Undergraduate students’ perspectives of healthcare professionals’ use of shared decision-making skills

Essential for future healthcare professionals (HCPs) to delivering ethical and empathetic patient-centred care (PCC) as a team is the understanding of appropriate shared decision-making (SDM) responses when facilitating discussions with patients and family members. The purpose of this study was to evaluate undergraduate students’ perspectives about HCPs’ use of SDM as described in a case-study reflection assignment. An exploratory qualitative approach was used to analyse student-reflection assignments. The sample included 42 undergraduate students enrolled in an interprofessional education (IPE) course at a Midwest university based in the United States. Data consisted of student responses in a course reflection assignment that captured their perspectives about recommended SDM responses by HCPs. Student assignments were randomly selected using stratified sampling to provide representation of eight HCP roles. Analysis revealed two themes related to students’ use of SDM responses. Results provide evidence supporting the tenet that through IPE, healthcare students can develop an understanding of SDM and ethical principles related to PCC.     

Comparing an Individual's Test Score Against Norms Derived from Small Samples

The standard method for comparing an individual's test score with a normative sample involves converting the score to a z score and evaluating it using a table of the area under the normal curve. When the normative sample is small, a more appropriate method is to treat the individual as a sample of N = 1 and use a modified t test described by Sokal and Rohlf (1995). The use of this t test is illustrated with examples and its results compared to those from the standard procedure. It is suggested that the t test be used when the N of the normative sample is less than 50. Finally, a computer program that implements the modified t-test procedure is described. This program can be downloaded from the first author's website.     

Schizophrenia and bipolar disorder are associated with opposite brain reward anticipation-associated response

Blunted and exaggerated neuronal response to rewards are hypothesized to be core features of schizophrenia spectrum disorders (SZ) and bipolar disorder (BD), respectively. Nonetheless, direct tests of this hypothesis, in which response between SZ and BD is compared in the same study, are lacking. Here we examined the functional correlates of reward processing during the Incentivized Control Engagement Task (ICE-T) using 3T fMRI. Reward-associated activation was examined in 49 healthy controls (HCs), 52 recent-onset individuals with SZ, and 22 recent-onset individuals with Type I BD using anterior cingulate (ACC), anterior insula, and ventral striatal regions of interest. Significant group X reward condition (neutral vs. reward) interactions were observed during reward anticipation in the dorsal ACC (F(2,120) = 4.21, P = 0.017) and right insula (F(2,120) = 4.77, P = 0.010). The ACC interaction was driven by relatively higher activation in the BD group vs. HCs (P = 0.007) and vs. individuals with SZ (P = 0.010). The insula interaction was driven by reduced activation in the SZ group relative to HCs (P = 0.018) and vs. people with BD (P = 0.008). A composite of reward anticipation-associated response across all associated ROIs also differed significantly by diagnosis (F(1,120) = 5.59, P = 0.02), BD > HC > SZ. No effects of group or group X reward interactions were observed during reward feedback. These results suggest that people with SZ and BD have opposite patterns of activation associated with reward anticipation but not reward receipt. Implications of these findings in regard to Research Domain Criteria-based classification of illness and the neurobiology of reward in psychosis are discussed.Subject terms: Schizophrenia, Bipolar disorder     

A Field-Based Community Assessment of Intoxication Levels Across College Football Weekends: Does It Matter Who’s Playing?

While alcohol consumption has been consistently linked to college football games in the United States, this literature lacks (a) field-based event-level analyses; (b) assessments of the context of drinking, such as days leading to an event, that occurs in conjunction with a contest; (c) investigations of non-student drinking; and (d) objective assessments of opponent rating. Therefore, the present study: (1) examines the extent to which breath alcohol concentrations (BrAC) among restaurant and bar district patrons differ for low- and high-profile games and (2) explores the relationship between an objective rating of a team’s opponent and BrAC levels. Data were collected throughout the fall 2011 football season via six anonymous field studies in a bar district within a southeastern college community. During low-profile game weekends, respondents recorded significantly lower BrAC levels than those during high-profile game weekends. Additionally, there was a positive correlation between opponent rating and BrAC levels, such that mean BrAC readings were highest prior to the game featuring the highest rated opponent. Overall, participants exhibited significantly higher BrACs when a higher-rated opponent was playing that weekend. When resources (money, manpower) are limited, community-based prevention and enforcement efforts should occur during the weekends surrounding higher-profile games.     

Wound healing activity of aqueous extract of Crotalaria verrucosa in Wistar albino rats

ObjectiveTo evaluate the wound healing effect of aqueous extract of Crotalaria verrucosa (C. verrucosa) in rats.MethodsThree wound models including incision, excision and dead space wounds were used in this study. The parameters studied were breaking strength in incision models, granulation tissue dry weight, breaking strength and hydroxyproline content in dead space wounds, percentage of wound contraction and period of epithelialization in excision wound model.ResultsTwo doses of the extract with and without dexamethasone showed significant increases in mean hydroxyproline, total protein content and dry weight of granulation tissue but it was higher with dose 800 mg/kg comparing with the control. The dexamethasone treated group showed a significant (P<0.001) reduction in the wound breaking strength when compared to control group in incision type of wound model. Coadministration of C. verrucosa with dexamethasone significantly (P<0.001) increased the breaking strength compared to the dexamethasone treated only group. In excision wound model, the percentage of the wound contraction was significantly (P<0.01) increased by two doses of test extract on all the days except the lower dose which exhibited only on 12 th, 16 th days of drug treatment and it also reversed the dexamethasone suppressed wound contraction. It significantly (P <0.001) reduced the time required for epithelialization and reversed the epithelialization delaying effect of dexamethasone (P<0.001).ConclusionsC. verrucosa was found to possess significant wound healing property. This was evident by decrease in the period of epithelialization, increase in the rate of wound contraction, skin breaking strength, and granulation tissue dry weight content. Hence C. verrucosa could be a good wound healing agent.