Differences In Pass Rates Research Articles

Establishment and discussion of autoverification rules for transfusion compatibility testing.

To develop an automated verification workflow for transfusion compatibility testing (TCT) based on the AUTO10-A guidelines and blood group serology characteristics and to conduct a simulated validation of the test and subtest results by assessing the appropriateness of the autoverification rules. The accuracy of TCT results is a fundamental prerequisite for ensuring the safety of blood transfusions. However, the verification of these results still requires manual intervention. Five autoverification rules and their standards were determined: agglutination intensity, normal results, logical relationships, delta checks and interlaboratory test comparisons. The established categories and standards for the five rules were retrospectively validated using 13 506 samples (requests) that had been manually verified in our laboratory from January 2020 to June 2023. A total of 66 638 test items were involved in the autoverification, with 3844 items violating the verification rules, resulting in a pass rate of 96.10%. Considering individual test items, four tests had a pass rate of more than 90% in both the test item result table and the test subitem result table. However, there were significant differences in the pass rates between different tests. The same conclusion can be drawn when the unit is requests. The different standards set for the agglutination intensity and the delta check in the ABO typing testing subitems showed significant differences in pass rates. The incorporation of manually verified results into the automated verification simulation indicated that the five rules established in this study have good applicability, and appropriate standards can lead to reasonable pass rates.

Paper 23: Functional Stability Testing and Athletic Shoulder Performance Testing Higher in Patients Able to Return to Sport Following Arthroscopic Shoulder Stabilization

Objectives: There is a paucity of literature on return to sport functional testing following arthroscopic labral repair for shoulder instability leading to uncertainty of when it is safe to return to sport. Currently, the most commonly used evaluation metrics are time after surgery and less commonly range of motion and strength of operative extremity. There is currently no validated return to sport testing protocol after arthroscopic labral repair. The aim of this study was to compare elements of a proposed return to sport battery for those undergoing arthroscopic Bankart repair between those able to return to play and those who were not able to by 6 months. Methods: All patients who participated in athletics who underwent arthroscopic labral repair for shoulder instability from June 2021 to December 2022 with a fellowship trained orthopedic surgeon were eligible to participate. Study protocol was to undergo functional testing at 4 months post operatively and every 2 months thereafter until cleared for athletics. Functional testing included Closed Kinetic Chain Upper Extremity Stability Test (CKCUES), Posterior Shoulder Endurance Test (PSET), Strength via handheld dynamometry at various range of motion positions. The Athletic Shoulder Test (ASH) has two components- peak force in I, T, Y position (PEAK), and rate of force development in I, T, Y position (RATE). Absolute value as well as limb symmetry index (LSI) were compared. For each test, passing was determined to be greater than 90% symmetry with contralateral extremity. Tests that had a greater than 20% difference in pass rates between the not return to play group (NRTP) and the return to play (RTP) groups were considered to be predictive. Results: Overall, 22 patients with at least 6 months of follow up, completed functional testing battery, and cleared to return to play were included. Mean age was 19.8 years (range 11-44 years), with 12 males and 10 females, and the mean follow up was 11 months (6-24 months). Seventeen returned to play (RTP) at mean 6.3 months (range 4.5-23.1), five did not to return (NRTP). Mean SANE score was higher in RTP vs NRTP, 61 (range 25-95) vs 86.7 (60-100), p=0.03). Those that returned to sport met a mean of 6.25 of the 12 criteria at 4 months compared to 4.20 of those that did not return to sport (p-value = .22). At 4 months, RTP group passed several tests at higher rates than NRTP group - CKCUES (78% vs 0%), PEAK (62.5% vs 20%), RATE (50% vs 0%), and Shoulder Flexion strength (88.9% vs 50%). Other strength measurements were not significantly different between groups. Conclusions: CKCUES and ASH (PEAK and RATE) performance testing criteria were significantly higher at 4 months in patients who are able to eventually be cleared to return to sport compared to those that are not able to. Traditional strength testing did not demonstrate differences between groups. Therefore, we recommend that CKCUES testing and ASH testing with force plates should be incorporated in functional testing as early as 4 months.

A study on the hearing protection and intervention effects of silicone earplug usage among manufacturing workers

Objective: To assess the efficacy of silicone earplugs in protecting workers exposed to noise in a typical manufacturing environment, and to provide training interventions for workers who do not achieve the anticipated noise reduction levels, as well as examining the spectral characteristics of earplug attenuation. Methods: From June to August 2022, a total of 294 noise-exposed workers in two manufacturing enterprises equipped with the same type of earplug were studied by cluster sampling method, by conducting questionnaire surveys, collecting data, fitting tests, and providing trainings, the current noise exposure levels of workers in the industry as well as the perception about the earplug were understood. Additionally, the attenuation before and after intervention in workplace were measured, the spectral characteristics of noise reduction were were described and compared. Results: The percentage of workers with Personal Attenuation Rating (PAR) of 0 is 32.7% (96/294), and the baseline pass rates are all below 60%. There were no significant differences in pass rates based on gender, age, noise exposure, education level, or cognition of earplug effectiveness. After adjusting the way that earplugs are worn or changing the type of earplugs, all workers were able to meet their noise reduction requirements. The median PAR improvement for both companies is above 10 dB. The noise attenuation of the earplug vary with frequency, with lower attenuation at 4 000 Hz and higher attenuation at 8 000 Hz, showing some deviation from the nominal values. Conclusion: The difference between the actual sound attenuation value of earplugs and the nominal value is related to the noise frequency. When using silicone earplugs, attention should be paid to the spectral composition of the noise in the workplace.

Pass rates of four P2/N95 respirators or filtering facepiece respirators in Australian healthcare providers: A prospective observational study.

P2/N95 respirators or filtering facepiece respirators may not have the same pass rate on quantitative fit testing. The aim of this study was to investigate the pass rate of four commonly used filtering facepiece respirators in Australian healthcare providers. The secondary objectives included assessing the ease of donning, doffing and comfort of wearing these four filtering facepiece respirators for more than 30 minutes. A multivariable analysis was also conducted to assess if certain variables (e.g. age, sex, body mass index, ethnicity, facial width and length) were associated with passing or failing fit testing. We conducted a prospective observational study of 150 hospital staff who presented for fit testing in a metropolitan hospital in Victoria, Australia. The order of the four filtering facepiece respirators being tested was randomised. A Cochran's Q test was used to test the global null hypothesis that all four filtering facepiece respirators being tested have the same pass rate. A difference in pass rate was found between the four filtering facepiece respirators that were tested (P < 0.001). The 3M™ Aura 1870+ (3M Australia Pty Ltd, North Ryde, NSW) had the highest pass rate (83%) followed by the 3M™ 1860 (3M Australia Pty Ltd, North Ryde, NSW) (61%), BSN ProShield™ N95 (BSN Medical, Mulgrave, Victoria) (55%) and the BYD DE2322 N95 (BYD Care, Los Angeles, CA, USA) (44%). There was also a difference in the ease of donning, doffing and comfort. Therefore, healthcare facilities that perform fit testing should take these factors into consideration when designing an effective respiratory protection programme.

Knowledge and Awareness of Healthcare Professionals about Infant Oral Health

Introduction: The strategy of utilizing primary medical care to promote oral health is particularly necessary and especially through infant oral health measures (IOH). Pediatricians and family physicians were knowledgeable about some aspects of ECC and infant oral health but were uncertainly identifying dental caries and the early signs of ECC. The majority of physicians reported that they play an important role and are involved in promoting the oral health of children in their practices. Aim: This cross-sectional study was designed to assess baseline knowledge of infant oral health IOH among healthcare professionals. Design: An online self-reported cross-sectional survey was designed to assess awareness about IOH. A total number of 449 healthcare professionals (dentists, physicians, nurses and dental assistances), working in facilities dealing with infant health responded to the survey in various countries. The survey was consisting of 12 questions regarding IOH. A score of 70% or more was considered as a “pass” score based. Results: Descriptive and analytic statistics were performed for all groups and subgroups based on their responses which reflect their awareness of IOH. Around 53% of health professionals (n= 242) were able to achieve pass scores, while 47% of health professionals (n=207) did not achieve it. Regarding demographic and occupational characteristics there was a significant difference in pass rate about age (p&lt; 0.001) being lower in the age group below 30 years. We also found a significant difference in pass rate in relation to gender and type of job (p&lt; 0.05). However, there was no significant difference in relation to the duration of the experience (p&gt; 0.05). Conclusion: There is a need for continuous education and training programs on updated oral health measures for all healthcare providers. This study calls for further research to evaluate the role of various factors involved in IOH care and to effectively educate all healthcare providers.

ICRE Top Research Abstracts

ICRE Top Research Abstracts

RETROSPECTIVE REVIEW OF ORAL FOOD CHALLENGE OUTCOMES IN A MILITARY MEDICAL CENTER

<h3>Introduction</h3> Oral food challenges (OFCs) are the gold standard for diagnosis of food allergies. Limited data exists comparing OFCs across adult and pediatric subgroups in the military's health care system. The purpose of this study is to identify clinical and laboratory predictors of negative OFCs in one military medical center. <h3>Methods</h3> A retrospective chart review was performed on all open OFCs between June 2014 and June 2021 at a military tertiary center allergy clinic. <h3>Results</h3> 652 patients who underwent 1,112 OFCs were included with 910 negative total OFCs (81.8%). A total of 615 pediatric (82.0%) and 294 of adult (81.4%) passed their OFCs. Successful OFCs were highest among almond (94.4%), shrimp (94.2%), crab (91.9%), and egg (88.9%) and lowest among cashew (62.0%), walnut (63.5%), pistachio (69.7%), and pecan (71.2%). There was statistical significance in outcomes when analyzing sIgE (P <0.001), SPT wheal size (P <0.001), and history of a prior failed challenge (p=0.042). Walnut OFCs demonstrated an outcome difference between age groups (P= 0.008) – pediatrics subgroup with a higher pass rate (74.4%) compared to adults (40.0%). Higher levels of Ara h2 were also associated with a greater number of failed challenges (p= 0.045). <h3>Conclusion</h3> For OFCs performed in a military medical center which can influence career decisions, sIgE is a reliable lab marker in risk stratification of outcomes. Higher Ara h 2 was associated with failed OFCs. A significant difference in pass rate was noted between pediatric and adult populations for certain foods.

Expanding APHON's Pediatric Chemotherapy/Biotherapy Provider and Instructor Program to Spanish-Speaking Countries: Pilot Series Development and Evaluation.

Background: To address the need for standardized, comprehensive chemotherapy/biotherapy education in Latin American and Caribbean (LAC) countries, the Association of Pediatric Hematology/Oncology Nurses (APHON) Pediatric Chemotherapy/Biotherapy Provider and Instructor program courses were culturally adapted, translated to Spanish, and piloted. The process of course adaptation and implementation are described. A Context, Input, Process, Product model outcomes evaluation determined: (a) differences in pass rates by test version and pilot location, (b) predictors of pass rates, (c) course appropriateness for nurses' education and practice levels, and (d) strategies for course improvements. Methods: The Spanish APHON Pediatric Chemotherapy/Biotherapy Provider program was piloted four times and the Instructor program twice with nurses from Mexico, Central America, the Caribbean, South America, and Spain. Statistical analysis identified factors associated with pass rates. Results: Of the 203 students in four Spanish APHON Provider program courses, data from 108 students (three pilots) were analyzed (one unplanned pilot excluded for missing data). Significant predictors of pass rates included: pediatric oncology frontline nurses (OR = 9.86; 95% CI [2.56, 65.23]; p = .004), nurses dedicated to an inpatient or outpatient unit (non-rotating) (OR = 6.79 [1.29, 51.98]; p = .033), and graduation from a 5-year nursing program (OR = 5.92; 95% CI [1.30, 33.15]; p = .028). Discussion: The Spanish APHON Pediatric Chemotherapy/Biotherapy program was determined appropriate for nurses' education and practice levels in LAC countries. Through the APHON Spanish language instructor network, pediatric oncology nurses in LAC countries have increased access to standardized, comprehensive chemotherapy/biotherapy education.

Statistical Analysis on Grading Characteristics between Dense and Stone Matrix Asphalt Mixtures

Gradation information can be really useful when evaluating the performance of pavement, especially when the local climate condition or traffic volume have special requirements on gradations of asphalt pavement. However, due to poor management or long construction time, it may be difficult to accurately acquire the asphalt gradation type on site. To solve this problem, this study aimed to analyze the grading characteristics of both asphalt concrete (AC) and stone matrix asphalt (SMA) mixtures through statistics and to propose a quantitative indicator that could distinguish them rapidly. Methodologically, passing rate difference (PRD) between two adjacent sieve sizes was used to characterize the gradation and to distinguish AC from SMA. Five sieve sizes were considered in this study, namely, 16 mm, 13.2 mm, 9.5 mm, 4.75 mm, and 2.36 mm, and four PRDs were computed and analyzed. A total of 854 sets of gradation data were collected from 437 papers. To study the influence of nominal maximum particle size (NMPS), the data were further categorized into three types, namely, gradation data with NMPS of 16 mm, 13 mm, and regardless of NMPS. As a result, in all cases of NMPS, critical PRDs were determined to distinguish between SMA and AC mixtures. Moreover, when a critical PRD was determined, for a given gradation, the confidence level to correctly identify an AC gradation was generally higher regardless of NMPS.

Disagreement in Pass Rates Between Strength and Performance Tests in Patients Recovering From Anterior Cruciate Ligament Reconstruction

Background: Performance on strength and functional tests is often used to guide postoperative rehabilitation progress and return to activity decisions after anterior cruciate ligament reconstruction (ACLR). Clinicians may have difficulty in determining which criteria to follow if there is disagreement in performance outcomes among the tests. Purpose/Hypothesis: The purpose of this study was to compare pass rates between strength tests and single-leg hop (SLHOP) tests among men and women and between patients with lower and higher preinjury activity levels recovering from ACLR. We hypothesized that pass rates would be nonuniformly distributed among test types, sex, and activity level and that more participants would pass hop tests than strength tests. Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 299 participants (146 men; 153 women)—at a mean of 6.8 ± 1.4 months after primary, unilateral, and uncomplicated ACLR (mean age, 23 ± 9.7 years; mean height, 172 ± 10.5 cm; mean mass, 75.8 ± 18.4 kg)—completed testing. Quadri.tif strength was evaluated using peak torque during isokinetic knee extension at 90 deg/s and 180 deg/s. Jump distance during the SLHOP and triple hop tests was measured (in cm). Strength and hop test measures were evaluated based on the limb symmetry index ((LSI) = (ACLR / contralateral side) × 100). We operationally defined “pass” as >90% on the LSI. Results: Pass rates were nonuniformly distributed between isokinetic knee extension at 90 deg/s and the SLHOP test (χ2 = 18.64; P < .001). Disagreements between isokinetic testing at 90 deg/s and the SLHOP test occurred in 36.5% (109/299) of the participants. Among those who failed strength testing and passed hop testing, a greater portion reported higher activity levels before their injury (χ2 = 6.90; P = .01); however, there was no difference in pass rates between men and women. Similar patterns of disagreement were observed between all strength test and hop test outcomes. Conclusion: ACLR patients with higher activity levels may be more likely to pass hop testing despite failing quadri.tif strength testing. This may be an indicator of movement compensations to achieve jump symmetry in the presence of quadri.tif weakness.

Factors that predict NCLEX-RN success at a Historically Black College and University: A four-year retrospective study.

Ensuring NCLEX-RN success for graduates of Historically Black Colleges and Universities (HBCUs) is integral to increasing Blacks and other racial/ethnic minorities underrepresented as registered nurses (RNs). To examine the association between program type (traditional (TBSN) and accelerated Bachelor of Science [ABSN]) and first-time NCLEX-RN exam outcome. A retrospective descriptive design was used. TBSN and ABSN students (n = 465) who graduated between 2015-2018 at an HBCU were examined. First-time pass rates for the total sample was 91.58%. Differences were observed between program type in 10 nursing courses for both programs, with Child Health being the only course predicting NCLEX-RN in both programs. In a multivariate logistic regression model, male students were 69% less likely to pass NCLEX-RN exam on first attempt compared to females, AOR = 0.31, p = 0.005. HBCUs can successfully prepare a diverse population of BSN graduates who pass NCLEX-RN on first attempt. Increased understanding of factors that decrease NCLEX-RN success of males is a prerequisite to development of strategies to ensure that all students have positive outcomes. There is also a need to understand differential relationships between nursing course grades and NCLEX-RN success among students enrolled in TBSN versus ABSN paths.

The impact of dental curriculum format on student performance on the national board dental examination.

The effectiveness of different curriculum types has long been debated by dental educators aiming to provide the best education possible to their students. This study aimed to evaluate the effect of curriculum type (hybrid problem-based learning [PBL] vs. traditional) on National Board Dental Examination (NBDE) part I and II pass rates METHODS: A retrospective cohort study was conducted with a hybrid PBL cohort and traditional cohort. NBDE part I and II pass rates for the two cohorts were acquired, along with demographic and scholastic variables. Pass rates, scholastic variables, and demographic variables were compared using two-sample t-tests and chi-square tests. Associations of the variables with pass rates were analyzed using logistic regression. Significance was set at 5% RESULTS: No significant differences in pass rates for NBDE part I and II were observed between the cohorts. Cumulative dental school grade point average (GPA) was found to be an independent predictor of success for NBDE part I (odds ratio (OR): 1.40, 1.24-1.59 for 0.1 point intervals) and II (OR: 1.34, 1.18-1.52 for 0.1 point intervals), (p<0.01). DAT biology sub-score was found to be predictive of success for NBDE part I (OR: 1.58, 1.14-2.19), (p=0.01) CONCLUSIONS: No significant difference in NBDE part I and II pass rates between the cohorts was found. Dental school GPA was the most predictive variable for success on NBDE part I and II. These findings may be helpful considerations as institutions assess the structure of their school curricula.

Does your team know how to respond safely to an operating room fire? Outcomes of a virtual reality, AI-enhanced simulation training.

Operating room (OR) fires are rare but devastating events requiring immediate and effective response. Virtual Reality (VR) simulation training can provide a safe environment for practice of skills in such highly stressful situation. This study assessed interprofessional participants' ability to respond to VR-simulated OR fire scenarios, attitudes, numbers of attempt of the VR simulation do participants need to successfully respond to OR fires and does prior experience, confidence level, or professional role predict the number of attempts needed to demonstrate safety and pass the simulation. 180 surgical team members volunteered to participate in this study at Beth Israel Deaconess Medical Center, Boston, MA. Each participant completed five VR OR simulation trials; the final two trials incorporated AI assistance. Primary outcomes were performance scores, number of attempts needed to pass, and pre- and post-survey results describing participant confidence and experiences. Differences across professional or training role were assessed using chi-square tests and analyses of variance. Differences in pass rates over time were assessed using repeated measures logistic regression. One hundred eighty participants completed simulation testing; 170 (94.4%) completed surveys. Participants included surgeons (17.2%), anesthesiologists (10.0%), allied health professionals (41.7%), and medical trainees (31.1%). Prior to training, 45.4% of participants reported feeling moderately or very confident in their ability to respond to an OR fire. Eight participants (4.4%) responded safely on the first simulation attempt. Forty-three participants (23.9%) passed by the third attempt (VR only); an additional 97 participants (53.9%) passed within the 4-5th attempt (VR with AI assistance). Providers are unprepared to respond to OR fires. VR-based simulation training provides a practical platform for individuals to improve their knowledge and performance in the management of OR fires with a 79% pass rate in our study. A VR AI approach to teaching this essential skill is innovative, feasible, and effective.

Variation in performance on common content items at UK medical schools

BackgroundDue to differing assessment systems across UK medical schools, making meaningful cross-school comparisons on undergraduate students’ performance in knowledge tests is difficult. Ahead of the introduction of a national licensing assessment in the UK, we evaluate schools’ performances on a shared pool of “common content” knowledge test items to compare candidates at different schools and evaluate whether they would pass under different standard setting regimes. Such information can then help develop a cross-school consensus on standard setting shared content.MethodsWe undertook a cross-sectional study in the academic sessions 2016-17 and 2017-18. Sixty “best of five” multiple choice ‘common content’ items were delivered each year, with five used in both years. In 2016-17 30 (of 31 eligible) medical schools undertook a mean of 52.6 items with 7,177 participants. In 2017-18 the same 30 medical schools undertook a mean of 52.8 items with 7,165 participants, creating a full sample of 14,342 medical students sitting common content prior to graduation. Using mean scores, we compared performance across items and carried out a “like-for-like” comparison of schools who used the same set of items then modelled the impact of different passing standards on these schools.ResultsSchools varied substantially on candidate total score. Schools differed in their performance with large (Cohen’s d around 1) effects. A passing standard that would see 5 % of candidates at high scoring schools fail left low-scoring schools with fail rates of up to 40 %, whereas a passing standard that would see 5 % of candidates at low scoring schools fail would see virtually no candidates from high scoring schools fail.ConclusionsCandidates at different schools exhibited significant differences in scores in two separate sittings. Performance varied by enough that standards that produce realistic fail rates in one medical school may produce substantially different pass rates in other medical schools – despite identical content and the candidates being governed by the same regulator. Regardless of which hypothetical standards are “correct” as judged by experts, large institutional differences in pass rates must be explored and understood by medical educators before shared standards are applied. The study results can assist cross-school groups in developing a consensus on standard setting future licensing assessment.

Learning and teaching of calculus: performance analysis in a unified system

ABSTRACT This work presents an evaluation of a unified Calculus 1 course in a large Brazilian federal university. By course unification we mean having all the sections following the same weekly schedule, under the same syllabus and common assessment. We analyse two sets of data: pass rates relative to the 9 semesters prior to the unification and to the following 12 semesters; results of objective tests based on the item response theory, taken by the students during the period following unification. Data analysis gives us the average students' performances grouped by programme for which Calculus 1 is compulsory and shows us no difference in pass rates over the two periods. These two results help us to point out the problems in the implementation of our unification. We also explain traditional low pass rates for some sections and why our Calculus 1 may not be adequate to some of the programmes for which it is compulsory. More importantly, we show that among the students' abilities assessed by the objective tests, two seem to be necessary for the learning of Calculus and proficiency in Calculus 1 appears to be related to seven of these abilities.

How Does Cochlear Implantation Lead to Improvements on a Cognitive Screening Measure?

Purpose Cognitive screening tools to identify patients at risk for cognitive deficits are frequently used by clinicians who work with aging populations in hearing health care. Although some studies show improvements in performance on cognitive screening exams when hearing loss intervention is provided in the form of a hearing aid or cochlear implant (CI), it is worth examining whether these improvements are attributable to increased auditory access to test items. This study aimed to examine whether performance and pass rate on a cognitive screening measure, the Montréal Cognitive Assessment (MoCA), improve as a result of CI, whether improved performance on auditory-based test items drives changes in MoCA performance, and whether postoperative MoCA performance relates to post-CI speech perception ability. Method Data were collected in adult CI candidates pre-implantation and 6 months postimplantation to examine the effect of intervention on MoCA performance. Participants were 77 CI users between the ages of 55 and 85 years. Participants completed the MoCA, administered audiovisually, and speech perception testing with monosyllabic (CNC) words at both intervals. Results Compared to 31 participants pre-operatively, 45 participants passed the MoCA postoperatively, which was a significant difference in pass rate. An improvement in MoCA scores could be attributed primarily to improvement in the "Delayed Recall" test domain, which was auditory based. Post-CI MoCA performance was related to post-CI CNC speech perception performance. Conclusions Improved performance and pass rates were demonstrated on the traditional MoCA test of cognitive screening from before to 6 months after CI. Improvements could primarily be attributed to better performance on a delayed recall task dependent on auditory access, and post-CI MoCA scores were related to post-CI speech perception abilities. Further studies are needed to investigate the application of cognitive screening tools in patients receiving hearing loss interventions, and these interventions' impact on patients' real-world functioning.

The effect of measurement geometry on patient specific QA pass/fail rates for stereotactic body radiation therapy (SBRT) Plans.

Patient quality assurance (QA) is a required part of the treatment care path, and plan failure can lead to increased personnel hours or delay of treatment. The recommendation by the American Association of Physicists in Medicine is that gamma analysis be used to evaluate measured volumetric modulated arc therapy plans. Vendors have developed many different measurement geometries for patient QA devices which could yield varying pass rates when used with the recommended tolerances, normalization, and criterion. For this study, clinically treated stereotactic body radiation therapy plans were used to evaluate differences in gamma dose tolerances and sampled dose distribution complexity for centralized or peripheral measurement geometries on a cylindrical phantom. Random errors were then introduced into a subset of these plans, and the differences in pass rates between the geometries were correlated with differences in the observed mathematical differences. Finally, a single clinically relevant target coverage deviation was introduced to another subset of plans to evaluate whether a particular geometry is measurably better at identifying clinically relevant errors. It was found that centralized geometries resulted in more lenient dose tolerances and less complex sampled dose distributions compared to peripheral geometries. Pass rates were uniformly lower in the peripheral measurement geometry, and the difference in pass rates between the geometries correlated strongly with the difference in dose tolerance and weakly with the difference in the chosen complexity metrics. However, neither of the geometries were sufficiently sensitive enough to detect clinically relevant changes to target coverage when using recommended tolerances and criteria, and no statistically significant difference was found between their pass rates. Given these findings, the authors concluded that stereotactic body radiation therapy plans could fail patient QA when measured in the peripheral geometry but pass in the centralized geometry, with possibly neither having correlation to true clinical deviation.

Narrative and Other Pragmatic Language Abilities of Children With a History of Maltreatment

Introduction In any given year, about 3.5 million children in the United States are suspected of having experienced maltreatment resulting in complex trauma involving the exposure to traumatic events and the long-term effects of this exposure on the child's psychological, emotional, social, linguistic, and communicative development. Method In this study, we analyzed retrospective data on the pragmatic language and social communication skills exhibited by children between the ages of 5 and 15 years with a documented history of maltreatment. Researchers analyzed the children's performance on the Hyter Pragmatic Protocol–Revised and the Clinical Evaluation of Language Fundamentals–Fifth Edition Screening Test to determine their syntactic, semantic, and pragmatic abilities. Analyses were also conducted to determine if children with different genders, ages, and numbers of exposures demonstrated differences in performance. Results Results showed that many children with trauma exposure demonstrated specific deficits in both narrative and expository language skills. High percentages of children exhibited difficulty using narrative cohesion, narrative coherence, expository content, expository structure, and expository coherence on the Hyter Pragmatic Protocol–Revised. The number of maltreatment exposures did not significantly impact performance on narrative measures. Female participants tended to perform better on pragmatic language tests. Younger children performed better than older children on narrative cohesion and produced a landscape of action in their narratives. Most children received passing scores on the Clinical Evaluation of Language Fundamentals–Fifth Edition Screening Test, and there were no significant differences in pass rates among age, gender, and number of exposures. Conclusions Clinical implications for assessment are discussed. Implications include the need for clinicians to test pragmatic language, especially the narrative language of children exposed to complex trauma. Because older children with trauma exposure demonstrated lower scores on certain tests of narrative language, there is a need for periodic reassessment of these pragmatic skills as children age.

Introduction of a Reliable Software for the Calculation of the Gamma Index

Introduction: The gamma index is a known parameter for radiotherapy dose verification. Many free and commercial programs have been written for the calculation of this index. However, the verification of the results has been overlooked in many of the programs. The present study tested the validity of three gamma index calculator programs. Material and Methods: The gamma indices for three measured and calculated dose distribution pairs presented in Low et al., Medical Physics, (1998) were calculated using three programs to compare with the results of the published paper. They included an executable program working in Gnuplot software environment (i.e., Gamma_index.exe), simple implementation of the formulas by MATrix LABoratory (MATLAB) software (i.e., Simple m-file), and CalcGamma MATLAB-based program distributed at GitHub website (i.e., Geurts). The resulted gamma distributions were compared with the three figures of the study by Low et al. Results: According to the results, it was observed that neither Gamma_index.exe nor Simple m-file calculated gamma indices was valid, with up to 31% difference in pass rates. On the other hand, Geurts showed fairly good agreement with the gamma indices presented in Low et al. paper. Conclusion: Use of gamma index calculator programs, such as Gamma_index.exe should strongly be prohibited without verification. Furthermore, the implementation of the gamma index formulas without enough preprocessing of the data results in invalid values. Geurts is a reliable program that can be used in its current form or it can be changed to stand-alone executable software for the use in studies and clinics.

Evaluating the numeracy skills of pharmacy students in multiple choice questions and free-text answer assessments and their perception of numeracy in clinical practice

IntroductionNumerical errors can cause unintentional harm to patients and are a burden to healthcare systems worldwide. There is a paucity of research regarding numerical competence in pharmacists and pharmacy students and how this should be assessed within undergraduate and licensure assessments. MethodsTwo numeracy assessments were given to year three and four pharmacy students at the University of Sunderland, United Kingdom. One paper included ten multiple-choice questions (MCQs) and the second ten free-text answer questions. Participants were then given an evaluation questionnaire to explore their perceptions about the assessments and numeracy in clinical practice. ResultsA response rate of 75% (n = 247) was achieved, with 60.9% of students passing the MCQ and 27.9% passing the free-text answer assessments. There were statistically significant differences in pass rates depending on year of study, ethnicity, and previous mathematics qualifications. Participants were asked if numeracy was an important skill for pharmacists in practice; 57.9% thought it were essential and 36.4% quite important. However, only 1.4% felt sufficiently supported in the development of the required numeracy skills, and this has prompted a redesign of teaching and assessment at the university. ConclusionsEducators need to ensure taught and assessed numeracy is reflective of and transferable to pharmacy practice, whilst ensuring students are supported effectively and engaged. This is likely to be achieved with integrated and clinically focused teaching approaches and appropriately constructed assessments throughout the pharmacy programme.