Reliable Assessment Tool Research Articles

An Overview of Traditional and Novel Tools to Assess Diet.

Effective dietary interventions are vital for combating morbidity and mortality, necessitating reliable assessment tools. This article explores diverse dietary assessment methods, emphasizing their complexities and applications. Food Frequency Questionnaires (FFQs) offer insights into dietary habits over specified periods but require validation for target populations. Traditional Food Records provide detailed insights but are labor-intensive and prone to underreporting. Technology-based and technology-assisted records offer efficient alternatives, leveraging mobile apps and wearable sensors, albeit with access and privacy concerns. 24hour Dietary Recall (24HR) methods capture detailed intake within a day, with traditional and technology-assisted approaches strengthening population studies. The Automated Multi-Pass Method (AMPM) and technology-assisted ASA24 represent traditional and contemporary 24HR methodologies, respectively, both yielding comprehensive dietary data. In conclusion, dietary assessments are crucial for understanding dietary patterns and health implications. Integration of novel technologies streamlines data collection and analysis, enhancing researchers' ability to accurately gauge short- and long-term dietary impacts. Proper utilization of these tools empowers researchers to make informed decisions regarding dietary interventions and public health initiatives.

Assessing Scar Outcomes Using Objective Scar Measurement Tools: An Adjunct to Validated Scar Evaluation Scales.

The assessment of scar outcomes is important to both patient care and research focused on understanding the results of medical and surgical interventions. The Vancouver Scar Scale and Patient and Observer Scar Assessment Scale are validated and simple instruments to assess scars. However, these subjective scales have shortcomings. The VSS fails to capture patient perception and has indeterminate validity and reliability. The POSAS captures patient perception, but the observer scale has been shown to have moderate amounts of inter-rater variability. Studies highlighting the ability of objective scar assessment tools to produce reliable and reproducible results are needed. In this study, we aimed to validate the use of the Fibrometer ®, Elastimeter ®, and SkinColorCatch ® as an objective adjunct in the assessment of hypertrophic scar and keloid outcomes. This was a prospective single-center study which assessed patient scars using the Vancouver Scar Scale, the Patient and Observer Scar Assessment scale, and the aforementioned objective study tools. Correlations between the different methods of scar assessment were measured. The Fibrometer ® and SkinColorCatch ® showed significant correlations with the VSS total and the Observer POSAS total. The Elastimeter ® showed significant correlations with both the Patient and Observer POSAS totals. Unexpected correlations between Elastimeter ® measurements and the vascularity/pigmentation of scars indicate that scoring of these categories may be influenced by how severe the scar looks to the observer subjectively, further necessitating the need for reliable objective scar assessment tools. These results highlight the ability of these devices to assess scars and demonstrate their potential in serving as an important adjunct to previously validated scar assessment scales.

The psychometric properties of the lifelong learning measurement scale (LLMS): the study of validation in higher education setting

In the dynamic world of higher education, lifelong learning is important to both individuals and institutions, and measuring it can provide insightful data for both. The purpose of this study is therefore to refine and validate the psychometric qualities of the Lifelong Learning Measurement Scale (LLMS), created to measure academic staff’s engagement with lifelong learning in higher education institutions. Using a cross-sectional study design, the current study validated the scale using rigorous psychometric procedures. The study involved 396 participants, who were selected using a simple random sampling technique. The collected data were analysed using factorial analysis methods. The results provide a theoretically based four-factor structure consisting of 16 items of the LLMS. Strong evidence for the validity of the scale comes from its content validity, construct-related validity, and criterion-related validity. In addition, the scale and its factors demonstrate excellent levels of trustworthiness, according to estimates of composite reliability and internal consistency. The impartial and fair use of the scale is further supported by strong evidence for measurement invariance across gender groups. In conclusion, these results confirm that the LLMS is a legitimate and trustworthy tool that can be used in a variety of research and practices related to lifelong learning in a higher education setting. Furthermore, it is important to note that further research is needed to examine its applicability in different contexts. Subsequent research on its longitudinal stability and sensitivity to different cultural characteristics could also confirm LLMS as a reliable and integrative assessment tool for lifelong learning.

Development and validation of the clinical judgment capability questionnaire in nurses: A sequential exploratory mixed method study

BackgroundClinical judgment is one of the most important competencies required for safe care, decision-making, and diagnosis in nursing profession. Therefore, it is necessary to examine clinical judgment in nursing care. Existing a standard questionnaire based on cultural and social conditions can accurately evaluate clinical judgment in nurses. ObjectiveThe present study aimed to develop and validate clinical judgment capability questionnaire in nurses. DesignThe current research was a sequential exploratory mixed method study. SettingThe teaching hospitals affiliated to Jahrom University of Medical Sciences in the South of Iran in 2023. ParticipantsTwelve clinical nurses were included in the qualitative part and 181 nurses in the quantitative part. MethodsThe study was conducted in two parts: one qualitative and one quantitative. In the qualitative part, the concept of clinical judgment was explored using qualitative content analysis. Then, the initial pool of items was generated to develop a questionnaire. In the quantitative part, psychometric properties of the questionnaire were evaluated including face, content, and structure validity and reliability (internal consistency and stability). ResultsAfter examining the psychometric properties, 22 items were developed for the final questionnaire. The results of factor analysis led to the extraction of four factors, including noticing, interpreting, responding, and reflecting. The internal consistency of the questionnaire was confirmed with a Cronbach's alpha coefficient of 0.95 and its stability with an intraclass correlation coefficient of 0.84. ConclusionThe developed 22-item questionnaire is a valid and reliable tool for assessment of clinical judgment capability in nurses.

Simultaneous Determination of Isoniazid and Pyridoxine Hydrochloride in Tablet Dosage Forms using Ratio Subtraction Spectrophotometry

<p>The study focused on the simultaneous quantification of Isoniazid (INH) and Pyridoxine Hydrochloride (PRD) in tablet form, commonly used in antituberculosis treatments. Assessing the accurate concentration of both INH and PRD in tablets is vital to ensure their effectiveness, safety, and quality. Using the ratio subtraction spectrophotometry method, the study analyzed INH and PRD in Pehadoxin forte® tablets (batch no. 36057007, PT. Phapros, Indonesia), with 0.1 N HCl as the solvent. The method involved obtaining ratio absorption spectra by dividing the absorption spectra of INH and PRD, respectively, to derive zero-order spectra for each drug. Method validation parameters included linearity, accuracy, precision, Limit of Detection (LOD), and Limit of Quantification (LOQ). The results showed linearity values of 0.9985 for INH and 0.9988 for PRD. Accuracy was 98.1838% for INH and 100.0205% for PRD, while precision was 1.8769% for INH and 0.2037% for PRD. LOD and LOQ for INH were 0.8116 µg/mL and 2.7053 µg/mL, respectively, and for PRD, 1.3127 µg/mL and 4.3757 µg/mL. The levels of INH and PRD in the tablets were found to be 102.1157% and 101.3874%, aligning with the Indonesian Pharmacopoeia's standards. This methodological approach provides a reliable analytical tool for the simultaneous assessment of INH and PRD in tablets, potentially extendable to other drug combinations and formulations, thereby contributing to pharmaceutical quality control processes. </p>

Cracking the code: unveiling the nexus between atopic dermatitis and addictive behavior: a cross-sectional exploration of risk factors

Atopic dermatitis (AD) stands as a prevalent chronic inflammatory skin disorder with a global reach. Beyond its cutaneous manifestations, AD is accompanied by comorbidities and psychological issues, significantly compromising the overall quality of life for individuals who suffer from AD. Previous research has evidenced a heightened prevalence of addictive disorders among dermatological patients when compared to the general population. Considering these findings, this study endeavors to examine the prevalence of addictive disorders among AD patients and, furthermore, to discern potential risk factors associated with this comorbidity. Therefore, a cross-sectional study was conducted involving patients with AD diagnosed by dermatologists within a large university hospital in Munich, South Germany, between January 2016 and December 2019. Patients received an anonymous paper-based questionnaire comprising standardized and reliable assessment tools concerning disease severity, quality of life, sexual dysfunction, well-being, and anxiety disorder as well as screening tools for various addictive disorders (compulsive internet use, drug abuse, pathological alcohol consumption, and smoking). Data were analyzed descriptively, and a multivariate logistic regression model was conducted. A total of 208 patients participated in the study, comprising 38% males and 62% females with a mean age of 44.8 ± standard deviation:17.9 years. Females showed a higher mean POEM (Patient-Oriented Eczema Measure) score compared to males (female 14.6 ± 7.8; male 12.5 ± 7.7), as well as a higher DLQI (Dermatology Life Quality Index) (female 8.5 ± 6; male 6.5 ± 6.5). Positive addictions were found in 14.9% for daily smoking, 15.4% for critical alcohol consumption, 16.8% for compulsive internet use, and 5.8% for drug abuse. Younger patients were more likely to be affected by one or multiple addictions than older patients. Patients with at least one addiction showed significantly impaired well-being and increased severe anxiety symptoms. Given the notable prevalence of addictive disorders among individuals with AD, it could be useful to implement systematic screening for such conditions as part of patient-centered care, especially focusing on young AD patients or those displaying concurrent indications of depression or anxiety.

Prevalence of Poor Body Posture among Physiotherapists Using APECS

Background: Poor posture among healthcare professionals, particularly physiotherapists, can adversely affect their ability to provide care and may lead to musculoskeletal disorders. Despite the physical demands of their profession, there is a lack of routine posture assessment and preventative measures to mitigate these risks. Objective: This study aims to evaluate the prevalence of poor body posture among physiotherapists and to determine the efficacy of the APECS-AI Posture Evaluation and Correction System® (Apecs) mobile application as a tool for posture assessment. Methods: A cross-sectional study was conducted over four months, with 309 clinical physiotherapists from various healthcare institutions in Lahore. Using a non-probability convenient sampling technique, participants were assessed with the APECS app for deviations in the frontal and sagittal planes. The app, serving as a cost-effective alternative to 3D-marker-based systems, was used to categorize postural deviations as normal, mild, or severe disturbances. Data analysis was performed using SPSS version 26.0. Results: The findings revealed that 56% of the participants suffered from severe postural disturbances, while 32% had mild disturbances, and only 12% maintained a normal posture. The mean age was 26.17±2.21 years, with a distribution leaning towards novice practitioners, indicating a need for early intervention in posture management. Conclusion: The high prevalence of poor posture among physiotherapists highlights an occupational health concern. The study supports the use of the APECS mobile app as an accessible and reliable tool for posture assessment, which could lead to improved clinical practices and better healthcare outcomes.

Redefining Wound Healing Using Near-Infrared Spectroscopy.

No standard definition for a completely healed wound currently exists; it is recommended that providers use a reliable wound assessment tool to determine healing. The objective of this feasibility study was to determine if a point-of-care, noncontact, near-infrared (NIR) imaging device could provide an objective measure of wound resolution and guide clinical decision-making for the optimal time to transition from protective wound dressings and gradual return to full activity. In this single-center feasibility study, adult patients 18 years and older with a lower extremity wound of any size and etiology were seen weekly for wound assessment and standard-of-care treatment. The researchers performed serial imaging with a point-of-care, noncontact, NIR imaging device (Snapshot NIR ; Kent Imaging Inc) to assess the wound and surrounding skin and evaluated the difference in time to 100% reepithelialization on visual inspection and homogeneous tissue oxygen saturation levels at the wound site and surrounding closed skin envelope. An average time difference of 13.5 ± 10 days (median, 12 days; range, 0-35 days) was observed between 100% reepithelialization on visual wound inspection and imaging assessment. Further, NIR imaging could determine when a patient was at risk for recurrent wound breakdown. The addition of point-of-care, noncontact, NIR imaging may help guide clinical decision-making for the optimal time to transition from protective wound dressings with gradual return to full activity and minimize wound recurrence.

Translation, Adaptation and Validation of the Greek Version of the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score in Greek Overhead Athletes.

Athletes engaging in overhead activities often face injury risks, emphasising the need for reliable assessment tools. This study focused on the translation and psychometric evaluation of the Kerlan-Jobe Orthopaedic Clinic (KJOC) Shoulder and Elbow Score into Greek (Gr-KJOC) for assessing upper limb function in Greek-speaking overhead athletes. The Gr-KJOC underwent meticulous translation and adaptation processes, ensuring linguistic equivalence and cultural relevance. A sample of 60 athletes participated in the psychometric evaluation, including assessments of internal consistency, test-retest reliability, construct validity, and structural validity. The Gr-KJOC demonstrated excellent internal consistency (Cronbach's alpha = 0.95), indicating consistent measurement of the underlying construct. Test-retest reliability was excellent (ICC = 0.95), with low measurement errors. Construct validity was confirmed through correlations with the Disabilities of the Arm, Shoulder and Hand (DASH) Questionnaire. Structural validity revealed a unidimensional structure with high explained variance (75%). No floor or ceiling effects were observed, and the questionnaire proved feasible, with an average completion time of 6 min. The Gr-KJOC emerges as a reliable, valid, and feasible tool for evaluating upper limb function in Greek-speaking overhead athletes. Its psychometric properties support its utility in clinical and research contexts, contributing to the effective assessment and management of shoulder and elbow conditions in the realm of overhead sports in Greece.

Semi-automatic proximal humeral trabecular bone density assessment tool: technique application and clinical validation.

This study aimed to apply a newly developed semi-automatic phantom-less QCT (PL-QCT) to measure proximal humerus trabecular bone density based on chest CT and verify its accuracy and precision. Subcutaneous fat of the shoulder joint and trapezius muscle were used as calibration references for PL-QCT BMD measurement. A self-developed algorithm based on a convolution map was utilized in PL-QCT for semi-automatic BMD measurements. CT values of ROIs used in PL-QCT measurements were directly used for phantom-based quantitative computed tomography (PB-QCT) BMD assessment. The study included 376 proximal humerus for comparison between PB-QCT and PL-QCT. Two sports medicine doctors measured the proximal humerus with PB-QCT and PL-QCT without knowing each other's results. Among them, 100 proximal humerus were included in the inter-operative and intra-operative BMD measurements for evaluating the repeatability and reproducibility of PL-QCT and PB-QCT. A total of 188 patients with 376 shoulders were involved in this study. The consistency analysis indicated that the average bias between proximal humerus BMDs measured by PB-QCT and PL-QCT was 1.0 mg/cc (agreement range - 9.4 to 11.4; P > 0.05, no significant difference). Regression analysis between PB-QCT and PL-QCT indicated a good correlation (R-square is 0.9723). Short-term repeatability and reproducibility of proximal humerus BMDs measured by PB-QCT (CV: 5.10% and 3.41%) were slightly better than those of PL-QCT (CV: 6.17% and 5.64%). We evaluated the bone quality of the proximal humeral using chest CT through the semi-automatic PL-QCT system for the first time. Comparison between it and PB-QCT indicated that it could be a reliable shoulder BMD assessment tool with acceptable accuracy and precision. This study developed and verify a semi-automatic PL-QCT for assessment of proximal humeral bone density based on CT to assist in the assessment of proximal humeral osteoporosis and development of individualized treatment plans for shoulders.

Construct validity, responsiveness, minimal detectable change, and minimal clinically important difference of the stroke self-efficacy questionnaire in individuals receiving stroke rehabilitation

Purpose To assess the clinimetric properties of the Stroke Self-Efficacy Questionnaire (SSEQ) and estimate the minimal detectable change (MDC) and minimal clinically important difference (MCID) from the database of our randomized controlled trials (RCT) of individuals receiving stroke rehabilitation. Methods We retrieved the pre- and post-intervention scores of the SSEQ and Stroke Impact Scale (SIS) from 80 stroke survivors. The analysis of clinimetric properties was performed using: (1) confirmatory factor analysis and item response theory modeling (IRT) for construct validity; (2) standardized response mean and Glass’s delta for responsiveness; (3) MDC based on the standard deviation (SD) or standard error of measurement (SEM) of the SSEQ change scores; (4) MCID determined by the external anchor–SIS; (5) conditional MDC (cMDC) derived from the IRT analysis. Results There was a bi-factorial construct with excellent model-data fit and marked responsiveness. The MDC determined by the SD and SEM were 1.5 and 3.0, respectively, and the MCIDs were 3.3 and 3.7. Conclusions This study confirmed that SSEQ is a valid and reliable assessment tool for patients receiving stroke rehabilitation. We also provided practical threshold values, especially demonstrating the benefit of using individualized cMDC, to help clinicians better interpret the change in the SSEQ scores.

Modified rankin scale is a reliable tool for the rapid assessment of stroke severity and predicting disability outcomes.

'Time is brain' goes the adage. Rapid and precise management of stroke is of the utmost essence. The modified National Institutes of Health Stroke Scale (mNIHSS) and the modified Rankin Scale (mRS) predict stroke severity and functional disability outcomes. However, the mRS can be administered more rapidly than the mNIHSS and therefore might be better to assess patient outcomes. Hence, the aim of this study was to assess the correlation of stroke severity on admission and functional disability outcomes on the day of discharge or on the 8th day of hospitalization. This was an observational, cross-sectional study with a sample size of 61 participants. The mNIHSS score was calculated on admission for patients with clinical features suggestive of stroke and mRS was calculated on the 8th day of hospitalization or on discharge. Evaluation of the association between continuous variables was done using Spearman's correlation analysis. Correlation between mNIHSS and mRS was positive and statistically significant (rho = 0.866, 95% CI [0.751, 0.925]. For each point increase in the mNIHSS, the odds of having higher mRS scores are 153% more than the odds of having lower mRS scores (aOR = 2.534, 95% CI [1.904, 3.560]). Our study concluded that mRS can be reliably used to predict the functional outcomes for patients with stroke in circumstances where the mNIHSS may prove to be lengthy. Thus, where 'time is brain', the mRS can be used with a similar power to predict the outcome.

Validating the Korean shorter Diagnostic Thinking Inventory in medical education: a pilot study.

Developing clinical reasoning across the medical curriculum requires valid, reliable, and feasible assessment tools. However, few validated tools are available for the convenient and efficient quantification of clinical reasoning. Thus, this study aimed to create a shorter version of the Diagnostic Thinking Inventory (DTI) and validate it in the Korean medical education context (DTI-SK). The DTI-SK was constructed using content validity and a translation and back-translation process. It comprises two subcategories and 14 items. Its validity and reliability were explored using exploratory and confirmatory factor analyses, mean comparisons of four medical student groups (med 1 to med 4), and internal consistency using Cronbach's α. Two hundred medical students were invited to participate through email, and the survey was administered for 2 weeks. Data from 136 students were analyzed. Exploratory factor analysis revealed two factors with eigenvalues greater than 1.0 and they together explained 54.65% of the variance. Confirmatory factor analysis demonstrated that the model had acceptable level of fit and convergent validity. Discriminant validity was confirmed using heterotrait-monotrait criterion. Group comparisons demonstrated that the med 4 students showed significantly higher scores than the med 1 and 2 students. The inventory exhibited strong internal consistency for all items (Cronbach's α=0.906). The findings indicated that the DTI-SK is a reliable and valid tool for measuring medical students' clinical reasoning in the context of Korean medical education.

Adaptation of the Australian National University Alzheimer's Disease Risk Index-Short Form (ANU-ADRI-SF) into Turkish.

The 'Australian National University Alzheimer's Disease Risk Index' (ANU-ADRI) assesses the risk of developing Alzheimer's disease (AD) and is a potential tool for its prevention. The aim of this study is to adapt the ANU-ADRI-SF (the short version of ANU-ADRI) into the Turkish language and Turkish cultural context. The study was methodological and involved the translation and intercultural adaptation of the ANU-ADRI-SF into the Turkish language. The study included 384 community-based participants from a province in the Western Black Sea Region of Türkiye. Data was collected via an online form prepared using Google Forms. The index was translated from its original language, English, into Turkish and then retranslated to English by bilingual translators. It was then reviewed and evaluated for possible issues related to translation and degrees of equivalence. When TR-ANU-ADRI-SF levels were compared according to sex, the mean risk scores were found to be 11.25 ± 7.02 for males and 11.69 ± 7.99 for females. After cross-cultural adaptation, the TR-ANU-ADRI-SF was conceptually intelligible to Turkish adults. The TR-ANU-ADRI-SF is a valid and reliable AD risk assessment tool. Given the increase in AD and its impact on people's health, there is a great need for strategies to be implemented by health professionals to improve the lifestyle of the adult population. For use in conjunction with these strategies, a localised AD risk assessment tool that can be applied by clinicians or by individual patients has been adapted and introduced to the Turkish literature.

Research on the Design of Adaptive Testing Based on Multiple Intelligences Theory and Its Impact on Student Learning Outcomes

This paper examines the transformative potential of incorporating Howard Gardner’s Multiple Intelligences Theory (MIT) into adaptive testing frameworks within the United Kingdom’s educational settings. By moving beyond traditional, one-dimensional assessments that prioritize linguistic and logical-mathematical intelligences, MIT-based adaptive testing aims to offer a more personalized and inclusive approach to evaluating student capabilities. Through a comprehensive review of recent research, this study explores the theoretical underpinnings of MIT, the design and implementation of adaptive testing models that accommodate a broader spectrum of intelligences, and the empirical impacts of such assessments on student engagement, motivation, and academic achievement. The findings highlight the benefits of adaptive testing for fostering a more equitable educational environment, while also addressing the challenges and considerations for successful implementation. The discussion underscores the need for ongoing research, professional development for educators, and the development of reliable and valid assessment tools. Ultimately, this paper contributes to the dialogue on enhancing educational practices to better meet the diverse needs of learners, advocating for assessment models that recognize and value the wide array of human intelligences.

Correlation between serum markers and transjugular intrahepatic portosystemic shunt prognosis in patients with cirrhotic ascites.

Individuals with refractory ascites in the context of liver cirrhosis typically face an adverse prognosis. The transjugular intrahepatic portosystemic shunt (TIPS) is an efficacious intervention, but there is a lack of reliable tools for postoperative prognosis assessment. Previously utilized clinical biochemical markers, such as the serum albumin concentration (Alb), sodium (Na+) concentration, and serum creatinine (Scr), have limited predictive value. Therefore, the quest for novel, specific biomarkers to evaluate the post-TIPS prognosis in patients with liver cirrhosis and refractory ascites holds significant practical importance. To investigate the associations between the Child-Pugh score, model for end-stage liver disease (MELD) score, and serum cystatin C (Cys C) level and post-TIPS prognosis in patients with liver cirrhosis and refractory ascites. A retrospective analysis was conducted on 75 patients with liver cirrhosis and refractory ascites who underwent TIPS at our institution from August 2019 to August 2021. These patients were followed up regularly for two years, and the death toll was meticulously documented. The patients were allocated into a survival group (n = 45 patients) or a deceased group (n = 30 patients) based on their prognosis status. The clinical data of the two groups were collected, and Child-Pugh scores and MELD scores were calculated for analysis. Spearman correlation analysis was carried out to evaluate the correlation of prognosis with Child-Pugh grade, MELD score, and Cys C level. Additionally, a multiple-factor analysis utilizing the Cox proportional hazard model was used to identify independent risk factors affecting the post-TIPS prognosis of patients with liver cirrhosis and refractory ascites. The receiver operating characteristic curve (ROC) ascertained the predictive value of the Cys C concentration, Child-Pugh grade, and MELD score for the prognosis of liver cirrhosis with refractory ascites in post-TIPS patients. During a 2-year follow-up period, among 75 patients with liver cirrhosis and refractory ascites who underwent TIPS treatment, 30 patients (40.00%) passed away. The deceased cohort exhibited heightened aspartate aminotransferase, alanine aminotransferase, total bilirubin, Scr, prothrombin time, Cys C, international normalized ratio, Child-Pugh, and MELD scores compared to those of the survival cohort, while Alb and Na+ levels were attenuated in the deceased group (P < 0.05). Spearman analysis revealed moderate to high positive correlations between prognosis and Child-Pugh score, MELD score, and Cys C level (r = 0.709, 0.749, 0.671, P < 0.05). Multivariate analysis using the Cox proportional hazard model demonstrated that the independent risk factors for post-TIPS prognosis in patients with liver cirrhosis and refractory ascites were Cys C (HR = 3.802; 95%CI: 1.313-11.015), Child-Pugh (HR = 3.030; 95%CI: 1.858-4.943), and MELD (HR = 1.222; 95%CI: 1.073-1.393) scores. ROC analysis confirmed that, compared to those of the classic prognostic models for Child-Pugh and MELD scores, the predictive accuracy of Cys C for post-TIPS prognosis in patients with liver cirrhosis and refractory ascites was slightly lower. This analysis yielded sensitivity and specificity values of 83.33% and 82.22%, respectively. The area under the curve value at this juncture was 0.883, with an optimal cutoff value set at 1.95 mg/L. Monitoring the serum Cys C concentration is valuable for assessing the post-TIPS prognosis in patients with liver cirrhosis and refractory ascites. Predictive models based on serum Cys C levels, as opposed to Scr levels, are more beneficial for evaluating the condition and prognosis of patients with ascites due to cirrhosis.

Employing Bayesian analysis to establish a cut-off point and assess stigma prevalence in substance use disorder: a comprehensive study of the Chinese version of the Substance Use Stigma Mechanism Scale.

In China, individuals with substance use disorders (SUD) face severe stigma, but reliable stigma assessment tool is lacking. Therefore, this study aimed to validate the Chinese version of the Substance Use Stigma Mechanism Scale (SU-SMS-C) and set its cut-off point. We recruited 1005 individuals with SUDs from Chinese rehabilitation centers. These participants completed a battery of questionnaires that included the SU-SMS-C, The Multidimensional Scale of Perceived Social Support (MSPSS), Center for Epidemiologic Studies Depression Scale (CES-D), General Self-Efficacy Scale (GSES), and Perceived Devaluation and Discrimination (PDD). Confirmatory factor analysis was used to assess the construct validity of the scale. Additionally, the Naive Bayes classifier was used to establish the cut-off point for the SU-SMS-C. We additionally explored the correlation between patient demographic characteristics and stigma. A confirmatory factor analysis was utilized, revealing a second-order five-factor model. Based on the Naive Bayes classifier, the area under the receiver operating characteristic (AUCROC) of 0.746, the cut-off point for the SU-SMS-C was established at 44.5. The prevalence of stigma observed in the study population was 49.05%. Significant disparities were observed in the distribution of stigma across genders, with males experiencing more pronounced stigma than females. Moreover, patients consuming different primary substances reported diverse levels of stigma. Notably, those primarily using heroin endured a higher degree of stigma than users of other substances. The study is the first to identify a cut-off point for the SU-SMS-C by Naive Bayes classifier, bridging a major gap in stigma measurement research. SU-SMS-C may help treat and manage SUDs by reducing stigma.

Preparing for the ‘Blues’: Building Midwives’ Capacity for the Delivery of Perinatal Mental Health Care and Services in Ghana

Background: There is limited empirical evidence on the use of standardized and validated assessment tools such as PHQ-9 and GAD-7 by midwives in Ghana to screen perinatal women for symptoms of anxiety and depression and provide the needed support accordingly. Preliminary studies have reported a lack of sufficient knowledge, skills, and preparedness among medical staff, including midwives for the task of screening pregnant women for mental health disorders [21]. This study intends to inform midwives of the availability of tools to assist them make appropriate diagnostic impression of depression and anxiety and to provide a clear pathway to support the perinatal women in their care. Overall, the aim of this study is to promote the exchange of ideas and collaboration among stakeholders to ensure that the training and practice of midwifery in Ghana become more robust and meet global standards. Additionally, it is meant to inform, prepare competent, resourceful, knowledgeable, and most importantly adaptable midwives who can contribute to and promote the overall health of the women in their care. Objective: To address the gap in maternal mental health practice by equipping midwives with the requisite knowledge and skills on the use of globally validated and reliable assessment tools for depression and anxiety to support the perinatal women in their care. Methods: The study involved different two sections. In the first section, a structured questionnaire was used to collect data from 319 participants (midwives) to explore their knowledge on perinatal depression and anxiety assessment tools whiles the second component involved equipping midwives with the requisite mental health assessment skills through a two-week seminar that was organised and facilitated by the research team. Feedback on the level of confidence, suitability, and competence as well as the resourcefulness of the use of the tools was collected from participants (midwives) after three (3) months. The study was conducted in selected hospitals across all 16 regions in Ghana. The regions have several government and private hospitals that provide primary and specialised health care services to the public. They include teaching hospitals, regional hospitals, municipal hospitals, district hospitals as well as clinics within the sub-districts. Basic descriptive quantitative analysis was used based on frequency tables, pie chart and graphical illustration to interpret the data. Results: The study revealed that lack of resources and inadequate capacity-building to practically equip midwives are a major setback for the delivery of perinatal mental health services. It also identified perceived discrimination and stigmatisation on the part of the perinatal women as a major barrier in the provision of maternal mental health services. However, the participants demonstrated having adequate knowledge on the impact of perinatal anxiety and depression on birth and maternal outcomes. Nonetheless, there remains a huge deficit in their ability to use the validated and reliable assessment tools in recognizing clinical cues related to anxiety and depression among perinatal women. Surprisingly, over 50% of the midwives were unfamiliar with the commonly used assessment tools for depression and anxiety such as the GAD-7 and PHQ-9. Additionally, nearly 40% of the participants lack the requisite assessment skills for assessing perinatal anxiety and depression. In furtherance, over 97% of the participants demonstrated an appreciable level of confidence in terms of using the PHQ-9 and the GAD-7 following the post-assessment tool seminar. Conclusion: Perinatal mental health should be made a critical component of perinatal care, with midwives being well situated to recognize the manifestations of deteriorating mental health among the perinatal women in their care and provide the needed support and required level of supervision. It is therefore imperative to train midwives on basic mental health assessment skills and encourage them to incorporate mental health care into the delivery of routine perinatal care and services.

Inter-rater reliability in the Testing methods of the International Dysphagia Diet Standardization Initiative (IDDSI) in Slovenian language

Background: Texture modification of drinks and food is a widespread clinical intervention for managing dysphagia. The descriptive and experiential approach to measurement is mainly used by healthcare professionals, caregivers, and patients. This study examines the inter-rater reliability of the International Dysphagia Diet Standardization Initiative (IDDSI) Testing methods on different food samples from the hospital’s central kitchen.&#x0D; Methods: Nine previously trained healthcare professionals of different professional backgrounds and working experiences independently evaluated 34 food samples in IDDSI levels 4, 5, 6, and 7.1, using a Slovenian translation of the IDDSI Audit Tools. The 12 descriptive food characteristics were observed during the two consecutive days of data collection, representing 7 IDDSI Testing Methods. The Fleiss’ Kappa was used as a measure of agreement.&#x0D; Results: Perfect agreement among raters was found for the Fork drip test regarding both observed parameters: dripping and holding shape. All ratings of participants were completely the same. Therefore, Fleiss’ Kappa is considered (κ =1) in both cases. Moderate agreement (κ = 0.583) was found in particle size assessment. Fair agreement was observed in the Fork Pressure Test (κ = 0.361) and Finger Test, indicating bolus separation (κ = 0.328), pressure (κ = 0.305), and moisture (κ = 0.297). Fair agreement was also found for the Fork/Spoon Separation Test (κ = 0.265) and the Spoon Tilt Test in parameters of holding shape on the spoon (κ =0.233) and stickiness (κ = 0.327). No statistically significant results were found in the assessment of adhesiveness (κ = 0.059) in the Spoon Tilt Test and assessment of a typical pattern (κ = 0.039) in the Fork Pressure Test.&#x0D; Conclusions: The study proved the Fork Drip Test to be a comprehensive and highly reliable assessment tool, while the other IDDSI Testing Methods showed low inter-rater reliability. The study highlights the risks of low agreement among raters. It draws attention to the IDDSI descriptors, which should be improved with additional instructions or standardised training protocol for learning the IDDSI Testing Methods.

Metabolomics integration with chemometrics for the quality assessment: A case study with commercially important Himalayan medicinal plant Aconitum heterophyllum Wall.

Herein, targeted and non-targeted metabolomics was coupled with chemometrics tools for easy and reliable quality assessment of commercially important Himalayan medicinal plant Aconitum heterophyllum Wall. having annual demand of 100–200 metric tons in India. Seventeen root (tubers) (sixteen from different geographical locations and one marketed sample) of this plant were evaluated for the quality assessment using ultra-high performance liquid chromatography. Targeted metabolomics involves quantification of specialized metabolites of A. heterophyllum, revealing phytochemical variation among different locations. The root sample from Chitkul (Himachal Pradesh) was found to have a high content of major metabolites atisinium and aconitic acid. Non-targeted metabolomics includes chemical profiling followed by MZmine-based data processing and chemometrics tools for the quality evaluation. Chemometrics tools such as principal component analysis (PCA), orthogonal partial least square-discriminant analysis (OPLS-DA), and variable importance plot (VIP) serve as excellent tools facilitating quality evaluation revealing samples with chemical similarity, compounds responsible for phytochemical similarity/dissimilarity and identifying samples with high content of desired compounds. Fingerprint chromatograms authenticate all samples to be of A. heterophyllum indicating hetisine and atisinium to be the major constituents however, similarity/dissimilarity was observed in term of presence/absence or high/low mass intensity. Hence developed method can be easily implemented to authenticate plant material and quality assessment with respect to desired marker compounds. Further, chemical profiling suggests the presence of high-intensity unidentified compounds which underscores the potential for further research to uncover unique and previously unknown metabolites in the plant.