Percentage Of Correct Responses Research Articles

The impact of online CME on clinicians’ ability to utilize immunotherapy in unique populations of patients with NSCLC.

e21004 Background: Immunotherapy (IO) has become a standard of care in the management of advanced non-small cell lung cancer (NSCLC). However, treatment with IO-based regimens may not always be straightforward, particularly in unique clinical scenarios and patient populations. As such, members of the multidisciplinary care team, including oncologists and pulmonologists, may lack experience in utilizing IO in these instances. The objective of this study was to assess the educational impact of a series of continuing medical education (CME) activities on the knowledge, competence, and confidence of oncologists and pulmonologists with respect to recognizing strategies that facilitate the safe and effective use of IO in patients with advanced NSCLC. Methods: The educational analysis consisted of 2 online, CME-certified activities. Educational impact was assessed with repeated pre-/post-education including multiple choice knowledge/competence questions and 5-point Likert scale confidence questions. Data from all oncologists and pulmonologists who completed pre- and/or post-education assessments were aggregated across activities and stratified by learning theme. Relative changes in percentage of correct responses and clinicians who were confident (value of 4 or 5) were used to measure improvement in knowledge, competence, and confidence. A McNemar’s test assessed significant levels of changes reported with P values <.05 considered statistically significant. The first activity in the analysis launched October 2023 and the last launched November 2023; data were collected until January 2024. Results: The educational series resulted in improvements in oncologists’ (N=119) and pulmonologists’ (N=49) knowledge, competence, and confidence after education. Conclusions: This analysis demonstrates that oncologists’ and pulmonologists’ knowledge, competence, and confidence regarding the safe and effective use of IO in patients with advanced NSCLC improved after education. Despite these improvements, additional educational activities are needed to address residual gaps and further increase clinicians’ ability in these dynamic and challenging clinical settings. [Table: see text]

Attention facilitates initiation of perceptual decision making: a combined psychophysical and electroencephalography study

Humans can selectively process information and make decisions by directing their attention to desired locations in their daily lives. Numerous studies have shown that attention increases the rate of correct responses and shortens reaction time, and it has been hypothesized that this phenomenon is caused by an increase in sensitivity of the sensory signals to which attention is directed. The present study employed psychophysical methods and electroencephalography (EEG) to test the hypothesis that attention accelerates the onset of information accumulation. Participants were asked to discriminate the motion direction of one of two random dot kinematograms presented on the left and right sides of the visual field, one of which was cued by an arrow in 80% of the trials. The drift–diffusion model was applied to the percentage of correct responses and reaction times in the attended and unattended fields of view. Attention primarily increased sensory sensitivity and shortened the time unrelated to decision making. Next, we measured centroparietal positivity (CPP), an EEG measure associated with decision making, and found that CPP latency was shorter in attended trials than in unattended trials. These results suggest that attention not only increases sensory sensitivity but also accelerates the initiation of decision making.

Report from a text-based blood pressure monitoring prospective cohort trial among postpartum women with hypertensive disorders of pregnancy

BackgroundHypertensive disorders of pregnancy are a main cause of maternal morbidity and mortality in the United States and worldwide, and it is estimated that approximately 60% of maternal deaths in the United States occur during the postpartum period. The utilization of telehealth modalities such as home blood pressure monitoring has shown improvement in blood pressure control and adherence with follow up visits. Our study sought to determine if standardized education improved patient hypertension knowledge and if this when combined with home blood pressure telemonitoring increased participants’ postpartum self-blood pressure monitoring and postpartum visit attendance.MethodsThis is an Institutional Review Board approved prospective cohort study conducted at the University of Mississippi Medical Center. Women with a hypertensive disorder of pregnancy who met the inclusion criteria and provided written informed consent to participate were enrolled. Participants received a baseline pre-education questionnaire designed to assess their knowledge of their hypertensive diagnosis, hypertension management, and postpartum preeclampsia (PreE). Participants then received standard education, a blood pressure monitor, and were scheduled a follow-up visit during the first 10 days following discharge. Remote home blood pressure monitoring was performed via text messages and voice calls for 6-weeks postpartum. At the conclusion of the study, participants repeated their original questionnaire.Results250 women provided informed consent to participate in the study and were included in this analysis. Relative to the baseline survey, there was a significant increase (p = 0.0001) in the percentage of correct responses. There was not an association between study engagement and percentage of correct responses on end of study questionnaire (p = 0.33) or postpartum visit attendance (p = 0.69). Maternal age was found to drive study engagement, even when adjusted for community-level distress (p = 0.03) and maternal race (p = 0.0002).ConclusionImplementing a standardized postpartum education session was associated with improvement in patient’s knowledge. Further studies are needed with more longitudinal follow up to assess if this program would also result in improved long-term outcomes and decreased hospital readmission rates.Trial registrationNCT04570124.

Can Inexperienced Listeners Hear Who Is Singing? The Role of Motivation in Singer Discrimination Across Pitch

Previous research has shown that in a task identifying singers across pitch, inexperienced listeners perform very poorly compared to their experienced counterparts. This poor performance may partially be due to lower motivation and reduced attention on the part of inexperienced listeners. The current experiment is designed to examine the role of motivation in difficult perceptual tasks through use of an established methodology that uses singing voice stimuli. This study used an ABX paradigm. Listeners heard two different singers, singing /ɑ/ at the same pitch and had to identify which of the two singers produced a third /ɑ/ at a different pitch. Pitches varied across 1.5 octaves. Inexperienced listeners were randomly assigned to 1 of 3 conditions: (1) no feedback, (2) percent correct feedback, and (3) percentile feedback. Prior to the experiment, listeners rated their motivation using the Situational Intrinsic Motivation Scale (SIMS). Data were collected from 99 inexperienced listeners. There were no significant differences between the three feedback conditions, No Feedback, Percent Correct, and Percentile, for any SIMS subscale. Likewise, there were no significant differences in musical experience between the three feedback conditions. A repeated measures ANOVA designed to test the effect of feedback group on mean percent correct responses revealed no significant main or interaction effects of feedback. However, amotivation was a significant predictor of mean percent correct scores. Motivation is a complex construct that, while not being a primary factor in the current audio-perceptual task, could still be an important confounding factor in perceptual research. In the case of the current study, the two feedback conditions utilized in this study, Percent Correct and Percentile, may not have provided sufficiently robust external motivation to elicit differences in performance. Perceptual and behavioral researchers should be vigilant. More research is necessary.

Numerosity comparison, cognitive strategies, and general cognitive functioning in older people.

Studies have shown age-related differences in numerical cognition, for example, in the level of numerosity comparison ability. Moreover, some studies point out individual differences in the cognitive strategies employed during the performance of numerosity comparison tasks and reveal that they are related to the aging process. One probable cause of these differences is the level of cognitive functioning. The aim of our study was to determine the relationships among numerosity comparison ability, the cognitive strategies utilized in the performance of numerosity comparison tasks and the general cognitive functioning in older people. Forty-seven elderly people participated in the study. The participants were examined using overall cognitive functioning scales and computerized numerosity comparison task. The results showed many correlations between the participants' level of cognitive functioning and the percent of correct responses (PCR) and response time (RT) during numerosity comparison, as well as with the cognitive strategies applied by the participants. Task correctness was positively related to the level of performance in the attention and executive function tasks. In contrast, the long-term memory resources index and visuospatial skills level were negatively correlated with RT regarding numerosity comparison task performance. The level of long-term memory resources was also positively associated with the frequency of use of more complex cognitive strategies. Series of regression analyses showed that both the level of general cognitive functioning and the cognitive strategies employed by participants in numerosity comparison can explain 9-21 percent of the variance in the obtained results. In summary, these results showed significant relationships between the level of cognitive functioning and proficiency in numerosity comparison measured in older people. Moreover, it has been shown that cognitive resources level is related to the strategies utilized by older people, which indicates the potential application for cognitive strategy examinations in the development of new diagnostic tools.

Performance of Google's Artificial Intelligence Chatbot "Bard" (Now "Gemini") on Ophthalmology Board Exam Practice Questions.

To assess the performance of "Bard," one of ChatGPT's competitors, in answering practice questions for the ophthalmology board certification exam. In December 2023, 250 multiple-choice questions from the "BoardVitals" ophthalmology exam question bank were randomly selected and entered into Bard to assess the artificial intelligence chatbot's ability to comprehend, process, and answer complex scientific and clinical ophthalmic questions. A random mix of text-only and image-and-text questions were selected from 10 subsections. Each subsection included 25 questions. The percentage of correct responses was calculated per section, and an overall assessment score was determined. On average, Bard answered 62.4% (156/250) of questions correctly. The worst performance was 24% (6/25)on the topic of "Retina and Vitreous," and the best performance was on "Oculoplastics," with a score of 84% (21/25). While the majority of questions were entered with minimal difficulty, not all questions could be processed by Bard. This was particularly an issue for questions that included human images and multiple visual files. Some vignette-style questions were also not understood by Bard and were therefore omitted. Future investigations will focus on having more questions per subsection to increase available data points. While Bard answered the majority of questions correctly and is capable of analyzing vast amounts of medical data, it ultimately lacks the holistic understanding and experience-informed knowledge of an ophthalmologist. An ophthalmologist's ability to synthesize diverse pieces of information and draw from clinical experience to answer complex standardized board questions is at present irreplaceable, and artificial intelligence, in its current form, can be employed as a valuable tool for supplementing clinicians' study methods.

A Decision Aid to Support Tubal Sterilization Decision-Making Among Pregnant Women

Tubal sterilization is common, especially among individuals with low income. There is substantial misunderstanding about sterilization among those who have undergone the procedure, suggesting suboptimal decision-making about a method that permanently ends reproductive capacity. To test the efficacy of a web-based decision aid for improving tubal sterilization decision quality. This randomized clinical trial conducted between March 2020 and November 2023 included English- or Spanish-speaking pregnant cisgender women aged 21 to 45 years who had Medicaid insurance and were contemplating tubal sterilization after delivery. Participants were recruited from outpatient obstetric clinics in 3 US cities. Participants were randomized 1:1 to usual care (control arm) or to usual care plus a web-based decision aid (MyDecision/MiDecisión) (intervention arm). The aid includes written, audio, and video information about tubal sterilization procedures; an interactive table comparing contraceptive options; values-clarifying exercises; knowledge checks; and a summary report. The co-primary outcomes were tubal sterilization knowledge and decisional conflict regarding the contraceptive decision. Knowledge was measured as the percentage of correct responses to 10 true-false items. Decisional conflict was measured using the low-literacy Decision Conflict Scale, with lower scores on a range from 0 to 100 indicating less conflict. Among the 350 participants, mean (SD) age was 29.7 (5.1) years. Compared with the usual care group, participants randomized to the decision aid had significantly higher tubal sterilization knowledge (mean [SD] proportion of questions answered correctly, 76.5% [16.9%] vs 55.6% [22.6%]; P < .001) and lower decisional conflict scores (mean [SD], 12.7 [16.6] vs 18.7 [20.8] points; P = .002). The greatest knowledge differences between the 2 groups were for items about permanence, with more participants in the intervention arm answering correctly that tubal sterilization is not easily reversible (90.1% vs 39.3%; odds ratio [OR], 14.2 [95% CI, 7.9-25.4]; P < .001) and that the tubes do not spontaneously "come untied" (86.6% vs 33.7%; OR, 13.0 [95% CI, 7.6-22.4]; P < .001). MyDecision/MiDecisión significantly improved tubal sterilization decision-making quality compared with usual care only. This scalable decision aid can be implemented into clinical practice to supplement practitioner counseling. These results are particularly important given the recent increase in demand for permanent contraception after the US Supreme Court decision overturning federal abortion protections. ClinicalTrials.gov Identifier: NCT04097717.

Accuracy and consistency of chatbots versus clinicians for answering pediatric dentistry questions: A pilot study

ObjectivesArtificial Intelligence has applications such as Large Language Models (LLMs), which simulate human-like conversations. The potential of LLMs in healthcare is not fully evaluated. This pilot study assessed the accuracy and consistency of chatbots and clinicians in answering common questions in pediatric dentistry. MethodsTwo expert pediatric dentists developed thirty true or false questions involving different aspects of pediatric dentistry. Publicly accessible chatbots (Google Bard, ChatGPT4, ChatGPT 3.5, Llama, Sage, Claude 2 100k, Claude-instant, Claude-instant-100k, and Google Palm) were employed to answer the questions (3 independent new conversations). Three groups of clinicians (general dentists, pediatric specialists, and students; n = 20/group) also answered. Responses were graded by two pediatric dentistry faculty members, along with a third independent pediatric dentist. Resulting accuracies (percentage of correct responses) were compared using analysis of variance (ANOVA), and post-hoc pairwise group comparisons were corrected using Tukey's HSD method. ACronbach's alpha was calculated to determine consistency. ResultsPediatric dentists were significantly more accurate (mean±SD 96.67 %± 4.3 %) than other clinicians and chatbots (p < 0.001). General dentists (88.0 % ± 6.1 %) also demonstrated significantly higher accuracy than chatbots (p < 0.001), followed by students (80.8 %±6.9 %). ChatGPT showed the highest accuracy (78 %±3 %) among chatbots. All chatbots except ChatGPT3.5 showed acceptable consistency (Cronbach alpha>0.7). Clinical SignificanceBased on this pilot study, chatbots may be valuable adjuncts for educational purposes and for distributing information to patients. However, they are not yet ready to serve as substitutes for human clinicians in diagnostic decision-making. ConclusionIn this pilot study, chatbots showed lower accuracy than dentists. Chatbots may not yet be recommended for clinical pediatric dentistry.

Cognitive training of mice attenuates age-related decline in associative learning and behavioral flexibility.

Identifying factors that influence age-related cognitive decline is crucial, given its severe personal and societal impacts. However, studying aging in human or animal models is challenging due to the significant variability in aging processes among individuals. Additionally, longitudinal and cross-sectional studies often produce differing results. In this context, home-cage-based behavioral analysis over lifespans has emerged as a significant method in recent years. This study aimed to explore how prior experience affects cognitive performance in mice of various age groups (4, 12, and 22 months) using a home-cage-based touchscreen test battery. In this automated system, group-housed, ID-chipped mice primarily obtain their food during task performance throughout the day, motivated by their own initiative, without being subjected to food deprivation. Spatial working memory and attention were evaluated using the trial unique non-matching to location (TUNL) and the five-choice serial reaction time task (5-CSRTT), respectively. The same set of mice learned both of these demanding tasks. While signs of cognitive decline were already apparent in middle-aged mice, older mice exhibited poorer performance in both tasks. Mice at both 12 and 22 months displayed an increase in perseverance and a decrease in the percentage of correct responses in the TUNL test compared to the 4-month-old mice. Furthermore, during the 5-CSRTT, they exhibited higher rates of omissions and premature responses compared to their younger counterparts. Additionally, the correct response rate in 22-month-old mice was lower than that of the 4-month-old ones. However, mice that had undergone cognitive training at 4 months maintained high-performance levels when re-tested at 12 months, showing an increase in correct responses during TUNL testing compared to their untrained controls. In the 5-CSRTT, previously trained mice demonstrated higher correct response rates, fewer omissions, and reduced premature responses compared to naive control mice. Notably, even when assessed on a visual discrimination and behavioral flexibility task at 22 months, experienced mice outperformed naive 4-month-old mice. These findings highlight the advantages of early-life cognitive training and suggest that its benefits extend beyond the cognitive domains primarily targeted during early training. The success of this study was significantly aided by the fully automated home-cage-based testing system, which allows for high throughput with minimal human intervention.

L2 Arabic learners' processing of Arabic garden-path sentences: a consistent reading pattern.

The main purpose of this study was to investigate to what extent the L2 Arabic learners' reading process is affected by the incomplete representation of speech (the absence of short vowels and diacritics) while reading ambiguous sentences (garden path sentences). With a self-paced reading software program, 41 non-native male students, aged from 22 to 26, enrolled in King Saud University, participated in reading 44 sentences (followed by reading comprehension questions) representing three reading conditions, plain, vowelized-discretized, and wrongly-vowelized. For the reading times data, the analysis revealed that the GP structure had a significant effect on the reading processes of L2 Arabic learners; it took them longer to read the GP sentences than their non-GP counterparts. For the reading comprehension, the analysis did not reveal any significant differences between the means for the percentages of correct responses. For the comparison between the three reading conditions, a significant difference was found: it took the participants on average less time to read the GP sentences when presented plain, and more time with the incorrect representation. However, their reading comprehension was not affected. In addition to the good-enough model and the nature of Arabic morphology, the reading experience, is a good candidate to start with as an important factor in the interpretation of the ineffectiveness of the GP structure on the reading comprehension process of Arabic readers, in which the segregability of Arabic writing system prepare the readers to emphasize some sensory inputs and ignore others based on their past reading experience.

Nutrition Education and Nutrition Knowledge Among Obstetrics and Gynecology Residents.

Background: Nutrition in pregnancy is a component of the Council on Resident Education in obstetrics and gynecology core curriculum; however, no studies currently examine adherence to this goal. Objectives: Our objective was to assess obstetrics and gynecology (Ob/Gyn) residents' education and knowledge surrounding nutrition in pregnancy, including (1) amount of dedicated didactic time to and attitudes toward, (2) subjective comfort in counseling patients on, and (3) objective knowledge of pregnancy-related nutrition. Materials and Methods: This is a cross-sectional electronic survey-based study. A 28-item questionnaire was distributed to residents enrolled in Ob/Gyn training programs across the United States in 2022. Results: From 247 Ob/Gyn residency programs, 218 residents across postgraduate years and from geographically diverse locations consented to participation and completed all survey questions. Almost half (48%) of participants reported 0 hours per year of dedicated nutrition-related education, 49% reported 1-2 hours, and 3% reported >2 hours. Most residents (92%) strongly agreed or agreed that education regarding pregnancy-related nutrition guidelines would be useful for clinical practice. However, less than one-third (31%) of residents reported feeling comfortable counseling patients on nutrition in pregnancy. On assessment of residents' objective knowledge of pregnancy-related nutrition, mean percentage of correct responses was 74%. Conclusions: This study identifies a gap in graduate medical education, specifically a disconnect between the recognized impact of nutrition on pregnancy outcomes and residents' ability to confidently and effectively counsel patients on nutrition in pregnancy. Results demonstrate a need to develop curriculum and interventions to educate Ob/Gyn residents about pregnancy-related nutrition.

The effect of multifocal contact lenses on the dynamic accommodation step response.

To measure the dynamic accommodation response (AR) to step stimuli with and without multifocal contact lenses (MFCLs), in emmetropes and myopes. Twenty-two adult subjects viewed alternating distance (0.25D) and near (3D) Maltese crosses placed in free space, through two contact lens types: single vision (SVCL) or centre-distance multifocal (MFCL; +2.50D add). The AR level was measured along with near to far (N-F) and far to near (F-N) step response characteristics: percentage of correct responses, magnitude, latency, peak velocity and duration of step response. There was no difference between N-F and F-N responses, or between refractive groups in any aspect of the accommodation step response dynamics. The percentage of correct responses was unaffected by contact lens type. Through MFCLs, subjects demonstrated smaller magnitude, longer latency, shorter duration and slower peak velocity steps than through SVCLs. When viewing the near target, the AR through MFCLs was significantly lower than through SVCLs. When viewing the distance target with the MFCL, the focal points from rays travelling through the distance and near zones were approximately 0.004D behind and 2.50D in front of the retina, respectively. When viewing the near target, the respective values were approximately 1.89D behind and 0.61D in front of the retina. The defocus error required for accommodation control appears not to be solely derived from the distance zone of the MFCL. This results in reduced performance in response to abruptly changing vergence stimuli; however, these errors were small and unlikely to impact everyday visual tasks. There was a decrease in ocular accommodation during near tasks, which has previously been correlated with a reduced myopic treatment response through these lenses. With MFCLs, the estimated dioptric myopic defocus was the largest when viewing a distant stimulus, supporting the hypothesis that the outdoors provides a beneficial visual environment to reduce myopia progression.

A Web-Based Educational Module Using Clinical Neuroscience to Deliver the Diagnosis of Functional Neurological Disorder.

Neuroscience-based patient education has become an evidence-based strategy for enhancing chronic pain treatment. Advances in understanding the neuroscience of functional neurological disorder (FND) may allow similar approaches to be developed and disseminated to clinicians, given the public health need for greater provider awareness and expertise around the condition. Accordingly, the authors developed an online video module for clinicians that delivers neuroscience-based psychoeducation for FND and assessed whether the intervention would be associated with changes in clinicians' perception of FND patients and knowledge about the condition. The online intervention consisted of a 20-minute video module, including an 8-minute scripted role-play that modeled neuroscience-informed diagnosis delivery. Pre- and postintervention questionnaires were embedded into the online module and included a self-assessment of FND-related perceptions and knowledge and a multiple-choice assessment of retention of the neuroscience-based content. Wilcoxon signed-rank tests and McNemar's tests were used for statistical analyses. Of the 103 individuals who submitted surveys, 40 participants provided a complete data set from before and after the intervention. Following the intervention, self-assessment items showed respondents had significantly greater comfort with diagnosis delivery and treatment options and decreased negative perception of FND patients. The percentage of correct responses on a multiple-choice assessment regarding the functional neuroanatomy of FND was significantly increased. In summary, the online neuroscience-based educational intervention was effective for increasing clinician knowledge about FND and comfort with diagnosis delivery and treatment options. Implementing web-based formats may be a viable and cost-effective approach to disseminating knowledge and basic clinical skills in the care of patients with FND.

The effects of dark chocolate on cognitive performance during cognitively demanding tasks: A randomized, single-blinded, crossover, dose-comparison study

Dark chocolate, rich in polyphenols, increases cerebral blood flow and improves cognitive function. This study aimed to determine whether the consumption of chocolate with a high concentration of polyphenols helps to maintain cognitive performance during cognitively demanding tasks. In this randomized, single-blinded, crossover, dose-comparison study, 18 middle-aged adults consumed two types of chocolate (25 g each), one with a high concentration (635.0 mg) and the other with a low concentration (211.7 mg) of cacao polyphenols, and performed a cognitive task requiring response inhibition and selective attention over two time periods (15–30 min and 40–55 min after consumption, respectively). Autonomic nerve function and subjective feelings, such as fatigue and concentration, were measured before food intake and after the second task to assess the participant's state. The results showed that the average reaction time between the first and second sessions was not significantly different for either high- or low-concentration chocolate consumption. However, the percentage of correct responses was similar in the first (96.7 %) and second (96.8 %) sessions for high-concentration chocolate consumption and significantly lower for low-concentration chocolate consumption in the second (96.4 %) session than in the first session (97.3 %). Autonomic nerve function showed a significant increase in sympathetic nerve activity after the second task with high-concentration chocolate consumption, while subjective feelings showed an increase in mental fatigue for both chocolate types but a significant decrease in concentration only after the second task with low-concentration chocolate consumption. These findings suggest that dark chocolate consumption contributes to the maintenance of performance and concentration in continuous and demanding cognitive tasks.

베트남인의 한국어 폐쇄음 산출에 대한 한국인의 지각 연구

The purpose of this paper is to investigate the perception patterns of Koreans regarding the production of Korean stop consonants by Vietnamese Korean language learners. For this purpose, an experiment was conducted on Koreans' perception of Vietnamese learners’ production of Korean stop consonants.&#x0D; The results of the experiment show that when the presentation sound is located at the beginning of the word, the correct answer rate was ‘/ㅌ/ 89%) &gt; /ㅋ/(88%) &gt; /ㅍ/=/ㅂ/(84%) &gt; /ㄱ/=/ㄸ/(74%) ) &gt; /ㄷ/(72%) &gt; /ㅃ/(65%) &gt; /ㄲ/(61%)', and in the case of word-medial onset consonants, ’/ㅍ/, /ㅋ/(91%) &gt; /ㅌ /(88%) &gt; /ㄷ/(68%) &gt; /ㅂ/(61%) &gt; /ㄸ/(60%) &gt; /ㄲ/(51%) &gt; /ㅃ/(46%) &gt; /ㄱ/(40%)’. Except for the case of /ㄸ/ in word-initial and /ㄱ/ in word-medial, accuracy was found to be high in the order of aspirated consonants &gt; plain consonants &gt; tense consonants for both word-initial and word-medial positions. The percentage of correct responses in the word-initial environment was higher than that in the word-medial environment, and this was revealed more clearly through matrix analysis. In both word-initial and word-medial environments, when the target sound was ‘plain’, it was confused with ‘tense’, when it was ‘tense’ it was confused with ‘aspirated’, and when it was ‘aspirated’ it was confused with ‘plain’. Looking at the correct rate for each following vowel, except for the word-medial plain consonant (/ㅣ/ &gt; /ㅜ/ &gt; /ㅏ/), in all other cases, the correct rate was high in the order of /ㅣ/ &gt; /ㅏ/ &gt; /ㅜ/. This result shows that the correct response rate for the following vowels decreases as the vowels move from the front vowels to the back vowels.

A community health promotion project: Amazing Race for Heart Health.

American Indians have higher rates of cardiovascular disease (CVD), likely due to disproportionate burden of diabetes and limited access to widespread CVD prevention programs such as Honoring the Gift of Heart Health (HGHH), a 10-week CVD risk factor awareness curriculum. Due to its length, HGHH may be difficult to complete; therefore, we aimed to evaluate a shortened CVD risk factor awareness program based on the HGHH educational materials for American Indians residing in southwest Oklahoma, entitled "The Amazing Race for Heart Health." We conducted an interventional study where each participant served as their own control (n = 61), with pre- and post-intervention measurements. We included American Indians from seven tribal nations in southwest Oklahoma. At two interventional meetings we used educational materials and activities from HGHH focusing on nutrition, cholesterol, diabetes, hypertension, physical activity, and heart attack warning signs. McNemar's test was used to determine the effectiveness of the intervention on raising CVD risk factor awareness. When comparing the pre- and post-survey responses, the percentage of correct responses either stayed the same or increased. Knowledge improved in 11/25 (44%, p < 0.05) domains including the difference between good and bad cholesterol and types of physical activity that can prevent CVD. When considering diabetes, knowledge increased regarding the interaction between diabetes and cholesterol in the association with CVD. These results demonstrate that the "Amazing Race for Heart Health," a shortened CVD risk factor educational program based on the HGHH educational materials, was effective at increasing awareness regarding CVD risk factors.

Impact of a virtual educational intervention on knowledge and awareness of biomedical waste management among Peruvian dental professionals

Waste from healthcare is a significant global issue, with around 85% of it being common waste and the remaining 15% being hazardous waste that is infectious and toxic. Dentistry uses various materials that create a substantial amount of biomedical waste capable of impacting the environment. Therefore, the purpose of this study was to assess the effects of a virtual educational program on the knowledge and awareness of dental material recycling and reuse, as well as biomedical waste management, among dental professionals in Peru. The current study was a longitudinal and quasi-experimental evaluation of 165 dentists from Peru. A validated questionnaire consisting of 30 items was administered at three different intervals (pre-test, immediate post-test, and 14-day post-test). Statistical analysis was conducted using the Mann Whitney U and Kruskal Wallis H tests to compare scores between categories of each sociodemographic variable, and the Cochrane’s Q and Friedman test was used for related measures comparison. A significance level of p < 0.05 was considered. When comparing the percentage of correct responses regarding recycling and reuse of dental materials and biomedical waste management between the pre-test and the immediate post-test, a significant improvement in knowledge was observed for most of the questionnaire items (p < 0.05). At 14 days after the test, those who studied at a private university, unmarried, bachelors, non-specialists, non-teachers and have less than 10 years of professional experience did not did not retain knowledge on biomedical waste management (p < 0.05) or recycling and reusing dental materials (p < 0.05) to a significant extent. There was a significant enhancement in dentists' knowledge and awareness of managing biomedical waste, recycling, and reusing dental materials following the educational intervention. This improvement was observed across all sociodemographic variables considered in the study. However, this knowledge was not retained beyond two weeks for those who studied at a private university, unmarried, bachelor, with no specialty, non-teachers and with less than 10 years of professional experience. Government authorities should encourage oral health professionals to conduct research with educational interventions focused on improving and evaluating the sustainability and environmental impact of dental practices. This will enable professionals to better understand, control and evaluate the consequences of their practical work.

Knowledge and Attitudes of Parents and Caregivers in New Delhi to Childhood Hearing Loss and Hearing Services.

Parental and caregiver support is crucial for addressing childhood hearing loss in low and middle-income countries, where a significant burden of disabling hearing loss exists among children. This study aimed to assess the knowledge and attitudes of parents and caregivers regarding childhood hearing loss and available hearing services in both urban and rural settings in Delhi, India. A total of 314 participants were recruited and interviewed using a culturally adapted questionnaire consisting of 26 items, covering topics like biomedical and non-biomedical beliefs, knowledge of otitis media-related hearing loss, identification, and intervention. Statistical analysis of data was performed using Mann Whitney U tests and categorical principal component analysis (PCA). The study found that parents generally had a higher percentage of correct responses compared to caregivers in both urban and rural areas. Categorical PCA revealed variations in responses between fathers, mothers, and caregivers. In the urban group, mothers exhibited higher knowledge and more positive attitudes, while fathers showed lower involvement. In the rural group, while mothers demonstrated relatively higher awareness on all categories compared to fathers, these differences were highly relevant on questions concerning noise exposure, maternal medicine during pregnancy, and communication milestones. The findings emphasize the importance of considering regional and cultural factors when designing programs. Additionally, involving fathers in awareness campaigns and support networks is crucial to achieve comprehensive coverage in addressing childhood hearing loss. In conclusion, this study contributes valuable insights into the preparedness of parents and caregivers for audiology services and the need for contextually appropriate strategies to enhance childhood hearing health services in India.

Costa Rican students’ proportional reasoning and comparing probabilities in spinners

This research aimed to relate Costa Rican students (11-16-year-olds) competence to compare probabilities in spinners and proportional reasoning in the comparison of ratios. We gave one of two questionnaires to a sample of 292 students (grade 6 to grade 10) with three probability comparison and three ratio comparison problems each. Globally both questionnaires cover six different proportional reasoning levels for each type of problem. Additionally, each questionnaire contains two comparison probabilities items intended to discover a specific bias. We analyze the percentages of correct responses to the items, strategies used to compare probabilities per school grade, and students’ probabilistic reasoning level. The results confirm more difficulty in comparing ratio than in comparing probability and suggest that the reasoning level achieved is lower than established in previous research. The main bias in the students’ responses was to consider the physical distribution of colored sectors in the spinners. Equiprobability and outcome approach were very scarce.

ANALYSING COSTA RICAN AND SPANISH STUDENTS’ COMPARISONS OF PROBABILITIES AND RATIOS

We present an exploratory study of Costa Rican and Spanish students’ (11–16-year-olds) competence to compare probabilities in urns and compare ratios in mixture problems. A sample of 704 students in Grades 6 through to Grade 10, 292 from Costa Rica and 412 from Spain, were given one of two forms of a questionnaire with three probability comparison and three ratio comparison problems each. The full questionnaire consisting of both forms covers six different proportional reasoning levels for each type of problem. We analysed the percentages of correct responses to the items and the strategies used by students in each grade and in each country. The results suggest students had the highest difficulty in comparing probabilities for items at the same proportional reasoning level. The results also point to the probabilistic biases in students’ responses, although these biases were less frequent than in previous research.