176 research outputs found
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Variability in passing standards for graduation-level knowledge questions across UK Medical Schools
Given the absence of a common passing standard for students at UK medical schools, this paper compares independently
-set standards for common “1 from 5” single-best answer (multiple choice) items used in graduation-level applied knowledge examinations and explores potential reasons for any differences.
: A repeated cross-sectional study, with participating schools sent a common set of graduation-level items (55 in 2013/14; 60 in 2014/1 5). Items were selected against a blueprint and underwent a quality review process. Each school employed their own standard setting process for the common items. The primary outcome was the passing standard for the common items for each medical school using the Angoff or Ebel methods.
: 22 (of 31 invited) medical schools participated in 2013/14 (71%) and 30 (97%) in 2014/15. Schools used a mean of 49 and 53 common items in 2013/14 and 2014/5 respectively; around one-third of the items in the examinations in which they were embedded. Data from 19 (61%) and 26 (84%) schools respectively met inclusion criteria for comparison of standards. There were statistically significant differences in the passing standard set by schools in both years (effect size (f) 0.041 in 2013/14 and 0.218 in 2014/15, both p<0.001). The inter-quartile range of standards was 5.7 percentage points in 2013/14 and 6.5 percentage points in 2014/15. There was a positive correlation between the relative standards set by schools in the two years (Pearson’s r=0.57, n=18, p=0.014). Time allowed per item, method of standard setting and timing of exam in the curriculum did not have a statistically significant impact on standards.
: Independently-set standards for common single-best answer items used in graduation-level examinations vary between UK medical schools. Further work to examine standard setting processes in more detail is needed to help to explain this variability and develop methods to help reduce it.This study was funded by the Medical Schools Council Assessment Alliance (MSCAA)
Motor competence assessments for children with intellectual disabilities and/or autism: a systematic review.
Objective: Gross motor competence is essential for daily life functioning and participation in physical activities. Prevalence of gross motor competence in children with intellectual disabilities (ID) and/or autism is unclear. This systematic review aimed to identify appropriate assessments for children with ID and/or autism. Design & data sources: An electronic literature search was conducted using the EBSCOhost platform searching MEDLINE, Education Research Complete, ERIC, CINAHL Plus and SPORTDiscus databases. Eligibility criteria: Included studies sampled children with ID and/or autism aged between 1 and 18 yrs, used field-based gross motor competence assessments, reported measurement properties, and were published in English. The utility of assessments were appraised for validity, reliability, responsiveness and feasibility. Results: The initial search produced 3182 results, with 291 full text articles screened. 13 articles including 10 assessments of motor competence were included in this systematic review. There was limited reporting across measurement properties, mostly for responsiveness and some aspects of validity. The Bruininks-Oseretsky Test of Motor Proficiency-2 followed by The Test of Gross Motor Development-2 demonstrated the greatest levels of evidence for validity and reliability. Feasibility results were varied, most instruments required little additional equipment (n=8) and were suitable for a school setting, but, additional training (n=7) was needed to score and interpret the results. Conclusion: This review found the BOT-2 followed by the TGMD-2 to be the most psychometrically appropriate motor competency assessments for children with ID and/or autism in field-based settings. Motor competence assessment research is limited for these cohorts and more research is needed
Walk well:a randomised controlled trial of a walking intervention for adults with intellectual disabilities: study protocol
Background - Walking interventions have been shown to have a positive impact on physical activity (PA) levels, health and wellbeing for adult and older adult populations. There has been very little work carried out to explore the effectiveness of walking interventions for adults with intellectual disabilities. This paper will provide details of the Walk Well intervention, designed for adults with intellectual disabilities, and a randomised controlled trial (RCT) to test its effectiveness. Methods/design - This study will adopt a RCT design, with participants allocated to the walking intervention group or a waiting list control group. The intervention consists of three PA consultations (baseline, six weeks and 12 weeks) and an individualised 12 week walking programme. A range of measures will be completed by participants at baseline, post intervention (three months from baseline) and at follow up (three months post intervention and six months from baseline). All outcome measures will be collected by a researcher who will be blinded to the study groups. The primary outcome will be steps walked per day, measured using accelerometers. Secondary outcome measures will include time spent in PA per day (across various intensity levels), time spent in sedentary behaviour per day, quality of life, self-efficacy and anthropometric measures to monitor weight change. Discussion - Since there are currently no published RCTs of walking interventions for adults with intellectual disabilities, this RCT will examine if a walking intervention can successfully increase PA, health and wellbeing of adults with intellectual disabilities
Associations between motor competence and physical activity levels of children with intellectual disabilities and/or autism spectrum disorder: Movement matters
Motor competence is important for lifelong physical activity (PA). The current study aimed to examine associations between PA and motor competence. In total, 43 children aged 7–12 years with intellectual disabilities and/or autism spectrum disorder completed anthropometric measures, the Bruininks-Oseretsky Test of Motor Proficiency-2, and wore a wrist accelerometer to capture total PA, moderate-to-vigorous PA (MVPA), average acceleration, and intensity gradient. No significant associations were found between PA outcomes and motor competence. Motor competence performance was commonly ‘below average’ or ‘average’. The weakest subtests were upper limb coordination and strength. The strongest subtest was running speed and agility. Total weekly MVPA was 336.1 ± 150.3 min, higher than UK recommendations of 120-180 per week for disabled children and young people. Larger scale studies are needed to better understand the relationship between PA and motor competence. Future research should also consider the influence of environmental factors on PA in this group
Weight management interventions in adults with intellectual disabilities and obesity: a systematic review of the evidence
o evaluate the clinical effectiveness of weight management interventions in adults with intellectual disabilities (ID) and obesity using recommendations from current clinical guidelines for the first line management of obesity in adults. Full papers on lifestyle modification interventions published between 1982 to 2011 were sought by searching the Medline, Embase, PsycINFO and CINAHL databases. Studies were evaluated based on 1) intervention components, 2) methodology, 3) attrition rate 4) reported weight loss and 5) duration of follow up. Twenty two studies met the inclusion criteria. The interventions were classified according to inclusion of the following components: behaviour change alone, behaviour change plus physical activity, dietary advice or physical activity alone, dietary plus physical activity advice and multi-component (all three components). The majority of the studies had the same methodological limitations: no sample size justification, small heterogeneous samples, no information on randomisation methodologies. Eight studies were classified as multi-component interventions, of which one study used a 600 kilocalorie (2510 kilojoule) daily energy deficit diet. Study durations were mostly below the duration recommended in clinical guidelines and varied widely. No study included an exercise program promoting 225–300 minutes or more of moderate intensity physical activity per week but the majority of the studies used the same behaviour change techniques. Three studies reported clinically significant weight loss (≥ 5%) at six months post intervention. Current data indicate weight management interventions in those with ID differ from recommended practice and further studies to examine the effectiveness of multi-component weight management interventions for adults with ID and obesity are justified
Targeted prevention of common mental health disorders in university students: randomised controlled trial of a transdiagnostic trait-focused web-based intervention
Background:
A large proportion of university students show symptoms of common mental disorders, such as depression, anxiety, substance use disorders and eating disorders. Novel interventions are required that target underlying factors of multiple disorders.<p></p>
Aims:
To evaluate the efficacy of a transdiagnostic trait-focused web-based intervention aimed at reducing symptoms of common mental disorders in university students.<p></p>
Method:
Students were recruited online (n = 1047, age: M = 21.8, SD = 4.2) and categorised into being at high or low risk for mental disorders based on their personality traits. Participants were allocated to a cognitive-behavioural trait-focused (n = 519) or a control intervention (n = 528) using computerised simple randomisation. Both interventions were fully automated and delivered online (trial registration: ISRCTN14342225). Participants were blinded and outcomes were self-assessed at baseline, at 6 weeks and at 12 weeks after registration. Primary outcomes were current depression and anxiety, assessed on the Patient Health Questionnaire (PHQ9) and Generalised Anxiety Disorder Scale (GAD7). Secondary outcome measures focused on alcohol use, disordered eating, and other outcomes.<p></p>
Results:
Students at high risk were successfully identified using personality indicators and reported poorer mental health. A total of 520 students completed the 6-week follow-up and 401 students completed the 12-week follow-up. Attrition was high across intervention groups, but comparable to other web-based interventions. Mixed effects analyses revealed that at 12-week follow up the trait-focused intervention reduced depression scores by 3.58 (p<.001, 95%CI [5.19, 1.98]) and anxiety scores by 2.87 (p = .018, 95%CI [1.31, 4.43]) in students at high risk. In high-risk students, between group effect sizes were 0.58 (depression) and 0.42 (anxiety). In addition, self-esteem was improved. No changes were observed regarding the use of alcohol or disordered eating.<p></p>
Conclusions
This study suggests that a transdiagnostic web-based intervention for university students targeting underlying personality risk factors may be a promising way of preventing common mental disorders with a low-intensity intervention
Assessment of Objectively Measured Physical Activity Levels in Individuals with Intellectual Disabilities with and without Down's Syndrome
Objective: To investigate, using accelerometers, the levels of physical activity being undertaken by individuals with intellectual disabilities with and without Down’s syndrome. Methods: One hundred and fifty two individuals with intellectual disabilities aged 12–70 years from East and South-East England. Physical activity levels in counts per minute (counts/min), steps per day (steps/day), and minutes of sedentary, light, moderate, vigorous, and moderate to vigorous physical activity (MVPA) measured with a uni-axial accelerometer (Actigraph GT1M) for seven days. Results: No individuals with intellectual disabilities met current physical activity recommendations. Males were more active than females. There was a trend for physical activity to decline and sedentary behaviour to increase with age, and for those with more severe levels of intellectual disability to be more sedentary and less physically active, however any relationship was not significant when adjusted for confounding variables. Participants with Down’s syndrome engaged in significantly less physical activity than those with intellectual disabilities without Down’s syndrome and levels of activity declined significantly with age. Conclusions: Individuals with intellectual disabilities, especially those with Down’s syndrome may be at risk of developing diseases associated with physical inactivity. There is a need for well-designed, accessible, preventive health promotio
The impact of social deprivation on mortality following acute myocardial infarction, stroke or subarachnoid haemorrhage: a record linkage study
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