Yoxas/statistical_literacy huggingface dataset:
The clinical learning environment (CLE) is critical for developing the practical skills needed in healthcare professions. This study aimed to evaluate healthcare students' perceptions of the quality of the CLE using the Arabic version of the Clinical Learning Environment, Supervision and Nurse Teacher (ar. CLES + T) scale. The study also aimed to evaluate the tool's measurement invariance and compare perceptions among student groups. This cross-sectional study was carried out at two health education institutes in Morocco throughout the academic year 2018-2019 among 1550 undergraduate students who had just finished a clinical practicum in a hospital or primary healthcare facility. Data were gathered using the ar. CLES + T scale. Confirmatory factor analysis (CFA) and multigroup CFA were performed. The measurement invariance of the ar. CLES + T scale was assessed across gender, study year, and clinical practicum duration, using configural invariance, metric invariance, scalar invariance, and strict invariance. The t-test and analysis of variance were used to compare the mean scores of the student groups. Students expressed positive perceptions toward the CLE. The "Pedagogical atmosphere on the ward" dimension scored the highest, while the "Role of the nurse teacher" dimension received the lowest scores. The measurement invariance of the ar. CLES + T scale by gender, study year, and clinical practicum duration was established. First-year students and those with an extended practicum period were the most satisfied. To promote effective learning in the clinical environment, nurse teachers might use innovative teaching approaches tailored to their evolving role in these settings. Moreover, extending the duration of clinical practicum can further enhance student learning outcomes.
The clinical placement environment plays a pivotal role in shaping the learning experiences and outcomes of nursing students. In this article, the challenges and dynamics within the clinical placement environment are examined, with a particular focus on the role of registered nurse preceptors. The multifaceted nature of the clinical landscape is highlighted with consideration given to the impact on both students and preceptors. Key to the success of any placement is the relationship between nursing students and their preceptors. The quality of this relationship directly influences the learning journey of students, with positive interactions contributing to enhanced learning outcomes and professional growth. However, within the literature, a range of challenges faced by nurse preceptors are captured, including limited support, recognition, and formal training. This lack of preparation and support not only impacts the well-being of preceptors but also compromises the quality of education provided to nursing students. In this article, the complexities of the clinical environment, including high patient acuity, demanding workloads and limited teaching time, are highlighted. If we are serious about preparing quality nurses, then we need to get serious about supporting those who are key to their learning and transition into practice.
The clinical practice of preschool neuropsychology assumes that our assessment tools are measuring underlying neuropsychological functions, and that these functions are negatively impacted by early life neurological injury, disease, and disorder. This study hypothesized that general intellectual capacity and specific cognitive skills, both "broad" neuropsychological domains and "specific" subdomains within those broader clusters, would be differentiable in a preschool-age clinical population. Using neuropsychological data from 580 children (6 and 71 months) seen for a clinical neuropsychological evaluation in the Preschool and Infant Neuropsychological Testing (PINT) Clinic, exploratory factor analyses (EFA) were conducted. Results: A one-factor model provided a good fit when considering verbal, nonverbal, and adaptive functions. Consideration of one- versus two-factor solutions for broad neuropsychological domains indicated that a 2-factor solution provided a significantly better fit for the data. Factor 1 was defined by motor, language, and nonverbal reasoning abilities; Factor 2 was defined by inhibitory control and attention. Further consideration of specific neuropsychological functions also supported a 2-factor solution. Factor 1 ("thinking") was defined by nonverbal reasoning, receptive language, and expressive language; Factor 2 ("processing") was defined by impulse control, inhibitory control, inattention, visual-motor integration, and visuo-constructional abilities. Motor skills cross-loaded onto both factors. Secondary analyses suggest these models provide the best fit for preschool-aged children with > 70 overall intellectual functioning and no comorbid medical diagnosis. In a clinical sample of preschool-age children, neuropsychological assessment data appears to assess a general level of intellectual capacity or functioning. Further differentiation between assessing "thinking" (knowledge and reasoning skills) and "processing" (cognitive attention and processing of information) can be considered clinically. Next steps include more recent clinical sample replication, consideration of whether neuropsychological profiles are detectable in the preschool-age range and whether the results of early life assessment are predictive of future functioning.
The clinical quality improvement initiatives, led by the organisation's Health Equity Working Group (HEWG), aim to support healthcare providers to provide equitable, quality hypertension care worldwide. After coordinating with the India team, we started monitoring the deidentified patient data collected through electronic health records between January and May 2021. After stratifying data by age, sex and residence location, the team found an average of 55.94% of our hypertensive patients control their blood pressure, with an inequity of 11.91% between male and female patients.The objective of this study was to assess the effectiveness of using clinical quality improvement to improve hypertension care in the limited-resourced, mobile healthcare setting in Mumbai slums. We used the model for improvement, developed by Associates in Process Improvement. After 9-month Plan-Do-Study-Act (PDSA) cycles, the average hypertensive patients with controlled blood pressure improved from 55.94% to 89.86% at the endpoint of the initiative. The gender gap reduced significantly from 11.91% to 2.19%. We continued to monitor the blood pressure and found that the average hypertensive patients with controlled blood pressure remained stable at 89.23% and the gender gap slightly increased to 3.14%. Hypertensive patients have 6.43 times higher chance of having controlled blood pressure compared with the preintervention after the 9-month intervention (p<0.001).This paper discusses the efforts to improve hypertension care and reduce health inequities in Mumbai's urban slums. We highlighted the methods used to identify and bridge health inequity gaps and the testing of PDSA cycles to improve care quality and reduce disparities. Our findings have shown that clinical quality improvement initiatives and the PDSA cycle can successfully improve health outcomes and decrease gender disparity in the limited-resource setting.
The clinical reasoning process, which requires biomedical knowledge, knowledge about problem-solving strategies, and knowledge about reasons for diagnostic procedures, is a key element of physicians' daily practice but difficult to assess. The aim of this study was to empirically develop a Clinical Reasoning Indicators-History Taking-Scale (CRI-HT-S) and to assess the clinical reasoning ability of advanced medical students during a simulation involving history taking. The Clinical Reasoning Indictors-History Taking-Scale (CRI-HT-S) including a 5-point Likert scale for assessment was designed from clinical reasoning indicators identified in a qualitative study in 2017. To assess indicators of clinical reasoning ability, 65 advanced medical students (semester 10, n = 25 versus final year, n = 40) from three medical schools participated in a 360-degree competence assessment in the role of beginning residents during a simulated first workday in hospital. This assessment included a consultation hour with five simulated patients which was videotaped. Videos of 325 patient consultations were assessed using the CRI-HT-S. A factor analysis was conducted and the students' results were compared according to their advancement in undergraduate medical training. The clinical reasoning indicators of the CRI-HT-S loaded on three factors relevant for clinical reasoning: 1) focusing questions, 2) creating context, and 3) securing information. Students reached significantly different scores (p < .001) for the three factors (factor 1: 4.07 ± .47, factor 2: 3.72 ± .43, factor 3: 2.79 ± .83). Students in semester 10 reached significantly lower scores for factor 3 than students in their final year (p < .05). The newly developed CRI-HT-S worked well for quantitative assessment of clinical reasoning indicators during history taking. Its three-factored structure helped to explore different aspects of clinical reasoning. Whether the CRI-HT-S has the potential to be used as a scale in objective structured clinical examinations (OCSEs) or in workplace-based assessments of clinical reasoning has to be investigated in further studies with larger student cohorts.
The clinical reasoning skills is often gained when the biomedical knowledge is broadened and deepened alongside exposure to patients. The 'ideal' blend of axioms of clinical reasoning and case based learning would establish the pedagogical bridges right from the first year of medical education. So this study aimed to investigate the perceived importance and efficacy of teaching clinical reasoning skills among first year medical students, as this has not previously been described. As a priori, two clinical reasoning skill sessions were conducted using clinico-anatomical case vignettes designed according to the literature regarding clinical reasoning ('serial cue' approach and hypothetico-deduction). Students were divided into intervention and control group and crossed over in subsequent sessions. Analysis was done by mixed method approach including measuring proof of benefit using post-test comparison, quantitative survey and qualitative analysis by nominal group discussion. Post test scores were compared using student's t-test. Feedbacks were analysed using descriptive statistics. The results showed that post test scores were significantly higher in intervention group than the control group in both sessions (P<0.001, 0.016). A total of 66% students felt, diagnostic skills and lateral thinking abilities were improved and It helped in developing problem-solving abilities for 67% students. clinico-anatomical case vignettes helped in understanding anatomical basis of clinical conditions for 61% students. To conclude, introducing clinical reasoning has considerable effect in improving the decision making ability of the students and if incorporated right from the first year, would better prepare the students in successful transition to clinical learning environment.
The coexistence of diabetes and depression has resulted in poor quality of life. Reported literature suggested the need for research for assessing the correlates of both quality of life along with depression in diabetic persons. To assess the quality of life (QOL), the prevalence of depression and associated factors in diabetic patients attending the lifestyle clinic of a tertiary healthcare facility in Eastern India. This hospital-based descriptive, cross-sectional research recruited 219 patients with diabetes to assess the QOL and depression in the lifestyle clinic of a tertiary healthcare facility. The quality of life was assessed with the help of the World Health Organization (WHO) QOL BREF instrument. Depression was determined by a standardized Patient Health Questionnaire - 9(PHQ-9). The sociodemographic and diabetes-related information were collected by a semistructured questionnaire. Clinical and anthropometric examinations were conducted. All the available data were initially coded and then analyzed using the SPSS 22.0 licensed software. The participants had a median age of 54 years. Illiteracy was significantly more among females. Hypertension was the most common comorbidity. Gender-wise difference in mean of weight, height, hip circumference, and QOL score in the psychosocial domain was significant. The mean QOL score was least in the social domain and highest in the environmental domain. Literate patients had a statistically significantly better QOL. Depression was observed significantly more in females, illiterates, and unemployed respondents. Diabetic women with lesser literacy have an increased risk of poor QOL. Women, illiterates, and the unemployed suffered more from depression. Therefore, a target-specific, routine, and well-planned clinic approach is needed to improve the QOL and mental health of respondents.
The coexistence of heart failure and diabetes is prevalent, particularly in Intensive Care Units (ICU). However, the relationship between the triglyceride-glucose (TyG) index, heart failure, diabetes, and the length of hospital stay (LHS) in patients with cerebrovascular disease in the ICU remains uncertain. This study aims to investigate the association between the TyG index and LHS in patients with heart failure and diabetes. This retrospective study utilized the Medical Information Mart for Intensive Care (MIMIC)-IV database to analyze patients with diabetes and heart failure. Participants were categorized into quartiles based on the TyG index, and the primary outcome was LHS. The association between the TyG index at ICU admission and LHS was examined through multivariable logistic regression models, restricted cubic spline regression, and subgroup analysis. The study included 635 patients with concurrent diabetes and heart failure. The fully adjusted model demonstrated a positive association between the TyG index and LHS. As a tertile variable (Q2 and Q3 vs Q1), the beta (β) values were 0.88 and 2.04, with a 95% confidence interval (95%CI) of -0.68 to 2.44 and 0.33 to 3.74, respectively. As a continuous variable, per 1 unit increment, the β (95% CI) was 1.13 (0.18 to 2.08). The TyG index's relationship with LHS showed linearity (non-linear p = 0.751). Stratified analyses further confirmed the robustness of this correlation. The TyG index exhibited a linearly positive association with the LHS in patients with both heart failure and diabetes. Nevertheless, prospective, randomized, controlled studies are imperative to substantiate and validate the findings presented in this investigation.
The cognitive and behavioral deficits associated with air pollution exposure may have far-reaching negative effects on children's scholastic achievement. Moreover, air pollution may be conditioning the success of educational investments that support students who face greatest levels of societal adversity. This study examined the direct main effects of cumulative neurotoxicological exposure on annual reading improvement. We also tested the statistical interaction (i.e., moderation) of neurotoxicological exposure and academic intervention sessions on annual reading improvement for a large sample of ethnic minority (95%) elementary school children (n = 6080, k-6th grade) enrolled in a standard literacy enrichment program. These children were all behind grade level in reading and attended predominantly low-income schools (n = 85) in urban settings across the state of California. Multi-level modeling assessments accounted for random effects associated with school and neighborhood environments, and incorporated extensive individual, school, and community level covariates. Findings show individual elementary students of color to progress less in reading when exposed to greater accumulations of neurotoxin air pollution in their home and school environments, with the average deficit equivalent to 1.5 weeks of learning delay per year. Findings also show neurotoxicological exposure to diminish the efficacy of literacy intervention sessions received on reading improvement throughout the school year. Results suggest that pollution abatement can be a salient strategy to help bridge the child educational achievement gap. In addition to several methodological strengths, this study is one of the first to show that ambient pollution can undermine program efficacy of a literacy enrichment program.
The Cognitive Reflection Test (CRT) is a measure of analytical reasoning that cues an intuitive but incorrect response that must be rejected for successful performance to be attained. The CRT yields two types of errors: Intuitive errors, which are attributed to Type 1 processes; and non-intuitive errors, which result from poor numeracy skills or deficient reasoning. Past research shows that participants who commit the highest numbers of errors on the CRT overestimate their performance the most, whereas those with the lowest error-rates tend to slightly underestimate. This is an example of the Dunning-Kruger Effect (DKE). The present study examined how intuitive vs. non-intuitive errors contribute to overestimation in the CRT at different levels of performance. Female undergraduate students completed a seven-item CRT test and subsequently estimated their raw score. They also filled out the Faith in Intuition (FI) questionnaire, which is a dispositional measure of intuitive thinking. Data was separated into quartiles based on level of performance on the CRT. The results demonstrated the DKE. Additionally, intuitive and non-intuitive errors predicted miscalibration among low, but not high performers. However, intuitive errors were a stronger predictor of miscalibration. Finally, FI was positively correlated with CRT self-estimates and miscalibration, indicating that participants who perceived themselves to be more intuitive were worse at estimating their score. These results taken together suggest that participants who perform poorly in the CRT and also those who score higher in intuitive thinking disposition are more susceptible to the influences of heuristic-based cues, such as answer fluency, when judging their performance.
The combination of transcranial magnetic stimulation (TMS) and electroencephalography (EEG) allows researchers to explore cortico-cortical connections. To study effective connections, the first few tens of milliseconds of the TMS-evoked potentials are the most critical. Yet, TMS-evoked artifacts complicate the interpretation of early-latency data. Data-processing strategies like independent component analysis (ICA) and the combined signal-space projection-source-informed reconstruction approach (SSP-SIR) are designed to mitigate artifacts, but their objective assessment is challenging because the true neuronal EEG responses under large-amplitude artifacts are generally unknown. Through simulations, we quantified how the spatiotemporal properties of the artifacts affect the cleaning performances of ICA and SSP-SIR. We simulated TMS-induced muscle artifacts and superposed them on pre-processed TMS-EEG data, serving as the ground truth. The simulated muscle artifacts were varied both in terms of their topography and temporal profiles. The signals were then cleaned using ICA and SSP-SIR, and subsequent comparisons were made with the ground truth data. ICA performed better when the artifact time courses were highly variable across the trials, whereas the effectiveness of SSP-SIR depended on the congruence between the artifact and neuronal topographies, with the performance of SSP-SIR being better when difference between topographies was larger. Overall, SSP-SIR performed better than ICA across the tested conditions. Based on these simulations, SSP-SIR appears to be more effective in suppressing TMS-evoked muscle artifacts. These artifacts are shown to be highly time-locked to the TMS pulse and manifest in topographies that differ substantially from the patterns of neuronal potentials. Selecting between ICA and SSP-SIR should be guided by the characteristics of the artifacts. SSP-SIR might be better equipped for suppressing time-locked artifacts, provided that their topographies are sufficiently different from the neuronal potential patterns of interest, and that the SSP-SIR algorithm can successfully find those artifact topographies from the high-pass-filtered data. ICA remains a powerful tool for rejecting artifacts that are not strongly time locked to the TMS pulse.
The community misunderstands mental illness, resulting in stigmatizing attitudes toward persons with mental illness. High mental health literacy (MHL) among Accredited Social Health Activists (ASHA) workers can help spread mental health awareness to the community. The study aimed to assess the attitudes of ASHA workers toward the mentally ill. A cross-sectional survey was conducted among ASHA workers in the city of Ahmedabad using the Community Attitude toward Mentally Ill (CAMI) scale - Gujarati version. Census sampling was used to collect data from ASHA workers at various Urban Health Centers (UHC). We analyzed 265 responses. The mean (SD) of authoritarianism (AU), benevolence (BE), social restrictiveness (SR), and community mental health ideology (CMHI) subscales were 29.77(3.35), 35.33(3.78), 34.55(3.49), and 37.15(4.42), respectively (a higher mean suggests a negative attitude in the AU and SR subscales and a positive attitude in the BE and CMHI subscales). Although ASHA workers displayed goodwill and a welcoming attitude on the BE and CMHI subscales, they showed negative and stigmatizing attitudes on certain items of the AU and SR subscales. This necessitates a widespread mental health education campaign and training program for them.
The comparison of the educational curriculum improves the content and quality of the curriculum and needs to be revised and modified in line with the current needs of society. Development of nursing knowledge, the emergence of emerging diseases requires that the nursing curriculum be codified and provide the necessary skills to provide quality and safe care. The study aimed to Comparison of Iranian and Scandinavian Bachelor of Nursing Curriculum (Sweden). This descriptive-comparative study was conducted based on the Bereday model in four stages: Description, Interpretation, Juxtaposition, Comparison, and Analysis in 2022. We use relevant electronic databases such as PubMed, CINAHL, Web of Science, Iran Medex, SID, Magiran, Google Scholar, Iran Doc, and Science Direct databases. The results showed that despite the similarities, the Swedish nursing curriculum had special features in most of the mentioned dimensions. Including decentralized admission, Fits the need, competency-based curriculum, attention to holistic care and intercultural care, use of new digital technologies in education, and clinical training and evaluation. It seems that the Iranian nursing curriculum is far from the mentioned perspective. Using the experiences of the world's top universities, such as Sweden, can improve the quality of nursing undergraduate programs and improve the nursing profession by eliminating current shortcomings.