A reliability and validity study of the clock dial and the Raubitschek arrow test for astigmatism

A reliability and validity study of the clock dial and the Raubitschek arrow test for astigmatis

Promoting higher order thinking skills in biology: evaluation of a newly developed course using Bloom’s taxonomy.

We have recently designed and implemented a unique, large (1800 students/year) first year biological concepts of health course (BIOL*1080) aimed at promoting higher order thinking skills and attributes. Our course served as one of three courses that replaced two more traditional biology courses (BIOL*1030 and BIOL*1040) and incorporates seminar, lab and interdisciplinary assignments in an attempt to foster skills in areas such as oral and written communication, critical thinking, and independent learning. To determine if we were successful in designing a course centered on the teaching and assessment of higher order thinking skills, we ranked the course evaluative materials based on Bloom’s taxonomy (Zheng, A.Y., Science 319:414,2008). Bloom’s taxonomy is a hierarchical categorization of knowledge and thinking skills comprised of 6 levels (from lowest to highest): knowledge - 1, comprehension – 2, application – 3, analysis – 4, synthesis – 5, and evaluation – 6. Briefly, each exam question and assignment was scored by a team of 6 individuals with varying degrees of familiarity with the course. Scores per test/assignment were averaged and a weighted average was calculated for the entire course, with a higher weighted average representing assessment of a higher order of thinking. The average bloom level for our course was 3.28±0.15 which was significantly higher than one of the more traditional biology courses (BIOL*1030 – 1.93±0.08 ) but not the second course (BIOL*1040 – 2.95±0.17). The blooming exercise provided a useful metric to assess the level of higher order thinking required for newly developed courses and allowed for comparisons between courses to be objective

The association between socioeconomic status and disability after stroke: Findings from the Adherence eValuation After Ischemic stroke Longitudinal (AVAIL) registry

Background Stroke is the leading cause of disability among adults in the United States. The association of patients’ pre-event socioeconomic status (SES) with post-stroke disability is not well understood. We examined the association of three indicators of SES—educational attainment, working status, and perceived adequacy of household income—with disability 3-months following an acute ischemic stroke. Methods We conducted retrospective analyses of a prospective cohort of 1965 ischemic stroke patients who survived to 3 months in the Adherence eValuation After Ischemic stroke – Longitudinal (AVAIL) study. Multivariable logistic regression was used to examine the relationship of level of education, pre-stroke work status, and perceived adequacy of household income with disability (defined as a modified Rankin Scale of 3–5 indicating activities of daily living limitations or constant care required). Results Overall, 58% of AVAIL stroke patients had a high school or less education, 61% were not working, and 27% perceived their household income as inadequate prior to their stroke. Thirty five percent of patients were disabled at 3-months. After adjusting for demographic and clinical factors, stroke survivors who were unemployed or homemakers, disabled and not-working, retired, less educated, or reported to have inadequate income prior to their stroke had a significantly higher odds of post-stroke disability. Conclusions In this cohort of stroke survivors, socioeconomic status was associated with disability following acute ischemic stroke. The results may have implications for public health and health service interventions targeting stroke survivors at risk of poor outcomes

Health Services Research: A Critical Need in Stroke Care

Evidence defining high-quality stroke care has improved dramatically in the past 20 years; however, the gap between evidence and practice persists in stroke prevention, treatment, and rehabilitation.1 Although clinical trials have been instrumental in advancing the science supporting evidence- based guidelines, research is needed to identify gaps and factors contributing to gaps in care and outcomes and to develop strategies that promote uptake of evidence-based treatment and services for stroke patients. This article discusses health services research (HSR) as a multidisciplinary field encompassing outcomes research, implementation science, and financial evaluations that can address critical evidence, practice and policy gaps in stroke care

Best Practices for Building Interprofessional Telehealth: Report of a Conference

The Arizona Biomedical Research Centre (ABRC) has funded a series of workshops and conferences since 2016 to build the capacity of local, tribal, and state agencies, healthcare delivery organizations, and non-governmental organizations to engage in meaningful research related to health disparities. With the COVID-19 pandemic, the use of telehealth has dramatically increased, particularly in nursing, occupational therapy (OT), physical therapy (PT), and speech-language pathology (SLP). The purpose of this paper is to summarize the presentations and discussion from the conference titled “Telerehabilitation and Telepractice: An Interprofessional Conference to Build Connections and Best Practices,” held remotely on March 4-5, 2021. Terminology and concepts from the conference were debated, modified, and refined, based on an interprofessional audience. Presenters at the conference, all leaders in their field, discussed the current status of telehealth in their professions, including best practices, challenges, future trends, and research needs

A Large, First-Year, Introductory, Multi-Sectional Biological Concepts of Health Course Designed to Develop Skills and Enhance Deeper Learning

Large first-year biology classes, with their heavy emphasis on factual content, contribute to low student engagement and misrepresent the dynamic, interdisciplinary nature of biological science. We sought to redesign a course to deliver fundamental biology curriculum through the study of health, promote skills development, and encourage a deeper level of learning for a large, multi-section first-year class. We describe the Biological Concepts of Health course designed to encourage higher-order learning and teach oral communication and independent learning skills to large numbers of first-year students. We used the Blooming Biology Tool to determine the cognitive skills level assessed in the newly developed course and the courses it replaced. This evidence-based approach demonstrated that our new course design achieved the goal of encouraging a deeper level of cognition, and further, successfully introduced both oral communication and independent learning skills in large first-year classes.  En mettant l’emphase sur un contenu factuel, les grandes classes de biologie de première année contribuent au faible engagement des élèves et donnent une représentation imprécise de la nature dynamique et interdisciplinaire des sciences de la biologie. Afin d’offrir un programme fondamental en biologie par l’étude de la santé, de promouvoir le perfectionnement des compétences et d’encourager un niveau d’apprentissage marqué, nous avons repensé un cours pour une grande classe de première année contenant plusieurs sous-groupes. Nous décrivons le cours « Biological Concepts of Health » conçu pour encourager l’apprentissage supérieur, ainsi que pour enseigner la communication orale et les habiletés d’apprentissage individualisé à un grand nombre d’étudiants de première année. Pour déterminer le niveau d’habiletés cognitives évalué dans ce cours nouvellement conçu et les cours qu’il remplace, nous avons utilisé le « Blooming Biology Tool ». Cette approche éprouvée démontre que ce nouveau cours a atteint son but d’encourager l’approfondissement des connaissances et, par ailleurs, a réussi à introduire la communication orale, de même que les habiletés d’apprentissage individualisé aux grandes classes de première année

An economic evaluation of a primary care-based technology-enabled intervention for stroke secondary prevention and management in rural China : a study protocol

Introduction: Secondary prevention of stroke is a leading challenge globally and only a few strategies have been tested to be effective in supporting stroke survivors. The system-integrated and technology-enabled model of care (SINEMA) intervention, a primary care-based and technology-enabled model of care, has been proven effective in strengthening the secondary prevention of stroke in rural China. The aim of this protocol is to outline the methods for the cost-effectiveness evaluation of the SINEMA intervention to better understand its potential economic benefits. Methods: The economic evaluation will be a nested study based on the SINEMA trial; a cluster-randomized controlled trial implemented in 50 villages in rural China. The effectiveness of the intervention will be estimated using quality-adjusted life years for the cost-utility analysis and reduction in systolic blood pressure for the cost-effectiveness analysis. Health resource and service use and program costs will be identified, measured, and valued at the individual level based on medication use, hospital visits, and inpatients' records. The economic evaluation will be conducted from the perspective of the healthcare system. Conclusion: The economic evaluation will be used to establish the value of the SINEMA intervention in the Chinese rural setting, which has great potential to be adapted and implemented in other resource-limited settings

CYP450 phenotyping and metabolite identification of quinine by accurate mass UPLC-MS analysis: a possible metabolic link to blackwater fever

BACKGROUND: The naturally occurring alkaloid drug, quinine is commonly used for the treatment of severe malaria. Despite centuries of use, its metabolism is still not fully understood, and may play a role in the haemolytic disorders associated with the drug. METHODS: Incubations of quinine with CYPs 1A2, 2C9, 2C19, 2D6, and 3A4 were conducted, and the metabolites were characterized by accurate mass UPLC-MS(E) analysis. Reactive oxygen species generation was also measured in human erythrocytes incubated in the presence of quinine with and without microsomes. RESULTS: The metabolites 3-hydroxyquinine, 2’-oxoquininone, and O-desmethylquinine were observed after incubation with CYPs 3A4 (3-hydroxyquinine and 2’-oxoquininone) and 2D6 (O-desmethylquinine). In addition, multiple hydroxylations were observed both on the quinoline core and the quinuclidine ring system. Of the five primary abundance CYPs tested, 3A4, 2D6, 2C9, and 2C19 all demonstrated activity toward quinine, while 1A2 did not. Further, quinine produced robust dose-dependent oxidative stress in human erythrocytes in the presence of microsomes. CONCLUSIONS: Taken in context, these data suggest a CYP-mediated link between quinine metabolism and the poorly understood haemolytic condition known as blackwater fever, often associated with quinine ingestion

A novel approach using potable diagnostic ultrasound to inform treatment choices for hemiplegic shoulder pain – A case study

Introduction: Hemiplegic shoulder pain (HSP) has a reported incidence of up to 84% of patients. The purpose of this case study is to report findings from a patient with HSP who received problem specific treatment and underwent real-time scanning of shoulder region with a portable diagnostic ultrasound. Treatment was modified to address the problems. Methods/Case Description:The patient was a 45 year-old woman with right sided-hemiparesis resulting from a clot. Patient was undergoing rehabilitation in a private clinic and reported shoulder pain. Patient was undergoing rehabilitation (over-arm exercises, electrical stimulation, stretches, Saebo exercises) however, continued to complain of shoulder pain (VAS-7). Ultrasound scanning was undertaken and following observations were made on both affected (AF) and unaffected (UAF) shoulders. Acromion-greater tuberosity (AGT) distance (AF-3.35 cm, UAF-2.04 cm), diameter of supraspinatus in resting state (AF -1.16 cm, UAF-1.42cm) and contracted state (AF-1.14cm, UAF-1.63cm). Modified treatment included: 1) Isometric exercises to supraspinatus muscle 2) Trigger point release for trapezius 3) Electrical stimulation to lateral deltoid and supraspinatus 4) avoid over-arm activitiesResults: Ultrasound measurement suggested reduction in AGT immediately following treatment. 8 weeks later, VAS score was 3 and patient reported using her arm more for various functional tasks. Diameter of supraspinatus in resting state (AF -1.30 cm, UAF-1.45cm) and contracted state (AF-1.42cm, UAF-1.70cm) suggested some improvement.Conclusions: Real-time ultrasound has potential benefits as an assessment tool to inform treatment choices for HSP. Further studies are required in this area