Adaptation and Validation of the Tamil (Sri Lanka) Version ofthe Montreal Cognitive Assessment

The study aimed to develop the Tamil (Sri Lanka) version of the Montreal Cognitive Assessment (MoCA) and investigate its reliability and validity as a briefscreening tool for mild cognitive impairment (MCI). Tamil-speaking Sri Lankan elderly with normal cognition and MCI were recruited from a neurology clinic.Adaptation of the English MoCA to the Tamil (Sri Lanka) involved context-specific content modification and translation. The content validity, reliability, sensitivity,and specificity of the tool were evaluated. Study participants were 184 older adults, comprising 85 with normal cognition and 99 neurologist-diagnosed MCI.The tool had high internal consistency (Cronbach's alpha = 0.83). Receiver operating characteristic curve analyses showed an area under the curve of 0.87(95% CI = 0.83 - 0.91) for detecting MCI. The optimal cut-off score for detection of MCI was 23/24, yielded a sensitivity and specificity of 84.7% and 76.4%,respectively. The Tamil (Sri Lankan) version of the MoCA maintains its core diagnostic properties rendering it a valid and reliable tool for screening of MCIamong Tamil speaking Sri Lankan older adults.

Body Image and Body Satisfaction Differ by Race in Overweight Postpartum Mothers

Body image (BI) and body satisfaction may be important in understanding weight loss behaviors, particularly during the postpartum period. We assessed these constructs among African American and white overweight postpartum women

Metode Nonlinear Least Square (NLS) Untuk Estimasi Parameter Model Wavelet Radial Basis Neural Network (WRBNN)

The use of wavelet radial basis model for forecasting nonlinear time series is introduced in this paper. The model is generated by artificial neural network approximation under restriction that the activation function on the hidden layers is radial basis. The current model is developed from the multiresolution autoregressives (MAR) model, with addition of radial basis function in the hidden layers. The power of model is compared to the other nonlinear model existed before, such as MAR model and Generalized Autoregressives Conditional Heteroscedastic (GARCH) model. The simulation data which be generated from GARCH process is applied to support the aim of research. The sufficiency of model is measured by sum squared of error (SSE). The computation results show that the proposed model has a power as good as GARCH model to carry on the heteroscedastic process

Primary care multidisciplinary teams in practice: a qualitative study.

BACKGROUND: Current recommendations for strengthening the US healthcare system consider restructuring primary care into multidisciplinary teams as vital to improving quality and efficiency. Yet, approaches to the selection of team designs remain unclear. This project describes current primary care team designs, primary care professionals' perceptions of ideal team designs, and perceived facilitating factors and barriers to implementing ideal team-based care. METHODS: Qualitative study of 44 health care professionals at 6 primary care practices in North Carolina using focus group discussions and surveys. Data was analyzed using framework content analysis. RESULTS: Practices used a variety of multidisciplinary team designs with the specific design being influenced by the social and policy context in which practices were embedded. Practices overwhelmingly located barriers to adopting ideal multidisciplinary teams as being outside of their individual practices and outside of their control. Participants viewed internal organizational contexts as the major facilitators of multidisciplinary primary care teams. The majority of practices described their ideal team design as including a social worker to meet the needs of socially complex patients. CONCLUSIONS: Primary care multidisciplinary team designs vary across practices, shaped in part by contextual factors perceived as barriers outside of the practices' control. Facilitating factors within practices provide a culture of support to team members, but they are insufficient to overcome the perceived barriers. The common desire to add social workers to care teams reflects practices' struggles to meet the complex demands of patients and external agencies. Government or organizational policies should avoid one-size-fits-all approaches to multidisciplinary care teams, and instead allow primary care practices to adapt to their specific contextual circumstances.American Academy of Family Physicians Foundation’s Joint Grant Award Program [#G1401JG

Caregiving-related needs of family caregivers of older Singaporeans

10.1111/ajag.12370Australasian Journal on Ageing361143-14

Teaching clinical trials electronically

This ar ticle discusses the development, delivery and evaluation of an electronic extramural course, `Fundamentals of Clinical Tr ials’ , a CME course designed to reach physicians and health care researchers without easy access to a local university. Ten week-long modules of instruction were developed.These were based on a graduate course in clinical tr ials, standard textbook topics and additional course mater ials speci® cally developed for the course. Questions and course topics were to be discussed by the students, and each participant was encouraged to present an actual or proposed clinical tr ial to the vir tual class. Communication between students and tutors could be either `one to one’ or through a listserve, i.e. an automated mailing list available to all participants which copied and routed any message instantly to all participants. Ongoing evaluation of the course was accomplished by questions monitoring students’ attitudes and needs, and a more extensive on-line questionnaire administered at the end of the course. Ten students from four countr ies were accepted onto the course. Half of the students contr ibuted regularly and extensively, while the others tended to respond only when addressed directly.The students spent on average approximately 6 hours per week on the course. This differed little from regular classroom courses, but the students appreciated the ability to organize the course around their regular schedules.The students prefer red topics that encouraged discussion and differ ing opinions. From the instructors’ viewpoint, considerable time was required for course development and communication.This form of distance continuing medical education was preferr ed by all the students over regular cor respondence courses, as it allowed for more immediacy and interaction.However, the time required for developing and teaching courses over the Internet should not be underestimated

Maternal predictors of infant beverage consumption: Results from the Nurture cohort study

The goal of the present study was to estimate prevalence and maternal risk factors for infant beverage consumption.Design: Observational birth cohort.Setting: Central North Carolina, USA.Participants: Mothers 20-36 weeks pregnant were surveyed every 3 months through their infant\u27s first year (n 666) on their sociodemographics and infant\u27s consumption frequency of 100 % fruit and vegetable juices and sugar-sweetened-beverages (SSB). Repeated-measure models, using a compound symmetry covariance structure, were used to assess the association of sociodemographic and maternal predictors with introducing juice and SSB separately and explored interaction terms with time to determine how the effects of the predictors change over time.Results: On average, mothers were 28 years old, 72 % were non-Hispanic Black and 59 % were low-income. We found time by race, income, education, maternal age and breast-feeding duration interactions for both juice and SSB consumption. At approximately 6-7 months of age through 12 months of age, being Black, having a lower income (≤US 20 000 v. \u3eUS 20 000 per year) and education (less than high-school degree v. high-school degree or higher), being younger (\u3c26 years v. ≥26 years) and breast-feeding for fewer than 26 weeks were each associated with introduction of both juice and SSB consumption.Conclusions: Future efforts are needed to raise awareness on the importance of national recommendations of limiting juice and SSB for infants, together with decreasing disparities in unhealthy beverage intake early in life