Differences In Mean Total Scores Research Articles

Efficacy of problem-solving therapy in treating late-life depression with potential cognitive impairment: a systematic review and meta-analysis.

Late-life depression (LLD) is a global public health issue, often accompanied by cognitive impairments that can exacerbate the severity of depression and impair social functioning. Despite being a well-established treatment for LLD, the suitability of problem-solving therapy (PST) for individuals with LLD and varying degrees of cognitive impairments warrants further investigation. This paper presents the protocol for a systematic review and meta-analysis of randomised controlled trials (RCTs) aimed at evaluating the effectiveness and acceptability of PST for this specific demographic. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we will conduct a systematic review to synthesise existing research on PST for individuals in this demographic. We will comprehensively search multiple databases and sources, including PubMed, EMBASE, the Cochrane Database and APA PsycNET from inception to October 2023, without language, publication year or type restrictions. Relevant studies will be manually screened from the references. Only RCTs involving PST for LLD will be included. The primary efficacy outcome will be the standardised mean difference in total scores on continuous depression severity scales across different comparison arms. Data extraction will be conducted independently by two reviewers (CH and J-JW), and methodological rigour will be assessed using the Cochrane Risk of Bias assessment tool. Subgroup and sensitivity analyses will be performed to investigate the impact of concomitant cognitive impairments and to evaluate the robustness of the findings. The meta-analysis project is expected to be ethically unproblematic and does not require approval from a research ethics committee. The results of this study will be shared through articles in scholarly peer-reviewed journals and presentations in various formats, both print and digital. CRD42023473782.

Validity and Reliability of Age-Related Hearing Loss Questionnaire in Korean Elderly

Purpose: The objective of this study is to investigate the validity and reliability of the Age-Related Hearing Loss Questionnaire (ARHLQ) for Korean elderly, originally developed by Choi, to evaluate the communication difficulties faced by Korean elderly individuals with hearing loss everyday life. The ARHLQ consists of twenty-three questions in four subcategories of communication difficulties (9 items), communication environment (5 items), emotion and other’s reaction (6 items), and communication strategy (3 items).Methods: The ARHLQ was administrated to a total ninety subjects composed of three or four subject groups based on mild, moderate, moderate severe, and severe hearing loss determined by the pure tone threshold average (PTA) and high frequency threshold average (HFPTA), with an average age with the age of 77.22 ± 6.36 years old. Validity and reliability were calculated using Pearson’s correlation coefficient, the Kruskal-Wallis test for nonparametric independent samples, and Cronbach alpha coefficient.Results: Pearson’s correlations coefficients between total scores and four subcategories of ARHLQ were high ranging from 0.813 to 0.971 and the correlation coefficient between ARHLQ and the Korean Hearing Handicap Inventory for the Elderly (K-HHIE) was high (0.736). The correlation coefficients between four subcategories of ARHLQ and the two subcategories of K-HHIE were high ranging from 0.598 to 0.770. The mean difference in total score and four subcategories of ARHLQ by the hearing degrees of PTA and HFPTA were significantly observed. For internal consistency, Cronbach’s alpha coefficient in total scores and four subcategories was high ranging from 0.807 to 0.966. The test-retest correlation for reliability was very high (0.996).Conclusion: These findings suggest that the ARHLQ is a clinically useful tool to evaluate age-related hearing loss according to the degree of hearing loss.

Severe COVID anxiety among adults in the United Kingdom: cohort study and nested feasibility trial

BackgroundPeople with severe COVID anxiety have poor mental health and impaired functioning, but the course of severe COVID anxiety is unknown and the quality of evidence on the acceptability and impact of psychological interventions is low.MethodsA quantitative cohort study with a nested feasibility trial. Potential participants aged 18 and over, living in the UK with severe COVID anxiety, were recruited online and from primary care services. We examined levels of COVID anxiety in the six months after recruitment, and factors that influenced this, using linear regression. Those scoring above 20 on the short Health Anxiety Inventory were invited to participate in a feasibility trial of remotely delivered Cognitive Behavioural Therapy for Health Anxiety (CBT-HA). Exclusion criteria were recent COVID-19, current self-isolation, or current receipt of psychological treatment. Key outcomes for the feasibility trial were the level of uptake of CBT-HA and the rate of follow-up.Results204 (70.2%) of 285 people who took part in the cohort study completed the six month follow-up, for whom levels of COVID anxiety fell from 12.4 at baseline to 6.8 at six months (difference = -5.5, 95% CI = -6.0 to -4.9). Reductions in COVID anxiety were lower among older people, those living with a vulnerable person, those with lower baseline COVID anxiety, and those with higher levels of generalised anxiety and health anxiety at baseline. 36 (90%) of 40 participants enrolled in the nested feasibility trial were followed up at six months. 17 (80.9%) of 21 people in the active arm of the trial received four or more sessions of CBT-HA. We found improved mental health and social functioning among those in the active, but not the control arm of the trial (Mean difference in total score on the Work and Social Adjustment Scale between baseline and follow up, was 9.7 (95% CI = 5.8–13.6) among those in the active, and 1.0 (95% C.I. = -4.6 to 6.6) among those in the control arm of the trial.ConclusionsWhile the mental health of people with severe COVID anxiety appears to improve over time, many continue to experience high levels of anxiety and poor social functioning. Health anxiety is highly prevalent among people with severe COVID anxiety and may provide a target for psychological treatment.Trial registrationRetrospectively registered at ISRCTN14973494 on 09/09/2021.

Is the Pediatric Eosinophilic Esophagitis Symptom Score v2.0 reliable for telemedicine?

Eosinophilic esophagitis (EoE) is a chronic immune-mediated disease. Telemedicine is a healthcare technology used when a patient is separated by distance. The reliability of the Pediatric Eosinophilic Esophagitis Symptom Score, version 2.0 (PEESS v2.0) for telemedicine applications, has not been studied yet. Therefore, we aimed to evaluate the reliability of PEESS v2.0 for telemedicine. We sent a telesurvey using questionnaires via electronic telecommunication as the telemedicine method. Children with EoE and their parents were asked to complete PEESS v2.0 with the telesurvey method (unsynchronized with the physician) and attend in-person visits one week apart. Intraclass correlation (ICC), Wilcoxon, and Bland-Altman tests were used as reliability analyses. Reliability was defined as a strong agreement between the measurements in ICC ≥ 0.8 and a p-value of ≤0.05 and no statistically significant difference between the scores of the two methods in the Wilcoxon and Bland-Altman analyses, i.e. a p-value of >0.05. The total scores of children and parents were higher in in-person visits than in the telesurvey (Wilcoxon tests, p ≤ 0.05). Bland- Altman analysis showed that the mean difference in total scores between the two methods was significant for both children and parents (p ≤ 0.05). ICC levels for the children and parent scores for the entire group ranged from 0.595 to 0.763 (moderate agreement). Unsynchronized telesurvey use of PEESS v2.0 is unreliable both for children and parents. We suggest testing the reliability of chosen telemedicine methods before using them in clinical and research practice.

The Complexity of Educating Acute Care Nurses on Opioid Use Disorder: A Quality Improvement Project.

Opioid use disorder (OUD) is a public health crisis, yet most acute care nurses are not educated to deliver evidence-based OUD care. Hospitalization provides a unique opportunity to initiate and coordinate OUD care in people presenting for other medical-surgical reasons. The aim of this quality improvement project was to determine the impact of an educational program on self-reported competencies of medical-surgical nurses caring for people with OUD at a large academic medical center in the Midwestern United States. Data were collected from two time points using a quality survey examining self-reported nurse competencies related to (a) assessment, (b) intervention, (c) treatment recommendation, (d) resource use, (e) beliefs, and (f) attitudes toward caring for people with OUD. Nurses surveyed before education (T1G1, N = 123) and, after education, those who received the intervention (T2G2, N = 17) and those who did not (T2G3, N = 65) were included. Resource use subscores increased over time (T1G1: x = 3.83, T2G3: x = 4.07, p = .006). Results from the two measurement points found no difference in mean total scores (T1G1: x = 3.53, T2G3: x = 3.63, p = .09). Comparison of mean total scores of nurses who directly received the educational program with those who did not during the second time point showed no improvement (T2G2: x = 3.52, T2G3: x = 3.63, p = .30). Education alone was insufficient in improving self-reported competencies of medical-surgical nurses caring for people with OUD. Findings can be used to inform efforts to increase nurse knowledge and understanding of OUD and to decrease negative attitudes, stigma, and discriminatory behaviors perpetuating care.

Developing an Instructional Design-Based Dementia Education Program

Community building is necessary to help create a dementia-inclusive society. In this study, a one-of-a kind dementia education program based on mutual learning using instructional design was developed alongside community members and stakeholders. The purpose was to implement and evaluate this program and gain insight into dementia education for the community. A total of 118 individuals participated in the program; however, data of 80 participants (Male = 26, Female = 54), who completed a questionnaire before and after the program, were analyzed. The results showed a significant pre-post difference in mean total scores on the Attitudes Toward Dementia Scale (32.1 points pre-program vs. 33.7 points post-program). Nine necessary learning topics were identified. The program could successfully teach participants to take the perspectives of various other people, view dementia as something relevant to themselves, and think about specific ways of responding to people with dementia considering their feelings. This study recommends creating education programs using scenario stories that depict the desire of people with dementia to be a part of the community, using visual depictions to create a shared impression and facilitate mutual learning.

A COMPARATIVE STUDY OF STRESS AND COPING STRATEGIES AMONG UNDERGRADUATE MEDICAL STUDENTS DURING PRE AND POST COVID-19 PANDEMIC LOCKDOWN.

Background: Medical students are facing huge challenge due to COVID-19 pandemic which has impacted their learning and has become vital stressor and affecting their psychological well-being. The objective of this study was to assess the perception of the stress among the undergraduate medical students and their coping strategies pre and post lockdown. Materials and Method: A cross-sectional study was conducted on 321 undergraduate medical students at Adichunchanagiri Institute of Medical Sciences, Mandya, Karnataka, India. This study was initiated after getting approval from the Institutional Ethical Committee. After obtaining consent the extent of the students stress was assessed using Perceived Stress Scale and Brief COPE was used to assess their coping strategies. Scores were analysed using paired t test in Microsoft excel/ SPSS software. Results: On paired 't' t test the mean difference in total score was 0.68 and the p value was 0.166 for scores of perceived stress scale, similarly the mean difference in scores of sub groups under coping strategies was 0.90 and 0.49 with 'p' value 0.173 and 0.498 respectively. Conclusion: Overall, there was not much of difference in scores of perceived stress scale and coping strategies before and after lockdown. Except for minor difference across age group and scores of specic coping strategies which was again not statistically signicant.

Development and Initial Validation of the Chinese Version of the Florida Surgical Questionnaire for Parkinson's Disease.

Background Deep brain stimulation (DBS) for Parkinson's disease (PD) has evolved as a well-established treatment in neurosurgery, and identifying appropriate surgical candidates could contribute to better DBS outcomes. The Florida Surgical Questionnaire for Parkinson Disease (FLASQ-PD) is a reasonable screening tool for assessing DBS candidacy in PD patients; however, a Chinese version of FLASQ-PD is needed for functional neurosurgery units in China. In this study, we translated the FLASQ-PD to Chinese and assessed its reliability and validity for Chinese PD patients. Methods The FLASQ-PD was translated before the study formally started. A single-center retrospective analysis of FLASQ-PD was performed at the Ruijin Hospital, affiliated with Shanghai Jiaotong University School of Medicine, between July and December 2019. The Unified Parkinson Disease Rating Scale III (UPDRS-III) was also used to assess PD patients on and off medication. All patients were evaluated for surgical candidacy by specialists. Results Overall, 115 PD patients, 25 with parkinsonism and six with multiple system atrophy were consecutively included. Internal consistency of the Chinese FLASQ-PD was roughly adequate (Cronbach's alpha = 0.664). There were significant differences in mean total scores of the Chinese FLASQ-PD between the diagnostic (Kruskal–Wallis H value = 37.450, p ≤ 0.001) and surgery-candidacy groups (H = 48.352, p ≤ 0.001). Drug improvements in UPDRS-III scores were mildly correlated with the Chinese FLASQ-PD scores in the surgery-ready group (Pearson correlation = 0.399, p=0.001). Conclusions The Chinese FLASQ-PD, which is a simple and efficient screening tool for clinicians, was developed and initially validated in this retrospective single-center study.

Perceived Quality of Care Transitions between Hospital and the Home in People with Stroke

ObjectivesTo explore the perceived quality of care transitions from hospital to the home with referral to subsequent rehabilitation in the home, and factors associated with low perceived quality, in people with stroke. DesignObservational study. Setting and ParticipantsEligible were patients with a suspected acute stroke admitted to 1 of 4 inpatient hospital units in the Stockholm region and discharged home with referral to a neurorehabilitation team in primary care. MethodsData on perceived quality of care transition was collected with the Care Transition Measure (CTM-15) 1 week after discharge. Additional data were mainly retrieved from medical records. To analyze difference in mean total score of the CTM-15 between participants' characteristics, length of hospital stay, disease-related data, and functioning, the Mann-Whitney U test and independent sample t test were used for dichotomized variables and 1-way analysis of variance and the Tukey post hoc test for variables with more than 2 groups. To analyze differences between participants with low and high perceived quality per item, univariable regression analyses were performed. Thereafter, multivariable regression models were created to explore associations between low perceived quality and the independent variables. ResultsMean age of the 189 participants was 75 years and 91% had a mild or very mild stroke. The majority perceived most areas of the care transition to be of high quality. Nevertheless, several areas for improvement were identified. People with a more severe stroke perceived the quality of the care transition to be lower in comparison with those with a mild stroke. The association was weak between patient or clinical characteristics and the perceived quality. Conclusion and ImplicationsOur findings suggest that preparation for discharge and information and support for self-management postdischarge should be enhanced in the referral-based care transition after stroke. Special attention should be given to people with severe stroke.

Effectiveness of aquatic exercises compared to patient-education on health status in individuals with knee osteoarthritis: a randomized controlled trial

Objective: To compare the effectiveness of aquatic exercises with patient-education in individuals with knee osteoarthritis. Design: Randomized controlled trial with blinded assessor and intention-to-treat analysis. Setting: Aquatic Physiotherapy Centre and Primary Health Care Unit. Subjects: A total of 60 patients, aged 68.3 (SD = 4.8) with clinical symptoms and radiographic grading (Kellgren–Lawrence 1–4) of knee osteoarthritis were included. Interventions: An eight-week treatment protocol of aquatic exercise (n = 31) (16 individual sessions, twice a week) and an educational program (group sessions, once a week) (n = 29). Main measures: Before, after eight-week intervention, and a three-month follow-up with results for the following outcome measures: pain, function, quality of life, functional mobility, and depression. Results: At the end of treatment, the WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) functional capacity values reduced in favour of the aquatic exercise group for both the total score MD (mean difference) = –14.2; 95% CI (confidence interval) (−18; −10.5), P = 0.04 and the pain domain MD = −3.8 points; 95% CI (−8.71; −1), P = 0.021. The total score also reduced in the follow-up: MD = −12.3 points; 95% CI (−24.7; −6.1), P = 0.017. No differences were found for the outcomes functional mobility or depression. Conclusion: Aquatic exercise improved pain and function after eight weeks, and function at the three-month follow-up compared to the patient-education program.

IMPACT‐III is a valid and reliable questionnaire for assessing health‐related quality of life in Swedish children with inflammatory bowel disease

This study examined the reliability, validity and factor structure of the Swedish version of the IMPACT-III questionnaire for assessing health-related quality of life in children with inflammatory bowel disease. We recruited 202 participants aged eight to 18years, who were enrolled from 16 of the 23 paediatric gastroenterology clinics across Sweden during 2010-2013. This cross-sectional study compared two versions of the IMPACT-III questionnaire - one with six factors and 35 items and one with four factors and 19 items - plus the Paediatric Quality of Life Inventory 4.0 Generic Core Scale. Disease activity was assessed and defined as active or inactive. The mean total score for the six-factor IMPACT-III scale was 143.7/175, with a standard deviation (SD) of 17.9. There was a significant difference in mean total scores between the 133 children with inactive disease (147.8, SD: 14.9) and the 52 with active disease (133.0, SD: 20.3). Confirmatory factor analysis showed that the four-factor scale was more robust than the original six-factor scale. Concurrent validity and discriminant validity were high for both versions. The Swedish version of the IMPACT-III questionnaire was valid and reliable, but the shorter, four-factor version is quicker and may be more convenient in clinical settings.

Altered Neuronal Activity Topography Markers in the Elderly with Increased Atherosclerosis.

Background: Previously, we reported on vascular cognitive impairment (VCI) templates, consisting of patients with VCI associated with carotid stenosis (>60%) using a quantitative electroencephalographic (EEG) technique called neuronal activity topography (NAT). Here using the VCI templates, we investigated the hypothesis that internal carotid artery–intima-media thickness (ICA–IMT) is associated with EEG spectrum intensity (sNAT) and spectrum steepness (vNAT).Methods: A total of 221 community-dwelling elderly subjects were recruited. Four groups were classified according to quartiles of ICA–IMT as assessed by ultrasonography: control group A, normal (≤0.9 mm); group B, mild atherosclerosis (1−1.1 mm); group C, moderate atherosclerosis (1.2−1.8 mm); and group D, severe atherosclerosis (≥1.9 mm). EEG markers of power ratio index (PRI), and the binary likelihood of being in the VCI group vs. the that of being in control group A (sLx:VCI−A, vLx:VCI−A) were assessed, respectively. Differences in mean total scores for PRI, sLx:VCI−A, vLx:VCI−A, between control group A and the other groups were compared using Dunnett's test, respectively.Results: The mean total scores of the PRI were 3.25, 3.00, 2.77, and 2.26 for groups A, B, C, and D, respectively. There was a significant decrease in the PRI in group D compared with group A (P = 0.0066). The mean total scores of the sLx:VCI−A were −0.14, −0.11, −0.1, and −0.03 for groups A, B, C, and D, respectively. The sLx:VCI−A in group D was significantly higher compared to that in group A (P < 0.0001). The mean total scores of the vLx:VCI−A were −0.04,−0.01, 0.01, and 0.06 for group A, B, C, and D, respectively. The vLx:VCI−A in group D and group C was significantly higher compared to that in group A, respectively (P < 0.0001, P = 0.02).Conclusion: Community-dwelling elderly subjects in the increased carotid atherosclerosis of ICA–IMT (≥1.9 mm) were at greatest risk of an EEG change as assessed by NAT.

Long-term follow-up indicates unimpaired oral health-related quality of life for people having shortened dental arches

ObjectivesTo assess and analyse OHRQoL of people with shortened dental arches (SDA) in a long-term cohort study. MethodsAll participants of a long-term cohort study on SDA who were still attending the university dental clinic and still had an SDA (SDA group) with 3–5 posterior occluding pairs and intact anterior areas, an SDA plus removable dental prosthesis (SDA plus PRDP group) or complete dental arch (CDA group) completed the Dutch version of the Oral Health Impact Profile (OHIP-49NL) and additional questions on satisfaction with their dental status (yes/no). Mann-Whitney tests were performed for OHIP total scores and OHIP domain scores. The chance that the difference in median OHIP scores between the groups was larger than 6 OHIP units, was calculated by a bootstrapping procedure. Results10 participants were eligible for SDA group and 11 for CDA group. The SDA plus PRDP group (n=1) was excluded from analyses. Mean follow-up period was 29.3±5.5 for SDA group and 36.7±5.5years for CDA group. Mean OHIP-49NL score was 13.9±10.9 for SDA group and 11.3±8.6 for CDA group. Differences in mean total scores and mean scores per domain were not statistically different. The probability that a difference in median OHIP total scores between groups was larger than 6 OHIP units was 0.25. Both groups showed high percentages of satisfaction with dental condition, except for dental appearance. ConclusionOHRQoL of people with a long-term SDA condition was similar to that of people with CDA. Clinical significancePeople having SDA for long periods are expected to report similar OHRQoL and satisfaction levels/oral comfort as people with CDA.

Validation of an instrument to measure patients' experiences of medicine use: the Living with Medicines Questionnaire.

BackgroundMedicine-related burden is an increasingly recognized concept, stemming from the rising tide of polypharmacy, which may impact on patient behaviors, including nonadherence. No instruments currently exist which specifically measure medicine-related burden. The Living with Medicines Questionnaire (LMQ) was developed for this purpose.ObjectiveThis study validated the LMQ in a sample of adults using regular prescription medicines in the UK.MethodsQuestionnaires were distributed in community pharmacies and public places in southeast England or online through UK health websites and social media. A total of 1,177 were returned: 507 (43.1%) from pharmacy distribution and 670 (56.9%) online. Construct validity was assessed by principal components analysis and item reduction undertaken on the original 60-item pool. Known-groups analysis assessed differences in mean total scores between participants using different numbers of medicines and between those who did or did not require assistance with medicine use. Internal consistency was assessed by Cronbach’s alpha. Free-text comments were analyzed thematically to substantiate underlying dimensions.ResultsA 42-item, eight-factor structure comprising intercorrelated dimensions (patient–doctor relationships and communication about medicines, patient–pharmacist communication about medicines, interferences with daily life, practical difficulties, effectiveness, acceptance of medicine use, autonomy/control over medicines and concerns about medicine use) was derived, which explained 57.4% of the total variation. Six of the eight subscales had acceptable internal consistency (α>0.7). More positive experiences were observed among patients using eight or fewer medicines compared to nine or more, and those independent with managing/using their medicines versus those requiring assistance. Free-text comments, provided by almost a third of the respondents, supported the domains identified.ConclusionThe resultant LMQ-2 is a valid and reliable multidimensional measure of prescription medicine use experiences, which covers more diverse domains than existing questionnaires. However, further validation work is necessary.

A Survey of Knowledge and Attitudes of Nurses About Pain Management in End-Stage Liver Disease in a Geriatric Palliative Care Unit.

Palliative care is often initiated late for patients with end stage liver disease (ESLD) with pain being a common morbidity that is under-treated throughout the disease trajectory. When admitted to a palliative care unit (PCU), nurses play a pivotal role and must be highly informed to ensure effective pain management. The aim of this study is to determine the baseline level of knowledge and attitudes of PCU nurses regarding pain management in patients with ESLD. A descriptive, cross-sectional self-administered survey design was used for this study. The sample comprised 35 PCU nurses working at a continuing chronic care facility in Toronto, Ontario, Canada. Data on the knowledge and attitudes of the nurses regarding pain management in patients with ESLD, was obtained using a modified version of the "Nurses Knowledge and Attitudes Survey Regarding Pain" (NKASRP) tool. Thirty-one PCU nurses were included for the analysis, giving a response rate of 89%. The mean total percentage score for the nurses on the modified version of the NKASRP was 72%. Only 26% of the nurse participants obtained a passing score of 80% or greater. There were no significant differences in mean total scores by age, gender, years of nursing experience or education level. The findings of this study provide important information about the inadequate knowledge and attitude in nurses regarding pain management for patients with ESLD. It is suggested that targeted educational programs and quality improvement initiatives in pain management for patients with ESLD could improve knowledge and attitudes for PCU nurses.

Assessment of awareness of mycotoxins infections in stored maize (Zea mays L.) and groundnut (arachis hypogea L.) in Kilosa District, Tanzania

Surveys were conducted to determine awareness of mould infection in maize and groundnut in Kilosa District, Eastern Central Tanzania, between August and October 2010. Four villages of Msingisi, Rudewa-Batini, Mamoyo and Mkalama were surveyed. We sampled maize from each household for mycotoxins contamination after nine months of storage. A questionnaire was administered to heads of 72 selected households in the study area. Principal component analysis (PCA) was used to check factor dimensionality. The differences in mean total score of knowledge and awareness between the demographic and socio-economic factors were determined by t-test. Measurements of association were carried by Chi-square test (χ2), while ordinal logistic regression analysis was used to examine the correlations between social variables and awareness of mould infection. We found high levels of fumonisins in maize that ranged from 70.46 to 213.15. Aflatoxin levels in groundnuts ranged from 72.97 to 195.17. Result showed that 97 % of respondents were not aware of mould infection in stored maize and groundnuts. The mean score of mould infections awareness of females (1.7273 ± 0.45055) was significantly higher than that of males (1.5714 ± 13.7). Awareness of mould infection was high among educated (mean score 1.9231.3 ± 0.31470) than the less educated people (mean score 1.8913 ± 0.27175). Results revealed significant association between awareness of mould infection with age (p = 0.006), education (p = 0.039), marital status (p = 0.012), gender (0.037) and income (p = 0.044). Campaigns are needed to improve awareness of mould infection in Kilosa District, Tanzania.

Abstract 15507: CPR Education in Middle School Students During Physical Education Class

Introduction: AHA advocates for CPR education as a required element of the secondary school curriculum. Unfortunately, many states have not adopted CPR education as part of their standard curriculum. Our aim was to investigate a low-cost, and time effective method to educate students on Basic life Support (BLS) during a physical education (PE) class, including evaluation of the use of re-education. Hypothesis: We hypothesize that a 45 minute BLS class during PE class is sufficient to provide with CPR and AED knowledge and skills. Methods: This is a prospective, randomized study. The study included forty one 8 th grade students in an Alachua County Middle School in Gainesville, Florida. Education was performed by an AHA-certified provider during a 45 minute PE class. Education was limited to chest compressions and the usage of an Automatic External Defibrillator (AED). Students were randomized into two groups; one group received repeat education at two months post-initial education, while the second group did not. Students had a skills and knowledge test administered pre- and post-education, given after initial education and repeated two and four months later to assess retention. Total scores were compared between pre- and post- education, as well as between groups. Results: There was a significant difference in CPR skills and knowledge when comparing pre- and post-education results for all time-points (p&lt;0.001). When assessing retention, no significant difference in mean total scores was observed between the initial post-education as compared to two and four months (p&gt;0.1). Mean total scores compared between groups showed no statistical significance of re-education. However, a statistical significance was noted for AED usage in the repeat education group. Conclusions: Our study indicates significant increase in CPR knowledge and skills following a one-time 45 minute session. Repeat education may be useful as a yearly event, but would need further investigation. If schools across the United States invested one 45-60 minute period a year for each school year, this would ensure widespread CPR knowledge with minimal cost and loss of school time.

Interformat reliability of digital psychiatric self-report questionnaires: a systematic review.

BackgroundResearch on Internet-based interventions typically use digital versions of pen and paper self-report symptom scales. However, adaptation into the digital format could affect the psychometric properties of established self-report scales. Several studies have investigated differences between digital and pen and paper versions of instruments, but no systematic review of the results has yet been done.ObjectiveThis review aims to assess the interformat reliability of self-report symptom scales used in digital or online psychotherapy research.MethodsThree databases (MEDLINE, Embase, and PsycINFO) were systematically reviewed for studies investigating the reliability between digital and pen and paper versions of psychiatric symptom scales.ResultsFrom a total of 1504 publications, 33 were included in the review, and interformat reliability of 40 different symptom scales was assessed. Significant differences in mean total scores between formats were found in 10 of 62 analyses. These differences were found in just a few studies, which indicates that the results were due to study effects and sample effects rather than unreliable instruments. The interformat reliability ranged from r=.35 to r=.99; however, the majority of instruments showed a strong correlation between format scores. The quality of the included studies varied, and several studies had insufficient power to detect small differences between formats.ConclusionsWhen digital versions of self-report symptom scales are compared to pen and paper versions, most scales show high interformat reliability. This supports the reliability of results obtained in psychotherapy research on the Internet and the comparability of the results to traditional psychotherapy research. There are, however, some instruments that consistently show low interformat reliability, suggesting that these conclusions cannot be generalized to all questionnaires. Most studies had at least some methodological issues with insufficient statistical power being the most common issue. Future studies should preferably provide information about the transformation of the instrument into digital format and the procedure for data collection in more detail.

Construct validity and impact of mode of administration of the PedsQL™ among a pediatric injury population.

BackgroundThe purpose of this study was to determine the construct validity of the PedsQL™ health related quality of life (HRQoL) instrument for use among injured children and to examine the impact of using different modes of administration, including paper and pencil, online and telephone.MethodsTwo hundred thirty-three participants (aged 0 – 16) were recruited from hospital wards and the emergency department of a pediatric hospital in a large urban center in British Columbia, Canada. Data used to evaluate the construct validity of the PedsQL™ were collected from participants at the time of seeking injury treatment (baseline) to capture a retrospective measure of pre injury health, and one month post injury. Data used to compare different modes of administration (n = 44) were collected at baseline. To assess construct validity repeated measures analysis of variance (rANOVA) was used to determine whether the PedsQL™ tool was able to discriminate between patients pre and post injury while investigating possible interaction by category of length of stay in hospital. The impact of different modalities of administering the PedsQL™ on item responses was investigated using Bland-Altman plots.ResultsrANOVA showed significant differences in PedsQL™ total score between baseline and one month post injury (p < .001), and differences in mean total score at one month post injury by category of injury severity (p < .001). There was also significant interaction by category of injury severity for the change in PedsQL™ total score from baseline to one month (p < .001). Pearson’s correlations were highly significant across three modalities of survey administration: paper and pencil, computer and telephone administration (range: .92 to .97, p < .001). Bland-Altman plots showed strong consistency.ConclusionThe PedsQL™ instrument is able to discriminate between pre and post injury HRQoL, as well as HRQoL post injury for injuries of varying severity. These findings are an indication that this instrument has good construct validity for the purpose of evaluating HRQoL of injured children. Data collected via paper-pencil, online and telephone administration were highly consistent. This is important as depending on the setting, clinical or research, different modalities of completing this instrument may be more appropriate.

Outcomes of ptosis surgery assessed using a patient-reported outcome measure: an exploration of time effects

AimsTo explore effects of time following ptosis surgery on patient-reported quality-of-life outcomes.MethodsThe Glasgow Benefit Inventory (GBI), a validated, postinterventional questionnaire was administered to consecutive adults undergoing ptosis surgery on the...