Practical Instrument Research Articles

PENGARUH PENGGUNAAN MEDIA AUDIO VISUAL DAN MOTIVASI TERHADAP HASIL PRAKTIK IBADAH SISWA DI SMP

Reasoning of this research is still the low of education value of Islam, the low of enthusiasm and willingness to learn religion, the low of awareness practices religious service, the low of ability in choosing study media applied. Media audiovisual can assist optimal of ability of each student, builds student enthusiasm in learning, has skillful character, self-supporting and sensitive. This research aim to (1) knows usage influence of media audiovisual and print media to result of practice of student religious service, (2) knows motivation to result of practice of student religious service, and (3) knows interaction of motivation to result of practice of student religious service applies media audiovisual. This research type is quasi esperimen with factorial design 2x2. In process of this experiment done observation at two group of study that is group of experiment given treatment with media audiovisual, and group of control with print media. This research subject is class student VII even semester which amounts to 48 mans, what consisted of class VII A 24 as control class and class VII B 24 as experiment class. Instrument applied in this research is instrument of motivation and instrument practice of religious service. instrument of Motivation is made in the form of scale enquette likert. instrument validity of Item practice of religious service and motivation enquette item of religious service applies technique formula product moment. To test hypothesis applied factorial of 2 x 2 Anova two lines and test Tukey. From result of inferential research that: (1) There is usage influence of media audiovisual to result of practice of student religious service. (2) there is no Pengaruh motivation to result of practice of student religious service. (3) there is no usage influence of media audiovisual to result of practice of student religious service having high motivation. (4) there is no usage influence of media audiovisual to result of practice of student religious service having low motivation. (5) there are no interaction between visual audio medias with motivation to practice of religious service in education teaching of Islam. Keyword: Study Media, Motivation, Skill Is having religious service

Translation, cross-cultural adaptation, and preliminary validation of a patient-reported outcome measure for genetic counseling outcomes in Sweden.

Genetic counseling is key for understanding the consequences of hereditary and genetic diseases and, therefore, crucial for patients, their families, and healthcare providers. Genetic counseling facilitates individuals' comprehension, decision-making, and adaptation to hereditary diseases. This study focuses on the Swedish adaptation of the Genetic Counseling Outcome Scale-24 (GCOS-24), an internationally validated, patient-reported outcome measure (PROM) for quantifying patient empowerment in genetic counseling. This study aimed to translate and cross-culturally adapt the GCOS-24 to measure patient-reported outcome from genetic counseling in Sweden. The adaptation process was meticulously conducted, adhering to international guidelines, with cross-cultural adaptation, translation, and back translation, to ensure semantic, conceptual, and idiomatic equivalence with the original English version. Face validity and understandability was assured using qualitative cognitive interviews conducted with patient representatives, and by a committee of experts in the field. The psychometric properties of the Swedish version of GCOS-24 (GCOS-24swe) were evaluated using a robust sample of 374 patients. These individuals received genetic counseling by telephone or video, necessitated by the constraints of the COVID-19 pandemic. Participants responded to GCOS-24swe both before and after genetic counseling. The GCOS-24swe demonstrated face validity, good internal consistency (Cronbach's alpha = 0.86), significant responsiveness (Cohen's d = 0.65, p < 0.001), and good construct validity. The study's findings underscore the GCOS-24swe's potential as an effective instrument in both clinical practice and research within Sweden. It offers a valuable means for assessing patient empowerment, a key goal of genetic counseling. Additional psychometric assessment of test-retest reliability and interpretability would further enhance the utility of GCOS-24swe.

Psychometric evaluation of the patient health questionnaire stress scale

The “Patient Health Questionnaire (PHQ)” is a screening instrument, designed for time-efficient detection and severity assessment of depression, anxiety, and other syndromes in medical settings. Besides the questions on psychological symptoms, there are items on psychosocial functioning, on stressors and critical life events. However, for the stress items there are no psychometric properties available until now. The present study is thought to investigate item characteristics, internal consistency as well as factorial and construct validity of the stress scale of the PHQ. A representative sample of the general population of Germany was collected by a demography consulting company (USUMA, Berlin). Per random-route procedure, households and members of the households were selected. The sample was representative for the German community regarding age, gender, and education. In this investigation the following questionnaires were administered: PHQ-Stress, Questions on Life Satisfaction Modules (FLZ-M), Type-D Scale-14 (DS14). The sample included N = 2396 participants with mean age of 48.50 (SD = 17.75; range = 14 to 92) and 55.2 % being female. Reliability of the PHQ stress scale was acceptable (ω = 0.776), but some factor loadings were comparatively low. Model fit indices showed mixed results, some indicating unacceptable and some indicating acceptable fit of the 10-item stress scale of the PHQ. Correlations with related constructs demonstrated the scale's convergent validity. The results of this validation study indicate that the PHQ stress scale, which provides a one-dimensional total stress score, is a valid, good practical and reliable self-report instrument for assessing the severity of psychosocial stress.

Which Comprehensive Geriatric Assessment (CGA) instruments are currently used in Germany: a survey

BackgroundThe Comprehensive Geriatric Assessment (CGA) records geriatric syndromes in a standardized manner, allowing individualized treatment tailored to the patient’s needs and resources. Its use has shown a beneficial effect on the functional outcome and survival of geriatric patients. A recently published German S1 guideline for level 2 CGA provides recommendations for the use of a broad variety of different assessment instruments for each geriatric syndrome. However, the actual use of assessment instruments in routine geriatric clinical practice and its consistency with the guideline and the current state of literature has not been investigated to date.MethodsAn online survey was developed by an expert group of geriatricians and sent to all licenced geriatricians (n = 569) within Germany. The survey included the following geriatric syndromes: motor function and self-help capability, cognition, depression, pain, dysphagia and nutrition, social status and comorbidity, pressure ulcers, language and speech, delirium, and frailty. Respondents were asked to report which geriatric assessment instruments are used to assess the respective syndromes.ResultsA total of 122 clinicians participated in the survey (response rate: 21%); after data cleaning, 76 data sets remained for analysis. All participants regularly used assessment instruments in the following categories: motor function, self-help capability, cognition, depression, and pain. The most frequently used instruments in these categories were the Timed Up and Go (TUG), the Barthel Index (BI), the Mini Mental State Examination (MMSE), the Geriatric Depression Scale (GDS), and the Visual Analogue Scale (VAS). Limited or heterogenous assessments are used in the following categories: delirium, frailty and social status.ConclusionsOur results show that the assessment of motor function, self-help capability, cognition, depression, pain, and dysphagia and nutrition is consistent with the recommendations of the S1 guideline for level 2 CGA. Instruments recommended for more frequent use include the Short Physical Performance Battery (SPPB), the Montreal Cognitive Assessment (MoCA), and the WHO-5 (depression). There is a particular need for standardized assessment of delirium, frailty and social status. The harmonization of assessment instruments throughout geriatric departments shall enable more effective treatment and prevention of age-related diseases and syndromes.

Measuring Interest: Development and Application of a Three-Dimensional Situational Interest Short Scale

&lt;p&gt;Situational interest is an important factor that has a great influence on learning success in both in-school and out-of-school learning situations. Although there has been extensive research on interest in its diverse forms for decades, an evaluated measurement instrument for situational interest that covers the three theoretically defined components of interest (emotional, cognitive, value-related) is still missing. Therefore, in this study, based on person-object theory of interest, a short scale was developed that can be used in a variety of learning programs independent of content or methods. In study 1, eight suitable items were selected and their structure was examined using exploratory methods. In study 2, the results of study 1 were verified using confirmatory factor analyses. Study 3 shows an example of a practical application of the newly developed scale in two different learning settings. The findings provide evidence that the scale developed here is a practical instrument to measure situational interest taking into account all its components. On the one hand, the scale can help teachers evaluate their educational programs; on the other hand, it can be used by researchers to empirically investigate the construct of interest. Thus, the scale makes an important contribution to research and practice.&lt;/p&gt;

Experience of nurses using the COVID-19 Early Warning Score in the care of COVID-19 patients: A qualitative study

Experience of nurses using the COVID-19 Early Warning Score in the care of COVID-19 patients: A qualitative study Abstract: Background: In all phases of the COVID-19 disease, patients are at risk of acute deterioration. In order to identify patients at risk at an early stage, the COVID-19-EWS Salzburg was implemented in April 2020 at the University Hospital Salzburg. So far, the applicability, practicability and relevance of the EWS for acute inpatient COVID-19 care are unknown. Aim: The aim of this qualitative study was to describe the relevance and practicability of the COVID-19-EWS Salzburg as a risk assessment tool for acute inpatient COVID-19 care, based on the experiences of the nursing staff. Methods: Nine semi-structured expert interviews were conducted with the nursing staff of the COVID-19 acute care unit. The data were analysed by qualitative content analysis. Results: Nurses described the EWS as relevant to practice because the score facilitates decision-making, increases patient safety, and enhances interprofessional communication. Both the Early Warning Score (EWS) and experience in caring for COVID-19 patients were found to be relevant for decision-making in the context of managing clinical deterioration. The score provided a sense of security in the care of COVID-19 patients, particularly to new and inexperienced nurses. Conclusion: The participating nurses describe the COVID-19-EWS Salzburg as a useful and practical risk assessment instrument, complementing clinical judgment. A need for adaptation concerning the parameters oxygen saturation and oxygen requirement was identified.

Reliability and validity of the training satisfaction questionnaire for family members (TSQ-FM) entering the ICU during an isolation disease outbreak

BackgroundThe presence of family members in an isolated ICU during an isolation disease outbreak is restricted by hospital policies because of the infectious risk. This can be overcome by conferring to family members the skill and the ability to safely don and doff the personal protective equipment (PPE) through a nurse-led training intervention and assess their satisfaction, to respond to the need to define a safe, effective and quality care pathway focused on Family-Centered Care (FCC) principles. Objectivethe study aimed to build a valid and reliable instrument for clinical practice to assess family members’ satisfaction to allow ICU nurses to restore family integrity in any case of infectious disease outbreak that requires isolation. MethodsA cross-sectional study was conducted to test the psychometric properties. The questionnaire was constructed based on a literature review on the needs of family members in the ICU. 76 family members were admitted to a COVID-ICU. Cronbach's coefficient, Geomin rotated loading, and EFA were applied to assess the reliability and validity of the instrument. ResultsThe Kaiser-Mayer-Olkin (KMO) measure was 0.662, the Bartlett sphericity test showed a significant p-value (χ²=448.33; df=45; p < 0.01), Cronbach's alpha coefficient was.896. A further CFA analysis confirmed that all fit indices were acceptable. The results showed satisfactory validity and reliability, which could be generalized and extended to any outbreak of isolation disease. ConclusionsThis study provides a valid and reliable instrument for clinical practice to maintain family integrity in the dyadic relationship between the patient and the family member, even during an emergency infectious disease outbreak that requires isolation.

Cross-cultural Validation of the Health Mindset Scale for Brazil.

Objective To cross-culturally validate the Health Mindset Scale for Brazil, as well as adapt the terms and questionnaires for adequate understanding of Brazilians, using factor analysis as an instrument to validate its reliability. Methods Cross-cultural validation of the Health Mindset Scale into Brazilian Portuguese using the Beaton method, Cronbach's alpha calculation and factor analysis Results The sample consisted of 215 patients aged between 18 and 87 years (M = 41.98; SD = 15.72), with a mean age between 31 and 50 years (42.0%), and female (52 .6%), a marginally significant difference (p < 0.10) between men and women was observed for item 3. In this item, men's mean (M = 5.48; SD = 0.99) was higher than the average for women (M = 5.10; SD = 1.22), with a small effect size for the difference (d = 0.26). Pearson's r correlation coefficient was examined between the mean score and age (r = -0.21; p = 0.002), the result of which indicated a weak, negative and significant linear relationship. The older the age, the lower the average score on the Health Mindset Scale. Conclusion The version of the health-focused mindset scale for Brazilian Portuguese was introduced and cross-culturally validated, demonstrating good reliability with a Cronbach's alpha of 0.786. Consequently, it constitutes a new instrument for clinical practice and can be correlated with established scales in the literature.

Ranson Criteria – Old is Gold in Evaluating Acute Pancreatitis?

Abstract Acute pancreatitis (AP) is a communal gastrointestinal condition that can vary in severity and morbidity. The “Ranson Score,” which was created in 1974, was the 1st scoring scheme to predict the cruelty of AP. While the “Ranson Score” has remained popular for decades, it is to have some flaws, such as limited predictive power. It has also been chastised for requiring 48 h to compute the concluding score, which has been found to cause administration delays. Using the electronic databases Medline, PubMed, Embase, and Google, a literature search in English was carried out. The exploration terms were Ranson Criteria OR “Ranson Score” OR AP OR Diagnostic Criteria. Researchers concluded that the “Ranson Score” is comparable to other recent counting systems for classifying AP severity and predicting death, making it a valuable tool for prognosticating AP in contemporary clinical practice. The studies also demonstrated that there is no one best grading system for predicting mortality and severity in AP patients. There are advantages and disadvantages to using each measure, and variations in research outcomes may be attributed to changes in people’s characteristics, AP etiology, and clinical care heterogeneity. The “Ranson Score,” despite being the ancient scoring system known, has preserved its clinical validity over time. These features, combined with its comparative easiness of use and applicability in reserve/constrained situations, make the “Ranson Score” an important and useful instrument in present clinical practice.

Comparative Analysis of ML Models for Currency Exchange Rate Prediction

The primary aim of this research is to improve the prediction of the exchange rate between the United States Dollar (USD) and the Indian Rupee (INR), which is an area that has received little attention in the field of financial forecasting. In contrast to widespread methodologies that consolidate results over several currency pair, this study specifically concentrates on the USD to INR pair, recognising the distinctive economic and political dynamics between the United States and India. This study aims to do a comparative analysis of four various machine learning models, namely RNN, ARIMA, LSTM, and Random Forest, in order to determine the best effective tool for predicting exchange rates in a certain context. This research employs a holistic methodology, including a wide range of variables like trade balances, interest rates, and geopolitical events, so providing a multifaceted forecasting approach. The growing economic interdependence between the United States and India highlights the practical importance of precise predictions for many stakeholders, such as traders, investors, and politicians. Furthermore, the study examines the concept of dynamic model updating, a novel attribute that augments flexibility within the ever-changing financial industry. The primary objective of this work is to address a significant need in current academic research by developing a reliable and practical instrument for accurately forecasting the exchange rate between the United States Dollar (USD) and the Indian Rupee (INR). This research is notable for its specific concentration, use of comparative methods, and its potential to make substantial advancements in both academic and practical domains pertaining to currency exchange rate forecasting.

Assessing dental student knowledge on cannabis and demonstrating the need for cannabis education.

The American Dental Association advocates for dentists' education on therapeutic and legal issues related to medical cannabis. It is important to understand current knowledge of cannabis and cannabinoids and to have a practical knowledge assessment instrument. This exploratory study is the first of its kind to assess dental students' knowledge of cannabis and aims to determine if there is a need for more instruction regarding cannabis in a dental school's curriculum. Predoctoral dental students at the University at Buffalo School of Dental Medicine were recruited to participate. A validated, anonymous 22-item online survey was adapted and administered to students in all 4 years of the dental program. There was a total of 56 knowledge points. The average knowledge score was 21.6 points (SD=5.2, range: 7-34), corresponding to 38.5% (SD=9.2) of the answers correct. There were no overall differences in knowledge by gender, years in dental school, or by any reported source of formal education on cannabis. Those who reported doing their own research had higher knowledge scores. Most participants knew that there is an endogenous cannabinoid system (72.3%) and that Tetrahydrocannabinol (THC) is responsible for the "high" experienced with cannabis (76.6%). Most participants reported that they did not know the effective doses of THC (58.2%) and Cannabidiol (CBD) (66.7%); few provided an answer for THC (34%) or CBD (17%) in the acceptable range of 2-10mg. Dental students did not have adequate knowledge on cannabis and cannabinoids. Given the rapid expansion of cannabis legalization, additional efforts are needed to integrate cannabis topics into coursework and learning experiences.

A new measurement method of parental perception of child friendliness in neighborhoods to improve neighborhood quality and children's health and well-being

If parents perceive the neighborhood as child friendly, they will allow their children more independent travel and play. Parental perception of child friendliness is therefore an important prerequisite for designing neighborhoods that promote children's health and wellbeing. However, there is currently no comprehensive and practical instrument to measure it. This study develops and empirically validates a measurement instrument for parental perception of child friendliness in neighborhoods. Survey data was collected from 309 parents in the Netherlands. The data was randomly divided into a calibration (n = 155) and a validation sample (n = 154). The factorial validity of parental perception of child friendliness in neighborhoods was examined using exploratory and confirmatory factor analysis. The construct validity was tested by using structural equation modelling (SEM) of assumed relationships between parental perception of child friendliness in neighborhoods and variables influencing this perception (antecedents) and children's physical activity (consequence). Overall, the results provided good reliability and validity for the instrument. This instrument does not only offer a practical tool; it also provides practical guidelines for designing child-friendly neighborhoods as perceived by parents. It suggests that measures, such as providing green spaces, care facilities and recreation facilities, can enhance child friendliness of neighborhoods as perceived by parents.

The assessment of preschool children with ESSENCE symptoms: concordance between parents, preschool teachers and child psychologists

BackgroundIt is important to detect children with Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations (ESSENCE) in order to implement early intervention and support for the child and family. Standardized instruments for assessment in different contexts of behaviour problems, engagement and psychosocial health obtain an objective picture of the preschool child's mental health.AimTo explore and compare parents', preschool teachers' and child health care psychologists' assessment of behaviour, everyday function, engagement, social interaction and psychosocial health in children with ESSENCE symptoms.MethodParents of 152 children (114 boys and 38 girls, 4.5 ± 1 years) with ESSENCE symptoms, 155 preschool teachers and 8 child psychologists participated. Parents and preschool teachers assessed externalizing and internalizing behavioural problems using the Strengths and Difficulties Questionnaire (SDQ), including the SDQ supplement for assessing the impact of behavioral problems on daily function. Preschool teachers also assessed engagement and social interaction using the Children's Engagement Questionnaire (CEQ), and the child psychologists assessed psychosocial health with the Child Psychosocial Health Assessment (LillaLAPS) and template in conversations with parents of children with neurodevelopmental problems.ResultsParents', preschool teachers' and child psychologists' assessment of the child's ESSENCE symptoms overall agreed. Both parents and preschool teachers see a strength in the child's social abilities. Differences in mean values show that parents assess more conduct, emotional symptoms and problems in daily life and more social skills, compared to the preschool teachers rating more peer problems.ConclusionIt is important to consider different contexts to identify the child's need for support in everyday life. Expanded use of validated screening instruments in clinical practice would promote detection of children not already identified as exhibiting neurodevelopmental problems.

Climatological reference stations: Definitions and requirements

AbstractGround‐based stations are one of many observing systems contributing to the generation of data to evaluate climate trends and variations locally and globally. Networks of stations are made of various numbers of observing sites, equipped with different typologies and varieties of instruments, differently managed and maintained. Among such networks a limited number of stations are required as a reference, to provide top quality traceable measurements and as the top level of a tiered approach; it is these stations which are here designated as Climatological Reference Stations (CRS). At present, there is no agreed definition of the key instrumental and technical features of a CRS, nor are there defined reference measurement procedures. This leads to the situation of a multitude of approaches among different National Meteorological and Hydrological Services (NMHSs), research institutes and other agencies that reduces the comparability of results in space and in time. The lack of CRSs, moreover, is a major contributor to the huge efforts required to harmonize data and detect biases locally, regionally and globally, as in their absence there is a need to fall back on other stations which are more likely to have such biases. This article reports on the outcomes of the work of a group of experts, nominated by the World Meteorological Organization (WMO) Commission for Climatology (CCI), tasked to promote a standardized and agreed concept about the definitions, specifications and technical characteristics of climate reference data and stations for ground‐based networks, with the addition of a practical example of climatological reference station installed in the framework of an European funded project, with the purpose of comparing and confirming the prescribed characteristics and guidance, with respect to practical field use and available instrumentation. The adoption of a unique definition and prescription on the technical setup, measurement procedures and uncertainty evaluation will substantially progress towards a common approach in detecting climate trends. This will improve data comparability in space and time and allow a more robust understanding of climate evolution locally and globally.

Translation and Validation of Tamil Version of Fatigue Severity Scale (FSS) in Individuals with Rheumatoid Arthritis

Background: Fatigue has a significant negative impact on individuals with Rheumatoid Arthritis (RA). Fatigue Severity Scale (FSS) is the most widely used tool to assess fatigue severity which is a common problem in RA. Availability of FSS in local vernacular language could add more value and the study aims to construct the Tamil version of the FSS and validate it among patients with RA. Methodology: The study was conducted in 2 phases. In phase I, the English version of FSS was translated into Tamil by following the Linguistic Guidelines by mapi eprovide. In Phase II – Validation of Tamil version of FSS was carried out in 50 patients of RA by establishing; Test-retest reliability, Internal consistency, Content validity; and Convergent validity in comparison with HAQ-DI and SF-12 Results: The initial testing between Tamil FSS with English version revealed an intraclass correlation coefficient (ICC) (0.821) and α(0.902). The content validity was established by Cohen’ kappa agreement k which is &gt;80% with a significance &lt;0.004, which shows Good substantial agreement between raters. FSS showed strong positive correlation with HAQ-DI (&gt;0.0005) and negative correlation with SF-12 (&gt;0.0005). The scale demonstrated excellent internal consistency ( α = 0.972) and test-retest reliability (ICC = 0.93). Conclusions: The validated Tamil version demonstrated excellent content validity as well as good internal consistency and test-retest reliability, would be a useful instrument for clinical practice and research. It can be recommended for the assessment of Fatigue severity among Tamil-speaking population with RA.

The validity of simplifying gaming simulations

Simplifications of the real world affect the validity and reliability of gaming simulations. This challenges the application of gaming simulations as an instrument for experiential learning, reflective practices and data collection. This study investigates the effects of simplification on extracting tacit knowledge from human behavior by answering the research question: Can tacit knowledge in a simplified design of a gaming simulation be transferred without compromising the validity and reliability corresponding to the real-world complexity? By applying a participatory design a gaming simulation is tested as an instrument to extract tacit knowledge. To test and evaluate the validity of this application, simulation sessions have been performed with experts from the field. In simplifying reality, participants' participation emphasized that the most accurate representation of reality is a prerequisite for capturing tacit knowledge. This in turn contributes again to the validity of the simulation design. The results show that simplification of the real world didn't affect participants' perspective on the use of the gaming simulation as an experiential tool to enable learning processes or create awareness. And that a simplified simulation design, is still valid in addressing the real-world complexity, with minimization of the level of abstraction and maximization of the truthfulness.

Measurement of Diffusion Coefficients in Binary Mixtures and Solutions by the Taylor Dispersion Method

The theory and application of the Taylor Dispersion technique for measuring diffusion coefficients in binary systems is reviewed. The theory discussed in this paper includes both the ideal Taylor–Aris model and the estimation of corrections required to account for small deviations from this ideal associated with a practical apparatus. Based on the theoretical treatment, recommendations are given for the design of practical instruments together with suggestions for calibration, data acquisition and reduction, and the rigorous estimation of uncertainties. The analysis indicates that relative uncertainties on the order of 1% are achievable in practice.

Application of Northern Goshawk Back-Propagation Artificial Neural Network in the Prediction of Monohydroxycarbazepine Concentration in Patients with Epilepsy.

A northern goshawk back-propagation artificial neural network (NGO-BPANN) model was established to predict monohydroxycarbazepine (MHD) concentration in patients with epilepsy. The data were collected from 108 Han Chinese patients with epilepsy on oxcarbazepine monotherapy. The results of 14 genotype variates were selected as the input layer in the first BPANN model, and the variables that had a more significant impact on the plasma concentration of MHD were retained. With demographic characteristics and clinical laboratory test results, the genotypes of SCN1A rs2298771 and SCN2A rs17183814 were used to construct the BPANN model. The BPANN model was comprehensively validated and used to predict the MHD plasma concentration of five patients with epilepsy in our hospital. The model demonstrated favorable fitness metrics, including a mean squared error of 0.00662, a gradient magnitude of 0.00753, an absence of validation tests amounting to zero, and a correlation coefficient of 0.980. Sex, BMI, and the genotype SCN1A rs2298771 were ranked highest by the absolute mean impact value (MIV), which is primarily associated with the concentration of MHD. The test group exhibited a range of - 20.84% to 31.03% bias between the predicted and measured values, with a correlation coefficient of 0.941 between the two. With BPANN, the MHD nadir concentration could be predicted precisely. The NGO-BPANN model exhibits exceptional predictive capability and can be a practical instrument for forecasting MHD concentration in patients with epilepsy. www.chiCTR-OOC-17012141 .

Clinical analysis of a new multifunctional instrument set for gasless endoscopic thyroidectomy with two different approaches

BackgroundFollowing the rapid development of endoscopic thyroidectomy techniques, various surgical procedures have been developed (e.g., transoral, submandibular, areolar, axillary, retroauricular, and combined procedures), and each of these procedures has its own advantages. In recent years, gasless endoscopic thyroidectomy has emerged as a feasible procedure, and it has replaced traditional CO2 insufflation approaches because of advantages such as stable cavity construction, pollution reduction, resource saving, and risk reduction. However, each gasless procedure requires special instruments for cavity construction, and this results in enormous wastage of medical resources. In the present study, we introduced a set of instruments developed by our team. This set of instruments is designed to be compatible with the current gasless endoscopic thyroidectomy approaches, including transoral, submandibular, transareolar, transaxillary, retroauricular, combined, and lateral cervical lymph node dissection. Here, we introduced this set of instruments for two gasless endoscopic thyroidectomy procedures (transaxillary and transareolar). Following the incorporation of this set of instruments in regular clinical practice, it could be used for more gasless endoscopic thyroidectomy procedures in the future.ObjectiveTo investigate the feasibility, safety, and efficacy of the self-developed instruments for gasless endoscopic thyroidectomy in two different approaches.MethodsA total of 180 patients diagnosed to have papillary thyroid carcinoma (PTC) between January 2020 and April 2022 were retrospectively investigated. The patients were assigned to a gasless transaxillary group (group A) and a gasless transareolar group (group B). The same gasless endoscopic-assisted instruments were used for both groups. The clinical characteristics, treatment results, and complications were compared between the two groups.ResultsAll 180 patients were successfully operated. The extent of surgical resection in all patients was the same: “unilateral glandular lobectomy + isthmus combined with ipsilateral central zone lymph node dissection.” There were 130 and 50 patients in group A and group B, respectively; one patient in the former group was converted to open surgery due to intraoperative bleeding. No significant difference was observed between the two groups in terms of gender, age, body mass index (BMI), education level, and proportion of concomitant Hashimoto’s thyroiditis (P > 0.05). The establishment of cavity time was significantly longer in group A than in group B (35.62 ± 5.07 min vs. 17.46 ± 2.55 min, P < 0.01). The number of lymph nodes cleared was slightly less in group A than in group B (4.06 ± 2.93 vs. 4.52 ± 2.38, P = 0.07). Moreover, the two groups showed no significant differences (P > 0.05) in the total operative time (145.54 ± 45.11 min vs. 143.06 ± 46.70 min), tumor size (0.68 ± 0.46 cm vs. 0.71 ± 0.49 cm), postoperative hospital stay (4.08 ± 1.48 days vs. 3.72 ± 1.07 days), vocal cord paralysis [4 (3.1%) vs. 2 (4%)], postoperative swallowing discomfort [24 (18.5%) vs. 5 (10%)], and postoperative recurrence and satisfaction scores (3.27 ± 1.52 vs. 3.28 ± 1.53).ConclusionAlthough the two approaches of gasless endoscopic surgery have different operative paths and different time periods for cavity construction, both approaches are similar in terms of the principle of cavity construction, safe and reliable postoperative efficacy, and good cosmetic effect. Therefore, the same set of instruments can be used to complete the surgery in both approaches, thus saving medical resources and facilitating the popularization of this technology.

A streamlined survey instrument to moderate university students' grades for group projects

PurposeThe aim of this paper is to generate a streamlined, transparent and effective instrument to fairly measure the contribution made by each student to a group project within a higher education context. The primary aim is to moderate the grades of underperforming students at the end of the project. There is a secondary benefit in alerting underperforming students to raise their contribution mid-task or face a potentially reduced grade at the final stage.Design/methodology/approachThe development of this multi-dimensional instrument is guided by findings from previous research. The quest is to minimise the instructor's administrative work load in applying a moderation-only instrument that is open-source and available at no cost. Based on the literature, the survey instrument seeks to apply a peer-based, equitable and transparent evaluation of each member's contribution to a group task. The survey is applied at mid-task and again at end-task in order to afford underperformers the opportunity to address contribution deficits during the final phase of the project.FindingsThe instrument, called TANDEM©, offers a transparent, streamlined, equitable, confidential and practical measure of each student's contribution to a graded group task. Students whose end-task contribution falls below the group average rating receive a proportional reduction in their personal grade. Additionally, the end-task moderation instrument captures a single-item holistic measure of relative contribution that may, in the future, serve as a surrogate for the multi-dimensional measures currently in place.Research limitations/implicationsTANDEM© was developed with group sizes of four or five members in mind. There is no evidence to support its application to three-person groups. Moreover, the application was applied only amongst under-graduate students. It is yet to be applied across post-graduate groups and within online learning environments. Future research into diverse cultural settings would serve to advance understanding of how moderation is perceived across borders.Practical implicationsSeveral existing group grade moderation methods propose complex algorithms that are “black box” solutions from a student's perspective. In establishing a fair, streamlined, confidential and transparent process for peer-rated moderation, TANDEM© deploys a concise instrument with a relatively small administrative load. TANDEM © may be applied to all groups or can selectively be applied to groups that report moderate, strong or extreme levels of conflict.Social implicationsStudents will appreciate the opportunity to rate peer contributions to group projects. This will dissipate the negative social sentiment that may arise when fellow students benefit from the work of others. Those students seeking conflict resolution within the group will value the transparent and equitable moderation of grades as well as the positive social implications that follow.Originality/valueThis research forms part of an ongoing quest to present a moderation instrument that fairly identifies student contribution to a group project. Whilst the solution proposed is one of many existing alternatives, its focus is on a practical moderation-only instrument that can immediately be applied to a course or major. The benefits lie in the ease of application and minimal administrative workload. This constitutes an original contribution to the individual (course or major) coordinator who seeks to apply a moderation-only instrument without having to commit to an extensive, broad-based group optimisation programme.