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Objective: Anorexia nervosa (AN) has been associated with alterations in the processing of socio‐emotional information, including impairments in the recognition of emotions in other people's faces. However, adolescents with AN might not show the impairments found in adult patients. The present study investigated facial emotion recognition in adolescents with AN, aiming to replicate our previous results of superior emotion recognition abilities in adolescents with AN compared to adolescents without mental disorders. Method: Adolescent girls (12–18 years) with AN (n = 33) were compared to girls without mental disorders (n = 41). Participants completed one task requiring identification of emotions (happy, sad, afraid, angry, neutral) in faces and one control task. Results: As expected, adolescents with AN showed superior emotion recognition, with higher accuracy rates specifically for afraid faces. Conclusion: This is the first study replicating previous results on basic emotion recognition in adolescents with AN using (almost) the same methodology. The results suggest that, in contrast to adults, adolescents with AN do not show impairments in facial emotion recognition. The impairments may arise in the longer course of the illness, however, longitudinal studies are necessary to confirm this assumption. Highlights: Adolescent girls with anorexia nervosa (AN) did not show impairments in facial emotion recognition compared to adolescents girls with no mental disordersOn the contrary, adolescent with AN showed superior emotion recognition specifically for afraid faces (and a trend for sad faces)The results replicate those of a previous study and suggest that emotion recognition impairments may arise with prolonged illness duration [ABSTRACT FROM AUTHOR]

In this article, we discuss the practice of conducting research in one's own field, in this case, from a position as a researcher with a nursing background doing fieldwork in a hospital and in one's own organization, an orthopedic surgical department. We show how an "insider" researcher position paves the way for analytical insights about sleep as an institutional phenomenon in the orthopedic surgical infrastructure and how acute and elective patient trajectories differ but build on the same logic, creating the same dynamics of inclusion and exclusion. Through a situated and sociomaterial perspective, we analyze different clinical interactions in which we follow the hospital bed as an example of a central relational element that co‐creates sleep as an institutional phenomenon. Inspired by Karen Barad, we demonstrate how to move diffractively when doing and analyzing fieldwork and argue how moving diffractively as a researcher doing fieldwork "at home" is productive and challenges the concept and demand of "distance" as the phenomenological exercise in fieldwork. [ABSTRACT FROM AUTHOR]

Understanding the physiological basis of physical resilience to clinical stressors is crucial for the well‐being of older adults. This article presents a novel framework to discover the biological underpinnings of physical resilience in older adults as part of the "Characterizing Resiliencies to Physical Stressors in Older Adults: A Dynamical Physiological Systems Approach" study, also known as The Study of Physical Resilience and Aging (SPRING). Physical resilience, defined as the capacity of a person to withstand clinical stressors and quickly recover or improve upon a baseline functional level, is examined in adults aged 55 years and older by studying the dynamics of stress response systems. The hypothesis is that well‐regulated stress response systems promote physical resilience. The study employs dynamic stimulation tests to assess energy metabolism, the hypothalamic–pituitary–adrenal axis, the autonomic nervous system, and the innate immune system. Baseline characteristics influencing resilience outcomes are identified through deep phenotyping of physical and cognitive function, as well as of biological, environmental, and psychosocial characteristics. SPRING aims to study participants undergoing knee replacement surgery (n = 100), bone and marrow transplantation (n = 100), or anticipating dialysis initiation (n = 60). Phenotypic and functional measures are collected pre‐stressor and at multiple times after stressor for up to 12 months to examine resilience trajectories. By improving our understanding of physical resilience in older adults, SPRING has the potential to enhance resilient outcomes to major clinical stressors. The article provides an overview of the study's background, rationale, design, pilot phase, implementation, and implications for improving the health and well‐being of older adults. [ABSTRACT FROM AUTHOR]

Synchronous schedules of reinforcement are those in which the onset and offset of a reinforcer are synchronized with the onset and offset of a target behavior. The current study replicated and extended Diaz de Villegas et al. (2020) by comparing synchronous reinforcement to noncontingent stimulus delivery while evaluating on‐task behavior of school‐age children. A concurrent‐chains preference assessment was then used to determine the preferred schedule. Results indicated that the synchronous schedule was more effective than the continuous, noncontingent delivery of the stimulus at increasing on‐task behavior but that the children preferred noncontingent delivery. Additionally, the use of synchronous and noncontingent delivery did not alter the children's preference for the task. [ABSTRACT FROM AUTHOR]

Deficits in the study skills of college students can lead to lower academic performance and disqualification. Although behavior analytic research has evaluated strategies for improving student performance in the classroom, no studies have evaluated methods for improving study skills outside of the classroom. We evaluated the effects of a training package that consisted of instructions, written checklists, picture models, and performance feedback using a multiple probe design across skill sets of college students. We taught four college students how to set up their study environment, take notes on readings, and self‐test using their notes from readings. All participants exhibited improvements in targeted study skills during training, and three of four participants achieved mastery within two training sessions per skill set. Acquisition of targeted skill sets corresponded with increased scores on quizzes that assessed learning from the readings. Moreover, participants found the goals and procedures acceptable and the outcomes satisfactory. [ABSTRACT FROM AUTHOR]

Activities that teach PreK–1 students the six components of emergent literacy and beginning reading and word study are presented for classroom settings. These activities are adaptable developmentally and they highlight four important aspects of teaching phonics, spelling and word knowledge that are often overlooked: the rhythm of literacy, Concept of Word in Text (COW‐T), articulation in word study, and the role of spelling in the reciprocal processes of reading and writing (decoding/encoding). Research underlying these activities suggests that rhythmic activities in early literacy instruction can be a precursor to explicit instruction for phonological awareness with young children and students who struggle to learn to read. The research also shows how articulation and other multisensory aspects of learning to read are parts of development and instruction for emergent and beginning readers. The role of spelling during these early periods is highlighted and discussed. [ABSTRACT FROM AUTHOR]

Medical students' motivation and study strategies are crucial in determining academic performance. This study aimed to assess the motivation and learning strategies of medical students as well as their association with performance in anatomy examinations. The Motivated Strategies for Learning Questionnaire, two focus group discussions, and students' current anatomy cumulative grade point average (cGPA) were used. Generally, the medical students strongly felt that anatomy is fundamental to the practice of medicine and surgery. This result was consistent with high task value scores of 5.99 ± 1.25. They were also driven by extrinsic goal orientation (5.59 ± 1.42) and intrinsic goal orientation (5.08 ± 1.26). Most medical students typically relied on elaboration (5.35 ± 1.25) ahead of other cognitive strategies namely rehearsal (5.30 ± 1.11), organization (5.15 ± 1.34), and lowest‐rated critical thinking (4.77 ± 1.19). The students also relied on resource management strategies, effort regulation (5.15 ± 1.20) and time and study environment regulation (5.03 ± 1.03) more than the moderately scored peer learning (4.95 ± 1.50) and help‐seeking (4.95 ± 1.09). In the focus group discussions, students reported that they often narrate or explain to each other what they would have read and understood from anatomy lectures, tutorials, and textbooks. They also bemoaned the lack of institutional support for stress burdens. The motivation and learning strategies subscales were not correlated with anatomy cGPA. Males were driven by extrinsic goals and experienced significantly higher levels of test anxiety than females (P < 0.05). Knowing the motivation and learning strategies students employ early in the medical curriculum can be leveraged to promote self‐directed learning and academic achievement. [ABSTRACT FROM AUTHOR]

University students demonstrating higher levels of Attention‐Deficit Hyperactivity Disorder (ADHD) symptom severity largely experience lower academic achievement. Educational research has found that a group of behaviours (i.e., study skills, interpersonal skills, engagement, and motivation) known as academic enablers (AE) facilitate positive outcomes within a classroom‐based learning environment. The current study recruited 617 undergraduate students to explore whether ADHD symptomatology and AE emerge as significant predictors of academic achievement at the university level, and whether demonstration of AE contribute to predicting achievement above and beyond that of ADHD effects. Results from simple linear regression analysis indicated that higher ADHD symptom severity predicted poorer academic achievement. Greater application of AE—excluding interpersonal skills—predicted greater academic achievement among university students. Exploratory results from hierarchical linear regression analysis suggested that demonstration of engagement, motivation, and especially study skills contribute towards predicting greater academic achievement while controlling for negative effects from ADHD symptom presentation. These findings imply that undergraduate academic outcomes can potentially be improved for students struggling with more severe ADHD symptom presentation if more emphasis is placed by universities to promote academic enabling behaviours within the educational framework and environment. Keypoints: Undergraduate students at a Canadian university reported on their ADHD symptom severity and demonstration of academic enablers (i.e., study skills, interpersonal skills, engagement, and motivation).Stronger ADHD symptom severity predicted lower academic achievement, and greater demonstration of study skills, engagement, and motivation, predicted higher academic achievement.Overall, academic enabling behaviours contributed more to predicting academic achievement at the university level compared to effects from ADHD symptomatology.Emphasis placed by universities to encourage their students' development and sustained use of academic enablers, especially study skills, could offer an approach towards mitigating negative academic outcomes often experienced by undergraduate students who present high ADHD symptom severity. [ABSTRACT FROM AUTHOR]

The study purposes were to explore the level of students' academic enablers and gender‐based difference towards academic enablers scales (AES) among 3200 students that were selected randomly from 80 high schools of Punjab province of Pakistan. The descriptive design of the positivism research paradigm was used to accomplish the study. Academic enablers scale for students (AES‐students) was adapted to collect data about four academic enabling behaviors (motivation, engagement, interpersonal skills, and study skills). Hence, the psychometric properties of adapted AES‐students exhibited that it is a valid and reliable instrument to measure academic enablers. Results indicated that the majority of students had a competent level in all academic enabling behaviors while they are more motivated as compared to their study skills, interpersonal skills, and engagement. However, engagement is the least contributive enabler. Moreover, results also demonstrated a significant difference in girls' and boys' student perceptions towards AES. It is also determined that gender had a small effect size on students' academic enablers as Cohen's d values among 0.1 to 0.4. Academic enabling behaviors may be enhanced among boy students through the use of different teaching strategies in the classroom, such as enthusiastic demonstration style, group activities, and classroom symposiums. [ABSTRACT FROM AUTHOR]

The article discusses the trial of a coaching program that recruited senior medical students to be volunteer coaches to incoming medical students as of 2023. Topics covered include the online 7-week prematriculation course (PMC) and its implementation. Also noted are students' general positive comments on coaching, and the suggestion that pairing coaches and coachees with similar backgrounds and life experiences would be more ideal.

The focus of this paper is on a group of pupils with reading and writing difficulties who have been participating in an intervention study using assistive technology. That intervention study contained supervised training sessions with reading and writing tasks using an iPad with special supportive applications. The current study is a qualitative investigation of whether there has been any transfer from the intervention, to the pupils' everyday school activities. Interviews with pupils and their teachers and observations during classroom lectures have been used to collect data. The results show that the pupils were positive to the assistive technology (the applications on the iPads), they found the apps easy to learn how to use and they appreciated the benefits they could give. Even so, only a few of the pupils had found use for and continued to use the tools after the intervention period finished. Possible reasons are that when the novelty wore off, students reverted to their usual study habits and that older students with many teachers and different classrooms were less able to adapt to using the apps. To improve transfer, it is suggested to introduce assistive technology earlier to students, in the younger grades, before study habits have been formed and to inform teachers about the use of AT in the classroom, including what is available and how it can benefit students. [ABSTRACT FROM AUTHOR]

Aims: The aim and objective of the study was building on a previous call for the development of sport‐based life skills interventions for young people with first episode of psychosis (FEP) (Brooke, Lin, Ntoumanis, & Gucciardi, 2018), to explore the barriers and enablers to sport participation for young people with FEP. Method: We used a semi‐structured interview format to conduct one‐to‐one interviews with young people (aged 16‐25; n = 10) with FEP, and one‐to‐one interviews and focus groups with their clinicians (n = 33). Questions focused on barriers and facilitators (intrapersonal, interpersonal, psychological, environment, health/safety, logistical) to sport participation young people with FEP. Thematic analysis was used to analyse the data. Results: Four themes (and 11 sub‐themes) emerged from the analysis: (a) the need for sport in FEP recovery (perceived benefits; resource gap); (b) barriers (logistical; psychological); (c) enablers (positive environmental expectations and experiences) and (d) programme design (sport programme/type; life skills training; application to barriers/enablers). Conclusion: The participants responded favourably to the idea of using sport to promote recovery post‐FEP, and provided an insight into why sport is currently underutilized within FEP recovery efforts. The barriers, enablers, and specific suggestions for how to limit the barriers and strengthen the enablers are valuable for sport‐based intervention design, and may be applicable to non‐sport‐based interventions for people with FEP. [ABSTRACT FROM AUTHOR]

Aim: Documented evidence shows that training in life skills for school going children improves their physical and mental health status. Although Kenya has a curriculum and a policy for life‐skills training in schools, these have not been implemented because lack of local evidence for efficacy. Therefore, the objective of this study was to determine the efficacy and effectiveness of the life‐skill training curriculum for primary schools developed by the Ministry of Education, Kenya. Methods: We randomly selected 23 schools from two randomly selected sub‐counties representing urban/peri‐urban and rural contexts in Kenya. We collected baseline socio‐demographic characteristics and administered the locally validated youth self‐report (YSR) for 11 to 18 years old at baseline and 9 months post‐intervention. We used the Ministry of Education validated curriculum for life‐skills training for upper primary school as the intervention immediately after the baseline. Results: The World Health Organization life‐skills training is efficacious in reducing YSR scores in primary school going children in Kenya. We found that socio‐demographic characteristics were predictors for mental health and that there were significant positive improvements in internalizing and externalizing YSR symptoms and syndromes in both sites. The improvement was over 40% and therefore unlikely to be attributable to placebo effect or natural recovery without intervention. However, attention problems worsened more so in rural sites and particularly in girls. Conclusions: Life‐skills training is efficacious in improving mental health in school going children in the Kenyan context. However, it is not effective in attention problems which seem to be cognitive in nature. [ABSTRACT FROM AUTHOR]

Aim: The objective of this narrative review is to address the question: Should sport‐based life skills interventions be developed for young people recovering from first episode psychosis? Methods: A prose was developed through a broad, critical narrative review of literatures on (1) first episode psychosis recovery (FEP); and (2) life skills and sport, highlighting the conceptual (and limited empirical) links between the two. This style of review allowed for a critical examination of evidence from seemingly distinct literatures to address a question yet to be explored empirically. Results: The review process highlighted important overlaps between psychosis recovery and sport. A review of the FEP recovery literature reveals that important components of an individual's recovery following a psychotic episode are: (1) physical activity, (2) opportunities to build life skills, and (3) social connectivity. A review of the sport and life skills literature suggests that sport can be a powerful platform from which to: (1) promote physical activity, (2) teach life skills, and (3) foster social connectivity within vulnerable populations. Despite the clear links between the two fields, mental health interventions that combine both life skills training components and physical activity in a context that promotes social connectivity are scarce to none. Conclusions: We suggest that sport‐based interventions could be an opportunity to provide life skills training, social connectivity and physical activity opportunities in one intervention to individuals recovering from their first psychotic episode. We call for their development, and provide empirically‐based recommendations for intervention design. [ABSTRACT FROM AUTHOR]

Conventional approaches to relevance ranking typically optimize ranking models by each query separately. The traditional cluster hypothesis also does not consider the dependency between related queries. The goal of this paper is to leverage similar search intents to perform ranking consistency so that the search performance can be improved accordingly. Different from the previous supervised approach, which learns relevance by click‐through data, we propose a novel cocluster hypothesis to bridge the gap between relevance ranking and ranking consistency. A nearest‐neighbors test is also designed to measure the extent to which the cocluster hypothesis holds. Based on the hypothesis, we further propose a two‐stage unsupervised approach, in which two ranking heuristics and a cost function are developed to optimize the combination of consistency and uniqueness (or inconsistency). Extensive experiments have been conducted on a real and large‐scale search engine log. The experimental results not only verify the applicability of the proposed cocluster hypothesis but also show that our approach is effective in boosting the retrieval performance of the commercial search engine and reaches a comparable performance to the supervised approach. [ABSTRACT FROM AUTHOR]

Rationale, aims, and objectives: Waist circumference (WC) and waist‐to‐height ratio (WHtR) are superior surrogate markers of central obesity than body mass index. However, WC is not measured routinely in paediatric clinics. The objective of this study was to implement measurement of WC during routine assessment of children in an ambulatory outpatient clinic setting and subsequent dissemination of cardiometabolic risk counselling in children with central obesity (defined as WHtR ≥0.5). Method: Prospective cohort of patients aged 6 to 20 years. Study period was divided into three phases: baseline (3 months), process improvement (2 months), and implementation (6 months). Define‐Measure‐Analyse‐Improve‐Control (DMAIC) strategy was applied. Measurement of WC was implemented as a component of the physical examination in patients. Outcome measures were (1) improvement in frequency of WC measurement and (2) utilization of WHtR in cardiometabolic risk counselling. Results: Waist circumference was not measured in any patient during baseline phase (n = 551). During process improvement phase, of the total 347 patients, WC was measured in 35% vs target of 30%. In the implementation phase, WC was measured in 37% patients (365 out of 964). Of these 365 patients, 175 (48%) had elevated WHtR, and 73% of them (n = 128) were counselled about their increased cardiometabolic risk. Conclusions: Application of an evidence‐based DMAIC protocol led to significant improvement in assessment for central obesity in an ambulatory clinic practice and appropriate counselling regarding cardiometabolic risk reduction in children and adolescents with central obesity over an 8‐month period. Meticulous planning and execution, frequent reinforcement, and integrating feedback from the involved multi‐disciplinary team were important factors in successful implementation of this quality improvement project. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the impact of a criteria-based audit (CBA) of obstructed labor and fetal distress on cesarean delivery and perinatal outcomes.Methods: A cross-sectional study was performed at a tertiary referral hospital in Tanzania. Data were collected before and after CBA (January 2013-November 2013 and July 2015-June 2016). Outcomes of fetal distress (baseline CBA, n=248; re-audit, n=251) and obstructed labor (baseline CBA, n=260; re-audit n=250) were assessed using a checklist. Additionally, 27 960 parturients were assessed using the Robson classification.Results: Perinatal morbidity and mortality decreased from 42 of 260 (16.2%) to 22 of 250 (8.8%) among patients with obstructed labor after CBA (P=0.012). Cesarean delivery rate decreased for referred term multiparas with induced labor or prelabor cesarean delivery (odds ratio [OR] 0.28, 95% confidence interval [CI] 0.09-0.82). Cesarean delivery rate for preterm pregnancies increased among both referred (OR 1.28, 95% CI 1.02-1.63) and non-referred (OR 2.78, 95% CI 1.98-3.90) groups. Neonatal distress rate decreased for referred term multiparas (OR 0.72, 95% CI 0.56-0.92), referred preterm pregnancies (OR 0.32, 95% CI 0.25-0.39), and non-referred preterm pregnancies (OR 0.26, 95% CI 0.18-0.36).Conclusion: Use of CBA reduced poor perinatal outcomes of obstructed labor and increased uptake of cesarean delivery. [ABSTRACT FROM AUTHOR]

Objective: To compare Doppler ultrasonographic measurements of the fetal middle cerebral artery peak systolic velocity (MCA PSV) among women with or without gestational diabetes mellitus (GDM).Methods: A cross-sectional study was conducted among pregnant women who presented for prenatal care at a single hospital in Brazil between September 11, 2015, and January 6, 2017. Patients were stratified into a group with GDM and a control group without GDM. One Doppler ultrasonographic assessment was performed per participant. This measurement was made after diagnosis but before the start of treatment among women in the GDM group. Fetal ultrasonographic and biometric variables assessed included MCA PSV, MCA pulsatility index, umbilical artery pulsatility index, the MCA-to-umbilical artery ratio, abdominal circumference, and weight.Results: The study included 238 women: 115 in the GDM group and 123 in the control group. The median MCA PSV was 1.02 in the GDM group and 1.08 in the control group (P=0.036). No statistically significant between-group differences were found for the other fetal ultrasonographic variables or for the fetal biometric variables assessed. None of the maternal or fetal parameters assessed displayed a linear correlation with MCA PSV.Conclusion: Doppler ultrasonographic measurements of MCA PSV were lowered among the fetuses of women diagnosed with GDM. [ABSTRACT FROM AUTHOR]

Objective: To determine the association between low maternal vitamin D levels and preterm delivery among parturients in Lagos, Nigeria.Methods: The present study was an analytical cross-sectional study of women with preterm deliveries (defined as <37 weeks) and women with term deliveries (defined as ≥37 weeks) at the labor unit of Lagos University Teaching Hospital between December 1, 2015, and October 31, 2016. Relevant information was obtained via a proforma, and maternal venous samples were collected immediately after delivery. Serum 25-hydroxy vitamin D was determined by a vitamin D enzyme-linked immunoassay kit.Results: The study enrolled 103 women in each group. The overall prevalence of vitamin D deficiency was 14.1% (29/206). 24 (23.3%) women with preterm delivery had low serum vitamin D (<30 ng/mL) as compared with only 5 (4.9%) women with term delivery (P<0.001). Compared with normal serum vitamin D levels, low maternal vitamin D had an approximately nine-fold higher likelihood of preterm delivery (adjusted odds ratio 9.41, 95% confidence interval 2.42-36.54; P<0.001).Conclusion: The prevalence of serum vitamin D deficiency was higher among women with preterm delivery than among those with term delivery. The potential role of prenatal vitamin D supplementation in the prevention of preterm delivery should be further investigated. [ABSTRACT FROM AUTHOR]

Background/aim: The Approaches and Study Skills Inventory for Students (ASSIST) has been used previously to assess the learning approaches among students in higher education, but reports of its use with occupational therapy students are rare. This study investigated the factor structure of the ASSIST in a cross‐cultural sample of undergraduate occupational therapy students, and examined whether the factor structure from specific participant groups from different cross‐cultural contexts was consistent. Methods: Occupational therapy students (n = 712) from education programmes in Australia, Norway, Hong Kong and Singapore completed the ASSIST. To assess the factor structure of the instrument, a Principal Components Analysis (PCA) using a confirmatory approach, was completed. Cronbach's coefficient α and inter‐item correlations were used to assess the internal consistency of the ASSIST and its subscales. Results: For the whole sample, the PCA confirmed the three primary factors as previously established. Five subscales loaded on the first factor (strategic approach). Four subscales loaded on the second factor (surface approach), whereas the remaining four subscales loaded on the third factor (deep approach). Repeating the analysis for each of the country‐specific samples produced slightly diverging factor structures for the samples from Australia and Hong Kong. Conclusion: Considering all the data, the ASSIST subscales that emerged from the PCA used with a confirmatory approach in this study revealed a good degree of concordance with the established original factor, scale and subscale structure. The slightly deviating results obtained for the Hong Kong student group indicate that the established factor structure may not be the best fit across all settings, cultural contexts and sample groups. [ABSTRACT FROM AUTHOR]

Objective: To determine the causes, patterns and trends of respiratory diseases-related deaths in hospitals of Tanzania 2006-2015.Methods: Retrospective study involving 39 hospitals. Medical records of patients who died in hospital were retrieved, reviewed and analysed. Sources of data were hospital admission registers, death registers and International Classification of Diseases report forms. Information on demographic characteristics, date of death, the immediate underlying cause of death and co-morbid conditions was collected.Results: Of the 247 976 deaths reported during the 10-year period, respiratory diseases accounted for 12.92% (n = 32 042). The majority of the respiratory mortality was reported among males (55.9%). Overall median age at death was 31 years with an interquartile range (IQR) of 1-47. Median age at death was significantly higher among males (35 years) than females (28 years) (P < 0.0001). Most deaths (37.8%) occurred in eastern Tanzania. About one-third (31.3%) of all respiratory mortality was reported among under-five children, being among girls than boys (34.3% vs. 28.9%, χ2  = 10.3, P < 0.0001). Adolescent and young adult females (15-29 years) had higher age-standardised mortality rates per 100 000 due respiratory diseases than males. Pneumonia (n = 16 639; 51.9%) and pulmonary tuberculosis (n = 9687; 30.2%) accounted for the majority of deaths due to respiratory diseases. Significantly more females (n = 7665; 54.5%) than males died from pneumonia (n = 8878; 49.8%; χ2  = 8.5, P < 0.0001). By contrast, significantly more males (n = 6024; 34%) than females (n = 3596; 26%; χ2  = 15.5, P < 0.0001) died of tuberculosis. The proportion of death due to tuberculosis declined from 32.8% in 2006-2010 to 7.9% in 2011-2015. However, there was a significant increase in the proportion of death due to pneumonia from 49.6% in 2006-2010 to 53.4% in 2011-2015. Co-morbid conditions contributed to 9.1% (2871/31 628) of all deaths due to respiratory diseases. The most common co-morbid condition was HIV which accounted for 1735 (60.4%) deaths and was more common among males (60.8%; n = 957) than among females (59.7%; n = 764).Conclusions: Respiratory diseases account for a substantial proportion of all causes of hospital death in Tanzania. Pneumonia and tuberculosis contribute to more than three quarters of all deaths due to respiratory diseases. Since most major respiratory illnesses are avoidable, it is important to strengthen the capacity of the health delivery system in managing cases of respiratory diseases. [ABSTRACT FROM AUTHOR]

Objective: To estimate the effect of locally tailored clinical guidelines on intrapartum care and perinatal outcomes among women with severe hypertensive disorders in pregnancy (sHDP).Methods: A pre-post study at Zanzibar's low-resource Mnazi Mmoja Hospital was conducted. All labouring women with sHDP were included at baseline (October 2014 to January 2015) and at 9-12 months after implementation of the ongoing intervention (October 2015 to January 2016). Background characteristics, clinical practice, and delivery outcomes were assessed by criterion-based case file reviews.Results: Overall, 188 of 2761 (6.8%) women had sHDP at baseline, and 196 of 2398 (8.2%) did so during the intervention months. The median time between last blood pressure recording and delivery decreased during the intervention compared with baseline (P=0.015). Among women with severe hypertension, antihypertensive treatment increased during the intervention compared with baseline (relative risk [RR] 1.37, 95% confidence interval [CI] 1.14-1.66). Among the neonates delivered (birthweight ≥1000 g), stillbirths decreased (RR 0.56, 95% CI 0.35-0.90) and Apgar scores of seven or more increased during the intervention compared with baseline (RR 1.17, 95% CI 1.03-1.33).Conclusion: Although health system strengthening remains crucial, locally tailored clinical guidelines seemed to help work-overloaded birth attendants at a low-resource hospital to improve care for women with sHDP. CLINICALTRIALS.ORG: NCT02318420. [ABSTRACT FROM AUTHOR]

Objective: To assess the predictive ability of a combination of anogenital distance (AGD) and anti-Müllerian hormone (AMH) to diagnosis the presence of endometriosis without surgery.Methods: The present study included women diagnosed with endometriosis and a control group who attended the "Virgen de la Arrixaca" University Hospital, Murcia, Spain, between September 1, 2014, and May 31, 2015. Serum concentrations of AMH were measured, and two AGD measurements were obtained: from the anterior clitoral surface to the upper verge of the anus (AGDAC ), and from the posterior fourchette to the upper verge of the anus (AGDAF ). Data were assessed by receiver operator characteristic (ROC) curves.Results: Women in the endometriosis group (n=57) had significantly shorter AGDAF (22.8 ± 4.6 vs 27.2 ± 5.7 mm; P<0.001) and lower AMH (2.2 ± 2.5 vs 3.3 ± 1.9 ng/mL; P<0.003) compared with the control group (n=93). Women with serum AMH below the clinical cut-off (1 ng/mL) were 17.40-times more likely to have endometriosis (95% confidence interval [CI] 5.64-53.82). The area under the ROC curve of combined AMH and AGDAF was 0.77 (95% CI 0.70-0.85).Conclusion: The model for predicting endometriosis on the basis of AMH and AGD could be useful for clinicians and epidemiologists to improve diagnosis and prognosis of this condition. [ABSTRACT FROM AUTHOR]

Objective: To investigate health-system challenges responsible for the poor performance of a cervical cancer prevention program in the Kurdistan Region of Iraq.Method: A qualitative study was conducted among a purposive sample of healthcare providers and female volunteers in Erbil, Kurdistan Region of Iraq, between December 10, 2014, and July 23, 2016. Data were collected from participants using in-depth semi-structured interviews. The interviews were then transcribed and analyzed with an inductive content analysis approach.Results: In total, 23 individuals completed the interviews. The participants included 8 (35%) female volunteers; 5 (22%) nurses; 4 (17%) managers; 3 (13%) doctors; and 3 (13%) gynecologists. The health-system challenges were classified into three main categories: existence of an official reminder system, public information delivery programs, and infrastructures of facilities, which included three subcategories-cervical cancer screening center, material resources, and human resources.Conclusions: The Kurdistan Region of Iraq health system faced several challenges in delivering a cervical cancer prevention program. These challenges must be addressed to improve the coverage of cervical cancer screening, diagnosis, and treatment. [ABSTRACT FROM AUTHOR]

Summary: Aims: To examine whether early rise of neutrophil‐to‐lymphocyte ratio (NLR) after patient hospitalization correlates with 30‐day mortality in patients with spontaneous intracerebral hemorrhage (ICH). Methods: This retrospective study included all patients receiving treatment for spontaneous ICH between January 2015 and September 2016 at the Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences in Shanghai, China. NLR was determined at admission (T1), at 24‐48 hours (T2) and 5‐7 days (T3). NLR and clinicopathologic features were compared between those who survived for >30 days vs not. Multivariate regression was used to identify risk factors for 30‐day mortality. Results: A total of 275 subjects were included in the analysis: 235 survived for at least 30 days; the remaining 40 subjects died within 30 days. The patients who died within 30 days had higher ICH score, larger ICH volume, and lower GCS score (all P < 0.05). In comparison with the baseline (NLRT1), NLR at 24‐48 hours (NLRT2) and 5‐7 days (NLRT3) was significantly higher in patients who died within 30 days (P < 0.05), but not in patients surviving for >30 days. In the multivariate analysis, the 30‐day mortality was associated with both NLRT2 (OR 1.112, 95%CI 1.032‐1.199, P = 0.006) and NLRT3 (OR 1.163, 95%CI 1.067‐1.268, P = 0.001). Spearman correlation analysis showed that both NLRT2 and NLRT3 correlated inversely with GCS score and positively with ICH score and ICH volume at the baseline. Conclusions: Early rise of NLR predicts 30‐day mortality in patients with spontaneous ICH. [ABSTRACT FROM AUTHOR]

Summary: Background: The purposes of this study were three‐fold: (i) to determine the contribution of known genes to the causation of a broad‐spectrum of pediatric drug‐resistant epilepsy (DRE), (ii) to compare the diagnostic yield and cost among different next‐generation sequencing (NGS) approaches, and especially (iii) to assess how NGS approaches can benefit patients by improving diagnosis and treatment efficiency. Methods: This study enrolled 273 pediatric DRE patients with no obvious acquired etiology. Seventy‐four patients underwent whole‐exome sequencing (WES), 141 patients had epilepsy‐related gene panel testing, and another 58 patients had clinical WES gene panel testing. We obtained these patients' seizure and hospitalization frequency by periodic follow‐up phone calls and outpatient visits. Results: Genetic diagnosis was achieved in 86 patients (31.5%) and involved 93 likely disease‐causing mutations in 33 genes. In this study, the detection rates of the epilepsy‐related gene panel, the clinical WES gene panel, and WES were 32.6% (46/141), 44.8% (26/58), and 17.3% (13/74), respectively. Moreover, 34 patients accepted corrective therapy according to their mutant genes, after which 52.9% (18/34) became seizure‐free and 38.2% (13/34) achieved seizure reduction. In the end, patients with either positive or negative genetic results had significantly fewer hospitalization incidents (times/half year) than before (positive genetic results group 0.58 ± 1.14 vs 0.10 ± 0.26; negative genetic results group 0.72 ± 1.65 vs 0.12 ± 0.33). Conclusions: These results offer further proof that NGS approaches represent powerful tools for establishing a definitive diagnosis. Moreover, this study indicated how NGS can improve treatment efficacy and reduce hospitalization in children with DRE. [ABSTRACT FROM AUTHOR]

Background: Thyroid cancer (TC) is one of the most commonly seen secondary malignancy in breast cancer (BC) survivors. Materials and methods: A retrospective study was conducted in BC patients in our center from 1999 to 2013. Patients were divided into BC‐TC group and BC‐alone group. Results: In total, 13 978 BC patients were identified, among whom 247 (1.8%) had TC. The standardized incidence ratio (SIR) of TC was 4.48 compared with Chinese females, and up to 98.0% of cases were thyroid papillary carcinomas. A family history of malignancy was the only independent risk factor (odds ratio = 1.457, P = 0.025) for development of TC in patients with BC. We also identified inferior survival in patients with synchronous versus metachronous BC‐TC (P = 0.016). Synchronous BC‐TC (risk ratio = 5.597, P = 0.018) was an independent prognostic factor for inferior RFS. Conclusions: We observed high co‐occurrence of TC in patients with BC. There might be different mechanisms behind synchronous and metachronous BC‐TC. In the current study, we investigated the association of thyroid cancer incidence in a cohort of 13 978 breast cancer patients. We identified that the standardized incidence ratio of secondary thyroid cancer was significantly increased and a family history of malignancy was the only independent risk factor, which provided a new insight into the association of breast cancer and thyroid cancer. [ABSTRACT FROM AUTHOR]

Abstract: This forum highlights research that literacy teachers, students, and others can explore, use, or adapt as they provide literacy instruction and develop related programs and research agendas. [ABSTRACT FROM AUTHOR]

Abstract: Although there is mounting evidence that selective social learning begins in infancy, the psychological mechanisms underlying this ability are currently a controversial issue. The purpose of this study is to investigate whether theory of mind abilities and statistical learning skills are related to infants’ selective social learning. Seventy‐seven 18‐month‐olds were first exposed to a reliable or an unreliable speaker and then completed a word learning task, two theory of mind tasks, and a statistical learning task. If domain‐general abilities are linked to selective social learning, then infants who demonstrate superior performance on the statistical learning task should perform better on the selective learning task, that is, should be less likely to learn words from an unreliable speaker. Alternatively, if domain‐specific abilities are involved, then superior performance on theory of mind tasks should be related to selective learning performance. Findings revealed that, as expected, infants were more likely to learn a novel word from a reliable speaker. Importantly, infants who passed a theory of mind task assessing knowledge attribution were significantly less likely to learn a novel word from an unreliable speaker compared to infants who failed this task. No such effect was observed for the other tasks. These results suggest that infants who possess superior social‐cognitive abilities are more apt to reject an unreliable speaker as informant. A video abstract of this article can be viewed at: https://youtu.be/zuuCniHYzqo [ABSTRACT FROM AUTHOR]

ABSTRACT: BACKGROUND: High school completion provides health and economic benefits. The purpose of this study is to describe dropout rates based on longitudinal trajectories of aggression and study skills using teacher ratings. METHODS: The sample consisted of 620 randomly selected sixth graders. Every year from Grade 6 to 12, a teacher completed a nationally normed behavioral rating scale. We used latent class mixture modeling to identify the trajectories. RESULTS: Participants followed 3 trajectories of aggression (Low, Medium Desisting, and High Desisting) and 5 trajectories of study skills (Low, Average‐Low, Decreasing, Increasing, and High). Over three‐quarters of the sample were in stable trajectories of study skills over time. Most students in the High Desisting Aggression group were in the Low Study Skills group, and all students in the High Study Skills group were in the Low Aggression group. The overall dropout rate was 17%, but varied dramatically across combined aggression and study skills groups, ranging from 2% to 50%. CONCLUSIONS: The results highlight the importance of early prevention that combines academic enhancement and behavioral management for reducing school dropout. [ABSTRACT FROM AUTHOR]

The article introduces a learning‐oriented approach to test preparation that could help in easing the tension between learning and assessment. The first part of the article discusses the different concepts that are usually used in the context of test preparation. The second section reports on the literature pertaining to the effects of test preparation on teaching, learning, and test performance. The article also attempts to differentiate between appropriate and unhealthy practices and show the intricate differences between these concepts. In conclusion, the author suggests a number of guidelines for different stakeholders about how to conduct test preparation activities effectively and how to avoid the common pitfalls when carrying out this task. These guidelines focus specifically on how to develop and carry out test preparation activities that are learning‐oriented, how to develop assessment tasks that discourage inappropriate test preparation practices, and how to use strategies for promoting professionally sound test preparation activities. [ABSTRACT FROM AUTHOR]

This chapter describes a Reading and Study Skills program and course that are offered to first-year students who are underprepared or reluctant and who may be at risk for failure in other courses as well as at risk for long-term retention and graduation. The course is discussed with respect to its parallels to the MVP model, and initial evidence of its success is provided. The MVP cycle is reflected in course design and process and in a textbook created specifically to accompany the course. [ABSTRACT FROM AUTHOR]

When linked to program review and improvement, program evaluation can help practitioners to ensure that career-technical education (CTE) and science, technology, engineering, and mathematics (STEM) programs offer equitable access and outcomes for underserved student groups. [ABSTRACT FROM AUTHOR]

The article explores how an experienced third-grade teacher systematically addresses the learning skills involved in self-regulation to foster dependence and responsibility in her students. Topics discussed include the definition of self-regulated learning, the strong similarities between self-regulated learning and the characteristics of students who function competently in the digital world, and the characteristics of self-regulated learners.

People with dyslexia are vastly under-represented in universities (Katusic et al., , Richardson & Wydell, ; Stampoltzis & Polychronopoulou, ). This situation is of concern for modern societies that value social justice. This study was designed to explore learning experiences of university students with dyslexia and factors that could contribute to their success. Thirteen students with dyslexia and 20 non-dyslexic peers were interviewed about their university learning experiences using a semi-structured qualitative approach. Students with dyslexia described engaging in learning activities intensively, frequently and strategically. They reported challenges and strengths relating to study skills, lectures, assessments, technology and support services. They also described helpful strategies including self-directed adaptive techniques, provisions from lecturers and assistance from the university. These findings suggest that students with dyslexia experience broad challenges at university, but helpful strategies may be available. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This forum highlights and evaluates apps, computer programs, and websites that teachers, students, and other interested parties can use to explore, research, and engage in content learning and literacy practices. [ABSTRACT FROM AUTHOR]

Most people have struggled with reading in one situation or another, depending on their appreciation for the content, their prior experiences, and the texts. This department column shares ways for educators to help literacy learners unlock their potential with instruction anchored in their skills, knowledge, ways of learning, interests, and attitudes. [ABSTRACT FROM AUTHOR]

This forum reviews high-interest young adult literature and adult texts. Exploring both print-based and multimodal works, this column considers all kinds of texts that are encountered by contemporary readers, considering how the texts challenge and are challenged by readers. [ABSTRACT FROM AUTHOR]

Through a campuswide project using the Degree Qualifications Profile (DQP) as a comparison tool that engaged students and faculty, the authors share findings and implications about learning outcomes for IR professionals and DQP authors while considering the role of IR in large-scale, campuswide projects. [ABSTRACT FROM AUTHOR]

Dental educators intend to promote integration of knowledge, skills, and values toward professional competence. Studies report that retrieval, in the form of testing, results in better learning with retention than traditional studying. The aim of this study was to evaluate test-enhanced experiences on demonstrations of competence in diagnosis and management of malocclusion and skeletal problems. The study participants were all third-year dental students (2011 N=88, 2012 N=74, 2013 N=91, 2014 N=85) at New York University College of Dentistry. The 2013 and 2014 groups received the test-enhanced method emphasizing formative assessments with written and dialogic delayed feedback, while the 2011 and 2012 groups received the traditional approach emphasizing lectures and classroom exercises. The students received six two-hour sessions, spaced one week apart. At the final session, a summative assessment consisting of the same four cases was administered. Students constructed a problem list, treatment objectives, and a treatment plan for each case, scored according to the same criteria. Grades were based on the number of cases without critical errors: A=0 critical errors on four cases, A-=0 critical errors on three cases, B+=0 critical errors on two cases, B=0 critical errors on one case, F=critical errors on four cases. Performance grades were categorized as high quality (B+, A-, A) and low quality (F, B). The results showed that the test-enhanced groups demonstrated statistically significant benefits at 95% confidence intervals compared to the traditional groups when comparing low- and high-quality grades. These performance trends support the continued use of the test-enhanced approach. [ABSTRACT FROM AUTHOR]

Informed by the latest research on how people learn, effective teachers address both aspects of the teaching-learning equation-they engage students in the course material by implementing best teaching practices and they prepare students for learning by sharing best learning practices. The purpose of this study was to evaluate the impact of student-centered learning practices on students' perceptions of their ability to learn, specifically in a large enrollment, introductory food science and human nutrition course. Featured student-centered learning practices included required assignments, optional study tools, and supplemental learning resources. A mixed method survey instrument with 5-point Likert scales and qualitative, open-ended questions was used to determine students' (1) use of optional study tools and supplemental learning resources; (2) perceptions as to the quality and impact of required assignments, optional study tools, and supplemental learning resources to enhance their ability to learn; (3) perceptions as to the usefulness of required assignments, optional study tools, and supplemental learning resources to help them perform better in this course; and (4) overall satisfaction, as a learner, in this course. Overall, students identified study guides (developed using Bloom's taxonomy action verbs) (Mean = 4.34), microthemes (Mean = 4.27), and quizzes (Mean = 4.11) as the most beneficial resources to enhance their learning of the course material. Overall, 85% of students said they were extremely or very satisfied as learners in the course and nearly 75% of the students said the student-centered learning practices should be offered to future FSHN 101 students. [ABSTRACT FROM AUTHOR]

This article explores how adolescents layer literacies in and outside school. Findings from a longitudinal study of gaming in a public library, as well as data related to the use of Portal 2 in a New York City middle school classroom, reveal how the students created, showcased, analyzed, and experimented with online and offline artifacts and knowledge. By examining the ways youths collaboratively and independently moved about their various practices, the authors not only address characteristics of contemporary learning but also call for flexible opportunities for agentive and layered meaning making. [ABSTRACT FROM AUTHOR]

Context Students tend to postpone preparation for a test until the test is imminent, which raises various risks associated with 'cramming' behaviours, including that for suboptimal learning. Cumulative assessment utilises spaced testing to stimulate students to study more frequently and to prevent procrastination. This randomised controlled study investigated how cumulative assessment affects time spent on self-study and test performance compared with end-of-course assessment. Methods A total of 78 undergraduate medical students in a Year 2 pre-clinical course were randomly assigned to either of two conditions. Students in the cumulative assessment condition were assessed in weeks 4, 8 and 10. Students in the end-of-course assessment condition were assessed in week 10 only. Each week, students reported the number of hours they spent on self-study. Results Students in the cumulative assessment condition ( n = 25) spent significantly more time on self-study than students in the end-of-course assessment condition ( n = 37) in all weeks of the course except weeks 5, 9 and 10. Overall, the cumulative assessment group spent 69 hours more on self-study during the course than did the control group, although the control group spent 7 hours more in studying during the final week of the course than did the cumulative assessment group. Students in the cumulative assessment condition scored slightly higher on questions concerning the content of the last part of the course. Conclusions Cumulative assessment encourages students to distribute their learning activities over a course, which leaves them more opportunity to study the content of the last part of the course prior to the final examination. There was no evidence for a short-term effect of cumulative assessment on overall knowledge gain. We hypothesise that larger positive effects might be found if retention were to be measured in the long term. [ABSTRACT FROM AUTHOR]

The current study examined the link between academic enablers and different types of reading achievement measures. Academic enablers are skills and behaviors that support, or enable, students to perform well academically, such as engagement, interpersonal skills, motivation, and study skills. The sample in this study consisted of 61 third-, fourth-, and fifth-grade students (54% male). Academic enablers were rated by classroom teachers via the Academic Competence Evaluation Scales (ACES; DiPerna & Elliott, ). Four different measures of reading achievement were included: classroom grades, global ratings of reading skills, standardized test scores, and Reading CBM scores. Results indicated that academic enablers were significantly related to each type of reading outcome. Academic enablers accounted for the greatest amount of variance for classroom grades (45%) and the least amount of variance in standardized test scores (11%). Results suggest that academic enablers are an important part of academic success in reading, particularly classroom grades, but when considering the variance accounted for by academic enablers, they alone are not likely to improve Reading CBM scores or standardized test scores. [ABSTRACT FROM AUTHOR]

Context Some characteristics of assessments exert a strong influence on how students study. Understanding these pre-assessment learning effects is of key importance to the designing of medical assessments that foster students' reasoning abilities. Perceptions of the task demands of an assessment significantly influence students' cognitive processes. However, why and how certain tasks positively 'drive' learning remain unknown. Medical tasks can be assessed as coherent meaningful whole tasks (e.g. examining a patient based on his complaint to find the diagnosis) or can be divided into simpler part tasks (e.g. demonstrating the physical examination of a pre-specified disease). Comparing the benefits of whole-task and part-task assessments in a randomised controlled experiment could guide the design of 'assessments for learning'. Objectives The purpose of this study was to determine whether the knowledge that an objective structured clinical examination ( OSCE) will contain whole tasks, as opposed to part tasks, increases the use of diagnostic reasoning by medical students when they study for this assessment. Methods In this randomised, controlled, mixed-methods experiment, 40 medical students were randomly paired and filmed while studying together for two imminent physical examination OSCE stations. Each 25-minute study period began with video cues and ended with a questionnaire on cognitive loads. Cues disclosed either a part-task OSCE station (examination of a healthy patient) or a whole-task OSCE station (hypothesis-driven physical examination [ HDPE]). In a crossover design, sequences were randomised for both task and content (shoulder or spine). Two blinded and independent authors scored all 40 videos in distinct randomised orders, listening to participants studying freely. Mentioning a diagnosis in association with a sign was scored as a backward association, and the opposite was scored as a forward association; both revealed the use of diagnostic reasoning. Qualitative data were obtained through group interviews. Results Studying for whole-task OSCE stations resulted in a greater use of diagnostic reasoning. Qualitative data triangulate these findings and show the precedence of cues sourced from the 'student grapevine'. Conclusions In comparison with 'traditional' part-task OSCEs, whole-task OSCEs like the HDPE increase students' use of diagnostic reasoning during study time. [ABSTRACT FROM AUTHOR]

The purpose of this study was to develop, scale, and validate assessments in engineering, science, and mathematics with grade appropriate items that were sensitive to the curriculum developed by teachers. The use of item response theory to assess item functioning was a focus of the study. The work is part of a larger project focused on increasing student learning in science, technology, engineering, and mathematics ( STEM)-related areas in grades 4-8 through an engineering design-based, integrated approach to STEM instruction and assessment. The fact that the assessments are available to school districts at no cost, and represent psychometrically sound instruments that are sensitive to STEM-oriented curriculum, offers schools an important tool for gauging students' understanding of engineering, science, and mathematics concepts. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine the concept development of decimal numbers in 244 Chinese elementary students in grades 4-6. Three grades of students differed in their intuitive sense of decimals and conceptual understanding of decimals, with more strategic approaches used by older students. Misconceptions regarding the density nature of decimals indicated the progress in an ascending spiral trend (i.e., fourth graders performed the worst; fifth graders performed the best; and sixth graders regressed slightly), not in a linear trend. Misconceptions regarding decimal computation (i.e., multiplication makes bigger) generally decreased across grades. However, children's misconceptions regarding the density and infinity features of decimals appeared to be more persistent than misconceptions regarding decimal computation. Some students in higher grades continued to use the discreteness feature of whole numbers to explain the distance between two decimal numbers, indicating an intermediate level of understanding decimals. The findings revealed the effect of symbolic representation of interval end points and students' responses were contingent on the actual representations of interval end points. Students in all three grades demonstrated narrowed application of decimal values (e.g., merchandise), and their application of decimals was largely limited by their learning experiences. [ABSTRACT FROM AUTHOR]