Score Mean Research Articles

Assessing quality of health care in the context of patient satisfaction from patients’ perspective among a physical therapy and rehabilitation unit

Health service policies are evolving into qualified health care providing best possible outcomes as well as focused on patient satisfaction. Hence the qualification valued health care includes patient satisfaction measurements, it is suggested to get feedbacks during the assessment of outcomes from the patient’s perspective. Aging of the world population accelerates demand on rehabilitation medicine which means recovering impairments so is directly related with quality of life. This study measures the patient satisfaction among 286 patients referring to outpatient clinics and receiving therapy within Physical Medicine and Rehabilitation Unit of City Hospital in Balikesir, Turkey. Results showed 63.4 ± 2.6 years mean of age and female majority (63.6%). Region of therapy included 9.8% for total body, plegic syndromes, 19.6% for neck, 25.2% for shoulder, 21.6% for knee and 23.8% for lumbar regions. Patients are grouped in two according to ‘yes’ or ‘no’ answer of the question ‘Do you agree with you have benefit from applied treatment, does the treatment met your expectations?’. 274 patients (95.8%) were agree with therapy met their expectations. Article discusses one of the valid patient satisfaction questionnaire as evidence based outcome measures. In divisions the means of query scores were 3.9 for technical quality, 4.2 for communication with therapist, 3.6 for physical comfort, 3.9 for communication with secretary, 4.1 for communication with doctor, 3.5 for accessibility and 3.5 for cleanliness. Comparison of means among groups did not seem statistically significant as result of Mann–Whitney U test, p > 0.05. In conclusion in the context of qualified health service providing, it is essential to get feedback from health care receivers to measure satisfaction and this needs improvement of generally valid questionnairres. Improved communication and greater provider sensitivity towards patients can enhance patient satisfaction resulting as meeting the expectation.

A concept-aware explainability method for convolutional neural networks

Although Convolutional Neural Networks (CNN) outperform the classical models in a wide range of Machine Vision applications, their restricted interpretability and their lack of comprehensibility in reasoning, generate many problems such as security, reliability, and safety. Consequently, there is a growing need for research to improve explainability and address their limitations. In this paper, we propose a concept-based method, called Concept-Aware Explainability (CAE) to provide a verbal explanation for the predictions of pre-trained CNN models. A new measure, called detection score mean, is introduced to quantify the relationship between the filters of the model and a set of pre-defined concepts. Based on the detection score mean values, we define sorted lists of Concept-Aware Filters (CAF) and Filter-Activating Concepts (FAC). These lists are used to generate explainability reports, where we can explain, analyze, and compare models in terms of the concepts embedded in the image. The proposed explainability method is compared to the state-of-the-art methods to explain Resnet18 and VGG16 models, pre-trained on ImageNet and Places365-Standard datasets. Two popular metrics, namely, the number of unique detectors and the number of detecting filters, are used to make a quantitative comparison. Superior performances are observed for the suggested CAE, when compared to Network Dissection (NetDis) (Bau et al., in: Proceedings of the IEEE conference on computer vision and pattern recognition (CVPR), 2017), Net2Vec (Fong and Vedaldi, in: Paper presented at IEEE conference on computer vision and pattern recognition (CVPR), 2018), and CLIP-Dissect (CLIP-Dis) (Oikarinen and Weng, in: The 11th international conference on learning representations (ICLR), 2023) methods.

Effect of music therapy on behavioral and physiological neonatal outcomes: A systematic review and dose-response meta-analysis.

Previous studies have documented the effectiveness of music therapy in improving adverse neonatal outcomes in premature infants. However, this review aims to address the question of how long listening to music can enhance these neonatal outcomes. To conduct this dose-response meta-analysis, we searched the PubMed, Scopus, Web of Science, and Cochrane Library databases. The inclusion criteria comprised randomized clinical trials that investigated the effects of music therapy on improving adverse neonatal outcomes. Preterm infants were defined as those born between 27 and 37 weeks of gestation, as fetuses are known to respond to auditory stimuli starting at the 27th week of pregnancy. The initial search was performed on January 28, 2024, and there were no restrictions on the time frame for the search. Ultimately, we employed a two-stage random effects model using the "drmeta" package in Stata software to perform this dose-response meta-analysis. In total, 30 articles (1855 participants) were identified for inclusion in our meta-analysis. According to pooled analysis with each minute increase in music therapy, the means of respiratory rate, pain score, SBP, DBP, behavioral score, and body temperature decrease by 35.3 beats per minutes, 15.3 VAS, 30.7 mmHg, 8.9 mmHg, 2.7, and 0.27°C. On the other hand, with each minute increase in listening to the music, the mean of O2 saturation, heart rate and sleep duration increase 1.7%, 89.2 beats per minutes and 5.081 minutes per day, respectively. Music therapy improves the neonatal outcomes of O2 saturation, heart rate, respiratory rate, sleep duration, body temperature and systolic and diastolic blood pressures. Therefore, the existence of a dose-response relationship can indicate a causal relationship between music therapy and the improvement of neonatal outcomes.

A Comprehensive Approach to Intelligent Garment for Posture Correction: A Preliminary Study for Integrating Aesthetics and Sensor Interaction

PurposeThis study investigates design and evaluation of an intelligent vest integrating Marginal Absolute Relative Gradient (MARG) sensors for posture correction. The research aims to enhance ergonomic interventions through a lightweight, aesthetic garment that provides real-time feedback, addressing both functional and design in wearable technology.MethodsThe vest incorporates Adafruit FLORA microcontroller boards and MARG sensors to monitor neck and shoulder movements. Experimental setups involved recording roll and pitch angles during various postures. A sample of 10 female participants was recruited for usability testing, and quantitative analyses of sensor data were performed to validate the vest's performance. Moreover, user feedback on the vest's visual (LED) and tactile (vibration) feedback, comfort, and posture correction effectiveness was collected.ResultsData revealed distinct posture patterns, including a mean neck pitch of −61.80° during forward tilts and synchronized neck-shoulder movements when leaning right (correlation coefficient of 0.46 for pitch). Conversely, independent movements were observed in leftward tilts (correlation coefficients of 0.07 for roll and −0.18 for pitch). User feedback indicated high ratings for comfort (mean = 4.4) and LED feedback effectiveness (mean = 4.3), while haptic feedback received moderate scores (mean = 3.6).ConclusionThe intelligent vest successfully integrates posture correction functionality with user-friendly design, providing detailed real-time feedback and maintaining wearability. This study highlights its potential in health-related applications and underscores the importance of aesthetics in wearable technology for enhanced adoption and usability.

Knowledge, Attitude, and Practice of Novel Coronavirus (COVID-19) Among Young Adults in Iraq

Background: Society's information regarding practices, attitudes, and knowledge influences the society's behaviors and practices toward COVID-19 and affects preventive measures and disease control. Aim: This study aims to assess the knowledge, attitude, and practices towards COVID-19 in the young adults of the Iraqi general population. Materials and Methods: Cross-sectional study web-based survey conducted between 30th September 2023 to 31st January 2024. The data was gathered through an electronic questionnaire. The survey was conducted in the Iraqi population and included male and female participants aged ≥ 18 years. A self-administered structured questionnaire was used for data gathering. The questionnaire consists of items to get information from the participants: risk factors, knowledge, attitudes and practices toward SARS-CoV-2 infection, and social and demographic characteristics. An Arabic version of the questionnaire was prepared. The questionnaire consists of the knowledge part, which includes 11 questions, while attitudes include 10 questions and practices include 8 questions. The knowledge was evaluated on the basis of the correct answer and converted to a score of 5. While for the attitudes, a 5-point Likerttype scoring system was created for responses (1- strongly disagree; 2- disagree; 3-neutral; 4- agree; 5- strongly agree). For the practices, a 5-point Likert score is used for response evaluation (5- always; 4- often; 3- sometimes; 2- rarely; 1-never). The questionnaire link was sent online to the participants via Facebook, Instagram, Telegram, and WhatsApp. The questionnaire participants replied in the Microsoft Excel sheet. An ANOVA test was used to determine the differences in significance between the KAP items and within the section of each KAP. Post-hoc test used for analysis of significance between K and A, K and P, A and P. The significance of the differences between groups was determined using the chi-square test. The analysis was performed using SPSS version 20. Results: There were 1484 participants, with a survey response rate of 86.7% (1484/1712). The majority of the participants (69.3%) were in the age group of 18 to 25 years, and 85.9% of them were B.Sc., M.Sc., Ph.D., and college students. 90.5% were from urban areas, and 27.6% participated in an online course for COVID-19. The mean score of knowledge was 3.04 ± 0.84, which means that the mean correct answer of the knowledge item was 61%. The highest correctly answered question (87%) was regarding the preventive measures for COVID-19 infection, followed by the main symptoms of COVID-19 (76.5%). The lowest correctly answered question (27%) was regarding the mortality rate of COVID-19, followed by complications of COVID-19 (38.1%). The total knowledge mean score was 61% of the scale (score 3.04/5), and this indicated that 61% of the population has good knowledge regarding the COVID- 19 pandemic. Additionally, there were high significance (p < 0.01) differences between the knowledge item score and the correct answer. A post-hoc test indicated a significant difference (p = 0.0305) in item scores between knowledge and practices, but there was no significant difference between knowledge versus attitudes or between attitudes versus practices. Attitudes mean score was 3.6 and 72% frequency of correct answers for the items. A significant number of participants expressed worry about themselves, their family members, friends, or society (64.8%) getting infected. Thus, about 1/3 of the participants were not worried about getting an infection. However, 18.4% of participants did not express any as they gave a neutral answer. It is interesting that 80.3% of the participants believed that an asymptomatic patient could transmit the virus to others. The survey indicated a rate with an average of 12.5% to 36% of neutral responses to the addressed questions. The mean score of practice was 9.98 and the correct answer frequency was 79.6%. The majority of participants (83.3%) reported an acceptable practice. Individual questions were answered correctly in a range of 88.1% to 94.7%, with the exception of carefully removing PPE and discarding it in the proper place (17.1%). Conclusions: The young adults Iraqi general population had a good KAP standard. Attitudes and practice scores were higher than those of knowledge. The knowledge score mean value was 3.04 and the correct answers frequency was 61%, with the items score range of 1.4 and 4.4, while the correct answers frequency range was 27% and 87%. The mean score of attitudes was 3.6 with a range of 2.8–4.2, while the correct mean frequency was 72% with a range of 56% to 84%. The mean score of practices was 3.98 with a range of 1.6 to 4.5, while the mean frequency of the correct answer was 79.6% with a range of 32% to 90%.

Evaluation of Respiratory Function, Respiratory Muscle Strength, Physical Activity, and Functionality in Patients with Lower Extremity Lymphedema.

Background: Lymphedema is a chronic, progressive condition that has major physical and psychological consequences. It was aimed to examine the respiratory functions, respiratory muscle strength, physical activity level, and functionality of patients with lower extremity lymphedema and to compare them with healthy controls. Methods and Results: A total of 82 individuals (29.3% male, 70.7% female, with a mean age of 49.89 ± 15.07 years) with lower extremity lymphedema (Group 1) and healthy individuals (Group 2) were included. Respiratory functions of the participants were evaluated by spirometry, respiratory muscle strength by maximum oral pressure measurements, physical activity levels using the International Physical Activity Questionnaire-Short Form (IPAQ-SF), functionality by Lower Extremity Functional Scale (LEFS) and Timed Up and Go test (TUG test). All respiratory function test measurements were lower in mean Group 1 than in Group 2 (p < 0.05). While inspiratory muscle strength did not differ between the groups (p > 0.05), expiratory muscle strength was lower in Group 1 than Group 2 (p < 0.05). Although spent time and energy for sitting were higher in Group 1 (p < 0.05), IPAQ vigorous-, moderate-, and light-intensity physical activity (MET-min/week) and IPAQ-total score did not differ between groups (p > 0.05). In Group 1, mean of LEFS score was lower and TUG test (seconds) in Group 1 was longer compared to Group 2 (p < 0.05). Conclusions: Respiratory functions, expiratory muscle strength, and functionality in patients with lower extremity lymphedema were adversely affected; however, inspiratory muscle strength and physical activity levels were similar to those of healthy controls.

Unsupervised clustering of a deeply phenotyped cohort of adults with idiopathic generalized epilepsy.

Idiopathic generalized epilepsy (IGE) in adults comprise juvenile myoclonic epilepsy (JME), juvenile absence epilepsy (JAE), and epilepsy with generalized tonic-clonic seizures alone (EGTCS), which are defined by their seizure types but also cover a broad endophenotype of symptoms. Controversy exists on whether adult IGE is a group of distinct diseases or a clinical spectrum of one disease. Here, we used a deeply phenotyped cohort to test the hypothesis that IGE comprises three distinct clinical entities. Patients (>18 years old) with IGE were recruited between 2016 and 2020 at Odense University Hospital and the Danish Epilepsy Center. Complete data were available for basic demographics, imaging, social status, and treatment response. Subjects were offered neuropsychological screening (including symptoms of psychiatric disease). Electroencephalograms (EEGs) were reanalyzed, and missing data were imputed. After selecting the features and normalizing the data, the dataset and an identical randomized dataset were subjected to k-means cluster analysis. The dataset comprised 502 patients and 22 distinct nonoverlapping clinical features. Elbow and gap analyses revealed an optimal number of clusters of 1; the features with the highest eigenvalues were age at diagnosis and self-reported executive dysfunction. Applying k-means clustering yielded three low-quality clusters as assessed by silhouette score (mean = .400 ± .01). The corresponding mean silhouette score for the randomized control dataset was .390 (±.002). Age at diagnosis was associated with the epileptic discharges on EEG and treatment response. Self-reported executive dysfunction showed associations with psychiatric symptoms and impulsivity. JME, JAE, and EGTCS were loosely associated with the clusters (k = .088, p = .002) but showed a specific distribution within a matrix defined by age at diagnosis and self-reported executive dysfunction. IGE in adults is best described as a continuum of symptoms, where age at diagnosis and executive dysfunction are two main factors explaining most of its clinical variability. The seizure-defined syndromes cover different patient groups within the clinical spectrum.

School Management Activities in a Digital Age: An International Comparison Based on ICILS 2018

Principals have an important role to play in the implementation of digitalization in schools. They can be seen as role models for teachers with regard to information and communication technology (ICT) usage. Furthermore, there is nowadays a solid research linking educational leadership and management indirectly to student achievement. However, there is a lack of studies on the specific ICT usage of principals and the relationship with students' ICT skills. Against this background, our research aimed to find out whether different clusters of principals in Chile, Denmark, Germany, the Republic of Korea, and the United States can be identified on the basis of their leadership and management activities using ICT and whether there are differences in the distribution of the identified clusters across the countries. A latent class analysis was conducted using the International Computer and Information Literacy Study (ICILS) 2018 school questionnaire data. Across the five countries, three different clusters were identified based on principals’ activities using ICT. Proportions of principals’ distribution across the clusters varied significantly between the countries. In addition, it was investigated whether the clusters are related to students' computer and information literacy (CIL) using the means of student's scores in the computer based CIL test. No significant relation was found either when the five countries were considered together or individually.

Lower extremity lymphedema in patients with gynecologic cancer: Validation of the Gynecologic Cancer Lymphedema Questionnaire (GCLQ) in German language and investigation of lymphedema real-world treatment

Abstract Purpose The Gynecologic Cancer Lymphedema Questionnaire (GCLQ) is an established patient-reported outcome measure for lower extremity lymphedema (LEL) in gynecologic oncology. We aimed to validate the GCLQ in German language (GCLQ-GER) for lymphedema detection in German-speaking patients and also investigated real-world patterns of lymphedema treatment. Methods The GCLQ was translated from English into German in accordance with the standards of a professional translation process. Subsequently, the questionnaire was administered in a prospective observational study including 102 patients who had undergone lymph node dissection (LND) within gynecologic cancer surgery. Various test quality criteria were calculated for the GCLQ-GER. As gold standard of testing methods, patients were clinically evaluated for LEL, and limb volume measurements were taken. Further data for lymphedema treatment were collected in patients with lymphedema diagnosis. Results Patients with LEL had increased GCLQ-GER total scores (mean 7.27) compared to patients without LEL (mean 1.81), p &lt; 0.001. High diagnostic accuracy was indicated by the large area under the receiver operating characteristics curve (AUC) of 0.874 (95% CI 0.802–0.946). Based on sensitivity and specificity values ≥ 79.0%, the GCLQ total score ≥ 4 was determined as the optimal cut-off value to identify LEL. Excellent internal consistency was demonstrated by Cronbach’s alpha of 0.876. The clinical examination revealed a LEL prevalence of 48.0% (n = 49), and 85.7% (n = 42) of these patients received treatment. Conclusion The GCLQ-GER is a valid and feasible patient-reported outcome measure for lymphedema detection in German-speaking gynecologic cancer survivors. Its clinical introduction could improve secondary prevention of lymphedema and real-world treatment.

Implementation of Science Module Integrated with Google Colaboratory to Improve Students’ Computational Thinking Skill. Is it Effective?

Computational thinking skills are one of the supporters of the achievement of 21st century skills. Computational thinking is recognised as the third pillar of science, along with theory and experimentation. This study aims to improve students’ computational thinking skill through implementation science module integrated with Google Colaboratory. Computational thinking skills in students can be improved through learning programming. Students must be guided to connect concepts and activities from students by creating computer programming. This research uses one group pretest-posttest, then the result will be analyzed using N-gain and paired sample test. The object of this research is 36 students in junior high school level. The result of this study shows that the mean of the pre-test score is 27,25 and the mean of the post-test score being 62,36 with the N-gain score is 0,48 in the moderate category. Results of paired sample test show a Sig. (2-tailed) of 0.000, which is smaller than the threshold of 0.05. This result shows that the implementation of the learning module had a significant positive effect on improving computational thinking skills.

Seeking greener pastures: attitudes towards brain drain among turkish medical students

BackgroundMedical brain drain is a critical issue for healthcare systems worldwide. This study investigated attitudes toward brain drain and influencing factors among medical students at Pamukkale University.MethodsA cross-sectional study was conducted with 1,129 students (80.8% response rate) during the 2021–2022 academic year. Data, including sociodemographics, views on studying/working abroad, and the 16-item Brain Drain Attitude Scale (BDAS), were collected via a structured online questionnaire. Descriptive statistics, the Mann‒Whitney U test, the Kruskal‒Wallis test, and multiple linear regression were used for analysis.ResultsOver half (52.9%) of the students desired to work abroad, motivated by better working conditions (73.7%), higher salaries (57.8%), and social living conditions (66.8%). The BDAS score (mean = 61.26) indicated a moderate tendency toward brain drain. Key factors associated with higher brain drain attitude scores included financial constraints (B = 0.389, p = 0.001), independent living (B = 0.296, p < 0.001), initial reluctance to attend medical school (B = 0.598, p < 0.001), having friends or relatives abroad (B = 0.347, p < 0.001), considering exchange programs (B = 1.004, p < 0.001), and moderate foreign language proficiency (B = 0.300, p < 0.001).ConclusionA significant portion of Turkish medical students expressed a desire to work abroad, driven primarily by better working conditions, social living conditions, higher salaries, and excessive workloads in Türkiye. Financial constraints, independent living, dissatisfaction with medical school choices, and social networks with international experiences emerged as significant factors influencing attitudes toward brain drain.

Can We Ethically Influence Learning Processes by Technology? Effects of Interruptions on Knowledge Assessment

AbstractThe real-time availability of information and the intelligence of information systems have changed the way we deal with information. Current research is primarily concerned with the interplay between internal and external memory, i.e., how much and which forms of cognitively demanding processes we handle internally and when we use external storage media (analog on paper, digital on the computer). This interplay influences how and what we memorize and learn consequently. This study was motivated by the finding that people perform significantly worse in a quiz setting when they obtain content from external sources instead of reading the same content directly in the question system. In our experiments, we wanted to investigate whether interruption by the user interface (ethical appeal or forced time delay) can improve performance in the quiz when users obtain external content. We evaluated the results of 262 valid participants to complete one of three topics at random and then randomly assigned them to one of three possible conditions (ethical appeal, forced time delay, no interruption). The calculated one-way ANOVA shows a statically significant F-value ($$3.25,\,p &lt; 0.05$$ 3.25 , p &lt; 0.05 ), and the separate t-tests show that an ethical appeal ($$t = 2.29,\,p &lt; 0.05$$ t = 2.29 , p &lt; 0.05 ) and an enforced delay ($$t = 2.08,\,p &lt; 0.05$$ t = 2.08 , p &lt; 0.05 ) lead to a significantly higher mean of quiz scores across all three topics. The mean values of the quiz scores of the ethical appeal and the forced time delay are not significantly different. The present results should contribute to further studies of proactive learning interfaces.

Comparison of the power and type 1 error of total score models for drug effect detection in clinical trials

Composite scale data consists of numerous categorical questions/items that are often summed as a total score and are commonly utilized as primary endpoints in clinical trials. These endpoints are conceptually discrete and constrained by nature. Item response theory (IRT) is a powerful approach for detecting drug effects in composite scale data from clinical trials, but estimating all parameters requires a large sample size and all item information, which may not be available. Therefore, total score models are often utilized. The most popular total score models are continuous variable (CV) models, but this strategy establishes assumptions that go against the integer nature, and typically also the bounded nature, of data. Bounded integer (BI) and Coarsened grid (CG) models respect the nature of the data. However, their power to detect drug effects has not been as thoroughly studied in clinical trials. When an IRT model is accessible, IRT-informed models (I-BI and I-CV) are promising methods in which the mean and variability of the total score at any position are extracted from the existing IRT model. In this study, total score data were simulated from the MDS-UPDRS motor subscale. Then, the power, type 1 error, and treatment effect bias of six total score models for detecting drug effects in clinical trials were explored. Further, it was investigated how the power, type 1 of error, and treatment effect bias for the I-BI and I-CV models were affected by mis-specified item information from the IRT model. The I-BI model demonstrated the highest statistical power, maintained an acceptable Type I error rate, and exhibited minimal bias, approaching zero. Following that, the I-CV, BI, and CG with Czado transformation (CG_Czado) models provided the maximum power. However, the CG_Czado model had inflated type 1 error under low sample size scenarios in each arm of clinical trials. The CG model among total score models displayed the lowest power and the most inflated type 1 error. Therefore, the results favor the I-BI model when an IRT model is available; otherwise, the BI model.

Communication Skills and Illness Perception Among Non-Japanese-Speaking Patients in Japan.

Non-Japanese-speaking patients taking medical treatment in Japan face language barriers and lack of language assistance. Language barriers influence all processes from preventive services to treatment, and insufficient communication can affect patient outcomes. Illness perception, which is related to illness-coping behaviors and self-care behaviors, is an important factor for effective treatment, but no studies have investigated the relationship between communication skills and illness perception among non-Japanese-speaking patients. The purpose of this cross-sectional study was to assess communication skills utilizing ENDCORE, to clarify the relationship between communication skills and illness perception among non-Japanese-speaking patients in Japan, and to identify the impact of language assistance on these factors. A web questionnaire survey was conducted between February and April 2024, targeting 1,904 non-Japanese-speaking patients who had visited medical institutions in Japan. The survey items included basic attributes, purpose of the medical visit, Japanese language proficiency, communication tool, language assistance, communication skills (using ENDCORE), and illness perception (using the Brief Illness Perception Questionnaire; B-IPQ). The Kruskal-Wallis test and Mann-Whitney U test were used to examine factors related to the means of ENDCORE scores and B-IPQ scores, and Spearman's rank correlation coefficient was used for correlation analysis. The analysis included data for 354 participants. Participants who received language assistance scored lower on communication skills than those who did not receive language assistance, but they reported more positive illness perception. For factors related to ENDCORE means, statistically significant differences were observed for country of origin, residence qualifications, Japanese language proficiency, communication tool, and language assistance. For factors related to the B-IPQ means, statistically significant differences were observed for sex, country of origin, residence qualifications, communication tool, and language assistance. The correlationanalysis of ENDCORE and the B-IPQ items showed that the sense of control a person feels they have over their illness (r = 0.201, p < .001), the significance of treatment (r = 0.215, p < .001), and understanding of the illness (r = 0.318, p < .001) were weakly positively correlated. The findings suggest that language assistance for non-Japanese-speaking patients can lead to more beneficial communication between them and their physicians and more positive illness perception for those patients. We also believe that maximizing patients' communication skills will facilitate more appropriate diagnoses and treatments, improve patients' coping behaviors, and contribute to patient safety and quality of medical care.

Enhancing Students' Writing Skills through Project-Based Learning with Digital Media Integration: An Experimental Study

This study introduces an innovative approach by integrating Project-Based Learning (PBL) with digital media to improve Indonesian university students’ academic writing skills. Using a mixed-methods approach, the research involved 118 third-semester English students divided into an experimental group using the PBL model and a control group following traditional teaching methods. A quasi-experimental design was implemented, with pre-tests and post-tests assessing students’ writing performance. Surveys and open-ended responses provided qualitative insights into students’ perceptions of the intervention. The findings revealed a significant improvement in the writing skills of the experimental group, supported by statistical analysis that showed the significant improvement in the writing skills of the experimental group’s post-test scores (mean difference of 10.305, p &lt; 0.001) compared to the control group (mean difference of 3.475, p &lt; 0.001). Students expressed positive perceptions of the PBL approach, appreciating its interactive and collaborative elements. Thus, the integration of digital media with PBL proved effective in enhancing students’ writing abilities, fostering creativity, and promoting active learning. Overall, this study provides strong evidence for the benefits of integrating digital tools into project-based learning to enhance writing instruction and prepare students for the demands of the digital age.

A Comparative Study on Traditional and Case Based Teaching Learning Methods and Its Impact on Academic Performance Among First Year Medical Students

Background: The goal of medical education is to develop skilled practitioners who are attuned to the health issues faced by the community. Although lectures are commonly employed to impart new information, a drawback is that the audience tends to be passive and may thus become disengaged. Learning is made up of various interconnected components and involves complex mental processes like problem-solving and analytical thinking. The goal of using structured methods and organized resources is to equip students with effective learning tools. This enables them to gain a deep understanding of cognitive processes and develop the relevant skills needed for their careers. Case-Based Learning (CBL) involves examining a health issue presented by a patient, analysing and understanding pertinent details from past cases, systematically exploring and evaluating the situation, and planning the appropriate management for the patient. Materials and methods: The present study was cross sectional case control study conducted in the department of anatomy, Sri Siddhartha Medical College, Tumkur, Karnataka, India. Results: A total of 192 first year MBBS students participated in the first session of the study and 172 first year MBBS students participated in the second session of the study. The pre-test and post-test total scores of first and second session shows that students have performed better in CBL group when compared to the traditional lecture method of teaching. In the Critical Thinking Exercise scores of session -1 and 2, CBL group was found to be higher when compared to the traditional lecture group which was statistically significant. Comparison of means of internal assessments scores of CBL and Traditional lecture groups showed that the mean internal assessments score of CBL group was higher compared to Traditional lecture group which was statistically significant. Conclusion: Incorporating case-based learning (CBL) into our medical curriculum as a regular teaching method for large group settings should be considered. The integration of didactic lectures with CBL proves to be an effective educational approach. Positive feedback from both students and faculty suggests that CBL has been successfully introduced in departments like anatomy. However, further research is needed to evaluate how well students learn, understand, and retain the course content to fully support the implementation of this method in large undergraduate classes. KEY WORDS: Case-based learning, Traditional teaching learning methods, Critical thinking.

Efficacy of the Geriatric Trauma Outcome Score (GTOS) in Predicting Mortality in Trauma Patients: A Retrospective Cross-Sectional Study.

Trauma has a profound impact on mortality as well as short- and long-term health outcomes. For trauma patients to receive medical care in a timely manner, early identification and risk assessment are essential. The Geriatric Trauma Outcome Score (GTOS), which was created by combining age, the Injury Severity Score (ISS), and the requirement for packed red blood cell transfusion, has proven to be a valuable prognostic tool for elderly trauma patients, though its applicability to general trauma patients is still understudied. This retrospective study analyzed data from the Trauma Registry System at a Level I trauma center in southern Taiwan, covering the period from 1 January 2009 to 31 December 2021. This study included 40,068 trauma patients aged 20 years and older. Statistical analyses included chi-square tests, ANOVA, Mann-Whitney U tests, and multivariate analyses to identify independent risk factors for mortality. The predictive performance of the GTOS was assessed using the area under the curve (AUC) of the receiver operating characteristic curve. The final study population included 40,068 patients, with 818 deaths and 39,250 survivors. Deceased patients had higher GTOS scores (mean 132.8 vs. 76.1, p < 0.001) and required more blood transfusions (mean 4.0 vs. 0.3 units, p < 0.001) compared to survivors. The optimal GTOS cut-off value for predicting mortality was 104.5, with a sensitivity of 82.6% and a specificity of 84.3% (AUC = 0.917). A high GTOS score was associated with increased mortality (9.6 vs. 0.4%, p < 0.001) compared with a low GTOS score, even after adjusting for confounding factors (adjusted mortality rate of 2.86, p < 0.001), and a longer hospital stay (14.0 vs. 7.7 days, p < 0.001). The GTOS is a valuable prognostic tool for predicting mortality in trauma patients, providing a simple and rapid assessment method. Its high predictive accuracy supports its use in broader trauma patient populations beyond the elderly. Further studies are recommended to refine and validate the GTOS in diverse trauma settings to enhance its clinical utility.

How do children understand and respond to the EQ-5D-Y-3L? A mixed methods study in a community-based sample of 6–12-year-olds

BackgroundThe EQ-5D-Y-3L is widely used for measuring and valuing HRQoL in paediatric populations. This mixed methods study used the EQ-5D-Y-3L measure and applied a retrospective think-aloud approach to examine the self-report validity in children of varying chronological age.MethodsA mixed methods study was conducted in a community-based sample of 39 children aged 6–12 years. In a semi-structured interview, children self-completed the EQ-5D-Y-3L and then engaged in retrospective think-aloud. Conversations were audio-recorded and transcribed for analysis in NVivo using the Tourangeau four-stage response model framework to assess comprehension, judgment, recall, and response mapping issues. Fisher’s exact test was used to assess the differences between child-self reported HRQoL across subgroups. The inter-rater agreement between child-parent dyads was assessed with CCC for overall HRQoL and Gwet’s AC1 for dimension level HRQoL.ResultsOverall, response issues were detected in n = 18 (46%) children. Comprehension issues were apparent in the “having pain or discomfort” dimension where children found it challenging to understand ‘discomfort’. Recall-related issues were observed where children’s responses were influenced by their typical tendencies (e.g., being usually worried) or past incidences (e.g., feeling pain sometimes). Judgement-related issues were the most common, particularly in the “doing usual activities” dimension, where children tended to respond based on their self-perceived ability to engage in activities rather than health-related limitations. None of the participants were found to have problems with response mapping. A healthy lifestyle that included diet and exercise was a notable consideration in EQ VAS ratings.The younger age groups had a higher proportion of response issues (6–7 years: 64%, 8–10 years: 62%), compared to older children (11–12 years: 20%). Moreover, children with response issues demonstrated significantly lower EQ-5D-Y-3L scores (mean = 0.78, se = 0.04) as compared to those without (mean = 0.95, se = 0.02) (p-value < 0.001). The overall inter-rater agreement was higher for those without any response issues (CCC = 0.33) than those with (CCC = 0.14). Additionally, higher agreement was noted across all the five dimensions in the subgroup with no response issues relative to those with.ConclusionsChildren in the general community may have different perceptions of HRQoL when responding to the EQ-5D-Y-3L possibly due to their limited experience with health-related challenges. The retrospective think-aloud approach adopted highlighted the relatively higher prevalence of response issues in the younger children (ages < 11 years), indicating the need for careful interpretation of self-reported HRQoL using the current version of the EQ-5D-Y-3L in this population.

Doctor-Patient Communication skills: Knowledge and Practice among Physicians of private medical colleges of Chattogram, Bangladesh

Background: Quality patient care and fostering doctor- patient relationships with compassion and mutual respect rely on effective communication. This study sought to evaluate the physicians' knowledge and proficiency in doctor-patient communication skills across three private medical colleges and hospitals in Chattogram, Bangladesh. Materials and Methods: From April to May 2024, Chattogram, Bangladesh's Southern Medical College (SMC), BGC Trust Medical College (BGC TMC), and Chattogram Maa O Shishu Hospital Medical College (CMOSHMC) conducted a descriptive cross-sectionalresearch. A total of 384 physicians voluntarily participated in this study. A structured questionnaire including Knowledge and Practice towards Doctor-Patient Communication skills based on Calgary- Cambridge framework was distributed among the physicians. Data were analyzed by Statistical Package of Social Sciences version 24. Results: In this study, out of 384 physicians, 168(43.8%) were male and 216 (56.3%) were female. The mean age of the physicians was 33.0859 ± 9.241. 142(37%) were from Chattogram Maa O Shishu Hospital Medical College (CMOSHMC), 132(34.4) from BGC Trust Medical college (BGCTMC) and 110(28.6) from Southern Medical College (SMC). The mean of total knowledge score was 41.914 (SD: ±3.893) and total practice score was 38.554 (SD: ±4.317). According to Bloom's scale, the doctors in this research had a moderate degree of practice (76%) but an excellent level of knowledge (&gt;80%) about doctor-patient communication. Conclusion: Though physicians in this study had a good level of knowledge but illustrated a Moderate level of Practice on Doctor Patient Communication skill. The barriers to practice good communication skills must be overcome for a better Doctor Patient Relationship.

Comparison of erector spinae plane block and transverse abdominis plane block in postoperative recovery after laparoscopic colorectal surgery: a randomized, double-blind, controlled trial

BackgroundPatients experience significant postoperative pain after laparoscopic resection of colorectal cancer. Transversus abdominis plane block (TAPB) provides effective analgesia, and recent studies have also shown that erector spinae plane block (ESPB) can be used for postoperative analgesia in abdominal surgery. However, there is a lack of comparison between the two methods regarding recovery quality following laparoscopic colorectal surgery.MethodsSixty patients scheduled for laparoscopic radical resection of colorectal cancer were randomly assigned to receive either a ESPB with TAPB (n = 30). Both groups received a single injection of 20 mL of 0.25% ropivacaine bilaterally. The primary outcome was the quality of recovery (QoR) at 24 h postoperatively, using the quality of recovery-15 (QoR-15) scale. Secondary outcomes included the QoR at 48 h postoperatively, visual analogue scale (VAS) pain scores during the first 48 h postoperatively in both resting and active states, requirements for rescue analgesia, cumulative postoperative opioid consumption, patient satisfaction, incidence of postoperative nausea and vomiting (PONV), time to first flatus and ambulation, the Comprehensive Complication Index (CCI) score, and postoperative hospital stay.ResultsAt 24 h postoperatively, the QoR-15 score (mean ± standard deviation) was significantly higher in the ESPB group (109.2 ± 8.7) compared to the TAPB group (101 ± 10.1) (p = 0.001). Similarly, at 48 h postoperatively, the QoR-15 score remained higher in the ESPB group (118.5 ± 8.8) than in the TAPB group (113.8 ± 8.1) (p = 0.035). Patients in the ESPB group reported lower visual analog scale (VAS) pain scores during the first 24 h postoperatively (all p < 0.05) compared to those in the TAPB group. The sufentanil consumption median (interquartile range) in the ESPB group at 24 h postoperatively was lower (62, 61–65 μg) compared to the TAPB group (66, 63–70 μg) (p < 0.001). Hospital stay median was 7 (6–9) days for the ESPB group and 8 (7–10) days for the TAPB group (p = 0.037).ConclusionsPatients who received ESPB showed better recovery quality, improved analgesic effects, and higher postoperative satisfaction compared to those who underwent preoperative TAPB.Trial registrationhttps://www.chictr.org.cn (ChiCTR2400081157); date of registration: February 24, 2024. The first participant was enrolled on February 27, 2024.