Improvement In Test Scores Research Articles

Ethno-Regional Favoritism and the Political Economy of School Test Scores

The northern provinces of Burundi have suffered from an inferior education system since independence. This paper shows that the current, northern-led regime has chosen a drastic way to reverse that subordination. The national test (Concours National) at the end of primary school is at the heart of the matter. Using the universe of individual test score data which can be used to construct a school-level panel and applying differencein-differences analysis, the paper shows strong improvements in test scores in northern versus southern schools since the ruling party won an absolute majority in the 2010 elections. Immediately after these elections, schools situated in very poor, rural areas in the north scored as high as schools in non-poor areas of the capital. The paper finds that increased success rates, improved mean test scores and decreased standard deviations are explained by the percent of votes at the municipality level obtained by the ruling party in the 2010 parliamentary elections. Controlling for school budget and cohort size variables does not change the results. The latter are interpreted in the political economy of education reform in Burundi and considered as a case of ethno-regional favoritism in Africa.

THE EFFECT OF A GENRE-BASED PEDAGOGICAL APPROACH ON ORANG ASLI STUDENTS’ EFL WRITING PERFORMANCE

Purpose – In the 21st century, the importance of having good English proficiency in Malaysia and globally has impacted educators, especially in terms of their pedagogical practices. Although students are exposed to 11 years of English language instruction in Malaysia, Orang Asli students still possess low English proficiency and poor writing skills. This study aims to determine the extent to which the genre-based pedagogical approach is able to improve Orang Asli students’ English as a foreign language (EFL) writing performance and analyse their responses in using the genre-based pedagogical approach as a framework to improve their EFL writing performance. Methodology – This quasi-experimental study included 78 students from a secondary school in Pahang, Malaysia. Participants were assigned to the experimental and control groups (N=39) to generate students’ pretest and posttest scores. Quantitative data from the students’ questionnaire were also triangulated with qualitative data from the focus group discussions with the experimental group. Findings – The approach was effective in improving students’ descriptive writing and had a more significant effect than the mainstream process-based approach. Students reacted positively to the approach as they found it useful in improving their writing skills, which correlated with their improved test scores. Therefore, the genre-based pedagogical framework can be further enhanced by incorporating more grammar-related activities to meet the learning needs of Orang Asli students lacking in EFL writing skills. Significance – The novelty of this study is that the framework has the potential to be implemented in Malaysian secondary schools and other indigenous’ educational contexts. Furthermore, this study can be a point of reference to stakeholders, English language teaching (ELT) practitioners and educators in terms of advocating a genre-based pedagogical approach in an EFL context.

Substance use Pattern Analysis among Spanish Medical Students

Background and objectivesSubstance use and the increasing consumption of energy drinks are currently severe social health problems, and medical students are not an exception. The study’s aims are to know the prevalence of different legal and illegal substances consumption among them (energy drinks included), and to evaluate different consequences and their aims for using them. Prevalence rates were compared to other national and international medical student samples and to general population of the same age range.MethodsA cross-sectional descriptive study was carried out in 168 medicine students in Las Palmas de Gran Canaria who responded a survey on their substances use.ResultsAlmost all of the study participants (162 (96.4%)) had ever tried/taken alcohol in their lifetime, 131 (78%) had consumed energy drinks, 109 (64.9%) had taken tobacco and 86 (51.2%) had taken cannabis. Main consequences included hangover 120 (71.4%), nausea or vomiting 100 (59.5%), and repenting of something done under the effect of substances 70 (41.7%). Looking for an improvement of their academic performance, 96 (57.1%) and 76 (45.2%) of medical students admitted having increased substance use and energy drinks consumption respectively.ConclusionsThe prevalence of alcohol, tobacco, cannabis, anxiolytics and amphetamines abuse is higher among medical students as compared to the general population. Energy drinks are widespread used (specifically higher for males). Almost half of medical students acknowledged having increased their consumption to improve test scores.

A comparitive study on square stepping exercise versus balance training exercises on fear of fall and balance in parkinsonism patients

To study the effect of square stepping exercise and balance exercise to improve balance impairment and reducing the fear of falling on Parkinsonism patient. This is a pre-test and post-test experimental design comparative in nature. Subject aged between 60 – 70 years having Parkinson’s disease were included for the study. Group A (15 subjects) participated in square stepping exercise for 5 times in a week for 4 weeks and Group B (15 subjects) participated in balance exercise for 5 times in a week for 4 weeks. The outcome was measured by using Berg balance scale, Time up and go (TUG) test and fall efficacy scale. Statistical analysis done by using pair ‘t’ test and unpair ‘t’ test showed that there is significant improvement in subject who underwent the square stepping exercise program compared to balance exercise on fear of fall and balance in parkinsonism patients. It is concluded that square stepping exercise group exhibited statistically significant improvement in Berg Balance Scale, Time up and Go test score and fall efficacy test score compared to the balance training exercise group.

School Entry Plays an Insignificant Role in Attention Performance, Impulse Control, and Motor Activity of Same-Aged Children from Preschool and Elementary School.

The transition from preschool to elementary school places demands on children to pay attention, control their impulses, and avoid fidgeting. However, to the best of our knowledge, no studies have investigated whether these characteristics are influenced by elementary school entry. The current study compares same-aged preschool and elementary-school children regarding their attention performance, impulse control, and motor activity. A total of 60 children (30 preschool and 30 elementary school; 6 years old) underwent the Quantified Behavior (Qb) Test. The children's parents responded to a conventional questionnaire for measuring attention-deficit/hyperactivity disorder. We found that formal schooling (mean: 3 months) did not significantly affect the examined variables (p > .05). The results imply that improvements in questionnaire and computer test scores shown by previous studies are rather caused by maturation than the educational context. The assumption that inattention ratings increase after school entry because inattention can be better observed in an academic setting could not be verified either. Our study substantiates that the normative data used in clinical practice need not consider the educational context.

Psychosocial factors and lack of asthma knowledge undermine child and adolescent adherence to inhaled corticosteroid

Objective: This study aimed to evaluate inhaled corticosteroid (ICS) adherence and identify factors associated with nonadherence in pediatric asthma patients. Methods: A total of 134 patients aged 8–18 years old were included. At the first visit, patient adherence, asthma knowledge, and outcome expectation data were collected and recorded. Depression, anxiety, and self-esteem were assessed using psychiatric questionnaires. After providing asthma education, reevaluation of adherence and asthma control was performed at one 3- to 6-month follow-up visit. Results: The mean ICS adherence was 75.9 ± 27.5%. Fifty-seven patients (42.5%) were defined as having poor adherence (<75%). “Intentional” and “hectic lifestyle and forgetfulness” were the main reasons for missing ICS doses in mid-late adolescents and children, respectively. Asthma knowledge generally improved with age. Overall, 89% and 67.7% of patients could define symptoms and triggers of asthma, respectively; however, less than 25% understood how asthma affected their body and the chronic nature of asthma. Patients with ICS adherence <75% had unfavorable expectations from asthma treatment (odds ratio [OR]: 1.05, 95% confidence interval [CI]: 1.01–1.10), and a higher proportion of inhaled short-acting beta-agonist use before exercise (OR: 4.12, 95% CI: 1.27–13.36). Depression and anxiety were frequently found (27.5%) and 23.3%, respectively; p > 0.05). Significant improvement in ICS adherence (p = 0.02) and Asthma Control Test scores (p = 0.02) were observed at the follow-up visit. Conclusions: Patient outcome expectations could be predictors of ICS adherence. Patient education regarding the mechanism and nature of asthma should be considered as an intervention for improving pediatric patient adherence. Psychological evaluation is warranted in pediatric patients with asthma.

Role of 3D printing technology in paediatric teaching and training: a systematic review

BackgroundIn the UK, undergraduate paediatric training is brief, resulting in trainees with a lower paediatric knowledge base compared with other aspects of medicine. With congenital conditions being successfully treated at...

Can Cranioplasty Be Considered a Tool to Improve Cognitive Recovery Following Traumatic Brain Injury? A 5-Years Retrospective Study.

Cranioplasty (CP) is a neurosurgical intervention of skull repairing following a decompressive craniectomy. Unfortunately, the impact of cranioplasty on cognitive and motor function is still controversial. Fifteen TBI subjects aged 26–54 years with CP after decompressive craniectomy were selected in this observational retrospective study. As per routine clinical practice, a neuropsychological evaluation carried out immediately before the cranioplasty (Pre CP) and one month after the cranioplasty (T0) was used to measure changes due to CP surgery. This assessment was performed each year for 5 years after discharge in order to investigate long-term cognitive changes (T1-T5). Before cranioplasty, about 53.3% of subjects presented a mild to severe cognitive impairment and about 40.0% a normal cognition. After CP, we found a significant improvement in all neuropsychological test scores. The more significant differences in cognitive recovery were detected after four years from CP. Notably, we found significant differences between T4 and T0-T1, as well as between T5 and T0-T1-T2 in all battery tests. This retrospective study further suggests the importance of CP in the complex management of patients with TBI showing how these patients might improve their cognitive function over a long period after the surgical procedure.

Endoscopic Sinus Surgery for Cystic Fibrosis: Variables Influencing Sinonasal and Pulmonary Outcomes.

Endoscopic sinus surgery is a well-established treatment for chronic rhinosinusitis in patients with cystic fibrosis, though its benefits seem to be limited to improving sinonasal symptoms rather than affecting lung function. This study aims to identify clinical and demographic factors that may influence sinonasal and pulmonary outcomes after surgery. This is a six-year retrospective analysis of adult cystic fibrosis patients who underwent endoscopic sinus surgery at a tertiary care center. 22-Item Sino-Nasal Outcomes Test scores and mean forced expiratory volume data at baseline and three to six months after surgery were analyzed using t-test and stepwise regression with the following covariates: age, gender, lung transplant, revision surgery, and pseudomonas on sinus culture. 119 surgeries were performed on 88 patients, with 69% on patients with transplant. The overall mean (Standard Deviation) improvement in 22-Item Sino-Nasal Outcomes Test score was 9.42 (18.15) for the entire cohort (P < .001). Pseudomonas on culture was associated with less improvement in sinonasal scores (P = .002). There was no significant change in forced expiratory volume after surgery (P = .94). Revision surgery (P = .004) and older age (P = .007) were associated with less favorable change of pulmonary function on stepwise regression (P = .002). There was no correlation between change in sinonasal scores and pulmonary function. Although surgery was associated with a clinically and statistically significant improvement in sinonasal scores in cystic fibrosis patients, patients with pseudomonas may experience less benefit. Revision surgery and older age may be associated with less favorable pulmonary outcomes. Awareness of such variables may help when deciding which cystic fibrosis patients should undergo surgery.

Abstract 9117: Heart Failure E-learning Training for Low Income Countries is Effective and Feasible: A Pilot Study

Introduction: Heart failure (HF) is a burden in low income countries (LICs). However, HF care is complex and skilled providers in LICs are limited. E-learning (EL) could offer access to specialized HF training, but little is known about its feasibility in rural LICs. We describe the design and pilot study of an EL HF module. Methods: An interdisciplinary team from Partners In Health adapted an existing classroom based HF curriculum for an online, self-guided, asynchronous EL format. We emphasized design features promoting user engagement (clinical cases, animations, interactions) and functionality (download for offline viewing). Due to paucity of EL data in LICs, an introduction to Heart Failure pilot module was used to evaluate implementation.In phase 1, we evaluated usability among 7 experienced HF providers in Rwanda, Malawi, and Liberia. In phase 2, we assessed the ability of 19 novice providers in Rwanda to learn concepts using EL ( Figure 1) . Pre and posttests, post-course surveys, and semi-structured group interviews were used for evaluation. Results from phase 1 informed changes piloted in phase 2. Results: Providers from both phases improved test scores with a significant change among novices ( Figure 1 ). Figure 2 summarizes key findings identified in surveys and focus group analyses. Discussion: An EL module teaching basic HF concepts is feasible and shows early signs of effectiveness in rural LICs. EL training modules may benefit from interactive content, reliable internet, and a simple interface. EL may facilitate HF training for both novice and experienced providers through decentralized programs like the Package of Essential Noncommunicable Disease Plus (PEN-Plus).

Correlation between telomere length and efficacy of oral and long-acting injectable antipsychotics on severity and cognitive impairment of schizophrenia

Objective To study the correlation between telomere length (TL) and long-acting injectable (LAI) and oral atypical antipsychotic (OAA) efficacy on schizophrenia (SCZ) severity and cognitive impairment. Methods Sixty Schizophrenia patients of 18–50 years and of either sex were included in a 12-week study. Thirty patients were recruited in each group, LAI and OAA. Positive and Negative Syndrome Scale (PANSS) and National Institute of Mental Health and Neuro-Sciences (NIMHANS) neuropsychological battery tests were evaluated at baseline and 12 weeks. TL was estimated at baseline. Results Both groups showed a significant improvement in PANSS and NIMHANS battery test scores after treatment (p < 0.001) within the group, though not between the groups. Mean TL at baseline was 407.58 ± 143.93 and 443.40 ± 178.46 in LAI and OAA groups respectively. A significant negative correlation (r = −0.28, p = 0.03) of TL was seen with the mean change in negative PANSS score after treatment. Conclusions LAI antipsychotics are similar to OAA in decreasing the disorder severity and improving the cognitive impairment in schizophrenia. Also, patients who have shorter TL show greater improvement in the negative PANSS score. Hence, TL holds the potential of predicting antipsychotic drug response in schizophrenia patients. KEY POINTS Long-acting injectable antipsychotic was comparable to oral atypical antipsychotics in bringing out improvement in disorder severity, cognitive functions over 12 weeks. Shorter telomere length has been found to be associated with a greater response in negative symptoms of schizophrenia.

Forced oscillatory parameters as predictors of COPD assessment test improvement in untreated COPD patients

BackgroundFew studies have examined whether baseline spirometry and the forced oscillation technique (FOT) would predict The COPD Assessment Test (CAT) score improvement after treatment of untreated COPD patients. MethodsThe study subjects included 65 untreated COPD patients. They underwent the CAT, spirometry, and FOT (MostGraph) before and after treatment for more than 2 months. In addition, recursive partitioning analysis was performed using spirometry and the FOT parameters to identify the predictors of CAT improvement (CAT score ≥2). ResultsCAT scores and lung function significantly improved after treatment. Recursive partitioning analysis identified 3 improved classes, defined by Rrs at 20 Hz (R20), Xrs at 5 Hz (X5), and ΔX5, but not by spirometry. The accuracy of predicting CAT improvement was as follows: odds ratio, 25.3; 95 % confidence interval, 6.1 to 104.1; sensitivity, 91.2 %; specificity, 71.0 %; positive likelihood ratio, 3.14; and negative likelihood ratio, 0.12. ConclusionsFOT helps predict improved health status in untreated COPD patients.

A collaborative escape room as gamification strategy to increase learning motivation and develop curricular skills of occupational therapy students

BackgroundThis study presents an experiment regarding the introduction of gamification strategies in occupational therapy courses. Based on previous studies, the objective is to adapt the idea of recreational escape rooms to educational environments of health sciences like occupational therapy to increase student motivation and promote game-based learning and key skills, such as teamwork.MethodsComputer software was created for a collaborative escape room which allows on-line simultaneous play of up to 24–30 students. It was tested three times in an occupational therapy degree program with 75 students and it was based on two different subjects, although it can be adapted to others. The escape room was evaluated using feedback surveys and comparing students’ performances before and after the game. Descriptive exploratory statistical analysis was performed using SPSS version 24.ResultsAn appropriate use of educational escape rooms can have significant positive impacts on students’ engagement and learning. Students were found to prefer using gamification tools in their learning. Their degrees of satisfaction exceeded their expectations.ConclusionsEducational escape rooms may have a positive impact on students’ motivation and a statistically significant improvement of test scores after playing was found. Comments from the feedback surveys were used to improve successive versions of the software and design of the game.Trial registrationT.F.G. n° 2020.038 (Research Ethics Committee of the Principality of Asturias).

A task-based learning strategy in preclinical medical education.

Preclinical task-based learning (TskBL) is a simulated learning approach in which the focus for students is a real task done by a medical professional. TskBL includes standardized patient encounters and is helpful to provide early clinical exposure. Our study aimed at planning, implementing, and assessing TskBL among first-year medical students and comparing it to the conventional method of tutorials in the physiology MBBS curriculum. This is a nonequivalent group quasi-experimental study approved by the institutional ethics committee. TskBL was conducted for seven topics among first-year medical students of Kasturba Medical College, Mangalore for three academic years. Participants were divided into a TskBL group and a control group. Both groups attended the theory classes in physiology, practical sessions, and clinical examinations concerning the tasks. After this, the TskBL group underwent TskBL, and the control group underwent tutorials. Pretest and posttest assessments were conducted by using a multiple choice question (MCQ) test and objective structured clinical examinations (OSCEs).The mean TskBL scores for MCQ (exception: hypertension, myasthenia gravis, and chronic obstructive pulmonary disease) and OSCE (exception: anemia and hypertension) were significantly higher than the tutorial group. Pretest and posttest scores revealed significantly higher MCQ and OSCE scores for TskBL (exception: MCQ score for hypertension and chronic obstructive pulmonary disease). The tutorial group did not show a significant improvement in test scores for all the tasks. The TskBL strategy could be used for topics that are likely to be encountered by the students during clinical attachments. Small group teaching can include TskBL in preference to tutorials to provide early clinical exposure in medical schools.

Does a Structured Clinical Training Focused on Range of Motion and Spasticity Assessment Improve Therapist Reliability When Assessing Children with Neuromuscular Diagnoses?

<h3>Research Objectives</h3> 1) To investigate inter-rater agreement of lower extremity (LE) range of motion (ROM) and spasticity assessment in children with neuromuscular disorders among physical therapists (PT) before and after training, 2) investigate whether training improves ROM documentation consistency, and 3) investigate PT perceptions of clinical assessment of ROM and spasticity. <h3>Design</h3> Correlational. <h3>Setting</h3> Hospital-based outpatient PT department. <h3>Participants</h3> 12 PTs with at least one year pediatric experience, two highly experienced PTs, and 13 children, 5-18 years old with known neuromuscular diagnoses. <h3>Interventions</h3> PTs completed a clinical practice/perceptions questionnaire and assessed the children's LE ROM and spasticity before and after participating in training. Training included standardized evidence-based online and hands-on assessment of LE ROM and spasticity. A test was given before and after online training. <h3>Main Outcome Measures</h3> LE ROM was assessed using a standard goniometer (9 measurements, one predetermined LE) and spasticity was assessed using the Modified Modified Ashworth Scale (MMAS). The questionnaire included 15 10-point Likert scale items covering PT confidence, frequency, and perceived need for LE ROM and spasticity assessment training. The online test included 20 questions covering the assessment of LE ROM and spasticity. <h3>Results</h3> There was no difference in average ROM between PTs and expert before (10.74°) and after training (10.76°). PT documentation consistency improved after training. Spasticity assessment agreement between PTs and expert did not significantly improve before (47%) to after training (50%). Inter-rater agreement did not significantly improve, 53% pre and post. Inter-rater agreement kappa values with expert were .35 (pre-training), and .39 (post-training). Test scores demonstrated evidence of improvement after online training, 24% average increase. Pre-questionnaire average score for confidence was 5.29, need for training 8.31, training would be beneficial 9.14. <h3>Conclusions</h3> Experienced PTs indicated a need for additional LE ROM and spasticity assessment training. After training, issues with reliability and agreement of measures continued. Post-online training test score improvement indicated increased didactic knowledge; however, this didn't translate into improved performance. Training program modifications are need to address inconsistencies found. Further assessment with a larger cohort of PTs is needed. <h3>Author(s) Disclosures</h3> The authors declare no conflict of interest.

Night Vision and Carotenoids (NVC): A Randomized Placebo Controlled Clinical Trial on Effects of Carotenoid Supplementation on Night Vision in Older Adults.

Twilight and low luminance levels are visually challenging environments for the elderly, especially when driving at night. Carotenoid rich diets are known to increase macular pigment optical density (MPOD), which in turn leads to an improvement in visual function. It is not known whether augmenting MPOD can lead to a decrease in vision related night driving difficulties. Additionally, it is unknown if carotenoid supplementation provides additional measurable benefits to one’s useful field of view (UFOV) along with a decreased composite crash risk score. The aim of the study was to evaluate changes in night vision function and UFOV in individuals that took carotenoid vitamin supplements for a six-month period compared to a placebo group. Methods: A prospective, randomized, double-blind, six-month trial of a 14 mg zeaxanthin/7 mg lutein-based supplement was carried out. Participants were randomized into active or placebo group (approx 2:1). Results: n = 33 participants (26 males/7 females) participated with 93% capsule intake compliance in the supplemented group (n = 24) and placebo group (n = 9). MPOD (mean/standard error SE) in the active group increased in the Right eye from 0.35 density units (du)/0.04 SE to 0.41 du/0.05 SE; p < 0.001 and in the Left eye from 0.35 du/0.05 SE to 0.37 du, p > 0.05). The supplemented group showed significant improvements in contrast sensitivity with glare in both eyes with improvements in LogMAR scores of 0.147 and 0.149, respectively (p = 0.02 and 0.01, respectively), monocularly tested glare recovery time improved 2.76 and 2.54 s, respectively, (p = 0.008 and p = 0.02), and we also noted a decreased preferred luminance required to complete visual tasks (p = 0.02 and 0.03). Improvements in UFOV scores of divided attention (p < 0.001) and improved composite crash risk score (p = 0.004) were seen in the supplemented group. The placebo group remained unchanged. Conclusions: The NVC demonstrates that augmenting MPOD in individuals with difficulty in night vision showed measurable benefits in numerous visual functions that are important for night vision driving in this small sample RCT. Additionally, we observed an improvement in UFOV divided attention test scores and decreased composite risk scores.

Pre-clinical medical student cardiac point-of-care ultrasound curriculum based on the American Society of Echocardiography recommendations: a pilot and feasibility study

BackgroundCardiac point-of-care ultrasound (POCUS) training has been integrated into medical school curricula. However, there is no standardized cardiac POCUS training method for medical students. To address this issue, the American Society of Echocardiography (ASE) proposed a framework for medical student cardiac POCUS training. The objective of this pilot study was to develop a medical student cardiac POCUS curriculum with test scoring systems and test the curriculum feasibility for a future definitive study.MethodsBased on the ASE-recommended framework, we developed a cardiac POCUS curriculum consisting of a pre-training online module and hands-on training with a hand-held ultrasound (Butterfly iQ, Butterfly Network Inc., Guilford, CT, USA). The curriculum learning effects were assessed with a 10-point maximum skill test and a 40-point maximum knowledge test at pre-, immediate post-, and 8-week post-training. To determine the curriculum feasibility, we planned to recruit 6 pre-clinical medical students. We semi-quantitatively evaluated the curriculum feasibility in terms of recruitment rate, follow-up rate 8 weeks after training, instructional design of the curriculum, the effect size (ES) of the test score improvements, and participant satisfaction. To gather validity evidence of the skill test, interrater and test-retest reliability of 3 blinded raters were assessed.ResultsSix pre-clinical medical students participated in the curriculum. The recruitment rate was 100% (6/6 students) and the follow-up rate 8 weeks after training was 100% (6/6). ESs of skill and knowledge test score differences between pre- and immediate post-, and between pre- and 8-week post-training were large. The students reported high satisfaction with the curriculum. Both interrater and test-retest reliability of the skill test were excellent.ConclusionsThis pilot study confirmed the curriculum design as feasible with instructional design modifications including the hands-on training group size, content of the cardiac POCUS lecture, hands-on teaching instructions, and hand-held ultrasound usage. Based on the pilot study findings, we plan to conduct the definitive study with the primary outcome of long-term skill retention 8 weeks after initial training. The definitive study has been registered in ClinicalTrials.gov (Identifier: NCT04083924).

Can training trunk musculature influence musculoskeletal pain and physical performance in military police officers?

To investigate the effect of a Trunk Training (TT) program on the general musculoskeletal pain (GMP) and physical performance of Military Police Officers. Twenty officers were divided into either control group (CG) or TT group (TTG). Both groups performed nine weeks of traditional physical training. However, the TTG had 25-minutes allocated to TT during each scheduled physical training period. Anthropometric, trunk endurance, and physical fitness tests were completed pre- and post-training for both groups. Both groups also answered a weekly questionnaire about their GMP. Post-training, trunk endurance performance was significantly higher (p < 0.05) and the GMP significantly lower (p < 0.05) in the TTG when compared to the CG. Improvement in side plank test scores was associated with a decreased in GMP (r = −0.495, p < 0.05). TT can reduce the perception of GMP in addition to increasing the endurance of the trunk muscles. The side plank was the only physical test associated with GMP. Practitioner summary: Trunk Training can reduce general musculoskeletal pain and increase the endurance of the trunk muscles without a concomitant loss in general fitness in elite Military Police Officers. This research lasted 11 weeks and presents real-world and pragmatic findings.

Asthma biologics: Real-world effectiveness, impact of switching biologics, and predictors of response

BackgroundConfirmation of effectiveness of asthma biologics in the real world is desirable because patient characteristics and experiences may differ from those included in randomized controlled trials. ObjectiveTo evaluate real-world effectiveness of asthma biologics and identify predictors of response. MethodsWe performed a retrospective study in patients with severe asthma receiving biologics. The primary outcome was change in clinically significant exacerbations at 12 months after starting biologic therapy, compared with 12 months before. Secondary outcomes were change in severe exacerbations, maintenance oral corticosteroid (OCS) dose, prebronchodilator forced expiratory volume in 1 second (FEV1), and asthma control test scores. Subgroup analyses were performed for subjects who were biologic naive or not. A stepwise logistic regression model was performed to compare responders to nonresponders. ResultsA total of 112 patients were included. Biologic therapy was associated with a 59% reduction in clinically significant exacerbations (P < .001), 65% reduction in severe exacerbations (P < .001), and 54% reduction in maintenance OCS dose (P = .001) in the 12 months after starting therapy. Biologics also resulted in improvement in prebronchodilator FEV1 (P = .002) and Asthma Control Test score (P < .001). Subjects who were previously on another biologic also experienced significant improvements in exacerbation frequency, maintenance OCS dose, and asthma control. Responders were more likely to be nonsmokers and have higher baseline FEV1, gastroesophageal reflux disease, and eosinophil counts greater than 500 cells/μL. ConclusionIn a real-world setting, biologic therapy in asthma is effective in improving exacerbations, asthma control, and lung function. Patients who have a suboptimal response to 1 biologic can still benefit from treatment with a different biologic.

A-98 Public Misconceptions about Concussion Are Not Improved by Standard Post-Injury Advice

Abstract Objective Insufficient public knowledge of concussion is thought to contribute to poor injury recognition and management, particularly in community sports. It is not clear whether such knowledge can be improved by standard post-injury discharge advice. This study determined if a widely used concussion leaflet would improve concussion knowledge in a community sample of adults. Method Prospective, controlled study, with random allocation to advice conditions. One hundred and ninety-nine Australian adults received either concussion (CA, n = 101) or non-concussion advice (NCA, n = 98). All volunteers completed the Rosenbaum Concussion Knowledge and Attitudes Survey (RoCKAS) on three occasions (baseline, immediately post-advice, and after a one-week delay). Standard scores were derived, including for the 25-item Concussion Knowledge Index. Results A 2 (condition) X 3 (occasion) mixed ANOVA did not find a statistically significant interaction or any main effects on concussion knowledge (p &amp;lt; 0.05). On all three occasions, both groups obtained a RoCKAS total score of ~80% correct; but they also held some key misconceptions about concussion. Conclusions Compared to giving non-concussion information, public knowledge of concussion was not significantly improved by the concussion advice. The leaflet may not have conveyed the information needed to improve test scores, or the baseline performance of the groups could have suppressed the effect. Since correct injury recognition and management relies on community knowledge, alternate means of improving public knowledge of concussion should be explored. Concussion advisories should also be reviewed to ensure they can correct public misconceptions about concussion.