Mortality from head injury over four decades in Scotland

Although the causes of head injury, the population at risk and approaches to prevention and treatment are continually evolving, there is little information about how these are reflected in patterns of mortality over time. We used population based comprehensive data uniquely available in Scotland to investigate changes in the total numbers of deaths from 1974 to 2012, as well as the rates of head injury death, from different causes, overall and in relation to age and gender. Total mortality fell from an annual average of 503 to 339 with a corresponding annual decrease in rate from 9.6 to 6.4 per 100,000 population, the decline substantially occurring between 1974 and 1990. Deaths in children fell strikingly but rose in older people. Deaths in males fell to a greater extent than females but remained at a higher rate overall. Initially, a transport accident accounted for most deaths but these fell by 80%, from 325 per year to 65 per year over the 39 year period. Deaths from falling and all other causes did not decline, coming to outnumber transport accident deaths by 1998, which accounts for the overall absence of change in total mortality in recent years. In order to reduce mortality in the future, more effective measures to prevent falls are needed and these strategies will vary in younger adults (where alcohol is often a factor), and in older adults where infirmity can be a cause. In addition, measures to sustain reductions in transport accidents need to be maintained and further developed

Community College Faculty Self-Efficacy in Student Centered Teaching

The purpose of this study was to investigate if faculty self-efficacy beliefs impacted their choice of teaching methods in the classroom. Self-efficacy beliefs help to explain teacher instructional activities and their orientation toward the education process. Findings have implications for higher education as the strategies faculty use in the classroom are linked to student success

Are routinely collected NHS administrative records suitable for endpoint identification in clinical trials? Evidence from the West of Scotland coronary prevention study

Background: Routinely collected electronic patient records are already widely used in epidemiological research. In this work we investigated the potential for using them to identify endpoints in clinical trials.<p></p> Methods: The events recorded in the West of Scotland Coronary Prevention Study (WOSCOPS), a large clinical trial of pravastatin in middle-aged hypercholesterolaemic men in the 1990s, were compared with those in the record-linked deaths and hospitalisations records routinely collected in Scotland.<p></p> Results: We matched 99% of fatal study events by date. We showed excellent matching (97%) of the causes of fatal endpoint events and good matching (.80% for first events) of the causes of nonfatal endpoint events with a slightly lower rate of mismatching of record linkage than study events (19% of first study myocardial infarctions (MI) and 4% of first record linkage MIs not matched as MI). We also investigated the matching of non-endpoint events and showed a good level of matching, with .78% of first stroke/TIA events being matched as stroke/TIA. The primary reasons for mismatches were record linkage data recording readmissions for procedures or previous events, differences between the diagnoses in the routinely collected data and the conclusions of the clinical trial expert adjudication committee, events occurring outside Scotland and therefore being missed by record linkage data, miscoding of cardiac events in hospitalisations data as ‘unspecified chest pain’, some general miscoding in the record linkage data and some record linkage errors.<p></p> Conclusions: We conclude that routinely collected data could be used for recording cardiovascular endpoints in clinical trials and would give very similar results to rigorously collected clinical trial data, in countries with unified health systems such as Scotland. The endpoint types would need to be carefully thought through and an expert endpoint adjudication committee should be involved.<p></p&gt

Analysis of auditory functions in grades one, two, and three.

Thesis (Ed.M.)--Boston Universit

Quantitative Methods for Tracking Cognitive Change 3 Years After Coronary Artery Bypass Surgery

Background: The analysis and interpretation of change in cognitive function test scores after Coronary Artery Bypass Grafting (CABG). Longitudinal studies with multiple outcomes present considerable statistical challenges. Application of hierarchical linear statistical models can estimate the effects of a surgical intervention on the time course of multiple biomarkers. Methods: We use an analyze then summarize approach whereby we estimate the intervention effects separately for each cognitive test and then pool them, taking appropriate account of their statistical correlations. The model accounts for dropouts at follow-up, the chance of which may be related to past cognitive score, by implicitly imputing the missing data from individuals’ past scores and group patterns. We apply this approach to a study of the effects of CABG on the time course of cognitive function as measured by 16 separate neuropsychological test scores, clustered into 8 cognitive domains. The study includes measurements on 140 CABG patients and 92 nonsurgical controls at baseline, and 3, 12, and 36 months. Including a nonsurgical control group allows comparison of changes in cognition over time between the surgery group and patients with similar risk factors, controlling for potential effects of aging and vascular disease. Results: We find that CABG patients have very longitudinal changes from baseline in cognitive function similar to those observed for nonsurgical controls. Any small differences tend to favor greater improvement in CABG patients than in the nonsurgical controls. Conclusions: The methods used have application to a wide range of intervention studies in which multiple biomarkers are followed over time to quantify health effects. Software to implement the methods in commonly used statistical packages is available from the authors at http://www.biostat.jhsph.edu/research/software.shtml

Why Teach? Exploring the Motivations and Expectations of First-year, Alternatively Certified Agriscience Teachers

School-Based agricultural education increasingly depends upon alternatively certified (AC) teachers to teach agriculture across the United States. Understanding why these individuals become teachers is an important step to better recruit and retain educators who do not complete traditional preparation programs. The purpose of our study was to explore the backgrounds, motivations, and expectations of AC agriscience teachers joining the profession. Our study was guided by the social cognitive career theory and utilized a qualitative phenomenological approach. We interviewed seven AC agriscience teachers in Florida during their first-year teaching to explore their journey into teaching agricultural education. Six major themes were found, including background and interest in agriculture, positive teaching self-efficacy expectations, positive teaching outcome expectations, right location and right time, exciting but challenging, and more than expected. We recommend providing support programs tailored for AC agriscience teachers that are guided by the similar backgrounds, motivations, and expectations of AC teachers

tert-Butyl­dimethyl­silanol hemihydrate

The crystal structure of the title compound, C6H16OSi·0.5H2O, reveals an asymmetric unit containing two mol­ecules of the silanol and a single water mol­ecule. There is evidence of hydrogen bonding between the three mol­ecules in the asymmetric unit. The H atoms of the silanol OH groups and the water H atoms are each disordered equally over two positions

Associations between significant head injury in male juveniles in prison in Scotland UK and cognitive function, disability and crime: a cross sectional study

Background: Although the prevalence of head injury is estimated to be high in juveniles in prison, the extent of persisting disability is unknown and relationships with offending uncertain. This limited understanding makes it difficult to develop effective management strategies and interventions to improve health or reduce recidivism. This study investigates effects of significant head injury (SHI) on cognitive function, disability and offending in juvenile prisoners, and considers relationships with common comorbidities. Methods: This cross-sectional study recruited male juvenile prisoners in Scotland from Her Majesty’s Young Offenders Institute (HMYOI) Polmont (detaining approximately 305 of 310 male juveniles in prison in Scotland). To be included juveniles had to be 16 years or older, fluent in English, able to participate in assessment, provide informed consent and not have a severe acute disorder of cognition or communication. Head injury, cognition, disability, history of abuse, mental health and problematic substance use were assessed by interview and questionnaire. Results: We recruited 103 (34%) of 305 juvenile males in HMYOI Polmont. The sample was demographically representative of juvenile males in prisons for young offenders in Scotland. SHI was found in 82/103 (80%) and head injury repeated over long periods of time in 69/82 (85%). Disability was associated with SHI in 11/82 (13%) and was significantly associated with mental health problems, particularly anxiety. Group differences on cognitive tests were not found. However the SHI group reported poorer behavioural control on the Dysexecutive Questionnaire and were more often reported for incidents in prison than those without SHI. Characteristics of offending, including violence, did not differ between groups. Conclusions: Although SHI is highly prevalent in juvenile prisoners, associated disability was relatively uncommon. There was no evidence for differences in cognitive test performance or offending in juveniles with and without SHI. However, signs of poorer behavioural control and greater psychological distress in juveniles with SHI suggest that they may be at greater risk of recidivism and of potentially becoming lifelong offenders. This implies a need for remedial programmes for juvenile prisoners to take account of persisting effects of SHI on mental health and self-control and education and to improve their understanding of the effects of SHI reduce the likelihood of cumulative effects from further SHI