Association between self-reported METs and other perioperative cardiorespiratory fitness assessment tools in abdominal surgery-a prospective cross-sectional correlation study.

Cardiovascular complications represent a significant proportion of adverse events during the perioperative period, necessitating accurate preoperative risk assessment. This study aimed to investigate the association between well-established risk assessment tools and self-reported preoperative physical performance, quantified by metabolic equivalent (MET) equivalents, in high-risk patients scheduled for elective abdominal surgery. A prospective cross-sectional correlation study was conducted, involving 184 patients admitted to a Gastrointestinal Surgery Department. Various risk assessment tools, including the Revised Cardiac Risk Index (RCRI), Surgical Mortality Probability Model (S-MPM), American University of Beirut (AUB)-HAS2 Cardiovascular Risk Index, and Surgical Risk Calculator (NSQIP-MICA), were utilized to evaluate perioperative risk. Patients self-reported their physical performance using the MET-REPAIR questionnaire. The findings demonstrated weak or negligible correlations between the risk assessment tools and self-reported MET equivalents (Spearman's ρ = - 0.1 to - 0.3). However, a statistically significant relationship was observed between the ability to ascend two flights of stairs and the risk assessment scores. Good correlations were identified among ASA-PS, S-MPM, NSQIP-MICA, and AUB-HAS2 scores (Spearman's ρ = 0.3-0.8). Although risk assessment tools exhibited limited correlation with self-reported MET equivalents, simple questions regarding physical fitness, such as the ability to climb stairs, showed better associations. A comprehensive preoperative risk assessment should incorporate both objective and subjective measures to enhance accuracy. Further research with larger cohorts is needed to validate these findings and develop a comprehensive screening tool for high-risk patients undergoing elective abdominal surgery.

Assessment of occupational stress among certified registered anesthetists in the Greater Accra region.

Background: Work-related stress is a prevailing concern within the community of Certified Registered Anesthetists (CRAs), significantly impacting both the health and professional performance of these individuals. This study aimed to assess work-related stress and its influencing factors among CRAs practicing in the Greater Accra region was examined. Methods: Using convenience sampling techniques, data were gathered from 140 participants via a Google form questionnaire distributed through WhatsApp. Descriptive statistics were employed to analyze the collected data, focusing on frequencies and proportions for categorical variables. For continuous variables, bivariate analysis (Chi-square) and ordinal logistic regression were conducted using STATA 16. A p-value <0.05 was considered significant. Results: Among the 140 CRAs, 20 individuals (14.3%) reported experiencing mild stress levels according to the Weiman Occupational Stress Scale. Approximately 3 out of 4 CRAs (73.6%) reported having moderate stress levels, and 12.1% reported severe stress levels. This indicated that the majority of CRAs experienced moderate levels of stress, which was notably affected by the type of health facility and the use of inadequate or sub-standard equipment in the hospitals. Conclusion: Based on these findings, the study recommends educational programs and counseling for CRAs to heighten awareness of the demanding nature of their job. Additionally, it suggests the provision of proper resources and standard equipment for CRAs. Facility-level motivation for CRAs is also advised to alleviate their stress. Finally, the study proposes further investigations into the factors contributing to work-related stress among CRAs.

Screening of sustainable supply chain performance evaluation indicators based on the ill-conditioned index cycle method.

The establishment of an evaluation indicator system that can accurately assess the sustainability of a supply chain while further enhancing its performance is vital and relevant. Based on the connotation of sustainable supply chains and triple bottom line theory, indicators are initially proposed from economic, environmental, and social dimensions. To increase the explanatory power of the indicator system and decrease information redundancy, the coefficient of variation is applied to identify the indicators with weak interpretation intensity, the ill-conditioned index cycle method is utilized to filter out indicators with redundant information, and data on 100 Chinese listed companies from 2019 to 2021 are used as samples. A performance evaluation indicator system of sustainable supply chains with 16 indicators is ultimately established. The information interpretation strength index and cumulative information contribution rate verify the rationality of the final indicator system. The outcome demonstrates that this screening method can strengthen the representativeness of the indicator system and rapidly reduce redundancy, leading to the better discrimination of the evaluation results. The findings of this study provide an indicator system and a methodological reference for both companies and policymakers and can aid in the transformation of supply chains toward sustainability.

Spatial patterns and determinants of low utilization of delivery care service and postnatal check-up within 2 months following birth in Ethiopia: Bivariate analysis.

BACKGROUND: Home delivery is a nonclinical childbirth practice that takes place in one's home with or without traditional birth attendants and postnatal care is the care given to the mother and her newborn baby; according to world health organization (WHO), the postnatal phase, begins one hour after birth and lasts six weeks (42 days). This paper aimed to study the spatial pattern and determinant factors of low utilization of delivery care (DC) services and postnatal check-up (PNC) after live births in Ethiopia. METHODS: This study used the 2016 Ethiopian Demographic and Health Survey data as a source. A total weighted samples of 11023 women-children pairs were included. The bivariate binary logistic regression analyses with spatial effect were modeled using SAS version 9.4 and ArcGIS version 10.8 was used for mapping. RESULTS: The spatial distribution of low utilization of delivery care service and postnatal check-up were significantly clustered in Ethiopia (Moran's I statistic 0.378, P-value < 0.001 and 0.177, P-value < 0.001 respectively). Among 11023 children-women pair, the prevalence of home delivery and no postnatal check-up within two months following birth were 72.6% and 91.4% respectively. The Liben, Borena, Guji, Bale, Dolo and Zone 2 were predicted to have high prevalence of home delivery and part of Afder, Shabelle, Korahe, Dolo and Zone 2 were high risk areas of no postnatal checkup. CONCLUSION AND RECOMMENDATIONS: Lack of occupation, region, large family size, higher birth order, low utilization of antenatal care visit, unable to access mass media, big problem of health facility distance and the spatial variable were found to be jointly significant predictors of low utilization of DC and PNC in Ethiopia. Whereas older age, being reside in rural area and low wealth status affects delivery care service utilization. We suggest health providers, policy makers and stakeholders consider those variables with priority given to Liben, Borena, Guji, Bale, Dolo, Zone 2, Afder, Shabelle and Korahe, where home delivery and no PNC were predicted relatively high. We also recommend researchers to conduct further studies using latest survey data set.

A postpartum functional assessment tool for women based on the international classification of functioning, disability and health.

BACKGROUND: Postpartum dysfunctions and complications can occur in women. However, functional assessment should be conducted to make treatment plans before any intervention is implemented. In this context, the International Classification of Functioning, Disability and Health (ICF) may be a useful tool for women postpartum to document functional data and set rehabilitation goals. The purpose of this study was to determine the corresponding domains that should be considered in the evaluation of women's postpartum functioning based on the International Classification of Functioning, Disability and Health (ICF) model using the Delphi method. METHODS: Fifteen domestic experts were invited to conduct two rounds of expert consensus survey on the ICF-based postpartum functional assessment category pool obtained through literature retrieval, clinical investigation, and reference to relevant literature. The sample was medical staff with professional knowledge of women's health. The opinions of experts were summarized, and the positive coefficient, authority coefficient and coordination degree of experts were calculated. RESULTS: A total of 15 domestic experts participated in this expert consensus. Through two rounds of a questionnaire survey, 69 items were finally selected to form the ICF-based postpartum functional assessment tool for women. The items included 32 items of body function, 12 items of body structure, 17 items of activity and participation, and 8 items of environmental factors. In addition, we identified 8 items of personal factors. The expert positive coefficients of the two rounds of expert consensus were both 100%, the authority coefficient was 0.789, and the coefficient of variation was between 0.09 to 0.31. CONCLUSION: A postpartum functional assessment tool for women based on the ICF model was constructed based on the Delphi method, which can provide more comprehensive health management and life intervention for postpartum women. TRIAL REGISTRATION: The Registration number of the Chinese Clinical Trial Registry is ChiCTR2200066163, 25/11/2022.

Implicit Bias Toward Lesbian and Gay Persons Among Nursing Students: A Correlation Study.

AIM: The purpose of this study was to measure implicit bias among nursing students toward lesbian and gay (LG) persons. BACKGROUND: Implicit bias is identified as a contributor to the health disparities experienced by LG persons. This bias has not been studied among nursing students. METHOD: This descriptive, correlation study used the Implicit Association Test to measure implicit bias in a convenience sample of baccalaureate nursing students. Demographic information was collected to identify relevant predictor variables. RESULTS: Implicit bias in this sample ( n = 1,348) favored straight persons over LG persons ( D -score = 0.22). Participants identifying as male ( B = 0.19), straight ( B = 0.65), other sexuality ( B = 0.33), somewhat ( B = 0.09) or very religious ( B = 0.14), or enrollment in an RN-BSN program ( B = 0.11) predicted stronger bias favoring straight persons. CONCLUSION: Implicit bias toward LG persons among nursing students remains a challenge for educators.

Los patrones básicos de movimiento saltar y lanzar: la evaluación del proceso y el producto / Basic movement patterns in jumping: an assessment of the process and output / Os padrões fundamentais de movimento de salto e arremesso: a avaliação do processo e do produto

Resumen Este estudio analizó la relación entre la evaluación del producto y la evaluación del proceso de los patrones básicos de movimiento saltar y lanzar. 40 sujetos, todos hombres, 10.03 ± 0.3 años, 37.82 ± 13.9 kg, 139 ± 28 cm y 19.38 ± 4.5 IMC (kg/m2). Se utilizó el Instrumento Patrones Básicos de Movimiento (IPBM) para la evaluación del proceso; en los productos se realizaron las pruebas salto de longitud y de lanzamiento por encima del hombro para saltar y lanzar, respectivamente. Se hizo estadística descriptiva (promedios y desviaciones estándar) para las medidas antropométricas y para analizar la relación de los resultados de los dos intentos de producto y de proceso, correlación de Spearman a un nivel de significancia de p ≤ .05 y p ≤ .01. Las correlaciones obtenidas expusieron la existencia de una relación positiva y significativa entre la evaluación del proceso y la evaluación del producto de saltar en el intento 1 (r = 0.447; p = .004; r2 = 0.200) y en el intento 2 (r = 0.562; p < .0001; r2 = 0.316), de igual forma entre la evaluación del proceso y la evaluación del producto de lanzar en el intento 1 (r = 0.332; p = .043; r2 = 0.011) y en el intento 2 (r = 0.311; p = .051, r2 = 0.097). La correlación indica que los sujetos con mejores resultados en las evaluaciones orientadas al proceso tienen mejores resultados en las evaluaciones orientadas al producto; sugiere que, al mejorar la técnica, se puede mejorar el producto. Al comprender cómo la evaluación orientada al proceso y la evaluación orientada al producto se relacionan entre sí e identificar qué se quiere medir y para qué, se puede esperar objetividad en los métodos de la valoración de la ejecución del movimiento humano desde el enfoque del proceso y el producto.

Abstract This study examines the relationship between output assessment and process assessment for basic movement patterns in jumping and throwing. Forty subjects, all male, 10.03 ± 0.3 years old, 37.82 ± 13.9 kg, 139 ± 28 cm and 19.38 ± 4.5 IMC (kg/m2) participated. The Basic Movement Patterns Instrument (IPBM) was used for assessing the process. For the output, length jump and over-the-shoulder throw tests were made for jumping and throwing, respectively. A descriptive statistics was carried out (averages and standard deviations) for the anthropometric measurements, and for examining the relationship of the outcomes of the two output and process attempts, Spearman correlation at a significance level of p ≤ 0.5 and p ≤ .01 was used. The resulting correlations showed the existence of a positive and significant relationship between process assessment and output assessment of jumping of (r = 0.447; p = .004; r2 = 0.200) in attempt 1 and of (r = 0.562; p < .0001; r2 = 0.316) in attempt 2. Similar results were found between process assessment and output assessment of throwing, (r = 0.332; p = .043; r2 = 0.011) in attempt 1 and (r = 0.311; p = .051, r2 = 0.097) in attempt 2. The correlation indicates that the subjects with the best results in process-oriented assessments have better results in output-oriented assessments; this suggests that the output can be improved by improving the technique. In understanding how process-oriented assessment and output-oriented assessment are mutually related, and in identifying what you want to measure and for what purpose, objectivity can be expected in the methods for assessing the performance of human movement with a process and output approach.

Resumo Este estudo analisou a relação entre a avaliação do produto e a avaliação do processo dos padrões fundamentais de movimento de salto e arremesso. 40 indivíduos, todos do sexo masculino, 10,03 ± 0,3 anos, 37,82 ± 13,9 kg, 139 ± 28 cm e 19,38 ± 4,5 IMC (kg/m2). O Instrumento de Padrões Fundamentais de Movimento (IPFM) foi utilizado para avaliar o processo; os produtos foram testados para salto em distância e arremesso sobre o ombro para salto e arremesso, respectivamente. Estatísticas descritivas (médias e desvios padrão) foram feitas para as medidas antropométricas e para analisar a relação dos resultados das duas tentativas de produto e processo, correlação de Spearman com nível de significância p ≤ 0,05 e p ≤ 0,01. As correlações obtidas expuseram a existência de uma relação positiva e significativa entre a avaliação do processo e a avaliação do produto do salto na tentativa 1 (r = 0,447; p = .004; r2 = 0,200) e na tentativa 2 (r = 0,562; p < 0,0001; r 2 = 0,316), da mesma forma entre a avaliação do processo e a avaliação do produto do arremesso na tentativa 1 (r = 0,332; p = 0,043; r 2 = 0,011) e na tentativa 2 (r = 0,311; p = 0,051, r 2 = 0,097). A correlação indica que os indivíduos com melhores resultados nas avaliações voltadas para o processo têm melhores resultados nas avaliações voltadas para o produto; sugere que melhorando a técnica, o produto pode ser melhorado. Ao compreender como a avaliação voltada para o processo e a avaliação voltada para o produto se relacionam entre si e identificar o que e para que medir, é possível esperar objetividade nos métodos da avaliação da execução do movimento humano a partir da perspectiva do processo e do produto.

Agricultural total factor productivity, digital economy and agricultural high-quality development.

The long-term and stable development of agriculture is the key to China's economic development and social stability. Agricultural total factor productivity and the digital economy have become new kinetic energy and new engines driving agricultural high-quality development. It is of great significance to verify whether there are significant spatial and threshold effects in the process of high-quality development of agriculture and to explore the intrinsic relationship between high-quality development of agriculture and agricultural total factor productivity and digital economy. This paper takes 31 provinces in China from 2011 to 2020 as the research object. The coefficient of variation method is used to estimate the comprehensive evaluation index of agricultural high-quality development and digital economy. And Dea-Malmquist index method is used to estimate agricultural total factor productivity. On this basis, the spatial Durbin model and threshold regression model are constructed to explore the spatial and threshold effects of agricultural total factor productivity, digital economy and other factors and high-quality agricultural development. The conclusion is as follows: the high-quality development of agriculture has significant spatial autocorrelation. Agricultural total factor productivity and digital economy have significant direct effect and indirect spillover effect on the high-quality development of agriculture. Agricultural total factor productivity has stage differences in each range of digital economy level, but its influence on agricultural high-quality development shows a positive state. Based on this, the paper puts forward some countermeasures to promote the high-quality development of agriculture.

Nonparametric item response models: a comparison on recovering true scores / Modelos de resposta ao item não-paramétricos: comparando a recuperação de escores verdadeiros / Modelos de respuesta al item no-paramétricos: comparando la recuperación de puntuaciones verdaderas

Nonparametric procedures are used to add flexibility to models. Three nonparametric item response models have been proposed, but not directly compared: the Kernel smoothing (KS-IRT); the Davidian-Curve (DC-IRT); and the Bayesian semiparametric Rasch model (SP-Rasch). The main aim of the present study is to compare the performance of these procedures in recovering simulated true scores, using sum scores as benchmarks. The secondary aim is to compare their performances in terms of practical equivalence with real data. Overall, the results show that, apart from the DC-IRT, which is the model that performs the worse, all the other models give results quite similar to those when sum scores are used. These results are followed by a discussion with practical implications and recommendations for future studies.(AU)

Procedimentos não paramétricos são usados para adicionar flexibilidade aos modelos. Três modelos não paramétricos de resposta ao item foram propostos, mas não comparados diretamente: o Kernel smoothing (KS-IRT); a Curva Davidiana (DC-IRT); e o modelo semiparamétrico Rasch Bayesiano (SP-Rasch). O objetivo principal do presente estudo é comparar o desempenho desses procedimentos na recuperação de escores verdadeiros simulados, utilizando escores de soma como benchmarks. O objetivo secundário é comparar seus desempenhos em termos de equivalência prática com dados reais. De forma geral, os resultados mostram que, além do DC-IRT, que é o modelo que apresenta o pior desempenho, todos os outros modelos apresentam resultados bastante semelhantes aos de quando se usam somatórios. Esses resultados são seguidos de uma discussão com implicações práticas e recomendações para estudos futuros.(AU)

Se utilizan procedimientos no paramétricos para agregar flexibilidad a los modelos. Se propusieron tres modelos de respuesta al ítem no paramétricos, pero no se compararon directamente: Kernel smoothing (KS-IRT); la curva davidiana (DC-IRT); y el modelo bayesiano de Rasch semiparamétrico (SP-Rasch). El objetivo principal del presente estudio es comparar el desempeño de estos procedimientos en la recuperación de puntajes verdaderos simulados, utilizando puntajes de suma como puntos de referencia. El objetivo secundario es comparar su desempeño en términos de equivalencia práctica con datos reales. En general, los resultados muestran que, a excepción de DC-IRT, que es el modelo con peor desempeño, todos los otros modelos presentan resultados bastante similares a los obtenidos cuando se utilizan sumatorios. Estos resultados son seguidos por una discusión con implicaciones prácticas y recomendaciones para estudios futuros.(AU)

Neighborhood Unsafety, Discrimination, and Food Insecurity among Nigerians Aged 15-49.

We investigated the association between discrimination, neighborhood unsafety, and household food insecurity (FI) among Nigerian adults, as well as the gender-specific differences in these associations. Our analysis utilized data from the 2021 Multiple Indicator Cluster Survey (MICS), comprising 56,146 Nigerian adults aged 15-49 (17,346 males and 38,800 females). For bivariate analysis, we employed the Rao-Scott chi-square test to examine the relationship between predictors (discrimination, neighborhood unsafety, and a composite variable of both) and the outcome variable (FI). Food insecurity was assessed using both a dichotomous measure (food insecure vs. food secure) and a multinomial variable (food secure, mild FI, moderate FI, and severe FI). To model the association between predictors and FI while controlling for potential confounding factors, we utilized weighted binary and multinomial logistic regression. Among Nigerian adults, the prevalence of having ever experienced FI was 86.1%, with the prevalence of mild FI, moderate FI, and severe FI being 11.5%, 30.1%, and 44.5%, respectively. In the binary model, experiencing discrimination (OR = 1.36, 95% CI = 1.19-1.55), living in an unsafe neighborhood (OR = 1.33, 95% CI = 1.14-1.54), and facing both discrimination and unsafe neighborhood conditions (OR = 1.97, 95% CI = 1.57-2.48) were significantly associated with FI. In the multinomial model, discrimination, neighborhood unsafety, and experiencing both remained associated with moderate and severe FI. In the gender-specific models, discrimination and neighborhood unsafety were found to be significantly associated with FI in women but not in men. This study underscores the importance of implementing policies and programs that address the underlying causes of food insecurity, with specific attention to discrimination and neighborhood safety concerns, particularly for Nigerian women.

Trends in Cumulative Disenrollment in the Medicare Advantage Program, 2011-2020.

Importance: The Medicare Advantage (MA) program is rapidly growing. While previous work has found that beneficiaries with substantial health needs disenroll from plans at higher rates, the long-term frequency of disenrollment is not well understood. Objective: To compare cumulative disenrollment trends in the MA program by beneficiary and plan characteristics. Design, Setting, and Participants: This retrospective, serial cross-sectional study included beneficiaries with any MA enrollment from January 1, 2011, to December 31, 2020. Data analysis took place from September 2022 to March 2023. Exposures: Beneficiary characteristics, including race and ethnicity, length of Medicare enrollment, dual eligibility, and comorbidity burden, and contract characteristics, including vertical integration status, premium, and MA star rating. Main Outcomes and Measures: The main outcome was disenrollment from an MA contract within 5 years. Rates of cumulative disenrollment by beneficiary and contract characteristics were compared. Pearson correlation coefficients were calculated to assess the correlation between a contract's 1-year disenrollment and the contract's disenrollment over a longer period. Results: The sample included 82 377 917 beneficiaries (524 442 225 beneficiary-year observations; 56.7% female; mean [SD] age, 71.9 [10.3] years). After 1 year, 13.2% of nondually enrolled and 15.9% of dually enrolled beneficiaries had left their contract, increasing to 48.3% and 53.4%, respectively, after 5 years. Black enrollees disenrolled at the highest rates among race and ethnicity categories, with 14.8% disenrolling after 1 year and 52.6% disenrolling after 5 years. Contracts had a median disenrollment rate of 9.8% (IQR, 4.5%-19.0%) after 1 year and 56.1% (IQR, 23.1%-79.0%) after 5 years. Contracts rated 5 stars had substantially lower 5-year disenrollment rates (23.0% after 5 years compared with 41.2% for 4- to 4.5-star contracts and 67.2% for 3- to 3.5-star contracts). Disenrollment from a contract after 1 year was not well correlated with disenrollment after 5 years (r, 0.46). Conclusions and Relevance: This cross-sectional study found substantial cumulative rates of disenrollment from MA plans within 5 years between 2011 and 2020, with wide variation in 5-year disenrollment by contract. The findings suggest that evaluating long-term disenrollment rates in MA performance measures may capture different outcomes than single-year disenrollment alone.

Evaluation of the usefulness of a paper-pencil group cognitive assessment for older adults in the community.

BACKGROUND: As the older population increases, the need for early detection of cognitive decline is also increasing. In this study, we examined whether our paper-pencil type group examination for cognitive assessment (PAPLICA) could detect the effects of years of education and aging. METHODS: PAPLICA was conducted on 829 older people. The inclusion criteria were age 60 years or older and the ability to come to the event site alone. The exclusion criteria were participants with a medical or psychiatric disorder or dementia.One examiner conducted the test on a group of approximately 10-20 people in approximately 25 min. Participants were instructed on tackling the issues projected on the projector, and their answers were recorded in a response booklet. RESULTS: An independent sample t-test was performed for years of education, and ANCOVA was performed for aging. Among the test items included in PAPLICA, the Speed I and Letter fluency tests were unable to detect the effects of aging. Furthermore, the age at which the effect of aging manifests varies depending on the test item. For instance, a decline in scores in the Speed I and Picture ECR Free recall tests was observed in the 70-74 age group; for that of Word DRT, Picture ECR cued recall, and Similarity, in the 75-79 age group; for CFT, in the 80-84 age group, and for CLOX, the decline was observed in the 85 ≤ age group. CONCLUSIONS: PAPLICA, similar to other neuropsychological tests, was able to detect the effects of years of education and aging. Future testing should be conducted on different demographics to identify the differences in patterns of cognitive decline.

Multivariate decomposition of gender differentials in successful aging among older adults in India.

BACKGROUND: Rowe and Kahn define successful aging as a high physical, psychological, and social functioning in old age without major diseases. It is considered a viable solution to the burdens placed on healthcare systems and financial and social security in societies with aging population. The present study aimed to determine the prevalence of successful aging and explore the factors contributing to gender differentials in successful aging among older adults in India. METHODS: This study utilized data from the nationally representative Longitudinal Ageing Study in India, conducted in 2017-18. The study is based on a sample of 15,098 older men and 16,366 older women aged 60 years and above. The outcome variable was a dichotomous measure of successful aging with six components including absence of chronic diseases, free from disability, high cognitive ability, free from depressive symptoms, active social engagement in life and free from obesity. Older adults satisfying all these conditions were considered aging successfully. Descriptive and bivariate analyses were carried out. Proportion test was used to evaluate the gender differentials and reflect the statistical significance in the associated factors. Multivariate decomposition analysis was conducted to identify covariates' contribution in explaining the gender differences in successful aging. RESULTS: There was a significant gender difference in successful aging among older adults in India (Difference: 8.7%; p-value < 0.001] with 34.3% older men and 25.6% older women experiencing successful aging. A proportion of 88% of gender difference in successful aging was explained by the differences in the distribution of characteristics (Coef: 0.082; p-value < 0.05). Considerable gender gap in successful aging would be reduced if women had similar levels of work status (28% reduction) to their male counterparts. Bringing the level of frequent physical activity in women to the same levels observed in men would reduce the gender gap by 9%. CONCLUSIONS: The findings suggest that women had a lower score in successful aging, which is attributed to several socioeconomic and behavioural factors including not working status and physical inactivity. More studies must be done to explore the reasons for such differences and what particular factors in low-income countries create differences among older men and women in achieving successful aging.

A clinimetric assessment of the validity and reliability of 3D technology for scar surface area measurement.

INTRODUCTION: The quality of scars has become an important outcome of burn care. Objective scar assessment through scar surface area measurement enables quantification of scar formation and evaluation of treatment efficacy. 3D technology has proven valid and reliable but often remains cumbersome, expensive, and time-consuming. 3D technology with depth sensors on mobile devices has become available and might surpass these limitations. This study provides a clinimetric assessment of the validity and reliability of a 3D system with a depth sensor for scar surface area measurement. METHODS: A technology involving a depth sensor mounted on a mobile device was used. Images and analyses were made with a custom-made software application. A standardized one-keyframe image capturing procedure was followed. To assess validity, stickers with predefined dimensions (8.01 cm2 - 77.70 cm2) were imaged in a single observer setting on various body parts of healthy volunteers. To assess reliability, hypertrophic scars, keloids, and normotrophic scars were imaged and rated by two observers independently. Data are expressed as mean (+/-SD), Coefficient of Variation (CV), Intraclass Correlation Coefficients (ICC), and Limits of Agreements (LoA). RESULTS: Eighty stickers placed on 20 healthy volunteers showed validity with CV between 0.62%- 1.67% for observer A and 0.75%- 1.19% for observer B. For the reliability study, 69 scars on 36 patients were included. Mean scar surface area ranged from 0.83 cm2 to 155.59 cm2. Mean scar surface area measurement was 13.83 cm2 (SD 23.06) for observer A and 13.59 cm2 (SD 23.31) for observer B. Adjusted interobserver CV for trained observers is estimated as 5.59%, with corresponding LoA = 0 ± 0.15 x mean surface area. Interobserver ICCs were 0.99-1.00. CONCLUSION: This 3D technology with a depth sensor for measuring scar surface area provides valid and reliable data and thereby surpasses expensive and time-consuming 3D cameras.

Third-Grade Educational Outcomes of the Children of Adolescent Women.

OBJECTIVES: To evaluate third-grade reading and math proficiency for children born to adolescent women compared with those born to non-adolescent women. METHODS: A statewide, retrospective cohort study was conducted in Rhode Island using third-grade year-end examination data from 2014 to 2017 as part of a statewide initiative to improve third grade reading levels. Children's third-grade reading and math proficiencies were compared between those born to nulliparous adolescent women (age 15-19 at the time of delivery), and nulliparous women 20 years or older at delivery. Bivariate analyses were conducted to compare maternal and child characteristics between adolescent and non-adolescent groups. Multivariable logistic regression was used to examine the association between having an adolescent mother and being proficient in reading and math after adjusting for lunch subsidy, core city residence, child race/ethnicity and sex. RESULTS: Of the 8,248 children meeting the inclusion criteria, 20% were born to adolescent women and the remaining 80% were born to non-adolescent women. After adjusting for potential confounders, children born to adolescent women were significantly less likely to be proficient in both reading (adjusted risk ratio (aRR) 0.77, 95% confidence interval (CI): 0.71-0.83) and math (aRR 0.78, 95% CI: 0.72-0.85). CONCLUSIONS FOR PRACTICE: Children born to adolescent women had significantly lower rates of reading and math proficiency when compared with children of non-adolescent women. These children may benefit from additional resources focused on early academic performance in order to address disparities in reading and math proficiency.

Brief international cognitive assessment for MS (BICAMS) and global brain volumes in early stages of MS - A longitudinal correlation study.

BACKGROUND: Cognitive impairment is common in patients with multiple sclerosis, even in the early stages of the disease. The Brief International Cognitive Assessment for multiple sclerosis (BICAMS) is a short screening tool developed to assess cognitive function in everyday clinical practice. OBJECTIVE: To investigate associations between volumetric brain measures derived from a magnetic resonance imaging (MRI) examination and performance on BICAMS subtests in early stages of multiple sclerosis (MS). METHODS: BICAMS was used to assess cognitive function in 49 MS patients at baseline and after one and two years. The patients were separated into two groups (with or without cognitive impairment) based on their performances on BICAMSs subtests. MRI data were analysed by a software tool (MSMetrix), yielding normalized measures of global brain volumes and lesion volumes. Associations between cognitive tests and brain MRI measures were analysed by running correlation analyses, and differences between subgroups and changes over time with independent and paired samples tests, respectively. RESULTS: The strongest baseline correlations were found between the BICAMS subtests and normalized whole brain volume (NBV) and grey matter volume (NGV); processing speed r = 0.54/r = 0.48, verbal memory r = 0.49/ r = 0.42, visual memory r = 0.48 /r = 0.39. Only the verbal memory test had significant correlations with T2 and T1 lesion volumes (LV) at both time points; T2LV r = 0.39, T1LV r = 0.38. There were significant loss of grey matter and white matter volume overall (NGV p<0.001, NWV p = 0.003), as well as an increase in T1LV (p = 0.013). The longitudinally defined confirmed cognitively impaired (CCI) and preserved (CCP) patients showed significant group differences on all MRI volume measures at both time points, except for NWV. Only the CCI subgroup showed significant white matter atrophy (p = 0.006) and increase in T2LV (p = 0.029). CONCLUSIONS: The present study found strong correlations between whole brain and grey matter volumes and performance on the BICAMS subtests as well as significant changes in global volumes from baseline to follow-up with clear differences between patients defined as cognitively impaired and preserved at both baseline and follow-up.

Macular integrity assessment microperimeter, Humphrey field analyzer and OCT in glaucoma practice: a correlation study.

OBJECTIVE: To compare and correlate retinal sensitivities measured with macular integrity assessment microperimetry (MAIA-MP) and Humphrey field analyzer (HFA) 10-2 tests with structural parameters obtained from optical coherence tomography (OCT) in primary open-angle glaucoma (POAG) and ocular hypertension. METHODS: This study included 63 participants (22 with POAG, 20 with ocular hypertension, and 21 control individuals). All participants underwent HFA 10-2 and MAIA-MP (macular retinal sensitivity tests) and measurements for optic nerve head (ONH), peripapillary retinal nerve fibre layer thickness (PRNFLT), and ganglion cell inner plexiform layer thickness (GCIPLT) using OCT. The relationship between macular retinal sensitivity and OCT parameters was evaluated by Pearson correlation analysis and linear regression modelling. RESULTS: POAG cases had a strong association between the MAIA-MP and ONH parameters (optic disc area [ODA], p = 0.037; cup volume, p = 0.043), PRNFLT (average, p = 0.009; inferior PRNFLT, p = 0.004), and GCIPLT in all macula sectors (p ≤ 0.005 for all). HFA 10-2 had a moderate correlation with the ONH parameters (cup-to-disc ratio [CDR], p = 0.042; vertical CDR, p = 0.037; cup volume, p = 0.037; ODA, p = 0.014), PRNFLT (average, inferior, and nasal, p < 0.05 for all), and GCIPLT in all macula sectors (p < 0.005 for all). OHT cases had a weak correlation between HFA 10-2 and nasal and superior PRNFLTs (p = 0.035 and p = 0.047, respectively). CONCLUSION: MAIA-MP and HFA 10-2 functional parameters have strong correlations with the structural parameters obtained by OCT in POAG cases. Both devices are useful in assessing the central visual field in glaucoma, with MAIA-MP potentially beneficial in patients with limited cooperation or poor vision.

The Bayley Social-Emotional Scale and the Assessment of Preterm Infants: a systematic review / Escala Socioemocional Bayley e Avaliação de Bebês Prematuros: uma revisão sistemática / Escala Socioemocional de Bayley y Evaluación para Bebés Prematuros: una revisión sistemática

The Bayley scale is one of the most widely used instruments for assessing infant development. This article aimed to systematically review the contribution of the Bayley social-emotional scale in the assessment of social-emotional development in preterm infants. This systematic review followed PRISMA guidelines and was registered in PROSPERO. According to the inclusion criteria, 19 articles were selected from electronic databases. The results indicate reduced rates in evaluating the scale for children with lower gestational age, birth weight, and the association with environmental, biological, and hospital clinical factors. However, no analysis was found between the axes that guide the social-emotional development milestones present in the Bayley assessment and the developmental outcomes of preterm children. Bayley's social-emotional scale and other assessment methods can jointly compose a detailed and sensitive protocol for preterm infants regarding early childhood emotional health care. (AU)

A escala Bayley é um dos instrumentos mais utilizados para avaliação do desenvolvimento infantil. O objetivo deste artigo foi realizar uma revisão sistemática sobre a contribuição da escala socioemocional, pertencente à Bayley, na avaliação de crianças prematuras. A revisão seguiu as recomendações PRISMA e foi registrada no PROSPERO. Conforme critérios de inclusão, 19 artigos foram selecionados a partir de bancos de dados eletrônicos. Os resultados indicam índices reduzidos na avaliação da escala para crianças com menor idade gestacional, peso ao nascer e a associação com fatores ambientais, biológicos e clínicos hospitalares. No entanto, não foram encontradas análises entre os eixos que orientam os marcos de desenvolvimento socioemocional, presentes na avaliação Bayley e os resultados do desenvolvimento das crianças prematuras. A escala socioemocional da Bayley e outros métodos de avaliação podem conjuntamente compor um protocolo detalhado e sensível destinado ao cuidado da saúde emocional de crianças nascidas prematuras. (AU)

La escala Bayley es uno de los instrumentos más utilizados para la evaluación del desarrollo infantil. El propósito del artículo fue revisar sistemáticamente la contribución de la escala socioemocional de Bayley en la evaluación de bebés prematuros. La revisión siguió las recomendaciones PRISMA y fue registrada en PROSPERO. Según los criterios de inclusión, se seleccionaron 19 artículos de bases de datos electrónicas. Los resultados indican índices reducidos en la evaluación de la escala para niños con menor edad gestacional, peso al nacer asociaciados con factores ambientales, biológicos y clínicos hospitalarios. Sin embargo, no se encontraron análisis entre los ejes que orientan los hitos del desarrollo socioemocional, presentes en la evaluación Bayley, y los resultados del desarrollo de los niños prematuros. La Escala Socioemocional de Bayley y otros métodos de evaluación pueden formar en conjunto un protocolo detallado y sensible para el cuidado de la salud emocional de niños prematuros. (AU)

Avaliação psicológica no estado do Maranhão: cenário atual e direções futuras / Psychological assessment in the state of Maranhão: current scenario and future directions / Evaluación psicológica en el estado de Maranhão: escenario actual y direcciones futuras

As últimas duas décadas trouxeram mudanças para o campo da Avaliação Psicológica (AP) no Brasil. Considerando que historicamente o desenvolvimento da Psicologia foi desigual entre as regiões do país, este estudo teve como objetivo investigar as práticas, a formação e o conhecimento de psicólogos maranhenses sobre avaliação psicológica. Participaram 124 psicólogos com registro ativo no Conselho Regional de Psicologia do Maranhão, que responderam a um roteiro estruturado de entrevista elaborado para este estudo. Os resultados mostraram que a maioria afirma realizar AP na sua prática profissional, que entrevista é a técnica mais usada e considerada mais importante para o processo, que há indícios de avanço na formação em AP no estado do Maranhão, mas que permanecem dificuldades em relação à compreensão de conceitos psicométricos e na inserção das práticas de AP no dia a dia do trabalho dos psicólogos. (AU)

The field of Psychological Assessment (PA) in Brazil faced changes in the last two decades. Since the development of Psychology has been historically uneven between the regions of the country, this study aimed to assess the practices, academic training, and knowledge of psychologists from the state of Maranhão on psychological assessment. 124 psychologists with active registration in the Regional Council of Psychology of Maranhão participated responding to a structured interview script prepared for this study. The results show that most claim to perform PA in their professional practice; that interview is the most used technique and it is considered the most important for the process; that there are indications of progress in PA training in the state of Maranhão, but some difficulties remain regarding the comprehension of psychometric concepts and the insertion of PA practices in the daily work of psychologists. (AU)

Las ultimas dos décadas trajeron cambios para el campo de la Evaluación Psicológica (EP) en Brasil. Considerando que históricamente el desarrollo de la Psicología fue desigual entre las regiones del país, este estudio tuvo como objetivo investigar las prácticas, la formación y el conocimiento de psicólogos del estado de Maranhão sobre evaluación psicológica. Participaron 124 psicólogos con matrícula activa en el Consejo Regional de Psicología de Maranhão, que respondieron a un guión estructurado de entrevista elaborado para este estudio. Los resultados mostraron que: la mayoría afirma realizar EP en su práctica professional; la entrevista es la técnica mas usada y considerada mas importante para el processo; hay indicios de avances en la formación en EP en el estado de Maranhão, pero permanecen dificultades en relación a la comprensión de conceptos psicométricos y en la inserción de las prácticas de EP en el día a día del trabajo de los psicólogos. (AU)

A comprehensive accuracy assessment of Samsung smartwatch heart rate and heart rate variability.

BACKGROUND: Photoplethysmography (PPG) is a low-cost and easy-to-implement method to measure vital signs, including heart rate (HR) and pulse rate variability (PRV) which widely used as a substitute of heart rate variability (HRV). The method is used in various wearable devices. For example, Samsung smartwatches are PPG-based open-source wristbands used in remote well-being monitoring and fitness applications. However, PPG is highly susceptible to motion artifacts and environmental noise. A validation study is required to investigate the accuracy of PPG-based wearable devices in free-living conditions. OBJECTIVE: We evaluate the accuracy of PPG signals-collected by the Samsung Gear Sport smartwatch in free-living conditions-in terms of HR and time-domain and frequency-domain HRV parameters against a medical-grade chest electrocardiogram (ECG) monitor. METHODS: We conducted 24-hours monitoring using a Samsung Gear Sport smartwatch and a Shimmer3 ECG device. The monitoring included 28 participants (14 male and 14 female), where they engaged in their daily routines. We evaluated HR and HRV parameters during the sleep and awake time. The parameters extracted from the smartwatch were compared against the ECG reference. For the comparison, we employed the Pearson correlation coefficient, Bland-Altman plot, and linear regression methods. RESULTS: We found a significantly high positive correlation between the smartwatch's and Shimmer ECG's HR, time-domain HRV, LF, and HF and a significant moderate positive correlation between the smartwatch's and shimmer ECG's LF/HF during sleep time. The mean biases of HR, time-domain HRV, and LF/HF were low, while the biases of LF and HF were moderate during sleep. The regression analysis showed low error variances of HR, AVNN, and pNN50, moderate error variances of SDNN, RMSSD, LF, and HF, and high error variances of LF/HF during sleep. During the awake time, there was a significantly high positive correlation of AVNN and a moderate positive correlation of HR, while the other parameters indicated significantly low positive correlations. RMSSD and SDNN showed low mean biases, and the other parameters had moderate mean biases. In addition, AVNN had moderate error variance while the other parameters indicated high error variances. CONCLUSION: The Samsung smartwatch provides acceptable HR, time-domain HRV, LF, and HF parameters during sleep time. In contrast, during the awake time, AVNN and HR show satisfactory accuracy, and the other HRV parameters have high errors.