Assessing medical student empathy in a family medicine clinical test: validity of the CARE measure

Introduction: The Consultation and Relational Empathy (CARE) measure developed and validated in primary care settings and used for general practitioner appraisal is a 10-item instrument used by patients to assess doctors’ empathy. The aim of this study is to investigate the validity of the CARE measure in assessing medical students’ empathy during a formative family medicine clinical test. Method: All 158 final-year medical students were assessed by trained simulated patients (SPs) – who completed the CARE measure, the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE), and a global rating score to assess students’ empathy and history-taking ability. Results: Exploratory and confirmatory factor analysis identified a unidimensional structure. The CARE measure strongly correlated with both convergent measures: global rating (ρ=0.79 and <0.001) and JSPPPE (ρ=0.77 and <0.001) and weakly correlated with the divergent measure: history-taking score (ρ=0.28 and <0.001). Internal consistency was excellent (Cronbach’s α=0.94). Conclusion: The CARE measure had strong construct and internal reliability in a formative, undergraduate family medicine examination. Its role in higher stakes examinations and other educational settings should be explored.published_or_final_versio

Single-channel electroencephalographic recording in children with developmental coordination disorder: Validity and influence of eye blink artifacts

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Protocol-directed Weaning in a Neurosurgical intensive Care Unit – a Pilot Study

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An International Reading Literacy Study: Factor Structure of the Chinese Version of the Student Questionnaire (PIRLS-SQCV 2011)

The student questionnaire (PIRLS-SQ 2011) of the Progress in International Reading Literacy Study (PIRLS) was designed to gather information from pupils on reading literacy development as to aspects of pupils’ self-lives, home, and school lives across countries/districts. In order to serve the purposes of research and international comparison, the questionnaire was translated into various languages. Using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), the current study investigates the psychometric properties of the Chinese version of the student questionnaire (PIRLS-SQCV 2011) and identifies its underlying factor structure among Chinese fourth-grade pupils in Hong Kong. A 10-factor structure model was identified and much resemblance could be drawn to the original PIRLS structure. While the similarity allows international comparisons of studies in different places following the PIRLS strategy, the findings of this study add to extant literature on the relationship between student factors and reading achievement.published_or_final_versio

Raf/MEK/MAPK signaling stimulates the nuclear translocation and transactivating activity of FOXM1c

The forkhead box (FOX) transcription factor FOXM1 is ubiquitously expressed in proliferating cells. FOXM1 expression peaks at the G2/M phase of the cell cycle and its functional deficiency in mice leads to defects in mitosis. To investigate the role of FOXM1 in the cell cycle, we used synchronized hTERT-BJ1 fibroblasts to examine the cell cycle-dependent regulation of FOXM1 function. We observed that FOXM1 is localized mainly in the cytoplasm in cells at late-G1 and S phases. Nuclear translocation occurs just before entry into the G2/M phase and is associated with phosphorylation of FOXM1. Consistent with the dependency of FOXM1 function on mitogenic signals, nuclear translocation of FOXM1 requires activity of the Raf/MEK/MAPK signaling pathway and is enhanced by the MAPK activator aurintricarboxylic acid. This activating effect was suppressed by the MEK1/2 inhibitor U0126. In transient reporter assays, constitutively active MEK1 enhances the transactivating effect of FOXM1c, but not FOXM1b, on the cyclin B1 promoter. RT-PCR analysis confirmed that different cell lines and tissues predominantly express the FOXM1c transcript. Mutations of two ERK1/2 target sequences within FOXM1c completely abolish the MEK1 enhancing effect, suggesting a direct link between Raf/MEK/MAPK signaling and FOXM1 function. Importantly, inhibition of Raf/MEK/MAPK signaling by U0126 led to suppression of FOXM1 target gene expression and delayed progression through G2/M, verifying the functional relevance of FOXM1 activation by MEK1. In summary, we provide the first evidence that Raf/MEK/MAPK signaling exerts its G2/M regulatory effect via FOXM1c.published_or_final_versio

Shoulder mobility, muscular strength and quality of life in breast cancer survivors with and without Tai Chi Qigong training

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Hospital Authority audit of the outcome of endoscopic resection of superficial upper gastro-intestinal lesions in Hong Kong

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Examining Factor Structure of the Chinese Version of the PIRLS 2011 Home Questionnaire

The home questionnaire of the Progress in International Reading Literacy Study (PIRLS-HQ 2011) was designed to gather information from parents or primary caregivers of fourth-grade pupils on their reading literacy development related to aspects of pupils’ home lives across countries/districts. The questionnaire was translated into different languages for international comparison and research purposes. This study aims to assess the psychometric properties of the Chinese version of the PIRLS 2011 home questionnaire (PIRLS-HQCV 2011) and identify the underlying factor structure using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) among Chinese fourth-grade pupils in Hong Kong. A 7-factor structure model has been identified by EFA and confirmed to resemble much to the original PIRLS structure by CFA. Additional conceptually important domains have been identified which add further insights into the inconclusive results in the literature regarding the relationship between home factors and reading achievement. Implications for further studies are discussed.published_or_final_versio

The anti-epileptic drug Valproic Acid (VPA) inhibits steroidogenesis in bovine theca and granulosa cells in vitro

Valproic acid (VPA) is used widely to treat epilepsy and bipolar disorder. Women undergoing VPA treatment reportedly have an increased incidence of polycystic ovarian syndrome (PCOS)-like symptoms including hyperandrogenism and oligo- or amenorrhoea. To investigate potential direct effects of VPA on ovarian steroidogenesis we used primary bovine theca (TC) and granulosa (GC) cells maintained under conditions that preserve their 'follicular' phenotype. Effects of VPA (7.8-500 µg/ml) on TC were tested with/without LH. Effects of VPA on GC were tested with/without FSH or IGF analogue. VPA reduced (P99% decrease; P<0.0001) with lesser effects on LHR, STAR, CYP11A1 and HSD3B1 mRNA (<90% decrease; P<0.05). VPA only reduced TC progesterone secretion induced by the highest (luteinizing) LH dose tested; TC number was unaffected by VPA. At higher concentrations (125-500 µg/ml) VPA inhibited basal, FSH- and IGF-stimulated estradiol secretion (P<0.0001) by GC without affecting progesterone secretion or cell number. VPA reversed FSH-induced upregulation of CYP19A1 and HSD17B1 mRNA abundance (P<0.001). The potent histone deacetylase (HDAC) inhibitors trichostatin A and scriptaid also suppressed TC androstenedione secretion and granulosal cell oestrogen secretion suggesting that the action of VPA reflects its HDAC inhibitory properties. In conclusion, these findings refute the hypothesis that VPA has a direct stimulatory action on TC androgen output. On the contrary, VPA inhibits both LH-dependent androgen production and FSH/IGF-dependent estradiol production in this in vitro bovine model, likely by inhibition of HDAC