Education In Years Research Articles

Determinants of the consumption of ultra-processed foods in the Brazilian population.

This article aims to evaluate the sociodemographic determinants of ultra-processed foods (UPF) consumption in the Brazilian population ≥ 10 years of age. The study used data from the personal and resident food consumption module of the Family Budget Surveys, grouping foods according to the NOVA classification of food processing. The classification and regression tree (CART) was used to identify the factors determining the lowest to highest percentage participation of UPF in the Brazilian population. UPF accounted for 37·0 % of energy content in 2017-2018. In the end, eight nodes of UPF consumption were identified, with household situation, education in years, age in years and per capita family income being the determining factors identified in the CART. The lowest consumption of UPF occurred among individuals living in rural areas with less than 4 years of education (23·78 %), while the highest consumption occurred among individuals living in urban areas, < 30 years of age and with per capita income ≥ US$257 (46·27 %). The determining factors identified in CART expose the diverse pattern of UPF consumption in the Brazilian population, especially conditions directly associated with access to these products, such as penetration in urban/rural regions. Through the results of this study, it may be possible to identify focal points for action in policies and actions to mitigate UPF consumption.

EFL instructors’ perceptions of integration digital transformation in EFL learning context in Higher Education

This paper explores the integration of digital technologies and tools in English as a Foreign Language (EFL) learning in Jordanian Higher Education through a qualitative open-ended online survey. It highlights the perceptions of 100 Jordanian EFL instructors, each with a minimum of five years of experience, on the digital transformation in the EFL learning process. The survey, consisting of ten open-ended questions, gathered in-depth insights on the benefits, challenges, and implications of this transformation. Thematic analysis was employed to analyze the qualitative data, revealing varied levels of experience, the use of diverse digital tools, and both technical and pedagogical challenges. Key findings include the positive impact of digital tools on teaching and learning experiences, enhanced student engagement, and opportunities for personalized learning and collaboration. The study concludes that leveraging digital resources can enhance EFL learner engagement and learning outcomes, inform future pedagogical practices, and shape the landscape of digital transformation in EFL Higher Education for years to come.

Perceptions of undergraduate nursing students regarding their competency in administering medications: A qualitative study

AimThis study aims to explore and describe self-reported perceptions of nursing students’ competence in the administration of medication. BackgroundMedication errors are a significant concern in hospitals, as they can result in serious harm and even death for patients. Nursing students play a crucial role in administering medication and preventing errors, but they are also prone to making mistakes. While numerous studies have extensively examined the factors that contribute to medication errors, few have focused on the assessment of competency among nursing students. DesignThis study employed a qualitative exploratory and descriptive design. MethodsA total of 10 undergraduate nursing students at a higher education institution consented to participate in face-to-face, semi-structured individual interviews. Data were collected between August and September 2022 using an interview guide. The interviews were audio recorded and analysed using Braun and Clarke's six steps of thematic analysis. ResultsThe study revealed two major themes: (1) ‘Perceived barriers to competency’, which include participants' concerns regarding making errors, knowledge in pharmacology, self-efficacy in mathematics and level of supervision; and (2) ‘Mechanisms for improvement’, which centre on enhancing simulation proficiency, improving supervision and integrating pharmacology education in year two of nursing training. ConclusionThe study findings suggest that student nurses face various barriers to competence, such as a fear of making mistakes, a lack of pharmacology knowledge and low self-confidence in calculating drug dosages. To address these issues, prioritising supervision is crucial to facilitate student learning and ensure safety. Future research should consider investigating the perspectives of nurse educators on pharmacology curricula.

Association Between Years of Education and Amyloid Burden in Patients With Subjective Cognitive Decline, MCI, and Alzheimer Disease.

Higher-educated patients with Alzheimer disease (AD) can harbor greater neuropathologic burden than those with less education despite similar symptom severity. In this study, we assessed whether this observation is also present in potential preclinical AD stages, namely in individuals with subjective cognitive decline and clinical features increasing AD likelihood (SCD+). Amyloid-PET information ([18F]Flutemetamol or [18F]Florbetaben) of individuals with SCD+, mild cognitive impairment (MCI), and AD were retrieved from the AMYPAD-DPMS cohort, a multicenter randomized controlled study. Group classification was based on the recommendations by the SCD-I and NIA-AA working groups. Amyloid PET images were acquired within 8 months after initial screening and processed with AMYPYPE. Amyloid load was based on global Centiloid (CL) values. Educational level was indexed by formal schooling and subsequent higher education in years. Using linear regression analysis, the main effect of education on CL values was tested across the entire cohort, followed by the assessment of an education-by-diagnostic-group interaction (covariates: age, sex, and recruiting memory clinic). To account for influences of non-AD pathology and comorbidities concerning the tested amyloid-education association, we compared white matter hyperintensity (WMH) severity, cardiovascular events, depression, and anxiety history between lower-educated and higher-educated groups within each diagnostic category using the Fisher exact test or χ2 test. Education groups were defined using a median split on education (Md = 13 years) in a subsample of the initial cohort, for whom this information was available. Across the cohort of 212 individuals with SCD+ (M(Age) = 69.17 years, F 42.45%), 258 individuals with MCI (M(Age) = 72.93, F 43.80%), and 195 individuals with dementia (M(Age) = 74.07, F 48.72%), no main effect of education (ß = 0.52, 95% CI -0.30 to 1.58), but a significant education-by-group interaction on CL values, was found (p = 0.024) using linear regression modeling. This interaction was driven by a negative association of education and CL values in the SCD+ group (ß = -0.11, 95% CI -4.85 to -0.21) and a positive association in the MCI group (ß = 0.15, 95% CI 0.79-5.22). No education-dependent differences in terms of WMH severity and comorbidities were found in the subsample (100 cases with SCD+, 97 cases with MCI, 72 cases with dementia). Education may represent a factor oppositely modulating subjective awareness in preclinical stages and objective severity of ongoing neuropathologic processes in clinical stages.

Exploring Undergraduate Nursing Students' Perceptions on Clinical Learning Environment in the UAE: A Focus on Perceived Benefits and Challenges.

Establishing a supportive clinical environment is paramount for enhancing nursing students' engagement in clinical practice, their clinical proficiencies, and satisfaction. The increase in nursing student enrollment at the Nursing College, driven by the collaborative efforts between Abu Dhabi Health Services Company (SEHA) and universities, has given rise to concerns regarding the quality of education and clinical instruction. These concerns are primarily due to the increased student-to-instructor ratio. Furthermore, the unsupportive clinical settings and learning tensions underscore the need to understand students' learning experiences and address research gaps within the field of clinical learning in the United Arab Emirates (UAE). The purpose of this study is to investigate the undergraduate nursing students' perceptions of their clinical learning environment, with a focus on perceived benefits and challenges. This study used a cross-sectional survey design. The researchers administered a five-point Likert scale questionnaire, which had been adapted and contextualized, to a convenience sample of 217 third and fourth-year nursing students who willingly participated in this study. Despite the presence of positive aspects, such as diverse clinical experiences and strong support from both clinical instructors and peers, several challenges affect the students' clinical learning. These challenges encompass disparate perceptions of supervision among staff nurses, learning tensions related to student academic workload, insufficient clinical supervision, and difficulties in finding assistance when needed. There is a clear need to enhance the overall ward learning environment to optimize students' academic motivation and clinical skills. Several measures can be taken to achieve this goal, including incentivizing and reducing the workload of staff nurses, investing in the professional development of clinical instructors, promoting peer interactions and group learning, and adopting a block pattern of education in years three and four for better clinical knowledge assimilation and reduced theoretical workload.

Is it really a neuromyth? A meta-analysis of the learning styles matching hypothesis.

Learning styles have been a contentious topic in education for years. The purpose of this study was to conduct a meta-analysis of the effects of matching instruction to modality learning styles compared to unmatched instruction on learning outcomes. A systematic search of the research findings yielded 21 eligible studies with 101 effect sizes and 1,712 participants for the meta-analysis. Based on robust variance estimation, there was an overall benefit of matching instruction to learning styles, g = 0.31, SE = 0.12, 95% CI = [0.05, 0.57], p = 0.02. However, only 26% of learning outcome measures indicated matched instruction benefits for at least two styles, indicating a crossover interaction supportive of the matching hypothesis. In total, 12 studies without sufficient statistical details for the meta-analysis were also examined for an indication of a crossover effect; 25% of these studies had findings indicative of a crossover interaction. Given the time and financial expenses of implementation coupled with low study quality, the benefits of matching instruction to learning styles are interpreted as too small and too infrequent to warrant widespread adoption.

EDUCATION AS A RISK FACTOR OF MILD COGNITIVE IMPAIRMENT—THE ROLE OF THE GUT MICROBIOME

Abstract Background Social determinants of health relate to an individual’s risk of MCI and dementia. However, pathways from identified modifiable risk factors such as education are not well understood, yet. While previous findings suggest distinct taxonomic signatures of the gut microbiome in dementia and MCI patients, and further education linked to its composition, we sought to test the possibly mediating role of the gut microbiome in the relationship between education and MCI. Method: Gut microbiome composition was ascertained with 16S rRNA gene amplicon sequencing. MCI classification was based on the Montreal Cognitive Assessment. Education in years was grouped (0-10, 10-16, 16+). Mediation analysis was conducted decomposing direct and indirect effects of education on MCI mediated by gut microbiome diversity (Chao1, Inverse Simpson, Shannon) or individual species at Genus level (ldm-med, permanova-med). Differential abundance analysis across education groups was conducted (ANCOM-BC, DESeq2). Result: After exclusion of participants with PD, below age 50, or with missing data, n=256 participants (n=58 with MCI) of the Luxembourg Parkinson’s Study were eligible for analysis (M[SD] Age=64.7[8.3] years). Education (16+ compared to 0-10 years of education) had a natural direct effect of NDE=0.36 (P&amp;lt;.01) on MCI, Chao1 included as mediator. We did not find significant mediation by gut microbiome composition or individual species. Conclusion Our findings indicate direct effects of education not mediated by the gut microbiome. Taxonomic analysis suggests a signature linked to lower risk of dementia in higher educated individuals. Longitudinal research is needed to investigate associations over time.

Associations between Distinct Trajectories of Cardiometabolic Risk Factors (Hypertension, Hypercholesterolemia, and Diabetes) over 15 Years Preceding Dementia and Incidence of Dementia

AbstractBackgroundCardiometabolic Risk Factors (Hypertension, Hypercholesterolemia, and Diabetes) have been reported inconsistently to associate with dementia, with both increased and decreased risks. The purpose of this study was to examine longitudinal distinct trajectories of cardiometabolic risk factors over 15 years preceding dementia with incident dementia using the large national dataset from National Alzheimer’s Coordinating Center (NACC).MethodWe used NACC dataset from 2005 to December 2020 and performed a nested case‐control study (up to 1 to 5 match). The sample included 720 cases of all‐causes dementia with at least 5–years follow‐up time preceding dementia diagnosis, and 2526 non‐dementia controls matched on age, sex, race, education and baseline cognitive status. Group‐based trajectory models were applied to identify longitudinal distinct trajectory groups of binary status measures (absent/inactive vs. recent/active) of hypertension, hypercholesterolemia and diabetes among this sample. Conditional logistic regression models were used to evaluate the effect of distinct trajectories of each cardiometabolic risk factor, APOE genotype and the interaction between them with incident dementia.ResultFor the case group (n = 720), mean age at enrollment was 75.5 years and average education in years was 15.6, participants were more female (58.7%), non‐Hispanic white (87.1%) and healthy cognitive status at initial visit (61.9%). All three binary outcome trajectory models identified similar three trajectory groups over 15 years preceding dementia: “low‐flat,” “low‐to‐high,” and “high‐flat”. Conditional logistic regression model revealed no significant main effects of hypercholesterolemia and hypertension as well as no interaction between them and APOE genotype on the incidence of dementia. However, there is borderline significant effect of diabetes trajectory group on the incidence of dementia. Comparing to “low‐flat” diabetes trajectory group, “high‐flat” group were more likely to develop dementia [OR = 1.32, 95% CI (0.99‐1.76), P = 0.056] after controlling APOE genotype.ConclusionOur findings suggest the existence of distinct trajectories of cardiometabolic risk factors preceding incident dementia. Active diabetes status may play an important role for developing dementia especially those who are with long‐term diabetes are with greater risk for the incidence of dementia.

Normative data on the CERAD Word List in a robustly intact sample of older adults

AbstractBackgroundList learning and memory tests are frequently used to evaluate older adults for late life cognitive disorders, such as Alzheimer’s disease. The Word List subtest of the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) neuropsychological battery has been widely‐used in clinical research, including clinical trials, to identify and track such disorders. It is also freely‐available, as it is in the public domain. However, normative data, especially in robustly intact older adults, is lacking.MethodCERAD Word List data from 897 older adults (age in years: M = 81.1, SD = 8.1, range 55‐100; 67% women; education in years: M = 14.8, SD = 2.8, range = 7‐24) deemed to be cognitively intact at two annual visits in a longitudinal observational study from the Uniform Data Set of the National Alzheimer’s Coordinating Center were used to generate predicted Word List scores based on age, sex, and education. Predicted scores were compared to observed scores to preliminarily validate these normative values.ResultFor six primary scores from the Word List subtest (Trial 1, Trial 2, Trial 3, Total Acquisition, Delay Recall, Recognition Total Correct), the three demographic variables significantly predicted test scores, with R2s ranging from 0.03 – 0.18 (p‐values&lt;0.001). When these predicted scores were compared to observed scores, there were no significant differences (p‐values&gt;0.40), indicating preliminary support for these prediction scores.ConclusionAlthough further validation is needed in independent intact and impaired samples, the current demographically‐based prediction scores provide normative data for the CERAD Word List subtest for older adults being evaluated for cognitive complaints. The inclusion of additional variables needs to be examined to improve the accuracy of these prediction scores. Nonetheless, normative data allows providers and researchers to be confident in using this learning and memory test in clinics and clinical trials.

Identifying change on the CERAD Word List with standardized regression‐based scores

AbstractBackgroundList learning and memory tests are frequently used to evaluate older adults for Mild Cognitive Impairment and Alzheimer’s disease. One such test, the Word List subtest of the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD), has been widely‐used in clinical trials track such disorders. However, data is lacking on the amount of change that is needed to accurately identify decline.MethodParticipants included 897 older adults (age in years: M = 81.1, SD = 8.1, range 55‐100; 67% women; education in years: M = 14.8, SD = 2.8, range = 7‐24) who were cognitively intact at two annual visits in a longitudinal observational study from the Uniform Data Set of the National Alzheimer’s Coordinating Center. Each participant completed the Word List subtest at two visits, which were approximately 1 year apart (interval in years: M = 1.3, SD = 1.0). Multiple linear regression predicted Time 2 scores from Time 1 scores and simple demographic variables (age, sex, education). The predicted Time 2 scores were compared to observed Time 2 scores to preliminarily validate this change data.ResultFor three primary scores from the Word List subtest (Acquisition Total Correct, Delay Recall Total Correct, Recognition Total Correct), the Time 2 scores were significantly predicted from the other variables, with R2s ranging from 0.16 – 0.41 (p‐values&lt;0.001). When these predicted Time 2 scores were compared to observed Time 2 scores, there were no significant differences (p‐values≧0.19), indicating preliminary support for these prediction scores.ConclusionThe current prediction equations appear to allow clinicians and researchers to accurately track change on the Word List subtest of the CERAD by comparing their patients/participants to the current sample of robustly intact older adults. Consistent with past work in this area, Time 1 cognitive scores were the best predictors of Time 2 cognitive scores, although demographic variables added to that prediction. Future work should consider if additional variables can improve the prediction equations. Future work should also validate these equations in independent samples to examine their clinical utility.

96 Health Factors and Psychosocial Factors as Predictors of Depressive Symptoms and the Association of Depressive Symptoms and Cognitive Functioning in Congolese Older Adults

Objective:Late-life depression is a complex condition impacted by both mental and physical health outcomes and psychosocial factors. Psychosocial predictors of depression are reliant on cultural factors including socioeconomic variables, stigmas, and cultural values. Most research on late-life depression and its effect on cognitive functioning has been completed in so-called Western, Educated, Industrialized, Rich, and Democratic (WEIRD) populations and findings may not generalize to older adults living in other areas of the world. The current study explored predictors of depressive symptoms as well as the association between depressive symptoms and neuropsychological functioning in Congolese older adults.Participants and Methods:A total of 319 participants (mean age=72.7±6.15, mean education in years=7.6±4.56; 47% female) were randomly recruited. Depressive symptoms were assessed with the Geriatric Depression Scale. Given the exploratory nature of the current study, forward stepwise linear regression models were run to assess predictors of depressive symptoms. The independent variables assessed as potential predictors included age, years of education, gender, participant income, parental income, living arrangement (i.e., alone or with others), functional abilities (FAQ), fragility, and self-rated overall health. Analyses were run in the overall sample as well as stratified by gender. The association between depressive symptoms and performance on the Community Screening Instrument for Dementia (SCID) was also explored.Results:Higher depressive symptoms were found in women (ß=.228, p=0.036), those with lower parental income (ß=-.156, p=.005), higher fragility (ß=-.237, p&lt;.001), and worse overall health (ß=-.311, p=.020). Among women, lower parental income, (ß=-.230, p=.002), higher fragility (ß=-.312, p&lt;.001), and lower overall health (ß=-.235, p=.004) predicted higher depressive symptoms, while in men only higher fragility (ß=-.164, p=.041) and living alone (ß=-.184, p=.022) predicted higher depressive symptoms. There was also a significant association between depressive symptoms and lower scores on the CSID (ß=-.189, p=.001)Conclusions:Similar to results in WEIRD populations, general health and fragility predicted depressive symptoms in Congolese older adults. However, parental income (more so than participant income) also predicted depressive symptoms in Congolese older adults, particularly in women, while living alone was a predictor in Congolese older men. It is possible that the difference in depressive symptoms between men and women is driven by underreporting of depressive symptoms among men. Our results also showed that there was an association between depressive symptoms and global cognitive functioning similar to prior findings in WEIRD populations. Our results are important for clinicians assessing depressive symptoms in patients in or from Congo or sub-Saharan Africa.

Associations between distinct trajectories of body mass index (BMI) over 15 years preceding dementia and incidence of dementia

AbstractBackgroundBMI has been reported to associate with dementia, with both increased and decreased risks. The purpose of this study was to examine longitudinal distinct trajectories of BMI over 15 years preceding dementia with incident dementia using the large national dataset from National Alzheimer’s Coordinating Center (NACC).MethodWe used NACC dataset from 2005 to December 2020 and performed a nested case‐control study (up to 1 to 4 match). The sample included 699 cases of all‐causes dementia with at least 5–years follow‐up time preceding dementia diagnosis, and 2120 non‐dementia controls matched on age, sex, race, education and baseline cognitive status. A group‐based trajectory model was applied to identify longitudinal distinct trajectory groups of BMI among this sample. Conditional logistic regression model was used to evaluate the effect of distinct trajectories of BMI, APOE genotype and the interaction between them with incident dementia.ResultFor the case group (n = 699), mean age at enrollment was 75.5 years and average education in years was 16.1, participants were more female (58.8%), non‐Hispanic white (86.8%) and healthy cognitive status at initial visit (64%). A three‐group linear trajectory model best fit BMI trajectory before the onset of dementia that featured a normal weight‐decreasing BMI group (45.5%), overweight‐decreasing BMI group (43.6%) and obese‐decreasing BMI group (10.9%). There is statistically significant linear decreasing trend over 15 years for each trajectory group (P&lt;0.0001). The average BMI at 15 years preceding dementia for each trajectory group was 22.7, 29.9 and 36.7 respectively. Conditional logistic regression model revealed significant interaction between BMI trajectory group and APOE genotype. Comparing to obese‐decreasing and ε4 non‐carriers, the ε4 carriers in either overweight‐decreasing group or obese‐decreasing group were more likely to develop dementia [OR = 1.53, 95% CI (1.00‐2.34), P = 0.05; OR = 1.88, 95% CI (1.06‐3.34), P = 0.03]. Especially, the ε4 carriers within normal weight‐decreasing BMI group had triple the likelihood of dementia ([OR = 3.25, 95% CI (2.13‐4.94), P&lt;0.0001].ConclusionOur findings suggest the existence of distinct developmental trajectories of BMI preceding incident dementia and the possible effect of gene‐environment interaction on dementia. The ε4 carriers within normal weight‐decreasing BMI trajectory group exhibited the highest risk of dementia.

Inverse relationship between education and amyloid burden in individuals with subjective cognitive decline plus and mild cognitive impairment

AbstractBackgroundHigher educated patients with MCI can tolerate more neuropathology than lower educated patients with similar clinical impairment. It is not known whether this observation also accounts for potential preclinical stages of AD, namely subjective cognitive decline plus (SCD+).MethodData of 197 SCD+ individuals, 227 MCI and 157 AD patients were included, which were collected as part of the AMYPAD‐DPMS cohort (https://amypad.eu/). First, median education in years was computed across the AD‐spectrum groups for each of the 8 European sites. Next, using a median split, the SCD+, MCI and AD cohort were separately categorized into a higher and lower educated group, excluding subjects with median education. Afterwards, the higher and lower educated AD‐spectrum groups were matched for age, sex and cognitive function (MMSE) using propensity score matching in R, leading to the following sample (low/high education): 54/54 SCD+, 70/81 MCI and 56/65 AD patients. Global amyloid load was compared between education groups using Centiloid (CL) information derived from Flutemetamol and Florbetaben PET scans. To confirm the results of the stringent group comparison, partial correlations between years of education and CL values correcting for age, sex and tracer type were performed for each AD‐spectrum group. All analyses were conducted in SPSS 28 and significance level was set to p &lt; .05.ResultHigher educated SCD+ subjects presented significantly (p &lt;. 001) lower CL values (M(CL) = 16.48) than lower educated SCD+ subjects (M(CL) = 32.17), whereas the opposite effect (p &lt; .046) was observed in the MCI cohort with higher educated MCI patients presenting greater CL values (M(CL) = 57.08) compared to the lower educated MCI group (M(CL) = 41.74). No difference was found in the AD group. Results were further confirmed by the correlation approach across the unmatched sample yielding a negative association between years of education and CL values in the SCD+ group (r = ‐.159, p = .027) and a positive association in the MCI group (r = .153, p = .022).ConclusionThese results indicate that sensitivity to early amyloid accumulation may possibly increase with higher education in potential preclinical stages of AD, whereas in clinical stages of AD higher education may support compensatory mechanisms against amyloid burden.

Meninjau Kembali Peran Strategis Pendidikan Islam di Indonesia

People continue to argue about education for years. Both Islamic religious education and the education system in general make people curious. Muslims believe that their education system should be holistic. This means combining spiritual, intellectual, emotional and physical development. It is based on teachings from the Qur'an and Hadith. This is done through qualitative research with a transcendental phenomenological approach. The study seeks to learn more about educators' experiences in helping autistic children learn. Qualitative research, as defined by its name, encourages an understanding of a subject through consideration of perceptions, motivations, behaviors and other aspects that help define it. This is achieved through the use of language and words to describe this experience holistically. . Formal education in Indonesia is in the form of Islamic education at the grassroots level. It is said that this is the first form of formal education in the country, especially at the national level. By fostering a general sense of learning rooted in respect, it is believed to have made a major contribution to Indonesia's current education system. It is clear that Islamic education plays a huge role in Indonesian culture. It is so pervasive throughout the country that students are encouraged to actively participate in public life to shape their character as Muslims and maintain their cultural and religious identity.

Does intellectual disability in children impact access to preventive dental services and oral health?

The aim of this study was to determine the access to preventive dental care and oral health among children with additional educational support needs as compared to normal children in primary education years. This was a population-based record-linkage study, where the data was retrieved from six different nationaldatabases. Children born in Scotland between years 2011 and 2014 and entered elementary school education in years 2016-19 were included and the corresponding information about their additional educational support needs (ASNs) was determined using a Pupil Census database. These children with intellectual disabilities were categorised as:intellectual disabilities, Autism spectrum, social learning-disabilities and other learning-disabilities. The data about their oral health, including caries experience and extractions under GA, and the data about their access to preventive dental care, including professional brushing instructions, fluoride varnish (FV) applications etc. was retrieved from other national databases. The caries experience and access to dental care was compared for these special children with that of normal children without any ASNs. Among primary outcomes, significantly higher caries experience was recorded among children with 'social'(aRR = 1.42, CI = 1.38-1.46) and 'other'(aRR = 1.17, CI = 1.13-1.21) ASNs, while higher risk of extractions under GA was found in ID (aRR = 1.67, CI = 1.16-2.37), social (aRR = 1.24, CI = 1.08-1.42) groups while autism group showed nonsignificant higher risk (aRR = 1.12, CI = 0.79-1.53). Among secondary outcomes, significantly less attendance at general/public dental practice was recorded for all the intellectual disabilities' groups, with least attendance by children with social ASNs (aRR = 0.51 CI = 0.49-0.54). Least exposure to professional advice was received by autism group (aRR = 0.93, CI = 0.87-0.99). Further, all the groups showed less participation in nursery toothbrushing (NTB) and FV program at school; while least exposure to these preventive programs was depicted by children with social ASNs (NTB: aRR = 0.89, CI = 0.86-0.92, FV aRR = 0.95, CI = 0.92-0.98). Children with intellectual disabilities have poor access to preventive dental care and also exhibit higher incidence of caries experience and extractions.

The MetaPharmacy: What Happens When Big Pharma Goes Virtual?

The MetaPharmacy: What Happens When Big Pharma Goes Virtual?

Intergenerational educational attainment among Latino and White men and women and incident risk for dementia and cognitive impairment without dementia

AbstractBackgroundLate life cognitive outcomes may depend on an individuals’ and their parents’ educational attainment levels. We evaluate the association of intergenerational education on dementia/Cognitive impairment without dementia (CIND) risk for Latino compared to White men and women.MethodWe analyzed data from 26,643 US Health and Retirement Study (HRS) Latino and non‐Hispanic white participants from 1998‐2016 (new entry cohorts enrolled every 6 years). Age‐eligible (50+ years at enrollment) respondents without probable dementia/CIND at baseline were included in the analyses with follow‐up waves every 2 years. Exposure was a 4‐category variable based on participants’ and parents’ (highest of mother’s or father’s) education in years: 1) first‐generation high‐school graduate (participant≥12; parents’ education&lt;12); 2) multi‐generation (both≥12: reference); 3) only parents graduated high school but not respondent (participant&lt;12; parent(s)≥12); and 4) neither parents nor participant completed high school (both&lt;12). Probable dementia/CIND cases were classified using the Langa‐Weir 27‐point scale. We used Cox proportional hazard models to evaluate the association between education and dementia/CIND risk and included interactions to evaluate effect modification by gender and race/ethnicity.ResultOur sample was 9% Latino, 46% men and 31% were classified with probable dementia/CIND during follow‐up from 2000‐2016 (mean follow‐up: 9 years). Compared to multi‐gen, first‐gen graduates showed higher dementia/CIND risk (HR:1.49 [95% CI: 1.40, 1.60]) independent of demographic factors. The magnitude of increased risk was smaller for men compared to women (interaction term:0.78 [0.70, 0.89]) and did not vary for Latinos compared to whites. Compared to multi‐gen, only parent graduate showed higher dementia/CIND risk (HR:2.21 [2.05, 2.37]), and the magnitude of risk was greatest for Latino compared to white men (interaction term:1.31 [0.77, 2.23]). Lastly, compared to multi‐gen, neither‐graduates showed higher dementia/CIND risk (HR:2.37 [2.14, 2.64]); association did not vary by gender or race/ethnicity.ConclusionWhile all groups showed increased risk for dementia/CIND compared to multi‐gen high school graduates, the most disadvantaged were downwardly mobile Latino men. Our findings suggest declines in dementia risk potentially attributable to growing educational attainment may persist in the future and be especially marked for racial/ethnic groups historically excluded from educational policies rendering high school completion.

Current Status of Immunology Education in U.S. Medical Schools

Immunology is an integral component of undergraduate medical education because of its critical role in many disease processes. Due to the complexity of the subject, the best practice of immunology education in the undergraduate medical curriculum has not been extensively discussed. This study intended to determine the current status of immunology education in U.S. medical schools with the hope of providing insight into curriculum design pertaining to this subject. Immunology curriculum information was collected from the curriculum Web pages of 199 U.S. medical schools, including multiple campuses. Data pertaining to the setting of immunology education such as subjects that are co-taught with immunology, timing of courses, credit hours, and integration level were recorded in Microsoft Excel for analysis. Of 199 U.S. medical schools studied, 174 posted curriculum information related to immunology online. For course settings, 59 (33.9%) offer immunology with microbiology, 42 (24.1%) offer immunology as part of a foundational sciences course, and 18 (10.3%) offer immunology as a stand-alone course. Ten programs (5.7%) have immunology fully integrated in system-based curriculum. Of 119 medical schools that provide information regarding timing, 94 (71.9%) provide immunology education in year 1 of the curriculum, 16 (9.2%) in year 2, and 9 (5.2%) in both years 1 and 2. Differences exist in allopathic versus osteopathic programs in the immunology curriculum setting. Credit hour data were not complete due to inconsistent availability. Our data suggest that immunology education in U.S. medical schools lacks consensus. Continued discussion on best practices of immunology education across U.S. medical schools is recommended.

Southeast Asian Students’ Perspective in Science and science education

The study describes the attitudes and beliefs towards science and science education of Year 9 and 10 Southeast Asian students including gender and year level differences based on the seven categories. This study involved Year 9 and 10 students from seven SEAMEO countries. Out of 5,375 samples selected, 2,158 were boys and 3,217 were girls. There were seven categories in the survey instrument that was administered, including students’ perceptions about: (1) science; (2) science outside school; (3) science topics; (4) scientist vocation; (5) self-efficacy in science; (6) teaching and learning science; as well as (7) future participation in science. The analyses showed that generally students had positive attitudes on categories such as: science, science outside school, teaching and learning science, scientist vocation, science topics and future participation in science. However, in general, the students in this region had slightly low self-efficacy in science in which included items such as science as a difficult subject and science classes are boring. The results also showed that Year 9 and boys acted more positively than Year 10 and girls in the attitudes and beliefs towards science. Further research and recommendations are explored. The findings would be used as a tool to revise the national science curriculum of the participating countries in terms of content standards and inform teachers of how teaching and learning practices can be aligned with students’ attitudes and perceptions to obtain better learning outcomes. The research findings could also be used as a springboard for further research exploring deeper the variables affecting students’ success in science and providing intervention for teachers’ training curriculum and continuing professional development in terms of technological pedagogical content knowledge (TPACK) that would increase the interest of students in learning and exploring science.

Adverse childhood experiences and fronto-subcortical structures in the developing brain.

The impact of adverse childhood experiences (ACEs) differs between individuals and depends on the type and timing of the ACE. The aim of this study was to assess the relation between various recently occurred ACEs and morphology in the developing brain of children between 8 and 11 years of age. We measured subcortical volumes, cortical thickness, cortical surface area and fractional anisotropy in regions of interest in brain scans acquired in 1,184 children from the YOUth cohort. ACEs were based on parent-reports of recent experiences and included: financial problems; parental mental health problems; physical health problems in the family; substance abuse in the family; trouble with police, justice or child protective services; change in household composition; change in housing; bereavement; divorce or conflict in the family; exposure to violence in the family and bullying victimization. We ran separate linear models for each ACE and each brain measure. Results were adjusted for the false discovery rate across regions of interest. ACEs were reported for 83% of children in the past year. Children were on average exposed to two ACEs. Substance abuse in the household was associated with larger cortical surface area in the left superior frontal gyrus, t(781) = 3.724, pFDR = 0.0077, right superior frontal gyrus, t(781) = 3.409, pFDR = 0.0110, left pars triangularis, t(781) = 3.614, pFDR = 0.0077, left rostral middle frontal gyrus, t(781) = 3.163, pFDR = 0.0195 and right caudal anterior cingulate gyrus, t(781) = 2.918, pFDR = 0.0348. Household exposure to violence (was associated with lower fractional anisotropy in the left and right cingulum bundle hippocampus region t(697) = −3.154, pFDR = 0.0101 and t(697) = −3.401, pFDR = 0.0085, respectively. Lower household incomes were more prevalent when parents reported exposure to violence and the mean parental education in years was lower when parents reported substance abuse in the family. No other significant associations with brain structures were found. Longer intervals between adversity and brain measurements and longitudinal measurements may reveal whether more evidence for the impact of ACEs on brain development will emerge later in life.