning, I; Janssens, A C J W; Witteman, J C M; Aulchenko, Y S; Frants, R R; Oostra, B A; van Dijk, K Willems; van Duijn, C M

2010-08-01

While type 2 diabetes is well-known to be associated with poorer cognitive performance, few studies have reported on the association of metabolic syndrome (MetS) and contributing factors, such as insulin-resistance (HOMA-IR), low adiponectin-, and high C-reactive protein (CRP)-levels. We studied whether these factors are related to cognitive function and which of the MetS components are independently associated. The study was embedded in an ongoing family-based cohort study in a Dutch population. All participants underwent physical examinations, biomedical measurements, and neuropsychological testing. Linear regression models were used to determine the association between MetS, HOMA-IR, adiponectin levels, CRP, and cognitive test scores. Cross-sectional analyses were performed in 1,898 subjects (mean age 48 years, 43% men). People with MetS had significantly higher HOMA-IR scores, lower adiponectin levels, and higher CRP levels. MetS and high HOMA-IR were associated with poorer executive function in women (P = 0.03 and P = 0.009). MetS and HOMA-IR are associated with poorer executive function in women.

Academic performance in adolescents born after ART-a nationwide registry-based cohort study.

PubMed

Spangmose, A L; Malchau, S S; Schmidt, L; Vassard, D; Rasmussen, S; Loft, A; Forman, J; Pinborg, A

2017-02-01

Is academic performance in adolescents aged 15-16 years and conceived after ART, measured as test scores in ninth grade, comparable to that for spontaneously conceived (SC) adolescents? ART singletons had a significantly lower mean test score in the adjusted analysis when compared with SC singletons, yet the differences were small and probably not of clinical relevance. Previous studies have shown similar intelligence quotient (IQ) levels in ART and SC children, but only a few have been on adolescents. Academic performance measured with standardized national tests has not previously been explored in a complete national cohort of adolescents conceived after ART. A Danish national registry-based cohort including all 4766 ART adolescents (n = 2836 singletons and n = 1930 twins) born in 1995-1998 were compared with two SC control cohorts: a randomly selected singleton population (n = 5660) and all twins (n = 7064) born from 1995 to 1998 in Denmark. Nine children who died during the follow-up period were excluded from the study. Mean test scores on a 7-point-marking scale from -3 to 12 were compared, and adjustments were made for relevant reproductive and socio-demographic covariates including occupational and educational level of the parents. The crude mean test score was higher in both ART singletons and ART twins compared with SC adolescents. The crude mean differences were +0.41 (95% CI 0.30-0.53) and +0.45 (95% CI 0.28-0.62) between ART and SC singletons and between ART and SC twins, respectively. However, the adjusted mean overall test score was significantly lower for ART singletons compared with SC singletons (adjusted mean difference -0.15 (95% CI -0.29-(-0.02))). For comparison, the adjusted mean difference was +2.05 (95% CI 1.82-2.28) between the highest and the lowest parental educational level, suggesting that the effect of ART is weak compared with the conventional predictors. The adjusted analyses showed significantly lower mean test scores in mathematics and physics/chemistry for ART singletons compared with SC singletons. Comparing ART twins with SC twins yielded no difference in academic performance in the adjusted analyses. Similar crude and adjusted overall mean test scores were found when comparing ART singletons and ART twins. Missing data on educational test scores occurred in 6.6% of adolescents aged 15-16 years for the birth cohorts 1995-1997, where all of the children according to their age should have passed the ninth grade exam at the time of data retrieval. As sensitivity analyses yielded no significant difference in the adjusted risk of having missing test scores between any of the groups, it is unlikely that this should bias our results. Adjustment for body mass index and smoking during pregnancy was not possible. As our results are based on national data, our findings can be applied to other populations. The findings of this paper suggest that a possible small negative effect of parental subfertility or ART treatment is counterbalanced by the higher educational level in the ART parents. The Danish Medical Association in Copenhagen (KMS) funded this study with a scholarship grant. None of the authors had any competing interests. 704676. © The Author 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Addressing criticisms of existing predictive bias research: cognitive ability test scores still overpredict African Americans' job performance.

PubMed

Berry, Christopher M; Zhao, Peng

2015-01-01

Predictive bias studies have generally suggested that cognitive ability test scores overpredict job performance of African Americans, meaning these tests are not predictively biased against African Americans. However, at least 2 issues call into question existing over-/underprediction evidence: (a) a bias identified by Aguinis, Culpepper, and Pierce (2010) in the intercept test typically used to assess over-/underprediction and (b) a focus on the level of observed validity instead of operational validity. The present study developed and utilized a method of assessing over-/underprediction that draws on the math of subgroup regression intercept differences, does not rely on the biased intercept test, allows for analysis at the level of operational validity, and can use meta-analytic estimates as input values. Therefore, existing meta-analytic estimates of key parameters, corrected for relevant statistical artifacts, were used to determine whether African American job performance remains overpredicted at the level of operational validity. African American job performance was typically overpredicted by cognitive ability tests across levels of job complexity and across conditions wherein African American and White regression slopes did and did not differ. Because the present study does not rely on the biased intercept test and because appropriate statistical artifact corrections were carried out, the present study's results are not affected by the 2 issues mentioned above. The present study represents strong evidence that cognitive ability tests generally overpredict job performance of African Americans. (c) 2015 APA, all rights reserved.

How Is Family Support Related to Students' GPA Scores? A Longitudinal Study

ERIC Educational Resources Information Center

Cheng, Wen; Ickes, William; Verhofstadt, Lesley

2012-01-01

Previous studies of the influence of family support on college students' academic performance have yielded inconsistent results. Therefore, the present study aimed to examine the link between family support and students' university-level academic performance in a more detailed way. First, we sought to clarify how two distinct aspects of perceived…

Self-efficacy, disability level and physical strength in the injured workers: findings from a major factory disaster in Bangladesh.

PubMed

Villanueva, Gabriela; Fitch, Taylor; Quadir, Mohammad Morshedul; Raju Sagiraju, Hari Krishna; Alamgir, Hasanat

2017-04-01

In 24 April 2013, Rana Plaza - a high-rise building in Bangladesh where garments were being made for the Western markets collapsed. In this study, we report on the surviving workers' physical strength, self-efficacy, and disability level one year after the disaster. This cross-sectional study took place at the Centre for the Rehabilitation of the Paralysed (CRP) which provided care for more than 600 victims. For this study, upper extremity strength among the survivors was assessed by dynamometer hand grip (HG) and lower extremity strength by five time sit to stand test (FTSST). The WHODAS tool measured level of disability and General Self-Efficacy questionnaire measured self-efficacy. Post-traumatic stress disorder (PTSD) prevalence was determined by the PCL-scale. The study recruited 181 injured workers. The mean disability score among them was 49.8 (SD 17.5) and mean self-efficacy score was 24.9 (SD 6.9). In multivariate models, after adjusting for age, gender, education, injury profile, employment, marital status and job category, self-efficacy was found to be higher among those who scored above median HG test score [β= -2.32 (95% CI: -4.63, -0.01)] and FTSST performance score [β= -2.69 (95% CI: -4.93, -0.46)]. The disability level was found to be significantly associated with PTSD score [β = 0.84 (95% CI: 0.62, 1.06)] and self-efficacy score [β= -0.45 (95% CI: -0.78, -0.13)]. There is an immense need to develop and deliver effective post-injury recovery, rehabilitation and return-to-work programs for injured workers in resource poor countries. Implications for Rehabilitation The study findings suggest that one year after the factory disaster in Bangladesh, the injured workers are suffering from a high degree of disability, low physical performance and reporting low self-efficacy. The national and international stakeholders including Western buyers, aid agencies, NGOs, worker advocacy groups, consumer associations and the government of Bangladesh can be updated on the progress made so far. There is an immense need to develop and deliver effective post-injury recovery, rehabilitation and return-to-work programs for injured workers in resource poor countries. International organizations like ILO, WHO, World Bank can help developing countries in building these capacities.

Virtual reality, ultrasound-guided liver biopsy simulator: development and performance discrimination.

PubMed

Johnson, S J; Hunt, C M; Woolnough, H M; Crawshaw, M; Kilkenny, C; Gould, D A; England, A; Sinha, A; Villard, P F

2012-05-01

The aim of this article was to identify and prospectively investigate simulated ultrasound-guided targeted liver biopsy performance metrics as differentiators between levels of expertise in interventional radiology. Task analysis produced detailed procedural step documentation allowing identification of critical procedure steps and performance metrics for use in a virtual reality ultrasound-guided targeted liver biopsy procedure. Consultant (n=14; male=11, female=3) and trainee (n=26; male=19, female=7) scores on the performance metrics were compared. Ethical approval was granted by the Liverpool Research Ethics Committee (UK). Independent t-tests and analysis of variance (ANOVA) investigated differences between groups. Independent t-tests revealed significant differences between trainees and consultants on three performance metrics: targeting, p=0.018, t=-2.487 (-2.040 to -0.207); probe usage time, p = 0.040, t=2.132 (11.064 to 427.983); mean needle length in beam, p=0.029, t=-2.272 (-0.028 to -0.002). ANOVA reported significant differences across years of experience (0-1, 1-2, 3+ years) on seven performance metrics: no-go area touched, p=0.012; targeting, p=0.025; length of session, p=0.024; probe usage time, p=0.025; total needle distance moved, p=0.038; number of skin contacts, p<0.001; total time in no-go area, p=0.008. More experienced participants consistently received better performance scores on all 19 performance metrics. It is possible to measure and monitor performance using simulation, with performance metrics providing feedback on skill level and differentiating levels of expertise. However, a transfer of training study is required.

Factors associated with the health and cognition of 6-year-old to 8-year-old children in KwaZulu-Natal, South Africa.

PubMed

Ajayi, Oluwakemi R; Matthews, Glenda; Taylor, Myra; Kvalsvig, Jane; Davidson, Leslie L; Kauchali, Shuaib; Mellins, Claude A

2017-05-01

To investigate 6-year-old to 8-year-old children's health, nutritional status and cognitive development in a predominantly rural area of KwaZulu-Natal, South Africa. Cohort study of 1383 children investigating the association of demographic variables (area of residence, sex, pre-school education, HIV status, height for age and haemoglobin level) and family variables (socioeconomic status, maternal and paternal level of education), with children's cognitive performance. The latter was measured using the Grover-Counter Scale of Cognitive Development and subtests of the Kaufman Assessment Battery for Children, second edition (KABC-II). General linear models were used to determine the effect of these predictors. Area of residence and height-for-age were the statistically significant factors affecting cognitive test scores, regardless of attending pre-school. Paternal level of education was also significantly associated with the cognitive test scores of the children for all three cognitive test results, whereas HIV status, sex and their socioeconomic status were not. Children with low cognitive scores tended to be stunted (low height-for-age scores), lacked pre-school education and were younger. Area of residence and their parents' educational level also influenced their cognition. © 2017 John Wiley & Sons Ltd.

Predicting performance using background characteristics of international medical graduates in an inner-city university-affiliated Internal Medicine residency training program.

PubMed

Kanna, Balavenkatesh; Gu, Ying; Akhuetie, Jane; Dimitrov, Vihren

2009-07-13

IMGs constitute about a third of the United States (US) internal medicine graduates. US residency training programs face challenges in selection of IMGs with varied background features. However data on this topic is limited. We analyzed whether any pre-selection characteristics of IMG residents in our internal medicine program are associated with selected outcomes, namely competency based evaluation, examination performance and success in acquiring fellowship positions after graduation. We conducted a retrospective study of 51 IMGs at our ACGME accredited teaching institution between 2004 and 2007. Background resident features namely age, gender, self-reported ethnicity, time between medical school graduation to residency (pre-hire time), USMLE step I & II clinical skills scores, pre-GME clinical experience, US externship and interest in pursuing fellowship after graduation expressed in their personal statements were noted. Data on competency-based evaluations, in-service exam scores, research presentation and publications, fellowship pursuance were collected. There were no fellowships offered in our hospital in this study period. Background features were compared between resident groups according to following outcomes: (a) annual aggregate graduate PGY-level specific competency-based evaluation (CBE) score above versus below the median score within our program (scoring scale of 1 - 10), (b) US graduate PGY-level specific resident in-training exam (ITE) score higher versus lower than the median score, and (c) those who succeeded to secure a fellowship within the study period. Using appropriate statistical tests & adjusted regression analysis, odds ratio with 95% confidence intervals were calculated. 94% of the study sample were IMGs; median age was 35 years (Inter-Quartile range 25th - 75th percentile (IQR): 33-37 years); 43% women and 59% were Asian physicians. The median pre-hire time was 5 years (IQR: 4-7 years) and USMLE step I & step II clinical skills scores were 85 (IQR: 80-88) & 82 (IQR: 79-87) respectively. The median aggregate CBE scores during training were: PG1 5.8 (IQR: 5.6-6.3); PG2 6.3 (IQR 6-6.8) & PG3 6.7 (IQR: 6.7 - 7.1). 25% of our residents scored consistently above US national median ITE scores in all 3 years of training and 16% pursued a fellowship.Younger residents had higher aggregate annual CBE score than the program median (p < 0.05). Higher USMLE scores were associated with higher than US median ITE scores, reflecting exam-taking skills. Success in acquiring a fellowship was associated with consistent fellowship interest (p < 0.05) and research publications or presentations (p <0.05). None of the other characteristics including visa status were associated with the outcomes. Background IMG features namely, age and USMLE scores predict performance evaluation and in-training examination scores during residency training. In addition enhanced research activities during residency training could facilitate fellowship goals among interested IMGs.

Predicting performance using background characteristics of international medical graduates in an inner-city university-affiliated Internal Medicine residency training program

PubMed Central

Kanna, Balavenkatesh; Gu, Ying; Akhuetie, Jane; Dimitrov, Vihren

2009-01-01

Background IMGs constitute about a third of the United States (US) internal medicine graduates. US residency training programs face challenges in selection of IMGs with varied background features. However data on this topic is limited. We analyzed whether any pre-selection characteristics of IMG residents in our internal medicine program are associated with selected outcomes, namely competency based evaluation, examination performance and success in acquiring fellowship positions after graduation. Methods We conducted a retrospective study of 51 IMGs at our ACGME accredited teaching institution between 2004 and 2007. Background resident features namely age, gender, self-reported ethnicity, time between medical school graduation to residency (pre-hire time), USMLE step I & II clinical skills scores, pre-GME clinical experience, US externship and interest in pursuing fellowship after graduation expressed in their personal statements were noted. Data on competency-based evaluations, in-service exam scores, research presentation and publications, fellowship pursuance were collected. There were no fellowships offered in our hospital in this study period. Background features were compared between resident groups according to following outcomes: (a) annual aggregate graduate PGY-level specific competency-based evaluation (CBE) score above versus below the median score within our program (scoring scale of 1 – 10), (b) US graduate PGY-level specific resident in-training exam (ITE) score higher versus lower than the median score, and (c) those who succeeded to secure a fellowship within the study period. Using appropriate statistical tests & adjusted regression analysis, odds ratio with 95% confidence intervals were calculated. Results 94% of the study sample were IMGs; median age was 35 years (Inter-Quartile range 25th – 75th percentile (IQR): 33–37 years); 43% women and 59% were Asian physicians. The median pre-hire time was 5 years (IQR: 4–7 years) and USMLE step I & step II clinical skills scores were 85 (IQR: 80–88) & 82 (IQR: 79–87) respectively. The median aggregate CBE scores during training were: PG1 5.8 (IQR: 5.6–6.3); PG2 6.3 (IQR 6–6.8) & PG3 6.7 (IQR: 6.7 – 7.1). 25% of our residents scored consistently above US national median ITE scores in all 3 years of training and 16% pursued a fellowship. Younger residents had higher aggregate annual CBE score than the program median (p < 0.05). Higher USMLE scores were associated with higher than US median ITE scores, reflecting exam-taking skills. Success in acquiring a fellowship was associated with consistent fellowship interest (p < 0.05) and research publications or presentations (p <0.05). None of the other characteristics including visa status were associated with the outcomes. Conclusion Background IMG features namely, age and USMLE scores predict performance evaluation and in-training examination scores during residency training. In addition enhanced research activities during residency training could facilitate fellowship goals among interested IMGs. PMID:19594918

An international comparison study of pharmacy students' achievement goals and their relationship to assessment type and scores.

PubMed

Alrakaf, Saleh; Anderson, Claire; Coulman, Sion A; John, Dai N; Tordoff, June; Sainsbury, Erica; Rose, Grenville; Smith, Lorraine

2015-04-25

To identify pharmacy students' preferred achievement goals in a multi-national undergraduate population, to investigate achievement goal preferences across comparable degree programs, and to identify relationships between achievement goals, academic performance, and assessment type. The Achievement Goal Questionnaire was administered to second year students in 4 universities in Australia, New Zealand, England, and Wales. Academic performance was measured using total scores, multiple-choice questions, and written answers (short essay). Four hundred eighty-six second year students participated. Students showed an overall preference for the mastery-approach goal orientation across all sites. The predicted relationships between goal orientation and multiple-choice questions, and written answers scores, were significant. This study is the first of its kind to examine pharmacy students' achievement goals at a multi-national level and to differentiate between assessment type and measures of achievement motivation. Students adopting a mastery-approach goal are more likely to gain high scores in assessments that measure understanding and depth of knowledge.

An International Comparison Study of Pharmacy Students’ Achievement Goals and their Relationship to Assessment Type and Scores

PubMed Central

Anderson, Claire; Coulman, Sion A.; John, Dai N.; Tordoff, June; Sainsbury, Erica; Rose, Grenville; Smith, Lorraine

2015-01-01

Objective: To identify pharmacy students’ preferred achievement goals in a multi-national undergraduate population, to investigate achievement goal preferences across comparable degree programs, and to identify relationships between achievement goals, academic performance, and assessment type. Methods: The Achievement Goal Questionnaire was administered to second year students in 4 universities in Australia, New Zealand, England, and Wales. Academic performance was measured using total scores, multiple-choice questions, and written answers (short essay). Results: Four hundred eighty-six second year students participated. Students showed an overall preference for the mastery-approach goal orientation across all sites. The predicted relationships between goal orientation and multiple-choice questions, and written answers scores, were significant. Conclusion: This study is the first of its kind to examine pharmacy students’ achievement goals at a multi-national level and to differentiate between assessment type and measures of achievement motivation. Students adopting a mastery-approach goal are more likely to gain high scores in assessments that measure understanding and depth of knowledge. PMID:25995510

Risk of Acute Liver Failure in Patients With Drug-Induced Liver Injury: Evaluation of Hy's Law and a New Prognostic Model.

PubMed

Lo Re, Vincent; Haynes, Kevin; Forde, Kimberly A; Goldberg, David S; Lewis, James D; Carbonari, Dena M; Leidl, Kimberly B F; Reddy, K Rajender; Nezamzadeh, Melissa S; Roy, Jason; Sha, Daohang; Marks, Amy R; De Boer, Jolanda; Schneider, Jennifer L; Strom, Brian L; Corley, Douglas A

2015-12-01

Few studies have evaluated the ability of laboratory tests to predict risk of acute liver failure (ALF) among patients with drug-induced liver injury (DILI). We aimed to develop a highly sensitive model to identify DILI patients at increased risk of ALF. We compared its performance with that of Hy's Law, which predicts severity of DILI based on levels of alanine aminotransferase or aspartate aminotransferase and total bilirubin, and validated the model in a separate sample. We conducted a retrospective cohort study of 15,353 Kaiser Permanente Northern California members diagnosed with DILI from 2004 through 2010, liver aminotransferase levels above the upper limit of normal, and no pre-existing liver disease. Thirty ALF events were confirmed by medical record review. Logistic regression was used to develop prognostic models for ALF based on laboratory results measured at DILI diagnosis. External validation was performed in a sample of 76 patients with DILI at the University of Pennsylvania. Hy's Law identified patients that developed ALF with a high level of specificity (0.92) and negative predictive value (0.99), but low level of sensitivity (0.68) and positive predictive value (0.02). The model we developed, comprising data on platelet count and total bilirubin level, identified patients with ALF with a C statistic of 0.87 (95% confidence interval [CI], 0.76-0.96) and enabled calculation of a risk score (Drug-Induced Liver Toxicity ALF Score). We found a cut-off score that identified patients at high risk patients for ALF with a sensitivity value of 0.91 (95% CI, 0.71-0.99) and a specificity value of 0.76 (95% CI, 0.75-0.77). This cut-off score identified patients at high risk for ALF with a high level of sensitivity (0.89; 95% CI, 0.52-1.00) in the validation analysis. Hy's Law identifies patients with DILI at high risk for ALF with low sensitivity but high specificity. We developed a model (the Drug-Induced Liver Toxicity ALF Score) based on platelet count and total bilirubin level that identifies patients at increased risk for ALF with high sensitivity. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

Feature level fusion of hand and face biometrics

NASA Astrophysics Data System (ADS)

Ross, Arun A.; Govindarajan, Rohin

2005-03-01

Multibiometric systems utilize the evidence presented by multiple biometric sources (e.g., face and fingerprint, multiple fingers of a user, multiple matchers, etc.) in order to determine or verify the identity of an individual. Information from multiple sources can be consolidated in several distinct levels, including the feature extraction level, match score level and decision level. While fusion at the match score and decision levels have been extensively studied in the literature, fusion at the feature level is a relatively understudied problem. In this paper we discuss fusion at the feature level in 3 different scenarios: (i) fusion of PCA and LDA coefficients of face; (ii) fusion of LDA coefficients corresponding to the R,G,B channels of a face image; (iii) fusion of face and hand modalities. Preliminary results are encouraging and help in highlighting the pros and cons of performing fusion at this level. The primary motivation of this work is to demonstrate the viability of such a fusion and to underscore the importance of pursuing further research in this direction.

Effect of Divided Attention on Children's Rhythmic Response

ERIC Educational Resources Information Center

Thomas, Jerry R.; Stratton, Richard K.

1977-01-01

Audio and visual interference did not significantly impair rhythmic response levels of second- and fourth-grade boys as measured by space error scores, though audio input resulted in significantly less consistent temporal performance. (MB)

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

PubMed

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

2016-11-01

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

Using Audience Response Technology to provide formative feedback on pharmacology performance for non-medical prescribing students--a preliminary evaluation.

PubMed

Mostyn, Alison; Meade, Oonagh; Lymn, Joanne S

2012-11-13

The use of anonymous audience response technology (ART) to actively engage students in classroom learning has been evaluated positively across multiple settings. To date, however, there has been no empirical evaluation of the use of individualised ART handsets and formative feedback of ART scores. The present study investigates student perceptions of such a system and the relationship between formative feedback results and exam performance. Four successive cohorts of Non-Medical Prescribing students (n=107) had access to the individualised ART system and three of these groups (n=72) completed a questionnaire about their perceptions of using ART. Semi-structured interviews were carried out with a purposive sample of seven students who achieved a range of scores on the formative feedback. Using data from all four cohorts of students, the relationship between mean ART scores and summative pharmacology exam score was examined using a non-parametric correlation. Questionnaire and interview data suggested that the use of ART enhanced the classroom environment, motivated students and promoted learning. Questionnaire data demonstrated that students found the formative feedback helpful for identifying their learning needs (95.6%), guiding their independent study (86.8%), and as a revision tool (88.3%). Interviewees particularly valued the objectivity of the individualised feedback which helped them to self-manage their learning. Interviewees' initial anxiety about revealing their level of pharmacology knowledge to the lecturer and to themselves reduced over time as students focused on the learning benefits associated with the feedback.A significant positive correlation was found between students' formative feedback scores and their summative pharmacology exam scores (Spearman's rho = 0.71, N=107, p<.01). Despite initial anxiety about the use of individualised ART units, students rated the helpfulness of the individualised handsets and personalised formative feedback highly. The significant correlation between ART response scores and student exam scores suggests that formative feedback can provide students with a useful reference point in terms of their level of exam-readiness.

Longitudinal motor performance development in early adolescence and its relationship to adult success: An 8-year prospective study of highly talented soccer players

PubMed Central

Kelava, Augustin; Raabe, Johannes; Höner, Oliver

2018-01-01

Several talent identification and development (TID) programs in soccer have implemented diagnostics to measure players’ motor performance. Yet, there is a lack of research investigating the relationship between motor development in adolescence and future, adult performance. This longitudinal study analyzed the three-year development of highly talented young soccer players’ speed abilities and technical skills and examined the relevance of this development to their adult success. The current research sample consisted of N = 1,134 players born between 1993 and 1995 who were selected for the German Soccer Association’s TID program and participated in nationwide motor diagnostics (sprinting, agility, dribbling, ball control, shooting) four times between the Under 12 (U12) and Under 15 (U15) age class. Relative age (RA) was assessed for all players, and a total motor score was calculated based on performances in the individual tests. In order to investigate players’ future success, participants were divided into two groups according to their adult performance level (APL) in the 2014/2015 season: Elite (1st-5th German division; N = 145, 12.8%) and non-elite players (lower divisions; N = 989, 87.2%). Using multilevel regression analyses each motor performance was predicted by Time, Time2 (level-1 predictors), APL, and RA (level-2 covariates) with simultaneous consideration for interaction effects between the respective variables. Time and Time2 were significant predictors for each test performance. A predictive value for RA was confirmed for sprinting and the total motor score. A significant relationship between APL and the motor score as well as between APL and agility, dribbling, ball control, and shooting emerged. Interaction effects distinctly failed to reach significance. The study found a non-linear improvement in players’ performance for all considered motor performance factors over a three-year period from early to middle adolescence. While their predictive value for future success was confirmed by a significant relationship between APL and most of the considered factors, there was no significant interaction between APL and Time. These findings indicate that future elite players had already been better at the beginning of the TID program and maintained this high level throughout their promotion from U12 to U15. PMID:29723200

Longitudinal motor performance development in early adolescence and its relationship to adult success: An 8-year prospective study of highly talented soccer players.

PubMed

Leyhr, Daniel; Kelava, Augustin; Raabe, Johannes; Höner, Oliver

2018-01-01

Several talent identification and development (TID) programs in soccer have implemented diagnostics to measure players' motor performance. Yet, there is a lack of research investigating the relationship between motor development in adolescence and future, adult performance. This longitudinal study analyzed the three-year development of highly talented young soccer players' speed abilities and technical skills and examined the relevance of this development to their adult success. The current research sample consisted of N = 1,134 players born between 1993 and 1995 who were selected for the German Soccer Association's TID program and participated in nationwide motor diagnostics (sprinting, agility, dribbling, ball control, shooting) four times between the Under 12 (U12) and Under 15 (U15) age class. Relative age (RA) was assessed for all players, and a total motor score was calculated based on performances in the individual tests. In order to investigate players' future success, participants were divided into two groups according to their adult performance level (APL) in the 2014/2015 season: Elite (1st-5th German division; N = 145, 12.8%) and non-elite players (lower divisions; N = 989, 87.2%). Using multilevel regression analyses each motor performance was predicted by Time, Time2 (level-1 predictors), APL, and RA (level-2 covariates) with simultaneous consideration for interaction effects between the respective variables. Time and Time2 were significant predictors for each test performance. A predictive value for RA was confirmed for sprinting and the total motor score. A significant relationship between APL and the motor score as well as between APL and agility, dribbling, ball control, and shooting emerged. Interaction effects distinctly failed to reach significance. The study found a non-linear improvement in players' performance for all considered motor performance factors over a three-year period from early to middle adolescence. While their predictive value for future success was confirmed by a significant relationship between APL and most of the considered factors, there was no significant interaction between APL and Time. These findings indicate that future elite players had already been better at the beginning of the TID program and maintained this high level throughout their promotion from U12 to U15.

Internet Addiction in High School Students in Turkey and Multivariate Analyses of the Underlying Factors.

PubMed

Kilic, Mahmut; Avci, Dilek; Uzuncakmak, Tugba

2016-01-01

The aim of this study is to examine the Internet addiction among adolescents in relation to their sociodemographic characteristics, communication skills, and perceived familial social support. This cross-sectional research is conducted in the high schools in some city centers, in Turkey, in 2013. In this study, cluster sampling was used. In each school, a class for each grade level was randomly selected, and all the students in the selected classes were included in the sample. One thousand seven hundred forty-two students aged between 14 and 20 years were included in the sample.The mean Internet Addiction Scale (IAS) score of the students was found to be 27.9 ± 21.2. According to the scores obtained from IAS, 81.8% of the students were found to display no symptoms (<50 points), 16.9% were found to display borderline symptoms (50-79 points), and 1.3% were found to be Internet addicts (≥80 points). According to the results of the binary logistic regression, male students and the students in single sex vocational schools were found to report higher levels of borderline Internet addiction. It was also observed that the IAS score increases when the father's educational level increases and when the students' school performance is worse. On the other hand, the IAS score decreases when the student grade level, perceived family social support, and communication skills scores increase.The risk factors for Internet addiction are being a male, low academic achievement, inadequate social support and communication skills, and father's high educational level.

Does a Weekly Didactic Conference Improve Resident Performance on the Pediatric Domain of the Orthopaedic In-Training Examination?

PubMed

Franklin, Corinna C; Bosch, Patrick P; Grudziak, Jan S; Dede, Ozgur; Ramirez, Rey N; Mendelson, Steven A; Ward, W Timothy; Brooks, Maria; Kenkre, Tanya; Lubahn, John D; Deeney, Vincent F; Roach, James W

2017-03-01

Performance on the Orthopaedic In-training Examination (OITE) has been correlated with performance on the written portion of the American Board of Orthopaedic Surgery examination. Herein we sought to discover whether adding a regular pediatric didactic lecture improved residents' performance on the OITE's pediatric domain. In 2012, a didactic lecture series was started in the University of Pittsburgh Medical Center (UPMC) Hamot Orthopaedic Residency Program (Hamot). This includes all topics in pediatric orthopaedic surgery and has teaching faculty present, and occurs weekly with all residents attending. A neighboring program [UMPC Pittsburgh (Pitt)] shares in these conferences, but only during their pediatric rotation. We sought to determine the effectiveness of the conference by comparing the historic scores from each program on the pediatric domain of the OITE examination to scores after the institution of the conference, and by comparing the 2 programs' scores. Both programs demonstrated improvement in OITE scores. In 2008, the mean examination score was 19.6±4.3 (11.0 to 30.0), and the mean percentile was 57.7±12.6 (32.0 to 88.0); in 2014, the mean examination score was 23.5±4.2 (14.0 to 33.0) and the mean percentile was 67.1±12.1 (40.0 to 94.0). OITE scores and percentiles improved with post graduate year (P<0.0001). Compared with the preconference years, Hamot residents answered 3.99 more questions correctly (P<0.0001) and Pitt residents answered 2.93 more questions correctly (P<0.0001). Before the conference, site was not a predictor of OITE score (P=0.06) or percentile (P=0.08); there was no significant difference found between the mean scores per program. However, in the postconference years, site did predict OITE scores. Controlling for year in training, Hamot residents scored higher on the OITE (2.3 points higher, P=0.003) and had higher percentiles (0.07 higher, P=0.004) than Pitt residents during the postconference years. This study suggests that adding a didactic pediatric lecture improved residents' scores on the OITE and indirectly suggests that more frequent attendance is associated with better scores. Level III-retrospective case-control study.

Using Precept-Assist® to predict performance on the American Board of Family Medicine In-Training Examination.

PubMed

Post, Robert E; Jamena, Gemma P; Gamble, James D

2014-09-01

Precept-Assist® (PA) is a computer-based program developed by the Virtua Family Medicine Residency where residents receive a score on a Likert-type scale from an attending for each precept based on their knowledge base. The purpose of this study was to attempt to validate this program for precepting family medicine residents. This was a validation study. PA and American Board of Family Medicine (ABFM) In-Training Exam (ITE) scores for all residents from a community-based family medicine residency between the years 2002 and 2011 were included (n=216). Pearson correlation coefficients were calculated between PA scores for the second quarter of the academic year (October 1 to December 31) and scores on the ITE. An ROC curve was also created to determine sensitivity and specificity for various PA scores in predicting residents scoring 500 or above on the ITE. The PA mean (SD) score was 5.18 (0.84) and the ITE mean (SD) score was 425.1 (87.6). The Pearson correlation coefficient between PA and ITE scores was 0.55, which is a moderately positive correlation. The AUC of the ROC curve was 0.783 (95% CI 0.704-0.859). A PA score of 5.5 (between the level of a PGY-2 and PGY-3) was 72% sensitive and 77% specific for scoring 500 or above on the ITE with a positive LR of 3.12. There is a significant correlation between PA scores and ABFM In-Training Exam scores. PA is a valid screening tool that can be used as a predictor for future performance in Family Medicine In-Training exams.

3-year changes in physical activity and physical performance decline over 9 years of follow-up in older adults: The InCHIANTI study

PubMed Central

Martinez-Gomez, David; Bandinelli, Stefania; Del-Panta, Vieri; Patel, Kushang V; Guralnik, Jack M; Ferrucci, Luigi

2016-01-01

OBJECTIVES To examine the associations of cumulative physical activity (PA) and its changes over 3-year with changes over 9 years of follow-up in physical performance in older adults. DESIGN Longitudinal. SETTING Community-based. PARTICIPANTS Men and women, aged 65 years and older, from the InCHIANTI study (N=782). MEASUREMENTS Physical performance was assessed at baseline and at 3-, 6- and 9-year follow-up with the Short Physical Performance Battery (SPPB). PA was assessed through an interviewer-administered questionnaire at baseline and at 3-year follow-up. Analyses were adjusted for education, body mass index, smoking, alcohol intake, coronary heart disease, stroke, peripheral arterial disease, cancer, lung disease, lower extremity osteoarthritis, depression, and Mini-mental state examination. RESULTS Over 3-year of follow-up, the prevalence of participants inactive, minimally active and active was 27.8%, 52.2% and 20.0%, respectively. The prevalence of participants who decreased, no change or increased PA over 3-year of follow-up was 37.2%, 50.1% and 12.7%, respectively. Compared with participants who spent most of the time inactive and after adjustment for potential covariates (−2.60 score, 95%CI: −2.92, −2.27), being mostly active (−1.08 score, 95%CI: −1.43, −0.73) and even minimally active (−1.33 score, 95%CI: −1.53, −1.12) over 3 years of follow-up was associated with lower declines in the SPPB score. When analyzing changes, increasing PA (−0.57 score, 95%CI: −1.01, −0.12) was associated with lower declines in the SPPB score over 9 years as compared with those who decreased PA (−2.16 score, 95%CI: −2.42, −1.89). CONCLUSION Maintaining or increasing PA levels may attenuate age-associated physical performance decline. PMID:28248412

Insulin resistance and cognitive test performance in elderly adults: National health and nutrition examination survey (NHANES).

PubMed

Sherzai, Ayesha Z; Shaheen, Magda; Yu, Jeffrey J; Talbot, Konrad; Sherzai, Dean

2018-05-15

To examine the relationship between homeostatic model of insulin resistance (HOMA-IR) and cognitive test performance among population≥60years in a national database. Higher insulin resistance is associated with lower cognitive test performance score in the population≥60years. We analyzed data from the National Health and Nutrition Examination Survey (NHANES) 1999-2000 and 2001-2002. Cognitive test performance was measured by the Digit Symbol Substitution (DSS) exercise score. The main independent variable was the homeostasis model assessment of insulin resistance (HOMA-IR). We used bivariate analysis and generalized linear model adjusting for age, gender, race, education, body mass index, and systolic and diastolic blood pressures; total cholesterol, low density lipoprotein (LDL), high density lipoprotein (HDL) and triglyceride levels; and physical activity, diabetes mellitus, stroke, and congestive heart failure. STATA 14 was used to analyze the data taking into consideration the design, strata and weight. Of the 1028 participants, 44% were male and 85% were white. The mean age was 70.0±0.28 (SE) years. Their average HOMA-IR was 3.6±0.14 and they had a mean of 49.2±0.8 correct DSS score in the cognitive test. Adjusting for the confounding variables, HOMA-IR was associated with decline in DSS score (B=-0.30, 95% confidence interval=-0.54 and -0.05, p=0.01). The model explained 44% of the variability of the DSS score (R 2 =0.44). Significant predictors of decline in DSS score were age, gender, race, and education (p=0.01). Insulin resistance as measured by HOMA-IR was independently associated with lower cognitive test performance score among elderly participants aged ≥60years. Longitudinal studies are needed to test the mechanism and the causal relationship. Copyright © 2017. Published by Elsevier B.V.

Oxford NOTECHS II: a modified theatre team non-technical skills scoring system.

PubMed

Robertson, Eleanor R; Hadi, Mohammed; Morgan, Lauren J; Pickering, Sharon P; Collins, Gary; New, Steve; Griffin, Damian; Griffin, Damien; McCulloch, Peter; Catchpole, Ken C

2014-01-01

We previously developed and validated the Oxford NOTECHS rating system for evaluating the non-technical skills of an entire operating theatre team. Experience with the scale identified the need for greater discrimination between levels of performance within the normal range. We report here the development of a modified scale (Oxford NOTECHS II) to facilitate this. The new measure uses an eight-point instead of a four point scale to measure each dimension of non-technical skills, and begins with a default rating of 6 for each element. We evaluated this new scale in 297 operations at five NHS sites in four surgical specialities. Measures of theatre process reliability (glitch count) and compliance with the WHO surgical safety checklist were scored contemporaneously, and relationships with NOTECHS II scores explored. Mean team Oxford NOTECHS II scores was 73.39 (range 37-92). The means for surgical, anaesthetic and nursing sub-teams were 24.61 (IQR 23, 27); 24.22 (IQR 23, 26) and 24.55 (IQR 23, 26). Oxford NOTECHS II showed good inter-rater reliability between human factors and clinical observers in each of the four domains. Teams with high WHO compliance had higher mean Oxford NOTECHS II scores (74.5) than those with low compliance (71.1) (p = 0.010). We observed only a weak correlation between Oxford NOTECHS II scores and glitch count; r = -0.26 (95% CI -0.36 to -0.15). Oxford NOTECHS II scores did not vary significantly between 5 different hospital sites, but a significant difference was seen between specialities (p = 0.001). Oxford NOTECHS II provides good discrimination between teams while retaining reliability and correlation with other measures of teamwork performance, and is not confounded by technical performance. It is therefore suitable for combined use with a technical performance scale to provide a global description of operating theatre team performance.

Fundamentals of endoscopic surgery: creation and validation of the hands-on test.

PubMed

Vassiliou, Melina C; Dunkin, Brian J; Fried, Gerald M; Mellinger, John D; Trus, Thadeus; Kaneva, Pepa; Lyons, Calvin; Korndorffer, James R; Ujiki, Michael; Velanovich, Vic; Kochman, Michael L; Tsuda, Shawn; Martinez, Jose; Scott, Daniel J; Korus, Gary; Park, Adrian; Marks, Jeffrey M

2014-03-01

The Fundamentals of Endoscopic Surgery™ (FES) program consists of online materials and didactic and skills-based tests. All components were designed to measure the skills and knowledge required to perform safe flexible endoscopy. The purpose of this multicenter study was to evaluate the reliability and validity of the hands-on component of the FES examination, and to establish the pass score. Expert endoscopists identified the critical skill set required for flexible endoscopy. They were then modeled in a virtual reality simulator (GI Mentor™ II, Simbionix™ Ltd., Airport City, Israel) to create five tasks and metrics. Scores were designed to measure both speed and precision. Validity evidence was assessed by correlating performance with self-reported endoscopic experience (surgeons and gastroenterologists [GIs]). Internal consistency of each test task was assessed using Cronbach's alpha. Test-retest reliability was determined by having the same participant perform the test a second time and comparing their scores. Passing scores were determined by a contrasting groups methodology and use of receiver operating characteristic curves. A total of 160 participants (17 % GIs) performed the simulator test. Scores on the five tasks showed good internal consistency reliability and all had significant correlations with endoscopic experience. Total FES scores correlated 0.73, with participants' level of endoscopic experience providing evidence of their validity, and their internal consistency reliability (Cronbach's alpha) was 0.82. Test-retest reliability was assessed in 11 participants, and the intraclass correlation was 0.85. The passing score was determined and is estimated to have a sensitivity (true positive rate) of 0.81 and a 1-specificity (false positive rate) of 0.21. The FES hands-on skills test examines the basic procedural components required to perform safe flexible endoscopy. It meets rigorous standards of reliability and validity required for high-stakes examinations, and, together with the knowledge component, may help contribute to the definition and determination of competence in endoscopy.

Factors associated with increased felt stigma among individuals with epilepsy.

PubMed

Bautista, Ramon Edmundo D; Shapovalov, Denys; Shoraka, Ali Reza

2015-08-01

The aim of the study is to determine whether certain demographic, clinical, and psychosocial traits are associated with higher levels of felt stigma among persons with epilepsy (PWE) patients followed at a level 4 epilepsy center. We performed a direct survey of 182 consenting patients that included the Epilepsy Stigma Scale. On univariate analysis, higher levels of perceived stigma were associated with age, marital status, race, driving, work status, seizure etiology, Quality of Life in Epilepsy-10 (QOLIE-10) scores, and health literacy. Among coping reactions, the use of denial, behavioral disengagement and venting were also associated with higher degrees of felt stigma. Using multiple linear regression, being single, poorer QOLIE-10 scores, difficulties understanding written information, and the use of behavioral disengagement were independently associated with poorer scores on the Epilepsy Stigma Scale. Our study paints a compelling profile of a PWE who has greater perceived stigma. Programs that increase the level of social support, improve health literacy, and enhance quality of life may also help decrease the amount of felt stigma among PWE. Copyright © 2015 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Mitigating Task Saturation in Critical Care Air Transport Team Red Flag Checklist

DTIC Science & Technology

2015-04-14

Cincinnati. Team and individual performances were scored using a validated assessment tool for NOTECHS. Salivary cortisol levels were measured at baseline...deployment experience (pɘ.04) continued to be significant. Salivary cortisol levels increased by 0.124μg/dL over baseline as the result of the...Figure Page 1 Salivary cortisol levels for all 48 participants in the simulations ........................................3

[Intelligence level and structure in school age children with fetal growth restriction].

PubMed

Ma, Jian; Ma, Hong-Wei; Tian, Xiao-Bo; Liu, Fang

2009-10-01

To study the intelligence level and structure in school age children with fetal growth restriction (FGR). The intelligence levels were tested by the Wechsler Children Scales of Intelligence (C-WISC) in 54 children with FGR and in 84 normal children. The full intelligence quotient (FIQ), verbal IQ (VIQ) and performance IQ (PIQ) in the FGR group were 105.9+/-10.3, 112.4+/-11.2 and 97.1+/-10.6 respectively, and they all were in a normal range. But the PIQ was significantly lower than that in the control group (104.8+/-10.5; p<0.001), and the picture arrangement and the decipher subtest scores were significantly lower than those in the control group (p<0.01). The scores of perception/organization and memory/attention factors in the FGR group were 99.8+/-11.1 and 116.3+/-14.4, respectively, which were inferior to those in the control group (104.6+/-11.5 and 113.4+/-14.5 respectively; p<0.05). The total intelligence level of children with FGR is normal, but there are imbalances in the intelligence structure and dysfunctions in performance ability related to right cerebral hemisphere. Performance trainings should be done from the infancy in children with FGR.

Study on relationship of performance shaping factor in human error probability with prevalent stress of PUSPATI TRIGA reactor operators

NASA Astrophysics Data System (ADS)

Rahim, Ahmad Nabil Bin Ab; Mohamed, Faizal; Farid, Mohd Fairus Abdul; Fazli Zakaria, Mohd; Sangau Ligam, Alfred; Ramli, Nurhayati Binti

2018-01-01

Human factor can be affected by prevalence stress measured using Depression, Anxiety and Stress Scale (DASS). From the respondents feedback can be summarized that the main factor causes the highest prevalence stress is due to the working conditions that require operators to handle critical situation and make a prompt critical decisions. The relationship between the prevalence stress and performance shaping factors found that PSFFitness and PSFWork Process showed positive Pearson’s Correlation with the score of .763 and .826 while the level of significance, p = .028 and p = .012. These positive correlations with good significant values between prevalence stress and human performance shaping factor (PSF) related to fitness, work processes and procedures. The higher the stress level of the respondents, the higher the score of selected for the PSFs. This is due to the higher levels of stress lead to deteriorating physical health and cognitive also worsened. In addition, the lack of understanding in the work procedures can also be a factor that causes a growing stress. The higher these values will lead to the higher the probabilities of human error occur. Thus, monitoring the level of stress among operators RTP is important to ensure the safety of RTP.

Evaluation of a cardiopulmonary resuscitation curriculum in a low resource environment.

PubMed

Chang, Mary P; Lyon, Camila B; Janiszewski, David; Aksamit, Deborah; Kateh, Francis; Sampson, John

2015-11-07

To evaluate whether a 2-day International Liaison Committee on Resuscitation (ILCOR) Universal Algorithm-based curriculum taught in a tertiary care hospital in Liberia increases local health care provider knowledge and skill comfort level. A combined basic and advanced cardiopulmonary resuscitation (CPR) curriculum was developed for low-resource settings that included lectures and low-fidelity manikin-based simulations. In March 2014, the curriculum was taught to healthcare providers in a tertiary care hospital in Liberia. In a quality assurance review, participants were evaluated for knowledge and comfort levels with resuscitation before and after the workshop. They were also videotaped during simulation sessions and evaluated on standardized performance metrics. Fifty-two hospital staff completed both pre-and post-curriculum surveys. The median score was 45% pre-curriculum and 82% post-curriculum (p<0.00001). The median provider comfort level score was 4 of 5 pre-curriculum and 5 of 5 post-curriculum (p<0.00001). During simulations, 93.2% of participants performed the pulse check within 10 seconds, and 97.7% performed defibrillation within 180 seconds. Clinician knowledge of and comfort level with CPR increased significantly after participating in our curriculum. A CPR curriculum based on lectures and low-fidelity manikin simulations may be an effective way to teach resuscitation in this low-resource setting.

Nutritional Status of Patients with Chronic Obstructive Pulmonary Disease in Relation to their Physical Performance.

PubMed

Matkovic, Zinka; Cvetko, Danijel; Rahelic, Dario; Esquinas, Cristina; Zarak, Marko; Miravitlles, Marc; Tudoric, Neven

2017-12-01

Nutritional abnormalities and physical inactivity are highly prevalent in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to determine the association between nutritional status/body composition and physical performance in patients with COPD. A cross-sectional observational study was conducted in outpatients with clinically stable, moderate to very severe COPD. In the assessment of nutritional status, we used dual energy X-ray absorptiometry, anthropometry, serum biomarkers, and the Mini-Nutritional Assessment (MNA) questionnaire. Physical performance was measured by the 6-minute walk distance (6MWD), 4-metre gait speed (4MGS), and physical activity. Univariate and multivariate analyses were performed. In 111 patients (mean age 68 years, 69% men), the mean 6MWD was 376 ± 119 m, 4MGS 0.9 ± 0.2 m/s, and the average daily step count 8,059 ± 4,757. Patients with low exercise capacity (6MWD ≤ 350 m) had a significantly lower lean mass index (LMI) (p < 0.01), fat-free mass index (FFMI) (p < 0.01), bone mineral content (p < 0.01), bone mineral density (p < 0.01), T-score (p < 0.05), MNA score (p < 0.01), and serum albumin and prealbumin levels (p < 0.05). Patients with low physical activity (daily step count ≤ median) had lower LMI, FFMI, MNA score, serum prealbumin (for all comparisons p < 0.05) and vitamin D levels (p < 0.01). However, none of the nutritional variables showed an independent association with low physical performance in the multivariate models. In conclusion, patients with low physical performance have deficient nutritional status, but we could not demonstrate an independent relationship between nutritional parameters and physical performance.

"It's Always the Judge's Fault": Attention, Emotion Recognition, and Expertise in Rhythmic Gymnastics Assessment.

PubMed

van Bokhorst, Lindsey G; Knapová, Lenka; Majoranc, Kim; Szebeni, Zea K; Táborský, Adam; Tomić, Dragana; Cañadas, Elena

2016-01-01

In many sports, such as figure skating or gymnastics, the outcome of a performance does not rely exclusively on objective measurements, but on more subjective cues. Judges need high attentional capacities to process visual information and overcome fatigue. Also their emotion recognition abilities might have an effect in detecting errors and making a more accurate assessment. Moreover, the scoring given by judges could be also influenced by their level of expertise. This study aims to assess how rhythmic gymnastics judges' emotion recognition and attentional abilities influence accuracy of performance assessment. Data will be collected from rhythmic gymnastics judges and coaches at different international levels. This study will employ an online questionnaire consisting on an emotion recognition test and attentional test. Participants' task is to watch a set of videotaped rhythmic gymnastics performances and evaluate them on the artistic and execution components of performance. Their scoring will be compared with the official scores given at the competition the video was taken from to measure the accuracy of the participants' evaluations. The proposed research represents an interdisciplinary approach that integrates cognitive and sport psychology within experimental and applied contexts. The current study advances the theoretical understanding of how emotional and attentional aspects affect the evaluation of sport performance. The results will provide valuable evidence on the direction and strength of the relationship between the above-mentioned factors and the accuracy of sport performance evaluation. Importantly, practical implications might be drawn from this study. Intervention programs directed at improving the accuracy of judges could be created based on the understanding of how emotion recognition and attentional abilities are related to the accuracy of performance assessment.

“It’s Always the Judge’s Fault”: Attention, Emotion Recognition, and Expertise in Rhythmic Gymnastics Assessment

PubMed Central

van Bokhorst, Lindsey G.; Knapová, Lenka; Majoranc, Kim; Szebeni, Zea K.; Táborský, Adam; Tomić, Dragana; Cañadas, Elena

2016-01-01

In many sports, such as figure skating or gymnastics, the outcome of a performance does not rely exclusively on objective measurements, but on more subjective cues. Judges need high attentional capacities to process visual information and overcome fatigue. Also their emotion recognition abilities might have an effect in detecting errors and making a more accurate assessment. Moreover, the scoring given by judges could be also influenced by their level of expertise. This study aims to assess how rhythmic gymnastics judges’ emotion recognition and attentional abilities influence accuracy of performance assessment. Data will be collected from rhythmic gymnastics judges and coaches at different international levels. This study will employ an online questionnaire consisting on an emotion recognition test and attentional test. Participants’ task is to watch a set of videotaped rhythmic gymnastics performances and evaluate them on the artistic and execution components of performance. Their scoring will be compared with the official scores given at the competition the video was taken from to measure the accuracy of the participants’ evaluations. The proposed research represents an interdisciplinary approach that integrates cognitive and sport psychology within experimental and applied contexts. The current study advances the theoretical understanding of how emotional and attentional aspects affect the evaluation of sport performance. The results will provide valuable evidence on the direction and strength of the relationship between the above-mentioned factors and the accuracy of sport performance evaluation. Importantly, practical implications might be drawn from this study. Intervention programs directed at improving the accuracy of judges could be created based on the understanding of how emotion recognition and attentional abilities are related to the accuracy of performance assessment. PMID:27458406

Role of maca (Lepidium meyenii) consumption on serum interleukin-6 levels and health status in populations living in the Peruvian Central Andes over 4000 m of altitude.

PubMed

Gonzales, Gustavo F; Gasco, Manuel; Lozada-Requena, Ivan

2013-12-01

Lepidium meyenii (Maca) is a plant that grows at over 4,000 m above sea level in the central Peruvian Andes. The hypocotyls of this plant are traditionally consumed for their nutritional and medicinal properties. The aim of this study was to determine the health status based on a health related quality of life (HRQL) questionnaire (SF-20) and serum levels of interleukin 6 (IL-6) in subjects that are maca consumers. For this, a cross-sectional study was designed to be performed in 50 subjects from Junin (4,100 m): 27 subjects were maca consumers and 23 were non-consumers. The SF-20 survey is used to obtain a summary measure of health status. The stand up from a chair and sit down (SUCSD) test (to assess lower-extremity function), hemoglobin measurement, blood pressure, sexual hormone levels, serum IL-6 levels and the score of chronic mountain sickness (CMS) were evaluated. Testosterone/estradiol ratio (P <0.05), IL-6 (P < 0.05) and CMS score were lower, whereas the health status score was higher, in maca consumers when compared to non-consumers (P < 0.01). A greater proportion of maca consumers successfully completed the SUCSD test compared to non-consumers (P < 0.01), showing a significant association with lower values of serum IL-6 (P < 0.05). In conclusion, consumption of maca was associated with low serum IL-6 levels and in turn with better health status scores in the SF-20 survey and low chronic mountain sickness scores.

Rifaximin Improves Driving Simulator Performance in a Randomized Trial of Patients with Minimal Hepatic Encephalopathy

PubMed Central

Bajaj, Jasmohan S; Heuman, Douglas M; Wade, James B; Gibson, Douglas P; Saeian, Kia; Wegelin, Jacob A; Hafeezullah, Muhammad; Bell, Debulon E; Sterling, Richard K; Stravitz, R. Todd; Fuchs, Michael; Luketic, Velimir; Sanyal, Arun J

2010-01-01

Background & Aims Patients with cirrhosis and minimal hepatic encephalopathy (MHE) have driving difficulties but the effects of therapy on driving performance have not been assessed. We evaluated whether performance on a driving simulator improves in patients with MHE following treatment with rifaximin. Methods Patients with MHE who were current drivers were randomly assigned to placebo or rifaximin groups and followed for 8 weeks (n=42). Patients underwent driving simulation (driving and navigation tasks) at the start (baseline) and end of the study. We evaluated patients’ cognitive abilities, quality-of-life (using the Sickness Impact Profile [SIP]), serum levels of ammonia, levels of inflammatory cytokines, and MELD scores. The primary outcome was percent who improved in driving performance, calculated by: total driving errors=speeding + illegal turns + collisions. Results Over the 8-week study period, patients given rifaximin made significantly greater improvements than those given placebo in avoiding total driving errors (76% vs. 31%, P=0.013), speeding (81% vs. 33%, P=0.005), and illegal turns (62% vs. 19%, P=0.01). Of patients given rifaximin, 91% improved their cognitive performance, compared with 61% of patients given placebo (P=0.01); they also made improvements in the psycho-social dimension of the SIP, compared with the placebo group (P=0.04). Adherence to the assigned drug averaged 92%. Neither group had changes in ammonia levels or MELD scores, but patients in the rifaximin group had increased levels of the anti-inflammatory cytokine interleukin-10. Conclusions Patients with MHE significantly improve driving simulator performance following treatment with rifaximin, compared with placebo. PMID:20849805

The EPOS-CC Score: An Integration of Independent, Tumor- and Patient-Associated Risk Factors to Predict 5-years Overall Survival Following Colorectal Cancer Surgery.

PubMed

Haga, Yoshio; Ikejiri, Koji; Wada, Yasuo; Ikenaga, Masakazu; Koike, Shoichiro; Nakamura, Seiji; Koseki, Masato

2015-06-01

Surgical audit is an essential task for the estimation of postoperative outcome and comparison of quality of care. Previous studies on surgical audits focused on short-term outcomes, such as postoperative mortality. We propose a surgical audit evaluating long-term outcome following colorectal cancer surgery. The predictive model for this audit is designated as 'Estimation of Postoperative Overall Survival for Colorectal Cancer (EPOS-CC)'. Thirty-one tumor-related and physiological variables were prospectively collected in 889 patients undergoing elective resection for colorectal cancer between April 2005 and April 2007 in 16 Japanese hospitals. Postoperative overall survival was assessed over a 5-years period. The EPOS-CC score was established by selecting significant variables in a uni- and multivariate analysis and allocating a risk-adjusted multiplication factor to each variable using Cox regression analysis. For validation, the EPOS-CC score was compared to the predictive power of UICC stage. Inter-hospital variability of the observed-to-estimated 5-years survival was assessed to estimate quality of care. Among the 889 patients, 804 (90%) completed the 5-years follow-up. Univariate analysis displayed a significant correlation with 5-years survival for 14 physiological and nine tumor-related variables (p < 0.005). Highly significant p-values below 0.0001 were found for age, ASA score, severe pulmonary disease, respiratory history, performance status, hypoalbuminemia, alteration of hemoglobin, serum sodium level, and for all histological variables except tumor location. Age, TNM stage, lymphatic invasion, performance status, and serum sodium level were independent variables in the multivariate analysis and were entered the EPOS-CC model for the prediction of survival. Risk-adjusted multiplication factors between 1.5 (distant metastasis) and 0.16 (serum sodium level) were accorded to the different variables. The predictive power of EPOS-CC was superior to the one of UICC stage; area under the curve 0.87, 95% CI 0.85-0.90 for EPOS-CC, and 0.80, 0.76-0.83 for UICC stage, p < 0.001. Quality of care did not differ between hospitals. The EPOS-CC score including the independent variables age, performance status, serum sodium level, TNM stage, and lymphatic invasion is superior to the UICC stage in the prediction of 5-years overall survival. This higher accuracy might be explained by the inclusion of physiological factors, thus also taking non-tumor-associated deaths into account. Furthermore, EPOS-CC score may compare quality of care among different institutions. Future studies are necessary to further evaluate this score and help improving the prediction of long-term survival following colorectal cancer surgery.

Basal salivary oxytocin level predicts extra- but not intra-personal dimensions of emotional intelligence.

PubMed

Koven, Nancy S; Max, Laura K

2014-06-01

A wealth of literature suggests that oxytocin is an important mediator of social cognition, but much of the research to date has relied on pharmaceutical administration methods that can raise oxytocin to artificially high levels. The present study builds upon previous work by examining whether basal oxytocin level predicts intra- and extra-personal (i.e., self- and other-focused) elements of emotional intelligence (EI), independent of shared variance with current mood. The sample included 71 healthy young adults (46 women). Assessment measures included the Mayer-Salovey-Caruso Emotional Intelligence Test Version 2.0 (MSCEIT), the Trait Meta-Mood Scale, and the Profile of Mood States. Peripheral oxytocin levels were examined with enzyme-linked immunosorbent assay from saliva after solid phase extraction. Oxytocin level was unrelated to TMMS scores but was positively associated with performance in the Experiential EI domain of the MSCEIT. However, total mood disturbance was positively related to MSCEIT scores. Hierarchical regression analysis indicated that oxytocin level added unique variance to the prediction of MSCEIT performance beyond that of current mood. These results confirm an association between endogenous levels of oxytocin in healthy adults and a subset of EI abilities, including extra-personal emotion recognition and the channeling of emotions to enhance social proficiency. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Effect of Altitude and Travel on Rugby Union Performance: Analysis of the 2012 Super Rugby Competition.

PubMed

George, Tina M; Olsen, Peter D; Kimber, Nick E; Shearman, Jeremy P; Hamilton, Jamie G; Hamlin, Michael J

2015-12-01

The aim of this study was to investigate whether playing rugby at altitude or after travel (domestic and international) disadvantaged teams. In a retrospective longitudinal study, all matches (N = 125) played in the 2012 Super Rugby Competition were analyzed for key performance indicators (KPI) from coded game data provided by OPTA sports data company. Matches were played in a home-away format in New Zealand, South Africa, and Australia. Teams based at sea level but playing at altitude (1,271-1,753 m) were more likely to miss tackles (mean ± 90% confidence interval, 1.4 ± 1.7) and score fewer points in the first half compared with games at sea level. In the second half of games, sea level teams at altitude were very likely to make fewer gain lines (-4.0 ± 2.7) compared with the second half of games at sea level. The decreased ability to break the defensive line, which may be the result of altitude-induced fatigue, could reduce the likelihood of scoring points and winning a game. Travel also had an effect on KPI, where international travel resulted in more missed tackles (1.7 ± 1.3) and less frequent gain lines (-3.0 ± 1.9) in the first half relative to matches at home; overall, away teams (domestic and international) scored 4 less points in the second half compared with home teams. In conclusion, playing away from home in another country, particularly at altitude, can have a detrimental effect on KPI, which may affect the overall performance and the chances of winning matches.

Comparison of physical examination performance of medical students trained by musculoskeletal versus non-musculoskeletal specialists.

PubMed

Melo, Luciano; Schrieber, Leslie; Eyles, Jillian; Deveza, Leticia A; Meneses, Sarah R F; Hunter, David J

2017-04-01

To compare the musculoskeletal (MSK) physical examination skills, knowledge acquisition and performance of first-year medical students trained by MSK specialist tutors to students trained by non-MSK specialist tutors, after a 6-week MSK physical examination tutorial program. Twenty-first year medical students took part in the study. They were recruited into two groups, according to their exposure to either an MSK specialist or a non-MSK specialist tutor during their 6-week MSK training block. Knowledge acquisition was measured via a pre- and post-training objective structured clinical examination (OSCE). We assessed students' self-belief and confidence levels regarding their newly acquired skills via a questionnaire. Independent t tests were used to examine mean group differences of OSCE scores and perceived level of confidence. Both groups demonstrated a significant improvement (3.9 and 3.8 points, respectively, on an eight-point scale for shoulder assessment, P < 0.01, 3.3 and 3.5, respectively, on a five-point scale for spine assessment, P < 0.01) in OSCE scores compared to baseline after completing the 6-week MSK physical examination tutorial program. There was no between-group difference in the OSCE scores from pre- to post-training (P = 0.92 for shoulder, P = 0.66 for spine) or for perceived level of confidence in performing a basic MSK examination after training (P = 0.91). Students exposed to MSK specialist tutors did not demonstrate increased skill levels or knowledge in the area of MSK physical examination compared to those receiving the same training under the supervision of non-MSK specialist tutors. Both student groups demonstrated improvement. © 2017 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

Local distributions of wealth to describe health inequalities in India: a new approach for analyzing nationally representative household survey data, 1992-2008.

PubMed

Bassani, Diego G; Corsi, Daniel J; Gaffey, Michelle F; Barros, Aluisio J D

2014-01-01

Worse health outcomes including higher morbidity and mortality are most often observed among the poorest fractions of a population. In this paper we present and validate national, regional and state-level distributions of national wealth index scores, for urban and rural populations, derived from household asset data collected in six survey rounds in India between 1992-3 and 2007-8. These new indices and their sub-national distributions allow for comparative analyses of a standardized measure of wealth across time and at various levels of population aggregation in India. Indices were derived through principal components analysis (PCA) performed using standardized variables from a correlation matrix to minimize differences in variance. Valid and simple indices were constructed with the minimum number of assets needed to produce scores with enough variability to allow definition of unique decile cut-off points in each urban and rural area of all states. For all indices, the first PCA components explained between 36% and 43% of the variance in household assets. Using sub-national distributions of national wealth index scores, mean height-for-age z-scores increased from the poorest to the richest wealth quintiles for all surveys, and stunting prevalence was higher among the poorest and lower among the wealthiest. Urban and rural decile cut-off values for India, for the six regions and for the 24 major states revealed large variability in wealth by geographical area and level, and rural wealth score gaps exceeded those observed in urban areas. The large variability in sub-national distributions of national wealth index scores indicates the importance of accounting for such variation when constructing wealth indices and deriving score distribution cut-off points. Such an approach allows for proper within-sample economic classification, resulting in scores that are valid indicators of wealth and correlate well with health outcomes, and enables wealth-related analyses at whichever geographical area and level may be most informative for policy-making processes.

Failure to thrive and cognitive development in toddlers with infantile anorexia.

PubMed

Chatoor, Irene; Surles, Jaclyn; Ganiban, Jody; Beker, Leila; Paez, Laura McWade; Kerzner, Benny

2004-05-01

The goal of this study was to examine the relative contributions of growth deficiency and psychosocial factors to cognitive development in toddlers with infantile anorexia. Eighty-eight toddlers, ranging in age from 12 to 33 months, were enrolled in this study. Toddlers were evaluated by 2 child psychiatrists and placed into 1 of 3 groups: infantile anorexia, picky eater, and healthy eater. All 3 groups were matched for age, race, gender, and socioeconomic status (SES). Toddlers underwent nutritional evaluations and cognitive assessments with the Bayley Scales of Infant Development. Toddlers and their mothers were also videotaped during feeding and play interactions, which later were rated independently by 2 observers. On average, toddlers with infantile anorexia performed within the normal range of cognitive development. However, the Mental Developmental Index (MDI) scores of the healthy eater group (MDI = 110) were significantly higher than those of the infantile anorexia (MDI = 99) and picky eater (MDI = 96) groups. Within the infantile anorexia group, correlations between MDI scores and the toddlers' percentage of ideal body weight approached statistical significance (r =.32). Across all groups, the toddlers' MDI scores were associated with the quality of mother-child interactions, SES level, and maternal education level. Collectively, these variables explained 22% of the variance in MDI scores. This study demonstrated that psychosocial factors, such as mother-toddler interactions, maternal education level, and SES level, are related to the cognitive development of toddlers with feeding problems and explain more unique variance in MDI scores than nutritional status.

Measuring Primary Students' Graph Interpretation Skills Via a Performance Assessment: A case study in instrument development

NASA Astrophysics Data System (ADS)

Peterman, Karen; Cranston, Kayla A.; Pryor, Marie; Kermish-Allen, Ruth

2015-11-01

This case study was conducted within the context of a place-based education project that was implemented with primary school students in the USA. The authors and participating teachers created a performance assessment of standards-aligned tasks to examine 6-10-year-old students' graph interpretation skills as part of an exploratory research project. Fifty-five students participated in a performance assessment interview at the beginning and end of a place-based investigation. Two forms of the assessment were created and counterbalanced within class at pre and post. In situ scoring was conducted such that responses were scored as correct versus incorrect during the assessment's administration. Criterion validity analysis demonstrated an age-level progression in student scores. Tests of discriminant validity showed that the instrument detected variability in interpretation skills across each of three graph types (line, bar, dot plot). Convergent validity was established by correlating in situ scores with those from the Graph Interpretation Scoring Rubric. Students' proficiency with interpreting different types of graphs matched expectations based on age and the standards-based progression of graphs across primary school grades. The assessment tasks were also effective at detecting pre-post gains in students' interpretation of line graphs and dot plots after the place-based project. The results of the case study are discussed in relation to the common challenges associated with performance assessment. Implications are presented in relation to the need for authentic and performance-based instructional and assessment tasks to respond to the Common Core State Standards and the Next Generation Science Standards.

Neurocognitive screening of lead-exposed andean adolescents and young adults.

PubMed

Counter, S Allen; Buchanan, Leo H; Ortega, Fernando

2009-01-01

This study was designed to assess the utility of two psychometric tests with putative minimal cultural bias for use in field screening of lead (Pb)-exposed Ecuadorian Andean workers. Specifically, the study evaluated the effectiveness in Pb-exposed adolescents and young adults of a nonverbal reasoning test standardized for younger children, and compared the findings with performance on a test of auditory memory. The Raven Coloured Progressive Matrices (RCPM) was used as a test of nonverbal intelligence, and the Digit Span subtest of the Wechsler IV intelligence scale was used to assess auditory memory/attention. The participants were 35 chronically Pb-exposed Pb-glazing workers, aged 12-21 yr. Blood lead (PbB) levels for the study group ranged from 3 to 86 microg/dl, with 65.7% of the group at and above 10 microg/dl. Zinc protoporphyrin heme ratios (ZPP/heme) ranged from 38 to 380 micromol/mol, with 57.1% of the participants showing abnormal ZPP/heme (>69 micromol/mol). ZPP/heme was significantly correlated with PbB levels, suggesting chronic Pb exposure. Performance on the RCPM was less than average on the U.S., British, and Puerto Rican norms, but average on the Peruvian norms. Significant inverse associations between PbB/ZPP concentrations and RCPM standard scores using the U.S., Puerto Rican, and Peruvian norms were observed, indicating decreasing RCPM test performance with increasing PbB and ZPP levels. RCPM scores were significantly correlated with performance on the Digit Span test for auditory memory. Mean Digit Span scale score was less than average, suggesting auditory memory/attention deficits. In conclusion, both the RCPM and Digit Span tests were found to be effective instruments for field screening of visual-spatial reasoning and auditory memory abilities, respectively, in Pb-exposed Andean adolescents and young adults.

The effects of supplemental instruction (SI) on student performance in a college-level biology course

NASA Astrophysics Data System (ADS)

Fest, Brenda Joyce Rowland

1999-10-01

This experimental study examined the effects of participation in a Supplemental Instruction (SI) program on student performance in a college level biology course. SI is an academic support program which incorporates study techniques into the framework of an academic course through discussion sessions. According to Blanc, DeBuhr, and Martin (1983) and Kenney (1988), students who experienced Supplemental Instruction had higher course grades, semester grade point averages, and rates of re-enrollment than did non-participants. The present study was conducted within the scheduled discussion sections of a large lecture class of biology for science majors (n = 135). The researcher and another graduate student conducted these discussion sessions in which half of the sections served as the SI treatment group and half of the sections served as the non-SI (traditional) control group. This design eliminated both time on task and motivation as potential contaminating variables. This posttest only, quasi-experimental design study uses a modified nonequivalent control group design. The academic performance of students who participated in SI discussion sessions was compared to the academic performance of students who participated in traditional review-type discussion sessions. Other research questions examined the interactive effect of SI on student performance with respect to SI leader experience, student ability level as measured by total SAT scores, previous academic success as measured by previous college GPA, and different cognitive level of examination questions. t-test and ANOVA statistical methods were used to analyze the data. The results of the t-tests to compare the means of the SI group to the non-SI group (p < .458) do not indicate any significant difference in the semester course scores between the two groups. Thus, the data did not show an overall effect of SI on student performance. The most important results obtained from this study are those with respect to the interactive effect of SI and student ability groups as measured by SAT total scores and prior college GPA. In this study the students in middle ability groups seemed to benefit more from SI than did the lower and higher ability students.

Quantitative measures with WREX usage.

PubMed

Shank, Tracy M; Wee, Jinyong; Ty, Jennifer; Rahman, Tariq

2017-07-01

This paper presents the results of two surveys conducted with users of a functional upper extremity orthosis called the Wilmington Robotic EXoskeleton (WREX). The WREX is a passive anti-gravity arm orthosis that allows people with neuromuscular disabilities to move their arms in three dimensions. An online user survey with 55 patients was conducted to determine the benefits of the WREX. The survey asked 10 questions related to upper extremity function with and without the WREX as well as subjective impressions of the device. A second survey used a phone interview based on the Canadian Occupational Performance Measure (COPM). Parents rated their child's performance and satisfaction while partaking in important activities both with and without the exoskeleton device. Scores were assessed for change between the two conditions. Twenty-five families responded to this survey. Twenty-four out of 25 subjects reported greater levels of performance and satisfaction when they were wearing the WREX. The mean change in performance score was 3.61 points, and the mean change in satisfaction score was 4.44 points. Results show a statistically significant improvement in arm function for everyday tasks with the WREX.

[Competence of triage nurses in hospital emergency departments].

PubMed

Martínez-Segura, Estrella; Lleixà-Fortuño, Mar; Salvadó-Usach, Teresa; Solà-Miravete, Elena; Adell-Lleixà, Mireia; Chanovas-Borrás, Manel R; March-Pallarés, Gemma; Mora-López, Gerard

2017-06-01

To identify associations between sociodemographic characteristics variables and competence levels of triage nurses in hospital emergency departments. Descriptive, cross-sectional, multicenter study of triage nurses in hospital emergency departments in the southwestern area of Catalonia (Ebre River territory). We used an instrument for evaluating competencies (the COM_VA questionnaire) and recording sociodemographic variables (age, sex, total work experience, emergency department experience, training in critical patient care and triage) and perceived confidence when performing triage. We then analyzed the association between these variables and competency scores. Competency scores on the COM_VA questionnaire were significantly higher in nurses with training in critical patient care (P=.001) and triage (P=0.002) and in those with longer emergency department experience (P<.0001). Perceived confidence when performing triage increased with competency score (P<.0001) and training in critical patient care (P<.0001) and triage (P=.045). The competence of triage nurses and their perception of confidence when performing triage increases with emergency department experience and training.

National Undergraduate Medical Core Curriculum in Turkey: Evaluation of Residents

PubMed Central

Budakoğlu, Işıl İrem; Coşkun, Özlem; Ergün, Mehmet Ali

2014-01-01

Background: There is very little information available on self-perceived competence levels of junior medical doctors with regard to definitions by the National Core Curriculum (NCC) for Undergraduate Medical Education. Aims: This study aims to determine the perceived level of competence of residents during undergraduate medical education within the context of the NCC. Study Design: Descriptive study. Methods: The survey was conducted between February 2010 and December 2011; the study population comprised 450 residents. Of this group, 318 (71%) participated in the study. Self-assessment questionnaires on competencies were distributed and residents were asked to assess their own competence in different domains by scoring them on a scale of 1 to 10. Results: Nearly half of the residents reported insufficient experience of putting clinical skills into practice when they graduated. In the theoretical part of NCC, the lowest competency score was reported for health-care administration, while the determination of level of chlorine in water, delivering babies, and conducting forensic examinations had the lowest perceived levels of competency in the clinical skills domain. Conclusion: Residents reported low levels of perceived competency in skills they rarely performed outside the university hospital. They were much more confident in skills they performed during their medical education. PMID:25207163

The relationship between physical fitness and academic achievement among adolescent in South Korea.

PubMed

Han, Gun-Soo

2018-04-01

[Purpose] The purpose of this study was to identify the relationship between physical fitness level and academic achievement in middle school students. [Subjects and Methods] A total of 236 students aged 13-15 from three middle schools in D city, South Korea, were selected using a random sampling method. Academic achievement was measured by students' 2014 fall-semester final exam scores and the level of physical fitness was determined according to the PAPS (Physical Activity Promotion System) score administrated by the Korean Ministry of Education. A Pearson correlation test with SPSS 20.0 was employed. [Results] The Pearson correlation test revealed a significant correlation between physical fitness and academic achievement. Specifically, students with higher levels of physical fitness tend to have higher academic performance. In addition, final exam scores of core subjects (e.g., English, mathematics, and science) were significantly related to the PAPS score. [Conclusion] Results of this study can be used to develop more effective physical education curricula. In addition, the data can also be applied to recreation and sport programs for other populations (e.g., children and adult) as well as existing national physical fitness data in various countries.

Women With Breast Cancer: Self-Reported Distress in Early Survivorship

PubMed Central

Lester, Joanne; Crosthwaite, Kara; Stout, Robin; Jones, Rachel N.; Holloman, Christopher; Shapiro, Charles; Andersen, Barbara L.

2015-01-01

Purpose/Objectives To identify and compare levels of distress and sources of problems among patients with breast cancer in early survivorship. Design Descriptive, cross-sectional. Setting A National Cancer Institute–designated comprehensive cancer center. Sample 100 breast cancer survivors were selected to represent four time points in the cancer trajectory. Methods Distress was self-reported using the Distress Thermometer and its 38-item problem list. Analysis of variance and chi-square analyses were performed as appropriate. Main Research Variables Distress scores, problem reports, and time groups. Findings Participants scored in range of the cutoff of more than 4 (range = 4.1–5.1) from treatment through three months post-treatment. At six months post-treatment, distress levels were significantly lower. Significant differences were found between groups on the total problem list score (p = 0.007) and emotional (p = 0.01) and physical subscale scores (p = 0.003). Conclusions Comparison of groups at different points in the cancer trajectory found similar elevated levels from diagnosis through three months. Distress remained elevated in early survivorship but significantly decreased at six months post-treatment. Implications for Nursing Interventions to reduce or prevent distress may improve outcomes in early survivorship. PMID:25542330

Readability and quality assessment of internet-based patient education materials related to laryngeal cancer.

PubMed

Narwani, Vishal; Nalamada, Keerthana; Lee, Michael; Kothari, Prasad; Lakhani, Raj

2016-04-01

Patients are increasingly using the internet to access health-related information. The purpose of this study was to assess the readability and quality of laryngeal cancer-related websites. Patient education materials were identified by performing an internet search using 3 search engines. Readability was assessed using Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), and Gunning Fog Index (GFI). The DISCERN instrument was utilized to assess quality of health information. A total of 54 websites were included in the analysis. The mean readability scores were as follows: FRES, 48.2 (95% confidence interval [CI] = 44.8-51.6); FKGL, 10.9 (95% CI = 10.3-11.5); and GFI, 13.8 (95% CI = 11.3-16.3). These scores suggest that, on average, online information about patients with laryngeal cancer is written at an advanced level. The mean DISCERN score was 49.8 (95% CI = 45.4-54.2), suggesting that online information is of variable quality. Our study suggests much of the laryngeal cancer information available online is of suboptimal quality and written at a level too difficult for the average adult to read comfortably. © 2015 Wiley Periodicals, Inc.

Cognitive Function in a Randomized Trial of Evolocumab.

PubMed

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

2017-08-17

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

Service quality from the perspective of myocardial infarction patients.

PubMed

Gholipour, Kamal; Tabrizi, Jafar Sadegh; Azimzadeh, Solmaz; Ghafari, Samad; Iezadi, Shabnam

2018-04-01

Service quality (SQ) generally refers to the nonclinical aspects of health services and primarily focuses on the relationship between the care provider and the customers, and the environment in which care services are delivered. The aim of this study was to assess the SQ provided for myocardial infarction (MI) from the patients' perspective. A cross-sectional study was conducted with 164 patients with MI at the Tabriz Shahid Madani cardiology clinic. Study participants were selected using convenience sampling. SQ was measured using a validated Comprehensive Quality Measurement in Healthcare SQ questionnaire. The reliability was confirmed based on Cronbach's alpha coefficient (α=0.81). SQ was calculated using the formula SQ=10- (importance × performance), based on the importance and performance of non-health-related aspects from the customers' perspective. Importance scores ranged from 1 to 10 and performance was scored between 0 and 1. Of 164 participants, about 75% were men and almost 44% were between 51 and 65 years of age. From the customers' perspective, the total SQ score was 6.80 (0-10 scale), and the individual scores for all SQ aspects were below an acceptable level. Confidentiality, dignity and continuity were given the highest scores, while availability of support groups had the lowest score. The study findings revealed an opportunity to improve SQ. Patient and provider participation in quality improvement activities could be an effective strategy to improve the aspects of health care quality that were most important to the customers and those with low scores, such as availability of support groups.

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.

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

PubMed

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

2016-07-01

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

Students' perception of the learning environment and its relation to their study year and performance in Sudan.

PubMed

Ahmed, Yasar; Taha, Mohamed H; Al-Neel, Salma; Gaffar, Abdelrahim M

2018-05-24

To evaluate students' perceptions of the learning environment and to assess any differences in perception related to students' performance and their year of study. A descriptive cross-sectional study was performed of 638 students from the second, sixth and tenth semesters at the Faculty of Medicine at Gezira University, Sudan. This study employed the Arabic-translated Dundee Ready Education Environment Measure. The main predictor variables were the study year and academic performance. Descriptive statistics and one-way analysis of variance with a post hoc Tukey-Kramer multiple comparisons test were used for data analysis. The overall score for this study was 122/200 (SD=16.6), indicating a positive perception of the learning environment. The overall mean score was 109.94/200 (SD=21.2) for Semester 2 students, 122.9/200 (SD=20.29) for Semester 6 students, and 116.53 (SD=20.12) for Semester 10 students, reflecting a significant difference in students' perceptions in different years of study (F (2,2422) = 3.21, p=0.04). There was also a significant difference between the mean overall scores with respect to academic performance. High-achieving students' mean DREEM score was 126 (SD=24.4); while low-achieving students' mean DREEM score was 102 (SD=26.25) (F (2,2453) = 3.53, p=0.029). High achievers' perceptions of the learning environment are significantly better than those of low achievers. A significant difference was observed between students in different years of study. The differences in students' academic performance should be further investigated, targeting specific domains. A large-scale study is required to differentiate between the weakness and the strength of each academic level.

[Mini Mental State Examination (MMSE): determination of cutoff scores according to age and educational level].

PubMed

Solias, A; Skapinakis, P; Degleris, N; Pantoleon, M; Katirtzoglou, E; Politis, A

2014-01-01

For the last 38 years, Mini Mental State Examination (MMSE) has been widely used as a dementia screening measure in everyday clinical practice as well as in both cohort and cross-sectional studies. Its validity and reliability for the Greek population has explicitly been documented. However, the effect of age and education on the subject's performance makes it necessary to reckon them in the estimation of the "cutoff score". The purpose of this study is to estimate the prevalence of dementia in Greek population and determine the "cutoff score" by age and education-corrected norms. Cross sectional study of 630 patients older than 55 years, who live independently in Ilion and Helioupolis Municipalities was conducted, 27.3% of the subjects tested in the study were diagnosed with memory disorder according to their MMSE scores and the validation for the Greek population. The effect of age and education to the subjects' performance was statistically significant (p=.000). The use of standard "cutoff score" was not proved to be useful for the personalized interpretation of the results, as documented by the fact that older individuals with lower education had a poorer performance relatively to younger, highly educated subjects. Comparatively to the group age of 55-60 years, the odds ratio after the age of 75 years varies from 2.58 to 4.91. Regarding the variable factor of education, the odds ratio for the first degree education graduates decreases from 1.43 to 3.19 for the third degree education graduates in comparison with the group of illiterates. In conclusion, the use of the "cutoff score" algorithm and the simultaneous estimation of age and education effect on MMSE score may prove useful for the proper evaluation of MMSE performance. According to the age and education of examine candidates in the community and the primary care, we propose the use of the 25th percentile as a more useful cutoff score in order to decrease the false positive results.

ProDisc-L total disc replacement: a comparison of 1-level versus 2-level arthroplasty patients with a minimum 2-year follow-up.

PubMed

Hannibal, Matthew; Thomas, Derek J; Low, Jeffrey; Hsu, Ken Y; Zucherman, James

2007-10-01

This is a retrospective analysis of data that was collected prospectively from 2 concurrent FDA IDE lumbar arthroplasty clinical trials performed at a single center. To determine if there is a clinical difference between the 1-level ProDisc patients versus the 2-level ProDisc patients at a minimum of 2 years of follow-up. Marnay's work with ProDisc I prompted the U.S. Clinical Trials of the ProDisc II under the direction of the FDA. Disc replacement surgery in the United States has shown promising results for all types of prostheses up to 6 months. Marnay and colleagues showed that their results at 10 years were still promising, and they saw no significant difference between 1-level and multilevel disc replacements. The findings of Ipsen and colleagues suggest that multilevel arthroplasty cases may be less successful than disc replacement at a single level. Patients were part of the FDA clinical trial for the Prodisc II versus circumferential fusion study at a single institution. We identified 27 patients who received ProDisc at 1 level and 32 who received it at 2 levels with at least a 2-year follow-up, for a total of 59 patients. Unpaired t tests were performed on the mean results of Visual Analog Scale, Oswestry Disability Index, SF-36 Healthy Survey Physical Component Summary, and satisfaction using 10-cm line visual scale scores to determine a clinical difference if any between the 2 populations. While patients receiving ProDisc at 2 levels scored marginally lower in all evaluation indexes, score differences in each category were also found to hold no statistical significance. This study was unable to identify a statistically significant difference in outcome between 1- and 2-level ProDisc arthroplasty patients in a cohort from a single center. The equality of clinical effectiveness between 1- and 2-level ProDisc has yet to be determined.

Preliminary report of the Hepatic Encephalopathy Assessment Driving Simulator (HEADS) score.

PubMed

Baskin-Bey, Edwina S; Stewart, Charmaine A; Mitchell, Mary M; Bida, John P; Rosenthal, Theodore J; Nyberg, Scott L

2008-01-01

Audiovisual simulations of real-life driving (ie, driving simulators) have been used to assess neurologic dysfunction in a variety of medical applications. However, the use of simulated driving to assess neurologic impairment in the setting of liver disease (ie, hepatic encephalopathy) is limited. The aim of this analysis was to develop a scoring system based on simulated driving performance to assess mild cognitive impairment in cirrhotic patients with hepatic encephalopathy. This preliminary analysis was conducted as part of the Hepatic Encephalopathy Assessment Driving Simulator (HEADS) pilot study. Cirrhotic volunteers initially underwent a battery of neuropsychological tests to identify those cirrhotic patients with mild cognitive impairment. Performance during an audiovisually simulated course of on-road driving was then compared between mildly impaired cirrhotic patients and healthy volunteers. A scoring system was developed to quantify the likelihood of cognitive impairment on the basis of data from the simulated on-road driving. Mildly impaired cirrhotic patients performed below the level of healthy volunteers on the driving simulator. Univariate logistic regression and correlation models indicated that several driving simulator variables were significant predictors of cognitive impairment. Five variables (run time, total map performance, number of collisions, visual divided attention response, and average lane position) were incorporated into a quantitative model, the HEADS scoring system. The HEADS score (0-9 points) showed a strong correlation with cognitive impairment as measured by area under the receiver-operator curve (.89). The HEADS system appears to be a promising new tool for the assessment of mild hepatic encephalopathy.

Dental fluorosis in populations from Chiang Mai, Thailand with different fluoride exposures - Paper 2: The ability of fluorescence imaging to detect differences in fluorosis prevalence and severity for different fluoride intakes from water

PubMed Central

2012-01-01

Background To assess the ability of fluorescence imaging to detect a dose response relationship between fluorosis severity and different levels of fluoride in water supplies compared to remote photographic scoring in selected populations participating in an observational, epidemiological survey in Chiang Mai, Thailand. Methods Subjects were male and female lifetime residents aged 8-13 years. For each child the fluoride content of cooking water samples (CWS) was assessed to create categorical intervals of water fluoride concentration. Fluorescence images were taken of the maxillary central incisors and analyzed for dental fluorosis using two different software techniques. Output metrics for the fluorescence imaging techniques were compared to TF scores from blinded photographic scores obtained from the survey. Results Data from 553 subjects were available. Both software analysis techniques demonstrated significant correlations with the photographic scores. The metrics for area effected by fluorosis and the overall fluorescence loss had the strongest association with the photographic TF score (Spearman’s rho 0.664 and 0.652 respectively). Both software techniques performed well for comparison of repeat fluorescence images with ICC values of 0.95 and 0.85 respectively. Conclusions This study supports the potential use of fluorescence imaging for the objective quantification of dental fluorosis. Fluorescence imaging was able to discriminate between populations with different fluoride exposures on a comparable level to remote photographic scoring with acceptable levels of repeatability. PMID:22908997

Nutritional and Immunological Correlates of Memory and Neurocognitive Development Among HIV-Infected Children Living in Kayunga, Uganda.

PubMed

Ruiseñor-Escudero, Horacio; Familiar-Lopez, Itziar; Sikorskii, Alla; Jambulingam, Nikita; Nakasujja, Noelline; Opoka, Robert; Bass, Judith; Boivin, Michael

2016-04-15

To identify the nutritional and immunological correlates of memory and neurocognitive development as measured by the Mullen Scales of Early Learning (MSEL) and by the Color Object Association Test (COAT) among children in Uganda. This analysis uses baseline data collected between 2008 and 2010 from 119 HIV-infected children aged 1-6 years, participating in a randomized controlled trial of an interventional parenting program in Kayunga, Uganda. Peripheral blood draws were performed to determine immunological biomarkers. Unadjusted and adjusted linear regression models were used to relate MSEL and COAT scores to sociodemographic characteristics, weight-for-age Z scores (WAZs), antiretroviral therapy status, and immunological biomarkers. In the final analysis, 111 children were included. Lower levels of CD4 CD38 T cells (P = 0.04) were associated to higher immediate and total recall scores (P = 0.04). Higher levels of CD8 HLA-DR T cells were associated with higher total recall score (P = 0.04) of the COAT. Higher CD4 CD38 HLA-DR T cells levels were associated with higher gross motor scores of the MSEL (P = 0.02). WAZ was positively correlated to visual reception, fine motor, expressive language, and composite score of the MSEL. Overall, WAZ was a stronger predictor of neurocognitive outcomes assessed by the MSEL. CD4 CD38 T cells were more specifically associated with memory-related outcomes. Future research should include immunological markers and standardized neurocognitive tests to further understand this relationship.

Examination of Substance Use, Risk Factors, and Protective Factors on Student Academic Test Score Performance

PubMed Central

Arthur, Michael W.; Brown, Eric C.; Briney, John S.; Hawkins, J. David; Abbott, Robert D.; Catalano, Richard F.; Becker, Linda; Langer, Michael; Mueller, Martin T.

2016-01-01

BACKGROUND School administrators and teachers face difficult decisions about how best to use school resources in order to meet academic achievement goals. Many are hesitant to adopt prevention curricula that are not focused directly on academic achievement. Yet, some have hypothesized that prevention curricula can remove barriers to learning and, thus, promote achievement. This study examined relationships between school levels of student substance use and risk and protective factors that predict adolescent problem behaviors and achievement test performance in Washington State. METHODS Hierarchical Generalized Linear Models were used to examine predictive associations between school-averaged levels of substance use and risk and protective factors and Washington State students’ likelihood of meeting achievement test standards on the Washington Assessment of Student Learning, statistically controlling for demographic and economic factors known to be associated with achievement. RESULTS Results indicate that levels of substance use and risk/protective factors predicted the academic test score performance of students. Many of these effects remained significant even after controlling for model covariates. CONCLUSIONS The findings suggest that implementing prevention programs that target empirically identified risk and protective factors have the potential to positively affect students’ academic achievement. PMID:26149305

Results of arthroscopic treatment in unresolved Osgood-Schlatter disease in athletes.

PubMed

Circi, Esra; Beyzadeoglu, Tahsin

2017-02-01

In this study we aimed to determine outcomes following arthroscopic ossicle excision in athletes with unresolved Osgood-Schlatter disease (OSD). Arthroscopy was performed on 11 patients (11 knees) with OSD between September 2008 and November 2014. Surgical treatment inclusion criteria were determined as: failure of conservative treatment; isolated pain over the tibial tubercle and distal patellar tendon; pain limiting sporting performance at a competitive level. All patients had a documented history of OSD; the mean duration of persistent pain over the tibial tubercle was 15.5 months. The mean age was 23 years. The mean follow-up period was 66.1 months. The mean latency in returning to sports related training activities after the surgery was 6.7 weeks. The mean Kujala patello-femoral score improved from 82.9 points pre-operatively, to 98.5 points at the final follow-up (p < 0.01). The mean Lysholm knee scale score was 87.5 points in the pre-operative period, increasing to a score of 96.9 points at final follow-up (p < 0.01). The mean Tegner activity level score was 7.5 in the pre-operative period, increasing to 8.5 post-operatively (p < 0.01). We investigated the functional outcomes after arthroscopic treatment of unresolved OSD in athletes. All athletes with OSD showed satisfactory functional recovery following arthroscopic treatment. All patients were able to return to the same level of athletic activity. Arthroscopic surgery for unresolved OSD has the major advantage of faster recovery and avoiding damage to the patellar tendon.

New technique targeting the C5 nerve root proximal to the traditional interscalene sonoanatomical approach is analgesic for outpatient arthroscopic shoulder surgery.

PubMed

Dobie, Katherine H; Shi, Yaping; Shotwell, Matthew S; Sandberg, Warren S

2016-11-01

Regional anesthesia and analgesia for shoulder surgery is most commonly performed via interscalene nerve block. We developed an ultrasound-guided technique that specifically targets the C5 nerve root proximal to the traditional interscalene block and assessed its efficacy for shoulder analgesia. Prospective case series. Vanderbilt Bone and Joint Surgery Center. Patients undergoing shoulder arthroscopy at an ambulatory surgery center. Thirty-five outpatient shoulder arthroscopy patients underwent an analgesic nerve block using a new technique where ultrasound visualization of the C5 nerve root served as the primary target at a level proximal to the traditional interscalene approach. The block was performed with 15mL of 0.5% plain ropivicaine. Post anesthesia care unit pain scores, opioid consumption, hand strength, and duration of block were recorded. Cadaver dissection after injection with methylene blue confirmed that the primary target under ultrasound visualization was the C5 nerve root. Pain scores revealed 97% patients had 0/10 pain at arrival to PACU, with 91% having a pain score of 3/10 or less at discharge from PACU. Medical Research Council (MRC) hand strength mean (SD) score was 4.17 (0.92) on a scale of 1-5. The mean (SD) duration of the block was 13.9 (3.5) hours. A new technique for ultrasound-guided blockade at the level of the C5 nerve root proximal to the level of the traditional interscalene block is efficacious for shoulder post-operative pain control. Copyright © 2016 Elsevier Inc. All rights reserved.

Associations between cadmium exposure and neurocognitive test scores in a cross-sectional study of US adults.

PubMed

Ciesielski, Timothy; Bellinger, David C; Schwartz, Joel; Hauser, Russ; Wright, Robert O

2013-02-05

Low-level environmental cadmium exposure and neurotoxicity has not been well studied in adults. Our goal was to evaluate associations between neurocognitive exam scores and a biomarker of cumulative cadmium exposure among adults in the Third National Health and Nutrition Examination Survey (NHANES III). NHANES III is a nationally representative cross-sectional survey of the U.S. population conducted between 1988 and 1994. We analyzed data from a subset of participants, age 20-59, who participated in a computer-based neurocognitive evaluation. There were four outcome measures: the Simple Reaction Time Test (SRTT: visual motor speed), the Symbol Digit Substitution Test (SDST: attention/perception), the Serial Digit Learning Test (SDLT) trials-to-criterion, and the SDLT total-error-score (SDLT-tests: learning recall/short-term memory). We fit multivariable-adjusted models to estimate associations between urinary cadmium concentrations and test scores. 5662 participants underwent neurocognitive screening, and 5572 (98%) of these had a urinary cadmium level available. Prior to multivariable-adjustment, higher urinary cadmium concentration was associated with worse performance in each of the 4 outcomes. After multivariable-adjustment most of these relationships were not significant, and age was the most influential variable in reducing the association magnitudes. However among never-smokers with no known occupational cadmium exposure the relationship between urinary cadmium and SDST score (attention/perception) was significant: a 1 μg/L increase in urinary cadmium corresponded to a 1.93% (95%CI: 0.05, 3.81) decrement in performance. These results suggest that higher cumulative cadmium exposure in adults may be related to subtly decreased performance in tasks requiring attention and perception, particularly among those adults whose cadmium exposure is primarily though diet (no smoking or work based cadmium exposure). This association was observed among exposure levels that have been considered to be without adverse effects and these levels are common in U.S. adults. Thus further research into the potential neurocognitive effects of cadmium exposure is warranted. Because cumulative cadmium exposure may mediate some of the effects of age and smoking on cognition, adjusting for these variables may result in the underestimation of associations with cumulative cadmium exposure. Prospective studies that include never-smokers and non-occupationally exposed individuals are needed to clarify these issues.

Associations between cadmium exposure and neurocognitive test scores in a cross-sectional study of US adults

PubMed Central

2013-01-01

Background Low-level environmental cadmium exposure and neurotoxicity has not been well studied in adults. Our goal was to evaluate associations between neurocognitive exam scores and a biomarker of cumulative cadmium exposure among adults in the Third National Health and Nutrition Examination Survey (NHANES III). Methods NHANES III is a nationally representative cross-sectional survey of the U.S. population conducted between 1988 and 1994. We analyzed data from a subset of participants, age 20–59, who participated in a computer-based neurocognitive evaluation. There were four outcome measures: the Simple Reaction Time Test (SRTT: visual motor speed), the Symbol Digit Substitution Test (SDST: attention/perception), the Serial Digit Learning Test (SDLT) trials-to-criterion, and the SDLT total-error-score (SDLT-tests: learning recall/short-term memory). We fit multivariable-adjusted models to estimate associations between urinary cadmium concentrations and test scores. Results 5662 participants underwent neurocognitive screening, and 5572 (98%) of these had a urinary cadmium level available. Prior to multivariable-adjustment, higher urinary cadmium concentration was associated with worse performance in each of the 4 outcomes. After multivariable-adjustment most of these relationships were not significant, and age was the most influential variable in reducing the association magnitudes. However among never-smokers with no known occupational cadmium exposure the relationship between urinary cadmium and SDST score (attention/perception) was significant: a 1 μg/L increase in urinary cadmium corresponded to a 1.93% (95%CI: 0.05, 3.81) decrement in performance. Conclusions These results suggest that higher cumulative cadmium exposure in adults may be related to subtly decreased performance in tasks requiring attention and perception, particularly among those adults whose cadmium exposure is primarily though diet (no smoking or work based cadmium exposure). This association was observed among exposure levels that have been considered to be without adverse effects and these levels are common in U.S. adults. Thus further research into the potential neurocognitive effects of cadmium exposure is warranted. Because cumulative cadmium exposure may mediate some of the effects of age and smoking on cognition, adjusting for these variables may result in the underestimation of associations with cumulative cadmium exposure. Prospective studies that include never-smokers and non-occupationally exposed individuals are needed to clarify these issues. PMID:23379984

Validity and reliability of the robotic objective structured assessment of technical skills

PubMed Central

Siddiqui, Nazema Y.; Galloway, Michael L.; Geller, Elizabeth J.; Green, Isabel C.; Hur, Hye-Chun; Langston, Kyle; Pitter, Michael C.; Tarr, Megan E.; Martino, Martin A.

2015-01-01

Objective Objective structured assessments of technical skills (OSATS) have been developed to measure the skill of surgical trainees. Our aim was to develop an OSATS specifically for trainees learning robotic surgery. Study Design This is a multi-institutional study in eight academic training programs. We created an assessment form to evaluate robotic surgical skill through five inanimate exercises. Obstetrics/gynecology, general surgery, and urology residents, fellows, and faculty completed five robotic exercises on a standard training model. Study sessions were recorded and randomly assigned to three blinded judges who scored performance using the assessment form. Construct validity was evaluated by comparing scores between participants with different levels of surgical experience; inter- and intra-rater reliability were also assessed. Results We evaluated 83 residents, 9 fellows, and 13 faculty, totaling 105 participants; 88 (84%) were from obstetrics/gynecology. Our assessment form demonstrated construct validity, with faculty and fellows performing significantly better than residents (mean scores: 89 ± 8 faculty; 74 ± 17 fellows; 59 ± 22 residents, p<0.01). In addition, participants with more robotic console experience scored significantly higher than those with fewer prior console surgeries (p<0.01). R-OSATS demonstrated good inter-rater reliability across all five drills (mean Cronbach's α: 0.79 ± 0.02). Intra-rater reliability was also high (mean Spearman's correlation: 0.91 ± 0.11). Conclusions We developed an assessment form for robotic surgical skill that demonstrates construct validity, inter- and intra-rater reliability. When paired with standardized robotic skill drills this form may be useful to distinguish between levels of trainee performance. PMID:24807319

Aggregate risk score based on markers of inflammation, cell stress, and coagulation is an independent predictor of adverse cardiovascular outcomes.

PubMed

Eapen, Danny J; Manocha, Pankaj; Patel, Riyaz S; Hammadah, Muhammad; Veledar, Emir; Wassel, Christina; Nanjundappa, Ravi A; Sikora, Sergey; Malayter, Dylan; Wilson, Peter W F; Sperling, Laurence; Quyyumi, Arshed A; Epstein, Stephen E

2013-07-23

This study sought to determine an aggregate, pathway-specific risk score for enhanced prediction of death and myocardial infarction (MI). Activation of inflammatory, coagulation, and cellular stress pathways contribute to atherosclerotic plaque rupture. We hypothesized that an aggregate risk score comprised of biomarkers involved in these different pathways-high-sensitivity C-reactive protein (CRP), fibrin degradation products (FDP), and heat shock protein 70 (HSP70) levels-would be a powerful predictor of death and MI. Serum levels of CRP, FDP, and HSP70 were measured in 3,415 consecutive patients with suspected or confirmed coronary artery disease (CAD) undergoing cardiac catheterization. Survival analyses were performed with models adjusted for established risk factors. Median follow-up was 2.3 years. Hazard ratios (HRs) for all-cause death and MI based on cutpoints were as follows: CRP ≥3.0 mg/l, HR: 1.61; HSP70 >0.625 ng/ml, HR; 2.26; and FDP ≥1.0 μg/ml, HR: 1.62 (p < 0.0001 for all). An aggregate biomarker score between 0 and 3 was calculated based on these cutpoints. Compared with the group with a 0 score, HRs for all-cause death and MI were 1.83, 3.46, and 4.99 for those with scores of 1, 2, and 3, respectively (p for each: <0.001). Annual event rates were 16.3% for the 4.2% of patients with a score of 3 compared with 2.4% in 36.4% of patients with a score of 0. The C statistic and net reclassification improved (p < 0.0001) with the addition of the biomarker score. An aggregate score based on serum levels of CRP, FDP, and HSP70 is a predictor of future risk of death and MI in patients with suspected or known CAD. Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Cross-modal face recognition using multi-matcher face scores

NASA Astrophysics Data System (ADS)

Zheng, Yufeng; Blasch, Erik

2015-05-01

The performance of face recognition can be improved using information fusion of multimodal images and/or multiple algorithms. When multimodal face images are available, cross-modal recognition is meaningful for security and surveillance applications. For example, a probe face is a thermal image (especially at nighttime), while only visible face images are available in the gallery database. Matching a thermal probe face onto the visible gallery faces requires crossmodal matching approaches. A few such studies were implemented in facial feature space with medium recognition performance. In this paper, we propose a cross-modal recognition approach, where multimodal faces are cross-matched in feature space and the recognition performance is enhanced with stereo fusion at image, feature and/or score level. In the proposed scenario, there are two cameras for stereo imaging, two face imagers (visible and thermal images) in each camera, and three recognition algorithms (circular Gaussian filter, face pattern byte, linear discriminant analysis). A score vector is formed with three cross-matched face scores from the aforementioned three algorithms. A classifier (e.g., k-nearest neighbor, support vector machine, binomial logical regression [BLR]) is trained then tested with the score vectors by using 10-fold cross validations. The proposed approach was validated with a multispectral stereo face dataset from 105 subjects. Our experiments show very promising results: ACR (accuracy rate) = 97.84%, FAR (false accept rate) = 0.84% when cross-matching the fused thermal faces onto the fused visible faces by using three face scores and the BLR classifier.

Overall and class-specific scores of pesticide residues from fruits and vegetables as a tool to rank intake of pesticide residues in United States: a validation study

PubMed Central

Hu, Yang; Chiu, Yu Han; Hauser, Russ; Chavarro, Jorge; Sun, Qi

2016-01-01

Pesticide residues in fruits and vegetables are among the primary sources of pesticide exposure through diet, but the lack of adequate measurements hinder the research on health effects of pesticide residues. Pesticide Residue Burden Score (PRBS) for estimating overall dietary pesticide intake, organochlorine pesticide score (OC-PRBS) and organophosphate pesticide score (OP-PRBS) for estimating organochlorine and organophosphate pesticides-specific intake, respectively, were derived using U.S. Department of Agriculture Pesticide Data Program data and National Health and Nutrition Examination Survey (NHANES) food frequency questionnaire data. We evaluated the performance of these scores by validating the scores against pesticide metabolites measured in urine or serum among 3,679 participants in NHANES using generalized linear regression. The PRBS was positively associated with a score summarizing the ranks of all pesticide metabolites in a linear fashion (p for linear trend <0.001). Furthermore, individuals in the top quintile of this score had urinary pesticide metabolite levels 13.0% (95% CI 8.3%-17.7%) higher than individuals in the lowest quintile. Similarly, we observed significant associations of the OC-PRBS and OP-PRBS with the levels of lipid-adjusted total serum organochlorine pesticides and urinary creatinine-adjusted organophosphate pesticides, respectively. The relative difference (RD) in average pesticide metabolite rank between extreme quintiles was 17.8% (95% CI: 11.1%-24.4%, p for trend <0.001) for the OP-PRBS, whereas the RD was marginally significant at 7.0% (95% CI: -0.5%-14.4%, p for trend 0.07) for the OC-PRBS. The PRBS and OP-PRBS had similar performance when they were derived from fruits and vegetables with high vs. low pesticide residues, respectively (p for trend <0.001 for all associations). The OP-PRBS was associated with all measured organophosphate pesticides, whereas the positive association between OC-PRBS and averaged measured organochlorine pesticide residue rank was primarily driven by hexachlorobenzene. OC-PRBS had better performance when derived from more contaminated fruits and vegetables (p for trend 0.07) than from less contaminated Fruits and vegetables (p for trend 0.63), although neither of the associations achieved statistical significance. The PRBS and the class-specific scores for two major types of pesticides were significantly associated with pesticide biomarkers. These scores can reasonably rank study participants by their pesticide residue exposures from fruits and vegetables in large-scale environmental epidemiological studies. PMID:27128714

Overall and class-specific scores of pesticide residues from fruits and vegetables as a tool to rank intake of pesticide residues in United States: A validation study.

PubMed

Hu, Yang; Chiu, Yu-Han; Hauser, Russ; Chavarro, Jorge; Sun, Qi

2016-01-01

Pesticide residues in fruits and vegetables are among the primary sources of pesticide exposure through diet, but the lack of adequate measurements hinder the research on health effects of pesticide residues. Pesticide Residue Burden Score (PRBS) for estimating overall dietary pesticide intake, organochlorine pesticide score (OC-PRBS) and organophosphate pesticide score (OP-PRBS) for estimating organochlorine and organophosphate pesticides-specific intake, respectively, were derived using U.S. Department of Agriculture Pesticide Data Program data and National Health and Nutrition Examination Survey (NHANES) food frequency questionnaire data. We evaluated the performance of these scores by validating the scores against pesticide metabolites measured in urine or serum among 3,679 participants in NHANES using generalized linear regression. The PRBS was positively associated with a score summarizing the ranks of all pesticide metabolites in a linear fashion (p for linear trend <0.001). Furthermore, individuals in the top quintile of this score had urinary pesticide metabolite levels 13.0% (95% CI 8.3%-17.7%) higher than individuals in the lowest quintile. Similarly, we observed significant associations of the OC-PRBS and OP-PRBS with the levels of lipid-adjusted total serum organochlorine pesticides and urinary creatinine-adjusted organophosphate pesticides, respectively. The relative difference (RD) in average pesticide metabolite rank between extreme quintiles was 17.8% (95% CI: 11.1%-24.4%, p for trend <0.001) for the OP-PRBS, whereas the RD was marginally significant at 7.0% (95% CI: -0.5%-14.4%, p for trend 0.07) for the OC-PRBS. The PRBS and OP-PRBS had similar performance when they were derived from fruits and vegetables with high vs. low pesticide residues, respectively (p for trend <0.001 for all associations). The OP-PRBS was associated with all measured organophosphate pesticides, whereas the positive association between OC-PRBS and averaged measured organochlorine pesticide residue rank was primarily driven by hexachlorobenzene. OC-PRBS had better performance when derived from more contaminated fruits and vegetables (p for trend 0.07) than from less contaminated Fruits and vegetables (p for trend 0.63), although neither of the associations achieved statistical significance. The PRBS and the class-specific scores for two major types of pesticides were significantly associated with pesticide biomarkers. These scores can reasonably rank study participants by their pesticide residue exposures from fruits and vegetables in large-scale environmental epidemiological studies. Copyright © 2016 Elsevier Ltd. All rights reserved.

Models of cognitive functions with respect to selected parameters of functional state of the thyroid gland in post-menopausal women.

PubMed

Gujski, Mariusz; Pinkas, Jarosław; Witczak, Mariusz; Owoc, Alfred; Bojar, Iwona

2017-01-01

The objective of the study was the development of models of cognitive functions in a group of post-menopausal women, according to the concentration of the selected laboratory parameters evaluating the functional state of the thyroid gland. The study was conducted during 2012-2014, and covered women aged 50-65 years, minimum two years after the last menstruation, without chronic diseases, cancerous diseases, mental disorders, addiction to drugs or alcohol, and who did not use hormone replacement therapy. At the stage of qualification, a brief MoCA test was performed; 383 women were qualified for the study. Blood was collected for the determination of such parameters as: TSH, TT4, fT4, anti-TPO, anti-Tg, and AB-TSHR. Assessment of cognitive functions was performed using the diagnostic instrument Central Nervous System - Vital Signs (CNS-VS) (Polish version). The results were statistically analysed. The mean age of the women in the study was 56.4 ± 3.4; the mean TSH was 1.91 ± 1.35 mU/L, fT4 14.76 ± 2.34 pmol/L, and TT4 99.12 ± 16.98 nmol/L. Mean values were: 64.74 IU/L for anti-TPO, 100.69 IU/L for anti-Tg, and 1.40 IU/L for AB-TSHR. The examined women obtained the neurocognitive index (NCI) on the level of 84.4 scores, on average. The lowest results were obtained in tests assessing cognitive flexibility (mean 78.64 scores), processing speed (mean 79.25 scores), and executive functions (mean 79.75 scores). In the tests evaluating complex attention, the mean values were 82.24 scores, psychomotor speed - mean 83.42 scores, and reaction time - mean 86.87 scores. The women examined obtained the best results in tests assessing memory (mean 90.15 scores), including verbal (mean 91.22 scores), and visual (mean 93.37 scores). The NCI and cognitive function models were assessed from the aspect of thyroid gland examinations in post-menopausal women. Based on the analyses performed, the following conclusions were drawn: The developed models of cognitive functions indicate a considerable effect of TSH, fT4, AB-TSHR, and anti-TPO, as well as TT4 and anti-Tg, on the level of cognitive functions after menopause in the group examined. The conducted study suggests the need for examination of the functional state of the thyroid gland in post-menopausal women who show cognitive function disorders.

Preoperative prediction of inpatient recovery of function after total hip arthroplasty using performance-based tests: a prospective cohort study.

PubMed

Oosting, Ellen; Hoogeboom, Thomas J; Appelman-de Vries, Suzan A; Swets, Adam; Dronkers, Jaap J; van Meeteren, Nico L U

2016-01-01

The aim of this study was to evaluate the value of conventional factors, the Risk Assessment and Predictor Tool (RAPT) and performance-based functional tests as predictors of delayed recovery after total hip arthroplasty (THA). A prospective cohort study in a regional hospital in the Netherlands with 315 patients was attending for THA in 2012. The dependent variable recovery of function was assessed with the Modified Iowa Levels of Assistance scale. Delayed recovery was defined as taking more than 3 days to walk independently. Independent variables were age, sex, BMI, Charnley score, RAPT score and scores for four performance-based tests [2-minute walk test, timed up and go test (TUG), 10-meter walking test (10 mW) and hand grip strength]. Regression analysis with all variables identified older age (>70 years), Charnley score C, slow walking speed (10 mW >10.0 s) and poor functional mobility (TUG >10.5 s) as the best predictors of delayed recovery of function. This model (AUC 0.85, 95% CI 0.79-0.91) performed better than a model with conventional factors and RAPT scores, and significantly better (p = 0.04) than a model with only conventional factors (AUC 0.81, 95% CI 0.74-0.87). The combination of performance-based tests and conventional factors predicted inpatient functional recovery after THA. Two simple functional performance-based tests have a significant added value to a more conventional screening with age and comorbidities to predict recovery of functioning immediately after total hip surgery. Patients over 70 years old, with comorbidities, with a TUG score >10.5 s and a walking speed >1.0 m/s are at risk for delayed recovery of functioning. Those high risk patients need an accurate discharge plan and could benefit from targeted pre- and postoperative therapeutic exercise programs.

Individual differences in working memory capacity determine the effects of oculomotor task load on concurrent word recall performance.

PubMed

Lee, Eun-Ju; Kwon, Gusang; Lee, Aekyoung; Ghajar, Jamshid; Suh, Minah

2011-07-05

In this study, the interaction between individual differences in working memory capacity, which were assessed by the Korean version of the California Verbal Learning Test (K-CVLT), and the effects of oculomotor task load on word recall performance are examined in a dual-task experiment. We hypothesized that varying levels of oculomotor task load should result in different demands on cognitive resources. The verbal working memory task used in this study involved a brief exposure to seven words to be remembered, followed by a 30-second delay during which the subject carried out an oculomotor task. Then, memory performance was assessed by having the subjects recall as many words as possible. Forty healthy normal subjects with no vision-related problems carried out four separate dual-tasks over four consecutive days of participation, wherein word recall performances were tested under unpredictable random SPEM (smooth pursuit eye movement), predictive SPEM, fixation, and eyes-closed conditions. The word recall performance of subjects with low K-CVLT scores was significantly enhanced under predictive SPEM conditions as opposed to the fixation and eyes-closed conditions, but performance was reduced under the random SPEM condition, thus reflecting an inverted-U relationship between the oculomotor task load and word recall performance. Subjects with high K-CVLT scores evidenced steady word recall performances, regardless of the type of oculomotor task performed. The concurrent oculomotor performance measured by velocity error did not differ significantly among the K-CVLT groups. However, the high-scoring subjects evidenced smaller phase errors under predictive SPEM conditions than did the low-scoring subjects; this suggests that different resource allocation strategies may be adopted, depending on individuals' working memory capacity. Copyright © 2011 Elsevier B.V. All rights reserved.

Revision Hip Arthroscopy: A Systematic Review of Diagnoses, Operative Findings, and Outcomes.

PubMed

Cvetanovich, Gregory L; Harris, Joshua D; Erickson, Brandon J; Bach, Bernard R; Bush-Joseph, Charles A; Nho, Shane J

2015-07-01

To determine indications for, operative findings of, and outcomes of revision hip arthroscopy. A systematic review was registered with PROSPERO and performed based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Therapeutic clinical outcome studies reporting the indications for, operative findings of, and outcomes of revision hip arthroscopy were eligible for inclusion. All study-, patient-, and hip-specific data were extracted and analyzed. The Modified Coleman Methodology Score was used to assess study quality. Five studies were included (348 revision hip arthroscopies; 333 patients; mean age, 31.4 ± 4.2 years; 60% female patients). All 5 studies were either Level III or IV evidence. The surgeon performing revision hip arthroscopy was the same as the primary hip surgeon in only 25% of cases. The mean time between primary and revision hip arthroscopy was 27.8 ± 7.0 months (range, 2 to 193 months). Residual femoroacetabular impingement was the most common indication for and operative finding of revision hip arthroscopy (81% of cases). The most commonly reported revision procedures were femoral osteochondroplasty (24%) and acetabuloplasty (18%). The modified Harris Hip Score was used in all 5 analyzed studies, with significant (P < .05) improvements observed in all 5 studies (weighted mean, 56.8 ± 3.6 preoperatively v 72.0 ± 8.3 at final follow-up [22.4 ± 9.8 months]; P = .01). Other patient-reported outcomes (Non-Arthritic Hip Score, Hip Outcome Score, 33-item International Hip Outcome Tool, Short Form 12) showed significant improvements but were not used in all 5 analyzed studies. After revision hip arthroscopy, subsequent reported operations were hip arthroplasty in 11 patients and re-revision hip arthroscopy in 8 patients (5% total reoperation rate). Revision hip arthroscopy is most commonly performed for residual femoroacetabular impingement, with statistically significant and clinically relevant improvements shown in multiple patient-reported clinical outcome scores at short-term follow-up. The reoperation rate after revision hip arthroscopy is 5% within 2 years, including further arthroscopy or conversion to hip arthroplasty. Level IV, systematic review of Level III and IV studies. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Level of Service Program for INDOT Operations : APPENDIX D Deficiency Score Index

DOT National Transportation Integrated Search

2012-01-01

INDOT has used an inspection program named Maintenance Quality Survey (MQS) to perform a statewide inspection of their roadway assets, rightofway to rightofway. This inspection requires two twoperson teams approximately 18 months to...

Extracorporeal shock-wave therapy for supraspinatus calcifying tendinitis: a randomized clinical trial comparing two different energy levels.

PubMed

Ioppolo, Francesco; Tattoli, Maria; Di Sante, Luca; Attanasi, Carmine; Venditto, Teresa; Servidio, Marila; Cacchio, Angelo; Santilli, Valter

2012-11-01

Extracorporeal shock-wave therapy (ESWT) represents a valid intervention in the treatment of people with supraspinatus calcifying tendinitis (SCT), but there is limited evidence for the useful range of ESWT doses. The aim of this study was to compare 2 different ranges of energy flux density in treatment of SCT with ESWT. This study was designed as a single-blind randomized clinical trial. This study was performed in a university hospital. Forty-six patients with SCT were randomly assigned to 2 groups that received different therapeutic energy doses of ESWT: (1) group A received ESWT at an energy level of 0.20 mJ/mm², and (2) group B received ESWT at an energy level of 0.10 mJ/mm². The treatment protocol consisted of 4 sessions performed once a week. The change in mean Constant Murley Scale (CMS) scores at 3 and 6 months was the primary endpoint. The change in the mean visual analog scale (VAS) scores from baseline to 3 and 6 months after the intervention and radiographic change in size of calcium deposits were evaluated as secondary endpoints. At 12 months, pain relief was assessed using a numeric rating scale. Significant clinical improvement based on mean CMS scores was observed after 6 months in group A (X=79.43, SD=10.33) compared with group B (X=57.91, SD=6.53). Likewise, after 6 months, a significant decrease in VAS scores was found in group A (X=2.09, SD=1.54) compared with group B (X=5.36, SD=0.78). Calcific deposits disappeared in the same percentage of patients in both groups. The small sample size and lack of a control group were limitations of the study. In ESWT for SCT, an energy level of 0.20 mJ/mm² appears to be more effective than an energy level of 0.10 mJ/mm² in pain relief and functional improvement.

Poor psychometric scores of children living in isolated riverine and agrarian communities and fish-methylmercury exposure.

PubMed

Fonseca, Márlon de F; Dórea, José G; Bastos, Wanderley R; Marques, Rejane C; Torres, João P M; Malm, Olaf

2008-11-01

Because of heavy dependence on fish, Amazonian riparian communities are chronically exposed to high levels of methylmercury (MeHg). We studied fish-MeHg exposure (total hair-Hg, HHg) as a determinant of neurocognitive scores of children living in two geographically distant, culturally distinct and isolated poor communities of non-urban environments: Amazonian riverines (Riparians, n=38) of the Puruzinho Lake community in the Rio Madeira Basin and rural agrarians from Iúna, Espírito Santo (Agrarians, n=32). Nutritional status was estimated by anthropometry (Z-scores) and individual cognitive abilities were assessed by the Wechsler Intelligence Scale for Children-III (WISC-III) and the Human Figure Drawings (HFD), both validated versions for Brazilian children. Anthropometric assessment showed slightly elevated Z-scores for the Agrarian children (not statistically significant) but median HHg concentrations were 14.4 and 0.25microgg(-1) respectively for Riparian and Agrarian children (p=0.000). Despite paradoxical MeHg exposures, both groups showed comparable HFD scores but very poor performance in WISC-III test battery; median of sum of WISC-III subtests scores (SigmaTOT) were 17.9 and 28.6 (p<0.000) for Riparian and Agrarian children, respectively (percentage scale). Spearman correlation between nutritional status (attained growth) and psychometric scores were statistically significant between height-for-age Z-score and Object Assembly subtest (r=0.269; p=0.043), SigmaTOT (r=0.319; p=0.016), Performance-IQ (r=0.311; p=0.019) and Perceptual Organization Index scores (r=0.302; p=0.023). In these isolated communities there are stronger determinants of neurocognitive poor performance than MeHg exposure. Global strategies for reducing human exposure to MeHg by curtailing fish consumption are unrealistic options for riverine subsistence populations and are not justifiable to prevent low cognitive scores.

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

PubMed

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

2015-09-01

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

A Milestone-Based Evaluation System-The Cure for Grade Inflation?

PubMed

Kuo, Lindsay E; Hoffman, Rebecca L; Morris, Jon B; Williams, Noel N; Malachesky, Mark; Huth, Laura E; Kelz, Rachel R

2015-01-01

Controversy exists over the optimal use of the Milestones in the process of resident evaluation and feedback. We sought to evaluate the performance of a Milestones-based feedback system in comparison to a traditional model. The traditional evaluation system (TES) consisted of a generic 16-item survey using a 5-point Likert scale ranging from 1 to 5, and a free-text comments section. The Milestones-based evaluation system (MBES) was launched in July 2014, ranging from 0 to 4. Individual milestones were mapped to rotations based on resident educational goals by postgraduate year (PGY). The MBES consisted of a survey with a maximum of 7 items, followed by a free-text comment section. Within each evaluation system, an overall composite score was calculated for each categorical general surgical resident. To scale the 2 systems for comparison, TES scores were adjusted downward by 1 point. Descriptive statistics were performed. Univariate analysis was performed with the Wilcoxon signed-rank test. A test for trend across PGY was used for the MBES only. In the traditional system, the median score was 3.66 (range: 3.2-4.0). There was no meaningful difference in the median score by PGY. In the new system, the median score was 2.69 (range: 1.5-3.7, p < 0.01). The median score differed across PGY and increased by PGY of training (p < 0.01). There was an increase in differences between median scores by PGY. On using the milestones to facilitate faculty evaluation of resident knowledge and skill, there was a trend in increasing score by PGY of training. In the MBES, scores could be used to better discriminate resident skill and knowledge levels and resulted in improved differentiation in scoring by PGY. The use of the milestones as a basis for evaluation enabled the program to provide more meaningful feedback to residents and represents an improvement in surgical education. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Evaluation of the Bruker Biotyper Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry System for Identification of Aspergillus Species Directly from Growth on Solid Agar Media

PubMed Central

Li, Ying; Wang, He; Zhao, Yu-Pei; Xu, Ying-Chun; Hsueh, Po-Ren

2017-01-01

We evaluated the accuracy of the Bruker Biotyper matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) system at identifying clinical isolates of Aspergillus species that were grown on agar media. A total of 381 non-duplicate Aspergillus isolates representing 21 different Aspergillus species identified by molecular analysis were included in this study. The Bruker Biotyper MALDI-TOF MS system was able to identify 30.2% (115/381) of the isolates to the species level (score values of ≥2.000) and 49.3% to the genus level (score values of 1.700–1.999). When the identification cutoff value was lowered from ≥2.000 to ≥1.700, the species-level identification rate increased to 79.5% with a slight rise of false identification from 2.6 to 5.0%. From another aspect, a correct species-level identification rate of 89% could be reached by the Bruker Biotyper MALDI-TOF MS system regardless of the score values obtained. The Bruker Biotyper MALDI-TOF MS system had a moderate performance in identification of Aspergillus directly inoculated on solid agar media. Continued expansion of the Bruker Biotyper MALDI-TOF MS database and adoption of alternative cutoff values for interpretation are required to improve the performance of the system for identifying highly diverse species of clinically encountered Aspergillus isolates. PMID:28706514

Evaluation of the Bruker Biotyper Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry System for Identification of Aspergillus Species Directly from Growth on Solid Agar Media.

PubMed

Li, Ying; Wang, He; Zhao, Yu-Pei; Xu, Ying-Chun; Hsueh, Po-Ren

2017-01-01

We evaluated the accuracy of the Bruker Biotyper matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) system at identifying clinical isolates of Aspergillus species that were grown on agar media. A total of 381 non-duplicate Aspergillus isolates representing 21 different Aspergillus species identified by molecular analysis were included in this study. The Bruker Biotyper MALDI-TOF MS system was able to identify 30.2% (115/381) of the isolates to the species level (score values of ≥2.000) and 49.3% to the genus level (score values of 1.700-1.999). When the identification cutoff value was lowered from ≥2.000 to ≥1.700, the species-level identification rate increased to 79.5% with a slight rise of false identification from 2.6 to 5.0%. From another aspect, a correct species-level identification rate of 89% could be reached by the Bruker Biotyper MALDI-TOF MS system regardless of the score values obtained. The Bruker Biotyper MALDI-TOF MS system had a moderate performance in identification of Aspergillus directly inoculated on solid agar media. Continued expansion of the Bruker Biotyper MALDI-TOF MS database and adoption of alternative cutoff values for interpretation are required to improve the performance of the system for identifying highly diverse species of clinically encountered Aspergillus isolates.

Selection methods regulate evolution of cooperation in digital evolution

PubMed Central

Lichocki, Paweł; Floreano, Dario; Keller, Laurent

2014-01-01

A key, yet often neglected, component of digital evolution and evolutionary models is the ‘selection method’ which assigns fitness (number of offspring) to individuals based on their performance scores (efficiency in performing tasks). Here, we study with formal analysis and numerical experiments the evolution of cooperation under the five most common selection methods (proportionate, rank, truncation-proportionate, truncation-uniform and tournament). We consider related individuals engaging in a Prisoner's Dilemma game where individuals can either cooperate or defect. A cooperator pays a cost, whereas its partner receives a benefit, which affect their performance scores. These performance scores are translated into fitness by one of the five selection methods. We show that cooperation is positively associated with the relatedness between individuals under all selection methods. By contrast, the change in the performance benefit of cooperation affects the populations’ average level of cooperation only under the proportionate methods. We also demonstrate that the truncation and tournament methods may introduce negative frequency-dependence and lead to the evolution of polymorphic populations. Using the example of the evolution of cooperation, we show that the choice of selection method, though it is often marginalized, can considerably affect the evolutionary dynamics. PMID:24152811

Comprehension of Students with or without Learning Disabilities: Identification of Narrative Themes and Idiosyncratic Text Representations.

ERIC Educational Resources Information Center

Williams, Joanna P.

1993-01-01

Ten learning-disabled adolescents (LDs) performed a reading comprehension task below the level of same-age nondisabled students (NLDs) but at the same level as younger NLDs (YNDs). On a measure of incipient awareness of theme, LDs scored below YNDs. Why LDs have difficulty getting the point is discussed. (SLD)

RELATIONSHIP OF PRESEASON MOVEMENT SCREENS WITH OVERUSE SYMPTOMS IN COLLEGIATE BASEBALL PLAYERS

PubMed Central

Clifton, Daniel R.; Onate, James A.; Ramsey, Vincent K.; Cromartie, Fred

2017-01-01

Background: The shoulder mobility screen of the Functional Movement Screen™ (FMS™) and the upper extremity patterns of the Selective Functional Movement Assessment (SFMA) assess global, multi-joint movement capabilities in the upper-extremities. Identifying which assessment can most accurately determine if baseball players are at an increased risk of experiencing overuse symptoms in the shoulder or elbow throughout a competitive season may reduce throwing-related injuries requiring medical attention. Purpose: The purpose of this study was to determine if preseason FMS™ or SFMA scores were related to overuse severity scores in the shoulder or elbow during the preseason and competitive season. Study design: Cohort study. Methods: Sixty healthy, male, Division III collegiate baseball players (mean age = 20.1 ± 2.0 years) underwent preseason testing using the FMS™ shoulder mobility screen, and SFMA upper extremity patterns. Their scores were dichotomized into good and bad movement scores, and were compared to weekly questionnaires registering overuse symptoms and pain severity in the shoulder or elbow during the season. Results: Poor FMS™ performance was associated with an increased likelihood of experiencing at least one overuse symptom during the preseason independent of grade and position (adjusted odds ratio [OR] = 5.14, p = 0.03). Poor SFMA performance was associated with an increased likelihood of experiencing at least one overuse symptom during the preseason (adjusted OR = 6.10, p = 0.03) and during the competitive season (adjusted OR = 17.07, p = 0.03) independent of grade and position. Conclusion: FMS™ shoulder mobility and SFMA upper extremity pattern performance were related to the likelihood of experiencing overuse symptoms during a baseball season. Participants with poor FMSTM performances may be more likely to experience at least one overuse symptom in their shoulder or elbow during the preseason. Additionally, individuals with poor SFMA performances may be more likely to report overuse symptoms during the preseason or competitive season. Level of evidence: Level 3 PMID:29158957

Effect of coccidia challenge and natural betaine supplementation on performance, nutrient utilization, and intestinal lesion scores of broiler chickens fed suboptimal level of dietary methionine.

PubMed

Amerah, A M; Ravindran, V

2015-04-01

The aim of the present experiment was to examine the effect of coccidia challenge and natural betaine supplementation on performance, nutrient utilization, and intestinal lesion scores of broiler chickens fed suboptimal level of dietary methionine. The experimental design was a 2×2 factorial arrangement of treatments evaluating two levels of betaine supplementation (0 and 960 g betaine/t of feed) without or with coccidia challenge. Each treatment was fed to 8 cages of 8 male broilers (Ross 308) for 1 to 21d. On d 14, birds in the 2 challenged groups received mixed inocula of Eimeria species from a recent field isolate, containing approximately 180,000 E. acervulina, 6,000 E. maxima, and 18,000 E. tenella oocysts. At 21d, digesta from the terminal ileum was collected for the determination of dry matter, energy, nitrogen, amino acids, starch, fat, and ash digestibilities. Lesion scores in the different segments of the small intestine were also measured on d 21. Performance and nutrient digestibility data were analyzed by two-way ANOVA. Lesion score data were analyzed using Pearson chi-square test to identify significant differences between treatments. Orthogonal polynomial contrasts were used to assess the significance of linear or quadratic models to describe the response in the dependent variable to total lesion scores. Coccidia challenge reduced (P<0.0001) the weight gain and feed intake, and increased (P<0.0001) the feed conversion ratio. Betaine supplementation had no effect (P>0.05) on the weight gain or feed intake, but lowered (P<0.05) the feed conversion ratio. No interaction (P>0.05) between coccidia challenge and betaine supplementation was observed for performance parameters. Betaine supplementation increased (P<0.05) the digestibility of dry matter, nitrogen, energy, fat, and amino acids only in birds challenged with coccidia as indicated by the significant interaction (P<0.0001) between betaine supplementation and coccidia challenge. The main effect of coccidia challenge reduced (P<0.05) starch digestibility. Betaine supplementation improved (P<0.05) starch digestibility regardless of the coccidia challenge. For each unit increase in the total lesion score, there was a linear (P<0.001) decrease in digestibility of mean amino acids, starch, and fat by 3.8, 3.4 and 16%, respectively. Increasing total lesion scores resulted in a quadratic (P<0.05) decrease in dry matter digestibility and ileal digestible energy. No lesions were found in the intestine or ceca of the unchallenged treatments. In the challenged treatments, betaine supplementation reduced (P<0.01) the lesion scores at the duodenum, lower jejunum, and total lesion scores compared to the treatment without supplements. In conclusion, coccidia challenge lowered the digestibility of energy and nutrients and increased the feed conversion ratio of broilers. However, betaine supplementation reduced the impact of coccidia challenge and positively affected nutrient digestibility and the feed conversion ratio. © The Author 2015. Published by Oxford University Press on behalf of Poultry Science Association.

Vascular calcification and 25-hydroxyvitamin D levels in non-dialysis patients with chronic kidney disease stages 4 and 5.

PubMed

García-Canton, Cesar; Bosch, Elvira; Ramírez, Ana; Gonzalez, Yeray; Auyanet, Ingrid; Guerra, Rita; Perez, Miguel A; Fernández, Ernesto; Toledo, Agustín; Lago, Mar; Checa, Maria D

2011-07-01

Cardiovascular disease (CVD) is the leading cause of death among chronic kidney disease (CKD) patients. Vascular calcification is highly prevalent in this population and is an independent predictor of cardiovascular mortality. Vascular calcification in uraemic patients is known to be an active and regulated process subject to the action of many promoting and inhibitory factors. The role of vitamin D in this process remains controversial. We evaluated the relationship between serum levels of 25-hydroxyvitamin D (25(OH)D) and vascular calcification evaluated by plain X-ray images, in predialysis patients with CKD stages 4 and 5. We performed a cross-sectional study with 210 CKD patients stages 4 and 5 managed at our predialysis unit. Patients were 63.5 ± 13 years of age, 60.5% males, 64.8% diabetics and 47.1% with a history of CVD. Plain X-ray images of pelvis, hands and lateral lumbar spine from all subjects were studied for calculation of semiquantitative vascular calcification scores as described by Adragao and Kauppila. We found a high prevalence of vascular calcification in our population. Adragao scores revealed only 47 patients (22.4%) without vascular calcification and 120 (57.1%) with scores higher than 3. Kauppila scores revealed only 29 patients (13.8%) without aortic calcifications and 114 patients (54.3%) with scores higher than 7. Higher vascular calcification scores were related to older age, diabetes, history of CVD and lower levels of 25(OH)D. Only 18.5% of patients had adequate levels of 25(OH)D (> 30 ng/mL), 53.7% of them had insufficient levels (15-30 ng/mL) and 27.8% had deficient levels (< 15 ng/mL). Multivariate analysis showed that age, diabetes and CVD were directly associated and 25(OH)D levels were inversely associated with vascular calcifications. Our results show an independent and negative association between serum levels of 25(OH)D and vascular calcification. Further and larger prospective studies are needed to clarify the possible role of vitamin D deficiency in the development of vascular calcification in CKD patients.

Observer reliability of the Gross Motor Performance Measure and the Quality of Upper Extremity Skills Test, based on video recordings.

PubMed

Sorsdahl, Anne Brit; Moe-Nilssen, Rolf; Strand, Liv Inger

2008-02-01

The aim of this study was to examine observer reliability of the Gross Motor Performance Measure (GMPM) and the Quality of Upper Extremity Skills Test (QUEST) based on video clips. The tests were administered to 26 children with cerebral palsy (CP; 14 males, 12 females; range 2-13y, mean 7y 6mo), 24 with spastic CP, and two with dyskinesia. Respectively, five, six, five, four, and six children were classified in Gross Motor Function Classification System Levels I to V; and four, nine, five, five, and three children were classified in Manual Ability Classification System levels I to V. The children's performances were recorded and edited. Two experienced paediatric physical therapists assessed the children from watching the video clips. Intraobserver and interobserver reliability values of the total scores were mostly high, intraclass correlation coefficient (ICC)(1,1) varying from 0.69 to 0.97 with only one coefficient below 0.89. The ICCs of subscores varied from 0.36 to 0.95, finding'Alignment'and'Weight shift'in GMPM and'Protective extension'in QUEST highly reliable. The subscores'Dissociated movements'in GMPM and QUEST, and'Grasp'in QUEST were the least reliable, and recommendations are made to increase reliability of these subscores. Video scoring was time consuming, but was found to offer many advantages; the possibility to review performance, to use special trained observers for scoring and less demanding assessment for the children.

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

PubMed

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

2015-03-01

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