Clinical audit project in undergraduate medical education curriculum: An assessment validation study

Objectives: To evaluate the merit of the Clinical Audit Project (CAP) in an assessment program for undergraduate medical education using a systematic assessment validation framework. Methods: A cross-sectional assessment validation study at one medical school in Western Australia, with retrospective qualitative analysis of the design, development, implementation and outcomes of the CAP, and quantitative analysis of assessment data from four cohorts of medical students (2011-2014). Results: The CAP is fit for purpose with clear external and internal alignment to expected medical graduate outcomes. Substantive validity in students’ and examiners’ response processes is ensured through relevant methodological and cognitive processes. Multiple validity features are built-in to the design, planning and implementation process of the CAP. There is evidence of high internal consistency reliability of CAP scores (Cronbach’s alpha \u3e 0.8) and inter-examiner consistency reliability (intra-class correlation\u3e0.7). Aggregation of CAP scores is psychometrically sound, with high internal consistency indicating one common underlying construct. Significant but moderate correlations between CAP scores and scores from other assessment modalities indicate validity of extrapolation and alignment between the CAP and the overall target outcomes of medical graduates. Standard setting, score equating and fair decision rules justify consequential validity of CAP scores interpretation and use. Conclusions: This study provides evidence demonstrating that the CAP is a meaningful and valid component in the assessment program. This systematic framework of validation can be adopted for all levels of assessment in medical education, from individual assessment modality, to the validation of an assessment program as a whole

A comparison of cognitive restructuring and thought listing for excessive acquiring in hoarding disorder

Excessive acquiring is a common symptom of hoarding disorder (HD). Little is known about subjective distress associated with acquiring in HD. The present study examined acquiring- related distress and reactions to cognitive restructuring (CR) in 92 individuals with HD and 66 community control (CC) participants. All participants identified an item of interest at a high-risk acquiring location and then decided whether or not to acquire the item. HD participants completed the acquiring task while receiving a CR-based intervention or a thought-listing (TL) control condition. Results showed that HD participants reported more severe distress and greater urges to acquire the item of interest than did CC participants. Nevertheless, subjective distress decreased in both groups following the acquiring task. There were no differences in acquiring- related distress between the CR and TL conditions. The findings indicate that subjective distress may decrease after relatively short periods of time in individuals with HD, but that a single session of CR may not alleviate acquiring-related distress in HD participants.R01 MH068007 - NIMH NIH HHS; R01 MH068008 - NIMH NIH HHSAccepted manuscrip

Doomed drones? Using passage experiments and mathematical modelling to determine Deformed wing virus population dynamics in male honey bees

Funding: This research was funded by the BBSRC (Biotechnology and Biological Sciences Research Council), grant numbers: BB/M010996/1 and BB/R00305X/1. P.C.S was supported by the BBSRC, grant number: BB/S00243X/1.Varroa destructor is an ectoparasitic mite of honeybees which vectors a range of pathogenic viruses, the most notable being Deformed wing virus (DWV). Mites parasitise bees during pupal development and male honeybees, drones, have a longer development cycle than female workers (24 versus 21 days), allow for more progeny mites to develop per foundress (1.6–2.5 compared to 0.7–1.45). How this longer exposure time influences evolution of the transmitted virus population is unknown. Using uniquely tagged viruses recovered from cDNA we investigated the replication, competition and morbidity of DWV genotypes in drones. Assays examining virus replication and morbidity revealed drones are highly susceptible to both predominant genotypes of DWV. In virus passage studies using an equimolar inocula of major DNA genotypes and their recombinants, the recombinant form dominated but did not reach 100% of the virus population within 10 passages. Using an in-silico model of the virus–mite–bee system we examined bottlenecks during virus acquisition by the mite and subsequent injection of viruses into the host, which may play a significant role in shaping virus diversity. This study furthers our understanding of the variables influencing DWV diversity changes and provides insight into areas of future research in the mite–virus–bee system.Publisher PDFPeer reviewe

A Comparison of Cognitive Restructuring And Thought Listing For Excessive Acquiring In Hoarding Disorder

Excessive acquiring is a common symptom of hoarding disorder (HD). Little is known about subjective distress associated with acquiring in HD. The present study examined acquiring-related distress and reactions to cognitive restructuring (CR) in 92 individuals with HD and 66 community control (CC) participants. All participants identified an item of interest at a high-risk acquiring location and then decided whether or not to acquire the item. HD participants completed the acquiring task while receiving a CR-based intervention or a thought-listing (TL) control condition. Results showed that HD participants reported more severe distress and greater urges to acquire the item of interest than did CC participants. Nevertheless, subjective distress decreased in both groups following the acquiring task. There were no differences in acquiring-related distress between the CR and TL conditions. The findings indicate that subjective distress may decrease after relatively short periods of time in individuals with HD, but that a single session of CR may not alleviate acquiring-related distress in HD participants

Anti-parasitic benzoxaboroles are ineffective against Theileria parva in vitro

East Coast Fever (ECF) is a disease affecting cattle in sub-Saharan Africa, caused by the tick-borne Apicomplexan pathogen Theileria parva. The disease is a major problem for cattle farmers in affected regions and there are few methods of control, including a complex infection and treatment vaccine, expensive chemotherapy, and the more widespread tick control through acaricides. New intervention strategies are, therefore, sorely needed. Benzoxaboroles are a versatile class of boron-heterocyclic compounds with demonstrable pharmacological activity against a diverse group of pathogens, including those related to T. parva. In this study, the in vitro efficacy of three benzoxaboroles against the intracellular schizont stage of T. parva was investigated using a flow cytometry approach. Of the benzoxaboroles tested, only one showed any potency, albeit only at high concentrations, even though there is high protein sequence similarity in the CPSF3 protein target compared to other protozoan pathogen species. This finding suggests that benzoxaboroles currently of interest for the treatment of African animal trypanosomiasis, toxoplasmosis, cryptosporidiosis and malaria may not be suitable for the treatment of ECF. We conclude that testing of further benzoxaborole compounds is needed to fully determine whether any lead compounds can be identified to target T. parva

Child Maltreatment in Families Receiving Mandatory Versus Voluntary Child Protection Support:A Matched Cohort Study

Child safety is an important outcome of child protection services (CPSs); however, this is often assessed in terms of official registries (e.g., rereports). Little empirical evidence is available about how the frequency of child maltreatment changes during CPS intervention by using self-report measures. The present study evaluates the frequency of child maltreatment experienced by children receiving mandatory child protection support compared to carefully matched children receiving voluntary child protection support. The current study is part of an ongoing Dutch longitudinal study on family violence consisting of several cohorts with similar designs. Both parents and children reported on the frequency of child maltreatment using validated questionnaires at two timepoints, 12 months apart. To facilitate careful comparison, both groups were matched using propensity scores based on background variables, resulting in two groups of N = 178 children. GLMM analyses showed a significant decrease in the mean number of child maltreatment incidents over time in the total group. However, this decrease did not differ for children receiving mandatory and voluntary child protection support. The findings indicate that, despite possible motivational challenges in the mandatory group, mandatory child protection support elicits comparable results as voluntary support. Implications for further research and practice are discussed.</p