Collagen bundle morphometry in skin & scar tissue: a novel distance mapping method provides superior measurements compared to Fourier analysis

Histopathological evaluations of fibrotic processes require the characterization of collagen morphology in terms of geometrical features such as bundle orientation thickness and spacing. However, there are currently no reliable and valid techniques of measuring bundle thickness and spacing. Hence, two objective methods quantifying the collagen bundle thickness and spacing were tested for their reliability and validity: Fourier first-order maximum analysis and Distance Mapping, with the latter constituting a newly developed morphometric technique. Histological slides were constructed and imaged from 50 scar and 50 healthy human skin biopsies and subsequently analyzed by two observers to determine the interobserver reliability via the intraclass correlation coefficient. An intraclass correlation coefficient larger than 0.7 is considered as representing good reliability. The interobserver reliability for the Fourier first-order maximum and for the Distance Mapping algorithms, respectively, showed an intraclass correlation coefficient above 0.72 and 0.89. Additionally, we performed an assessment of validity in the form of responsiveness, in particular, demonstrating medium to excellent results via a calculation of the effect size, highlighting that both methods are sensitive enough to measure a treatment effect in clinical practice. In summary, two reliable and valid measurement methods were demonstrated for collagen bundle morphometry for the first time. Due to its superior reliability and more useful measures (bundle thickness and bundle spacing), Distance Mapping emerges as the preferred and more practical method. Nevertheless, in the future, both methods can be used for reliable and valid collagen morphometry of skin and scars, whereas further applications evaluating the quantitative microscopy of other fibrotic processes are anticipated

Psychometric properties of the Pelvic Organ Prolapse Symptom Score

Objective To assess the internal consistency, construct validity and sensitivity to change of a pelvic organ prolapse symptom score (POP-SS). Design Analysis of data from three prolapse studies, including symptomatic and asymptomatic women who completed the POP-SS. Setting (1) A community setting in New Zealand, (2) two gynaecology outpatient departments in Scotland and (3) a gynaecological surgery department in Scotland. Population or sample (1) Participants from a survey of postnatal women at 12-year follow up, invited to complete a prolapse questionnaire and have prolapse assessment, (2) new gynaecology outpatients presenting with prolapse symptoms, randomised to pelvic floor muscle training (PFMT) or control and (3) women having anterior and/or posterior prolapse surgery, randomised to mesh insert or no mesh. Method Data were analysed to assess internal consistency, construct validity and sensitivity to change of the POP-SS. Main outcome measures Cronbach's alpha, significance of differences in POP-SS scores between studies and significance of difference in POP-SS scores pre- to post-intervention. Results For internal consistency, Cronbach's alpha ranged from 0.723 to 0.828. Women having surgery had higher POP-SS scores than those having conservative management (mean difference 5.0, 95% CI 3.1–6.9), who in turn had higher scores than the asymptomatic women (mean difference 5.9, 95% CI 4.4–7.4). Significant differences in POP-SS score were detected after surgery and PFMT. The improvement due to surgery was significantly greater than that associated with PFMT (z =−3.006, P = 0.003). Conclusion The POP-SS has good internal consistency and construct validity and is sensitive to change.1 ProLong: University of Otago Postgraduate Scholarship in Obstetrics and Gynaecology. 2 POPPY: Health Services Research Committee grant, Chief Scientist Office, Scottish Government. 3 IMPRESS: None

Development of the Global Engineering Programming Model: A Participatory, Mixed-Methods Approach

Over the past few decades, higher education institutions have emphasized global education as a core aspect of their strategic goals, yet a gap exists in implementation at the school level, particularly in engineering. As engineering schools invest in internationalizing their programs, research is needed regarding key strategic areas and their relationship to sustained programming efforts. This study uses a participatory, integrative mixed-methods approach to develop an operational framework for global strategies, policies, and programs. A thematic, qualitative analysis of semi-structured interviews followed by a group concept mapping activity was conducted with directors of study abroad and vice provosts of global education from nine universities regarding their global programming strategies, intended outcomes, and organizational resources. The results of this research provide both implicit and explicit engineering school-wide global programming strategies, their sustainable development, and future program evaluation plans

Preliminary Results of an NSF Sponsored Cross Institutional Study for Assessing the Spectrum of International Undergraduate Engineering Educational Experiences and IDI Results of Short-Term Study Abroad (University of Rhode Island)

University XX participated in an NSF sponsored cross institutional study for assessing the spectrum of international undergraduate engineering educational experiences. XX was one of eleven schools that participated in the spring of 2016 (several more schools will be added in Fall 2016). The PIs formed a multidisciplinary team from four universities (Y1, Y2, Y3 and Y4) which investigates how the broad spectrum of international experiences both in and outside of formal curricula impact engineering students’ global preparedness. Its four major objectives are delineated into three separate, but interconnected studies (i.e., Delphi, mixed-methods, and cross-institutional) combined with a dissemination system. The author presents an analysis of the preliminary University XX results of the third study within this work, an in-depth study to analyze engineering students’ global preparedness as the result of their academic and non-academic international experiences. The instrument of the Global Perspective Inventory (GPI) was used to compare GPI scores of engineering freshmen and seniors with and without international experiences. We are reporting on the preliminary analysis of data of University XX provided by one of the PIs. According to those data, University xx students turned out to have some of the highest Global Perspective Inventory (GPI) scores across all 11 schools for senior students who only had international experiences during college and for seniors who have had experience both before and during college. When comparing the GPI scores at XX who have never had an international experience to those students who only had experiences in college, one can see a large effect of the international experiences that students are having during their college years. Across all three GPI dimensions, the effect sizes (measured by Cohen’s D) are all large (above 0.80) and are consistently higher than the other schools in the study. The effect sizes for the XX students in this category are also the most consistent across all GPI dimensions. In other words, while some schools might have had larger effect sizes in certain GPI dimensions, XX is the only school in the sample that have statistically large effect sizes across all dimensions of the GPI when comparing seniors with no experience to seniors with experience before and during college. Can we conclude from these results that the efficacy of the international programs and opportunities that XX offers its engineering student population is very high? What sort of programming might have led to the strong scores? How might the different types of experiences offered at XX relate to students’ global perspectives

Health-related quality of life in childhood epilepsy: Moving beyond 'seizure control with minimal adverse effects'

Childhood epilepsy is one of the most important and prevalent neurological conditions in the developing years. Persons with childhood onset epilepsy are at a high risk for poor psychosocial outcomes, even without experiencing co-morbidities. The goal of management of children with epilepsy should be to enable the child and the family to lead a life as free as possible from the medical and psychosocial complications of epilepsy. This comprehensive care needs to go beyond simply trying to control seizures with minimal adverse drug reactions. Seizure frequency and severity is only one important outcome variable. Other factors such as social, psychological, behavioural, educational, and cultural dimensions of their lives affect children with epilepsy, their families and their close social networks. A number of epilepsy-specific health-related quality of life (HRQL) scales for children have been developed with the aim to include and measure accurately the impact and burden of epilepsy. Their target populations, details of the origin of the items, and psychometric properties vary significantly. Their strengths and weaknesses will be identified more clearly through their continued use in the clinical setting and in research studies. Only a few studies to date have utilized these or generic HRQL measures to assess the HRQL of specific populations with epilepsy. Future research needs to develop theory driven models of HRQL and identify measurable factors that have important correlations with outcomes. Since biomedical variables like seizure frequency and severity have only moderate correlations with HRQL, other independent factors including the child's resilience, co-morbid conditions, parental well-being, family factors and societal/cultural variables may play a major role. We also need to learn what encompasses comprehensive patient care, define the goals of management and evaluate the impact of different interventions. Future studies need to include the children's own perspectives of their HRQL in addition to parental reports. Finally, clinicians need to familiarize themselves with outcome measures, be able to evaluate them, and use them routinely in their day-to-day practice

Using Concept Mapping to Investigate Engineering Students\u27 Global Workforce Perceptions

This study investigates engineering students’ global workforce perceptions as part of a larger research effort that addresses the global workforce expectation differences between industry and engineering graduates. Approximately 127 undergraduate engineers at a large university in the U.S. responded to the following question: What do you hope/expect to know upon completion of college to better prepare you to work successfully in a global engineering environment? To identify patterns in the responses, an integrative mixed-methods approach called concept mapping is utilized. The concept map visually illustrates and organizes dimensions related to student global workforce perceptions. Students also rated their confidence in attaining these skills as well as the importance of acquiring these skills. By combining the results of the concept map and constructing pattern matches with the rating data we identify gaps that may be used to inform future curriculum development in institutions of higher education

Psychometric properties of the Stroke and Aphasia Quality of Life Scale (SAQOL-39) in a generic stroke population

Background: We previously developed the Stroke and Aphasia Quality of Life scale (SAQOL-39) and tested it with people with chronic aphasia. A scale allowing comparisons of quality of life between people with versus without aphasia post-stroke would be of value to clinicians. Objectives: To evaluate the psychometrics of the SAQOL-39 in a generic stroke sample. Should this process result in a generic-stroke version of the scale (SAQOL-39g), a further aim is to compare the latter and the SAQOL-39 as tested in chronic aphasia. Design and subjects: Repeated measures psychometric study, evaluating internal consistency, test—retest reliability, construct validity and responsiveness to change. People admitted to hospital with a first stroke were assessed two weeks, three months and six months post stroke. Measures: SAQOL-39, National Institutes of Health Stroke Scale, Barthel, Frenchay Aphasia Screening Test, General Health Questionnaire-12 and Frenchay Activities Index. Results: Of 126 eligible participants, 96 (76%) participated and 87 (69%) were able to self-report and are presented here. Testing the SAQOL-39 in generic stroke resulted in the SAQOL-39g, which has the same items as the SAQOL-39 but three domains: physical, psychosocial, communication. The SAQOL-39g showed good internal consistency (α = 0.95 overall score, 0.92—0.95 domains), test—retest reliability (interclass correlation (ICC) = 0.96 overall, 0.92—0.98 domains), convergent (r = 0.36—0.70 overall, 0.47—0.78 domains) and discriminant validity (r = 0.26 overall, 0.03—0.40 domains). It differentiated people by stroke severity and visual analogue scale (VAS)-defined quality of life. Moderate changes (d = 0.35—0.49; standardized response mean (SRM) = 0.29—0.53) from two weeks to six months supported responsiveness. Conclusions: The SAQOL-39g demonstrated good reliability, validity and responsiveness to change. It can be used to evaluate quality of life in people with and without aphasia post stroke

A Systematic Inquiry on Global Engineering Education: Strategies and Impact

Higher education has increasingly emphasized global education programming as a core piece of its strategic goals over the past few decades, yet little empirical data has been collected to inform the decisions of global programming within the U.S, especially in the engineering discipline. As higher education institutions attempt to formalize their strategies for achieving global competency and invest in internationalizing their engineering programs, research is needed regarding: (1) key global engineering education target areas and their relationship to sustained global programming efforts; (2) programming directions that can be used by universities in general and engineering schools in particular; and (3) how effective programming contributes to students’ global competency development. Three separate studies framed in different analytical lenses are employed to address these research objectives. The first study uses a participatory, integrative mixed-methods approach to develop an operational framework for global strategies, policies, and programs. A thematic, qualitative analysis of semi-structured interviews with a group concept mapping activity was conducted with directors of study abroad and vice provosts of global education from nine universities regarding their global programming strategies, intended outcomes, and organizational resources that support the internationalization process. Global engineering education research has grown increasingly complex, and of particular importance is related to engineering students’ global perspectives. The second study applies finite mixture models to characterize engineering students’ global perspective development patterns. Further, the relationship among global perspective patterns, student backgrounds and prior international experiences is explored. The third study employs data envelopment analysis to investigate how engineering students utilize international experiences in college and the relative efficiency of students’ global perspective development. The results are used to identify which international experiences get the most “bang for your buck” and how engineering programs can tailor their international experiences to their student populations. The results of this research provide both implicit and explicit engineering school-wide global programming strategies and their sustainable development. Triangulating the results from each study informs international engineering education policy makers and scholars, and provides actionable information for program directors to further educate engineering student populations for the 21st century

Comparison of the CAT-QoL and PedsQLTM instruments in measuring quality of life in amblyopia treatment: preliminary results

Background/Aims: The Child Amblyopia Treatment Questionnaire (CAT-QoL) is a patient-reported outcome measure (PROM), designed to assess the impact of amblyopia treatment. The aim of this study was to compare the psychometric properties of two PROMs; the CAT-QoL instrument and Pediatric Quality of Life Inventory (PedsQLTM), a generic pediatric PROM. This work was part of a wider project to develop a condition-specific PROM for children with amblyopia. Methods: Three hundred and forty-two participants were recruited in a UK multi-center study. Quality of life data was collected using the CAT-QoL and the PedsQLTM instruments. The psychometric performance of the CAT-QoL and PedsQLTM were examined in terms of acceptability, reliability, and validity. Results: Both instruments demonstrated good reliability (CAT-QoL Cronbach's α = 0.793; PedsQLTMα = 0.872). The convergent validity of the CAT-QoL and PedsQLTM instruments was tested by comparing the instruments to each other. There was a moderate correlation between the PedsQLTM and the CAT-QoL scores, and this relationship was statistically significant (rs = -0.517, p < .000). No statistical significance was found between the level of amblyopia severity and the mean PedsQLTM score (p = .420). Conclusion: It was possible to assess the impact of amblyopia treatment using the CAT-QoL and PedsQLTM instruments. The preliminary findings from this are not conclusive, and it is not possible to advocate the use of one questionnaire over another based upon psychometric performance demonstrated here. This may be due to the sample population, as there were limited numbers of participants with severe amblyopia. Both the CAT-QoL and PedsQLTM instruments were noted to have some issues with ceiling effects at an individual item level. The CAT-QoL and PedsQLTM were reliable (as determined by Cronbach's alpha). The PedsQLTM instrument was not able to discriminate between amblyopia severity groups (discriminant validity). Further research is required to formally assess the psychometric properties of the CAT-QoL questionnaire