The Self-Reported Sexual Behaviors of Single Older African Americans

Abstract African Americans are disproportionally affected by HIV/AIDS, but little is known about the risky sexual behaviors of older African Americans. This cross-sectional, comparative study, investigated the self-reported sexual behaviors of sexually active older African Americans. The nonrandom sample (N = 78) included single African American men (59%) and women (41%), 50-74 years of age. Participants were recruited from various community sites, and data were collected with a standard sexual history questionnaire. Participants reported practicing risky behaviors such having unprotected oral, anal, and vaginal sex (96.5%), and having multiple sex partners (37.2%). There were several significant gender differences such as males using condoms more for vaginal sexual activity, and they discussed using a condom more than females. Faced with an aging population and a growing incidence of HIV/AIDS, older adults need to know the types of sexual behaviors that put them at risk and skills to reduce risky behaviors. Age/gender-appropriate interventions for HIV prevention are needed for older African Americans

Exploring Surgeons' Perceptions of the Role of Simulation in Surgical Education: A Needs Assessment

Introduction: The last two decades have seen the adoption of simulation-based surgical education in various disciplines. The current study’s goal was to perform a needs assessment using the results to inform future curricular planning and needs of surgeons and learners.Methods: A survey was distributed to 26 surgeon educators and interviews were conducted with 8 of these surgeons.  Analysis of survey results included reliability and descriptive statistics. Interviews were analyzed for thematic content with a constant comparison technique, developing coding and categorization of themes.Results: The survey response rate was 81%. The inter-item reliability, according to Cronbach’s alpha was 0.81 with strongest agreement for statements related to learning new skills, training new residents and the positive impact on patient safety and learning.   There was less strong agreement for maintenance of skills, improving team functioning and reducing teaching in the operating room. Interview results confirmed those themes from the survey and highlighted inconsistencies for identified perceived barriers and a focus on acquisition of skills only.  Interview responses specified concerns with integrating simulation into existing curricula and the need for more evaluation as a robust educational strategy.Conclusion: The findings were summarized in four themes: 1) use of simulation, 2) integration into curriculum, 3) leadership, and 4) understanding gaps in simulation use. This study exemplifies a mixed-methods approach to planning a surgical simulation program through a general needs assessment

Musculoskeletal education: a curriculum evaluation at one university

<p>Abstract</p> <p>Background</p> <p>The increasing burden of illness related to musculoskeletal diseases makes it essential that attention be paid to musculoskeletal education in medical schools. This case study examines the undergraduate musculoskeletal curriculum at one medical school.</p> <p>Methods</p> <p>A case study research methodology used quantitative and qualitative approaches to systematically examine the undergraduate musculoskeletal course at the University of Calgary (Alberta, Canada) Faculty of Medicine. The aim of the study was to understand the strengths and weaknesses of the curriculum guided by four questions: (1) Was the course structured according to standard principles for curriculum design as described in the Kern framework? (2) How did students and faculty perceive the course? (3) Was the assessment of the students valid and reliable? (4) Were the course evaluations completed by student and faculty valid and reliable?</p> <p><b>Results</b></p> <p>The analysis showed that the structure of the musculoskeletal course mapped to many components of Kern's framework in course design. The course had a high level of commitment by teachers, included a valid and reliable final examination, and valid evaluation questionnaires that provided relevant information to assess curriculum function. The curricular review identified several weaknesses in the course: the apparent absence of a formalized needs assessment, course objectives that were not specific or measurable, poor development of clinical presentations, small group sessions that exceeded normal 'small group' sizes, and poor alignment between the course objectives, examination blueprint and the examination. Both students and faculty members perceived the same strengths and weaknesses in the curriculum. Course evaluation data provided information that was consistent with the findings from the interviews with the key stakeholders.</p> <p>Conclusions</p> <p>The case study approach using the Kern framework and selected questions provided a robust way to assess a curriculum, identify its strengths and weaknesses and guide improvements.</p

The validity of a behavioural multiple-mini-interview within an assessment centre for selection into specialty training

Background Entry into specialty training was determined by a National Assessment Centre (NAC) approach using a combination of a behavioural Multiple-Mini-Interview (MMI) and a written Situational Judgement Test (SJT). We wanted to know if interviewers could make reliable and valid decisions about the non-cognitive characteristics of candidates with the purpose of selecting them into general practice specialty training using the MMI. Second, we explored the concurrent validity of the MMI with the SJT. Methods A variance components analysis estimated the reliability and sources of measurement error. Further modelling estimated the optimal configurations for future MMI iterations. We calculated the relationship of the MMI with the SJT. Results Data were available from 1382 candidates, 254 interviewers, six MMI questions, five alternate forms of a 50-item SJT, and 11 assessment centres. For a single MMI question and one assessor, 28% of the variance between scores was due to candidate-to-candidate variation. Interviewer subjectivity, in particular the varying views that interviewer had for particular candidates accounted for 40% of the variance in scores. The generalisability co-efficient for a six question MMI was 0.7; to achieve 0.8 would require ten questions. A disattenuated correlation with the SJT (r = 0.35), and in particular a raw score correlation with the subdomain related to clinical knowledge (r = 0.25) demonstrated evidence for construct and concurrent validity. Less than two per cent of candidates would have failed the MMI. Conclusion The MMI is a moderately reliable method of assessment in the context of a National Assessment Centre approach. The largest source of error relates to aspects of interviewer subjectivity, suggesting enhanced interviewer training would be beneficial. MMIs need to be sufficiently long for precise comparison for ranking purposes. In order to justify long term sustainable use of the MMI in a postgraduate assessment centre approach, more theoretical work is required to understand how written and performance based test of non-cognitive attributes can be combined, in a way that achieves acceptable generalizability, and has validity

Letters to the Editor Regarding NASW Press Censorship Issue

LETTERS TO THE EDITOR REGARDING NASW PRESS CENSORSHIP Marcia B. Cohen, Co-editor, Journal of Progressive Human Services Richard Hoefer, Editor, Journal of Policy Practice Tony Tripodi, Former Editor of Social Work Research Former Co-editor of Journal of Social Work Research and Evaluation Stanley L. Witkin, Former Editor-in-Chief, Social Work Elizabeth J. Clark, Executive Director, National Association of Social Workers (NASW

The Rice Haptic Rocker: Skin stretch haptic feedback with the Pisa/IIT SoftHand

Touch provides an important cue to perceive the physical properties of the external objects. Recent studies showed that tactile sensation also contributes to our sense of hand position and displacement in perceptual tasks. In this study, we tested the hypothesis that, sliding our hand over a stationary surface, tactile motion may provide a feedback for guiding hand trajectory. We asked participants to touch a plate having parallel ridges at different orientations and to perform a self-paced, straight movement of the hand. In our daily-life experience, tactile slip motion is equal and opposite to hand motion. Here, we used a well-established perceptual illusion to dissociate, in a controlled manner, the two motionestimates. According to previous studies, this stimulus produces a bias in the perceived direction of tactile motion, predicted by tactile flow model. We showed a systematic deviation in the movement of the hand towards a direction opposite to the one predicted by tactile flow, supporting the hypothesis that touch contributes to motor control of the hand. We suggested a model where the perceived hand motion is equal to a weighted sum of the estimate from classical proprioceptive cues (e.g., from musculoskeletal system) and the estimate from tactile slip

Deformation gradients imprint the direction and speed of en masse fibroblast migration for fast healing

En masse cell migration is more relevant than single cell migration in physiological processes of tissue formation, such as embryogenesis, morphogenesis and wound healing. In these situations, cells are influenced by the proximity of other cells including interactions facilitated by substrate mechanics. Here we found that when fibroblasts migrated en masse over a hydrogel, they established a well-defined deformation field by traction forces and migrated along a trajectory defined by field gradients. The mechanics of the hydrogel determined the magnitude of the gradient. For materials stiff enough to withstand deformation related to cellular traction forces, such patterns did not form. Furthermore, migration patterns functioned poorly on very soft matrices where only a minimal traction gradient could be established. The largest degree of alignment and migration velocity occurred on the gels with the largest gradients. Granulation tissue formation in punch wounds of juvenile pigs was correlated strongly with the modulus of the implanted gel in agreement with in vitro en masse cell migration studies. These findings provide basic insight into the biomechanical influences on fibroblast movement in early wounds and relevant design criteria for development of tissue-engineered constructs that aim to stimulate en masse cell recruitment for rapid wound healing

Hearing-in-Noise Benefits After Bilateral Simultaneous Cochlear Implantation Continue to Improve 4 Years After Implantation

The purpose of this 4-year longitudinal study was to assess the stability of the binaural benefits of head shadow, summation, and squelch for bilateral cochlear implant recipients and to quantify these benefits for the understanding of speech in noise

OA 06.08 Is Lung Cancer Screening Associated with a Negative Psychological Impact?

Background: Lung cancer screening can reduce lung cancer mortality by 20%. It is currently recommended in the USA, but not in the UK and ensuring any potential psychological harm is minimized is important. Current evidence is limited to the psychological impact of CT lung cancer screening. This study assesses psychological responses in the Early Cancer Detection Test - Lung Cancer Scotland Study (ECLS Study), whose participants have a tumor antibody blood test (Early CDT®-Lung test) and CT scans only for those with positive blood tests. Method: ECLS study participants were randomized to an Early CDT®-Lung test group or a control group. A sample (n=1032) participated in a nested psychological outcomes study. Questionnaires measured psychological responses (positive and negative affect scale (PANAS), lung cancer worry scale (LCWS) and impact of events scale (IES)) at baseline and 1, 3, 6 and 12 months post-trial recruitment. Psychological responses over time were assessed using multilevel modelling and compared between those in the control group, the test-positive group and the test-negative group. Result: In total, 350, 361 and 321 participants were in the control, test-negative and test-positive groups respectively. Follow-up questionnaire completion rates were ≥90% at all time-points. Baseline psychological measures did not differ significantly between groups. Significant differences were found between PANAS scores, but absolute differences between the groups were very small and unlikely to be clinically significant. The IES avoidance and intrusion scores were significantly higher in the positive than the negative group at all time-points and at 1, 3 and 6 months respectively. However, median scores for both subscales at all the time-points were in the subclinical range. Anxiety about future tests and treatment at 1 month was significantly higher in the test-positive group than the control (OR (95%CI) 3.55 (1.70, 7.41)), or the negative group (OR (95%CI) 5.74 (2.69, 12.2)). Worry about getting lung cancer in the future was significantly higher in the test-positive than the test-negative group at 1 month (OR (95%CI) 2.61 (1.35, 5.02)), 3 months (OR (95%CI) 2.52 (1.30, 4.87)) and 6 months ((OR (95%CI) 2.98 (1.53, 5.82)). Conclusion: Lung cancer screening using a blood test followed by CT scanning for test-positive individuals does not appear to impact on affect, intrusive thoughts or avoidant behavior to a clinically important degree. However, anxiety about future tests and treatment and future worry about lung cancer needs to be addressed if lung cancer screening is implemented in the UK