Noncompliance to iodine supplementation recommendation is a risk factor for iodine insufficiency in Portuguese pregnant women: results from the IoMum cohort.

PURPOSE: After a recommendation for iodine supplementation in pregnancy has been issued in 2013 in Portugal, there were no studies covering iodine status in pregnancy in the country. The aim of this study was to assess iodine status in pregnant women in Porto region and its association with iodine supplementation. METHODS: A cross-sectional study was conducted at Centro Hospitalar Universitário São João, Porto, from April 2018 to April 2019. Pregnant women attending the 1st trimester ultrasound scan were invited to participate. Exclusion criteria were levothyroxine use, gestational age < 10 and ≥ 14 weeks, non-evolutive pregnancy at recruitment and non-signing of informed consent. Urinary iodine concentration (UIC) was measured in random spot urine by inductively coupled plasma-mass spectrometry. RESULTS: Median UIC was 104 µg/L (IQR 62-189) in the overall population (n = 481) of which 19% had UIC < 50 µg/L. Forty three percent (n = 206) were not taking an iodine-containing supplement (ICS) and median UIC values were 146 µg/L (IQR 81-260) and 74 µg/L (IQR 42-113) in ICS users and non-users, respectively (p < 0.001). Not using an ICS was an independent risk factor for iodine insufficiency [adjusted OR (95% CI) = 6.00 (2.74, 13.16); p < 0.001]. Iodised salt use was associated with increased median iodine-to-creatinine ratio (p < 0.014). CONCLUSIONS: A low compliance to iodine supplementation recommendation in pregnancy accounted for a mild-to-moderately iodine deficiency. Our results evidence the need to support iodine supplementation among pregnant women in countries with low household coverage of iodised salt. Trial registration number NCT04010708, registered on the 8th July 2019.

Distorted perceptions of competence and incompetence are more than regression effects.

Students inaccurately assess their own skills, especially high- or low-performers on exams. This study assessed whether regression effects account for this observation. After completing the Infection and Immunity course final exam (IIF), second year medical students (N = 143) estimated their performance on the IIF in terms of percent correct and percentile rank. Second year grade point averages (M2GPAs) were combined with the IIF results to form five subgroups: 1 = true-low (lowest third on both IIF and M2GPA, 2 = false-low (lowest third on IIF only), 3 = middle (neither lowest nor highest third on IIF), 4 = false-high (highest third on IIF only), 5 = true-high (highest third on IIF and M2GPA). The false-low and false-high groups were considered more susceptible to regression effects due to likely group misclassification. Differences between self-assessment and actual performance within each group and between the five groups were used to estimate what portion of observed differences is due to general tendencies versus regression effects. Results found that students accurately assessed their percent correct, but inaccurately assessed their percentile rank. No statistically significant differences existed between the true and false-low subgroups nor the true- and false-high subgroups. Percentages of mean differences suggest that while regression effects resulted in 50-75% over/under-estimates of scores by students who were misclassified, when they were merged with the true-low/high groups, they do not account for more than 14% of low performer over-estimates of their performance and high performer under-estimates of their performance. Accurate percent correct assessments and distorted percentile rank assessments are challenges in using instructional methods dependent on student self-assessments of their learning needs. Identifying and helping students with distorted perceptions of their test performances may be a key issue in such instructional approaches.

Journal publications in radiologic education: a review of the literature, 1987-1997.

RATIONALE AND OBJECTIVES: This study was designed to analyze articles on radiologic education quantitatively and qualitatively, comparing those published in 1987-1997 with those published in 1966-1986. MATERIALS AND METHODS: An initial literature search used four major databases to identify and retrieve articles related to radiologic education. Additional articles were identified through manual cross-checking of references from the original articles. All articles were reviewed by two radiologists as to type of article (editorial, expository, survey, correlational, or experimental, including preexperimental, quasi-experimental, or true experimental), statistics used (inferential or descriptive), educational emphasis (medical student, resident, postgraduate, or other), and topic of article (philosophical or political, technology, program evaluation, program description, examinations, or career decisions). Interrater agreement was estimated by means of the kappa statistic. A chi2 test for independence was used to assess whether the relative distribution of articles was similar for the two periods. RESULTS: More articles per year were published in 1987-1997 (n = 12.6, P < .01) compared with 1966-1986 (n = 9.2). Articles pertinent to radiologic resident education predominated (50.7% vs 29.9% in the prior study, P < .01). In both periods, most articles were expository (37.7% vs 49.5%), and the most common topic was program description (34% vs 35%). Editorials decreased from 35.5% to 18.1%. Experimental studies accounted for 12.3%, increased from 8.7%. The fastest-growing topic of study was technology (30.4% vs 17.5%, P < .01). CONCLUSION: The increased number of articles addressing radiologic education is encouraging. Although the percentage of experimental studies increased slightly in this period, there is still little empirical research in radiologic education.

The effect of right or left placement of the positive response on Likert-type scales used by medical students for rating instruction.

PURPOSE: To determine whether students' ratings of instruction demonstrate a primary effect, to determine whether the primacy effect relates to the number of response options, and to assess whether the primacy effect relates to how favorably the instructional activity is rated. METHOD: Inf 1995-96 six different forms of a 13-item course-evaluation questionnaire (with Likert-type items) were used to evaluate two second-year courses, Respiratory and Hepatic, at the University of Wisconsin Medical School; the first was one of the most highly rated courses at Wisconsin, and the second was less highly rated. The forms differed by whether they contained five, six, or seven response options, and whether the "strongly agree" rating was on the left side or the right side of the page. The second-year class that participated in the study comprised 140 students. The six different forms of the course-evaluation questionnaires were randomly distributed to the students in equal numbers. Results were analyzed with a number of statistical methods. RESULTS: Completed questionnaires were obtained from 132 students (94%) in Respiratory and from 119 students (85%) in Hepatic. Overall, the forms with the positive rating on the left side had more positive ratings and less variance. For Respiratory, primacy affected the response variance. For Hepatic, primacy affected the response means. CONCLUSION: Faculty-evaluation systems are increasingly using students' ratings for making important decisions regarding salaries, teaching assignments, tenure, etc. The evidence that the primacy effect influences such ratings highlights the need to standardize as much as possible how such ratings are obtained.