Validation of the language component of the Addenbrooke's Cognitive Examination – Revised (ACE‐R) as a screening tool for aphasia in stroke patients

Aim: Several tests are available for aphasia screening following stroke. However, some of them have shortcomings such as need of specialist knowledge, low sensitivity and/or specificity and lengthy administration time. Our study aims to evaluate the language component of the Addenbrooke's Cognitive Examination – Revised (ACE‐R) as a screening tool for aphasia in stroke patients. Methods: The language component of ACE‐R was administered to consecutive patients admitted to a post‐acute stroke unit. Patients who were medically unstable or had a significant history of sensory impairment or mental health issues were excluded. The test was administered by two junior doctors with basic training in ACE‐R administration. Patients recruited were also assessed by an experienced speech and language therapist (SLT). The results of the two assessments were documented by a different member of the team and the SLT results were used as the benchmark to calculate the ACE‐R language component sensitivity and specificity. Results: Fifty‐nine participants were recruited and 27 of them were women. The mean age was 72 (SD 11.9). Thirty‐four participants had left and 11 right hemisphere stroke. Fourteen had bilateral affection. Six participants were left handed. A cut‐off value of 22/26 of ACE‐R language component showed 100% specificity and 83.1% sensitivity, while a cut‐off value of 16/26 had 88.2% specificity and 100% sensitivity. Conclusion: Our results suggest that the language component of ACE‐R has a satisfactory sensitivity and specificity compared with other screening tests used in strokes. It is easy to administer and free to use.     

Attitudes of undergraduate nursing students toward Objective Structure Practical Examination: An Exploratory study

BackgroundObjective Structured Practical Examination (OSPE) is a method of assessment of clinical competence. The examination is conducted at multiple stations. Besides practical and problem-solving skills, theoretical knowledge is also tested. OSPE can be traced back more than 40 years. OSPE has been included more than two decades, as a part of assessment in the College of Nursing, All India Institute of Medical Sciences (AIIMS), New Delhi.ObjectivesThis study was carried out to determine nursing students' attitudes towards OSPE as an assessment tool.ParticipantsThe responses of all the 252 Undergraduate nursing students studying at the College of Nursing, AIIMS were obtained for this study (77 from B.Sc.(H) Nursing first year, 61 from the second year, 69 from the third year and 45 from the fourth year).MethodsThe students attitudes towards OSPE were assessed by using a validated questionnaire containing 28 item statements on Likert's 5-point scale (LS) and 11 bipolar adjectives on Osgood's 7-point Semantic' Differential Scale (OSDS).ResultMost of the students approved of OSPE and felt that it was fair, useful, good, effective, exciting, interesting, practical, skill oriented but also taxing. The study also revealed that amongst the second years' students there was a strong correlation between Overall Rank in the Class and Assessment of OSPE.ConclusionThe study supports the introduction of OSPE as one of the methods of assessment of B.Sc. (Hons.) Nursing students.     

A comprehensive review of intake estimates of di-isononyl phthalate (DINP) based on indirect exposure models and urinary biomonitoring data

Di-isononyl phthalate (DINP) is a high molecular weight general purpose plasticizer used principally in the manufacture of flexible polyvinyl chloride (PVC) articles. DINP metabolites can be measured in biological media such as blood and urine. However, measurement of a substance in the blood or urine does not by itself mean that the chemical causes or is associated with adverse health outcomes. This is particularly pertinent given the advances in modern analytical techniques whereby ever diminishing trace amounts of substances can be detected. Therefore, it is a scientific necessity that risk assessors understand the relationship of biomonitoring data to estimation of exposure so that appropriate comparisons can be made to the no observed adverse effects levels (NOAELs) or other points of departure from toxicological studies in animals. In this paper, estimates of daily DINP intake are calculated for various population segments based on urinary biomonitoring data and are compared to estimates of exposure based on indirect methods and to health-based exposure guidance values. In general, intake estimates converge on a mean of 1–2 μg/kg/day regardless of source of exposure or population cluster; a value 2-orders of magnitude lower than health-based exposure guidance values, ranging from 120 to 290 μg/kg/day, which have been established by regulatory authorities and other authoritative bodies as representing acceptable levels.     

美国儿科药品审批政策概述

简要介绍美国儿科药品审批政策并进行深入分析,总结其成功经验,为建立适合我国的儿科药品审批政策提供参考.     

肝硬化食管胃底静脉曲张及出血的非侵入性临床检查研究

目的 研究分析非侵入性临床检查在肝硬化食管胃底静脉曲张及出血的应用,为临床诊断提供参考意见.方法 选取肝硬化食管胃底静脉曲张及出血患者作为观察组(n=20),并选取同期住院患者中明确诊断为肝硬化合并食管胃底静脉曲张未破裂出血的病例作为对照组(n=20)进行研究,对比分析2组患者血小板计数(PLT)、血小板压积(PCT)、血小板平均体积(MPV)、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT),腹部超声及CT相关指标即门静脉直径(PV)及脾静脉直径(SV)等.结果 观察组患者PLT、PCT、MPV较对照组明显降低(P相似文献   

Long-Term Weight Loss and Metabolic Health in Adults Concerned With Maintaining or Losing Weight: Findings From NHANES

More than two-thirds of American adults are overweight or obese, with many attempting to lose weight to avoid adverse health outcomes and improve well-being. Achieving long-term weight loss (LTWL) success, defined as reaching at least a 5% to 10% weight loss goal, is challenging, yet important for overall metabolic health. It is currently unclear whether achieving higher thresholds of LTWL is associated with improved health. Therefore, the purpose of this study was to examine the association between LTWL thresholds (5%-9.9%, 10%-14.9%, 15%-19.9%, ≥20%) and metabolic health (metabolic syndrome and metabolic risk z score) among 7670 US adult respondents to the National Health and Nutrition Examination Survey (2007-2014) who were overweight or obese (past or present), were not underweight in the past year, not pregnant, and attempting to lose or maintain weight. A subsample of 3362 participants was used in the analysis of the metabolic risk z score. Multivariable regression models were constructed adjusting for covariates. Results indicate that the lowest and the 2 highest LTWL thresholds were related to lower odds for metabolic syndrome; for example, greater than or equal to 20% LTWL (odds ratio=0.52; 95% CI, 0.23-0.44; P<.001). All LTWL thresholds were significantly associated with the metabolic risk z score, with the largest effect among the 2 highest LTWL thresholds, that is, 15% to 19.9% LTWL (β=?0.45; 95% CI, ?0.54 to ?0.36; P<.001) and greater than or equal to 20% LTWL (β=?0.35; 95% CI, ?0.53 to ?0.17; P<.001). In conclusion, although achieving the currently recommended LTWL target was related to improved metabolic health, the 15% LTWL threshold was associated with more favorable outcomes.