Low Performance Group Research Articles

Individual hand hygiene improvements and effects on healthcare-associated infections: a long-term follow-up study using an electronic hand hygiene monitoring system

Obtaining detailed insights into people's unique hand hygiene behaviour could play an important role in developing the most effective long-term hand hygiene compliance (HHC) interventions. To investigate the effect of two feedback interventions provided by an electronic hand hygiene monitoring system (EHHMS) on sustained HHC improvement, individual responsiveness, and prevention of hospital-acquired bloodstream infections (HABSIs) and urinary tract infections (HAUTIs). The study included two 2-year cohorts (exposed and unexposed to EHHMS) observed over 4 years in an internal medicine department with 142 caregivers and 39 doctors. Healthcare workers (HCWs) were stratified into four groups based on their baseline performance to assess predicted responsiveness to the interventions. All HCWs increased their HHC independently from their performance at baseline, except for a few in the low-performance groups with constantly low HHC. The two low-performance groups at baseline were most responsive to group feedback (weekly change in HHC of 4.4% and 3.1%) compared with individual feedback (weekly change in HHC of 1.0% and 2.2%). The number of cases of HABSI reduced significantly during the intervention period (P=0.01), with the greatest effect on Staphylococcus aureus. No significant change in HAUTIs was observed. The EHHMS interventions sustained the HHC improvements successfully and reduced the number of cases of HABSI. Nearly all HCWs responded to the interventions. The two low-performance groups at baseline never reached the same HHC levels as those in the high-performance groups, indicating the potential for further improvement and the need for intensified individualized interventions.

A Status and Performance of Dairy Cooperative Societies in Karnataka

The present study was carried out in Karnataka state to assess the status and performance of Dairy Cooperative Societies (DCS). A total number of 18 DCS were selected from the three regions of the state, such as the southern, central coastal and , northern regions, in equal numbers. The annual growth rate of the establishment of dairy cooperatives in the state was reported to be 4.01 per cent, and the growth rate of the milk procurement of the society per annum was increased to 9.18 per cent. The milk procurement of the society directly influenced the performance of the DCS. Among the selected societies, the highest milk procurement was observed for those under BAMUL, followed by SHIMUL and RBKMUL. The Principal Component Analysis (PCA) was applied to assess the performance of selected DCS. The results of PCA showed that about 39 per cent of the DCS were categorized under the lowperformance group, followed by 33 and 28 per cent of the societies classified as medium and high-performance, respectively. Overall, the performance of DCS was low to medium, which may be attributed to less per cent of active members per DCS, low milk procurement per society per day and unequal distribution of inputs. Therefore, dairy farmers need to be aware of the benefits provided by dairy cooperatives so that many farmers may participate actively and get benefitted.

Influence de la comparaison symbolique versus non symbolique sur le risque de difficultés d’apprentissage en mathématiques en éducation de la petite enfance

The main goal of this study was to clarify if students at risk of Mathematics Learning Disabilities had deficits in symbolic, non-symbolic processing, or both. Other purpose was to know if the Open Algorithm Based on Numbers (OBN) teaching method offers advantages over Closed Algorithms Based on Ciphers (CBC) method. A total of 307 Early Childhood Education students participated in this study. Based on student’ scores obtained in Test of Early Mathematics Ability (TEMA-3), that assesses formal and informal thinking, three analysis groups were designed: low-performance group, average-performance group, and high-performance group. There were significant differences in symbolic comparison and, consequently, the post hoc analysis showed significant differences between all groups in symbolic comparison except between the High and Average groups calculation. However, there were no differences in non-symbolic comparison between any of the groups. The teaching method and the mathematical competence showed a significant effect only on the symbolic comparison, resulting in a small size of effect for both the method and the Early Math Competence rate. These data support the dual representation hypothesis, in which the non-symbolic magnitudes would activate the Numerical Approximation System (ANS) and the symbolic quantities an exact representation of the numbers. This being a significant source of mathematical learning that could contribute to the improvement of the ANS.

High masticatory ability attenuates psychosocial stress: A cross-sectional study.

Mastication interventions have previously been shown to alleviate acute stress. However, the relationship between masticatory performance and stress response among individuals remains unclear. This study aimed to examine the relationship between masticatory ability and stress response in young women by measuring the autonomic nerve function and salivary α-amylase activity during psychosocial stress. Eighty women (aged 20.0 ± 1.9 years) were divided into either a low or high masticatory performance group, and the Trier Social Stress Test was conducted. Moreover, the autonomic function was measured at rest, immediately before stress, immediately after stress, and 10 min after stress. The salivary α-amylase activity was also measured at rest, 5 min after stress, and 15 min after stress. The visual analog scale (VAS) was used for subjective stress evaluation. There was a significant increase in the autonomic balance of both groups immediately before stress loading, but whilst the high masticatory ability group showed a return to resting-state levels after stress loading, the low masticatory ability group showed elevated levels after stress loading. Salivary α-amylase activity significantly increased 5 min after stress loading in the low, but not high, masticatory ability group. Furthermore, the VAS scores for tension and confusion after stress were significantly higher in the low masticatory ability group than in the high masticatory ability group. Our findings suggest that high masticatory performance may contribute to alleviating psychosocial stress. This is the first study to clarify the relationship between habitual masticatory performance and psychosocial stress suppression in young women.

Faulty Hip and Pelvis Biomechanics Do Not Differentiate Between 5k Performance in NCAA Division II Cross-Country Runners

Introduction: Excessive hip adduction (HADD) and contralateral pelvis drop (CPD) angles during running are associated with running-related injuries. Their influence on performance is less known. Therefore, we aimed to determine if HADD and CPD could differentiate between high and low race performers, and if there were relationships between CPD, HADD and race performance. Methods: Twenty-six healthy male and female NCAA Division II cross-country runners participated in this prospective study. They underwent 3D motion analysis of their HADD and CPD during pre-participation physical examinations. Times from the first race of the season were converted to International Association of Athletics Federation (IAAF) points and high and low performance groups were created. Pearson correlation coefficients were used to examine the associations between HADD, CPD and IAAF points, and Independent Samples T-tests were used to determine differences in HADD and CPD between high and low performance groups. Results: There were no significant relationships between IAAF points and left HADD (r=0.11, p=0.59), right HADD (r=0.19, p=0.35), left CPD (r=-0.06, p=0.79), or right CPD (r=-0.06, p=0.76). There were no significant differences between high and low performance groups in left HADD (t(24)=0.48, p=0.64), right HADD (t(24)=0.45, p=0.33), left CPD (t(24)=0.62, p=0.27), or right CPD (t(24)=0.53, p=0.30). Conclusions: The RRI biomechanics of excessive CPD and HADD do not influence 5k race performance in collegiate distance runners.

Race development and performance-determining factors in a mass-start cross-country skiing competition.

Although five of six Olympic events in cross-country skiing involve mass-starts, those events are sparsely examined scientifically. Therefore, in this study, we investigated speed profiles, pacing strategies, group dynamics and their performance-determining impact in a cross-country skiing mass-start competition. Continuous speed and position of 57 male skiers was measured in a six-lap, 21.8 km national mass-start competition in skating style and later followed up with an online questionnaire. Skiers ranked from 1 to 40 were split into four performance-groups: R1-10 for ranks 1 to 10, R11-20 for ranks 11 to 20, R21-30 for ranks 21 to 30, and R31-40 for ranks 31 to 40. All skiers moved together in one large pack for 2.3 km, after which lower-performing skiers gradually lost the leader pack and formed small, dynamic packs. A considerable accordion effect occurred during the first half of the competition that lead to additional decelerations and accelerations and a higher risk of incidents that disadvantaged skiers at the back of the pack. Overall, 31% of the skiers reported incidents, but none were in R1-10. The overall trend was that lap speed decreased after Lap 1 for all skiers and thereafter remained nearly unchanged for R1-10, while it gradually decreased for the lower-performing groups. Skiers in R31-40, R21-30, and R11-20 lost the leader pack during Lap 3, Lap 4, and Lap 5, respectively, and more than 60% of the time-loss relative to the leader pack occurred in the uphill terrain sections. Ultimately, skiers in R1-10 sprinted for the win during the last 1.2 km, in which 2.4 s separated the top five skiers, and a photo finish differentiated first from second place. Overall, a high correlation emerged between starting position and final rank. Our results suggest that (a) an adequate starting position, (b) the ability to avoid incidents and disadvantages from the accordion effect, (c) tolerate fluctuations in intensity, and (d) maintain speed throughout the competition, particularly in uphill terrain, as well as (e) having well-developed final sprint abilities, are key factors determining performance during skating-style mass-start cross-country skiing competitions.

Creative problem-solving ability does not occur by chance: Examining the dynamic system model of creative problem solving ability

This study examined Cho’s dynamic system model of creative problem-solving ability in a sample of 112 gifted and non-gifted students. The cluster analysis and t-test results indicated that students should be categorized into high and low performance groups. Students who scored three points or more across all attributes also had a higher likelihood of possessing better mathematical creative problem-solving abilities. Furthermore, significant differences were found in the two groups’ scores on the Creative Problem Solving Attributes Inventory and Mathematical Creative Problem Solving Ability Test. The environment attribute was the only one on which the two groups did not differ significantly; this may be the result of education fever in Asian societies. Finally, the results of this study not only indicated that creativity does not rely on a single factor but that a well-balanced environment is imperative to nurturing creativity.

Idea Improvement and Socially Shared Regulation Matter in Cross-Cultural Online Collaborative Learning

Cross-cultural collaborative learning has been paid more and more attention in recent years. To promote productive cross-cultural collaborative learning, idea generation and improvement, and socially shared regulation is crucial. The study aimed to identify the differences in idea generation and improvement as well as socially shared regulation between high- and low-performance groups in cross-cultural online collaborative learning. In this study, 24 culturally diverse university students composed of eight groups conducted cross-cultural online collaborative learning to solve problems collaboratively. Epistemic network analysis and lag sequential analysis methods were employed to analyze data quantitatively and qualitatively. The results revealed that different strategies shape different learning performances. High-performance groups adopted more cognitive, social, and regulation processes than low-performance groups. The results extend the existing literature by indicating that idea elaboration, refining or building on ideas, and appraisal is strongly connected to new ideas. In addition, transitions from monitoring and controlling to adapting metacognition in collaborative learning activities are the main difference in socially shared regulation between high-performance and low-performance groups. This study shed light on how to engage culturally diverse students to generate and improve ideas as well as jointly regulate collaborative learning.

Association of low-carbohydrate-diet score and cognitive performance in older adults: National Health and Nutrition Examination Survey (NHANES)

BackgroundTo investigate the association between low-carbohydrate-diet (LCD) score and cognitive performance based on a nationally representative sample aged ≥ 60 years from National Health and Nutrition Examination Survey (NHANES) database.MethodsThis cross-sectional study included 2,537 eligible older adults from the NHANES database 2011–2014. The Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) word learning subtest, Animal Fluency Test (AFT), and Digit Symbol Substitution Test (DSST) were used to assess the cognitive performance. All participants were categorized into the low and normal cognitive performance groups. The univariate and multivariate logistic regression analyses were utilized to evaluate the association of LCD score with cognitive performance. Stratified analyses based on age, body mass index (BMI), gender, marital status, education level was conducted.ResultsAfter adjusting age, education level, marital status, household income, history of diabetes, history of hypertension, history of congestive heart failure, history of coronary heart disease, history of heart disease, history of stroke, magnesium and the using of psychotropic medication, LCD score was correlated with the CERAD word learning subtest. The associations between LCD score and AFT, DSST were not statistically significant. Moreover, LCD score was also related to cognitive performance among individuals who were aged < 65 years or BMI 25–30 kg/m2 or was married/separated, or had an education level of high school or above.ConclusionThe adherences to LCD might be associated with the risk of cognitive performance among older adults. Further large-scale cohort studies are needed to test the causal relationship of LCD and cognitive performance.

COUNTERMOVEMENT JUMP FORCE-TIME METRICS AND MAXIMAL HORIZONTAL DECELERATION PERFORMANCE IN PROFESSIONAL MALE BASKETBALL PLAYERS

Basketball is a sport that relies heavily on an athlete’s ability to rapidly decelerate in order to change direction, avoid a defender, or create space. Recent literature has proposed novel ways of measuring maximal horizontal deceleration using radar technology. The aim of this study was to investigate the relationships between different countermovement jump (CMJ) force-time characteristics and metrics related to maximal horizontal deceleration for a sample of professional male basketball players. To gain further insight into performance qualities that influence horizontal deceleration performance, athletes were separated into high- and low-performance groups for all horizontal deceleration metrics, using a median split analysis, and differences in CMJ force-time metrics were investigated between groups. The results revealed no significant correlations between any CMJ force-time metrics and horizontal deceleration performance. However, athletes’ height and body mass were correlated with different deceleration performance measures, such as average deceleration, horizontal deceleration impulse, and time to stop. Higher performing athletes with regards to average horizontal deceleration and horizontal braking impulse relative to body mass generated greater concentric power (effect size (ES) = 1.04, ES = 0.86) and concentric velocities (ES = 1.17, ES = 0.97), as well as greater jump heights (ES = 1.19, ES = 0.99). Reactive Strength Index modified values were also greater in the higher performing group for horizontal braking impulse relative to body mass (ES = 1.06). On the other hand, higher-performing athletes with regard to horizontal braking impulse generated greater eccentric deceleration force (ES = 0.81) and eccentric power values (ES = 0.88) in the CMJ. Findings may be of interest to practitioners physically preparing basketball players for the sport-specific deceleration actions they may encounter.

The role of argumentation on high- and low-creative performing groups: A structuration analysis of undergraduate students’ group discussion

Communication is essential for group creativity, and involves cognitive and social processes. However, research rarely investigates how these two processes unfold from a communication perspective, and its consequences on group creative performance. This study adopted the structuration theory as a framework that is capable of integrating both approaches in the study of in-group communication. In particular, we employed a structuration view to examine group argument; a social practice defined as both a system (argumentative patterns of interactive behaviors) and a structure (rules and resources undergirding the system). By applying the Conversational Argument Coding Scheme (CACS) and Lag Sequential Analysis (LSA) to analyze the argumentative behaviors of 17 groups of undergraduate students performing a creative task, we identified significant differences in the systems and structures exhibited by high and low-performing groups. Successful creative groups exhibit argumentative patterns characterized by conflict, which contributes to the generation of new ideas and the integration of diverse perspectives. In contrast, less successful groups revealed a system that focused on reaching consensus rather than challenging or evaluating ideas. This paper further discusses the first empirical evidence provided by LSA on unpacking the communication dynamics that involve social and cognitive processes in in-group creative discussions.

Relationship between Physical Fitness and Academic Performance in University Students.

Several studies involving students have been developed with the objective to analyse the influence of different factors on academic performance. Nevertheless, all these studies were focused on stress and sympathetic modulation response instead of contemplating other physiological parameters that may affect academic performance. The aim of the present study was to analyse body composition, cardiovascular, sleep habits and physical activity factors related to the academic performance of university students. Two hundred and sixty-one students with bachelor's degrees in physical activity and sports science participated in the present study (age: 22.49 ± 3.84 years; weight: 73.94 ± 11.4 kg; height: 176.28 ± 7.68 cm; 87.7% males). Participants were divided into two groups according to their academic performance: low academic performance group (LAPG) and high academic performance group (HAPG). Body composition, blood pressure, physical activity and sleep habits were measured, and maximum oxygen uptake was estimated by the Cooper's 12 min run test. The results show that students with a high academic performance presented a higher VO2 max than the LAPG (LAPG = 40.32 ± 6.07; HAPG = 47.91 ± 6.89 mL/kg/min; p &lt; 0.001), as well as lower diastolic blood pressure (LAPG = 72.44 ± 14.27; HAPG = 67.48 ± 13.50 mmHg; p &lt; 0.01) and insomnia levels caused by breathing problems (LAPG = 0.37 ± 0.8; HAPG = 0.13 ± 0.42 a.u.; p = 0.046). Therefore, we found a relevant association between academic performance and VO2 max, diastolic blood pressure, and insomnia caused by breathing problems. These results highlight the importance of applying different programmes that may improve these factors, especially those related to physical activity and sleep habits in order to improve academic achievement.

Association between exposure to phenols and parabens and cognitive function in older adults in the United States: A cross-sectional study

BackgroundPeople are commonly exposed to mixtures of parabens and phenols. Most studies investigating such exposure and cognitive performance tend to assess only single chemicals, and the tools used to assess cognitive function are not uniform. ObjectiveThis study aimed to examine the association between multiple parabens and phenols and cognitive function in older Americans. MethodsThe study included data of older Americans from two cycles of the NHANES survey. Participants were divided into normal cognitive performance and low cognitive performance groups based on the scores of four cognitive tests: the Immediate Recall test (IRT), the Delayed Recall test (DRT), the Animal Fluency test (AFT) and the Digit Symbol Substitution test (DSST). Generalized linear regression models (GLMs), restricted cubic spline (RCS), weighted quantile sum (WQS) and Bayesian kernel machine regression (BKMR) were used to assess relationships between chemical exposure and cognitive performance. ResultsIn this cross-sectional study, a total of 961 participants, 470 males and 491 females, were included. GLMs revealed positive association between high levels of bisphenol A (BPA) and low cognitive performance on DRT, especially in male (OR (95%CI): 2.25 (1.10–4.61)), and this association was consistent with WQS and BKMR. In female participants, the third quartile of BPA exposure showed a positive association with low cognition on IRT and global cognition. GLMs also showed that high levels of propylparaben were positively associated with cognitive performance on the IRT in male participants (OR (95%CI): 0.37 (0.18–0.76)). In BKMR, an overall positive correlation between the mixture and low cognition as measured with DRT was observed in male subjects when the mixture was at the 65th percentile or higher. ConclusionExposure to a mixture of parabens and phenols was positively associated with low cognitive performance on DRT in older male subjects, while BPA was the main driver of this outcome.

Resting-State EEG in Alpha Rhythm May Be Indicative of the Performance of Motor Imagery-Based Brain-Computer Interface.

Motor imagery-based brain-computer interfaces (MI-BCIs) have great application prospects in motor enhancement and rehabilitation. However, the capacity to control a MI-BCI varies among persons. Predicting the MI ability of a user remains challenging in BCI studies. We first calculated the relative power level (RPL), power spectral entropy (PSE) and Lempel-Ziv complexity (LZC) of the resting-state open and closed-eye EEG of different frequency bands and investigated their correlations with the upper and lower limbs MI performance (left hand, right hand, both hands and feet MI tasks) on as many as 105 subjects. Then, the most significant related features were used to construct a classifier to separate the high MI performance group from the low MI performance group. The results showed that the features of open-eye resting alpha-band EEG had the strongest significant correlations with MI performance. The PSE performed the best among all features for the screening of the MI performance, with the classification accuracy of 85.24%. These findings demonstrated that the alpha bands might offer information related to the user's MI ability, which could be used to explore more effective and general neural markers to screen subjects and design individual MI training strategies.

Factors Contributing to Poor Academic Achievement Among Low Performing Pupils: A Case Study

: Despite numerous efforts by the Malaysian Ministry of Education to raise educational quality especially in the wake of the Covid 19 pandemic, the number of low-performing pupils in Malaysian schools remains a serious concern. Additionally, the number of pupils’ dropping out has increased during the period of online facilitation. This qualitative case study examines factors contributing to poor academic achievement among low performing pupils. Also, it explored the strategies to overcome those factors. Sampling was purposeful as this study required the views of both those who were directly part of the low-performing group either as students or educators. Five teachers and five low academic performing pupils were chosen as participants from a Malaysian primary school. Data was gathered through scheduled semi-structured interviews with teachers and pupils. The study sought to explore the factors that contribute to poor academic achievement, and those which are frequently overlooked. The findings revealed that the main factors related to pupils with low academic performance, were lack of family or parental support, financial issues, motivation, learning facilities, interaction, equality and teaching techniques. These findings will help teachers, school administrators, curriculum designers and developers to plan new teaching and learning strategies in their classrooms.

Event-related microstate dynamics represents working memory performance

In recent years, EEG microstate analysis has attracted much attention as a tool for characterizing the spatial and temporal dynamics of large-scale electrophysiological activities in the human brain. Canonical 4 states (classes A, B, C, and D) have been widely reported, and they have been pointed out for their relationships with cognitive functions and several psychiatric disorders such as schizophrenia, in particular, through their static parameters such as average duration, occurrence, coverage, and transition probability. However, the relationships between event-related microstate changes and their related cognitive functions, as is often analyzed in event-related potentials under time-locked frameworks, is still not well understood. Furthermore, not enough attention has been paid to the relationship between microstate dynamics and static characteristics.To clarify the relationships between the static microstate parameters and dynamic microstate changes, and between the dynamics and working memory (WM) function, we first examined the temporal profiles of the microstates during the N-back task. We found significant event-related microstate dynamics that differed predominantly with WM loads, which were not clearly observed in the static parameters. Furthermore, in the 2-back condition, patterns of state transitions from class A to C in the high- and low-performance groups showed prominent differences at 50–300 ms after stimulus onset. We also confirmed that the transition patterns of the specific time periods were able to predict the performance level (low or high) in the 2-back condition at a significant level, where a specific transition between microstates, namely from class A to C with specific polarity, contributed to the prediction robustly. Taken together, our findings indicate that event-related microstate dynamics at 50–300 ms after onset may be essential for WM function. This suggests that event-related microstate dynamics can reflect more highly-refined brain functions.

Quantitative analysis of team communication for maritime collaborative task performance improvement

Poor communication may cause serious maritime accidents. In order to improve crews' collaborative task performance through team communication optimization, the present study implements a combination of social network analysis and speech-act coding analysis to quantitatively characterizes team communication. Twenty-one teams of eighty-four participants were recruited for an experiment in which they were instructed to perform three kinds of simulated collaborative tasks that are typical for maritime crews. Team communication was recorded using cameras and expert observation. The participants were divided into two groups according to task performance, and an independent sample t-test was used for group verification. The experimental results show that the high task performance group had a significantly shorter task completion time than that of the low task performance group. Besides, there existed significant differences in the communication mode adopted by the two groups. Compared with the low task performance group, the high task performance group exhibited a denser and more decentralised communication structure. They also had a stronger perception, deeper understanding, and greater prediction of communication content, which indicates better situation awareness. This study provides a theoretical basis and supporting data for improving crews’ collaborative task performance according to the quantitative analysis of team communication.

Joint energy and shot mechanical energy of glide-style shot put

Shot put is a throwing exercise in track and field. Performance has a strong relationship with the thrower’s height, technique, and energy transferred. The purpose of this study was to compare basic kinematics, joint movement, shot mechanical energy, and joint energy of the male glide-style shot put between high-performance (HP) and low-performance (LP) athletes. Data for 12 right-handed male shot putters with glide-style was captured at the National Games held in Taipei city in 2013. The HP ( n = 6) and LP ( n = 6) groups were classified according to their best throwing distance in the competition. Additionally, the 2D kinematics of their joints and shots were obtained by Kwon 3D motion analysis. Finally, the kinematics and energy were calculated in Excel software package. Results showed significant differences in throwing distance, the relationship between throwing distance and body height index (RDH index), release velocity, and the shoulder-shot (BSX) angle at right toe-off ground instant (RTF) and the angle difference between the right toe-off instant and release instant (RI-RTF) between the HP and LP groups. However, the energy of the joints and shots were not significantly different between the two groups. The better throwers exhibited a faster release velocity, accompanied by a smaller change in the SSX angle, and the SSX angle can be used by the coach to assess the body’s forward or backward tilt during training.

The Patient's Voice in Assessing Resident Communication Skills

To generate validity evidence for using patient-reported satisfaction ratings of residents' communication skills to determine progress along the Interpersonal and Communication Skills (ICS) Milestones. A single-institution, retrospective study analyzed a CAHPS Clinician and Group Survey (CG-CAHPS) database which collects inpatients' ratings of residents' communication skills using 6 questions on a scale of 1 (very poor) to 5 (very good). CG-CAHPS results for each resident were averaged for each question as well as across the 6 questions. The averaged ratings were compared between low and high performer groups. A large, academic, mid-western General Surgery residency program. General Surgery residents with 3 or more survey responses from July 2020 to June 2021 were included. Residents were dichotomized into low or high performer groups based on their end-of-year ICS1 sub-competency milestone within their post-graduate year (PGY) cohort. 543 CG-CAHPS responses across 44 residents were analyzed with a median of 9 (Interquartile range 6, 17) responses per resident. When residents were compared based on PGY, ratings for the question "resident's knowledge about your medical care of condition" demonstrated statistically significant differences with PGY5s receiving the lowest score (p = 0.05). PGY5s received the lowest averaged ratings across all questions (p = 0.08, η2 = 0.10). When residents were dichotomized into low (n = 21) and high performer groups (n = 23) based on ICS1 milestones, statistically significant differences were noted in ratings for the questions "concern the resident showed for your questions or worries" (4.81 vs. 5, p = 0.047) and "courtesy and respect of the resident" (4.75 vs. 5, p = 0.046). Analysis of patient ratings of surgery residents' communication skills demonstrated concordant findings between ICS1 milestone and 2 domains of CG-CAHPS responses. When low and high performer groups were compared, CG-CAHPS responses demonstrated a similar pattern. These findings provide validity evidence for CG-CAHPS data as a source of information for ICS1 sub-competency assessment.

Contributions of the psychology of mathematical cognition in early childhood education using apps.

Educational interventions are necessary to develop mathematical competence at early ages and prevent widespread mathematics learning failure in the education system as indicated by the results of European reports. Numerous studies agree that domain-specific predictors related to mathematics are symbolic and non-symbolic magnitude comparison, as well as, number line estimation. The goal of this study was to design 4 digital learning app games to train specific cognitive bases of mathematical learning in order to create resources and promote the use of these technologies in the educational community and to promote effective scientific transfer and increase the research visibility. This study involved 193 preschoolers aged 57–79 months. A quasi-experimental design was carried out with 3 groups created after scores were obtained in a standardised mathematical competence assessment test, i.e., low-performance group (N = 49), high-performance group (N = 21), and control group (N = 123). The results show that training with the 4 digital learning app games focusing on magnitude, subitizing, number facts, and estimation tasks improved the numerical skills of the experimental groups, compared to the control group. The implications of the study were, on the one hand, provided verified technological tools for teaching early mathematical competence. On the other hand, this study supports other studies on the importance of cognitive precursors in mathematics performance.