Measuring sociocultural engagement of health professions education students:a psychometric study

Background: Sociocultural engagement of students refers to broadening viewpoints and providing awareness of, and respect for, diverse backgrounds and perspectives. However, there are no existing validated instruments in the literature for measuring sociocultural engagement of health professions education (HPE) students. Therefore, the aim of this study is to develop and validate a questionnaire designed to assess sociocultural engagement among HPE students. Methods: The study included undergraduate HPE students (n = 683) at Gulf Medical University. The initial version of the sociocultural engagement of students’ questionnaire (SESQ) was developed after extensive literature review and guided by the Global Learning Qualifications Framework. We then tested the content validity of the questionnaire by using focus group discussion with subject experts (n = 16) and pilot testing with students (n = 20). We distributed the content-validated version of the SESQ (16 items) to undergraduate students in six HPE colleges. To examine the construct validity and construct reliability of the questionnaire, we conducted exploratory factor analysis, followed by confirmatory factor analysis. Results: Confirmatory factor analysis supported the two-factor structure which consists of 13 items with good fitness indices (χ2 = 214.35, df = 61, χ 2/df = 3.51, CFI = 0.98, RMSEA = 0.06, SRMR = 0.025, and AIC = 208.00). The two factors were sociocultural interactions (8 items) and sociocultural adaptation (5 items). The construct reliability of the total questionnaire is 0.97 and the two factors were 0.93 and 0.92 for sociocultural interactions and sociocultural adaptation, respectively. In addition, there were significant weak correlations between both factors of sociocultural engagement scores and student satisfaction with the university experience (r =.19 for each, P =.01). Conclusions: The sociocultural engagement of students’ questionnaire exhibits good evidence of construct validity and reliability. Further studies will be required to test the validity of this questionnaire in other contexts.</p

Physiology and Pathophysiology of the Swallowing Area of Human Motor Cortex

Swallowing problems can affect as many as one in three patients in the period immediately after stroke. Despite this, in the majority of cases, recovery usually occurs to a safe level after a month or two. In this review, we show. how the organization of the cortical projections to swallowing nuscles can account for many of the clinical observations on swallowing after stroke and explain why recovery is common in the long term. In addition, we examine approaches that may be useful in speeding up recovery of swallowing. Swallowing may be a useful model in which to study central nervous reorganization after injury

The Homogeneity of Interstellar Oxygen in the Galactic Disk

We present an analysis of high resolution HST Space Telescope Imaging Spectrograph (STIS) observations of O I 1356 and H I Lyman-alpha absorption in 36 sight lines that probe a variety of Galactic disk environments and include paths that range over nearly 4 orders of magnitude in f(H_2), over 2 orders of magnitude in mean sight line density, and that extend up to 6.5 kpc in length. Consequently, we have undertaken the study of gas-phase O/H abundance ratio homogeneity using the current sample and previously published Goddard High-Resolution Spectrograph (GHRS) results. Two distinct trends are identified in the 56 sight line sample: an apparent decrease in gas-phase oxygen abundance with increasing mean sight line density and a gap between the mean O/H ratio for sight lines shorter and longer than about 800 pc. The first effect is a smooth transition between two depletion levels associated with large mean density intervals; it is centered near a density of 1.5 cm^-3 and is similar to trends evident in gas-phase abundances of other elements. Paths less dense than the central value exhibit a mean O/H ratio of log_10 (O/H) = -3.41+/-0.01 (or 390+/-10 ppm), which is consistent with averages determined for several long, low-density paths observed by STIS (Andre et al. 2003) and short low-density paths observed by FUSE (Moos et al. 2002). Sight lines of higher mean density exhibit an average O/H value of log_10 (O/H) = -3.55+/-0.02 (284+/-12 ppm). The datapoints for low-density paths are scattered more widely than those for denser sight lines, due to O/H ratios for paths shorter than 800 pc that are generally about 0.10 dex lower than the values for longer ones.Comment: 33 pages, including 8 figures and 4 tables; accepted for publication in ApJ, tentatively in Oct 200

Construct validity of a questionnaire for measuring student engagement in problem-based learning tutorials

Background: Student engagement is student investment of time and energy in academic and non-academic experiences that include learning, teaching, research, governance, and community activities. Although previous studies provided some evidence of measuring student engagement in PBL tutorials, there are no existing quantitative studies in which cognitive, behavioral, and emotional engagement of students in PBL tutorials is measured. Therefore, this study aims to develop and examine the construct validity of a questionnaire for measuring cognitive, behavioral, and emotional engagement of students in PBL tutorials. Methods: A 15-item questionnaire was developed guided by a previously published conceptual framework of student engagement. Focus group discussion (n = 12) with medical education experts was then conducted and the questionnaire was piloted with medical students. The questionnaire was then distributed to year 2 and 3 medical students (n = 176) in problem-based tutorial groups at the end of an integrated course, where PBL is the main strategy of learning. The validity of the internal structure of the questionnaire was tested by confirmatory factor analysis using structural equation modeling assuming five different models. Predictive validity evidence of the questionnaire was studied by examining the correlations between students’ engagement and academic achievement. Results: Confirmatory factor analysis indicates a good fit between the measurement and structural model of an 11-item questionnaire composed of a three-factor structure: behavioral engagement (3 items), emotional engagement (4 items), and cognitive engagement (4 items). Models in which the three latent factors were considered semi-independent provided the best fit. The construct reliabilities of behavioral, cognitive, and emotional factors were 0.82, 0.82, and 0.76, respectively. We failed however to find significant relationships between academic achievement and engagement. Conclusions: We found a strong evidence to support the construct validity of a three-factor structure of student engagement in PBL tutorial questionnaire. Further studies are required to test the validity of this instrument in other educational settings. The predictive validity is another area needing further scrutiny.</p

Comparative quantitative survey of patient experience in Barrett's oesophagus and other gastrointestinal disorders

Objective To assess health-related quality of life in patients with non-dysplastic Barrett’s oesophagus (NDBO) and endoscopically treated dysplastic Barrett’s oesophagus (DBO). Design This quantitative, self-administered questionnaire study was conducted across three National Health Service hospitals. Data were collected from three other cohorts; gastro-oesophageal reflux disease (GORD), colonic polyp surveillance and healthy individuals. Fisher’s exact and Spearman’s rank correlation tests were used for analysis. Propensity score matching adjusted for age, sex and comorbidities. Results 687 participants were eligible for analysis (NDBO n=306, DBO n=49, GORD n=132, colonic polyps n=152 and healthy n=48). 53% of NDBO participants reported similarly high cancer worry, comparable to DBO (50%, p=0.933) and colonic polyp participants (51%, p=0.355). Less cancer worry was reported in GORD participants (43.4%, p=0.01 vs NDBO). NDBO participants reported anxiety in 15.8% and depression in 8.6% of cases, which was similar to the other disease cohorts. Moderate or severe heartburn or acid regurgitation was found in 11% and 10%, respectively, in the NDBO cohort, comparable to DBO participants (heartburn 2% p=0.172, acid regurgitation 4% p=0.31) but lower (better) than GORD participants (heartburn 31% p=<0.001, acid regurgitation 25% p=0.001). NDBO participants with moderate or severe GORD symptoms were associated with higher rates of anxiety (p=<0.001), depression (p=<0.001) and cancer worry (p=<0.001). NDBO patients appropriately perceiving their cancer risk as low had lower rates of cancer worry (p=<0.001). Conclusion This study provides insight into the problems Barrett’s oesophagus patients may face. Future care pathways must be more patient focussed to address misconceptions of cancer risk, oesophageal cancer related worry and GORD symptom control

Influence of chitosan on the mechanical and biological properties of HDPE for biomedical applications

High density polyethylene (HDPE) is widely used in biomedical field, except when strong cell-material interactions and high mechanical properties are required. To address this pitfall, two kinds of chitosan in different amounts were used as filler in the present research. Composites were prepared by melt extrusion process and their microstructural, thermal and mechanical properties were widely investigated. Also roughness and wettability were studied, as features of paramount importance in dictating cell response. Both types of chitosan endowed HDPE with higher Young modulus and lower elongation at break. Interestingly, fibroblast adhesion and viability were enhanced when a low amount of filler was used. The interaction of HDPE/chitosan composites with biological environment was investigated for the first time in order to assess the feasibility of these composites as materials for biomedical application

Methylene tetrahydrofolate reductase, transforming growth factor-β1 and lymphotoxin-α genes polymorphisms and susceptibility to rheumatoid arthritis

AbstractBackgroundRheumatoid arthritis is a widely prevalent autoimmune disorder with suggested genetic predisposition.ObjectivesThe aim of this study is to detect the pattern of genetic polymorphism of methylene tetrahydrofolate reductase (MTHFR C677 T and A1298 C), transforming growth factor-β1 (TGF-β1 T869 C) and lymphotoxin-α (LT-α A252G) in patients having rheumatoid arthritis and correlate these patterns to disease activity and serum levels of tumor necrosis factor-alpha (TNF-α), B-Cell Activating Factor (BAFF), and osteopontin.MethodsA total of 194 subjects, 90 controls and 104 patients with rheumatoid arthritis were genotyped for MTHFR C677 T and A1298 C, TGF-β1 T869 C and LT-α A252G polymorphisms using a methodology based on PCR-RFLP. Also serum levels of TNF-α, osteopontin and BAFF were measured by ELISA kits.ResultsThe CT genotype and T allele of MTHFR C677 T and GG genotype and G allele of LT-α A252G are associated with the risk of RA and with higher levels of the pro-inflammatory cytokine, TNF-α in patients with rheumatoid arthritis.ConclusionOur findings suggest that there is association between MTHFR C677 T and LT-α A252G genes polymorphisms and increased risk of RA in this sample of Egyptian population

Polimorfismos dos genes metilenotetrahidrofolato redutase, fator de crescimento transformador β1 e linfotoxina‐α e susceptibilidade à artrite reumatoide

ResumoAntecedentesA artrite reumatoide é uma doença autoimune amplamente prevalente com sugerida predisposição genética.ObjetivosDetectar o padrão de polimorfismo dos genes metilenotetrahidrofolato redutase (MTHFR C677T e A1298C), fator de crescimento transformador β1 (TGF‐β1 T869C) e linfotoxina‐α (LT‐α A252G) em pacientes com artrite reumatoide e correlacionar esses padrões com a atividade da doença e os níveis séricos de fator de necrose tumoral alfa (TNF‐α), fator ativador de linfócitos B (BAFF) e osteopontina.MétodosForam genotipados 194 indivíduos – 90 controles e 104 com artrite reumatoide – à procura de polimorfismos dos genes MTHFR C677T e A1298C, TGF‐β1 T869C e LT‐α A252G com uma metodologia baseada na PCR‐RFLP. Mensuraram‐se também os níveis séricos de TNF‐α, osteopontina e BAFF com kits de Elisa.ResultadosO genótipo CT e o alelo T do MTHFR C677T e o genótipo GG e alelo G do LT‐α A252G estão associados ao risco de AR e a níveis mais elevados da citocina pró‐inflamatória TNF‐α em pacientes com artrite reumatoide.ConclusãoOs achados do presente estudo sugerem que há associação entre os polimorfismos dos genes MTHFR C677T e LT‐α A252G e um risco aumentado de AR nessa amostra da população egípcia.AbstractBackgroundRheumatoid arthritis is a widely prevalent autoimmune disorder with suggested genetic predisposition.ObjectivesThe aim of this study is to detect the pattern of genetic polymorphism of methylene tetrahydrofolate reductase (MTHFR C677T and A1298C), transforming growth factor‐β1 (TGF‐β1 T869C) and lymphotoxin‐α (LT‐α A252G) in patients having rheumatoid arthritis and correlate these patterns to disease activity and serum levels of tumor necrosis factor‐alpha (TNF‐α), B‐Cell Activating Factor (BAFF), and osteopontin.MethodsA total of 194 subjects, 90 controls and 104 patients with rheumatoid arthritis were genotyped for MTHFR C677T and A1298C, TGF‐β1 T869C and LT‐α A252G polymorphisms using a methodology based on PCR‐RFLP. Also serum levels of TNF‐α, osteopontin and BAFF were measured by ELISA kits.ResultsThe CT genotype and T allele of MTHFR C677T and GG genotype and G allele of LT‐α A252G are associated with the risk of RA and with higher levels of the pro‐inflammatory cytokine, TNF‐α in patients with rheumatoid arthritis.ConclusionOur findings suggest that there is association between MTHFR C677T and LT‐α A252G genes polymorphisms and increased risk of RA in this sample of Egyptian population

Monocaprin eye drop formulation to combat antibiotic resistant gonococcal blindness

Abstract: Neisseria gonorrhoeae bacteria are acknowledged as an urgent threat to human health because this species has developed resistances to all of the antibiotics used clinically to treat its infections. N. gonorrhoeae causes the sexually transmitted disease gonorrhoea, but also causes blindness when the bacteria infect the eyes. Infants are particularly susceptible, acquiring the infection from their mothers at birth. We have shown that the monoglyceride monocaprin rapidly kills N. gonorrhoeae and other bacterial species and is non-irritating in ocular assays. Here we show that the physical and chemical properties of monocaprin make it ideal for use in a thickened eye drop formulation to combat eye infections. Monocaprin-containing formulations were assessed using analytical techniques and for antimicrobial activity in vitro and in ex vivo infections. Monocaprin-containing formulations retained activity after three years and are non-irritating, unlike preparations of povidone iodine in our assays. A recommended formulation for further development and investigation is 0.25% monocaprin in 1% HPMC with 1% polysorbate 20