Potential influence of selection criteria on the demographic composition of students in an Australian medical school

Background

Few studies have addressed the challenges that international medical students face and there is a dearth of information on the behavioural strategies these students adopt to successfully progress through their academic program in the face of substantial difficulties of language barrier, curriculum overload, financial constraints and assessment tasks that require high proficiency in communication skills.

Methods

This study was designed primarily with the aim of enhancing understanding of the coping strategies, skill perceptions and knowledge of assessment expectations of international students as they progress through the third and fourth years of their medical degree at the School of Medicine, University of Tasmania, Australia.

Results

Survey, focus group discussion and individual interviews revealed that language barriers, communication skills, cultural differences, financial burdens, heavy workloads and discriminatory bottlenecks were key factors that hindered their adaptation to the Australian culture. Quantitative analyses of their examination results showed that there were highly significant (p < 0.001) variations between student performances in multiple choice questions, short answer questions and objective structured clinical examinations (70.3%, 49.7% & 61.7% respectively), indicating existence of communication issues.

Conclusions

Despite the challenges, these students have adopted commendable coping strategies and progressed through the course largely due to their high sense of responsibility towards their family, their focus on the goal of graduating as medical doctors and their support networks. It was concluded that faculty needs to provide both academic and moral support to their international medical students at three major intervention points, namely point of entry, mid way through the course and at the end of the course to enhance their coping skills and academic progression. Finally, appropriate recommendations were made.     

Knowledge and Attitudes About HPV Infection, HPV Vaccination, and Cervical Cancer Among Rural Southeast Asian Women

Background

The incidence of cervical cancer in developing countries is high and even higher among women in rural areas in these countries.

Purpose

The purpose of this study is to assess the knowledge and attitudes towards human papillomavirus (HPV), HPV vaccination, and cervical cancer among young women in rural settings in a Southeast Asia country.

Methods

A convenience sample of ethnically diverse young rural women in Malaysia was surveyed. Participants were interviewed using a standard questionnaire.

Results

Among the participants (N?=?449), knowledge of HPV, HPV vaccination, cervical screening, and cervical cancer risk factors was extremely poor. The mean total knowledge score (14 items) was 2.37 (SD?±?1.97). Although many had never heard of the newly released HPV vaccine, two-thirds professed an intention to receive the HPV vaccine. Intention to receive the vaccine was significantly associated with knowledge of cervical screening and cervical cancer risk factors (OR 1.17; 95% CI 1.03–1.33; P?=?0.013). Reasons for vaccine refusal were doubts about safety and efficacy of the new vaccine (27.4%), perceived embarrassment at receiving an STI vaccine (20.7%), and perception of not being at risk of HPV infection (20.0%).

Conclusions

Providing HPV education to the rural residents is a high priority.     

Psychosomatic Conditions of the Children and Adolescents Exposed to 5.12 Wenchuan Earthquake

Background

A devastating earthquake registering 8.0 on the Richter Scale struck Wenchuan County in Northwest Sichuan Province in China on May 12, 2008, claiming over 69,200 lives, seriously wounding more than 374,600 people, and rendering more than 18,400 people missing. The epicenter was close to Yingxiu Township in Wenchuan County.

Purpose

This study aimed to investigate the psychosomatic conditions of the children and adolescents exposed to the devastating earthquake and explore the risk factors for psychosomatic symptoms.

Method

A total of 1,828 participants aged 6 to 16 years, of whom 842 from the affected area and 986 from non-affected area, were administered a Psychosomatic Conditions Scale.

Results

Each factor score, total somatic score, total psychological score, and total psychosomatic score of the experimental group were significantly higher than those of the control group (P?<?0.001). Positive correlation was found between the psychological state and somatic symptoms in the experimental group(r?=?0.157?~?0.489, P?<?0.01). Respiratory system, cardiovascular system, nervous system, digestive system, urogenital system, emotion, behavior, and language, combined as a panel, were significantly differentiated between the two groups, accounting for 73.4 % of the total difference. In the experimental group, the factor scores of anxiety, behavior, total psychological score, and total psychosomatic score of the girls were obviously higher than those of the boys (P?<?0.01?~?0.05); most somatic factors and psychological factors, total somatic score, total psychological score, and total psychosomatic score of the elder adolescents were significantly higher than those of the younger children (P?<?0.01?~?0.05).

Conclusion

The children and adolescents exposed to 5.12 earthquake greatly suffered from terrible psychosomatic conditions, among whom the elder girls had more severe symptoms, particularly in terms of anxiety and behavior.     

Preliminary Evidence for the Construct and Concurrent Validity of the DS14 in Hebrew

Background

Type D personality is a risk indicator in cardiac patients. While both the validity and reliability of the Type D scale (DS14) have been confirmed in Western Europe, less attention has been paid to the subject in other nations.

Purpose

The purpose of this study was to examine the validity of the Hebrew version of the DS14 among a sample of cardiac patients in Israel.

Method

Male patients (N?=?94) hospitalized for a first acute coronary syndrome (ACS) completed the DS14 1?month after their ACS. The Brief Symptoms Inventory (BSI) scales for depression and anxiety and the Buss?CDurkee Hostility Inventory-Dutch for measuring covert and overt aggressions were administered during the initial hospitalization (baseline). The BSI was administered again at the 6-month follow-up. At follow-up, patients were also asked about their participation in a formal cardiac rehabilitation program.

Results

The two-factor structure of the DS14 was confirmed and the DS14 subscales were internally consistent (Cronbach??s ???=?0.79/0.80). Type D cardiac patients had a significantly higher mean score on anxiety, depression, and covert aggression at baseline compared to non-Type D patients. At the 6-month follow-up, Type D was associated with more anxiety, more depression, and less attendance at a formal cardiac rehabilitation program. The prevalence of Type D in the current sample (5.3%) was found to be significantly lower than elsewhere in Europe.

Conclusion

Preliminary evidence suggests that it is possible to use the Hebrew version of the DS14 among Hebrew-speaking cardiac patients in future studies. However, the prevalence of the Type D personality in Israel should be further assessed.     

One year outcomes of a mentoring scheme for female academics: a pilot study at the Institute of Psychiatry,King's College London

Background

The professional development of under-represented faculty may be enhanced by mentorship, but we understand very little about the mechanisms by which mentoring brings about change. Our study posed the research question, what are the mechanisms by which mentoring may support professional development in under-represented groups?The study aims to: (i) to pilot a mentoring scheme for female academics; (ii) to compare various health-related and attitudinal measures in mentees at baseline, 6 months, and 1 year into the mentoring relationship and, (iii) to compare pre-mentoring expectations to outcomes at 6 months and 1 year follow-up for mentees and mentors.

Methods

Female academic mentees were matched 1:1 or 2:1 with more senior academic mentors. Online surveys were conducted to compare health-related and attitudinal measures and expectations of mentoring at baseline with outcomes at 6 months and 1 year using paired t-tests and McNemar's test for matched cohort data.

Results

N = 46 mentoring pairs, 44 (96%) mentees completed the pre-mentoring survey, 37 (80%) at 6 months and 30 (65%) at 1 year. Job-related well-being (anxiety-contentment), self-esteem and self-efficacy all improved significantly and work-family conflict diminished at 1 year. Highest expectations were career progression (39; 89%), increased confidence (38; 87%), development of networking skills (33; 75%), better time-management (29; 66%) and better work-life balance (28; 64%). For mentees, expectations at baseline were higher than perceived achievements at 6 months or 1 year follow-up.For mentors (N = 39), 36 (92%) completed the pre-mentoring survey, 32 (82%) at 6 months and 28 (72%) at 1 year. Mentors' highest expectations were of satisfaction in seeing people progress (26; 69%), seeing junior staff develop and grow (19; 53%), helping solve problems (18; 50%), helping women advance their careers (18; 50%) and helping remove career obstacles (13; 36%). Overall, gains at 6 months and 1 year exceeded pre-mentoring expectations.

Conclusions

This uncontrolled pilot study suggests that mentoring can improve aspects of job-related well-being, self-esteem and self-efficacy over 6 months, with further improvements seen after 1 year for female academics. Work-family conflict can also diminish. Despite these gains, mentees' prior expectations were shown to be unrealistically high, but mentors' expectations were exceeded.

     

Gender-Specific Associations of Perceived Stress and Coping Strategies with C-Reactive Protein in Middle-Aged and Older Men and Women

Background

Perceived stress and coping strategies may influence the risk of cardiovascular disease through their possible association with inflammation, but data remain controversial for perceived stress or scanty for coping strategies.

Purpose

We examined the associations of perceived stress and coping strategies with serum high-sensitivity C-reactive protein (CRP) in a Japanese general population.

Methods

This cross-sectional study included 2,971 men and 4,902 women aged 40–69 years who were enrolled between 2005 and 2007. Subjects with possible inflammation-related disease, CRP levels ≥3,000 ng/mL, or currently used analgesics or lipid-lowering drugs were excluded. Analyses were performed by gender with adjustment for lifestyle, socioeconomic, and psychosocial factors.

Results

Unexpectedly, elevated perceived stress was significantly associated with lower CRP levels in men (P _trend?P _trend?=?0.90) after adjustment for age and covariates. Among five items of coping strategies evaluated, “disengagement” showed a significant inverse association with CRP in men only (P _trend?=?0.027). In addition, a possible interaction between “emotional support seeking” and perceived stress on CRP was detected in men (P _interaction?=?0.021); “emotional support seeking” was associated with lower CRP at the high stress level only (P _trend?=?0.028).

Conclusions

Both perceived stress and coping strategies may be associated with systemic inflammation in Japanese men, yet caution must be exercised before accepting the stress–inflammation–disease pathway.     

Effect of a Telephone-Delivered Coronary Heart Disease Secondary Prevention Program (ProActive Heart) on Quality of Life and Health Behaviours: Primary Outcomes of a Randomised Controlled Trial

Background

Participation in coronary heart disease secondary prevention programs is low. Innovative programs to meet this treatment gap are required.

Purpose

To aim of this study is to describe the effectiveness of a telephone-delivered secondary prevention program for myocardial infarction patients.

Methods

Four hundred and thirty adult myocardial infarction patients in Brisbane, Australia were randomised to a 6-month secondary prevention program or usual care. Primary outcomes were health-related quality of life (Short Form-36) and physical activity (Active Australia Survey).

Results

Significant intervention effects were observed for health-related quality of life on the mental component summary score (p?=?0.02), and the social functioning (p?=?0.04) and role-emotional (p?=?0.03) subscales, compared with usual care. Intervention participants were also more likely to meet recommended levels of physical activity (p?=?0.02), body mass index (p?=?0.05), vegetable intake (p?=?0.04) and alcohol consumption (p?=?0.05).

Conclusions

Telephone-delivered secondary prevention programs can significantly improve health outcomes and could meet the treatment gap for myocardial infarction patients.     

Readability of state-sponsored advance directive forms in the United States: a cross sectional study

Background

State governments provide preprinted advance directive forms to the general public. However, many adults in the United States (US) lack the skills necessary to read and comprehend health care-related materials. In this study, we sought to determine the readability of state government-sponsored advance directive forms.

Methods

A cross sectional study design was used. The readability of advance directive forms available online from all 50 US states and the District of Columbia was determined using 6 validated readability scales.

Results

Overall, 62 advance directive forms were obtained. For 47 states, forms were available by way of government-sponsored Web sites. The average (SD) readability (with the Flesch-Kincaid score) of all forms was grade level 11.9 (2.6). Similar results were obtained with the other readability scales. No form had a readability score at the 5th grade level or lower, the level recommended by the National Work Group on Literacy and Health. The readability of the forms exceeded this level by an average of 6.9 grade levels (95% confidence interval, 6.3-7.6; P <.001). Only 5 of the forms had a readability score at 8th grade level or lower, the average reading skill level of US adults. The readability of the forms exceeded this level by an average of 3.9 grade levels (95% confidence interval, 3.3-4.6; P <.001).

Conclusions

The readability of US state government-sponsored advance directive forms exceeds the readability level recommended by the National Work Group on Literacy and Health and the average reading skill level of most US adults. Such forms may inhibit advance care planning and therefore patient autonomy.     

Human COL5A1 rs12722 gene polymorphism and tendon properties in vivo in an asymptomatic population

Purpose

Gene variants encoding for proteins involved in homeostatic processes within tendons may influence its material and mechanical properties in humans. The purpose of this study was to examine the association between one such gene variant, gene encoding collagen type V alpha 1 chain (COL5A1) rs12722, and patellar tendon dimensions and mechanical properties in vivo.

Methods

Eighty-four recreationally active, Caucasian, men and women, aged 18–39, with no history of injuries to the knee and a body mass index between 18.5 and 30 were recruited. Women were not recruited if they were pregnant or using any form of hormone-based contraception. The COL5A1 rs12722 genotype was determined using real-time polymerase chain reaction. Patellar tendon dimensions (volume) and functional (elastic modulus) properties were assessed in vivo using geometric modelling, isokinetic dynamometry, electromyography and ultrasonography.

Results

After adjustments for non-genetic factors, no significant associations were evident between the COL5A1 rs12722 gene variant and either patellar tendon volume (P = 0.933) or elastic modulus (P = 0.206), nor with a calculated Z score that combined these dimensional and functional properties into a composite value (P = 0.647). Similarly, no association was evident when comparing individuals with/without the rare C allele (volume, P = 0.883; elastic modulus, P = 0.129; Z score, P = 0.631).

Conclusions

Tendon properties do not seem to be influenced by the COL5A1 rs12722 gene variant. Although the COL5A1 rs12722 polymorphism has previously been associated with the risk of tendon pathology, that association is unlikely to be mediated via underlying tendon dimensional and functional properties.     

Use of complementary and alternative medicines by a sample of Turkish women for infertility enhancement: a descriptive study

Background

Lactic acid-producing bacteria (LAB) probiotics demonstrate immunomodulating and anti-inflammatory effects and the ability to lessen the symptoms of arthritis in both animals and humans. This randomized, double-blind, placebo-controlled, parallel-design, clinical pilot trial was conducted to evaluate the effects of the LAB probiotic preparation, Bacillus coagulans GBI-30, 6086, on symptoms and measures of functional capacity in patients with rheumatoid arthritis (RA) in combination with pharmacological anti-arthritic medications.

Methods

Forty-five adult men and women with symptoms of RA were randomly assigned to receive Bacillus coagulans GBI-30, 6086 or placebo once a day in a double-blind fashion for 60 days in addition to their standard anti-arthritic medications. Arthritis activity was evaluated by clinical examination, the American College of Rheumatology (ACR) criteria, the Stanford Health Assessment Questionnaire Disability Index (HAQ-DI), and laboratory tests for erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP).

Results

Subjects who received Bacillus coagulans GBI-30, 6086 experienced borderline statistically significant improvement in the Patient Pain Assessment score (P =.052) and statistically significant improvement in Pain Scale (P =.046) vs placebo. Compared with placebo, Bacillus coagulans GBI-30, 6086 treatment resulted in greater improvement in patient global assessment and self-assessed disability; reduction in CRP; as well as the ability to walk 2 miles, reach, and participate in daily activities. There were no treatment-related adverse events reported throughout this study.

Conclusions

Results of this pilot study suggest that adjunctive treatment with Bacillus coagulans GBI-30, 6086 LAB probiotic appeared to be a safe and effective for patients suffering from RA. Because of the low study population size, larger trials are needed to verify these results.

Trial registration

ACTRN12609000435280     

Sleep problems and poor academic performance in primary school children

Objective

Sleep problems may affect daytime performance. Thus, the prevalence of sleep problems and their associations with poor academic performance in a cross-sectional study performed in 27 primary schools in Hannover, Germany, were investigated.

Methods

Sleep problems (e.g., sleep onset delays, night awakenings, sleepwalking, nightmares, and bedwetting) were examined by parental and children’s questionnaires. Poor academic performance, defined as grade 4 or more on a 6-point scale, or requirement for additional lessons in mathematics, science, reading, spelling, or handwriting was assessed using grades from the last term’s school report forms.

Results

Of 1,144 children enrolled (mean age 9.6 years, 51% males), 760 (66.4%) had sleep problems reported by their parents, with sleep onset delays having the highest prevalence (prevalence 49.1%, 95% confidence interval (CI) 46.1–51.9). Children reported sleep problems more frequently than their parents. Significant associations with academic performance were found for night awakenings and nightmares; however, clear dose–response relationships were only found for nightmares. Children who “often” had nightmares (n?=?24) were more likely to have poor academic performance in mathematics (odds ratio 5.2, 95% CI 1.6–17.1), science (6.8, 95% CI 1.4–32.1), and spelling (7.5, 95% CI 2.3–24.9).

Conclusion

Sleep problems are common in primary school children. Among these, nightmares may have a negative impact on academic performance.     

Soluble levels of Osteopontin in Patients with Behcet's Disease: Association with Disease Activity and Vascular Involvement

Aim

Osteopontin (OPN) is a multifunctional molecule highly expressed in chronic inflammatory and autoimmune diseases. We aimed to assess the plasma OPN levels in Behcet's disease (BD) patients and identify potential associations between these levels with disease activity, severity and clinical manifestations with special emphasis on vascular affection.

Methods

We studied 55 BD patients and 31 age- and gender-matched healthy controls. Demographic, clinical and serological data were prospectively assessed. Activity and severity of BD were assessed using clinical scores and laboratory parameters. Plasma OPN levels were measured using enzyme-linked immunosorbent assay (ELISA).

Results

Plasma OPN levels were significantly higher in patients with BD compared to healthy controls (p?<?0.000). The means for plasma OPN levels in active and inactive BD patients were significantly higher than that for the normal controls (with p?<?0.000 and p?=?0.002 respectively). The mean OPN levels significantly associated with the BD clinical severity score from mild to severe (p?=?0.011). BD patients with vascular involvement had significant elevation of plasma OPN levels than those without (P?=?0.03). OPN levels positively correlated with severity score, IL6, hsCRP, ESR, leucocytes count and neutrophil count.

Conclusion

Plasma OPN levels were higher in BD patients than in healthy controls and were found to be associated with disease activity, severity and vascular involvement. To confirm our results we propose that larger scale, multicentre studies with longer evaluation periods are needed.     

Type D Personality is Not Associated with Coronary Heart Disease Risk in a North American Sample of Retirement-aged Adults

Background

Type D personality is associated with recurrent coronary heart disease (CHD) risk but there is limited and inconsistent evidence regarding incident risk among persons free of clinical CHD.

Purpose

We examined the association between Type D personality and coronary heart disease (CHD) risk in apparently healthy adults. We also explored the association of these traits with waist circumference, body mass index (BMI), and inhibited physician consultation behavior.

Methods

Cross-sectional study of North American retirement-aged residents (N?=?303). The primary outcome variable was a modified 10-year absolute CHD risk score from the Framingham Heart Study. Secondary outcomes included adiposity and a 5-item measure of patient/provider interaction inhibition. We regressed CHD risk on negative affect (NA), social inhibition (SI), and the NAxSI interaction (i.e., the Type D personality) and repeated these analyses for adiposity and for patient/provider interaction inhibition. We also contrasted CHD risk across Type D and non-Type D categories.

Results

None of the personality variables were associated with CHD risk for the whole sample (regression coefficients from ?0.11 to .10, Ps?>?0.29) or in gender-specific analyses. For adiposity, NA was positively associated and SI was negatively associated with BMI in women (Ps?<?0.05), but there were no other personality associations. Patient/provider interaction inhibition was associated with SI (P?<?0.001) but not NA or the NAxSI interaction (P?=?0.42). The contrast between Type D and non-Type D personality revealed no differences in CHD risk (P?=?0.93).

Conclusions

Neither Type D nor its constituent NA and SI traits were associated with absolute incident CHD risk in retirement-aged adults free of reported CHD. Optimal analytic practices and attention to patient/provider interaction behavior will improve our understanding of the association between Type D personality traits and health.     

Serum proteomic, peptidomic and metabolomic profiles in myasthenia gravis patients during treatment with Qiangji Jianli Fang

Background

Qiangji Jianli Fang (QJF) has been used for treatment of myasthenia gravis (MG) in China. However, our understanding of the effects of QJF against MG at the molecular level is limited. This study aims to investigate the effects of QJF treatment of MG patients on the protein, peptide and metabolite levels in serum.

Methods

High-throughput proteomic, peptidomic and metabolomic techniques were applied to investigate serum samples from 21 healthy individuals and 47 MG patients before and after QJF treatment via two-dimensional gel electrophoresis, matrix-assisted laser desorption/ionization time of flight mass spectrometry and liquid chromatography Fourier transform mass spectrometry, respectively.

Results

After QJF treatment, the expression levels of peptides m/z 1865.019, 2021.128 and 1211.668 of complement C3f increased (P?=?0.004, P?=?0.001 and P?=?0.043, respectively), while that of peptide m/z 1739.931 of component C4b decreased (P?=?0.043), in the serum of MG patients. The levels of ??-aminobutyric acid (P?=?0.000) and coenzyme Q4 (P?=?0.000) resumed their normal states.

Conclusion

QJF could inhibit the activity of the complement system and restore the normal levels of metabolites.     

The effect of sRAGE-Fc fusion protein attenuates inflammation and decreases mortality in a murine cecal ligation and puncture model

Objective

Inhibition of the receptor for advanced glycation end products (RAGE) may attenuate the systemic inflammatory response and ensuing severe sepsis. We report an investigation into the effect of soluble RAGE (sRAGE)-Fc fusion protein in severe sepsis induced by a cecal ligation and puncture (CLP) procedure.

Materials and methods

The experiment was performed using CLP control mice, mice treated with 0.5 or 1.0?μg sRAGE-Fc fusion protein, and sham surgery mice.

Results

Survival benefits over the CLP control group were evident (P?=?0.036) in mice given 1.0?μg sRAGE-Fc fusion protein. In addition, the pulmonary inflammation score in the sRAGE-Fc fusion protein-treated group was significantly lower than that in the CLP control group (P?<?0.05). Lung tissue in the sRAGE-Fc fusion protein-treated group revealed a significant decrease in the expression of inflammatory cytokines. Furthermore, levels of interleukin (IL)-1β and tumor necrosis factor-α were significantly lower in sRAGE-Fc fusion protein treated groups (P?<?0.001). Moreover, IL-6 levels showed a significant difference between CLP control and sRAGE-Fc fusion protein treated groups (P?<?0.01).

Conclusions

sRAGE-Fc fusion protein has beneficial effects in a standard murine model of polymicrobial, intra-abdominal severe sepsis.     

A one-day surgical-skill training course for medical students’ improved surgical skills and increased interest in surgery as a career

Background

Despite many high-quality programs in basic surgical-skill education, the surgical skill of junior doctors varies widely. This, together with the waning interest in surgery as a career among medical students, is a serious issue confronted by hospitals and healthcare systems worldwide. We, therefore, developed and implemented an intensive one-day surgical-skill training course for two purposes; it would improve surgical skills and increase interest in surgery among medical students.

Methods

The surgical-skill training program is named Surgical Skill Weekend (SSW) and it includes hands-on training sessions for surgical-suturing techniques and advanced surgical procedures (i.e. laparoscopic and robot-assisted surgery), hybrid simulation sessions, and an operating-room session where aforementioned sessions are all put together. By the end of the program, students’ improvements in surgical-suturing skills were assessed by experts in a form of checklist, and changes in the interest in a surgical career, if there were any, were answered by the students who participated in the program.

Results

A total of ninety-one (91) medical students participated in the 2015 and 2016 SSW courses. Their overall satisfaction level with the course was very high (Very satisfied: 78%, Quite satisfied: 22%). All of the participant’s surgical-suturing skills significantly improved (median score range: 14–20, P?<?0.05) and their interest in a surgical career increased significantly (from 56% to 81%, P?<?0.05) by completing the program.

Conclusions

An intensive and comprehensive surgical-skill training program for medical students can not only improve surgical-suturing skills but also increase interest in surgery as a career.

     

Patients with Primary Immunodeficiencies in Pediatric Intensive Care Unit: Outcomes and Mortality-Related Risk Factors

Purposes

The aims of this study were to review the frequency, characteristics, and the clinical course of primary immunodeficiency (PID) patients admitted to pediatric intensive care unit (PICU) and attempt to identify factors related with mortality that might predict a poor outcome.

Methods

We performed a retrospective review of children with PID aged 1 month to 18 years and admitted to PICU from January 2002 to January 2012 in our tertiary teaching children’s hospital.

Results

There were a total of 51 patients accounting for 71 admissions to the PICU. The most common diagnosis was severe combined immunodeficiency. Respiratory problems were the leading cause for admission. A total of 20 patients received hematopoietic stem cell transplantation. Immune reconstitution was achieved in 9 (45 %) patients and eight of them did survive. In all 56 % of all admission episodes resulted in survival. Risk factors for mortality included requirement of mechanical ventilation (P?<?.001), number of organ system failure (P?=?.013), need for renal replacement therapy (P?<?.001), use of inotropes (P?<?.001), higher Pediatric Logistic Organ Dysfunction (PELOD) score (P?=?.005), and length of PICU stay (P?<?.001).

Conclusions

This is the first study regarding the outcome and mortality-related risk factors for PID patients requiring PICU admission. We suggest that PICU management is as important as early diagnosis and treatment for these patients. Prediction of those at risk for poorer outcome might be beneficial for accurate intensive care management and survival.     

Towards a Formative Assessment of Classroom Competencies (FACCs) for postgraduate medical trainees

Background

New technologies that emerge at the interface of computational and biomedical science could drive new advances in global health, therefore more training in technology is needed among health care workers. To assess the potential for informatics training using an approach designed to foster interaction at this interface, the University of Washington and the Universidad Peruana Cayetano Heredia developed and assessed a one-week course that included a new Bioinformatics (BIO) track along with an established Medical/Public Health Informatics track (MI) for participants in Peru.

Methods

We assessed the background of the participants, and measured the knowledge gained by track-specific (MI or BIO) 30-minute pre- and post-tests. Participants' attitudes were evaluated both by daily evaluations and by an end-course evaluation.

Results

Forty-three participants enrolled in the course – 20 in the MI track and 23 in the BIO track. Of 20 questions, the mean % score for the MI track increased from 49.7 pre-test (standard deviation or SD = 17.0) to 59.7 (SD = 15.2) for the post-test (P = 0.002, n = 18). The BIO track mean score increased from 33.6 pre-test to 51.2 post-test (P < 0.001, n = 21). Most comments (76%) about any aspect of the course were positive. The main perceived strength of the course was the quality of the speakers, and the main perceived weakness was the short duration of the course. Overall, the course acceptability was very good to excellent with a rating of 4.1 (scale 1–5), and the usefulness of the course was rated as very good. Most participants (62.9%) expressed a positive opinion about having had the BIO and MI tracks come together for some of the lectures.

Conclusion

Pre- and post-test results and the positive evaluations by the participants indicate that this first joint Bioinformatics and Medical/Public Health Informatics (MI and BIO) course was a success.