Quality of group interaction, ethnic group composition, and individual mathematical learning gains

High-quality helping behavior is essential for effective peer interaction and learning. This study focused on ethnic group composition and the quality of group interaction as predictors of individual mathematics performance. Video-observations of 92 fifth-grade students working in groups balanced on mathematics performance level were analyzed. We expected a difference in the quality of interaction and test scores of native and non-native students. Multilevel analysis identified process regulation and giving answers as positive predictors of mathematics performance, whereas giving or applying explanations contributed negatively. Non-native students generally had lower achievement scores than native students. Non-native students working in ethnically heterogeneous groups performed better than did students working in homogenous groups. Homogeneous groups used more high-quality helping behaviors and engaged more often in task-oriented behavior. Heterogeneous groups engaged more often in low-quality helping behaviors. Working with native students may have been conducive to non-native students’ understanding of word problems in realistic mathematics education

Effects of antiplatelet therapy on menstrual blood loss in reproductive-aged women:a systematic review

Background: The effects of antiplatelet therapy on menstrual bleeding have not been well characterized. Objectives: To systematically review the effects of antiplatelet therapy on menstrual bleeding. Methods: A literature search was performed for studies of reproductive-aged women who received antiplatelet therapy. Characteristics of menstrual bleeding both before and after initiation of antiplatelet therapy and from comparison groups were collected. Two reviewers independently assessed the risk of bias in individual studies. Results: Thirteen studies with a total of 611 women who received antiplatelet therapy were included. Types of antiplatelet drugs used were aspirin (n = 8), aspirin and/or clopidogrel (n = 2), prasugrel (n = 1), and not specified (n = 2). Risk of bias was assessed at moderate (n = 1), serious (n = 8), critical (n = 2), and no information (n = 2). Three studies reported changes in menstrual blood loss volume. One of these showed no increase during antiplatelet therapy; the other 2 studies suggested that aspirin may increase menstrual blood loss volume. In 3 studies that assessed the duration of menstrual bleeding, up to 13% of women reported an increased duration of menstruation. In 5 studies that reported the intensity of menstrual flow, 13% to 38% of women experienced an increase in the intensity of flow. Five studies reported the prevalence of heavy menstrual bleeding in women who received antiplatelet therapy, with estimates ranging from 7% to 38%. Conclusion: There is lack of high-quality data on the effects of antiplatelet therapy on menstrual bleeding. Aspirin may increase menstrual blood loss, at least in a minority of women, whereas the effects of P2Y12 inhibitors are unknown.</p

Effects of antiplatelet therapy on menstrual blood loss in reproductive-aged women:a systematic review

Background: The effects of antiplatelet therapy on menstrual bleeding have not been well characterized. Objectives: To systematically review the effects of antiplatelet therapy on menstrual bleeding. Methods: A literature search was performed for studies of reproductive-aged women who received antiplatelet therapy. Characteristics of menstrual bleeding both before and after initiation of antiplatelet therapy and from comparison groups were collected. Two reviewers independently assessed the risk of bias in individual studies. Results: Thirteen studies with a total of 611 women who received antiplatelet therapy were included. Types of antiplatelet drugs used were aspirin (n = 8), aspirin and/or clopidogrel (n = 2), prasugrel (n = 1), and not specified (n = 2). Risk of bias was assessed at moderate (n = 1), serious (n = 8), critical (n = 2), and no information (n = 2). Three studies reported changes in menstrual blood loss volume. One of these showed no increase during antiplatelet therapy; the other 2 studies suggested that aspirin may increase menstrual blood loss volume. In 3 studies that assessed the duration of menstrual bleeding, up to 13% of women reported an increased duration of menstruation. In 5 studies that reported the intensity of menstrual flow, 13% to 38% of women experienced an increase in the intensity of flow. Five studies reported the prevalence of heavy menstrual bleeding in women who received antiplatelet therapy, with estimates ranging from 7% to 38%. Conclusion: There is lack of high-quality data on the effects of antiplatelet therapy on menstrual bleeding. Aspirin may increase menstrual blood loss, at least in a minority of women, whereas the effects of P2Y12 inhibitors are unknown.</p

Cognitive impairment in type 2 diabetes : Opportunities for diagnosis, prevention and management

In the Netherlands, hundreds of thousands of people aged 70 years or older are currently living with type 2 diabetes, and these numbers are expected to increase further. Older people with type 2 diabetes have an increased risk of cognitive impairment, including both mild cognitive impairment and dementia. We studied the impact of cognitive impairment on people with type 2 diabetes. We found that, besides a higher risk of cardiovascular events and death, people with diabetes have more depressive symptoms and visit the emergency room and the general practice out-of-hours services more often when they have cognitive impairment. We conclude that this is a vulnerable group that may benefit from tailored diabetes care. We also investigated possible starting points for the prevention of cognitive impairment in type 2 diabetes. We found that both low and high mean blood glucose levels are related to poor cognitive functioning, particularly in older women. Furthermore, we focused on the question “how should general practitioners identify cognitive impairment?”. Until now, all people who visit their general practitioner with cognitive complaints are offered the same cognitive test, the MMSE. Using three different cognitive tests (the clock-drawing-test, the MoCA and the MMSE), with the choice of the test depending on the chance that the patient has cognitive impairment, offers the opportunity to provide people more accurate answers to questions about their cognitive functioning. Finally, we demonstrated that the ‘Test-Your-Memory’ and ‘Self-Administered-Gerocognitive-Examination’ are suitable tests to screen for cognitive impairment in people with type 2 diabetes

Depressive symptoms and quality of life after screening for cognitive impairment in patients with type 2 diabetes : observations from the Cog-ID cohort study

Objectives To assess changes in depressive symptoms and health-related quality of life (HRQOL) after screening for cognitive impairment in people with type 2 diabetes. Design A prospective cohort study, part of the Cognitive Impairment in Diabetes (Cog-ID) study. Setting Participants were screened for cognitive impairment in primary care. People suspected of cognitive impairment (screen positives) received a standardised evaluation at a memory clinic. Participants Participants ≥70 years with type 2 diabetes were included in Cog-ID between August 2012 and September 2014, the current study includes 179 patients; 39 screen positives with cognitive impairment, 56 screen positives without cognitive impairment and 84 participants not suspected of cognitive impairment during screening (screen negatives). Outcome measures Depressive symptoms and HRQOL assessed with the Center for Epidemiologic Studies Depression Scale (CES-D), 36-Item Short-Form Health Survey, European Quality of Life-5 Dimensions questionnaire and the EuroQol Visual Analogue Scale. Outcomes were assessed before the screening, and 6 and 24 months after screening. An analysis of covariance model was fitted to assess differences in score changes among people diagnosed with cognitive impairment, screen negatives and screen positives without cognitive impairment using a factor group and baseline score as a covariate. Results Of all participants, 60.3% was male, mean age was 76.3±5.0 years, mean diabetes duration 13.0±8.5 years. At screening, participants diagnosed with cognitive impairment had significantly more depressive symptoms and a worse HRQOL than screen negatives. Scores of both groups remained stable over time. Screen positives without cognitive impairment scored between the other two groups at screening, but their depressive symptoms decreased significantly during follow-up (mean CES-D: -3.1 after 6 and -2.1 after 24 months); their HRQOL also tended to improve. Conclusions Depressive symptoms are common in older people with type 2 diabetes. Screening for and a subsequent diagnosis of cognitive impairment will not increase depressive symptoms