From Item Analysis to Assessment Analysis: Introducing New Formulae

Item analysis of individual multiple choice questions have been widely used for several decades. But formulae for analysis of manually-marked assessments are lacking. Evaluation and comparison of such assessments used in medical schools remain a guess work. In this study we have introduced new formulae aligned with item analysis formulae, which can be used to analyse all assessment methods. While the existing formulae use a binary (pass/fail) criterion, the new formulae have used actual scores. While the existing formulae use the scores of a single assessment to rank the candidates to determine the high and low scorers for calculating the discrimination index (DISi), the new formula used the grand total scores of the entire examination for it. It is claimed that the new formulae, utilizing actual scores, would make the indexes more realistic. Eight examinations, each comprising nine assessments, were used to validate this claim. The DISi and Difficulty Index (DIFi) were calculated using the binary formulae and the new formulae. Comparisons were made using parametric and non-parametric tests. The ensued positive correlation of indexes indicated that the new formulae are feasible, realistic and easy to apply. More replicates are required to prove their validity and reliability

\u27A LABOUR OF LOVE\u27: A KING\u27S COLLEGE LONDON PSYCHIATRY SOCIETY EVENT TO CHALLENGE THE STIGMA ATTACHED TO MENTAL HEALTH PROBLEMS IN POST-NATAL WOMEN

Background: On the 9th October 2000, Dr Daksha Emson, a London based psychiatrist with bipolar affective disorder, tragically killed herself and her three-month-old baby daughter during a psychotic episode. An independent inquiry into Dr Emson’s death concluded that mental health stigma in the National Health Service was a factor that contributed to her death. Despite the morbidity and mortality attributed to the stigma attached to post-natal mental health problems there are very few programmes that have been developed to challenge it. King’s College London Undergraduate Psychiatry Society organized an event entitled, ‘A Labour of Love’: Perinatal Mental Health to address this issue. The event included a talk from an expert by experience, a mother who developed post-partum mental health problems. Design: We conducted a single-arm, pre-post comparison study on participants who attended the KCL Psych Soc event. Validated stigma scales on knowledge (Mental Health Knowledge Schedule (MAKS)), attitudes (Community Attitudes towards the Mentally Ill (CAMI)) and behaviour (Reported and Intended Behaviour Scale (RIBS)) were administered before and immediately after exposure to the event. Results: 27/27 (100%) of participants recruited responded. There was a statistically significant difference in the pre-MAKS score compared to the post-MAKS score (p=0.0003), the pre-RIBS score compared to the post-RIBS score (p=0.0068) and in the pre- CAMI score compared to the post-CAMI score (p=0.0042). Discussion: There were statistically significant reductions in stigma in the domains of knowledge, attitude and behavior following exposure to the KCL Psych Soc event and no adverse effects were reported. Our study revealed that a brief intervention made a highly significant impact and maybe useful in challenging the stigma around post-natal mental illness. However, more research in this area is required to determine if the changes are sustained before we can consider rolling out and scaling up such an initiative nationally and internationally

Molecular Mechanisms of Adipogenesis: The Anti-adipogenic Role of AMP-Activated Protein Kinase

Obesity is now a widespread disorder, and its prevalence has become a critical concern worldwide, due to its association with common co-morbidities like cancer, cardiovascular diseases and diabetes. Adipose tissue is an endocrine organ and therefore plays a critical role in the survival of an individual, but its dysfunction or excess is directly linked to obesity. The journey from multipotent mesenchymal stem cells to the formation of mature adipocytes is a well-orchestrated program which requires the expression of several genes, their transcriptional factors, and signaling intermediates from numerous pathways. Understanding all the intricacies of adipogenesis is vital if we are to counter the current epidemic of obesity because the limited understanding of these intricacies is the main barrier to the development of potent therapeutic strategies against obesity. In particular, AMP-Activated Protein Kinase (AMPK) plays a crucial role in regulating adipogenesis – it is arguably the central cellular energy regulation protein of the body. Since AMPK promotes the development of brown adipose tissue over that of white adipose tissue, special attention has been given to its role in adipose tissue development in recent years. In this review, we describe the molecular mechanisms involved in adipogenesis, the role of signaling pathways and the substantial role of activated AMPK in the inhibition of adiposity, concluding with observations which will support the development of novel chemotherapies against obesity epidemics

A KING’S COLLEGE LONDON UNDERGRADUATE PSYCHIATRY SOCIETY EVENT TO CHALLENGE THE STIGMA ATTACHED TO PSYCHOLOGICAL PROBLEMS IN HEALTHCARE PROFESSIONALS AND STUDENTS

Background: There are higher levels of psychological distress in healthcare professionals and students compared to the general population. Yet, despite the availability of effective treatment, many in this group continue to suffer in silence. Fear of exposure to stigmatization has been identified to be a major barrier to accessing and using mental health services. King’s College London Undergraduate Psychiatry Society (KCL PsychSoc) organized an event entitled, \u27What does bipolar disorder even mean? Psychological distress: How can we challenge the stigma?\u27. Healthcare professionals who themselves recovered from psychological problems and a mental health advocate with first-hand experience of psychological distress were invited to deliver talks followed by an interactive question and answer session. Design: We conducted a single-arm pre-post comparison study. People who attended the KCL Psych Soc event were recruited to participate. Validated stigma scales on knowledge (Mental Health Knowledge Schedule (MAKS), attitudes (Community Attitudes towards the Mentally Ill) and behavior (Reported and Intended Behavior Scale (RIBS)) were administered on participants before and immediately after exposure to the event. Results: 44/44 of the participants recruited completed the study (100% response rate). There were statistically significant changes in the respondents’ scores for all 3 stigma scales (p value MAKS <0.0001, p value CAMI<0.0001, p value RIBS=0.0011). Discussion: As far as the authors are aware, this is the first study to date of an anti-stigma intervention comprised of healthcare professionals with first-hand experience of psychological distress. The KCL PsychSoc event was associated with statistically significant changes in the respondents\u27 scores in all three of the stigma scales. More robust research in this area is needed before scaling up similar anti-stigma initiatives

Adipogenesis, Role of Adenosine Monophosphate-Activated Protein Kinase (AMPK) and Use of Plants Products in Combating Obesity

The increasingly widespread emergence of obesity has become a matter of critical concern around the world due to its association with common morbidities including cancer, cardiovascular diseases and diabetes. Over-nutrition and the sedentary lifestyle are considered as the most significant causes of obesity: appropriate lifestyle and behavior interventions are the corner stones of successful weight loss, but to maintain such a lifestyle is highly challenging. There is therefore an urgent need to develop innovative non- or minimally-toxic means to combat obesity. Accordingly, ample natural products from plants (either as crude extracts or purified phytochemicals) have been scrutinized for their anti-obesogenic properties because they are believed to be non-toxic and cost-effective, and frequently well-accepted by patients because of their traditional use. In this review, we will discuss adipose tissue and adipogenesis, signaling pathways involved in the regulation of adipogenesis, role of energy sensor protein of the body AMPK, and recently reported plant products in the management of obesity. We will provide a common platform for understanding obesity, and a possible mechanism of action for anti-obesogenic plant products through activated AMPK, which will be helpful in the scientific development of traditional herbal medicine

In vitro antioxidant and anticancer activities of Clinacanthus nutans extracts

Clinacanthus nutans (CN), from the Acanthaceae family is a medicinal plant widely used in Thailand and Malaysia. CN is commonly used as a treatment of inflammation, cancer, and herpes virus infection. This study aimed to determine the antioxidant activity and anticancer properties of CN leaves extracts on human colorectal cancer cell lines, HCT 116 and HT-29. In this study, CN leaves powders were extracted in methanol, chloroform, and acetone at different durations. The crude extracts were assessed for total phenolic content (TPC), total flavonoid contents (TFC), 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging activity and MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) tetrazolium reduction assay. The extract using acetone showed with the highest TPC. The highest total flavonoid content was the methanol extract. The DPPH radical scavenging activity, IC50 of methanol extract was 19.67 µg/mL and exhibited the most efficacious antioxidant property among the others. The 24-hour methanol extract showed the most promising results on MTT assay. Therefore, CN methanol extract is a promising candidate to proceed in other anticancer studies such as cell cycle arrest and apoptosis assays

How to grade items for a question bank and rank tests based on student performance

Introduction: Not utilising post-test psychometric analyses of questions, and not maintaining a question bank seemed to adversely affect the quality of tests and increase the workload of academicians, as they are required to write fresh questions for all examinations. The literature review did not reveal any gold standard method for creating a question bank. This study has formulated criteria for recruiting multiple choice questions for a question bank and introduced a formula to rank whole tests. Methods: We collected used question papers of multiple true-false questions (MCQ) and one best answer questions (BAQ) and got two experienced academicians to scrutinize them and identify items with flaws. The flawless items were counted in each test and their test performance index (TPi) determined. The psychometric item analysis reports of the tests were analysed to enlist bankable items. The TPi of the tests were also calculated by this method. The TPi derived by expert opinions were compared with those obtained by objective criteria using the Pearson Correlation Coefficient and the Spearman’s rho. Results: Judgements by two experts showed a positive correlation, so also expert judgements against the objective formulae. Omission rates in MTF items showed a highly significant negative correlation with difficulty index, falling short of a perfect -1, which supported including omission index in their triple formula. The mean number of functioning distractors (FD) per BAQ item was1.87 (SD 1.14), which supported ≥2 FD per item in their triple formula. Conclusion: Expert judgments in question vetting is essential. However, objective post-test scrutiny of items using difficulty and discrimination indexes enhanced with omission index and distractor efficiency to recruit items for question banks are required. Test Performance Index will be a useful metric to rank the tests