Low Cognitive Level Research Articles

A Tool to Characterize Learning Objectives in Marine Science Education: Marine Science Learning Objectives Tool (MS-LOT)

Effective marine science teaching starts with well-written, measurable learning objectives that define outcomes for learners, inform instruction, and guide assessment. Yet, there are few resources to help marine science educators write effective learning objectives. To address this need, we created an evidence-based Marine Science Learning Objectives Tool (MS-LOT) to help marine educators evaluate their learning objectives. MS-LOT considers two critical aspects of learning objectives in marine science education: focus and assessment. As a case study, University of Georgia (UGA) Marine Extension and Georgia Sea Grant educators used MS-LOT to analyze their 207 learning objectives for 5th–12th grade educational programs. Findings revealed 1) gaps in content, science practices, and affective outcomes in instruction, 2) a focus on low-cognitive level outcomes, and 3) unmeasurable learning objectives. We respond to issues uncovered from the analysis and detail how MS-LOT will be useful for all marine educators, especially those working with K-12 learners.

Association of hemoglobin-to-red blood cell distribution width ratio and cognition: A cross-sectional study

PurposeThis study aimed to investigate the association between hemoglobin-to-red blood cell distribution width ratio (HRR) and cognitive function. MethodsData, including cognition assessment, general characteristics, lifestyle attributes, disease-related factors, and blood indicators, were extracted from older people from the National Health and Nutrition Examination Survey (NHANES) 2011–2014 database. Statistical analysis included the Mann-Whitney U test, chi-square test, spearman correlation, and multiple linear regression. ResultsA total of 2452 participants were included, with 631(25.7 %) identified as having low-level cognition. HRR was significantly lower in the lower cognition group (P < 0.001) and positively associated with cognition score (P < 0.001). Multiple linear logistic regression analysis indicated that HRR remained associated with cognition even after adjusting for general characteristics, lifestyle attributes, disease-related factors, and blood indicators (P = 0.046). ConclusionLower HRR is an independent risk factor for low cognitive performance in older adults. However, further investigation is needed to elucidate the precise mechanism underlying the impact of HRR on cognitive function.

Systematic research is needed on the potential effects of lifelong technology experience on cognition: a mini-review and recommendations.

Digital technology now occupies a fundamental space in human life. Increasingly sophisticated access to information and social interactions has enabled a sort of offloading of many aspects of cognition, and for many people, this technology use has been lifelong. While the global development of technologies advances exponentially as part of the Fourth Industrial Revolution, researchers have not yet fully characterized the human effects of this technology-centric revolution at the same pace. In this mini-review, we consider three important higher-level cognitive functions: creativity, adaptability, and decision-making, and discuss their potential relationship to lifelong digital technology experience, which here includes both passive exposure and active use of electronic devices. We then articulate the gaps in related literature and knowledge, and outline general considerations, suggestions, and challenges for future research avenues. In general, we found that prior research has investigated uses of specific technology products on lower-level cognition (e.g., how does the use of online search engines affect memory?), but there is a lack of research assessing the overall effects of technology experience on cognitive functioning, particularly complex cognition.

OFFSPRING EDUCATIONAL (DIS)ADVANTAGE, MECHANISMS, AND COGNITIVE FUNCTION IN KOREA

Abstract Adult children’s education plays a significant role in parental cognitive well-being later in the life course. However, there is limited evidence in rapidly changing societies, leaving several key questions unanswered, including (1) whether the effects of offspring educational disadvantage can also flow upward, (2) whether these effects operate through similar explanatory mechanisms, such as financial, social, and informational support from their children, as seen in educational advantage, and (3) whether gender moderates these associations. Focusing specifically on Korea, a society where education has expanded rapidly and support from children is increasingly crucial, this study utilizes longitudinal data from the Korean Longitudinal Study of Aging (2006-2018) to demonstrate the role of offspring education in cognitive function during mid-to-late life. First, having adult children with a college degree or higher is associated with elevated levels of cognition and slower cognitive decline, whereas having adult children with less than a high school education is linked to lower levels of cognition and faster cognitive decline during mid-to-late life. Second, the association between adult children’s education and cognitive health, regardless of whether they have a college degree or less than a high school education, remains robust even after accounting for various other mediators. Third, while the effect of adult children’s education is more pronounced for mothers compared to fathers, children’s gender does not moderate the association. Together, I offer a novel explanation for the association between offspring educational advantage and disadvantage, and their connection to parental cognition and its subsequent decline in rapidly changing society.

“Taxes, death, and trouble”: Role of structural socioeconomic racism on cognitive function for persons racialized as Black

AbstractBackgroundStructural racism has concentrated Americans racialized as Black in under‐resourced and disinvested neighborhoods. These same Americans experience higher rates of Alzheimer’s disease and related dementias (ADRD). Differences in socioeconomic opportunities structured by racism is a potential contributor to ADRD disparities. To investigate this hypothesis, we tested how life‐course exposure to area‐level measures of structural racism relate to late‐life cognitive test performance.MethodWe computed the Black‐White disparity in land ownership and value, residential and occupational segregation, and income, employment, and poverty at the county‐level using US Census data from 1930‐2010. We aggregated these data to the state‐level then created four unidimensional measures by life‐course period (Before‐Birth 1930‐50, Childhood 1960‐70, Adulthood 1980‐2000, Midlife 2010). We linked state‐ and life‐course‐period‐level data with individual‐level demographic and cognitive data from the US Health and Retirement Study. We included participants racialized as Black and born 1954‐59 (N = 1,172). We measured cognitive performance from repeated measures of the 27‐item global cognitive score from the modified Telephone Interview for Cognitive Status during 2010‐18 (average follow up of 4.1 years). Mixed effects models were used to test associations of life‐course‐period‐specific state‐level structural socioeconomic racism and cognitive change. Covariates were age, gender, education, Living arrangement, and year of death.ResultParticipants racialized as Black who lived in places with higher levels of area‐level structural socioeconomic racism experienced lower levels of cognition at baseline and at varying time points in the six‐year period—compared to those in places with lower structural socioeconomic racism. The effects of the life‐course‐period‐specific state‐level structural socioeconomic racism exposure on the slope were in the expected direction but not statistically different from zero (‐.02, SE 0.25, ‐.51, 4.7).ConclusionAmong participants racialized as Black in the HRS born during 1954‐59, effects of exposure to state‐level structural racism varied according to life course period of exposure. These findings reveal the utility of examining the impact of racist U.S. policies enacted in the past and present that influence health over time. In addition to exploring the epigenetic and in utero exposures that may contribute to ADRD risk later in life.

Implementing the flipped classroom model in mathematics class teaching

The aim with this research was to examine how the implementation of the flipped classroom model (FCM) impacted the quality and durability of 4th grade students’ knowledge in the field of measuring and measures when compared to traditional teaching (TT). The research was conducted in Serbia on a sample of 135 students, divided into 3 groups. The 3 groups were a control group (C) which was taught mathematics content using the TT model, an experimental group 1 (E1) which was taught using the FCM, while the students in experimental group 2 (E2) were taught using the FCM – the teacher also provided them with feedback regarding their work and made recommendations for their further development. The results show that the students from the E2 group surpassed those from the C and E1 groups regarding the quality and durability of their knowledge in the field of measuring and measures. There was a statistically significant difference in the knowledge of students in this field at the lower cognitive level among all the groups, while the statistically significant difference at the higher cognitive level was seen between the C and the E2 and between the E1 and the E2 groups.

The Effectiveness of Graphic Organisers for Improving Reading Comprehension in ESL Learners: A Systematic Literature Review

The objective of this study is to examine the effects of graphic organisers (GOs) as an instructional tool for enhancing reading comprehension among ESL learners. This paper presents a systematic review of related topics over the past decade, from 2015 to 2020, and found 31 journal papers that fulfilled the research criteria, representing the scholarly work in this field. These studies were published in journals indexed in Google Scholar, Eric, ProQuest, and JStor, and were selected according to a set of inclusion and exclusion criteria. The current literature review reveals that graphic organisers help learners visually organise and structure information, making complex concepts and relationships more accessible. They promote active engagement with the content as well as support the identification of main ideas, supporting details, and relationships between concepts. This enhanced comprehension leads to better retention and understanding of the material. However, the effectiveness of graphic organisers is influenced by issues such as visual literacy challenges, lack of familiarity with GOs, low cognitive level, and selection of an appropriate GO. In conclusion, our findings suggest that incorporating graphic organisers in language learning can be a valuable tool for educators to enhance their students’ reading comprehension skills. By considering the influencing factors, educators can tailor their teaching methods to optimise the benefits of graphic organisers.

More homework improve mathematics achievement? Differential effects of homework time on different facets of students' mathematics achievement: A longitudinal study in China.

Mathematics homework is highly prevalent in East Asia. Teachers and parents expect mathematics homework to improve students' performance; however, studies have not clearly defined the effectiveness of the assignment of different amounts of homework. This study analyses the differential effect of homework amount on various facets of Chinese students' mathematics achievement using a longitudinal design. It aims, thereby, to contribute to the existing knowledge of homework effectiveness and mathematics learning and to provide insights for student development. The sample included 2383 grade 9 students from a mid-sized city with a moderate level of economic and educational development in central China. We administered a student-reported questionnaire, collected school reports of mathematics achievements to track retrospective longitudinal variations in mathematics over half a year and analysed the differential effectiveness of homework on mathematics achievement at four hierarchical cognitive levels with Hierarchical Linear Model. The results indicated that assigning more homework at the class level could enhance students' mathematics achievement at a low cognitive level, although this effectiveness tended to disappear when the set homework time reached about 1.5-2 h. We did not find evidence that assigning more homework enhances students' mathematics achievement at higher cognitive levels. Overall, this study provides evidence on the effectiveness of homework and offers implications for educational practice and future research.

Knowledge and coping style about depression in medical students: A cross-sectional study in China.

The current study aimed at ascertaining the depression levels of medical students and their knowledge levels of depression, and exploring the relationship between the level of knowledge and coping styles of the medical students on depression. An online-based survey was developed in Changzhi Medical College. The questionnaire included demographic and socioeconomic data, questions about depression knowledge and copying styles of depression, and the Zung Self-Rating Depression Scale (SDS). A total of 1931 questionnaires were returned by respondents. The medical students produced a mean SDS score of 44.29 (SD = 11.67). The prevalence of depression was 29.7%. Sophomore, female, and poor family relationships were parameters associated with a higher SDS score. The total correct rate for knowledge of depression was 64.14%. There were statistical differences between with depression students and non-depression students on the rate of the correct answers in the following questions:"Female has more probability", "Depression can be adjusted by oneself", "Associated with one's character", "Know cure method of depression", "Know drug use of depression", "Know depression influence for health", and "Know prevention method of depression". Depression students were more likely to have a lower rate of correct answer for above questions. Asking for help from psychological consultation was the primary coping mechanism among the medical students. The logistic regression analysis results found that depressed students who chose the coping way of no ways of coping were more likely to be females OR = 1.470 (1.078, 2.005), residents in rural area OR = 1.496 (1.038, 2.156), in poor family relationships OR = 2.428 (1.790, 3.293), and have lower cognitive level of depression knowledge OR = 1.920 (1.426, 3.226). It is necessary to focus on mental health of medical students, especially in female, residents in rural area, in poor family relationships, and having lower cognitive level of depression knowledge. Medical students were insufficient on depression knowledge and coping styles, and efforts that train students know risk of impaired mental health could also improve diagnosis and treatment.

Fostering Creative Thinking Skills on High and Low Cognitive Levels Students with Project-based Inquiry Learning

Integrating the development of soft skills, such as creative thinking, into classroom learning is essential. This study aims to analyze whether students' creative thinking skills can be enhanced through project-based inquiry learning that is varied for high and low cognitive levels. This research used a quasi-experimental design of 2x2 factorial. The research was done at a private senior high school for over a month. Forty-six eleventh-grade students were involved in this study. The samples consist of 23 high- and 23 low-cognitive ability students, which were determined using a cognitive ability instrument. The creative thinking skill was assessed by comparing the N-gain of the pretest and posttest scores using a creative thinking instrument. The results revealed that the cognitive level affects creative thinking skills significantly, and there is an interaction effect between the variation of the PjBI model and the cognitive ability levels. This result implies that students with high-cognitive levels performed better on creative thinking skills when learning with independent PjBI, while low-cognitive students showed better creative thinking skills when learning with guided PjBI.

Niche Overlap and Proximity of Photosynthesis Concepts by Middle School Students' Cognitive Level

The purpose of this study is to analyze the niche overlap and proximity of photosynthetic domain concepts according to the cognitive level of middle school students. For this, the subjects were 204 7th grade students. The cognitive level of middle school students was classified using the questionnaire used in GALT. After that, data on the concept relevance score and understanding level were collected using the concept relevance and understanding level questionnaire. The understanding level analysis framework and analyzed using the classification criteria modified and supplemented by Lim et al. The niche overlap of concepts was visualized using McPherson's square method using the concept relevance score and understanding level score, and the proximity between concepts was visualized using the multidimensional scaling method. The results of this study are as follows. First, students in the formal operational stage recognized science concepts closely as a result of learning, and the niche overlap between science concepts was high. Second, even after learning, niche overlap and proximity between concepts unrelated to the domain were presented, which differed according to cognitive levels. Third, the same concept had different niche overlap and proximity according to the domains, and there was a difference according to the cognitive level. Through the results of this study, it is necessary to connect and explain related scientific concepts for students with low cognitive levels. In addition, when the same concept is presented in different domains, it is expected that the properties and characteristics of each domain are clearly distinguished and taught.

[A cross-sectional survey and influencing factors analysis of knowledge, attitude, and behavior of enteral nutrition implemented by nurses in burn intensive care unit].

Objective: To investigate the status of knowledge, attitude, and behavior of enteral nutrition implemented by nurses in burn intensive care unit (BICU) and analyze its influencing factors. Methods: A multi-center cross-sectional survey research method was used. On May 8th, 2022, 107 BICU nurses who met the inclusion criteria were selected from the burn departments of the First Affiliated Hospital of Army Medical University (the Third Military Medical University), Guangdong Provincial People's Hospital, the First Affiliated Hospital of Guangxi Medical University, the Affiliated Hospital of Qinghai University, the Second Affiliated Hospital of Air Force Medical University, the Affiliated Hospital of Nantong University, Guiyang Steel Factory Staff Hospital, and the Second Affiliated Hospital of Kunming Medical University. The self-made nurses' enteral nutrition nursing knowledge-attitude-behavior questionnaire for severely burned patients was used to investigate the nurses' gender, age, working years, professional title, position, highest educational background, and whether they received systematic training in knowledge of enteral nutrition, the scores of each factor, and the total scores of knowledge, attitude, and behavior dimensions of enteral nutrition in nurses. The nurses were classified according to the general data, and the total scores of their knowledge, attitude, and behavior of enteral nutrition were calculated. Data were statistically analyzed with independent sample t test, one-way analysis of variance, Mann-Whitney U test, and Kruskal-Wallis H test. According to the results of univariate analysis and combined with clinical experience and significance, the generalized linear model analysis was carried out to screen the independent influencing factors of the total scores of knowledge, attitude, and behavior of enteral nutrition in BICU nurses. Results: A total of 107 nurses were surveyed, and 107 valid questionnaires were collected, with an effective recovery rate of 100%. In the BICU nurses' enteral nutrition knowledge-attitude-behavior questionnaire, the total scores of knowledge, attitude, and behavior were 44±13, 87±15, and 70±19, respectively. Most of the BICU nurses in this survey were female, aged 22-48 (31±6) years, and the number of nurses worked for 1-5, 6-10, and ≥11 years was evenly distributed. The majority of the professional titles of nurses were nurses, positions were responsible nurses, and the highest educational background was undergraduate. Forty-four nurses received systematic training in knowledge of enteral nutrition. There were statistically significant differences in the total scores of knowledge of enteral nutrition among BICU nurses with different ages, working years, professional titles, positions, highest educational background, and whether they received systematic training in knowledge of enteral nutrition (with H values of 27.36, 15.27, and 10.19, respectively, Z values of -3.33, -2.59, and -6.46, respectively, P<0.05). There were no statistically significant differences in the total scores of attitude and behavior of enteral nutrition among BICU nurses with different gender, ages, working years, professional titles, positions, highest educational background, and whether they received systematic training in knowledge of enteral nutrition (P>0.05). Age (26-30, 31-35, and ≥36 years old), highest educational background (undergraduate), and the systematic training received in enteral nutrition knowledge were the independent influencing factors for the total score of knowledge of enteral nutrition in BICU nurses (with 95% confidence intervals of 0.12-0.36, 0-0.30, 0.03-0.31, 0.01-0.32, and 0.19-0.40, respectively, standardized regression coefficients of 0.24, 0.15, 0.17, 0.17, and 0.29, respectively, P<0.05). There were no independent influencing factors for the total scores of enteral nutrition attitude and behavior of BICU nurses in different characteristics (P>0.05). Conclusions: The BICU nurses have low cognitive level in the implementation of enteral nutrition, their concept needs to be updated in time, and their behavior needs to be further standardized. Age (26-30, 31-35, and ≥36 years old), highest educational background (undergraduate), and the systematic training received in enteral nutrition knowledge were the independent influencing factors for the knowledge of enteral nutrition in BICU nurses.

Cognition and Cognitive Changes in a Low-Income Sub-Saharan African Aging Population.

Cognition and its age-related changes remain vastly understudied in low-income countries (LICs), despite evidence suggesting that cognitive decline among aging low-income populations is a rapidly increasing disease burden often occurring at younger ages as compared to high-income countries (HICs). We examine patterns of cognition among men and women, 45 + years old, living in rural Malawi. We analyze how key socioeconomic characteristics predict levels of cognition and its changes as individuals get older. Utilizing the Mature Adults Cohort of the Malawi Longitudinal Study of Families and Health (MLSFH-MAC) collected during 2012-2017, we estimate standard regression models to analyze predictors of the age- and sex-specific levels and longitudinal changes in cognition. Cognition is assessed with a screening instrument that is adapted to this low-literacy context and measures different domains such as language, attention, or executive functioning. Women have lower levels of cognition than men, a pattern in stark contrast to findings in HICs. Schooling and socioeconomic status increase the probability of having consistently high performance during the cognitive assessment. Cognitive decline accelerates with age and is detectable already at mid-adult ages (45-55 years). Despite lower levels of cognitive function observed among women, the pace of decline with age is similar for both genders. Women are particularly affected by poor cognition in this context. The study emphasizes the importance of prioritizing cognitive health and research on cognition among older individuals in sub-Saharan Africa LICs, to which relatively little health care resources continue to be allocated.

ANALISIS TINGKAT KOGNITIF SOAL UJIAN SEKOLAH PADA MATA PELAJARAN PENDIDIKAN AGAMA ISLAM BERDASARKAN TAKSONOMI BLOOM REVISI 2001

This study aims to analyze the cognitive level of school exam questions on Islamic Religious Education subjects based on Bloom's Revised Taxonomy. Bloom's Revised Taxonomy is used as an assessment framework to describe the level of cognitive complexity requested by each exam question. The research method used was content analysis of Islamic Religious Education question banks from several schools covering primary and secondary education levels. The results of the analysis show that most of the Islamic Religious Education exam questions still concentrate on lower cognitive levels such as remembering and understanding. Higher cognitive levels such as applying, analyzing, evaluating and creating are rarely found in these questions. This indicates a tendency to use questions that tend to ask students to remember and understand religious concepts, rather than encouraging critical and analytical thinking skills

Conventional clock drawing tests have low to moderate reliability and validity for detecting subtle cognitive impairments in community-dwelling older adults.

Early identification of subtle cognitive decline in community-dwelling older adults is critical, as mild cognitive impairment contributes to disability and can be a precursor to dementia. The clock drawing test (CDT) is a widely adopted cognitive screening measure for dementia, however, the reliability and validity of paper-and-pencil CDT scoring scales for mild cognitive impairment in community samples of older adults is less well established. We examined the reliability, sensitivity and specificity, and construct validity of two free-drawn clock drawing test scales-the Rouleau System and the Clock Drawing Interpretation Scale (CDIS)-for subtle cognitive decline in community-dwelling older adults. We analyzed Rouleau and CDIS scores of 310 community-dwelling older adults who had MoCA scores of 20 or above. For each scale we computed Cronbach's alpha, receiver operating characteristic curves (ROC) for sensitivity and specificity using the MoCA as the index measure, and item response theory models for difficulty level. Our sample was 75% female and 85% Caucasian with a mean education of 16 years. The Rouleau scale had excellent interrater reliability (94%), poor internal consistency [0.37 (0.48)], low sensitivity (0.59) and moderate specificity (0.71) at a score of 9. The CDIS scale had good interrater reliability (88%), moderate internal consistency [0.66 (0.09)], moderate sensitivity (0.78) and low specificity (0.45) at a score of 19. In the item response models, both scales' total scores gave the most information at lower cognitive levels. In our community-dwelling sample, the CDIS's psychometric properties were better in most respects than the Rouleau for use as a screening instrument. Both scales provide valuable information to clinicians screening older adults for cognitive change, but should be interpreted in the setting of a global cognitive battery and not as stand-alone instruments.

Cognitive-Behavioral Profile in Pediatric Patients with Syndrome 5p-; Genotype-Phenotype Correlationships.

(1) Background: 5p minus Syndrome (S5p-) is a neurodevelopmental disorder caused by a deletion in the short arm of chromosome 5. Among the phenotypic characteristics of S5p-, the most characteristic and representative element is a monochromatic cry with a high-pitched tone reminiscent of a cat's meow. Individuals may also show great phenotypic heterogeneity and great genetic variability. Regarding cognitive-behavioral aspects of the syndrome, the studies are scarce and do not establish a general profile of the main cognitive-behavioral particularities that this syndrome presents. The main objective of this work was to describe the development profile of a cohort of 45 children with 5p minus Syndrome, concerning the biomedical, genetic, cognitive, and behavioral aspects. Establishing putative genotype-phenotype (cognitive-behavioral profiles) relationships in our cohort, from an interdisciplinary approach. (2) Methods: A selection of instruments of measures was selected for neuropsychological assessment (3) Results: In general, children with S5p- have a higher cognitive level than a communicative and motor level. Language difficulties, especially expressive ones, influence the frequency and severity of the most frequent behavioral problems in S5p. The most significant problem behavior of children with S5p-, especially girls, is self-harm. Compulsive behavior, limited preferences, and interest in monotony are significantly more frequent in subjects with better cognitive levels. We also find a significant correlation between the size of the loss of genetic material on 5p and the cognitive level of the subjects. (4) Conclusions: We described for the first time, the cognitive-behavioral profile of a cohort of minors with S5p-. Remarkably, it was found that language, especially of an expressive nature, modulates the most frequent behavioral aspects in subjects with lower cognitive levels, so it is essential to develop verbal or alternative communication strategies adjusted to these individuals.

Development of the Chinese Pop Music Module in Enhancing Chinese Culture Cognition, Learning Motivation, and Cross-cultural Adaptability of International Students in Chinese Higher Vocational Colleges

Under the Belt and Road initiative, the number of international students in China has grown significantly. How to help international students improve their low level of Chinese culture cognition, learning motivation, and cross-cultural adaptability in China has become a hot topic. This study developed the current Chinese pop music module to solve the main problems faced by international students in the first academic year of Chinese higher vocational colleges. The ASSURE model was used to develop the teaching process of the current Chinese pop music module to achieve the teaching objective and improve teaching effectiveness. Teaching content of the developed module included Chinese campus music, Chinese minority music and dance, Chinese rock music, Chinese rap, Chinese-style songs, and Chinese R&amp;B. The Chinese pop music module with improved teaching content was then discussed in detail.

The relationship between genetic liability, childhood maltreatment, and IQ: findings from the EU-GEI multicentric case–control study

This study investigated if the association between childhood maltreatment and cognition among psychosis patients and community controls was partially accounted for by genetic liability for psychosis. Patients with first-episode psychosis (N = 755) and unaffected controls (N = 1219) from the EU-GEI study were assessed for childhood maltreatment, intelligence quotient (IQ), family history of psychosis (FH), and polygenic risk score for schizophrenia (SZ-PRS). Controlling for FH and SZ-PRS did not attenuate the association between childhood maltreatment and IQ in cases or controls. Findings suggest that these expressions of genetic liability cannot account for the lower levels of cognition found among adults maltreated in childhood.

Association of poor oral health with increased incidence of dysphagia and impaired improvement in nutritional status among patients with acute heart failure: a prospective cohort study.

This study aimed to clarify the association between oral health and the incidence of dysphagia as well as the recovery of nutritional status and improvement of dysphagia in hospitalized patients with acute heart failure. Hospitalized patients with AHF were prospectively enrolled. Oral health was evaluated using the Japanese Version of the Oral Health Assessment Tool (OHAT-J) after circulation dynamics improved (defined as baseline), and participants were classified into good and poor oral health groups (OHAT-J 0-2 and ≧ 3, respectively). The primary outcome measure was the incidence of dysphagia evaluated using the Food Intake Level Scale (FILS) at baseline. Secondary outcome measures were nutritional status and FILS score at discharge. Nutritional status was assessed using the Mini Nutritional Assessment Short Form (MNA-SF). Univariate and multivariate logistic regression analyses were used to determine the association between oral health and the study outcomes. Of the 203 recruited patients (mean age, 79.5years; 50.7% female), 83 (40.9%) were in the poor oral health group. Participants with poor oral health were significantly older, had lower skeletal muscle mass and strength, lower nutrient intake and nutritional status, worse swallowing status, as well as lower cognitive level, and physical function than those with good oral health. In multivariate logistic regression analyses, baseline poor oral health was significantly associated with the incidence of dysphagia (odds ratio = 1.036, P = 0.020), as well as with the improvement in nutritional status (odds ratio = 0.389, P = 0.046) and dysphagia (odds ratio = 0.199, P = 0.026) at discharge. Poor baseline oral health was associated with the incidence of dysphagia, as well as with the lack of improvement in nutritional status and dysphagia in patients with acute heart failure.

Repetitive and restricted behaviors and interests in autism spectrum disorder: relation to individual characteristics and mental health problems

BackgroundAlthough repetitive and restricted behaviors and interests (RRBIs) may interfere with well-being and functioning in autistic individuals, research on their relation to sex, age, cognitive level, and mental health problems remains unclear. Much of the research to date has used broad categorizations rather than specific categorizations of RRBIs to examine the difference in RRBIs between individuals. The purpose of this study was to explore, in different groups of individuals, the presence of specific RRBI subtypes, and to examine the association of specific RRBI subtypes with symptoms of internalizing and externalizing behaviors.MethodsSecondary data analyses were conducted using the Simons Simplex Collection dataset, which included 2,758 participants (aged 4 to 18). Families of autistic children completed the Repetitive Behavior Scale–Revised (RBS-R) and the Child Behavior Checklist.ResultsAcross all RBS-R subtypes, results revealed no sex differences. Older children showed higher rates of Ritualistic/Sameness behaviors than younger children and adolescents, whereas younger and older children showed more Stereotypy than adolescents. Additionally, lower cognitive level groups showed higher rates of RBS-R subtypes except for Ritualistic/Sameness. After controlling for age and cognitive level, RBS-R subtypes accounted for a substantial amount of variance in internalizing and externalizing behaviors (23% and 25%, respectively). Specifically, Ritualistic/Sameness and Self-Injurious Behavior both predicted internalizing and externalizing behaviors, whereas Stereotypy only predicted internalizing behavior.ConclusionsThese findings have key clinical implications that emphasize not only the consideration of sex, age, and cognitive level, but also specific RRBIs and co-occurring mental health problems, when assessing for ASD and designing individualized interventions.