Multiple Assessment Tools Research Articles

A novel stability-indicating chromatographic quantification of the antiparkinsonian drug safinamide in its pharmaceutical formulation employing HPTLC densitometry and ion-pair HPLC–DAD

Parkinson's disease (PD) emerges as a notable health concern among the elderly population. Safinamide mesylate (SAF) is a novel and emerging add-on therapy in PD treatment. The stability of innovative drug formulations and the development of appropriate stability-indicating methods are of great importance to modern pharmaceutical analysis. The current work has established novel comprehensive stability-indicating chromatographic approaches, HPTLC coupled with densitometric quantification and HPLC–DAD, for the selective assay of SAF in pharmaceutical formulation along with its synthetic precursor impurity; 4-hydroxy benzaldehyde (4-HBD) in presence of its stress induced degradation products. The stability of SAF was investigated under different stress conditions. It was found that SAF is likely to undergo acid, base hydrolysis, and oxidative degradation. Using mass spectrometry and infrared spectroscopy, the structures of the forced degradation products were confirmed and elucidated. The dissolution behavior of Parkimedine® Tablets was also monitored in the FDA suitable medium. Multiple assessment tools were used to evaluate the environmental sustainability of the proposed methods and the reported one. The greenness tools included Complex-GAPI and AGREE metrics. In addition, the innovative concepts of "blueness" and "whiteness" evaluation were incorporated through the newly introduced BAGI and RGB12 algorithms, respectively.

Assessing key soft skills in organizational contexts: development and validation of the multiple soft skills assessment tool

Assessing key soft skills in organizational contexts: development and validation of the multiple soft skills assessment tool

Comparative Vulnerability Analysis of Thai and Non-Thai Mobile Banking Applications

The rapid adoption of mobile banking applications has raised significant concerns about their security vulnerabilities. This study presents a comparative vulnerability analysis of mobile banking applications from Thai and non-Thai banks, utilising the OWASP Mobile Top 10 framework. Nine mobile banking applications (five Thai and four non-Thai) were assessed using three vulnerability detection tools: AndroBugs, MobSF, and QARK. The results showed that both Thai and non-Thai mobile banking applications had vulnerabilities across multiple OWASP Mobile Top 10 categories, with reverse engineering, code tampering, and insufficient cryptography being the most common. Statistical analysis revealed that Thai banking applications exhibited significantly more vulnerabilities compared to non-Thai banking applications. In the context of vulnerability detection tools, AndroBugs and QARK proved more effective in detecting vulnerabilities compared to MobSF. Additionally, the study highlights critical security challenges in mobile banking applications, particularly for Thai banks, and emphasises the need for enhanced security measures. The findings also show the importance of using multiple assessment tools for comprehensive security evaluation and suggest potential areas for improvement in mobile banking applications.

To explore the postoperative nutritional status and factors influencing prognosis in patients with chronic constipation complicated by malnutrition.

Many patients with constipation also suffer from varying degrees of malnutrition, and the relationship between the two conditions is a vicious cycle. Surgery is the final step in the treatment of constipation, with a success rate of up to 95%. This study aims to investigate the effects of surgical treatment on the nutritional status of patients with chronic constipation and malnutrition. A total of 60 patients with chronic constipation and various degrees of malnutrition who underwent surgery in our department from January 2020 to March 2023 were included in this study. Biochemical tests including BMI, albumin, total protein, hemoglobin, cholesterol and lymphocyte count were conducted, as well as measurements of inflammatory markers such as Interleukin-6 (IL-6), Interleukin-8 (IL-8), and C-reactive protein (CRP). Additionally, multiple nutritional risk screening scales (NRS2002, MUST, NRI, and MNA) and the prognostic nutritional index (PNI) were used to assess the nutritional status of patients before surgery, as well as at 1 month, 3 months, and 6 months post-surgery. Finally, we analyzed the factors influencing postoperative recovery outcomes in patients. Compared to pre-operation, the BMI of patients significantly increased at 1 month, 3 months, and 6 months after the operation, with statistically significant differences (p < 0.001). Multiple nutritional risk assessment tools (NRS2002, MUST, NRI, and MNA), as well as the prognostic nutritional index (NPI), indicated a reduction in nutritional risk and improvement in nutritional status at 1, 3, and 6 months post-surgery, compared to pre-surgery levels (p < 0.001). The levels of albumin, total protein, and hemoglobin in patients at 1, 3, and 6 months after the surgery were significantly higher than those before the surgery (p < 0.001). However, there was no significant change in the number of lymphocytes. Inflammatory markers such as IL-6, IL-8, and CRP exhibited a significant decrease after the surgery, reaching normal levels at 6 months post-surgery (p < 0.001). Low BMI, low PNI, and low cholesterol levels are independent risk factors for patient prognosis (p < 0.05). Surgical treatment can enhance the nutritional status of constipation patients with malnutrition, which in turn promotes the restoration of intestinal motility. The patient's nutritional status will impact the postoperative recovery outcomes.

Targeted Screening for Cancer: Learnings and Applicability to Melanoma: A Scoping Review.

This scoping review aims to systematically gather evidence from personalized cancer-screening studies across various cancers, summarize key components and outcomes, and provide implications for a future personalized melanoma-screening strategy. Peer-reviewed articles and clinical trial databases were searched for, with restrictions on language and publication date. Sixteen distinct studies were identified and included in this review. The studies' results were synthesized according to key components, including risk assessment, risk thresholds, screening pathways, and primary outcomes of interest. Studies most frequently reported about breast cancers (n = 7), followed by colorectal (n = 5), prostate (n = 2), lung (n = 1), and ovarian cancers (n = 1). The identified screening programs were evaluated predominately in Europe (n = 6) and North America (n = 4). The studies employed multiple different risk assessment tools, screening schedules, and outcome measurements, with few consistent approaches identified across the studies. The benefit-harm assessment of each proposed personalized screening program indicated that the majority were feasible and effective. The establishment of a personalized screening program is complex, but results of the reviewed studies indicate that it is feasible, can improve participation rates, and screening outcomes. While the review primarily examines screening programs for cancers other than melanoma, the insights can be used to inform the development of a personalized melanoma screening strategy.

Physical Activity Levels in Persons With Patellofemoral Pain: A Systematic Review and Meta-analysis.

Pain and symptoms of patellofemoral pain (PFP) are often exacerbated during daily activities, which may result in reduced overall physical activity levels. To summarize the evidence for physical activity levels among persons with PFP compared with pain-free controls. PubMed, Embase, CINHAL, Cochrane Library, and SPORTDiscus were searched from January 1, 2000 to February 22, 2024. Peer-reviewed studies published in English that measured physical activity subjectively or objectively in persons with PFP and pain-free controls. Systematic review with meta-analysis. Level 1. Standardized mean difference (SMD) with 95% CI are reported based on Hedges' g effect sizes. From 23,745 records, 41 studies met the eligibility criteria. There was high-to-moderate-certainty evidence that persons with PFP reported higher physical activity levels compared with pain-free controls using the International Physical Activity Questionnaire (SMD, 0.27; 95% CI 0.03, 0.51), whereas lower physical activity levels compared with pain-free controls using the Tegner Activity Scale (SMD, -0.31; 95% CI -0.57, -0.04). There was low-to-moderate-certainty evidence that there was no group difference in physical activity levels using the Baecke Physical Activity Questionnaire (SMD, 0.17; 95% CI -0.09, 0.44) or self-reported sports participation duration (SMD, -0.46; 95% CI -0.98, 0.05). There was high-certainty evidence that runners with PFP reported shorter running distances compared with pain-free runners (SMD, -0.36, 95% CI -0.57, -0.14). No data pooling was possible for objectively measured physical activity levels due to device heterogeneity (ie, different algorithms used to quantify the intensity of physical activity). Self-reported physical activity levels among persons with PFP were inconsistent depending on the physical activity measurement tool used or which specific physical activity was measured. Clinicians should integrate multiple physical activity assessment tools to determine the extent to which PFP influences physical activity levels. PROSPERO #CRD42022314598.

Mobility Assessment Instruments

ObjectivesReview commonly used mobility assessment instruments and discuss their use in multidisciplinary research and clinical practice. MethodsData sources include peer-reviewed articles sourced in electronic databases (PubMed, CINAHL), government websites, national, and international best practice guidelines to describe frequently used mobility assessment instruments. ResultsNumerous clinician-, observer-, patient-reported, and performance outcome instruments and evidence-based implementation program resources exist, though these vary in their intended purpose and setting. Wearable and ambient sensors provide new opportunities to collect passive, objective physical activity data and observe changes in mobility across settings. ConclusionsSelection among multiple assessment tools requires consideration of the available evidence for use in the desired population, the outcomes of interest, whether use is feasible for the setting, and the strength of validity and reliability data for the tool. Implications for Nursing PracticeNurses, especially in the inpatient setting, are typically in most frequent contact with patients and are well-positioned to assess mobility and ensure that safe, progressive mobility care plans are in place. Development of an organization-wide mobility culture requires a systematic, multidisciplinary approach and long-term commitment.

Distinguishing between autism and the consequences of early traumatisation during diagnostic assessment: a clinical case study

PurposeDistinguishing between autism characteristics and trauma-related symptoms may be clinically challenging, particularly in individuals who have experienced early traumatisation. Previous studies have described a risk that trauma-related symptoms are misinterpreted and/or misattributed to autism. This study aims to describe and explore assessment strategies to distinguish autism and early traumatisation in the case of a young woman with mild intellectual disability.Design/methodology/approachA clinical case study outlining assessment strategies, diagnostic decision-making and initial intervention.FindingsA multi-informant interdisciplinary assessment using multiple assessment tools, together with a comprehensive review of records from previous assessments and contacts with various services, was helpful in distinguishing between autism and trauma. This included specific assessment tools for autism and trauma. Autism characteristics and trauma-related symptoms appeared to interact, not merely co-occur.Originality/valueThe current case demonstrates that diagnostic overshadowing may occur for autism in the context of early trauma. The case further highlights the importance of not ascribing trauma-related symptoms to autism, as service provision and treatment need to take account of both. Overlooking autism in individuals who have experienced early traumatisation may result in a risk that intervention and care are not appropriately adapted, which may involve a risk of exacerbating trauma symptoms.

Choosing the Right Tool: A Comparative Study of Wetland Assessment Approaches

There are over 700 aquatic ecological assessment approaches across the globe that meet specific institutional goals. However, in many cases, multiple assessment tools are designed to meet the same management need, resulting in a confusing array of overlapping options. Here, we look at six riverine wetland assessments currently in use in Montana, USA, and ask which tool (1) best captures the condition across a disturbance gradient and (2) has the most utility to meet the regulatory or management needs. We used descriptive statistics to compare wetland assessments (n = 18) across a disturbance gradient determined by a landscape development intensity. Factor analysis showed that many of the tools had internal metrics that did not correspond well with overall results, hindering the tool’s ability to act as designed. We surveyed regional wetland managers (n = 56) to determine the extent of their use of each of the six tools and how well they trusted the information the assessment tool provided. We found that the Montana Wetland Assessment Methodology best measured the range of disturbance and had the highest utility to meet Clean Water Act (CWA§ 404) needs. Montana Department of Environmental Quality was best for the CWA§ 303(d) & 305(b) needs. The US Natural Resources Conservation Service’s Riparian Assessment Tool was the third most used by managers but was the tool that had the least ability to distinguish across a disturbance, followed by the US Bureau of Land Management’s Proper Functioning Condition.

Exploring the relationship between AM-PAC scores and mobility components in falls and pressure injury risk assessment tools: A pathway to improve nursing clinical efficiency.

Nurses routinely perform multiple risk assessments related to patient mobility in the hospital. Use of a single mobility assessment for multiple risk assessment tools could improve clinical documentation efficiency, accuracy and lay the groundwork for automated risk evaluation tools. We tested how accurately Activity Measure for Post-Acute Care (AM-PAC) mobility scores predicted the mobility components of various fall and pressure injury risk assessment tools. AM-PAC scores along with mobility and physical activity components on risk assessments (Braden Scale, Get Up and Go used within the Hendrich II Fall Risk Model®, Johns Hopkins Fall Risk Assessment Tool (JHFRAT) and Morse Fall Scale) were collected on a cohort of hospitalised patients. We predicted scores of risk assessments based on AM-PAC scores by fitting of ordinal logistic regressions between AM-PAC scores and risk assessments. STROBE checklist was used to report the present study. AM-PAC scores predicted the observed mobility components of Braden, Get Up and Go and JHFRAT with high accuracy (≥85%), but with lower accuracy for the Morse Fall Scale (40%). These findings suggest that a single mobility assessment has the potential to be a good solution for the mobility components of several fall and pressure injury risk assessments.

Hydrometeorological Insights into the Forecasting Performance of Multi-Source Weather over a Typical Hill-Karst Basin, Southwest China

Reliable precipitation forecasts are essential for weather-related disaster prevention and water resource management. Multi-source weather (MSWX), a recently released ensemble meteorological dataset, has provided new opportunities with open access, fine horizontal resolution (0.1°), and a lead time of up to seven months. However, few studies have comprehensively evaluated the performance of MSWX in terms of precipitation forecasting and hydrological modeling, particularly in hill-karst basins. The key concerns and challenges are how precipitation prediction performance relates to elevation and how to evaluate the hydrologic performance of MSWX in hill-karst regions with complex geographic heterogeneity. To address these concerns and challenges, this study presents a comprehensive evaluation of MSWX at the Chengbi River Basin (Southwest China) based on multiple statistical metrics, the Soil and Water Assessment Tool (SWAT), and a multi-site calibration strategy. The results show that all ensemble members of MSWX overestimated the number of precipitation events and tended to have lower accuracies at higher altitudes. Meanwhile, the error did not significantly increase with the increased lead time. The “00” member exhibited the best performance among the MSWX members. In addition, the multi-site calibration-enhanced SWAT had reliable performance (Average Nash–Sutcliffe value = 0.73) and hence can be used for hydrological evaluation of MSWX. Furthermore, MSWX achieved satisfactory performance (Nash–Sutcliffe value &gt; 0) in 22% of runoff event predictions, but the error increased with longer lead times. This study gives some new hydrometeorological insights into the performance of MSWX, which can provide feedback on its development and applications.

P563 Nutritional screening in patients with inflammatory bowel disease: a challenge in the timely diagnosis of malnutrition and sarcopenia

Abstract Background Malnutrition is prevalent in inflammatory bowel disease (IBD) and has been reported in up to 70% in patients with active disease and 38% in patients in remission, being related to sarcopenia, so different tools have been proposed for the nutritional screening of these patients taking into account the importance of early intervention avoiding consequences related to altered body composition such as inadequate response to treatment and poor quality of life, but the evidence in IBD patients is still unclear and there are no studies in Colombian IBD patients. Therefore, the aim of this study is to describe the nutritional status of patients using multiple nutritional screening and assessment tools. Methods Descriptive observational cross-sectional study in patients diagnosed with IBD with clinical activity, by applying nutritional screening tools such as the Malnutrition Universal Screening Tool (MUST) and the Malnutrition Inflammation Risk Tool (MIRT) to determine their nutritional status and degree of sarcopenia. Results Nutritional screening was performed in 20 patients with Inflammatory Bowel Disease, with mild to moderate clinical activity of the disease; patients in clinical remission were excluded. Sixty percent were men and 40% women; with an average age of 44.5 years, 19 years as minimum age and 73 years as maximum age. Taking into account the Malnutrition Universal Screening Tool (MUST), 30% have a high risk of malnutrition, with a higher percentage in men. On the other hand, the MIRT (Malnutrition Inflammation Risk Tool), which evaluates BMI, showed that 25% have a score greater than or equal to 3, which indicates a risk. In addition, and 40% of the population underwent nutritional status assessment in order to rule out sarcopenia. Muscle strength, muscle mass and muscle function were assessed and 25% of this population were diagnosed with sarcopenia and another 25% with possible sarcopenia. Conclusion Patients with IBD are at increased risk of malnutrition, This is the first Colombian study to approach the nutritional assessment of IBD patients with mild to moderate disease activity using nutritional screening tools such as the Malnutrition Universal Screening Tool (MUST) and the Malnutrition Inflammation Risk Tool (MIRT), showing that up to one third of patients are at high risk of malnutrition and 50% have a diagnosis or possible diagnosis of sarcopenia, which is slightly lower than that described in the literature, However, it does raise awareness of the importance of nutritional screening in IBD patients as these alterations have been shown to be associated with increased hospitalisation requirements, number of disease flares and associated complications.

Surgeon fatigue in robot-assisted and laparoscopic gastrectomy for gastric cancer: Exploratory prospective observational study ancillary to JCOG1907 randomized controlled trial (JCOG1907A1).

TPS422 Background: Fatigue is being increasingly recognized as an important factor in surgical procedures, because it leads to errors in surgeons' decisions and reduced operating efficiency. In comparison to laparoscopic surgery, robot-assisted surgery is expected to reduce surgeon fatigue due to ergonomic adjustments, comfortable sitting positions, minimal restriction of instrument movement, and stable visualization. The aim of this study is to assess surgeon fatigue and explore the superiority of robot-assisted gastrectomy over laparoscopic gastrectomy in surgeon fatigue. Methods: This study is conducted as a prospective observational study ancillary to a randomized controlled phase III trial investigating the superiority in safety of robot-assisted gastrectomy over laparoscopic gastrectomy for clinical stage T1-4aN0-3 gastric cancer (JCOG1907: UMIN000039825). The lead surgeon and the first assistant performing surgeries as protocol treatment in JCOG1907 were included. Surgeon fatigue is quantitatively assessed using multiple assessment tools. The primary endpoint is the average NASA-Task Load Index (NASA-TLX) value for the lead surgeons. Secondary endpoints include six individual parameters of NASA-TLX, visual analog scale assessments for fatigue, advanced trail-making tests, and continuous heart rate variability measurements for lead surgeons and first assistants. The primary analysis compares surgeon fatigue between robot-assisted and laparoscopic surgery. Secondary analyses examine the association between surgeon fatigue and various factors, such as surgeon and patient background, and surgical findings, as well as cross-correlations among measures of surgical fatigue. In addition, the association between surgeon fatigue and postoperative complications and its impact on long-term survival outcomes is also evaluated. The sample size is 500 surgical cases, with a planned accrual period of 2 years. This study was initiated in April 2023 and registered at the University Hospital Medical Information Network as UMIN000052120. As of August 2023, 52 cases (10.4% of the planned accrual) have been enrolled in the study. Clinical trial information: UMIN000052120 .

Assessing the Quality of YouTube's Incontinence Information after Cancer Surgery: An Innovative Graphical Analysis.

Prostate and colorectum cancers rank among the most common cancers, and incontinence is a significant postsurgical issue affecting the physical and psychological well-being of cancer survivors. Social media, particularly YouTube, has emerged as a vital source of health information. While YouTube offers valuable content, users must exercise caution due to potential misinformation. This study aims to assess the quality of publicly available YouTube videos related to incontinence after pelvic cancer surgery. A search on YouTube related to "Incontinence after cancer surgery" was performed, and 108 videos were analyzed. Multiple quality assessment tools (DISCERN, GQS, JAMA, PEMAT, and MQ-VET) and statistical analyses (descriptive statistics and intercorrelation tests) were used to evaluate the characteristics and popularity, educational value, quality, and reliability of these videos, relying on novel graphical representation techniques such as Sankey and Chord diagrams. Strong positive correlations were found among quality rating scales, emphasizing agreement. The performed graphical analysis reinforced the reliability and validity of quality assessments. This study found strong correlations among five quality scales, suggesting their effectiveness in assessing health information quality. The evaluation of YouTube videos consistently revealed "high" quality content. Considering the source is mandatory when assessing quality, healthcare and academic institutions are reliable sources. Caution is advised with ad-containing videos. Future research should focus on policy improvements and tools to aid patients in finding high-quality health content.

Impact of Interprofessional Collaborative Practice on Functional Improvements Among Post-Acute Stroke Survivors: A Retrospective Cross-Sectional Study.

Stroke survivors in post-acute care frequently experience physiological dysfunction and reduced quality of life. This study aims to assess the impact of the Post-Acute Care Interprofessional Collaborative Practice (PAC-IPCP) program across different care settings, and to identify sensitive tools for assessing physiological functions among post-acute stroke survivors. This retrospective study involved 210 stroke survivors in Taiwan. Participants who self-selection for their preferred between hospital care setting and home care setting under PAC-IPCP. Multiple assessment tools were utilized, including the Barthel Index (BI), Functional Oral Intake Scale (FOIS), Mini Nutritional Assessment (MNA), EQ-5D-3L, and Instrumental Activities of Daily Living (IADL). The logistic regression was used to estimate the odds ratios of various functional assessment tools between hospital and home care settings. Additionally, the area under the ROC curves was used to determine which functional assessment tools had higher accuracy in measuring the association between care settings. Of the study population, 138 stroke survivors (65.71%) selection hospital care setting and 72 stroke survivors (34.29%) selection home care setting. The PAC-IPCP program was equally effective in both care settings for physical function status and quality of life improvements. Specifically, the BI emerged as the most sensitive tool for assessing care settings, with an adjusted OR of 1.04 (95% CI:1.02-1.07, p < 0.0001; AUC = 0.7557). IPCP-based hospital and home care models are equally effective in facilitating improved functional outcomes in post-acute stroke survivors. The PAC-IPCP program is versatile and effective across care settings. The BI stands out as a robust assessment tool for physiological functions, endorsing its broader clinical application. Future studies should also consider swallowing and nutritional status for a more holistic approach to rehabilitation.

Evaluation of different screening tools as the first step of the GLIM framework: A cross-sectional study of Chinese cancer patients in an outpatient setting.

Ambulatory cancer patients are at high risk of malnutrition. Multiple nutrition screening and assessment tools are used in the outpatient setting. This study aimed to evaluate the efficacy of different nutrition screening tools as the first step of the Global Leadership Initiative on Malnutrition (GLIM) framework in Chinese ambulatory cancer patients. A cross-sectional study was conducted in a tertiary hospital in China. Malnutrition diagnoses made by the GLIM framework using Malnutrition Screening Tool, Malnutrition Universal Screening Tool, Nutritional Risk Screening 2002, or short-form of Patient-Gernerated Subjective Global Assessment (PG-SGA) as the first step were compared with PG-SGA separately. Of the 562 included patients, 31.0% were diagnosed with malnutrition (PG-SGA: B + C), and 12.6% were diagnosed with severe malnutrition (PG-SGA: C). As the screening tool in the first step of the GLIM framework, the short form of PG-SGA (PG-SGA SF) with a cutoff value of ≥2 performed best in diagnosing malnutrition, with good sensitivity (SE) (80.5% [73.6-85.9]) and specificity (SP) (98.4% [96.5-99.4]) and substantial accordance (κ = 0.826), whereas PG-SGA SF with a cutoff value of ≥4 performed bestin diagnosing severe malnutrition, with fair SE (62.0% [49.6-73.0]), good SP (96.7% [94.6-98.1]) and moderate accordance (κ = 0.629). Using PG-SGA as the standard, the GLIM framework using PG-SGA SF as the screening tool has good accordance with the PG-SGA regardless of severity grading. PG-SGA SF can be used as a valid screening tool in the GLIM framework.

Assessment of Academic ESL Writing in an Online Tutorial for Graduate Students

English-as-a-second language (L2) graduate students often face challenges in developing academic writing skills, which can be exacerbated by a lack of timely support at institutional level. To help address this concern, an original set of online academic writing tutorials with a focus on the genre of Literature Review was designed by the authors to assist international graduate students enrolled in graduate programs in Canada. This paper introduces and compares multiple assessment tools employed in the online tutorial set for international English L2 graduate students. Our project pursues two major goals: First, to address the above-identified gap in Academic Writing support to English L2 graduate students with minimal costs and faculty involvement through designing the online tutorial set; second, to contribute to the research on e-learning of Academic English as a second language (ESL) writing in terms of developing integrated tools for online tutorial building, analysis of texts produced by learners, and assessment of learners’ writing progress. The research questions are: 1. What resources can be combined to develop an online tutorial set for graduate students at minimal costs? 2. How can the learners’ progress in academic ESL writing be assessed with different assessment tools? First, the paper describes the tools employed in the tutorial construction: MoodleCloud platform, H5P interactive e-book designed by the authors, surveys, and assessment tools. Second, we present and compare assessment tools employed to evaluate learners’ writing progress: Expert assessment with an analytic rubric, self-assessments of progress by the participants, and automated text analysis with corpus-based tools as reported in Li, Makarova, and Wang (2023). A comparison of the scores across the three assessment tools shows some discrepancies, which seems to suggest that combined tools yield a more comprehensive picture. The expert assessments and self-assessments demonstrate improvement in the writing quality over the course of the tutorial series, which are partially supported with the findings from corpus-based analysis of participants’ texts. The findings are of relevance to e-learning scholars, faculty, and administrators of English-medium universities with substantial intakes of international graduate students in Social Sciences and Education whose native languages are other than English.

Assessment for learning of paediatric cardiology trainees in 41 centres from 19 European countries.

Limited data exist on how trainees in paediatric cardiology are assessed among countries affiliated with the Association of European Paediatric and Congenital Cardiology. A structured and approved questionnaire was circulated to educationalists/trainers in 95 Association for European Paediatric and Congenital Cardiology training centres. Trainers from 46 centres responded with complete data in 41 centres. Instructional design included bedside teaching (41/41), didactic teaching (38/41), problem-based learning (28/41), cardiac catheterisation calculations (34/41), journal club (31/41), fellows presenting in the multidisciplinary meeting (41/41), fellows reporting on echocardiograms (34/41), clinical simulation (17/41), echocardiography simulation (10/41), and catheterisation simulation (3/41). Assessment included case-based discussion (n = 27), mini-clinical evaluation exercise (mini-CEX) (n = 12), directly observed procedures (n = 12), oral examination (n = 16), long cases (n = 11), written essay questions (n = 6), multiple choice questions (n = 5), and objective structured clinical examination (n = 2). Entrustable professional activities were utilised in 10 (24%) centres. Feedback was summative only in 17/41 (41%) centres, formative only in 12/41 (29%) centres and a combination of formative and summative feedback in 10/41 (24%) centres. Written feedback was provided in 10/41 (24%) centres. Verbal feedback was most common in 37/41 (90 %) centres. There is a marked variation in instructional design and assessment across European paediatric cardiac centres. A wide mix of assessment tools are used. Feedback is provided by the majority of centres, mostly verbal summative feedback. Adopting a programmatic assessment focusing on competency/capability using multiple assessment tools with regular formative multisource feedback may promote assessment for learning of paediatric cardiology trainees.

Association between depression and quality of life in older adults with type 2 diabetes: A moderated mediation of cognitive impairment and sleep quality

BackgroundThe acceleration of aging and the increase in life expectancy have resulted in an increasing number of older adults developing physical and mental comorbidities. We examined the association between depression and quality of life (QoL) using cognitive impairment (COI) as a mediator and sleep quality (SQ) as a moderator among older adults with type 2 diabetes. MethodsA total of 2646 participants from Weifang, Shandong, China completed the survey. Their depression, cognitive function, SQ, and QoL were assessed. PROCESS was used to investigate mediating and moderating effects. ResultsCOI mediated the association between depression and QoL (indirect effect = −0.1058, bootstrapped 95 % CI [−0.1417, −0.0725]). Moderated mediation analyses indicated that SQ moderated the first half of the pathway of depression's impact on QoL through COI (moderating effect = −0.1128, bootstrapped 95 % CI [−0.1981, −0.0348]). Depression negatively impacted cognitive function in participants with poor (vs. better) SQ. LimitationsFirst, multiple assessment tools should be considered to increase objective assessment. Second, the cross-sectional design limited our ability to make causal inferences. Third, additional diabetes-related variables should be included to explore this relationship. Finally, the pathways of influence and mechanisms of action of COI in older adults should be explored further. ConclusionDepression could impair the QoL of older adults by aggravating their COI. Fortunately, improving patients' SQ may undermine this negative effect. These findings may play an integral role in promoting the psychiatric health of older adults with type 2 diabetes.

Instructors’ perspectives in design and L-MOOCs: A qualitative look

This qualitative phenomenological study investigates international instructors’ perspectives and experiences in designing a successful language-based massive open online course (L-MOOC). Detailed information was gathered during Summer 2018 about the instructor’s challenges and strategies through semi-structured interviews with seven participants in six different countries: Ireland, Italy, Norway, Spain, the United Kingdom, and the United States. The findings indicated that curating and facilitating a learning environment with a design team helps create an efficient L-MOOC delivery. Additionally, having multiple moderators per course and using forums helps with monitoring learners’ progress. Moreover, according to these seven L-MOOC instructors, having a course platform with rigid structures prevents using multiple activities and assessment tools for language learning. Interviewees argued that it is important to implement a learner-centered approach in L-MOOC, where learners can interact with each other and construct their knowledge. Future research studies may include exploring L-MOOC to address the best instructional practices and contribute to expanding research in language education in massive open online course environment.