Percentile Rank Research Articles

The inpatient experience of emerging adults in the United States

ABSTRACT Objectives Emerging adults transitioning from pediatric to adult care experience worse outcomes including increased mortality. Improved patient experience (PEX) correlates with decreased inpatient mortality and better adherence to quality guidelines. We aimed to evaluate trends in the PEX of inpatients aged 14–29 years in the United States (US). Methods We performed a retrospective cohort study using a national, de-identified PEX survey obtained from hospitalized patients aged 14–29 years between 2017 and 2019. We described and compared survey responses across 10 domains. Composite mean scores for each health facility were converted to percentile rankings, which were then compared by age group to determine differences in percentile ranking (ΔPR). Results We evaluated the results of 174,174 PEX surveys across a national sample of 1519 US hospitals. The PEX percentile rankings for ages 18–21 were lower than ages 14–17 in almost every domain including experience with nurses (ΔPR = 43.4, p < 0.001), physicians (ΔPR = 31.1, p < 0.001), treatment (ΔPR = 12.3, p < 0.001), and overall experience (ΔPR = 26.5, p < 0.001). Similarly, 22–25-year-olds reported a worse PEX across nearly all domains when compared to 26–29-year-olds. Conclusion In a national sample of PEX surveys, hospitalized emerging adults aged 18–25 reported worse PEX when compared to both older children and established adults. These lower ratings were most strongly attributed to people, processes, and relationships as opposed to differences in the hospital environment. By ages 26–29, PEX returned to levels similar to those reported by ages 14–17. These results suggest that further investigation to elucidate the unique needs of hospitalized emerging adults may be warranted.

HCAHPS: having constant communication augments hospital and patient satisfaction

Background and aimThe Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) has become a standardised instrument to measure hospitalised patients’ perception of care. Our hospital’s HCAHPS scores for the...

Cognitive Flexibility and Decision Making Predicts Expertise in the MOBA Esport, League of Legends

In recent years, esports (the competitive video game industry) have evolved significantly, revolutionizing not only the competitive scene but also the teams and their professional staff. Sports psychologists need to face with cognitive demands related to this activity primarily mental, to respond to the specific needs of the sector (e.g., high performance interventions). The aim of this study was to determine the relationship between cognitive performance in tests and the MOBA League of Legends (LOL) game scores. A group of 36 pure-genre LOL players was evaluated with behavioral tests of fluid intelligence, attentional control inhibition, working memory, cognitive flexibility, and decision making. Furthermore, their in-game performance (rank percentile, kills death assists, minions per minute, and vision score) was recorded during a complete season (approximately 1 year). Data was analyzed by means of correlation and multiple regression analysis. Results showed that cognitive flexibility was positively related to the “rank percentile” ( p &lt; .001; R = .442; 95% CI [2.97, 74.76]). Besides, a positive relationship was found between decision making and the in-game performance variable “minions per minute” ( p = .009; R = .236; 95% CI [−8.46, 5.26]). These findings point that it is possible predict performance on specific variables, in esports with high cognitive impact throughout neuropsychological assessment. These results provide a starting point for research in the field of esports, sports psychology, and high-performance-oriented intervention.

Social vulnerability and cancer-related mortality among U.S. counties, 2013 to 2019.

162 Background: Substantial differences exist among US counties with regards to cancer-related mortality. Social determinants of health (SDOH) can predispose underserved communities to poor cancer outcomes. We investigated the impact of county-level social vulnerability on age-adjusted cancer mortality rates (AAMRs). Methods: We linked cancer-related deaths across US counties from 2013 to 2019 in the CDC WONDER database to county-level Social Vulnerability Index (SVI) data from the CDC/ATSDR. Scores for overall SVI and its 4 subcomponents (socioeconomic status; household composition and disability; minority status and language; housing type and transportation) were calculated using 15 SDOH attributes. These were presented as percentile rankings by county and classified into quartiles based on their distribution among US counties (1st [least vulnerable] = 0 - 0.25; 4th [most vulnerable = 0.75 - 1.00]). AAMRs per 100,000 individuals across US counties were compared between 1st and 4th SVI quartiles using robust linear regression models with a log scale. Results: There were 4,107,273 deaths with overall AAMR 173 per 100,000 individuals. Highest AAMRs were noted among older adults &gt; 65 years, men, non-Hispanic Black, and rural counties. AAMRs increased proportionally when moving from least to most vulnerable counties. Counties in 4th SVI quartile had 20% higher AAMRs compared to 1st SVI quartile (rate ratio; RR 1.08, 95% CI [1.08, 1.09], p &lt; 0.001). This was pronounced for ages 45-65 (42% increase; RR 1.21, 95% CI [1.12 – 1.24]), Hispanic race (26% increase; RR 1.11, 95% CI [1.06, 1.16]), and rural counties (21% increase; RR 1.17, 95% CI [1.15, 1.19]). Increase in AAMR between 1st and 4th SVI quartile from vulnerable socioeconomic status was most pronounced in rural counties (RR 1.17; 95% CI [1.15, 1.2]), women (RR 1.17; 95% CI [1.15, 1.2]) and ages 45-65 (RR 1.15; 95% CI [1.09, 1.14]). Vulnerable household composition/disability was most pronounced for rural residents (RR 1.12; 95% CI [1.09, 1.14]), and housing/transportation barriers for Hispanic individuals (RR 1.15; 95% CI [1.09, 1.21]). Conclusions: This study highlights the most socially vulnerable US counties have higher cancer mortality rates than the least vulnerable US counties. Furthermore, non-Hispanic blacks, older adults, and rural counties face highest risks of health inequities. Our findings inform ongoing congressional deliberations on transportation, telehealth, and rural infrastructure to achieve geographic parity.[Table: see text]

Cumulative Impacts of Diverse Land Uses in British Columbia, Canada: Application of the "EnviroScreen" Method.

(1) Objectives: Cumulative impacts refer to the legacies of land use decisions on environmental, community and health values. New integrative impact assessment tools are required to assess cumulative impacts on diverse values to meet sustainability goals in the 21st century. In this contribution, the CalEnviroScreen methodology-a screening tool capable of merging environmental, socioeconomic and health data-is applied to Local Health Areas in British Columbia, Canada. (2) Methods: The CalEnviroScreen is a method that standardizes environmental, socioeconomic and health data to depict an indicator’s percentile rank in the distribution of all units of analysis. The method combines indicators to measure four dimensions of pressure: environmental exposures, environmental effects, socioeconomic conditions, and sensitive populations (i.e., health outcomes). We create two versions of EnviroScreen: one following the CalEnviroScreen suite of indicators, and another that uses nuanced indicators to approximate the realities of industrial land uses present in British Columbia. BCEnviroScreen scores are plotted by race/ethnicity to understand potential racial inequities in cumulative exposures. (3) Results: The BCEnviroScreen has a greater likelihood of quantifying the cumulative impacts of diverse industries and land uses present across resource-dependent parts of the province, relative to the more urban-centric CalEnviroScreen indicator suite. Analyzing the distribution of BCEnviroScreen scores by race/ethnicity suggests that visible minority populations may be inequitably exposed to cumulative impacts in BC. (4) Conclusion: EnviroScreen tools hold significant potential to influence Canadian environmental health policy. This research demonstrates the applicability of the tool to British Columbia and other jurisdictions, illustrates how indicators can be tailored to better represent regional context, and shows how the tool can be used to screen for potential environmental health injustices.

Developing a granular scale environmental burden index (EBI) for diverse land cover types across the contiguous United States.

Critical to identifying the risk of environmentally driven disease is an understanding of the cumulative impact of environmental conditions on human health. Here we describe the methodology used to develop an environmental burden index (EBI). The EBI is calculated at U.S. census tract level, a finer scale than many similar national-level tools. EBI scores are also stratified by tract land cover type as per the National Land Cover Database (NLCD), controlling for urbanicity. The EBI was developed over the course of four stages: 1) literature review to identify potential indicators, 2) data source acquisition and indicator variable construction, 3) index creation, and 4) stratification by land cover type. For each potential indicator, data sources were assessed for completeness, update frequency, and availability. These indicators were: (1) particulate matter (PM2.5), (2) ozone, (3) Superfund National Priority List (NPL) locations, (4) Toxics Release Inventory (TRI) facilities, (5) Treatment, Storage, and Disposal (TSD) facilities, (6) recreational parks, (7) railways, (8) highways, (9) airports, and (10) impaired water sources. Indicators were statistically normalized and checked for collinearity. For each indicator, we computed and summed percentile ranking scores to create an overall ranking for each tract. Tracts having the same plurality of land cover type form a 'peer' group. We re-ranked the tracts into percentiles within each peer group for each indicator. The percentile scores were combined for each tract to obtain a stratified EBI. A higher score reveals a tract with increased environmental burden relative to other tracts of the same peer group. We compared our results to those of related indices, finding good convergent validity between the overall EBI and CalEnviroScreen 4.0. The EBI has many potential applications for research and use as a tool to develop public health interventions at a granular scale.

Association of County-degree Social Vulnerability with Chronic Respiratory Disease Mortality in the United States.

Rationale: Chronic respiratory diseases, the third leading cause of death worldwide, have been associated with significant morbidity, mortality, and increased economic burden that make a profound impact on individuals and communities. However, limited research has delineated complex relationships between specific sociodemographic disparities and chronic respiratory disease outcomes among U.S. counties. Objectives: To assess the association of county-level sociodemographic vulnerabilities with chronic respiratory disease mortality in the United States. Methods: Chronic respiratory disease mortality data among U.S. counties for 2014-2018 was obtained from the CDC WONDER (Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research) database. The social vulnerability index (SVI), including subindices of socioeconomic status, household composition and disability, minority status and language, and housing type and transportation, is a composite, percentile-based measure developed by the CDC to evaluate county-level sociodemographic vulnerabilities to disasters. We examined county-level sociodemographic characteristics from the SVI and classified the percentile rank into quartiles, with a higher quartile indicating greater vulnerability. The associations between chronic respiratory disease mortality and overall SVI, its four subindices, and each county characteristic were analyzed by negative binomial regression. Results: From 2014 to 2018, the age-adjusted mortality per 1,000,000 population attributed to chronic lower respiratory disease was 406.4 (95% confidence interval [CI], 405.5-407.3); chronic obstructive pulmonary disease (COPD), 393.7 (392.8-394.6); asthma, 10.0 (9.9-10.2); interstitial lung disease (ILD), 50.5 (50.1-50.8); idiopathic pulmonary fibrosis (IPF), 37.0(36.7-37.3); and sarcoidosis, 5.3 (5.2-5.4). Counties in the higher quartile of overall SVI were significantly associated with greater disease mortality (chronic lower respiratory disease, incidence rate ratios: fourth vs. first quartile, 1.43 [95% CI, 1.39-1.48]; COPD, 1.44 [1.39-1.49]; asthma, 2.06 [1.71-2.48]; ILD, 1.07 [1.02-1.13]; IPF, 1.14 [1.06-1.22]; sarcoidosis, 2.01 [1.44-2.81]). In addition, higher mortality was also found in counties in the higher quartile of each subindex and most sociodemographic characteristics. Conclusions: Chronic respiratory disease mortalities were significantly associated with county-level sociodemographic determinants as measured by the SVI in the United States. These findings suggested sociodemographic determinants may add a considerable barrier to establishing health equity. Multidegree public health strategies and clinical interventions addressing inequitable outcomes of chronic respiratory disease should be developed and targeted in areas with greater social vulnerability and disadvantage.

Iodine Concentration Effects on Linear Growth of Children after Nutrition Behavior intervention, Central Highland of Ethiopia: A Cluster Randomized Community Trial

Background: To improve the iodine status and growth of children was not documented in Ethiopia. This study aimed to determine the effects of nutrition behavior communication change (BCC) on improving iodine status and growth of children 6 to 59 months.&#x0D; Methods: A community cluster randomized trial with a single treatment arm was conducted from February 2018 to April 2020. “Kebeles” [lower administrative units] were randomly assigned to either the intervention or the control cluster. Mothers and their paired children were randomly selected from kebeles. Anthropometry data and urine samples were collected at baseline and end-line surveys. Percentile rank and Independent t-test were used to determine the difference between arms. Finally, Generalized Estimating Equation (GEE) is used to isolate independent predictors.&#x0D; Results: At baseline, 97.83 % (n = 812) mothers/ caregivers and paired children were enrolled for the trial study, but at the end-line, 88.05% (n =715) of children completed the intervention. Iodine deficiency prevalence was higher (11.82%, n = 96) at baseline and reduced to 6.15 % (n =44) at the end-line. The growth defect among children was 41 %( n = 332) at the baseline and declined to 28.67 %( n=205) at the end-line, while among interventions reduced by more than two times (39% to 12.81%). At the baseline, the median UIC among the intervention group was 106.0µg/L and increased to 207.190µg/L. The prevalence of iodine deficiency among intervention was 14.29% (n = 58) at the baseline and lowered to 3.45% (n=14) at the end-line, but a slight increment observed among control from 9.36% to 9.71% at end-line. The end-line median UIC was very high (210.56µg/L ± 150 compared to the baseline median UIC (107µg/L ± 8.66). Most (43.6%) of the intervention group found in the 4th and 5th percentile ranks factions of UIC by Height (Ht) mean differences. Being an intervention group increased Ht by 10.85cm (β =10.85, Std. E = 0.33). Likewise, for 1µg/l UIC change a 1cm (β = 1.0, p = &lt;0.05) Ht change predicted at the end-line.&#x0D; Conclusions: Findings from this trial enhance nutrition behavior communication to improve the iodine status and growth of young children in the community. Longitudinal studies are needed to determine the level of iodine deficiency disorders in the community.

Stable physical activity tracking during children's guided active play.

ObjectivePhysical activity (PA) decreases during childhood with PA tracking statistics showing moderate coefficients in early childhood moving to poor coefficients in late childhood. The age-related instability of PA tracking is attributed to variations in age-related PA behaviors when quantifying PA in different settings (in/out of school, sports camps, and habitual PA). This study has examined the stability of age-related PA for children (from 7 to 11 years) during self-paced guided active play (GAP) sessions separated by 12 months.MethodsChildren (n = 65) recruited from community camps in two consecutive years were assessed for growth and PA participation during GAP sessions (1 h.d−1 on 2 d.wk−1) using cooperative games. Accelerometer outputs were used to quantify PA and estimate energy expenditure (EE) and moderate-to-vigorous PA (MVPA). Tracking statistics were assessed by Spearman coefficients (r) and agreement scores for percentile rankings (Kappa (k)) after a 1-year interval.ResultsGrouped data for PA tracking (EE) over the 1-year interval showed strong coefficients (r = 0.88, p = 0.001) and moderate agreement scores (k = 0.54). Boys and girls showed similar results. During the 1-year interval, the MVPA tracking coefficient was r = 0.54 (p = 0.01) with a moderate k score of 0.47. Age-related PA (EE) tracking coefficients at 7 (r = 0.90), 8 (r = 0.88), 10 (r = 0.82), and 11 (r = 0.83) years showed strong coefficients except at 9 years (r = 0.51).ConclusionChildren's age-related PA tracking (EE and MVPA) is stable during self-paced GAP assessed over a 1-year interval. Since PA tracking is stable in self-paced GAP, GAP should be included in children's PA intervention strategies to improve health and fitness.

Gender Disparities Between Neighborhood Social Vulnerability and Psychological Distress Among Patients with Heart Disease.

Background: Psychological stress disorders are twice as prevalent in women with ischemic heart disease compared to men. The disproportionate psychological health experience of these women is not well understood. The objective of this study was to examine whether neighborhood social factors are associated with disparities in psychological health by gender. Materials and Methods: We studied 286 patients with heart disease recruited from Emory-based hospitals in the Myocardial Infarction and Mental Stress 2 Study (n = 286). A global measure of psychological distress was calculated by taking an average of ranks across symptom scales for depression, post-traumatic stress disorder, anxiety, anger, and perceived stress. The social vulnerability index (SVI) was developed by the Centers for Disease Control and Prevention and was used to rank patients' census tracks on 14 social factors. Beta coefficients for mean ranks in psychological distress scores were estimated per 10-unit increase in SVI percentile ranking using multilevel regression models. Results: The mean age of the sample was 51 years, 49% were women, and 66% African American. After adjusting for demographics, cardiovascular risk factors, and antidepressant use, each 10-unit increase in SVI percentile ranking was associated with 4.65 (95% CI: 0.61-8.69; p = 0.02) unit increase in mean scores for psychological distress among women only (SVI-by-gender-interaction = 0.01). These associations were driven by the SVI themes of lower socioeconomic status and poorer access to housing and transportation. Conclusion: Neighborhood social vulnerability may be a psychosocial stressor that potentiates women's susceptibility to adverse psychological and cardiovascular health.

Outcomes of the Early Specialization Program in Vascular Operation.

The Early Specialization Program (ESP) in vascular surgery (VS) began as a "pilot program" in 2003. There is only one published report on ESP outcomes. The general surgery (GS) and VS programs of all institutions using the ESP were contacted. Data gathered included demographics of ESP enrollees, participants' case logs (CLs), and CLs of participants' residency graduating classmates. National CLs, program and institutional data, and participants' certification status were publicly available. Nine institutions have enrolled 34 participants. Four withdrew, and four are in the GS component. Of 26 who have completed ESP, residency CLs were available for 20. Participants' percentile rankings among national contemporaries were lower than 13th for surgeon-junior cases (SJCs), higher than 73rd for surgeon-chief cases (SCCs), and 49th for total major cases (TMCs). They were lower than the 40th percentile in all domains except operative trauma (52; SD 23.8) and vascular (84.7; SD 22.1). As a percentage of the mean (% mean) for their own graduating classes, participants performed 91.8% (SD 16.5) as many SJCs, 143.7% (SD 45.1) as many SCCs, and 105% (SD 11.4) as many TMCs. Participants performed more than 79 % mean in every domain, including 213.4% (SD 82.4) as many vascular cases. As fellows, they ranked higher than the 50th percentile nationally in all but two categories. Twenty-four of 26 certified in GS. GS certification has lapsed for 5, 17 remain initially certified, and 2 have re-certified. All have current VS certification. Although infrequently employed, ESP remains an effective option for those who seek both GS and VS certification.

Item Analysis, Reliability Estimates, Percentile Ranks and Stanine Scores Among University Students in Ghana

The objective of the study was to perform item analysis on a forty (40) multiple choice test items among students of the University of Cape Coast in Ghana. The study further sought to estimate the reliability of the results and compute the percentile ranks and stanine scores. The results showed that, regarding the two statistics; difficulty (P) and discrimination (D) indices, it was observed that twelve (12) items functioned properly. Five items, although were easy, discriminated well. Nine (9) items were either easy or difficult and had low discrimination indices. It was found that nine (9) items had acceptable difficulty level but did not discriminate well. The results revealed that two (2) items had negative discrimination indices and two items were too easy and did not discriminate. The estimate of reliability; Spearman Brown prophecy (rxy) and Cronbach alpha (α) were found to be 0.63 and 0.78 respectively. It was found that examinees with scores of 33 had 99% of the norm group performing below them whiles examinees with scores of 26 had 70% of the norm group falling below them. Examinees with scores of 32 and 33 were found to be in stanine nine, those with scores of 23 to 24 were in stanine five whilst examinees with scores of 4 to 16 were in stanine one. Test results are essential for the determination of learner’s future endeavours. It is recommended that test item developers (teachers) in schools, colleges and universities adhere to principles of test construction, administration and interpretation so as to enhance dependability of learners’ test results.

Innovative Use of the Health Status Questionnaire-12 for Individual and Population Health.

Demonstrate how self-reported health (SRH) percentile ranks can be used in public health and clinical practice for better interpretable data. Secondary analysis was completed to standardize Health Status Questionnaire-12 Version 2.0 (HSQ-12) scores. The HSQ-12 is a multi-item measure of SRH, with a Total Health Status Scale (THSS) and two subscales, Physical Health Status Scale (PHSS) and Mental Health Status Scale (MHSS). The sample included adult (19 and older) participants in Medicaid, including a normed sample (n=7,110) and population cohorts of midlife women (n=417) and pregnant women (n=1,888). Normed percentile data for HSQ-12 using the Medicaid sample were calculated and populations of midlife and pregnant women were compared with the normed percentile ranks. Results illustrate differences in percentile rank scores for the various population cohorts. This innovative strategy has the potential to lead to decisions that may positively influence health policies, outcomes, and lower health costs.

Deciphering the molecular basis of tumor immunogenicity in high grade serous ovarian cancer (200)

<b>Objectives:</b> Response rates to immunotherapy in high-grade serous ovarian cancer (HGSOC) have thus far been disappointing, consistent with the understanding that HGSOC is not immunogenic cancer. We hypothesize that a subset of HGSOC may experience an immunemediated survival benefit and that these patients can be reproducibly identified by a gene signature developed through a novel cancer informatics approach. <b>Methods:</b> Gene expression signatures reflecting T cell-mediated antitumor activity show poor prognostic power in HGSOC. We hypothesized that this might be true for some tumors but not others. We developed a novel, Cox-regression-based, gene interaction algorithm to identify genes from tumor gene expression profiles whose expression levels are capable of stratifying patients into subgroups whereby a previously validated marker of T cell cytolytic activity (CYT gene signature) either does or does not achieve significant prognostic power. Six publicly available datasets of HGSOC gene expression profiles (<i>n</i>=1,525 tumors) were used to identify and validate a metagene (composed of many genes) in training and validation cohorts that could stratify HGSOC patients into population tertiles that differed according to the prognostic performance of the CYT signature. Kaplan-Meier analyses and multivariable Cox regression models were used to evaluate the significance of the association between the CYT signature and overall survival in the metagene patient tertiles. Gene ontology analyses using the Database for Annotation, Visualization and Integrated Discovery (DAVID) and Ingenuity Pathway Analysis (IPA) tools were performed to assess the pathway-level differences among metagene tertiles related to tumor immunogenic potential. <b>Results:</b> A metagene consisting of 43 genes was identified by our algorithm, and a percentile ranking procedure was applied to two independent training cohorts. In four independent validation cohorts, the metagene reproducibly identified a group of patients representing approximately one-third of each cohort where high expression of the CYT gene signature was associated with improved overall survival consistent with an immune-mediated survival benefit (Figure 1). This finding appeared independent of other prognostic variables in cox models, including stage, age, and tumor debulking status. In this metagene group, gene ontology analysis suggested a tumor molecular configuration in HGSOC reflective of increased immunogenicity via reduced immunosuppression by TGF-beta and Wnt signaling pathways. <b>Conclusions:</b> Approximately one-third of HGSOC tumors exhibit an immunogenic molecular background that may confer an immunemediated survival advantage to patients. The metagene described here may be a tool to better identify HGSOC patients likely to be responsive to immunotherapies. Our findings suggest that immune suppression by TGF-beta and Wnt pathways may be viable targets for further study and future drug development.

Vineland Adaptive Behavior Scale in a Cohort of Four ADNP Syndrome Patients Implicates Age-Dependent Developmental Delays with Increased Impact of Activities of Daily Living.

Activity-dependent neuroprotective protein (ADNP) is one of the lead genes in autism spectrum disorder/intellectual disability. Heterozygous, de novo ADNP mutations cause the ADNP syndrome. Here, to evaluate natural history of the syndrome, mothers of two ADNP syndrome boys aged 6 and a half and two adults aged 27years (man and woman) were subjected to Vineland III questionnaire assessing adaptive behavior. The boys were assessed again about 2years after the first measurements. The skill measures, presented as standard scores (SS) included domains of communication, daily living, socialization, motor skills and a sum of adaptive behavior composite. The age equivalent (AE) and growth scale values (GSV) encompassing 11 subdomains assess the age level at which the subject's raw score is found at a norm sample median and the individual temporal progression, respectively. The norm referenced standard scores age-matched, mean 100 ± 15 of the two children showed the lowest outcome in communication (SS: 20-30). Daily living skills presented SS of 50-60, with a possible potential loss of some activities as the child ages, especially in interpersonal relationships with people outside of the immediate family (boy A). In contrast, in socialization, both children were at the SS of 38, with some positive increase to SS of ~ 45 (interpersonal relations with family members and coping skills, depending on the particular individual), 2years later. Interestingly, there was an apparent large difference in motor skills (gross and fine) at the young age, with subject B showing a relatively higher level of skills (SS: 70), decreasing to subject A level (SS: 40) 2years later. Together, the adaptive behavior composite suggested a level of SS: 39-48 with B showing a potential increase (SS: 41-44) and A, a substantial decrease (SS: 48-39), suggesting a strong impact of daily living skills. Adults were at SS: 20, which is the lowest possible score. AE showed minor improvements for subject A and B, with all AE values being below 3years. GSVs for subject A showed some improvement with age, especially in interpersonal, play and leisure, and gross motor subdomains. GSV for subject B showed minor improvements in the various subdomains. Notably, all subjects showed a percentile rank < 1 compared with age-matched norms except for subject B as to motor domain (2nd percentile) at the age of 6years. In summary, the results, especially comparing SS and AEs between childhood and adulthood, implied a continuous deterioration of activities compared to the general population, encompassing a slower developmental process coupled to possible neurodegeneration, strongly supporting a great need for disease modifying medicinal procedures.

An Important Aspect of Satisfaction on Mobile Apps: An Usability Evaluation Based on Gender

The quality of the feasibility of a mobile application can be measured by evaluating the usability using certain testing methods. The refore to improve the performance of mobile applications, it is necessary to measure the level of satisfaction and user acceptance of the application. This study aims to improve the quality of the Myelkomsel mobile application by measuring the level of satisfaction and acceptance of end-users and evaluating the relationship between the level of user satisfaction with user gender differences using the System Usability Scale (SUS) method. Data collection was carried out by distributing questionnaires to 46 Telkomsel provider users consisting of 22 male users and 24 female users. The results showed that the average SUS score was 71.96 for the whole user. According to the calculation of the level of user acceptance included in the category of Acceptable, the scale of the class level is included in category C, and the ranking is included in the good category. While the results of calculations from the SUS Percentile Rank Score show that the MyTelkomsel mobile application is in class C. There are no significant differences according to gender, the average SUS score of the male is 71.93, and female is 71.98 so that gender differences do not affect the level of satisfaction and acceptance application. It can be seen that the level of end-user satisfaction from the MyTelkomsel mobile application is good but still has possible problems with its use

EVALUATION OF USER EXPERIENCE TLX TRAINING GATE FOR COMPETITIVE PROGRAMMING LEARNING USING USER EXPERIENCE QUESTIONNAIRE AND SYSTEM USABILITY SCALE

Usability is a measurement of software applications to determine how easy the software is. Usability testing is done by involving end users or it can also involve experts. User Experience Questionnaire (UEQ) and System Usability Scale (SUS) are two approaches that can be used to measure Usability. Based on the provisions for determining the results of the SUS assessment, the percentile rank score, which is seventy-five, the results of the respondents' assessment on the TLX Training Gate application, the user acceptance level is in the acceptable category, the scale grade level is in category C, and the rating adjective is in the good category and with UEQ approach There are 3 (three) scales in the Above Average range and 2 (two) scales still below average, and 1 on the good scale. The result of the stimulation score (1,35) and attractiveness (1,27) because this system is attractive and comfortable for students so that the value of this aspect has a positive impression. Based on research, for 6 (six) aspects this shows that system development is needed so that students as users can maximize their learning potential in competitive programming learning

Neighborhood disadvantage, health status, and health care utilization after blood or marrow transplant: BMTSS report

AbstractLiving in a disadvantaged neighborhood is associated with poor health outcomes. Blood or Marrow Transplant (BMT) survivors remain at risk of chronic health conditions requiring anticipatory management. We hypothesized that among BMT survivors, neighborhood disadvantage was associated with poor self-reported routine health care utilization and health. We leveraged data from BMTSS – a retrospective cohort study examining long-term outcomes among individuals surviving ≥2 y following BMT at three institutions between 1974 and 2014. Participants in this analysis completed the BMTSS survey (sociodemographics; chronic health conditions; time since routine check-up; self-reported health). The Area Deprivation Index (ADI) represented neighborhood disadvantage; this composite indicator of 17 census measures is a percentile rank (0 = least deprived to 100 = most deprived). Multivariable ordered logit regression adjusted for clinical factors and individual-level sociodemographics, modeling associations between ADI, time since routine check-up, and self-reported health. Among 2,857 survivors, median ADI was 24 (interquartile range: 10-46). Adjusting for self-reported individual-level socioeconomic indicators and chronic health conditions, patients in more disadvantaged neighborhoods had higher odds of reporting longer intervals since routine check-up (ORADI_continuous = 1.007, P < .001) and poorer health status (controlling for time since check-up; ORADI_continuous = 1.005, P = .003). Compared with patients living in the least disadvantaged neighborhood (ADI = 1), patients in the most disadvantaged neighborhood (ADI = 100), had twice the odds (ORADI = 1.007^99 = 2.06) of reporting no routine visits and 1.65-times the odds of reporting poor health (ORADI = 1.005^99 = 1.65). In BMT survivors, access to health care and health status are associated with area disadvantage. These findings may inform strategies to address long-term care coordination and retention for vulnerable survivors.

Intergenerational income mobility table revisited: A trajectory group perspective

There is a long history of studying intergenerational mobility using mobility tables or transition matrices. This approach has two potential limitations: each generation is typically divided into several equally sized income groups based on percentile ranking to create ad-hoc social classes or into predetermined broad occupational groups, and inter- and intragenerational changes in social class are not jointly analyzed. To address these limitations, we construct intergenerational income mobility tables using an alternative, group-based trajectory approach to determine the number of socioeconomic groups and characterize the development of social status over the course of individuals’ working lives. Using data from the Panel Study of Income Dynamics (1968–2017), we show intergenerational differences in income dynamics as each generation’s life-cycle profile unfolds. Specifically, parents and offspring who, based on their average household incomes, belong to different income strata may have similar working life-course income trajectory patterns. As a result, by focusing exclusively on the average income levels, studies using income quintiles for mobility tables may underestimate intergenerational income associations.

Reconceptualization of Coefficient Alpha Reliability for Test Summed and Scaled Scores

AbstractCoefficient alpha reliability persists as the most common reliability coefficient reported in research. The assumptions for its use are, however, not well‐understood. The current paper challenges the commonly used expressions of coefficient alpha and argues that while these expressions are correct when estimating reliability for summed scores, they are not appropriate to extend coefficient alpha to correctly estimate the reliability for nonlinearly transformed scaled scores such as percentile ranks and stanines. The current paper reconceptualizes coefficient alpha as a complement of the ratio of two unbiased estimates of the summed score variance. These include conditional summed score variance assuming uncorrelated item scores (gives the error score variance) and unconditional summed score variance incorporating intercorrelated item scores (gives the observed score variance). Using this reconceptualization, a new equation of coefficient generalized alpha is introduced for scaled scores. Coefficient alpha is a special case of this new equation since the latter reduces to coefficinet alpha if the scaled scores are the summed scores themselves. Two applications (cognitive and psychological assessments) are used to compare the performance (estimation and bootstrap confidence interval) of the reliability coefficients for different scaled scores. Results support the new equation of coefficient generalized alpha and compare it to coefficient generalized beta for parallel test forms. Coefficient generalized alpha produced different reliability values, which were larger than coefficient generalized beta for different scaled scores.