Rating Scale Analysis Research Articles

Ataxia Rating Scales: Content Analysis by Linking to the International Classification of Functioning, Disability and Health.

Ataxia management is mainly based on rehabilitation, symptomatic management, and functional improvement. Therefore, it is important to comprehensively assess ataxic symptoms and their impact on function. Recently, the movement disorders society recommended four generic ataxia rating scales: scale for assessment and rating of ataxia (SARA), international cooperative ataxia rating scales, Friedreich's ataxia rating scale (FARS), and unified multiple system atrophy rating scale (UMSARS). The aim of the study was to analyze and compare the content of the recommended ataxia rating scales by linking them to the international classification of functioning, disability and health (ICF). A total of 125 meaningful concepts from 93 items of the four included scales were linked to 57 different ICF categories. The ICF categories were distributed in body structure (n = 8), body function (n = 26), activity and participation (n = 20), and environmental factors (n = 3) components. UMSARS and FARS were the only ones that have addressed the body structure or environmental factors component. The content analysis of ataxia rating scales would help clinicians and researchers select the most appropriate scale and understand ataxic symptoms and their impact on function. It seems that SARA is the optimal scale for rapid assessment of ataxia or in busy clinical settings. UMSARS or FARS are more appropriate for the investigating the impact of ataxia on overall health, and monitoring ataxia progression and disability.

The effect of transcutaneous electrical nerve stimulation (TENS) on decreasing primary dysmenorrhea pain in adolescents

<p><strong><em>Background: </em></strong><em>Dysmenorrhea is medical condition indicated by an increase of the prostaglandin (PG) F2-alpha hormone and cyclooxygenase (COX-2) causing hypertonic as well as vasoconstriction activity to the myometrium. It leads to ischemia and stimulating pain in the uterine organs. The condition influence quality of life and productivity of majority female patients. Dysmenorrhea incidence in Indonesia is reported by 64.25% and a total of 52% of students in Yogyakarta experienced drop activity during menstruation. </em></p><p><strong><em>Objectives: </em></strong><em>This study aimed to evaluate the effect of</em><em> TENS</em><em> in reducing primary dysmenorrhea pain among female adolescents in General Ahmad Yani University Yogyakarta</em></p><p><strong><em>Methods: </em></strong><em>A quasi experiment study with pretest-posttest control group design was conducted. A total of 24 participants for intervention and control group were recruited. In order to recruit study participants, this research implemented a quota sampling approach. Primary dysmenorrhea pain measured using Numerical Rating Scale (NRS) and bivariate analysis between both groups carried out using T-test.</em></p><p><strong><em>Results: </em></strong><em>A</em><strong><em> </em></strong><em>significant difference (p<0.05) reported from both groups before and after the intervention. Prior to the treatment, the average pain score for intervention group was 6 (1.70) and ranging from 4-10. After the treatment being delivered, the intervention group experienced lower pain intensity by average 3.42 (1.6) between 1-6 score range. Control group in this study reported average pain score before the intervention by 4 (1.16) with and ranging from 3-6. The treatment decreased control group participants pain level to average 1.50 (0.52) between the range of 1-2. TENS is effective for severe pain management. Effleurage massage suitable for moderate level pain management. TENS intervention effective to lower pain by 3.50%.</em></p><strong><em>Conclusions: </em></strong><em>TENS and massage intervention potential to decrease pain intensity of primary dysmenorrhea. This study reported lower pain level associated with TENS by 3.50%. TENS had significant effect for reducing dysmenorrhea pain by 3.50%.</em>

Rasch rating scale analysis of the survey of attitudes toward statistics

Students in every discipline in higher education take at least one course in statistics. Therefore, it is necessary to enhance students’ understanding of statistics and their achievement in such courses by considering several factors that might contribute to this enhancement. Students’ attitudes toward statistics are a critical factor that influences their performance in statistics courses, and thus an accurate measurement of attitudes is needed. The survey of attitudes toward statistics (SATS-36) is widely used in measuring attitudes toward statistics; thus, it is important to ensure that its items accurately assess this construct. Therefore, the purpose of the current study was to validate this survey when administered to a convenience sample of 423 university students. Using the Rasch rating scale model, the current study examined the dimensionality, item fit to the Rasch model, item and person reliabilities, functionality of response categories, and distribution of the SATS-36 items along the attitudes toward statistics continuum.<br /> The findings revealed excellent item and person reliabilities (greater than 0.90) and the uni-dimensionality of the survey. Additionally, all items were closely aligned with the respondents, and the response categories were well-functioning as each category had more than 10 observations and outfit statistics were all low. However, some improvements were suggested. All items on the effect subscale and some others from different subscales need to be altered in content, deleting three items (two from the value subscale and one from the difficulty subscale) and adding more items to have a better distribution of items along the continuum. Finally, the number of response categories is recommended to be reduced to five instead of seven to have a more efficient rating scale. The findings of the current study imply that even though great care has been taken in the development of this survey, examining the quality of its items and the utility of its rating scale in new settings, and using different validation approaches is necessary.

A Comparison of the Mydriatic Efficacy of Tropicamide and Phenylephrine Eye Drops Administered as a Vaporized Spray in One Eye and Conventional Drop Instillation in the Other Eye in an Indian Pediatric Cohort.

To determine by serial measurements and compare the pupillary mydriasis effect of tropicamide and phenylephrine drops administered as a vaporized spray over closed lids in one eye and through conventional instillation of eye drops in the other eye in a pediatric cohort. This prospective study was conducted on healthy children aged 6-15 years. After visual assessment, investigator 1 examined the child for initial pupillary size. Investigator 2 instilled the drops in one eye and applied the spray to the other eye randomly, and the response of the child was noted using the Wong-Baker pain rating scale. The eyes receiving the spray and the eyes receiving drop instillation were considered as Groups 1 and 2, respectively. Subsequently, serial pupillary measurements were carried out every 10 min for up to 40 min by investigator 1. The patient compliance for the two methods of drug instillation was also compared. The study comprised 80 eyes. At 40 min, both the groups showed no statistical difference in the mydriasis effect, with Group 1 showing 7.23 mm mydriasis and Group 2 showing 7.58 mm (P = 0.058). The analysis of the pain rating scale showed better compliance with the spray method of drug instillation, which was statistically significant (P = 0.044). Our study shows that spray application is a less invasive method for pupillary dilatation, which has better compliance and provides equally good dilatation as conventional methods. This study proves the efficacy of spray application in an Indian pediatric cohort.

Pengaruh Komunikasi Tatap Muka Terhadap Kesadaran Swadaya Masyarakat

This study aims to determine the implementation of face-to-face communication carried out by the Rural PNPM Mandiri Activity Management Team, awareness of community self-help in the development of facilities and infrastructure, as well as to describe the effect of face-to-face communication by the Rural PNPM Mandiri activity management team on the awareness of community self-help in the development of facilities and infrastructure in rural areas. Dusun Kebon Kerep, Desa Darmareja, Kecamatan Nagrak, Kabupaten Sukabumi. This study uses the associative analysis method with a rating scale measurement and analysis using a continuum line. Meanwhile, to find the relationship between variables, the Pearson product moment correlation formula and the coefficient of determination formula are used. To find out the truth test of the correlation calculation, hypothesis testing is carried out using the t-test formula. The research sample was 148 people from a total population of 2,790 people with a disproportionate stratified random sampling technique. While the object of research is the community of Desa Darmareja which consists of village officials, PNPM actors, and the local community. The results of the study showed that TPK's face-to-face communication was in a fairly good category, with an average score of 3.1. Meanwhile, the awareness of community self-help in the development of facilities and infrastructure is categorized as quite good, with an average score of 3.2. There is an effect of face-to-face communication between the management team of PNPM Mandiri Rural activities on the awareness of community self-help in the development of facilities and infrastructure with a correlation value of 0.5343 (r count) greater than 0.159 (r table). The contribution of the influence of face-to-face communication on the awareness of self-help of the community is obtained by 28.55% while the remaining 71.45% is the influence of other factors. For hypothesis testing with the t-test formula with the calculation results of 9.036, the X variable has a significant effect on the Y variable because 9.036 (t count) is greater than 1.771 (t table), so there is a positive and significant effect of face-to-face communication on self-help awareness of the community. in the construction of facilities and infrastructure in Dusun Kebon Kerep, Desa Darmareja, Kecamatan Nagrak, Kabupaten Sukabumi.

The Outcome Analysis of Beck Depression Inventory Scale (BDI-II) and Hamilton Anxiety Rating Scale (HAM-A) Among Patients of Cancer Center of Combined Military Hospital Dhaka

Background: The Beck Depression Inventory (BDI) and the Hamilton Depression Rating Scale (HAMD) which is vice versa with equipercentile linking are the most frequently used observer-rated and self-report scales of depression, respectively. It is important to know what a given total score or a change score from baseline on one scale means in relation to the other scale. Objective: The aim of the study was to determine the depression symptoms rating scale of Beck Depression Inventory Scale (BDI-II) verses Hamilton Anxiety Rating Scale (HAM-A) among patients of Cancer Center of Combined Military Hospital Dhaka. Materials and Methods: It was a cross-sectional study. A total of 150 samples were selected by convenient sampling technique. The patients were studied after histopathological confirmation of diagnosis of cancer. Socio-demographic and other data were collected by face-to-face interview using semi structured questionnaire. The BDI-II and HAM-A was used to screen out the patients with depression and anxiety. The diagnosis was confirmed by a psychiatrist using DSM-5 criteria. Data analysis was done by Statistical Package for Social Sciences (SPSS) version 26.0 and results were presented with appropriate graphs and texts. Results: The mean age was 46.5±9.5 years. 65.3% were male and 34.7% respondents were female. Male: female ratio 1.9:1. 40.7% patients had moderate depression symptom followed by 30.0% had mild depression symptom, 17.3% patients had severe depression symptom and 12.0% patients had minimum depression symptom that can be considered as no depression. The overall mean score of Beck Depression Inventory (BDI-II) was 22.1±8.4 with range 5 to 45. Regarding anxiety of cancer patients, 45.3% patients had moderate to severe anxiety symptom followed by 29.3% patients had mild to moderate anxiety symptom, 25.3% patients had minimum anxiety symptom that can be considered as no anxiety symptom. The overall mean score of Hamilton Anxiety Rating Scale (HAM-A) was 21.6±6.7 with range 7 to 30. Comparatively most of the patients of 31-40 age groups had severe depression level symptoms and among above 50-60 year’s patients had the most severe anxiety symptoms. According to BD-II and HAM-A rating scale, among stage 4 patients 43.8% had severe depression symptom and 87.5% had severe anxiety symptom. Conclusion: Study shows that according to the rating scales both depression and anxiety symptoms are significantly higher in cancer patients. Moreover, frequency and severity of depression and anxiety symptom is much more significantly raised among older age group specially stage 4 cancer patients. Compared with both rating scales the depression level had also shown in 31-40 age groups.

Detecting Rating Scale Malfunctioning With the Partial Credit Model and Generalized Partial Credit Model.

Rating scale analysis techniques provide researchers with practical tools for examining the degree to which ordinal rating scales (e.g., Likert-type scales or performance assessment rating scales) function in psychometrically useful ways. When rating scales function as expected, researchers can interpret ratings in the intended direction (i.e., lower ratings mean "less" of a construct than higher ratings), distinguish between categories in the scale (i.e., each category reflects a unique level of the construct), and compare ratings across elements of the measurement instrument, such as individual items. Although researchers have used these techniques in a variety of contexts, studies are limited that systematically explore their sensitivity to problematic rating scale characteristics (i.e., "rating scale malfunctioning"). I used a real data analysis and a simulation study to systematically explore the sensitivity of rating scale analysis techniques based on two popular polytomous item response theory (IRT) models: the partial credit model (PCM) and the generalized partial credit model (GPCM). Overall, results indicated that both models provide valuable information about rating scale threshold ordering and precision that can help researchers understand how their rating scales are functioning and identify areas for further investigation or revision. However, there were some differences between models in their sensitivity to rating scale malfunctioning in certain conditions. Implications for research and practice are discussed.

The validity of the Danish version of the Fibromyalgia Impact Questionnaire – Revised applied in a clinical setting: a Rasch analysis

Objective The aim of this study was to evaluate the psychometric properties of the Danish version of the Fibromyalgia Impact Questionnaire – Revised (FIQR), when used to quantify the severity of disease burden in a Danish population of patients with chronic widespread pain (CWP), including fibromyalgia (FM). Method A total of 924 participants diagnosed with CWP and/or FM completed an electronic version of the FIQR via touchscreens in the clinic at referral for specialist care. Data were collected from 1 January 2018 to 3 September 2020. Rasch measurement methods were applied. Results Rating scale analysis suggested multiple threshold disordering in the 0–10 category rating scale. A principal component analysis suggested assessment of a multidimensional construct. Thus, the Rasch analysis of the full FIQR was discontinued. Instead, Rasch analyses were performed on the two subscales: ‘function’ and ‘symptoms’. By collapsing the rating scale to a 0–4 category scale, the remaining threshold disordering of both subscale was solved. Only the symptom subscale indicated multidimensionality. There was underfitting misfit of item 21 and overfitting misfit of item 12. No significant differential item functioning, defined by sex, ethnicity, or education, was found. Conclusion The FIQR should be considered as an instrument consisting of three separate subscales representing ‘function’, ‘overall impact’, and ‘symptoms’. We recommend calculating and reporting on both a 0–10 and a 0–4 category scale. Also, if using the total FIQR score as an outcome measure, this should be done with caution, until revision of the rating scale.

Research on Post Competency of Mechanical Design Engineer in Small and Medium-sized Manufacturing Enterprises under the Background of Industrial Upgrading

In view of the poor matching of mechanical design engineers in small and medium-sized enterprises under the background of industrial transformation and upgrading, this paper analyzes the requirements of this post for practitioners from the five dimensions of quality, motivation, knowledge, ability and psychology by constructing the competency model of this post. Through the investigation of small and medium-sized enterprises, 40 specific requirements indexes are determined, and the weight of each index is obtained by quantitative analysis with Likert rating scale analysis method, which can further distinguish the key indexes. Thus, it provides a basis for enterprises in talent recruitment, training and assessment, which can effectively improve the matching degree of talents and posts, and inject vitality into the development of small and medium-sized enterprises.

Evidence for validity of the Swedish self-rated 36-item version of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in patients with mental disorders: a multi-centre cross-sectional study using Rasch analysis

BackgroundThe World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is a generic instrument for the assessment of functioning in six domains, resulting in a total health-related disability score. The aim of this study was to investigate the psychometric properties of the Swedish-language version of the self-rated 36-item version in psychiatric outpatients with various common psychiatric diagnoses using Rasch analysis. A secondary aim was to explore the correlation between two methods of calculating overall scores to guide clinical practice: the WHODAS simple (summative) model and the WHODAS complex (weighted) model.MethodsCross-sectional data from 780 Swedish patients with various mental disorders were evaluated by Rasch analysis according to the partial credit model. Bivariate Pearson correlations between the two methods of calculating overall scores were explored.ResultsOf the 36 items, 97% (35 items) were within the recommended range of infit mean square; only item D4.5 (Sexual activities) indicated misfit (infit mean square 1.54 logits). Rating scale analysis showed a short distance between severity levels and disordered thresholds. The two methods of calculating overall scores were highly correlated (0.89–0.99).ConclusionsThe self-administered WHODAS 2.0 fulfilled several aspects of validity according to Rasch analysis and has the potential to be a useful tool for the assessment of functioning in psychiatric outpatients. The internal structure of the instrument was satisfactorily valid and reliable at the level of the total score but demonstrated problems at the domain level. We suggest rephrasing the item Sexual activities and revising the rating scale categories. The WHODAS simple model is easier to use in clinical practice and our results indicate that it can differentiate function among patients with moderate psychiatric disability, whereas Rasch scaled scores are psychometrically more precise even at low disability levels. Further investigations of different scoring models are warranted.

An Invitation into the Investigation of the Relationship between Mathematics Anxiety and Learning Styles in Elementary Preservice Teachers

Two hundred sixty-four students from a large southeastern U.S. university participated inthis study which investigated the relationship between mathematics anxiety and learningstyles in elementary preservice teachers. The Mathematics Anxiety Rating Scale (MARS)and Style Analysis Survey (SAS) were administered. Scores were analyzed using Pearsonproduct-moment correlations. Results showed a relationship between mathematics anxietyand global learning style (r = 0.42) indicating a tendency for global learners (wholepicture learners) to have higher levels of mathematics anxiety.

Interrater Reliability of an Observational Rating Scale and Video Analysis of Yoga Poses.

Yoga is increasingly popular, not only as a form of recreational exercise but also as a physician-recommended intervention for health conditions. While serious adverse effects accompanying yoga practice are rare, poses that involve upper-extremity weight-bearing have a high risk of discomfort. To better understand factors contributing to adverse effects, there is a critical need for robust instruments that objectively evaluate pose performance. The purpose of this study was to assess the interrater reliability of an observational scale developed to assess the alignment of 3 yoga poses. Cross-sectional experimental study. Thirty-eight individuals were given standardized instructions and performed 3 poses (Downward Dog, Plank, and Side Plank). Lateral videos were rated by 2 raters. A rating scale evaluating the alignment of 7 regions was developed by the study team with input from yoga teachers. Descriptive statistics were used to summarize the percentage of subjects showing ideal alignment and deviations. Interrater reliability was quantified using Cohen kappa coefficient (κ). In Downward Dog, the prevalence of ideal alignment was 20%, 28%, and 37%, at the neck, shoulder, and back, respectively; κ ranged from .44 to .69. In Plank, the prevalence of ideal alignment was 31%, 45%, and 54% at the neck, shoulder, and back, respectively; κ ranged from .47 to .95. In Side Plank, the prevalence of ideal alignment was 16, 41%, and 24%, at the neck, shoulder, and back, respectively; κ ranged from .20 to .84. The observational scale found a high prevalence of deviations, and demonstrated fair to substantial interrater agreement.

Item-Level Analysis of a Newly Developed Interactive Nutrition Specific Physical Exam Competency Tool (INSPECT) Using the Rasch Measurement Model.

The Interactive Nutrition Specific Physical Exam Competency Tool (INSPECT) is a tool designed specifically to observe and measure registered dietitian nutritionists’ (RDNs) nutrition-focused physical exam (NFPE) competence in authentic acute care settings. The initial INSPECT items were generated and tested for content and face validity using expert RDNs’ input. The INSPECT was further examined for inter-rater, intra-rater, and internal consistency using clinical supervisor observations of RDNs performing NFPE on patients in real-life acute care settings. These previous studies showed the INSPECT to have excellent content validity, acceptable face validity, good inter-rater reliability, moderate to strong intra-rater reliability, and excellent internal consistency. In the current study, the Rasch measurement model was applied to examine the item-level properties of the INSPECT. Results confirm that the INSPECT measured a single construct. All items fit the established criteria for clinical observations of >0.5 and <1.7, had positive point measure correlations, met the Wright Unidimensionality Index criteria of ≥0.9, exhibited one latent construct with >40% variance explained by the Rasch dimension as well as a sub-dimension based on item difficulty from the principal component analysis of the first contrast Rasch residuals. Rasch rating scale analysis revealed that the rating scale and majority of the items (39/41) fit the Rasch model. Rasch item hierarchy analysis matched the a priori hypothesized hierarchy for the top-most and bottom-most items. Ceiling effects were seen for three items (hand hygiene, personal protective equipment, and patient position) and one item (handgrip using hand dynamometer) reached the floor effect. Rasch reliability assessment demonstrated high person reliability (0.86), high item reliability (0.96), and person separation of 3.56 ability levels. The principal component analysis of residuals revealed two factors based on item difficulty, one for micronutrient exam and another for macronutrient exam, initial steps, and bedside manner. The resulting two factors may likely be due to a sub-dimension of the latent NFPE trait. Overall, the INSPECT items were found to have good item-level psychometrics. Continued testing of the INSPECT with RDNs at different ability levels will help to determine cut-off scores ranging from novice to expert. Establishing cut-off scores for the INSPECT will further enhance the utility of the tool.

Efficacy of caudal pedunculopontine nucleus stimulation on postural instability and gait disorders in Parkinson’s disease

Gait-related symptoms like postural instability and gait disorders (PIGD) inexorably worsen with Parkinson's disease (PD) deterioration and become refractory to current available medical treatment and deep brain stimulation (DBS) of conventional targets. Pedunculopontine nucleus (PPN) deep brain stimulation (DBS) is a promising method to treat PIGD. This prospective study aimed to clarify the clinical application of PPN-DBS and to explore effects of caudal PPN stimulation on PIGD. Five consecutive PD patients with severe medication-resistant postural instability and gait disorders accepted caudal PPN-DBS. LEAD-DBS toolbox was used to reconstruct and visualize the electrodes based on pre- and postoperative images. Outcomes were assessed with Movement Disorder Society (MDS)-Sponsored Revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS), gait-specific questionnaires, and objective gait analysis with GAITRite system. MDS-UPDRS subitems 35-38 scores were improved at postoperative 6months (mean, 4.40 vs 11.00; p = 0.0006) and 12months (mean, 5.60 vs 11.00; p = 0.0013) compared with baseline, and scores at 6months were slightly lower than scores at 12months (mean, 4.40 vs 5.60; p = 0.0116). Gait and Falls Questionnaire, New Freezing of Gait Questionnaire, and Falls Questionnaire scores also significantly improved at postoperative 6months and 12months compared with baseline. In addition, cadence, bilateral step length, and bilateral stride length significantly increased when PPN On-stimulation compared with Off-stimulation. This study suggested that caudal PPN low-frequency stimulation improved PIGD for PD patients at the 6- and 12-month period.

Determining levels of nurse burnout during the COVID-19 pandemic and Lebanon\u2019s political and financial collapse

BackgroundThe COVID-19 pandemic compounded political and financial pressures on the nursing workforce in Lebanon. The government resigned in October 2019 in response to the popular uprising that called for an end to corruption and economic mismanagement 5 months before the first COVID-19 case appeared in the country. The continuing crises and the added stress of COVID-19 has increased the risk of occupational burnout and turnover in the nursing workforce. Therefore, valid and reliable measurement is imperative to determine burnout levels, prioritize intervention, and inform evidence-based workforce policy and practice. The primary aim of the study was to delineate burnout levels and cut-points in a national sample of nurses to inform workforce policies and prioritize interventions.MethodsMultidimensional and unidimensional Rasch analyses of burnout data collected from a national convenience sample of 457 hospital nurses 9–12 months after Lebanon’s political and economic collapse began. The data were collected in July–October 2020.ResultsMultidimensional Rasch analysis confirmed that the Copenhagen Burnout Inventory has three highly correlated unidimensional scales that measure personal burnout, work-related burnout, and client-related burnout. Except for a ceiling effect of ~ 2%, the three scales have excellent measurement properties. For each scale, Rasch rating scale analysis confirmed five statistically different nurse burnout levels. The mean personal burnout scores and work-related burnout scores (50.24, 51.11 respectively) were not higher than those reported in the international literature. However, the mean client-related burnout score of 50.3 was higher than reported for other countries. Compared with a baseline study conducted at the beginning of Lebanon’s political and economic crises, only client-related burnout scores were higher p. <.01.ConclusionsThe CBI scales are reliable and valid measures for monitoring nurse burnout in crises torn countries. Stakeholders can use the CBI scales to monitor nurse burnout and prioritize burnout interventions. Urgent action is needed to reduce levels of client-related burnout in Lebanon’s nursing workforce.

Efficacy of dispersed fibrous carbon sorbent in treatment of malignant fungating wounds.

To evaluate the influence of dispersed fibrous carbon sorbent (DFCS) on malignant fungating wounds (MFWs) in Guerin's carcinoma-bearing rats with an assessment of wound bacterial microflora. The study was performed on female Wistar rats inoculated subcutaneously with Guerin T8carcinoma into the upper interscapular region. On day 20, the tumors were infected by injecting the suspension of S. aureus 8325-4. After 24h, gauze dressings were applied daily to the wounds in the control group and DFCS in the experimental one. The state of the wounds was assessed by visual control with photo monitoring, odor control on a verbal rating scale and microbiological analysis of qualitative and quantitative characteristics of wound microbiota. On the 3rd day after the start of dressings, the number of S. aureus of 8325-4strain was significantly higher in the wounds of rats in control group than experimental one (5.14± 0.27vs 3.43± 0.33lg CFU/ml). The total number of Staphylococci in the DFCS-treated wounds did not differ statistically from the number of S. aureus 8325-4strain whereas in control ones were higher by an order of magnitude. On the 10th day the total number of Staphylococci and S. aureus 8325-4in particular, remained consistently high in the wounds of the control rats, while was almost five orders of magnitude lower and represented mainly by S. aureus 8325-4in the experimental ones. The total number of aerobic and optionally anaerobic microorganisms was significantly lower as well. A greater variety of microorganisms in the gauze-covered wounds, as well as an their increased number were accompanied by enhancement of the wound odor from "noticeable" to "strong". There was an appearance of a "barely noticeable" odor in only one animal from the experimental group. The study has demonstrated the ability of DFCS to control substantially the bacterial microflora as well as malodor of MWFs in vivo. The results obtained can contribute to solving the problem of improving the quality of palliative care for patients with malignant and other chronic wounds.

Pain and mental health symptom patterns and treatment trajectories following road trauma: a registry-based cohort study

Purpose This study aimed to characterise recovery from pain and mental health symptoms, and identify whether treatment use facilitates recovery. Methods Victorian State Trauma Registry and Victorian Orthopaedic Trauma Outcomes Registry participants without neurotrauma who had transport injury claims with the Transport Accident Commission from 2007 to 2014 were included (n = 5908). Latent transition analysis of pain Numeric Rating Scale, SF-12, and EQ-5D-3L pain and mental health items from 6 to 12 months, and 12 to 24 months post-injury were used to identify symptom transitions. Results Four transition groups were identified: transition to low problems by 12-months; transition to low problems at 24-months; stable low problems; and no transition from problems. Group-based trajectory modelling of pain and mental health treatments found three treatment trajectories: low/no treatment, a moderate treatment that declined to low treatment 3–12 months post-injury, and increasing treatment over time. Predictors of pain and mental health recovery transitions, identified using multinomial logistic regression, were primarily found to be non-modifiable socioeconomic and health-related characteristics (e.g., higher education, working pre-injury, and not having comorbidities), and low treatment trajectories. Conclusions Targeted and collaborative rehabilitation should be considered for people at risk of persistent pain or mental health symptoms to optimise their recovery, particularly patients with socioeconomic disadvantage. IMPLICATIONS FOR REHABILITATION Two-thirds of people experience pain and/or mental health within the first 24-months after hospitalization for road trauma, of whom only 6–7% recover by 12-months, and a further 6% recover by 24-months post-injury. There were three main trajectories of administrative records of treatments received in the first two years after injury: 76 and 83% had low treatment, 18 and 12% had moderate then declining treatment levels, and 6 and 5% had stable high treatment for pain or mental health, respectively. People who recovered from pain or mental health symptoms generally had lower treatment and higher socioeconomic position, highlighting that coordinated rehabilitation care should be prioritized for people living with socioeconomic disadvantage.

Progression of Self-Perceived Speech and Swallowing Impairment in Early Stage Parkinson's Disease: Longitudinal Analysis of the Unified Parkinson's Disease Rating Scale.

The purpose of this study was to investigate the presence and progression of self-perceived speech and swallowing impairments in newly diagnosed people with Parkinson's disease (PD) longitudinally across 6 years. Longitudinal data from the Parkinson's Progression Markers Initiative were analyzed across six consecutive years in a cohort of 269 newly diagnosed people with PD, and a subset of those (n = 211) who were assessed at every time point across the 6 years. Dependent variables included self-perceived ratings of speech and swallowing impairment severity from the Unified Parkinson's Disease Rating Scale. Patient-centered factors of age at diagnosis and motor phenotype were also assessed to determine if they were related to the change in self-perceived speech and swallowing impairments. Overall, self-perceived speech and swallowing impairments were present in newly diagnosed people with PD, although over time, the degree of severity for both remained in the mild range. However, the rate of change over time was significant for perceived speech impairment, F(5.5, 1158.8) = 21.1, p < .001), and perceived swallowing impairment, F(5.2, 1082.6) = 8.6, p < .001. Changes for speech and swallowing impairment were both in the direction of progressive severity. There were no effects of age at diagnosis or motor phenotype on the degree of change for either speech or swallowing. Self-perceptions of speech and swallowing impairment changed significantly over time in newly diagnosed people with PD (PWPD). Consistent with existing literature, self-perceptions of speech impairment were rated as more severe than those of swallowing impairment. These findings reveal that even in the early years postdiagnoses, PWPD are experiencing changes to speech and swallowing function, albeit within the mildly severe range. The presence of self-perceived mild speech and swallowing impairments in the initial years postdiagnosis may support the need for intervention to improve and or sustain function over time.

An Item Response Theory analysis of the Unified Multiple System Atrophy Rating Scale

IntroductionThe Unified Multiple System Atrophy Rating Scale (UMSARS) has four subscales that have been specifically designed for the clinical assessment of MSA patients. UMSARS I (activities of daily living) and II (motor examination) subscales are regularly used as primary endpoints in treatment trials. The main objective of this study was to identify UMSARS I and II subscale items that best describe progression over time. MethodsAll MSA patients seen at the French Reference Centre for MSA from 2007 to 2020 were included in a prospective cohort with an annual follow-up assessment including UMSARS. The repeated measures of the 26 UMSARS I and II items were analyzed using a longitudinal Item Response Theory model to identify the most informative items for each of the five UMSARS IV disease stages. Sample size estimates were further calculated for the most informative items as a group. ResultsA total of 557 MSA patients were included with a mean follow-up of 2.3 years. The majority of items progressed with disease duration or across the different UMSARS IV disability stages, with the exception of those related to dysautonomia. Roughly 70% of the scale information was carried by only 11/26 items, many reflecting the patient perspective. These yielded similar sample size estimates than UMSARS I + II items. ConclusionThis study provides important information about the progression of UMSARS I and II subscale items. Improvements seem particularly necessary regarding those assessing dysautonomia. A shortened scale may be useful as outcome for future clinical trials.

Evaluating the psychometric properties of the Grit scale in Marine recruits using Rasch analysis

IntroductionSuccessful completion of initial military training has been suggested to be predicted by physical abilities, cognitive abilities and non-cognitive abilities such as hardiness and grit. This study aimed to assess...