Differences In Overall Scores Research Articles

A randomized, pilot trial comparing vaginal hyaluronic acid to vaginal estrogen for the treatment of genitourinary syndrome of menopause.

The aim of this study was to compare the efficacy of a non-hormone alternative, vaginal hyaluronic acid (HLA), to a standard-of-care therapy, vaginal estrogen, for the treatment of genitourinary syndrome of menopause (GSM). This was a randomized, parallel arm pilot trial. Women with GSM were randomized to an HLA vaginal suppository or vaginal estrogen cream for 12 wk to compare the primary outcome, the vulvovaginal symptom questionnaire (VSQ) score. Secondary outcomes included the following: the female sexual function index (FSFI), the vaginal symptom index (VSI), visual analog scale (VAS) for dyspareunia, vaginal itching, and vaginal dryness, patient global impression of improvement (PGI-I) at follow-up, vaginal maturation index, and vaginal pH. Differences between treatment groups were estimated using the two-sided, two-sample t -test and 95% confidence intervals. Forty-nine women were randomized and 45 participants (vaginal estrogen = 23, vaginal HLA = 22) provided data at week 12. Baseline characteristics were similar in both groups. On the VSQ, there was no observed difference in overall scores between the HLA and vaginal estrogen groups at 12 wk ( P = 0.81). Improvement was seen within both treatment groups on the VSQ after 12 wk. The VAS score, total VSI score, total FSFI score, and vaginal pH improved over time; however, improvement did not differ between study arms. Over 90% participants noted improvement on the PGI-I in both groups ( P = 0.61). No treatment-related serious adverse events occurred. There were no clinically meaningful differences between vaginal HLA and vaginal estrogen for the treatment of GSM after 12 wk. Vaginal HLA may be a promising non-hormone therapy for GSM.

Outcomes of Radial Forearm Free Flap Closure With Split-Thickness Skin Graft Versus Primary Closure.

This study compares patient-reported functional and aesthetic outcomes of split-thickness skin graft (STSG) versus hatchet flap closure of radial forearm free flap (RFFF) donor site. Patients with RFFF (2015-2020) were retrospectively identified. Those willing to participate in patient-reported outcomes (PRO) filled out Patient-Observer Scar Assessment Scale (POSAS) and Michigan Hand Outcome Questionnaire (MHOQ). 198 patients met our inclusion criteria and 81 participated in PRO. There was a higher rate of tendon exposure in STSG versus hatchet flap (11 vs. 1, p = 0.0019), but a lower rate of skin necrosis (5 vs. 16, p = 0.0190) and epidermolysis (1 vs. 12, p = 0.0028). Scar quality in STSG was superior to hatchet flap in all domains of POSAS. MHOQ scores were similar between both groups with no statistical difference in overall scores (p = 0.2165). STSG appeared to have less compromise in activities of daily living, better satisfaction and improved scar quality than hatchet flap, but a higher rate of tendon exposure. 3 Laryngoscope, 134:4266-4273, 2024.

INTER- AND INTRA-OBSERVER RELIABILITY OF THE MIRELS’ SCORING SYSTEM FOR THE DETERMINATION OF PATHOLOGICAL FRACTURE RISK IN METASTATIC BONE LESIONS AMONG ORTHOPEDIC SURGEONS WITH DIFFERENT LEVELS OF EXPERTISE

Objective: To assess inter- and intra-observer reliability of Mirels scoring for the determination of pathological fracture risk in metastatic bone lesions of 30 patients among six different levels of experienced orthopedic surgeons who were trained in the same university clinic. Material and Methods: Thirty patients were randomly selected from oncology unit consultations. Six observers were selected in accordance to their orthopedic experience. Mirels parameters except pain were evaluated by observers on two different times without the observers being aware of each other. Results: The Fleiss’ Kappa values were detected as κ=0.21, p<0.0001, and κ=0.15, p<0.0001 by inter-observers at the first and second observational points, respectively. The Kappa values were in perfect (κ=0.95), fair (κ=0.27) and fair (κ=0.10) agreements for the region, size and type of the metastatic involvement by inter-observers at the first observational point. The same parameters had similiar scores as κ=0.83, κ=0.13 and κ=0.28 for region, size and type for the second observation. Fair (κ=0.333), moderate (κ=0.413), fair (κ=0.225), slight (κ=0.035), fair (κ=0.369 and poor (κ=0.030) evidence of agreements were detected in the comparison of the first and second observations for total scores in seniority order. Conclusions: Kappa analysis showed perfect agreement for region, but slight to fair for size and type. There was a significant difference in overall scores across experience levels for the most and least experienced observers. A new rating system with revised parameters may be required to predict impending fractures.

Impact of Emergency First Response for Adolescents in Observation House in Taif, KSA

Background: The observation house in Taif is one of the social homes of the ministry of social affairs, which deals with the refinement, reform, and care of juveniles from the age of 12 to 18 years for whom the quantities are estimated to commit crimes of whatever crime, from minor and ordinary crimes to murders and this house is located north Taif City. Crisis first reaction alludes to the crisis or prompt consideration you ought to give when an individual is harmed or sick until full clinical therapy is accessible standard first aid training is done in this study. Aim: To evaluate the impact of emergency first response training among adolescents and workers in the observation house. Methods: Pre and post single arm community-based study design for Adolescents and workers in observation house in Taif City. Study duration from September 2020 to March 2021.data collected by standardized, close ended questionnaire for awareness through direct interview and observation checklist for emergency first response Care. Total coverage was taken during study duration. the study samples wear 100 (40 workers and 60 prisoners).the study had three phases and all participant pre assessment was done to find out the awareness and response needs during health emergencies and the intervention was designed according to the needs. The outcomes of the intervention were measured by comparison pre and post intervention scores. Data were analyzed by utilizing Levene's test for correspondence of differences and T – Test for uniformity of means Result: We have eight outcom to measure pre and post intervention, the results showed that all the variables tested there are an increase in post training scores, solely based on mean and deviation, compared to pre intervention. The results A two-tailed independent samples t-test was used to compare the mean difference in overall score between pre intervention and post intervention (n = 100). The Type I error rate was set at alpha = 0.05. The results showed the average overall mean score is less in pre intervention (M = 3.311, SD = 1.7485) than for post intervention (M = 11.556, SD = 0.5647), t(119,43) = 44.873, p = .000. Conclusion: emergency first response training in observation home given the adolescent's and worker's limited prior knowledge, it appears to be highly effective. One month following training, we saw substantial improvement and a high performance rate. Increasing the number of trained personnel in the observation house saves lives by reducing the number of persons who are injured or killed as a result of a delayed or inadequate response. While waiting for professional assistance, take urgent action and implement the right strategies., researchers recommended add the emergency first response to programs and activities that are provided to adolescents in the observation houses.

A25 CRITICAL APPRAISAL OF GI ENDOSCOPY CLINICAL PRACTICE GUIDELINES DURING THE COVID-19 PANDEMIC

BackgroundClinical Practice Guidelines (CPGs) are integral during a pandemic, offering guidance to clinicians through uncertainty. Existing literature has established that the need for rapid publication of CPGs during previous infectious disease outbreaks resulted in less rigorous guidelines. CPGs were rapidly developed since the onset of the pandemic in December 2019, providing guidance in gastrointestinal (GI) endoscopy, an area where COVID-19 may pose risk of transmission.AimsTo evaluate the quality of GI endoscopy guidelines developed during the COVID-19 pandemic and to compare these with (a) endoscopy CPGs developed prior to the pandemic; (b) CPGs for other endoscopic topics unrelated to COVID-19; and, (c) non-endoscopic CPGs published during the pandemic.MethodsWe systematically searched Medline, Embase and Scopus for CPGs published by GI societies from January 1, 2018 to December 31, 2020. A grey literature search was conducted. Two authors screened full-texts. In this interim analysis, CPGs were grouped based on publication year: before 2020, or 2020. Endoscopy CPGs published in 2020 were categorized as COVID or non-COVID related. Two authors independently assessed the CPGs using the AGREE II tool, consisting of six domains for evaluating guidelines. A domain score of 60 was set as a threshold to indicate good quality.ResultsThere were 70 endoscopy guidelines and 27 CPGs focused on other GI topics. The mean overall scores were 69% (±12%) for endoscopy CPGs published before 2020 (n=28), and 51% (±23%) for CPGs published in 2020 (n=42). For individual AGREE II domains, mean scores for pre-2020 CPGs ranged from 33.11 (±17.39) in Applicability to 81.55 (±10.37) in Clarity of Presentation. For CPGs published during COVID-19, mean domain scores ranged from 34.18 (±10.52) in Applicability to 75.26 (±13.85) in Clarity of Presentation. 21 of 42 CPGs published in 2020 were related to COVID. Mean overall scores were 35% (±20%) for COVID-related CPGs and 67% (±13%) for non-COVID-19 CPGs. For COVID-19 CPGs, scores ranged from 27.88 (±20.31) in Rigour of Development to 69.58 (±10.81) in Scope and Purpose. For non-COVID CPGs, the scores ranged from 37.30 (±8.93) in Applicability to 84.52 (±5.93) in Clarity of Presentation.ConclusionsThe difference in overall scores between COVID-19 endoscopy CPGs and non-COVID endoscopy CPGs may suggest that the urgency to disseminate COVID-19 information decreased CPG quality or completeness of reporting. This interim analysis is limited by the lack of distinction between peer-reviewed CPGs and non-peer reviewed recommendations. Given the importance of CPGs in clinical decision making, it is important to ensure that the rapid development of guidelines does not compromise quality and rigour.Funding AgenciesNone

Support for local wines in The Netherlands: opportunities for the hospitality industry

ABSTRACT This article reports on a research project to measure the current intrinsic competitive value of Dutch wine in comparison to wines from renowned wine countries based on a taste and olfactory evaluation, and to explore the sustainable benefits that local Dutch wine can offer and wines made from fungus-resistant grape varieties (FRG). Both factors aim to measure the unique selling point of Dutch wine and explore if adoption in The Netherlands can be strengthened in the future. A blind tasting experiment with four different tasting groups (n = 54) was conducted. Participants evaluated (blind) two Dutch wines (white and red), a New Zealand wine (white) and a Bordeaux blend (red), which were matched according to their flavour components and popularity in The Netherlands. The outcome of this research shows no significant difference in overall scores between groups when comparing Dutch wine to wines from renowned wine-producing countries when tasted blind. However, the Dutch white wine was significantly more likely to be purchased according to participants. Results show that the competitiveness of Dutch wine in comparison to other renowned wine regions is evident. Dutch wine has increased in quality over the last years, therefore it is more likely to be purchased now. This offers opportunities in marketing and sales to increase efforts towards a more sustainable food and beverage programme among restaurateurs in The Netherlands.

Applied machine learning in recognition of DGA domain names

Recognition of domain names generated by domain generation algorithms (DGAs) is the essential part of malware detection by inspection of network traffic. Besides basic heuristics (HE) and limited detection based on blacklists, the most promising course seems to be machine learning (ML). There is a lack of studies that extensively compare different ML models in the field of DGA binary classification, including both conventional and deep learning (DL) representatives. Also, those few that exist are either focused on a small set of models, use a poor set of features in ML models or fail to secure unbiased independence between training and evaluation samples. To overcome these limitations, we engineered a robust feature set, and accordingly trained and evaluated 14 ML, 9 DL, and 2 comparative models on two independent datasets. Results show that if ML features are properly engineered, there is a marginal difference in overall score between top ML and DL representatives. This paper represents the first attempt to neutrally compare the performance of many different models for the recognition of DGA domain names, where the best models perform as well as the top representatives from the literature.

THE EFFECTIVENESS OF NEW TEACHING STYLE ON THE STUDENTS’ PERFORMANCE IN VECTOR CALCULUS DURING MOVEMENT CONTROL ORDER

Teaching style becomes more challenging especially during Movement Control Order (MCO) due to Covid-19 pandemic. Thus, online learning be one of the new teaching styles used during MCO at all educations level. Therefore, to study the effectiveness of this style, this paper is conduct to explore the effect of the new teaching style on the engineering student’s performance by determine the difference of overall scores between batches for each program in Vector Calculus (VC) course with ordinary and new teaching style at Faculty of Engineering and Built Environment (FKAB), Universiti Kebangsaan Malaysia (UKM). Nonparametric test is used as Mann Whitney to analyze the difference of the teaching style. The results show that the achievement of students in VC course could be significantly distinguished by two batches of students with different teaching and assessment modes. In addition, JKKP program also shows there is no significant difference in overall scores between batches with different teaching styles.

Identifying areas of improvement for cultural competence in pharmacy curricula: A multi-school study using the self-assessment of perceived level of cultural competence (SAPLCC) questionnaire

IntroductionThe implementation of culturally competent healthcare services has been considered a key strategy for the provision of patient-centered care; however, a need remains to address the requirements of teaching cultural competence, including identifying gaps, designing and evaluating curricula, and assessing students' progress toward program objectives. The objective of this study was to explore the applicability of the Self-Assessment of Perceived Level of Cultural Competence (SAPLCC) questionnaire in the identification of improvement areas in cultural competence content in pharmacy curricula. MethodsThis study used previously-collected SAPLCC data from student pharmacists at eight United States pharmacy schools. Total and factor-specific SAPLCC scores were calculated based on the 14 factors published previously and grouped into six domains (knowledge, skills, attitudes, encounters, abilities, and awareness). Differences in overall scores by domain and factors across various student characteristics were examined using analysis of variance. ResultsThe overall mean total SAPLCC score was classified as moderate. Third-year students had significantly higher SAPLCC mean scores than first-year students, and African American students scored significantly higher than their counterparts. At the factor-level, students scored higher in the Attitudes and Awareness domains and scored lower in the Knowledge, Skills, and Encounters domains. ConclusionsThe application of the SAPLCC in schools participating in this preliminary study allowed for the identification of content areas that may benefit from revision. The SAPLCC may be a useful tool for mapping cultural competence curricular content by each specific domain and identifying areas of potential improvement regarding cultural competence training within pharmacy curricula.

Appraising the Quality of Reporting of American College of Surgeons NSQIP Emergency General Surgery Studies

The quality of emergency general surgery (EGS) studies that use the American College of Surgeons-National Quality Improvement Program (ACS-NSQIP) database is variable. We aimed to critically appraise the methodologic reporting of EGS ACS-NSQIP studies. We searched the PubMed ACS-NSQIP bibliography for EGS studies published from 2004 to 2019. The quality of reporting of each study was assessed according to the number of criteria fulfilled with respect to the 13-item RECORD statement and the 10-item JAMA Surgery checklist. Three criteria in each checklist were not applicable and were therefore excluded. An analysis was conducted comparing studies published in high and low impact factor (IF) journals. We identified a total of 99 eligible studies. Twenty-six percent of studies were published in high IF journals, and 73% of the journals had a policy requiring adherence to reporting statements. The median number of criteria fulfilled for the RECORD statement (out of 10 items) and the JAMA Surgery checklist (out of 7 items) were both equal to 4 (interquartile range [IQR] 3, 5). Sixty-three percent of studies did not explain the methodology for data cleaning, 81% of studies did not describe the population selection process, and 55% did not discuss the implications of missing variables. There were no differences in overall scores between studies published in high and low IF journals. The methodologic reporting of EGS studies using ACS-NSQIP remains suboptimal. Future efforts should focus on improving adherence to the policies to mitigate potential sources of bias and improve the credibility of large database studies.

Effect of pandemic on Quality of life in Diabetics (QOLID) assessment: Data from a teaching hospital in Bhubaneswar, Odisha, India.

Background:Quality of life in Diabetics (QOLID) questionnaire is a validated tool to assess the quality of life affected by diagnosed diabetic patients and has 8 sub domains, which are essential factors that have proven effect on the management. In a state of art Diabetic clinic in Bhubaneswar city, the tool was used to add more quality to diabetic management.Methods:The ongoing assessment through the months of 2020 (study period being from December 2019 to August 2020), offered an opportunity to assess the effect of the pandemic on QOLID scores and review some nascent or strong factors which may be affecting chronic disease management.Results:Complete data could be collected from 599 subjects, 343 from pre pandemic and 256 from pandemic period. The overall scores which were on 100, did not show any significant difference for pre covid and the Covid period, interestingly nearly 1.93 points better in Covid period (69.69±11.10 vs71.62±8.49; p=0.396). Mild difference in overall scores of 4.82 points is seen in females in Covid period; and as seen in age group data maximum gain in sub domains, more for females is seen in the emotional and mental health. Though women reporting to the clinic in both periods are usually in 1:2 ratios, as against men; but QOLID scores in both men and women in Covid period was 71 to 80 points. After the univariate analysis for significant factors, it was that Covid (1.50; 1.08 - 2.07) ; compliance to medications (2.27; 1.48 - 3.50) and reporting of all diabetic complications especially that of eye and depression are coming out to be strong associative factors to affect QOLID scores. Interestingly, rising education has a protective effect on QOLID scores that was significant as higher awareness and better job or earning opportunities may be a contributor for higher QOLID scores for the well educated.Conclusion:This brings out a strong emphasis on QOL assessments to be made an inbuilt part of Diabetic management at all centers to maximize treatment outcomes

Burnout in Japanese neurologists: comparison of male and female physicians

A questionnaire survey was conducted on 8,402 members of the Japanese Neurological Society to examine the current status and countermeasures for physician burnout, and 1,261 respondents (15.0%) responded. In this paper, we report the results of a comparison between male and female physicians. There was a significant difference in working and living conditions only for married people. It was confirmed that men work under stricter conditions in terms of working hours, and that the burden on women is heavier in the division of housework. Analysis using the Japanese Burnout Scale revealed no gender differences in overall scores, but as for factors related to burnout, in addition to factors common to both men and women, factors specific to men or women were clarified.

Incorporating Biobank Consent into a Healthcare Setting: Challenges for Patient Understanding

Background Biobank participants often do not understand much of the information they are provided as part of the informed consent process, despite numerous attempts at simplifying consent forms and improving their readability. We report the first assessment of biobank enrollees’ comprehension under an "integrated consent” process, where patients were asked to enroll in a research biobank as part of their normal healthcare experience. A number of healthcare systems have implemented similar integrated consent processes for biobanking, but it is unknown how much patients understand after enrolling under these conditions. Methods: We recruited patients who enrolled in a biobank while in a healthcare setting when receiving ordinary care. We assessed knowledge of consent materials using 11 true/false questions drawn from a well-known biobank knowledge test. After reviewing the results from 114 participants, we revised the consent form and repeated the knowledge assessment with 144 different participants. Results: Participants scored poorly on the knowledge test in both rounds, with no significant differences in overall scores or individual items between the rounds. In Phase 1, participants answered 53% of the questions correctly, 25% incorrectly, and 22% “I don’t know.” In Phase 2, participants answered 53% of questions correctly, 24% incorrectly, and 23% “I don’t know.” Participants scored particularly poorly on questions about data sharing and accessing medical records. Conclusions: Enrollees under an integrated consent model had significant misunderstandings that persisted despite an attempt to improve information specifically about those topics in a consent form. These results raise challenges for current approaches that attribute misunderstanding to overly complex consent forms. They also suggest that the pressures of the clinic may compound other problems with patient understanding of biobank consent. As health systems increasingly blend research and care, they may need to rethink their approach to educating patients about participation in a biobank.

Understanding the Long-Term Impact of Living-Related Liver Transplantation on Youth and Young Adults and their Family

PurposeThe purpose of this mixed methods study was to better understand the long term impact of living-related liver donation (LRLD) on youth and young adult (YYA) recipients and their family. Design and methodsSemistructured interviews were conducted with YYA, aged 11–18 years, who received a living donation from a parent. Interviews were audiotaped, transcribed, and analyzed to aggregate themes that represented the participants' views as live-liver recipients. An ethnographic process was conducted to understand the participants' social behavior. At interview, participants completed a demographics questionnaire and the Youth Quality of Life Instrument-Research Version (YQOL-R). ResultsThirteen adolescents were interviewed; six were re-interviewed as key informants. Three major categories were created from the data: Developing Identity, Redefining Family Relationships, Feeling Gratitude to Donors. The overarching theme was Resiliency. Findings from the YQOL-R showed no difference in overall scores or separate domains when compared with a reference population with no chronic illness. ConclusionQualitative and quantitative data highlight the positive effect that LRLD can have on pediatric patients as they transition from childhood to adolescence to young adulthood. Practice implications: As pediatric transplant centers in the United States soon mark 30 years of performing live-liver donation, recipients are becoming adults and understanding more clearly that the long-term effects of such donations will lead to improvements in future care.

Erectile Dysfunction in Peripheral Vascular Disease: Endovascular Revascularization as a Potential Therapeutic Target.

Erectile dysfunction (ED) affects more than 150 million men worldwide, with deleterious effects on quality of life. ED is known to be associated with ischemic heart disease but the impact of ED in patients with peripheral arterial disease (PAD) is unknown. We assessed the prevalence and severity of ED in patients with PVD. Following ethical approval, sequential male patients diagnosed with PAD over a 1-year period following diagnosis of intermittent claudication. The patient demographics and comorbidities were recorded, with the International Index of Erectile Function (IIEF-5) questionnaire used to grade severity of ED. Computed tomographic angiography and severity of stenosis in the proximal vessels and internal pudendal arteries were correlated using a modified Bollinger Matrix scoring system. 60 patients were recruited, most (77.2%) reported erectile dysfunction (52.5% severe, 22.5% moderate). Patients with severe ED were more likely to have 2 or more comorbidities (P = .009). 86.7% with severe ED had bilateral internal pudendal artery stenosis with a mean modified Bollinger score of 17.6. 35.5% of moderate ED patients had bilateral internal pudendal stenosis with a mean Bollinger score of 11.75. There was significant difference in overall scores between moderate and severe erectile dysfunction (p< 0.05), thus indicating a potential link between ED severity and extent of vessel stenosis. There is a substantial burden of clinically significant ED among patients with PAD. This study suggests ED should be discussed with all PAD patients and ED may precede a PAD diagnosis. There is scope for endovascular revascularization as a treatment option for ED secondary to arterial insufficiency.

The Effects of Test Type, Pronunciation, and Proficiency Level on EFL Learners’ Speaking Exam Scores

The present study aims to reveal the effects of test type, pronunciation and proficiency levels of the students on speaking test scores. A total of 147 Turkish EFL students consisting of 38 beginner, 36 elementary, 37 pre-intermediate and 36 intermediate levels participated in the study. Presentation as planned, and paired speaking test as unplanned one were used as instruments to figure out the effects of two different test types on the test scores. Being prepared for their performances, the students did their presentations lasting between 5 and 8 minutes in front of two raters. The same participants, at the end of each level, were invited to the paired-speaking tests designed for the students to show their spontaneous performances. The performances in both tests were scored through a scale with five criteria, and the criteria along with overall scores were examined through Paired Samples t-test to reveal the effects of test type, and through bivariate regression to see the proportion of pronunciation aspect on overall scores. The results showed that in beginner level, although no differences were found in the overall scores, the test type induced differences in pronunciation, vocabulary and relevance aspect of their speaking performances. Similar results were found in elementary level besides the difference found in accuracy aspect, which resulted in a significant difference in overall scores. However, in pre-intermediate level, the only significant difference was found in pronunciation. On the other hand, in intermediate level all the aspects along with the overall scores were found to be affected by the test type except for fluency and pronunciation. The bivariate regression revealed that the effect of pronunciation sub-score on overall scores is significant in each level and test type.

Dermatologist demographics and patient satisfaction: A single-center survey study

BackgroundPatient satisfaction is a proxy for quality clinical care. Understanding the factors that drive patient satisfaction scores is important because they are publicly reported, may be used in determining hospital and physician compensation, and may allow patients to preselect physicians.ObjectiveThis single-center survey study of adult patients at the Michigan Medicine outpatient dermatology clinics aimed to investigate how patients respond differently to theoretical dermatologic scenarios with varying dermatologist gender.MethodsEach questionnaire contained one of four clinical scenarios illustrating overall positive or negative encounters with a male or female dermatologist, followed by questions derived from the Press Ganey survey to assess patient satisfaction.ResultsA total of 452 completed questionnaires were collected. There were statistically significant differences in overall patient satisfaction scores between positive versus negative female and positive versus negative male dermatologists, but there were no differences in scores between positive female and positive male dermatologists or between negative female and negative male dermatologists. There were also no differences in overall scores after controlling for patient demographic characteristics or patient–dermatologist gender concordance.ConclusionPrevious studies have suggested that male physicians receive better patient satisfaction scores compared to female physicians. However, our study found that, in response to hypothetical scenarios of positive and negative dermatology encounters, dermatologist gender did not affect any domain of patient satisfaction scores. Limitations include the use of hypothetical patient–dermatologist encounters and possible lack of generalizability because the study was conducted at one academic center in southeast Michigan with a predominantly Caucasian patient population.

The Perinatal Loss Care Educational Programme and its Evaluation.

IntroductionWorking with bereaved parents is an immense challenge for professionals in the field of perinatal care and requires a high level of knowledge and skill. This article aims to evaluate the effectiveness of the Perinatal Loss Care blended educational programme.MethodsAn evaluative assessment was carried out using a scored questionnaire to gather pre- and post-programme data. Participants were medical and healthcare professionals (n=200) who participated in the programme voluntarily (the Medical Professional/Motivated group and the Others group) or were selected by their employer and for whom attendance was mandatory (the Medical Professional/Non/Motivated group).ResultsParticipants’ perception of their own knowledge and understanding of perinatal bereavement care was significantly higher on completion of the educational programme, proving its effectivity. There was a statistically significant effect on overall score in individual groups of respondents, as well as the whole set (p<0.001), with post-intervention scores higher than pre-intervention scores. No statistically significant differences in overall score were detected before participation in the educational programme in individual groups (p=0.204). Participants from the Medical Professional/Non/Motivated group achieved lower post-intervention scores to a significantly greater extent (p<0.05) and more often perceived the educational programme as being “very difficult” (χ2=20.66, df=6, P<0.01) compared to other groups.ConclusionsThe educational programme was assessed as effective. Care of bereaved parents has its specifics and healthcare professionals should possess a basic knowledge of how to provide sensitive care during this time.

Assessing the efficacy and experience of in-person versus telephonic psychiatric evaluations for asylum seekers in the U.S.

Psychiatric evaluations of asylum seekers in the U.S. play an important role in asylum cases; however, there are significant barriers to assessing asylum seekers’ psychological trauma. Telephonic psychiatric evaluations provide an opportunity to access important resources to bolster their case. In this retrospective study, we considered the efficacy of telephonic psychiatric evaluations and assessed their potential as a solution to meet the needs of asylum seekers. Ten affidavits produced from telephonic evaluations were compared to twenty produced from in-person evaluations using a standardized scoring rubric. Providers who conducted telephonic evaluations also completed a structured interview and a qualitative assessment of themes was conducted. Overall, there was a small, but non-significant difference in overall score. The presence of descriptions of cognitive complaints, appearance, motor activity and use of checklists were, however, all significantly lower in telephonic compared to in-person affidavits. Providers agreed that despite limitations, the ability to diagnose and advocate for asylum seekers is equivalent regardless of format. This study identifies that telephonic psychiatric evaluations produce comparable results to in-person evaluations with the benefit of reaching a hard to reach population. Evaluators, lawyers, and judges should consider these results in weighing the risk-benefits of a telephonic evaluation of an asylum seeker.

A semester-long critical thinking course in the first semester of pharmacy school: Impact on critical thinking skills

IntroductionTo determine whether critical thinking improved after student-pharmacists participated in a semester-long critical thinking course in the first semester of pharmacy school. MethodsStudents took the Health Sciences Reasoning Test-Numeracy (HSRT-N) on the first and last day of the course. The overall HSRT-N score, percentile ranking, and eight sub-categories within the HSRT-N (analysis, interpretation, inference, evaluation, explanation, induction, deduction, and numeracy) were evaluated. A multivariable quantile regression model evaluated the association between the post-test percentile and student age, at which campus the student was enrolled, and how many minutes the students required to take the test. ResultsThere were no significant differences in overall scores, percentile, or the sub-category scores with the exception of a significant increase in the analysis score and a significant decrease in the induction score. There was a greater increase for students in the lower quartiles on the pre-test compared to students in the higher quartiles on the pre-test. The largest percentile change occurred in students in the 25th–50th percentiles. ConclusionA statistically significant improvement in the analysis category of the HSRT-N and a greater increase for students in the lower quartiles on the pre-test to the post-test suggests students with the lowest quartiles on the HSRT-N would benefit the most from a critical thinking course.