Yoxas/statistical_literacy huggingface dataset:
The medical subinternship (also known as an acting internship) offers postclerkship medical students an opportunity for significant professional development. However, the skills required of a successful subintern-efficiency, patient triage, and advanced organization-are distinct from skills generally refined during the medicine clerkship. Few published curricula exist to prepare postclerkship students for success in this new role. To address this training gap, we introduced a novel tabletop role-playing game to equip medical subinterns with the necessary skills to deliver safe and efficient patient care. We created an hour-long game-based learning session for rising internal medicine and family medicine subinterns. Led by a single facilitator, students worked together to triage and complete tasks in a gamified simulated environment of a morning on the wards. To assess the session, we surveyed participants (N = 130) immediately after activity completion. Eighty-three participants completed the postactivity survey, for a response rate of 64%. A majority of students agreed that TaskMaster: The Subintern Adventure Game met its educational goals of increasing comfort with task prioritization, organization, and patient triage. Ninety-three percent of respondents (77 of 83) either agreed or strongly agreed that they felt more prepared to be a covering provider for patients after the activity. Participants also reported high engagement with the activity. Leveraging the interactivity, teamwork, and contextualized practice of game-based learning can offer low-cost and adaptable opportunities to teach higher-order clinical skills and increase preparedness for the subinternship.
The membrane interface probe (MIP) is an efficient and economical in-situ tool for chlorinated hydrocarbon (CH) contaminated site investigation. Given that the interpretation of MIP test is currently limited to a qualitative level, a theoretical model considering multiphase flow and multifield coupling is firstly proposed to simulate MIP test process. This model can consider phase change, membrane effect, adsorption and dissolution of the CH liquid, gas diffusion, and evaporation. Then, the model is used to study the changes in soil temperature and soil CH concentration during MIP test, as well as the influences of soil CH concentration and soil properties (initial water saturation, soil intrinsic permeability, and thermal properties) on MIP response. Finally, a simplified MIP interpretation model is developed based on parametric analysis results and verified against field and laboratory test data. It is found that the soil CH concentration, rather than soil properties, dominates the MIP response. The simplified interpretation model can deliver practical prediction of the CH concentration through the detected results by MIP, which may improve the applicability of MIP.
The mental and behavioral health workforce shortage has hindered access to care in the United States, resulting in long waitlists for persons who need behavioral health care. Global models for task sharing, combined with U.S.-led studies of nonspecialists delivering interventions for depression and anxiety, support the development of this workforce in a stepped care system. This Open Forum highlights an innovative effort in Washington State to initiate a bachelor's-level behavioral health support specialist curriculum leading to credentialing to expand the mental health workforce and improve access to care for people with depression and anxiety.
The mental disorder known as aboulomania, characterized by pathological indecisiveness, is not listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), widely used by mental health professionals to diagnose mental illnesses. However, it is frequently observed alongside other mental disorders. Aboulomania is linked to neurotic thinking or "neurosis," which pertains to a mental disorder arising from previous anxiety. This case presentation is on a 40-year-old Caucasian male, with a past psychiatric history of post-traumatic stress disorder (PTSD) and moderate cannabis use disorder, with no known medical history, who was involuntarily admitted to the psychiatric ward. Prolonged hospitalization of over two weeks was attributed to his severe and persistent indecisiveness, which hindered progress in discharge planning. In order to tackle this problem, the patient received encouragement from his treatment team to take small, concrete actions to deal with his indecisiveness. This case report emphasizes the significance of aboulomania in causing long-lasting indecisiveness and provides valuable insights on how to overcome this condition.
The mental health crisis among Native Hawaiian young adults is exacerbated by colonization-related risk factors, yet cultural identity stands as a key protective element. This study explored the link between cultural identity and stress, employing cultural reclamation theory, and surveyed 37 Native Hawaiians aged 18-24 through the Native Hawaiian Young Adult Well-being Survey. Engagement with culture, the significance of Hawaiian identity, and stress were assessed, revealing significant correlations between cultural and demographic factors and stress levels. Participants displayed high cultural engagement and valued their Hawaiian identity, with gender and education levels playing a notable role in stress. These findings highlight the importance of including Native Hawaiian perspectives in mental health research and may guide the development of targeted interventions.
The mental health of students plays a crucial role in their learning and performance. The COVID-19 pandemic, the political turmoil and a coup in Sudan has exacerbated stress and anxiety among university students in Sudan due to uncertainty about their academic activities. To assess post-traumatic stress disorder (PTSD) occurrence and coping strategies adopted by university students in Sudan. This cross-sectional survey was conducted from March to June 2022. It used the Coping Orientation to Problems Experienced (Brief-COPE) and Impact of Event Scale-Revised (IES-R) questionnaires to assess the occurrence of PTSD and coping strategies among 596 university students in Sudan. Descriptive statistics were used to determine the frequency and percentage, Student's t test was used to compare the means of 2 groups and one-way analysis of variance to compare the means of ≥ 3 groups. There was a high prevalence of PTSD among the students, with a score of 31.2 (SD 16.4). The total score of PTSD was higher among female students. Around 36% of the students had a PTSD score > 37, which is considered high enough to suppress immune function. The most widely adopted coping strategies were religion and acceptance of the situation, while substance use was the least. Students who had COVID-19 infection during the pandemic differed significantly from uninfected students in the application of coping strategies. In contrast, students whose family members or friends had COVID-19 were not significantly different from students with uninfected family members or friends in the application of the coping strategies, such as self-blame, denial, substance use, and behavioural disengagement. We recommend the initiation and implementation of psychological counselling programmes for university students in Sudan onsite or remotely. Further research should be carried out to assess the long-term effects of the pandemic and the political conflicts so as to design and implement appropriate and efficient interventions.
The metabolic and psychological management of paediatric type 1 diabetes mellitus (T1DM) can be challenging over time given that T1DM may cause a negative emotional burden and, consequently, result in poor metabolic control of the disease. The objectives of this study are to translate the Problem Area in Diabetes Survey-Pediatric version (PAID-Peds) into Spanish, adapt it culturally and validate it. Multicenter cross sectional study. 636 patients aged 8-17 years, diagnosed with T1DM, under treatment with insulin and follow-up at the Miguel Servet University Hospital in Zaragoza (Aragón, Spain), the Ramón y Cajal University Clinical Hospital in Madrid (Spain) and at the Sant Joan de Déu Hospital in Barcelona (Catalonia, Spain) between 1 January 2023 and 31 December 2024 will be included. This study will consist of two phases: (1) Translation and cultural adaptation of the original PAID-Peds® survey into Spanish following eight steps; (2) Validation of the Spanish version of the PAIS-Peds® survey. The statistical analysis will be performed using Jamovi® 2.1.23. The reliability or internal consistency will be calculated using Cronbach's alpha index (considering an index higher than 0.8 to be good) and the test-retest will be evaluated using the intraclass correlation coefficient. For validity, confirmatory factor analysis will be calculated. This study has been approved by the ethics and research committees at each centre. The translation and validation into Spanish language of the Problem Area in Diabetes Survey-Pediatric version will be feasible, valid and reliable to detecting the youth-perceived burden of T1DM. Therapeutic education in diabetes-recommended by the WHO and the Diabetes Education Study Group-has shown encouraging results in glycaemia and psychosocial and behavioural factors in T1DM.
The Mini Cambridge-Exeter Repetitive Thoughts Scale (Mini-CERTS) captures constructive and unconstructive aspects of repetitive thinking, but there is a need to revise and improve it given its novelty. For this reason, we present a validation and factor analysis of the Spanish version of the Mini-CERTS. Given that it is important to take cultural issues into account in instrument adaptation, we also assess its measurement invariance across Spanish (N = 430) and Peruvian (N = 394) populations. After deleting conflictive items, a 9-items version of the Mini-CERTS showed a two-factor model distinguishing constructive and unconstructive repetitive thinking, although this solution was not invariant across groups. Results also showed that the unconstructive factor was positively associated with anxiety, depression and stress measures. Despite its acceptable internal consistency, the absence of measurement invariance across groups does not recommend its use in cross-group comparisons in these populations. Cultural issues that could explain this result are discussed. Our findings highlight the importance of performing cross-cultural adaptations of assessment instruments even with the same language.
The mini-clinical evaluation exercise (mini-CEX) is a formative assessment tool designed to provide feedback on skills essential to good medical care by observing an actual clinical encounter. However, the bigger advantage of mini-CEX is the structured feedback that it provides to the students as well as the faculty, thus helping them to make better decisions. This study was a cross-sectional observational study. Sixteen surgery residents volunteered for participation and five professors conducted sessions; hence, 80 mini-CEX encounters. Seven core clinical skill assessments were done, and the performance was rated on a 9-point scale (grouped into unsatisfactory, satisfactory, and superior). Immediate feedback to the residents was given by the faculty. Delayed feedback from faculty and residents regarding the perception of mini-CEX was taken. Statistical analysis was done using SPSS version 20 and analysis of variance (ANOVA) for inferential statistics. As planned, 80 (100%) mini-CEX encounters were conducted. Surgery residents showed improvement that was statistically significant in the competencies of medical interviewing skills, physical examination skills, humanistic qualities/professionalism, and counseling skills. Most of the faculty (80%) were able to identify the gaps in the knowledge of students and areas of improvement for their teaching. However, 60% of the faculty felt that it required more effort than traditional methods. The mean time taken by the assessor for observation and feedback to residents was 12.51 min and 5.68 min, respectively. The mean scores of evaluator satisfaction and resident satisfaction with mini-CEX sessions were 6.04 and 7.49, respectively. Mini-CEX improves the learning environment in residency and also leads to improvement in medical interviewing skills, physical examination skills, humanistic qualities/professionalism, and counseling skills. It is done in the actual patient encounter and hence prepares the resident better for dealing with patients in the future.
The MiniMovers (MM) APP combines motor development theory with creativity expertise and has been designed to provide parents with developmentally appropriate activities to support children's motor skills. This study investigates how MiniMovers activities enabled parents to support their children's physical development. Families participated in an 8-week MM programme of activities from the MM APP (Mini, Mighty and Mega levels), with pre- and post-intervention data collected using multiple tools (e.g., motion capture system, force plate, eye-tracking glasses, and videos). Mixed research methods were applied among children (N = 8; aged 21-79 months) and their parents, providing quantitative analysis on children's performance (running, throwing, jumping, kicking, balancing and catching), as well as qualitative analysis on parents' attitude and behaviour (two-weekly feedback surveys and interviews). Lab-based measures showed significant improvements in run time, underarm throwing distance, and horizontal jump distance. Test of Gross Motor Development-3 showed a significant gain in running, underarm and overarm throwing, horizontal jump and kicking. Further, developmental stages indicated significant improvements in running, kicking and catching. Parents reported increased enjoyment and knowledge, children's enjoyment, independence and confidence. This pilot study provides support for the research and development of the MM App and suggests more research into the use of APPs to support home activities among families with young children.
The model of early rehabilitation for people with burns is still relatively novel in developing countries such as Egypt. The study examined the effect of a nurse-led rehabilitation program on functional outcomes in patients with severe hand burns. A quasi-experimental design was used in this study. The study was completed in the burn unit of a teaching university hospital in Alexandria, Egypt, with a convenience sample of 80 patients with severe hand burns. Participants were consecutively assigned to one of two groups: control ( n = 40), which received only routine hospital care and clinical interventions, or intervention ( n = 40), which received routine hospital care and clinical interventions and a 4-week nurse-led rehabilitation program (health education including audiovisual aids and burn rehabilitation education booklet, social support, and hand rehabilitation exercises). To assess functional outcomes, both groups were given pre- and posttests of the Disabilities of the Arm, Shoulder and Hand outcome and the Hand Motor Function Observational Checklist questionnaires. Descriptive and inferential statistics were conducted. Functional outcomes were significantly improved in the intervention participants compared to the control participants ( t = 5.710, p < .001). The differences in index scores between the two groups were statistically significant ( p < .001). The study provides information for burn rehabilitation nurses in developing countries to develop and test early interventions that improve functional outcomes in this population. A 4-week nurse-led program may be a beneficial intervention for improving functional outcomes in adult patients with severe hand burns who are undergoing rehabilitation.
The modern canon of open science consists of five "schools of thought" that justify unfettered access to the fruits of scientific research: i) public engagement, ii) democratic right of access, iii) efficiency of knowledge gain, iv) shared technology, and v) better assessment of impact. Here, we introduce a sixth school: due process. Due process under the law includes a right to "discovery" by a defendant of potentially exculpatory evidence held by the prosecution. When such evidence is scientific, due process becomes a Constitutional mandate for open science. To illustrate the significance of this new school, we present a case study from forensics, which centers on a federally funded investigation that reports summary statistics indicating that identification decisions made by forensic firearms examiners are highly accurate. Because of growing concern about validity of forensic methods, the larger scientific community called for public release of the complete analyzable dataset for independent audit and verification. Those in possession of the data opposed release for three years while summary statistics were used by prosecutors to gain admissibility of evidence in criminal trials. Those statistics paint an incomplete picture and hint at flaws in experimental design and analysis. Under the circumstances, withholding the underlying data in a criminal proceeding violates due process. Following the successful open-science model of drug validity testing through "clinical trials," which place strict requirements on experimental design and timing of data release, we argue for registered and open "forensic trials" to ensure transparency and accountability.
The modified nine-step test is a classical method for evaluating Eustachian tube function. However, clinical interpretation of the increased maximal difference in middle ear pressure (mdMEP) in the modified nine-step test is unknown. We hypothesised that the different reservoir effects of the mastoid cavity can bias the results of the modified nine-step test. A total of 108 consecutive participants (216 ears) were retrospectively screened. Of these, 55 participants (82 ears) who met the inclusion/exclusion criteria were enrolled. The volumetric results of the mastoid cavity, parameters of the modified nine-step test (mdMEP, middle ear pressure, tympanic membrane compliance), and demographic data were analysed. A significant negative correlation was found between mdMEP and mastoid cavity volume (R = .467, p < .001). Ears with mdMEP >70 daPa showed poor pneumatization in the mastoid cavity, with volumes less than 3000 mm3 (10th percentile of all ears analysed). Ears with mastoid cavity volumes lower than the 25th percentile showed a significantly higher mdMEP (p < .001). Patients with mastoid cavity volumes higher than the 75th percentile were significantly younger (p < .001). Multivariate regression analysis for mdMEP showed a good fit (R = .854) using factors including middle ear pressure, admittance and, most importantly, the reciprocal of mastoid volume (Beta = 0.752, p < .001). The mdMEP, the main parameter of the modified nine-step test, was negatively correlated with the mastoid cavity volume. Therefore, the results of the modified nine-step test should be interpreted with consideration of mastoid cavity volume.
The modularisation of sports science curricula allows students to individualise degrees to fit their interests and aspirations via elective modules. The aim of this study was to explore the factors which influence sports science students' elective biomechanics enrolment decisions. A total of 45 students completed an online survey focussing on personal and academic characteristics which may influence enrolment decisions. Significant differences were found for three personal characteristics. Biomechanics module enrolees were more positive in their self-concept of subject ability, had a greater like for their previous subject experience, and displayed a higher agreement in requiring the knowledge for future career aspirations. Although, statistical power was reduced when respondents were categorised into demographic sub-groups, exploratory analysis highlighted self-concept of subject ability may differentiate female students' enrolment, while previous subject experience may distinguish male students' enrolment and academic entry route students' enrolment. Undergraduate sports science core biomechanics modules should consider adopting learning pedagogies which help to increase individual students' self-concept of ability and inspires them to recognise the value of biomechanics in their potential career aspirations.
The morphometry of sural nerve biopsies, such as fibre diameter and myelin thickness, helps us understand the underlying mechanism of peripheral neuropathies. However, in current clinical practice, only a portion of the specimen is measured manually because of its labour-intensive nature. In this study, we aimed to develop a machine learning-based application that inputs a whole slide image (WSI) of the biopsied sural nerve and automatically performs morphometric analyses. Our application consists of three supervised learning models: (1) nerve fascicle instance segmentation, (2) myelinated fibre detection and (3) myelin sheath segmentation. We fine-tuned these models using 86 toluidine blue-stained slides from various neuropathies and developed an open-source Python library. Performance evaluation showed (1) a mask average precision (AP) of 0.861 for fascicle segmentation, (2) box AP of 0.711 for fibre detection and (3) a mean intersection over union (mIoU) of 0.817 for myelin segmentation. Our software identified 323,298 nerve fibres and 782 fascicles in 70 WSIs. Small and large fibre populations were objectively determined based on clustering analysis. The demyelination group had large fibres with thinner myelin sheaths and higher g-ratios than the vasculitis group. The slope of the regression line from the scatter plots of the diameters and g-ratios was higher in the demyelination group than in the vasculitis group. We developed an application that performs whole slide morphometry of human biopsy samples. Our open-source software can be used by clinicians and pathologists without specific machine learning skills, which we expect will facilitate data-driven analysis of sural nerve biopsies for a more detailed understanding of these diseases.
The mortality rate in intensive care units (ICUs) is notably high, with patients often relying on surrogates for critical medical decisions due to their compromised state. This paper provides a comprehensive overview of eHealth. The challenges of applying eHealth tools, including economic disparities and information inaccuracies are addressed. This study then introduces eHealth literacy and the assessment tools to evaluate users' capability and literacy levels in using eHealth resources. A clinical scenario involving surrogate decision-making is presented. This simulated case involves a patient with a hemorrhagic stroke who has lost consciousness and requires medical procedures such as tracheostomy. However, due to the medical surrogate's lack of familiarity with eHealth devices and limited literacy in using eHealth resources, difficulties arise in assisting the patient in making medical decisions. This scenario highlights challenges related to eHealth literacy and solution strategies are proposed. In conclusion, effective ICU decision-making with eHealth tools requires a careful balance between efficiency with inclusivity. Tailoring communication strategies and providing diverse materials are essential for effective eHealth decision resources in the ICU setting. Health professionals should adopt a patient-centered approach to enhance the decision-making experience, particularly for individuals with limited eHealth literacy.