Educational Achievement in Medical Students Entered University between 1995 and 2003, Kerman University of Medical Sciences

Background & Objective : Assessing students’ grades in their courses and in national comprehensive exams may help us in the assessment of educational status of different departments indirectly. In this study, the internal consistency of medical students’ scores in Kerman University of Medical Sciences was assessed. Methods : In a historical cohort study, students’ grades and other information for entrance years between 1995 and 2003 were extracted from the central admission office and 10 indicators for educational achievement were defined for each student. Having used Cronbach's alpha and linear regression, we checked the internal consistency of scores. Also, we used factorial analysis and related graphs (Dendrogram) to evaluate the consistency between factors of students’ educational achievement. Results : Females were more successful in all series of students except for national comprehensive exams. Although internal consistency in males’ scores was more than females’, males’ scores in specific courses of basic sciences were more related to the scores of their basic sciences comprehensive exams. In addition, internal consistency in males’ scores was more than females’ especially in clinical courses. Higher age at entering university could cause a decrease in educational success. Students’ grades in various courses had slight consistency with national comprehensive exams. Moreover, the internal consistency of scores during clerkship and internship were significantly lower than the other phases. Conclusion : Lower consistency of scores in clinical courses may imply lower validity of these scores. Unlike higher educational success in females, it seems that stability in males’ scores was greater in most indicators. Keywords: Educational achievement, Internal consistency, Educational success evaluation, Medical student of Kerman University of Medical Sciences

Micronutrients in HIV: A Bayesian MetaAnalysis

Background: Approximately 28.5 million people living with HIV are eligible for treatment (CD4&500), but currently have no access to antiretroviral therapy. Reduced serum level of micronutrients is common in HIV disease. Micronutrient supplementation (MNS) may mitigate disease progression and mortality. Objectives: We synthesized evidence on the effect of micronutrient supplementation on mortality and rate of disease progression in HIV disease. Methods: We searched MEDLINE, EMBASE, the Cochrane Central, AMED and CINAHL databases through December 2014, without language restriction, for studies of greater than 3 micronutrients versus any or no comparator. We built a hierarchical Bayesian random effects model to synthesize results. Inferences are based on the posterior distribution of the population effects; posterior distributions were approximated by Markov chain Monte Carlo in OpenBugs. Principal Findings: From 2166 initial references, we selected 49 studies for full review and identified eight reporting on disease progression and/or mortality. Bayesian synthesis of data from 2,249 adults in three studies estimated the relative risk of disease progression in subjects on MNS vs. control as 0.62 (95% credible interval, 0.37, 0.96). Median number needed to treat is 8.4 (4.8, 29.9) and the Bayes Factor 53.4. Based on data reporting on 4,095 adults reporting mortality in 7 randomized controlled studies, the RR was 0.84 (0.38, 1.85), NNT is 25 (4.3, ∞). Conclusions: MNS significantly and substantially slows disease progression in HIV+ adults not on ARV, and possibly reduces mortality. Micronutrient supplements are effective in reducing progression with a posterior probability of 97.9%. Considering MNS low cost and lack of adverse effects, MNS should be standard of care for HIV+ adults not yet on ARV

Home use of a bihormonal bionic pancreas versus insulin pump therapy in adults with type 1 diabetes: a multicentre randomised crossover trial

The safety and effectiveness of a continuous, day-and-night automated glycaemic control system using insulin and glucagon has not been shown in a free-living, home-use setting. We aimed to assess whether bihormonal bionic pancreas initialised only with body mass can safely reduce mean glycaemia and hypoglycaemia in adults with type 1 diabetes who were living at home and participating in their normal daily routines without restrictions on diet or physical activity

The internal consistency of medical students' scores in their physiopathology and clinical courses

Background: To quantify the internal consistency of medical students′ scores.Aim: We assessed the associations between medical students′ scores in physiopathology and clinical courses and compared these scores with their scores in their comprehensive exams. Settings and Design: We collected medical students′ scores in their courses and also in their comprehensive exam in six consecutive years. Materials and Methods: We assessed the associations between students′ scores and their personal characteristics, and the consistency between theoretical and practical courses. Statistical Analysis: We used Pearson correlation coefficient and linear regression. In addition, we computed difficulty and discrimination indices of students′ scores in their courses by comparing these scores with comprehensive clinical exam (CCE). Results: Generally, females and younger students were more successful. CCE were predicted by students′ scores and their characteristics relatively accurate (the adjusted R2 of the model was 0.59). Students′ scores in the pathology and in thesis had the maximum and minimum discrimination indices, while the difficulties of these two courses were in reverse order. The strongest association was observed between theoretical and practical scores in internal medicine while the associations between theoretical and practical scores in the other courses were not strong although all of them were statistically significant. Conclusions: Using this approach to explore the students′ score, might highlight the weak points of the current educational system. For example we found that the students′ score in thesis had the minimum accuracy; although students obtained very high score in this course. Hence, for better comparison of the accuracy students′ scores in colleges around the world, we recommend similar quantitative approac

Correction: Micronutrients in HIV: A Bayesian Meta-Analysis.

[This corrects the article DOI: 10.1371/journal.pone.0120113.]

Costs of implementing a multi-site facilitation intervention to increase access to medication treatment for opioid use disorder.

BACKGROUND: The United States has been grappling with the opioid epidemic, which has resulted in over 75,000 opioid-related deaths between April 2020 and 2021. Evidence-based pharmaceutical interventions (buprenorphine, methadone, and naltrexone) are available to reduce opioid-related overdoses and deaths. However, adoption of these medications for opioid use disorder has been stifled due to individual- and system-level barriers. External facilitation is an evidence-based implementation intervention that has been used to increase access to medication for opioid use disorder (MOUD), but the implementation costs of external facilitation have not been assessed. We sought to measure the facility-level direct costs of implementing an external facilitation intervention for MOUD to provide decision makers with estimates of the resources needed to implement this evidence-based program. METHODS: We performed a cost analysis of the pre-implementation and implementation phases, including an itemization of external facilitation team and local site labor costs. We used labor estimates from the Bureau of Labor and Statistics, and sensitivity analyses were performed using labor estimates from the Veterans Health Administration (VHA) Financial Management System general ledger data. RESULTS: The average total costs for implementing an external facilitation intervention for MOUD per site was $18,847 (SD 6717) and ranged between$11,320 and $31,592. This translates to approximately$48 per patient with OUD. Sites with more encounters and participants with higher salaries in attendance had higher costs. This was driven mostly by the labor involved in planning and implementation activities. The average total cost of the pre-implementation and implementation activities were $1031 and$17,816 per site, respectively. In the sensitivity analysis, costs for VHA were higher than BLS estimates likely due to higher wages. CONCLUSIONS: Implementing external facilitation to increase MOUD prescribing may be affordable depending on the payers budget constraints. Our study reported that there were variations in the time invested at each phase of implementation and the number and type of participants involved with implementing an external facilitation intervention. Participant composition played an important role in total implementation costs, and decision makers will need to identify the most efficient and optimal number of stakeholders to involve in their implementation plans