Rapid human immunodeficiency virus decay in highly active antiretroviral therapy (HAART)-experienced children after starting mega-HAART

Increasing numbers of patients are treated with mega-highly active antiretroviral therapy (HAART), or multiple-combination antiretroviral therapy, in an attempt to overcome the viral resistance that has contributed to treatment failure. Studies of human immunodeficiency virus (HIV) viral dynamics are used to quantify the potency of a given regimen. While mega-HAART is expected to provide potent therapy, its potency among heavily experienced HIV-infected children who have failed previous treatment is untested. HIV dynamics studies performed in children have provided minimal information on viral dynamics during mega-HAART. The present study estimates first- and second-phase viral dynamics in six children on mega-HAART, following failure of combination therapy. The first phase of viral decay was rapid, relative to rates reported in previous pediatric studies (median delta = 0.778d(-1), range = 0.583 to 1.088, half-life 1 [t1(1/2)] = 0.894d), while the second phase revealed results similar to those of previous studies (median mu = 0.026d(-1), range = -0.005 to 0.206, t2(1/2) = 9.316d). This indicates that mega-HAART can provide potent therapy among heavily experienced pediatric patients.     

The assessment of preschool children's motor skills after familiarization with motor tests

This research study was conducted to establish the influence of familiarization on the information component of movement in a motor task for the assessment of preschool children's motor skills. The sample included 50 children whose mean age was 5.9 years (71.5 months). The experimental group consisted of 27 children who were 5.9 years (71.5 months) old, and the control group consisted of 23 children who were 5.9 years (71.5 months) old. The examinees performed 2 motor tasks, standing long jump (SJ, explosive strength) and standing on 1 leg on a beam "flamingo test" (FT, balance). The experimental group underwent a period of familiarization with the motor task in 3 sessions with 5 trials every 3 days. The results indicate statistically significant differences in the final testing between both groups of examinees; the experimental group mean was 112.73 cm, and the control group mean was 100.62 in the SJ test (p = 0.00), and the experimental group mean was 27.10 seconds and the control group mean was 15.01 seconds in the FT (for balance) (p = 0.00). The results obtained in this research indicate that children significantly improved the results in the motor test of strength and balance, being influenced by familiarization. It was confirmed that it was necessary for preschool children to be familiar with the test and it is not justified to use testing and assessment protocols and standards for adults. Physical educators and coaches, when testing preschool children, should introduce children to tests to obtain the best result.     

Mastalgia: psychoneurosis or organic disease?

To test the traditional surgical view that pain in the breast is largely an expression of psychoneurosis, the Middelesex Hospital Questionnaire was given to 317 women with mastalgia and 170 controls with varicose veins. Their scores were compared with those of 173 women psychiatric outpatients tested by the designers of the questionnaire. The results were broadly similar in the mastalgia and varicose veins groups, and where there were significant differences women with varicose veins had a higher psychoneurotic score in each case. Within the mastalgia group no difference in scores was observed between patients with cyclical mastalgia and those with mastalgia due to periductal mastitis. Both groups of surgical outpatients had significantly lower scores in major traits than the psychiatric group, except for a small group of patients with breast pain who persistently failed to respond to treatment. Patients with mastalgia are therefore no more "neurotic" than those with varicose veins, and differ greatly from patients with recognized psychoneurosis. Most patients have a physiological or pathological basis for their breast pain, and they deserve an appropriate diagnostic and therapeutic approach.     

Spectral-spatial characteristics of theta range in the EEG of students with various productivity of performance for visual spatial tasks

Examinees, which consisted of 46 young males, were offered to memorize and recreate a sequence of signals on a computer monitor. These signals were to be recreated in regard to the original sequence and location. Examinees were divided into two groups depending on their degree of approximation of the correct location of the signal sequence. The first group, unlike the second (in contrast to the second one), had a very high rate of accuracy with the least number of mistakes. EEG reading was taken on the examinees prior to completing the test, during the memorization stage and during the completion of task. The EEG reading taken prior to the test and those of the completion of task showed no difference in the range ofteta rhythm for both groups of examinees. However, during the memorization stage, the examinees of the first group, unlike that of the second, showed an increase in the coefficient of proximity in the line of teta rhythm EEG of the right hemisphere of the brain. Three systems of connection with the focuses of activity in the right rear, right center and right front areas of the brain, in which the proximity of teta range of EEG during the memorization stage, were noticeably higher in the group of examines that showed high accuracy during the primary attempts of recreation of the sequence. Since the right hemisphere deals mainly with spatial perception of the information and is more active at processing of nonverbal and stereotyped signals, we suggest that students belonging to different groups employed different strategies of processing of the task during remembering.     

Comparative study on gene tags of the neurotransmission system in schizophrenic and suicidal subjects

Schizophrenia and suicidal behaviour are sever and complex mental disorders, largely determined by factors of inheritance. Both disorders present pathological changes in the catecholamine neurotransmitter system. The study was conducted on three groups; a group of subjects suffering from schizophrenia, a second compounded by individuals who attempted suicide and a third group of phenotypically healthy examinees. The blood samples of schizophrenic patients as of those who attempted suicide were obtained at the Psychiatric Hospital "Sveti Ivan" in Zagreb in the year 2004. Tests were conducted on the statistic relation between a total of 18 SNPs within three candidate-genes of the dopamine and adrenergic system (DRD4, SLC6A3 and ADRA2B) and the manifestation of schzophrenia and suicidal behaviour. Cases were genotyped by use of SNPlex system. Statistically significant differences were determined in the allelic frequency between the mentioned groups. Findings show a significant connection between 4 SNPs (ADRA2B rs749457, SLC6A3 rs464094, DRD4 rs11246226 and rs4331145) and schizophrenia, and 2 SNPs with suicidal attempt (ADRA2B rs1018351 i SLC6A3 rs403636). In addition, this is the first study that highlights the potential role/effect of polymorphisms in ADRA2B on the manifestation of schizophrenia, as on suicidal behaviour.     

Attitudes and sterotypes of supporting fields towards the persons with disabilities

The aim of this research was to establish the attitudes, the views and reactions of the helping fields (which include social workers and medical nurses) and those who aren't the part of that cathegory, towards the mentally ill people. One hundred and twenty persons questioned have taken part in this research where in the group of supporting fields consisted of social workers and medical nurses (N = 40). The questionnaire was used in examining the attitudes of those questioned persons, the questionnaire that was used in Joki?-Begi?'s research (2005) and it turned out to be a really good one in defining the attitudes and stereotypes towards the mentally ill persons. The questionnaire consisted of several parts in which different things have been examined such as stereotypes, knowledge, attitudes, level of acceptance and social- demographic information. The research has shown the differences among the attitudes and the level of acceptance of the mentally ill as well as the level of knowledge which the examinees had. All the examinees that have been the part of this research mentioned "ill" as a dominant trait of the mentally disturbed person. Furthermore, the characteristics such as instability, insecurity, nervousness and inclination to suicide, indicate that all of these three groups of examinees have sterotypes about unstable emotional condition and state of mind of the sick. The examinees that don't belong to this group of supporting fields have enough knowledge neither about the emergence of the disease nor about its development and preventive measures. However, the social workers have a bit more negative attitude towards the mentally ill if compared to medical nurses which could be explained by insufficient working experience with the mentioned group of patients. It's important to say that all of the three groups of examinees don't have extremely negative attitudes towards the people with mental disorder. We shouldn't ignore the fact that these three groups have noticable social restraint towards the mentally ill and they cannot easily accept them in their own environment. Considering the fact there is a low number of researches that deal with this problem of labelling or in other words- stigmatization of the mentally ill, this research gives a great stimulus for writeup this very important problem area, especially if we take into consideration that the attitude of the community may help to bring about the feeling of marginalization and unacceptability with the mentally ill.     

Incorporating DNA Sequencing into Current Prenatal Screening Practice for Down's Syndrome

Background

Prenatal screening for Down''s syndrome is performed using biochemical and ultrasound markers measured in early pregnancy such as the Integrated test using first and second trimester markers. Recently, DNA sequencing methods have been introduced on free DNA in maternal plasma, yielding a high screening performance. These methods are expensive and there is a test failure rate. We determined the screening performance of merging the Integrated test with the newer DNA techniques in a protocol that substantially reduces the cost compared with universal DNA testing and still achieves high screening performance with no test failures.

Methods

Published data were used to model screening performance of a protocol in which all women receive the first stage of the Integrated test at about 11 weeks of pregnancy. On the basis of this higher risk women have reflex DNA testing and lower risk women as well as those with a failed DNA test complete the Integrated test at about 15 weeks.

Results

The overall detection rate was 95% with a 0.1% false-positive rate if 20% of women were selected to receive DNA testing. If all women had DNA testing the detection rate would be 3 to 4 percentage points higher with a false-positive rate 30 times greater if women with failed tests were treated as positive and offered a diagnostic amniocentesis, or 3 times greater if they had a second trimester screening test (Quadruple test) and treated as positive only if this were positive. The cost per women screened would be about one-fifth, compared with universal DNA testing, if the DNA test were 20 times the cost of the Integrated test.

Conclusion

The proposed screening protocol achieves a high screening performance without programme test failures and at a substantially lower cost than offering all women DNA testing.     

Efficacy of empirical cardiac pacing in syncope of unknown cause.

Cardiac pacing is often considered in patients with recurrent syncope after repeated attempts to document the cause have failed. To assess the results of this tactic we reviewed the records of 104 patients who had received pacemakers for known or suspected bradycardia between September 1973 and March 1985. The patients were classified retrospectively into three groups: group 1 (31 patients with a mean age of 73 years) had unequivocal documentation of bradycardia during syncope, group 2 (42 patients with a mean age of 71 years) had electrocardiographic or electrophysiologic evidence of potential bradycardia but no documentation during spontaneous syncope, and group 3 (31 patients with a mean age of 69 years) had a history "suggestive of" bradycardia-related syncope but no other evidence to support the diagnosis. The rates of recurrence of syncope during follow-up were 6.3%, 7.3% and 32.2% in groups 1, 2 and 3 respectively (p less than 0.01). In group 3 recurrence was more probable in patients with loss of consciousness for more than 2 minutes than in those who were unconscious for 2 minutes or less (p less than 0.05). The results suggest that pacemaker implantation is justified for recurrent syncope after extensive attempts to document a spell have failed if abnormal diagnostic test results suggest bradycardia as a possible cause. Empirical pacing is less satisfactory in patients with normal results of evaluation but may arguably be justified when patients have recurrent syncope with injury.     

The mental health of children upon their return home after a long displacement period

The aim of this study was to determine the different levels of depression, hopelessness and post-traumatic stress disorder between two groups of adolescents, those who returned to Baranja and those from Osijek. The first group consisted of 57 adolescents (32 female and 25 male) with the mean age of 17.36, who were grammar school students in Beli Manastir (Gimnazija, Beli Manastir). The mean duration of displacement period was 7 years. The second group consisted of 58 adolescents of grammar school students in Osijek (III. gimnazija, Osijek) (32 female and 26 male) with the mean age of 17.28. All examinees filled in the Croatian version of the Children's Depression Inventory (CDI), the Hopelessness Scale for Children (HSC) and Children's Post-Traumatic Stress Disorder (PTSD) Inventory. The analysis of the results did not show any statistically significant difference between these two groups regarding levels of depression, hopelessness and post-traumatic stress disorder. The results point out rather good psychosocial adjustment of adolescents upon their return home after 4 years.     

Angiotensin II receptor antagonist treatment during pregnancy

Angiotensin II (A-II) is the main effector of the renin-angiotensin system. A-II functions by binding its type 1 (AT1) receptors to cause vasoconstriction and retention of sodium and fluid. Several AT1 receptor antagonists-a group of drugs collectively called "sartans"-have been marketed during the past few years for treatment of hypertension and heart failure. At least 15 case reports describe oligohydramnios, fetal growth retardation, pulmonary hypoplasia, limb contractures, and calvarial hypoplasia in various combinations in association with maternal losartan, candesartan, valsartan, or telmisartan treatment during the second or third trimester of pregnancy. Stillbirth or neonatal death is frequent in these reports, and surviving infants may exhibit renal damage. The fetal abnormalities, which are strikingly similar to those produced by maternal treatment with angiotensin-converting enzyme (ACE) inhibitors during the second and third trimesters of pregnancy, are probably related to extreme sensitivity of the fetus to the hypotensive action of these drugs. Very little information is available regarding the outcome of human pregnancies in which the mother was treated with an AT1 receptor antagonist during the first trimester, but animal studies have not demonstrated teratogenic effects after maternal treatment with large doses of AT1 receptor antagonists during organogenesis. We conclude that pharmacological suppression of the fetal renin-angiotensin system through ACE inhibition or AT1 receptor blockade seems to disrupt fetal vascular perfusion and renal function. We recommend that maternal treatment with AT1 receptor antagonists be avoided during the second and third trimesters of pregnancy and that women who become pregnant while taking one of these medications be changed to an antihypertensive drug of a different class as soon as the pregnancy is recognized.     

Evaluation of factors associated with the anxiety and depression of female infertility patients

Background

Because the primary aim of infertility treatment is to achieve pregnancy, mental health care during this treatment is often neglected. However, the inability to conceive children is stressful for couples throughout the world. Thus, the purpose of this study was to investigate factors related to the anxiety and depression of female infertility patients.

Methods

Participants included 83 Japanese women who initially visited the Reproduction Center of the Tokyo Dental College Ichikawa General Hospital to undergo testing and receive infertility treatment between February and April 2008. We administered two psychological tests, the Self-rating Depression Scale (SDS) test and the Hospital Anxiety and Depression Scale (HADS) test. We then examined the association of the test results with age, pregnancy and delivery history, employment status, duration of infertility, infertility treatment history, and male infertility.

Results

As patient age increased, total HADS and depression scores also increased. No correlation was observed between duration of infertility and SDS or HADS scores. Results were similar when the presence and absence of delivery history was compared. Patients who underwent infertility treatment were more likely to have high HADS depression scores compared to patients who had not undergone treatment. Additionally, patients whose husbands were infertile had significantly lower total HADS and anxiety scores than those whose husbands were not infertile.

Conclusions

Age and male infertility are factors that influence the presence of anxiety and depression in female infertility patients.     

Experience of time with mental disorder

The aim of research was to examine subjective experience of time with examinees with diagnosed schizophrenia and examinees with diagnosed neurotic disorder. Differences inside those two diagnostic categories of mental disorders, and differences u compare to examinees without diagnosed mental disorder were explored. For needs of research questionnaire was constructed accordingly to available data from literature. In research participated examinees from 30-50 of age, which were equaled by age and gender. Research was performed on three groups, first group was made of examinees with diagnosed schizophrenic disorder (n=43), second group was made of examinees with diagnosed neurotic disorder (n=40), and third group consisted of examines without mental disorder (n=39). Results of examination have showed significant statistical differences between certain groups considering particles of poll requester. Differences in subjective experience of time were presented according to items from questionnaire. Mutual for both groups of examinees with mental disorder is existence of pathological deviation in anticipating future. This was manifested in different ways and levels, depending of mental disorder. Given results confirm assumption that capability of anticipating future is important fact of mature and healthy individual.     

Factors associated with the intellectual ability of children born to women with high risk pregnancies.

The intellectual abilities of 242 children born to women who had been hypertensive during pregnancy were assessed at the age of 7 1/2 years. Associations between 15 maternal, fetal, perinatal, postnatal and environmental factors, and test scores were investigated. After adjustment for confounding variables children in the upper social classes, born to non-smokers, who were first born, breast fed, and with birth weights above the 10th centile had significantly higher scores in some aspects of ability than the rest. Children whose mothers had developed superimposed pre-eclampsia had higher scores than those whose mothers had not suffered preeclampsia; and children delivered by elective caesarean section had lower scores than those delivered spontaneously. In a small subgroup of women with particularly high risk pregnancies perinatal mortality had been 10 times greater than in the rest of the sample. At 7 1/2 years the intellectual ability of the survivors in this subgroup did not differ from that of the rest. These findings do not support the notion that there is a quantitative continuum of "reproductive casualty" from mortality to morbidity.     

Getting better all the time: improving preference scores reflect increases in the strength of filial imprinting

In the investigation of the neural mechanisms of filial imprinting, neurochemical measures are often correlated with preference score (PS): approach activity to the training stimulus/total approach in a test. In a previous study, domestic chicks, Gallus gallus domesticus, that had a PS under 65% were classed as 'poor learners' and those with a PS greater than 65% were called 'good learners'. We tested the effects of continued imprinting training in chicks from these two categories. After exposure to an imprinting stimulus for 30 min on day 1 after hatching, preferences were tested and then the chicks were exposed to the same stimulus for either 90 min, 3 h or 4 h on the next day, followed by a second preference test. In all these experiments there was a significant improvement in mean PS in the 'poor learners' between the first and second test, such that these chicks acquired a significant mean preference for the training stimulus. There was no such improvement in chicks that did not receive further training on day 2. When absolute approach was analysed, there was no significant difference between 'poor learners' and 'good learners' at the second test, after 4 h of retraining. Overall, mean preference scores increased with length of training. These results suggest that 'poor learners' are better characterized as 'slow learners', and that their initially low PS is not caused by, for example, a lack of motivation to express a preference. Preference scores reflect the strength of learning during imprinting. Copyright 2000 The Association for the Study of Animal Behaviour.     

Recanalization of chronic total coronary occlusions: the impact of a new specific guidewire on primary success rate

BACKGROUND: Although chronic total occlusions are encountered frequently in patients with coronary artery disease, an effective strategy to deal with them has yet to be devised. Various new guidewires have been designed in an attempt to negotiate chronic occlusions successfully. The authors have analysed the impact of the Athlete guidewire on procedural success in this lesion subset. METHODS: Sixty-two consecutive patients undergoing percutaneous intervention for chronic total occlusions over a two-year period were retrospectively studied. For the initial attempt, conventional guidewires were used. In case of failure, further attempts were made using the Athlete guidewire. Procedural success rates with the use of conventional and Athlete guidewires were assessed. RESULTS: Failure of the first attempt with the conventional guidewire occurred in 32 (51.6%) patients and success was achieved in 30 (48.4%) patients. In the former patients, a second attempt was made using the Athlete guidewire to cross the occlusion. The second attempt was successful in 20 patients (60%) in whom the first attempt was unsuccessful, while in the remaining 12 (40%) patients the occlusion could not be crossed even during the second attempt and the procedure was then terminated. Following the use of the Athlete guidewire, the success rate increased to 62% (p < 0.001). No complication occurred during the first attempt, while one patient had a coronary perforation using the Athlete guidewire, which was managed successfully without the need for bypass surgery. CONCLUSION: The use of the Athlete guidewire is feasible and safe, and enhances the chances of successfully treating chronic total occlusions during percutaneous coronary revascularization procedures.     

Repeated assessments of informed consent comprehension among HIV-infected participants of a three-year clinical trial in Botswana

Background

Informed consent (IC) has been an international standard for decades for the ethical conduct of clinical trials. Yet frequently study participants have incomplete understanding of key issues, a problem exacerbated by language barriers or lack of familiarity with research concepts. Few investigators measure participant comprehension of IC, while even fewer conduct interim assessments once a trial is underway.

Methods and Findings

We assessed comprehension of IC using a 20-question true/false quiz administered in 6-month intervals in the context of a placebo-controlled, randomized trial for the prevention of tuberculosis among HIV-infected adults in Botswana (2004–2009). Quizzes were offered in both Setswana and English. To enroll in the TB trial, participants were required to have ≥16/20 correct responses. We examined concepts understood and the degree to which understanding changed over three-years. We analyzed 5,555 quizzes from 1,835 participants. The participants'' highest education levels were: 28% primary, 59% secondary, 9% tertiary and 7% no formal education. Eighty percent of participants passed the enrollment quiz (Quiz1) on their first attempt and the remainder passed on their second attempt. Those having higher than primary education and those who took the quiz in English were more likely to receive a passing score on their first attempt (adjusted odds ratios and 95% confidence intervals, 3.1 (2.4–4.0) and 1.5 (1.2, 1.9), respectively). The trial''s purpose or procedures were understood by 90–100% of participants, while 44–77% understood randomization, placebos, or risks. Participants who failed Quiz1 on their initial attempt were more likely to fail quizzes later in the trial. Pass rates improved with quiz re-administration in subsequent years.

Conclusions

Administration of a comprehension quiz at enrollment and during follow-up was feasible in a large, international collaboration and efficiently determined IC comprehension by trial participants. Strategies to improve understanding of concepts like placebos and randomization are needed. Comprehension assessments throughout a study may reinforce key concepts.     

Role of Rilpivirine and Etravirine in Efavirenz and Nevirapine-Based Regimens Failure in a Resource-Limited Country: A Cross- Sectional Study

IntroductionEtravirine(ETR) can be used for patients who have failed NNRTI-based regimen. In Thailand, ETR is approximately 45 times more expensive than rilpivirine(RPV). However, there are no data of RPV use in NNRTI failure. Therefore, we assessed the susceptibility and mutation patterns of first line NNRTI failure and the possibility of using RPV compared to ETV in patients who have failed efavirenz(EFV)- and nevirapine(NVP)-based regimens.MethodsClinical samples with confirmed virological failure from EFV- or NVP-based regimens were retrospectively analyzed. Resistance-associated mutations (RAMs) were interpreted by IAS-USA Drug Resistance Mutations. Susceptibility of ETR and RPV were interpreted by DUET, Monogram scoring system, and Stanford University HIV Drug Resistance Database.Results1,279 and 528 patients failed EFV- and NVP-based regimens, respectively. Y181C was the most common NVP-associated RAM (54.3% vs. 14.7%, p<0.01). K103N was the most common EFV-associated RAM (56.5% vs. 19.1%, P<0.01). The results from all three scoring systems were concordant. 165(11.1%) and 161(10.9%) patients who failed NVP-based regimen were susceptible to ETR and RPV, respectively (p = 0.85). 195 (32.2%) and 191 (31.6%) patients who failed EFV-based regimen, were susceptible to ETR and RPV, respectively (p = 0.79). The susceptibility of ETV and RPV in EFV failure was significantly higher than NVP failure (p<0.01).ConclusionThe mutation patterns for ETR and RPV were similar but 32% and 11% of patients who failed EFV and NVP -based regimen, respectivly were susceptible to RPV. This finding suggests that RPV can be used as the alternative antiretroviral agent in patients who have failed EFV-based regimen.     

Patterns of Weight Change Associated With Long-Term Weight Change and Cardiovascular Disease Risk Factors in the Look AHEAD Study

This article provides an assessment of the associations that weight-loss patterns during the first year of an intensive lifestyle intervention have with 4-year maintenance and health outcomes. Two components described patterns of weight change during the first year of intervention: one reflected the typical pattern of weight loss over the 12 months, but distinguished those who lost larger amounts across the monthly intervals from those who lost less. The second component reflected the weight change trajectory, and distinguished a pattern of initial weight loss followed by regain vs. a more sustained pattern of weight loss. Two thousand four hundred and thirty eight individuals aged 45-76 years with type 2 diabetes mellitus, who enrolled in the weight-loss intervention of a randomized clinical trial, were assigned scores according to how their weight losses reflected these patterns. Relationships these scores had with weight losses and health outcomes (glycosolated hemoglobin-hemoglobin A1c (HbA1c); systolic blood pressure, high-density lipoprotein (HDL)-cholesterol, and triglycerides) over 4 years were described. When compared to those with lower scores on the two components, both individuals who had larger month-to-month weight losses in year 1 and whose weight loss was more sustained during the first year had better maintenance of weight loss over 4 years, independent of characteristics traditionally linked to weight loss success (P < 0.001). While relationships with year 4 weight loss were stronger, the pattern of larger monthly weight loss during year 1 was also independently predictive of year 4 levels of HbA1c, HDL-cholesterol, and systolic blood pressure.     

LIKING FOR ICE CREAM MEASURED WITH THREE PROCEDURES: SIDE-BY-SIDE, AFTER CONSUMPTION AND SINGLE SAMPLES

The purpose of this study was to compare how similar results are achieved by three different procedures of measuring liking for ice cream. Subjects (N=56) assessed their liking for three brands of vanilla ice cream on a 9-point scale in seven sessions within three weeks. The examined procedures were (1) tasting and rating all three brands simultaneously side-by-side within the same session, (2) rating each brand in separate sessions after ad libitum consumption and (3) tasting (without consumption) and rating each brand in separate sessions. The liking scores for brands differed significantly but the differences were small because all samples were well-liked. In all procedures, the ratings of liking differed clearly between those who ranked the brand first and those who ranked it second or third, even if there was a considerable number of tied first places. Correlations among the three different measurements of liking were relatively low for all brands of ice cream (r = 0.16 – 0.37). The most preferred brand for most respondents changed from one procedure to another. The perceived characteristics were close to ideal in all brands, and all three procedures gave similar mean results. The distance of mouthfeel, creaminess, sweetness, and vanilla aroma from ideal differed between those who liked the brand best and those who rated it second or third. These differences were larger in side-by-side and after consumption conditions compared to single sample presentation.     

Can Score Databanks Help Teaching?

Background

Basic courses in most medical schools assess students'' performance by conferring scores. The objective of this work is to use a large score databank for the early identification of students with low performance and to identify course trends based on the mean of students'' grades.

Methodology/Principal Findings

We studied scores from 2,398 medical students registered in courses over a period of 10 years. Students in the first semester were grouped into those whose ratings remained in the lower quartile in two or more courses (low-performance) and students who had up to one course in the lower quartile (high-performance). ROC curves were built, aimed at the identification of a cut-off average score in the first semesters that would be able to predict low performances in future semesters. Moreover, to follow the long-term pattern of each course, the mean of all scores conferred in a semester was compared to the overall course mean obtained by averaging 10 years of data. Individuals in the low-performance group had a higher risk of being in the lower quartile of at least one course in the second semester (relative risk 3.907; 95% CI: 3.378–4.519) and in the eighth semester (relative risk 2.873; 95% CI: 2.495–3.308). The prediction analysis revealed that an average score of 7.188 in the first semester could identify students that presented scores below the lower quartiles in both the second and eighth semesters (p<0.0001 for both AUC). When scores conferred by single courses were compared over time, three time-trend patterns emerged: low variation, upward trend and erratic pattern.

Conclusion/Significance

An early identification of students with low performance may be useful in promoting pedagogical strategies for these individuals. Evaluation of the time trend of scores conferred by courses may help departments monitoring changes in personnel and methodology that may affect a student''s performance.