Gender Influence on Perceptions of Healthy and Unhealthy Lifestyles

The purpose of this study was to determine if a gender bias exists in perceptions of a healthy vs. unhealthy lifestyle. The study was a 2 (male or female) x 2 (healthy or unhealthy) between subjects factorial design. College students (N = 53) read a scenario describing a lifestyle of a stimulus person. The participants then answered a 16-item questionnaire. The hypothesis that there is a gender difference in perceptions of a healthy lifestyle was not strongly supported. There was a strong main effect for the type of lifestyle with participants viewing the healthy lifestyle more positively. The hypothesis that participants who perceived themselves to be healthy would respond more positively to the description of the healthy lifestyle was supported for only two questions. In contrast to prior research, the results indicate that gender is not extremely important in regard to perceptions of an individual’s health

Applicability of Zipper Merge Versus Early Merge in Kentucky Work Zones

In an effort to improve work zone safety and streamline traffic flows, a number of state transportation agencies (STAs) have experimented with the zipper merge. The zipper merge differs from a conventional, or early, merge in that vehicles do not merge into the lane that remains open immediately after being notified of a lane closure. Rather, vehicles continue to occupy all lanes until they reach the taper, at which point — and directed by signage — vehicles take turns merging into the open lane, creating a zipper pattern. At the request of the Kentucky Transportation Cabinet (KYTC), Kentucky Transportation Center (KTC) researchers reviewed the performance of the zipper merge as documented in case studies from other states and analyzed two instances of the zipper merge being implemented in Kentucky. Previous studies found zipper merges are optimal on roadways with heavy traffic, whereas the conventional merge is preferable for uncongested and low-volume roadways. The case studies used a blend of quantitative and qualitative, observational data; researchers investigated the performance of zipper merges installed on Interstate 275’s Carroll Copper Bridge and KY 9’s Taylor Southgate Bridge. For the I-275 bridge, KTC researchers were able to compare the early merge configuration to the zipper merge. Here, the zipper merge brought about minor, although statistically insignificant, improvements in traffic flow and roadway safety. Analysis of the zipper merge on the Taylor Southgate Bridge relied more heavily on qualitative data, as the zipper merge was installed from the outset of the study and no comparison to an early merge could be made. The zipper merge appeared to improve traffic flow, reduce backups, and minimize the area impacted by construction. While neither case study offers definitive evidence that the zipper merge is significantly more effective than the early merge, they offer limited support for its use. On this basis, researchers suggest its continued implementation on other KYTC projects. Implementing the zipper merge elsewhere in Kentucky will enable further data collection and potentially identify locations and situations for which the zipper merge is the most appropriate merging method

Trauma ICU Prevalence Project: the diversity of surgical critical care.

Background:Surgical critical care is crucial to the care of trauma and surgical patients. This study was designed to provide a contemporary assessment of patient types, injuries, and conditions in intensive care units (ICU) caring for trauma patients. Methods:This was a multicenter prevalence study of the American Association for the Surgery of Trauma; data were collected on all patients present in participating centers' trauma ICU (TICU) on November 2, 2017 and April 10, 2018. Results:Forty-nine centers submitted data on 1416 patients. Median age was 58 years (IQR 41-70). Patient types included trauma (n=665, 46.9%), non-trauma surgical (n=536, 37.8%), medical (n=204, 14.4% overall), or unspecified (n=11). Surgical intensivists managed 73.1% of patients. Of ICU-specific diagnoses, 57% were pulmonary related. Multiple high-intensity diagnoses were represented (septic shock, 10.2%; multiple organ failure, 5.58%; adult respiratory distress syndrome, 4.38%). Hemorrhagic shock was seen in 11.6% of trauma patients and 6.55% of all patients. The most common traumatic injuries were rib fractures (41.6%), brain (38.8%), hemothorax/pneumothorax (30.8%), and facial fractures (23.7%). Forty-four percent were on mechanical ventilation, and 17.6% had a tracheostomy. One-third (33%) had an infection, and over half (54.3%) were on antibiotics. Operations were performed in 70.2%, with 23.7% having abdominal surgery. At 30 days, 5.4% were still in the ICU. Median ICU length of stay was 9 days (IQR 4-20). 30-day mortality was 11.2%. Conclusions:Patient acuity in TICUs in the USA is very high, as is the breadth of pathology and the interventions provided. Non-trauma patients constitute a significant proportion of TICU care. Further assessment of the global predictors of outcome is needed to inform the education, research, clinical practice, and staffing of surgical critical care providers. Level of evidence:IV, prospective observational study

Eliminating hepatitis C: Part 2. Assessing your patient for antiviral treatment

With the introduction of direct-acting antivirals (DAAs) in Australia in 2016, most people with chronic hepatitis C can be cured of this infection. GPs and suitably qualified nurse practitioners working in all areas of primary care have a key role in identifying, testing and treating their patients with hepatitis C. The previous article in this series discussed how to identify your patients with hepatitis C. This article provides practical advice on assessing a patient after diagnosis in preparation for DAA therapy. This includes determining whether they can be safely treated in general practice or require specialist referral

Reliability, acceptability, validity and responsiveness of the CHU9D and PedsQL in the measurement of quality of life in children and adolescents with overweight and obesity

Background The Paediatric Quality of life Inventory (PedsQLTM) Generic Core Scales and the Child Health Utilities 9 Dimensions (CHU9D) are two paediatric health-related quality of life (HRQoL) measures commonly used in overweight and obesity research. However, no studies have comprehensively established the psychometric properties of these instruments in the context of paediatric overweight and obesity. The aim of this study was to assess the reliability, acceptability, validity and responsiveness of the PedsQL and the CHU9D in the measurement of HRQoL among children and adolescents living with overweight and obesity. Subjects/Methods Subjects were 6544 child participants of the Longitudinal Study of Australian Children, with up to 3 repeated measures of PedsQL and CHU9D and aged between 10 and 17 years. Weight and height were measured objectively by trained operators, and weight status determined using World Health Organisation growth standards. We examined reliability, acceptability, known group and convergent validity and responsiveness, using recognised methods. Results Both PedsQL and CHU9D demonstrated good internal consistency reliability, and high acceptability. Neither instrument showed strong convergent validity, but PedsQL appears to be superior to the CHU9D in known groups validity and responsiveness. Compared with healthy weight, mean (95%CI) differences in PedsQL scores for children with obesity were: boys −5.6 (−6.2, −4.4); girls −6.7 (−8.1, −5.4) and differences in CHU9D utility were: boys −0.02 (−0.034, −0.006); girls −0.035 (−0.054, −0.015). Differences in scores for overweight compared with healthy weight were: PedsQL boys −2.2 (−3.0, −1.4) and girls −1.3 (−2.0, −0.6) and CHU9D boys: no significant difference; girls −0.014 (−0.026, −0.003). Conclusion PedsQL and CHU9D overall demonstrated good psychometric properties, supporting their use in measuring HRQoL in paediatric overweight and obesity. CHU9D had poorer responsiveness and did not discriminate between overweight and healthy weight in boys, which may limit its use in economic evaluation

Psychometric evaluation of the PedsQL GCS and CHU9D in Australian children and adolescents with common chronic health conditions

Background Generic instruments such as the Pediatric Quality of Life Inventory™ v4.0 Generic Core Scales (PedsQL GCS) and Child Health Utility 9D (CHU9D) are widely used to assess health-related quality of life (HRQOL) of the general childhood population, but there is a paucity of information about their psychometric properties in children with specific health conditions. This study assessed psychometric properties, including acceptability, reliability, validity, and responsiveness, of the PedsQL GCS and the CHU9D in children and adolescents with a range of common chronic health problems. Methods We used data from the Longitudinal Study of Australian Children (LSAC), for children aged 10–17 years with at least one of the following six parent-reported health conditions: asthma, anxiety/depression, attention deficit hyperactivity disorder (ADHD), autism/Asperger’s, epilepsy, and type 1 diabetes mellitus. The LSAC used parent proxy-reported PedsQL GCS and child self-reported CHU9D assessments. The performance of each instrument (PedsQL GCS and CHU9D) for each psychometric property (acceptability, reliability, validity, and responsiveness) was assessed against established criteria. Results The study sample included 7201 children and adolescents (mean age = 14 years; range 10.1–17.9 years; 49% female) with 15,568 longitudinal observations available for analyses. Across the six health conditions, acceptability of the PedsQL GCS was high, while acceptability for the CHU9D was mixed. Both the PedsQL GCS and CHU9D showed strong internal consistency (Cronbach’s alpha range: PedsQL GCS = 0.70–0.95, CHU9D = 0.76–0.84; item-total correlations range: PedsQL GCS = 0.35–0.84, CHU9D = 0.32–0.70). However, convergent validity for both the PedsQL GCS and CHU9D was generally weak (Spearman’s correlations ≤ 0.3). Known group validity was strong for the PedsQL GCS (HRQOL differences were detected for children with and without asthma, anxiety/depression, ADHD, autism/Asperger’s, and epilepsy). CHU9D was only able to discriminate between children with and without anxiety/depression, ADHD, and autism/Asperger’s. The responsiveness of both the PedsQL GCS and CHU9D was variable across the six conditions, and most of the estimated effect sizes were relatively small (< 0.5). Conclusion This study expands the evidence base of psychometric performance of the PedsQL GCS and CHU9D and can aid in appropriate HRQOL instrument selection for the required context by researchers and clinicians

Psychometric evaluation of the proxy-reported PedsQL Generic Core Scales across the childhood lifespan in Australian children and adolescents with specified health conditions

Objectives: Current generic childhood health-related quality of life instruments lack comprehensive psychometric evidence across all ages. The Pediatric Quality of Life Inventory™ v4.0 Generic Core Scales (PedsQL GCS) covers ages 2–18 years old but evidence on its psychometric properties is limited to restricted age groups. This study aimed to evaluate the proxy-reported PedsQL GCS across the entire childhood lifespan. Methods: The study used data from the Longitudinal Study of Australian Children, for children aged 2–17 years with one of six health conditions: high weight status, eczema, attention-deficit/hyperactivity disorder, vision problems, hearing problems, and learning difficulty. Psychometric properties of the proxy-reported PedsQL GCS were assessed in early childhood, middle childhood, and adolescence against established criteria. Results: In analyses of 9,317 children with 50,934 total observations, the PedsQL GCS demonstrated good acceptability across the childhood lifespan, except for high rates of missing data in 2–9 year olds (range=12–30%). Strong internal consistency was evident across health conditions and age (α range=0.72–0.93; item-total correlations range=0.28–0.80). Known group validity was strong with differentiation between children with/without the condition across all ages, except for eczema. Responsiveness was variable with inconsistencies mainly in early childhood. Conclusions: This study adds to the PedsQL psychometric evidence base, finding that the proxy-reported PedsQL GCS demonstrated robust reliability and known group validity, good acceptability, and mixed responsiveness in Australian children with health conditions across age. We propose the PedsQL GCS as a robust instrument to take forward for valuation to directly generate utility values for use in economic evaluations

Older Adults in Service to Society

Older Adults in Service to Societ

Exploring Simulations in Mathematics Teacher Education

This article originally appeared in Connections, available at https://www.amte.net/connections/2024/12/exploring-simulations-mathematics-teacher-educatio