Predictors of instrumental motivation for mathematics in Pisa 2012. The role of gender, self-concept, helplessness, negative emotions, worries and intrinsic motivation

The aim of our study was to define predictors of instrumental motivation for mathematics. In our research, we used the data on the Polish sample of the Programme for International Student Assessment (PISA) from 2012. We hypothesized that motivation to engage in mathematics at later stages of education and in professional career, called “instrumental motivation” in the project, can be predicted based on gender, mathematics self-concept, intrin- sic motivation, as well as worries about coping with mathematics and negative emotions. Using structural equation modelling, with gender and mathematics self-concept as predictors, and negative emotions, intrinsic motivation and worries about one’s math skills as mediators, we showed that helplessness in mathematics, indirectly determined by gender and mathematics self-concept, has an indirect effect on instrumental motivation, only through higher worries about one’s math abilities. Instrumental motivation turned out to be also strongly related to intrinsic motivation, which in turn is linked to a positive mathematics self-concep

Gastrojejunostomy Inserted Through Peg (Peg-J) in Prevention of Aspiration Pneumonia. Clinical Nutrition Complication in Dysphagic Patients

Percutaneous endoscopic gastrostomy (PEG) is the most commonly used method of access to the gastrointestinal tract in long‑term home enteral nutrition (HEN) in patients with neurogenic deglutition and stenosis of the upper gastrointestinal tract caused by tumour. One of the most common complications of HEN is pneumonia resulting from aspiration of saliva or food. The risk of aspiration and the potential consequent sudden death is further increased by concomitant delayed gastric emptying and gastroesophageal reflux disease. The aim of the study was to evaluate the efficacy of changing percutaneous endoscopic gastrostomy to a gastrojejunostomy inserted through the PEG (PEG-J) in the prevention of aspiration pneumonia. Materiał and methods. The study involved 158 patients receiving HEN by percutaneous endoscopic gastrostomy (PEG), aged 19 to 90 years. Indications for enteral nutrition in the study subjects included: neurogenic dysphagia - 95 patients (60%), and obstruction of the upper gastrointestinal tract due to cancer - 63 patients (40%). Results. The pulmonary and gastrointestinal complications were observed in 28 patients receiving gastric nutrition through PEG within one to nine months following the start of the feeding. In 20 patients, because of the symptoms of aspiration pneumonia with accompanying gastroesophageal reflux and delayed gastric emptying, PEG was changed to PEG-J as an alternative. There were no reports on food reflux and aspiration pneumonia in patients whose PEG has been replaced by PEG-J. Conclusions. The use of PEG-J appears to prevent the occurrence of aspiration pneumonia in patients receiving home enteral nutrition in the long‑ter