Preliminary psychometric characteristics of the critical thinking self-assessment scale

Critical thinking skills (CTS) have been conceptualized as having six core cognitive skills as purported by the American Philosophical Association (APA) through a Delphi survey. The APA report further provided directions for teaching - learning and evaluation of these cognitive skills. This scale construction study was based on the APA critical thinking skills construct definition. Using the APA evaluation directions as a guide, this researcher developed a self assessment scale for measuring the CTS of undergraduate nursing students with the intention of assisting students in developing and improving their thinking skills. The construction of the scale was based on Cronbach’s Generalizability theory, and used Messick’s (1990) unitary concept of construct validity framework for evaluating the psychometric properties of the scale. The researcher developed 196 peer reviewed items for the Critical Thinking Self Assessment Scale (CTSAS) and the scale was subjected to experts’ ratings to establish content relevance and representativeness of the items to the construct. Seventeen experts from different disciplines reviewed the items and rated the items as 3 or 4 if the items defined the construct. Mean, Median, range and Content Validity Index (I-CVI) and Aiken’s Content Validity Coefficient (VIk) were computed to retain, modify or reject the items. The decision criteria for retaining the items included a value of VIk significant at p < 0.05, a value of I-CVI ≥ 0.75, and a range value of < 2.75 for the ‘0 to 5’ rating continuum. Statistical analysis of the item ratings resulted in reducing 196 items to 115. Following the rigorous content validation process, the 115 item CTSAS was tested through two developmental samples; one of 887 undergraduate nursing students from five Colleges of Nursing from Mahatma Gandhi University of Kerala State, India, and the second 144 undergraduate students from the College of Nursing, University of Saskatchewan, Canada. The questionnaire booklet also included an 18 item Need for Cognition Scale (NCS-SF) developed by Cacioppo and Petty (1982) for testing convergent validity of CTSAS. Exploratory data screening for the participants’ responses resulted in the deletion of four items (both the samples showed similar results in these 4 items) and 19 cases from the Indian sample, which were either missing, skewed or outliers. The remaining 111 items were analyzed for internal consistency reliability with both Indian and Canadian samples and stability reliability with the retested Indian sample (251). Exploratory Factor Analysis (EFA) using Principal Component Analysis (PCA) with varimax and oblimin rotations was run for the six core scales separately, which were classified into 16 sub scales, with the Indian sample (868). This resulted in reducing 111 items to 90 items across 14 subscales. Two of the subscales failed to emerge in EFA. The item loadings to factors demonstrated homogeneity and loaded independently with large loading weights. The items loading were mostly consistent with the pre-designated scales. The EFA retained 90 items were fixed in six path diagrams in the Analysis of Moment Structure (AMOS, added program in SPSS-PASW Statistics 18) graphics and Confirmatory Factor Analysis (CFA) was run with the 144 Canadian sample for each of the core scales to see the model fit. Three of the six core scales demonstrated acceptable goodness of fit indices and the remaining three reached almost reasonable to close fit. The Maximum Likelihood (ML) estimation-minimum discrepancy function-χ2 values were significant for all six core scales. However, the three model fit scales had a ratio of χ2 to degrees of freedom (CMIN / df) < 2 indicating good model fit. The Null hypothesis “not - close fit” (H0 = Ԑ ≥ 0.05) was rejected in favour of the research hypothesis and it may be concluded that fit of the model in the population is close (i.e., Ԑ ≤ 0.05). The fit indices for the three core scales - Interpretation, Evaluation, and Inference, strongly supported the structural fidelity of the three core scales, and it is plausible to replicate similar findings in a comparable population. The results also supported the APA critical thinking construct definition for the three cognitive skills. All the core scales revealed a reliability value ≥ 0.80 for the core scales. Some of the subscales achieved lower levels of correlation, but none were lower than 0.60. The total scale had very good internal consistency reliability; Cronbach α for the Indian sample was 0.961 and for the Canadian sample 0.975, and had high levels of communalities required for reducing the length of the scale. However, EFA and CFA gave strong results indicating further testing and analyzing the scale was necessary to refine the items. The convergent validity of the CTSAS tested with NCS-SF found significant correlations for five of the six core scales. The main limitation of the study was inadequate sample size for performing CFA. The socio-cultural influence on critical thinking was not tested. The study examined only some aspects of Messick’s unitary concept of construct validity for establishing the psychometric of the CTSAS. However, the preliminary psychometrics results of the study were very appealing and the researcher is encouraged to further examine the usability of the scale and ensuring socio-cultural relevance of the CTSAS

Edible oysters — Present status of product development and domestic market potential in India

The fishery for oyster is worldwide. Extensive scientific studies on this species have taken place in our country also and the fishery, though in a moderate scale, is in existence along the coasts of Maharashtra and Kerala

Effectiveness of non-invasive ventilation in patients with type 2 respiratory failure

Background: Assess the use of non-invasive ventilation as an alternative way for ventilation in acute respiratory failure, determine factors that can predict the successful use of NIV, evaluate factors hindering success of NIV.Methods: Thirty hospitalised patients fulfilling inclusion criteria, diagnosed with Type II Respiratory Failure on ABG were recruited after obtaining an informed written consent. Complete history and detailed physical examination were followed by routine investigations.Results: Comparison of the pH on admission with the pH after 1st hour of NIV, the latter showed statistically significant improvement. Drop in PaCo2 and rise in PaO2 on ABG from admission and after stopping NIV was statistically significant. Patients with lower MMRC grade and severe cough showed significant improvement in pH, however patient with higher emergency visits and past hospitalisation showed less improvement in pH, after 1 hour of NIV therapy. A total 4 patients were intubated, with mean pH of 7.22, 3 out of them had higher emergency visits, 2 out of them had ICU admission.Conclusions: NIV treatment for COPD with type II respiratory failure avoids intubation, reduces complications and should be considered as first line therapy instead of ET intubation. Lower mMRC grade, lesser hospitalizations, lesser emergency visits, higher BMI, symptoms like cough, can have a positive predictive value for the outcome of NIV

Bronchiectasis in India:results from the European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) and Respiratory Research Network of India Registry

BACKGROUND: Bronchiectasis is a common but neglected chronic lung disease. Most epidemiological data are limited to cohorts from Europe and the USA, with few data from low-income and middle-income countries. We therefore aimed to describe the characteristics, severity of disease, microbiology, and treatment of patients with bronchiectasis in India. METHODS: The Indian bronchiectasis registry is a multicentre, prospective, observational cohort study. Adult patients ( 6518 years) with CT-confirmed bronchiectasis were enrolled from 31 centres across India. Patients with bronchiectasis due to cystic fibrosis or traction bronchiectasis associated with another respiratory disorder were excluded. Data were collected at baseline (recruitment) with follow-up visits taking place once per year. Comprehensive clinical data were collected through the European Multicentre Bronchiectasis Audit and Research Collaboration registry platform. Underlying aetiology of bronchiectasis, as well as treatment and risk factors for bronchiectasis were analysed in the Indian bronchiectasis registry. Comparisons of demographics were made with published European and US registries, and quality of care was benchmarked against the 2017 European Respiratory Society guidelines. FINDINGS: From June 1, 2015, to Sept 1, 2017, 2195 patients were enrolled. Marked differences were observed between India, Europe, and the USA. Patients in India were younger (median age 56 years [IQR 41-66] vs the European and US registries; p&lt;0\ub70001]) and more likely to be men (1249 [56\ub79%] of 2195). Previous tuberculosis (780 [35\ub75%] of 2195) was the most frequent underlying cause of bronchiectasis and Pseudomonas aeruginosa was the most common organism in sputum culture (301 [13\ub77%]) in India. Risk factors for exacerbations included being of the male sex (adjusted incidence rate ratio 1\ub717, 95% CI 1\ub703-1\ub732; p=0\ub7015), P aeruginosa infection (1\ub729, 1\ub710-1\ub750; p=0\ub7001), a history of pulmonary tuberculosis (1\ub720, 1\ub707-1\ub734; p=0\ub7002), modified Medical Research Council Dyspnoea score (1\ub732, 1\ub725-1\ub739; p&lt;0\ub70001), daily sputum production (1\ub716, 1\ub703-1\ub730; p=0\ub7013), and radiological severity of disease (1\ub703, 1\ub701-1\ub704; p&lt;0\ub70001). Low adherence to guideline-recommended care was observed; only 388 patients were tested for allergic bronchopulmonary aspergillosis and 82 patients had been tested for immunoglobulins. INTERPRETATION: Patients with bronchiectasis in India have more severe disease and have distinct characteristics from those reported in other countries. This study provides a benchmark to improve quality of care for patients with bronchiectasis in India. FUNDING: EU/European Federation of Pharmaceutical Industries and Associations Innovative Medicines Initiative inhaled Antibiotics in Bronchiectasis and Cystic Fibrosis Consortium, European Respiratory Society, and the British Lung Foundation

Idiopathic pulmonary fibrosis with bronchogenic carcinoma

Idiopathic pulmonary fibrosis is essentially a benign disease. We present a case of 65-year-old female patient who presented with left-sided chest pain and breathlessness. Her CT thorax revealed idiopathic pulmonary fibrosis along with a left-sided pleural-based mass. Biopsy of the mass revealed a squamous cell carcinoma. She was exposed to home wood smoke while cooking on the <i>chulla</i> for many years, which was possibly responsible for both the diseases

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Not AvailableInvestigations were carried out to study the effect of precooling and preservative chemicals on post harvest longevity of the florets of tuberose (Polianthes tuberosa L.) cv. Prajwal. The effect of precooling of tuberose florets in combination with four chemical treatments were studied and observations were recorded based on quality parameters like freshness of the florets, colour retention, physiological loss in weight and days to fifty per cent wilting. Pre-cooling of flower buds was found to improve the longevity (shelf life) of flower buds. Soaking of florets in 4 % Boric acid solution for two hours and air drying them before packing increased the shelf life up to six days.Not Availabl

Endobronchial tuberculosis mimicking malignancy

Endobronchial tuberculosis has a very varied presentation. Diagnosis is often very challenging as typical radiological features are absent and sputum smear for acid-fast bacilli is often negative. However, detection is essential as it may lead to long-term sequelae such as bronchial stenosis. Bronchoscopy is a very useful investigation in such cases. Our case is a rare manifestation of endobronchial tuberculosis as it mimicked malignancy

HAEMOPTYSIS - A RARE PRESENTATION OF AORTIC ANE URYSM

We report a case of a 65 year old man who presented with haemoptysis. X-ray chest PA view shows mediastinal widening suggestive of mediastinal mass. A CT scan of thorax shows a large aneurysm of ascending aorta & arch of aorta. This an-eurysm is eroding the trachea and abutting the sternum and vertebrae