Yoxas/statistical_literacy huggingface dataset:
To describe the simplicity, efficacy and safety of A. Chohan Continuous Squeezing Suture (ACCSS) for controlling haemorrhage from the lower uterine segment at caesarean section for placenta praevia and accreta spectrum disorders. This prospective study was conducted on 47 patients with placenta praevia and accreta spectrum disorders from February 2019 to May 2022 in two teaching hospitals of Lahore and ACCSS was applied. The outcome measures were peripartum hysterectomy procedure time, estimated blood loss, number of blood transfusions, duration of stay in the hospital, bladder trauma, uterine necrosis, pelvic abscess formation, secondary postpartum haemorrhage and maternal mortality. Descriptive statistics were calculated by using SPSS version 21. Out of 47 patients, 7 (15%) had placenta creta, 29 (61.7%) increta, 11 (23.3%) percreta (grade 3a), and 36 (76.6%) central anterior dominant placenta. Peripartum hysterectomy was prevented in 97.8% of patients. ACCSS procedure time was 5-10 minutes (87.2%), with mean blood loss 2500±485 ml, mean blood transfusion 1.85±1.02 units and mean hospital stay of 3.3±0.84 days. One patient had bladder trauma. There was no case of uterine necrosis, pelvic abscess formation, secondary postpartum haemorrhage or maternal mortality. ACCSS appears to be a simple, effective and safe treatment option for placenta praevia and accreta spectrum disorders, as an alternative to hysterectomy.
To describe the structure of a dedicated body oncologic imaging fellowship program. To summarize the numbers and types of cross-sectional imaging examinations reported by fellows. The curriculum, training methods, and assessment measures utilized in the program were reviewed and described. An educational retrospective analysis was conducted. Data on the number of examinations interpreted by fellows, breakdown of modalities, and examinations by disease management team (DMT) were collected. A total of 38 fellows completed the fellowship program during the study period. The median number of examinations reported per fellow was 2296 [interquartile range: 2148 - 2534], encompassing all oncology-relevant imaging modalities: CT 721 [646-786], MRI 1158 [1016-1309], ultrasound 256 [209-320] and PET/CT 176 [130-202]. The breakdown of examinations by DMT revealed variations in imaging patterns, with MRIs most frequently interpreted for genitourinary, musculoskeletal, and hepatobiliary cancers, and CTs most commonly for general staging or assessment of nonspecific symptoms. This descriptive analysis may serve as a foundation for the development of similar fellowship programs and the advancement of body oncologic imaging. The volume and diversity of examinations reported by fellows highlights the comprehensive nature of body oncologic imaging.
To design a prototype programmatic assessment model using integration of system thinking and design thinking frameworks, and to explore barriers in the way of its implementation in medical education. The qualitative case-study was conducted at Bahria University Medical and Dental College, Karachi from September to December 2022. Methodological approaches used were systems thinking and design thinking. Philosophical paradigm used was critical realism. Maximum variation purposive sampling technique was used for selecting faculty members and medical students. Data was collected in two sets of semi-structured interviews. The initial interviews were at the levels of empathise, define and ideate. After that low-fidelity prototype programmatic assessment design was created and presented to the participants. The second set of interviews were focussed on feedback on prototype of programmatic assessment design. Pattern matching method was used for data analysis. Of the 65 subjects, 20(30.7%) were faculty members; 5(25%) lecturers and 5(25%) professors each from basic and clinical sciences. The remaining 45(69.2%) were students; 5(11.1%)from each year of medical and dental streams. Initial interviews revealed that after failure, students struggle to understand the cause of failure as assessment system lacked narrative feedback mechanism and numbers or pass/fail decisions were not self-explanatory. Students lacked attitude towards continued improvement, formative assessment were not taken seriously as they carried only 10% weightage. After the programmatic assessment design was presented to the participants, faculty members voiced concerns regarding faculty training, shortage of resources and legal issues related to its implementation. Students supported the design, especially continued narrative feedback for their academic improvement. Portfolio development was considered a time-consuming task and they had reservations regarding their ability to make quality assessment portfolio. Implementation of programmatic assessment required faculty development and was resource-intensive, but stakeholders, especially students, were found interested in its implementation in medical education.
To design and implement a formal skills workshop for ophthalmology residents to practice breaking bad news. A 2-session workshop was developed for 7 ophthalmology residents at the University of Alberta based on a workshop published by Ohio State University. Residents discussed the SPIKES protocol for breaking bad news, practiced mock cases with standardized patients, and listened to shared experiences from patients who had received ocular diagnoses. All the residents (n = 6; p = 0.03) at the University of Alberta reported an increase in confidence in 3 measures of an encounter in which they had to break bad news, one of which shared the significant improvement reported by the Ohio State group (n = 9; p = 0.01): setting realistic expectations without destroying hope. Standardized patients discussed their satisfaction with their case training and suggested the provision of eye models or printouts to enhance the realism in the examination rooms. The University of Alberta workshop results replicated those from Ohio State in that the SPIKES lecture and standardized patient session were ranked highly in efficacy (median, 4 of 5). The University of Alberta panel discussion was ranked lower than at Ohio State University, which may have resulted from 1 of 2 patient guest speakers being unexpectedly unable to attend. The pilot Breaking Bad News Workshop was well received overall and may serve to inform future incorporation of soft skills development in a formal residency curriculum.
To design, implement, and launch courses that integrate foundational science learning and clinical application in a post-clerkship undergraduate medical school curriculum. In Academic Year (AY) 15-16, as part of a comprehensive curricular revision, Vanderbilt University School of Medicine (VUSM) formally implemented "Integrated Science Courses" (ISCs) that combined rigorous training in the foundational sciences with meaningful clinical experiences. These courses integrated foundational sciences that could be leveraged in the clinical environment, utilized a variety of instructional modalities, and included quantitative and qualitative (competency-based milestones) student assessments. Each ISC underwent a rigorous quality improvement process that required input on foundational science content, student experience, and student performance assessment. Eleven ISCs were delivered to 173 students in AY15-16, with some students taking more than one ISC. Immediately after completing each course, 93% (n=222) of ISC enrollees completed a course evaluation. Students (91%; n=201) 'agreed' or 'strongly agreed' that foundational science learning informed and enriched the clinical experiences. Furthermore, 94% (n=209) of students thought that the clinical experiences informed and enriched the foundational science learning. Ninety-four percent of the students anticipated using the foundational science knowledge acquired in future clinical training and practice. The teaching of foundational sciences in the clinical workplace in the post-clerkship medical curriculum is challenging and resource-intensive, yet feasible. Additional experience with the model will inform the mix of courses as well as the breadth and depth of foundational science instruction that is necessary to foster scientifically-based clinical reasoning skills in each student.
To detect the Marchiafava Bignami Disease (MBD) using a distinct deep learning technique. Advanced deep learning methods are becoming more crucial in contemporary medical diagnostics, particularly for detecting intricate and uncommon neurological illnesses such as MBD. This rare neurodegenerative disorder, sometimes associated with persistent alcoholism, is characterized by the loss of myelin or tissue death in the corpus callosum. It poses significant diagnostic difficulties owing to its infrequency and the subtle signs it exhibits in its first stages, both clinically and on radiological scans. The novel method of Variational Autoencoders (VAEs) in conjunction with attention mechanisms is used to identify MBD peculiar diseases accurately. VAEs are well-known for their proficiency in unsupervised learning and anomaly detection. They excel at analyzing extensive brain imaging datasets to uncover subtle patterns and abnormalities that traditional diagnostic approaches may overlook, especially those related to specific diseases. The use of attention mechanisms enhances this technique, enabling the model to concentrate on the most crucial elements of the imaging data, similar to the discerning observation of a skilled radiologist. Thus, we utilized the VAE with attention mechanisms in this study to detect MBD. Such a combination enables the prompt identification of MBD and assists in formulating more customized and efficient treatment strategies. A significant breakthrough in this field is the creation of a VAE equipped with attention mechanisms, which has shown outstanding performance by achieving accuracy rates of over 90% in accurately differentiating MBD from other neurodegenerative disorders. This model, which underwent training using a diverse range of MRI images, has shown a notable level of sensitivity and specificity, significantly minimizing the frequency of false positive results and strengthening the confidence and dependability of these sophisticated automated diagnostic tools.
To determine (1) the level of knowledge regarding COVID-19 and dental emergency (DE) along with the factors that might be associated (2) with the effect of educational video on the level of knowledge among nondental students. This online pre-experimental study used an educational video regarding COVID-19 and DE with a one-group pretest-posttest design toward the undergraduate nondental students (n = 363) from six public universities in West Java Province, Indonesia, aged 18 to 22 years. A Google Form was used and convenience sampling was undertaken. The chi-squared, Mann-Whitney, Wilcoxon, and Spearman correlation tests were performed. Cohen's deffect size was used to assess the effect of videos. Most of the respondents were females around 20.36 ± 0.94 years. There is a statistically significant difference between the pre- and posttest knowledge score for COVID-19 (p <0.001) and DE (p <0.001). The "with dental school" group had a significantly higher pretest score in DE literacy than the "without dental school" group. There is a significantly positive linear relationship between the frequency of watching videos and the posttest score. The effect size was 1.03 and 0.8 for COVID-19 and DE, respectively. The majority of students agreed (agree and very agree) with all statements regarding video education. The level of knowledge regarding COVID-19 and DE increased from 5.30 to 6.75 and 6.58 to 8.02, respectively. The associated factors were the type of university and the frequency of watching videos. Educational intervention seems to have a great effect in increasing the knowledge of nondental students.
To determine 1) the extent to which paper-based and computer-based environments influence the sufficiency of parents' report of child behaviors and the accuracy of data on current medications, and 2) the impact of parents' health literacy on the quality of information produced. We completed a randomized controlled trial of data entry tasks with parents of children with Attention Deficit Hyperactivity Disorder (ADHD). Parents completed the NICHQ Vanderbilt ADHD screen and a report of current ADHD medications on paper or using a computer application designed to facilitate data entry. Literacy was assessed by the Test of Functional Health Literacy in Adults (TOFHLA). Primary outcomes included sufficient data to screen for ADHD subtypes and accurate report of total daily dose of prescribed ADHD medications. Of 271 parents screened, 194/271 were eligible and 182 were randomized. Data from 180 parents were analyzed. 5.6% parents had inadequate/marginal TOFHLA scores. Using the computer, parents provided more sufficient and accurate data compared to paper (sufficiency for ADHD screening, paper vs. computer: 87.8% vs. 93.3%, P = 0.20; accuracy of medication report: 14.3% vs. 69.4%; p<0.0001). Parents with adequate literacy had increased odds of reporting sufficient and accurate data (sufficiency for ADHD screening: OR 8.0, 95% CI 2.0-32.1; accuracy of medication report: OR 4.4, 95% CI 0.5-37.4). In adjusted models, the computer task environment remained a significant predictor of accurate medication report (OR 18.7, 95% CI 7.5-46.9). Structured, computer-based data entry by parents may improve the quality of specific types of information needed for ADHD care. Health literacy affects parents' ability to share valid information.
To determine and identify distance patterns in the movements of medical students and junior doctors between their training locations. A retrospective cohort study of UK medical students from 2002 to 2015 (UKMED data). All UK medical schools, foundations and specialty training organisation. All UK medical students from 2002 to 2015, for a total of 97 932 participants. Individual movements and number of movements by county of students from family home to medical school training, from medical school to foundation training and from foundation to specialty training. Leslie matrix, principal components analysis, Gini coefficient, χ2 test, generalised linear models and variable selection methods were employed to explore the different facets of students' and junior doctors' movements from the family home to medical school and for the full pathway (from family home to specialty training). The majority of the movements between the different stages of the full pathway were restricted to a distance of up to 50 km; although the proportion of movements changed from year-to-year, with longer movements during 2007-2008. At the individual level, ethnicity, socioeconomic class of the parent(s) and the deprivation score of the family home region were found to be the most important factors associated with the length of the movements from the family home to medical school. Similar results were found when movements were aggregated at the county level, with the addition of factors such as gender and qualification at entry (to medical school) being statistically associated with the number of new entrant students moving between counties. Our findings show that while future doctors do not move far from their family home or training location, this pattern is not homogeneous over time. Distances are influenced by demographics, socioeconomic status and deprivation. These results may contribute in designing interventions aimed at solving the chronic problems of maldistribution and underdoctoring in the UK.
To determine associations between sociodemographic and medical factors and odds of readmission after discharge from the neonatal intensive care unit for infants with very low birth weight (<1500g). Cohort study using linked data from the California Perinatal Quality Care Collaborative, California Vital Statistics, and the Child Opportunity Index (COI) 2.0. Infants with very low birth weight born from 2009 through 2018 in California were considered. Odds ratios of readmission within 30 days of discharge adjusting for infant medical factors, maternal sociodemographic factors, and birth hospital were calculated via multivariable logistic regression and fixed-effect logistic regression models. A total of 42 411 infants met inclusion criteria. Also, 8.5% of all infants were readmitted within 30 days of discharge. In addition to traditional medical risk factors, two sociodemographic factors were significantly associated with increased odds of readmission in adjusted models: payor other than private insurance for delivery [aOR = 1.25 (95% CI 1.14-1.36)] and maternal education of less than high school degree [aOR = 1.19 (95% CI 1.06-1.33)]. Neighborhood Child Opportunity Index was not associated with odds of readmission. Sociodemographic factors, including lack of private insurance and lower maternal educational attainment, are significantly and independently associated with increased odds of readmission after neonatal intensive care unit discharge, in addition to traditional medical risk factors. Socioeconomic deprivation and health literacy may contribute to risk of readmission. Targeted discharge interventions focused on addressing social drivers of health warrant exploration.
To determine if distinct trajectories of coronary heart disease (CHD) self-care behaviours could be identified, linked to differences in quality of life (QoL), and predicted based on baseline characteristics. A secondary analysis of a prospective, longitudinal, observational study. Patients with CHD answered questionnaires at study enrolment and six months later: Self-Care of Coronary Heart Disease Inventory (three subscales: maintenance, management and confidence, scored 0-100, higher score = better self-care), Hospital Anxiety and Depression Scale, 12-Item Short Form Survey, 16-Item European Health Literacy Survey Questionnaire, CHD Education Questionnaire. Latent growth mixture modelling was used to identify distinct self-care trajectories over time.On average, patients (n = 430, mean age 64.3 ± 8.9, 79% male) reported inadequate self-care (maintenance 61.6 ± 15.4, management 53.5 ± 18.5) at enrolment. Two distinct trajectories of self-care behaviours were identified: First, an "inadequate-and-worsening" (IN-WORSE) trajectory (57.2%), characterised by inadequate self-care, improvement in maintenance (4.0 ± 14.5-point improvement, p < 0.001) and worsening of management over time (6.3 ± 24.4-point worsening, p = 0.005). Second, an "inadequate-but-maintaining" (IN-MAIN) trajectory (42.8%), characterised by inadequate self-care, improvement in maintenance (5.0 ± 16.2-point improvement, p < 0.001) and stability in management over time (0.8 ± 21.9-point worsening, p = 0.713). In comparison, patients in the IN-WORSE trajectory had less favourable characteristics (including lower health literacy, knowledge, confidence) and significantly lower QoL. Not attending rehabilitation (OR 2.175; CI 1.020-4.637, p = 0.044) and older age (OR 0.959; CI 0.924-0.994, p = 0.024) predicted (IN-WORSE) trajectory inclusion. Two self-care trajectories were identified, both suboptimal. Rehabilitation predicted membership in the more favorable trajectory and some positive characteristics were identified among patients in that group. Therefore, interventions supporting these factors may benefit patients' self-care and QoL.
To determine if there was an association between intrapartum stillbirths and both traveled distance for delivery and delivery care accessibility, assessing periods before and during the COVID-19 pandemic. This is a population-based cohort study. Patients had birth occurring after the onset of labor; the primary outcome was intrapartum stillbirth. City of residence was classified according to the ratio between deliveries performed and total births among its residents; values lower than 0.1 indicated low delivery care accessibility. Travel distance was calculated using the Haversine formula. Education level, maternal age, and birth sex were included. In each period, relative risk was assessed by generalized linear model with Poisson variance. There were 2 267 534 deliveries with birth occurring after the onset of labor. Most patients were between age 20 and 35 years, had between 8 and 11 years of education, and resided in cities with high delivery care accessibility. Low delivery care accessibility increased risk of intrapartum stillbirth in the pre-pandemic (relative risk [RR] 2.02; 95% CI [1.64, 2.47]; p < 0.01) and the pandemic period (RR 1.69; 95% CI [1.09, 2.55]; p = 0.015). This was independent of other risk-increasing factors, such as travel distance and fewer years of education. Low delivery care accessibility is associated with the risk of intrapartum stillbirths, and accessibility reduced during the pandemic. Delivery of patients by family physicians and midwives, as well as official communication channels between primary care physicians and specialists, could improve patient healthcare-seeking behavior.
To determine medical students' views of various aspects of a career in radiation oncology (RO) to identify areas that may benefit from reform and to guide initiatives to stimulate broader and more diverse student interest in the specialty. An electronic survey was sent to student oncology interest group members at seven US medical schools. The survey asked students to rate 19 aspects of RO on a 5-point bipolar Likert-type scale. Descriptive statistics are reported, along with subgroup analyses based on participants' demographics. The response rate was 51.1% (n = 275 of 538). The most favorably rated aspects of RO were outpatient working hours (mean ± SD Likert-type rating of 4.51 ± 0.82), routinely working with other physicians (4.45 ± 0.76), and use of advanced technology to treat patients. The most unfavorably rated aspects of RO were less geographic flexibility for residency or employment (1.98 ± 1.04), spending a lot of time on a computer doing treatment planning (2.80 ± 1.21), and having a job that is not well understood by most doctors and the general public (2.89 ± 1.02). Gender was associated with significant differences in 8 of 19 questions in how each aspect of RO was viewed. Few differences were observed based on race or ethnicity, though Asian participants had a significantly more favorable view of RO being a more science-oriented specialty compared with White or underrepresented students, respectively (3.50 versus 3.21 versus 2.84, P = .01). These findings inform the RO community in the development of more effective initiatives to encourage students to fully explore the specialty.
To determine mental health literacy (MHL) levels of older adults and the predictive factors of MHL. This cross-sectional study was conducted between October and December 2022, with 410 older adults aged ≥65 years. A Personal Information Form and the Mental Health Literacy Scale were used for data collection. Independent samples t test, analysis of variance, and multiple linear regression were used to analyze the data. Significant predictors of MHL in older adults were being aged 65 to 69 years, being female, being a university graduate, having an income more than expenses, receiving information from a health professional, interest in mental health, having friends or family members with mental illness, and good perception of health. Older adults were found to have low levels of MHL. Mental health professionals should focus on community-based education and interventions to increase the MHL levels of older adults. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx. ].