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Short Tests (short + test)

Distribution by Scientific Domains
Medical Sciences60%

Selected Abstracts

Health Literacy and Cognitive Performance in Older Adults

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2009
Alex D. Federman MD
OBJECTIVES: To study the relationship between health literacy and memory and verbal fluency in older adults. DESIGN: Cross-sectional cohort. SETTING: Twenty senior centers and apartment buildings in New York, New York. PARTICIPANTS: Independently living, English- and Spanish-speaking adults aged 60 and older (N=414). MEASUREMENTS: Health literacy was measured using the Short Test of Functional Health Literacy in Adults (S-TOFHLA). The associations between S-TOFHLA scores and immediate and delayed recall (Wechsler Memory Scale II), verbal fluency (Animal Naming), and global cognitive function (Mini-Mental State Examination, MMSE) were modeled using multivariable logistic and linear regression. RESULTS: Health literacy was inadequate in 24.3% of participants. Impairment of immediate recall occurred in 20.4%; delayed recall, 15.0%; verbal fluency, 9.9%; and MMSE, 17.4%. Abnormal cognitive function was strongly associated with inadequate health literacy: immediate recall (adjusted odds ratio (AOR)=3.44, 95% confidence interval (CI)=1.71,6.94, P<.001), delayed recall (AOR=3.48, 95% CI=1.58,7.67, P=.002), and verbal fluency (AOR=3.47, 95% CI=1.44,8.38, P=.006). These associations persisted in subgroups that excluded individuals with normal age-adjusted MMSE scores. CONCLUSION: Memory and verbal fluency are strongly associated with health literacy, independently of education and health status, even in those with subtle cognitive dysfunction. Reducing the cognitive burden of health information might mitigate the detrimental effects of limited health literacy in older adults. Research that examines the effect of materials modified to older adults' cognitive limitations on health literacy and health outcomes is needed. [source]

The effect of therapeutic glucocorticoids on the adrenal response in a randomized controlled trial in patients with rheumatoid arthritis,

ARTHRITIS & RHEUMATISM, Issue 5 2006
John R. Kirwan
Objective To measure the effect of low-dose systemic glucocorticoid treatment on the adrenal response to adrenocorticotropic hormone (ACTH) in patients with rheumatoid arthritis (RA). Methods Patients with RA who took part in a randomized double-blind placebo-controlled trial of budesonide (3 mg/day and 9 mg/day) and prednisolone (7.5 mg/day) underwent a short (60-minute) test with injection of ACTH (tetracosactide hexaacetate) at baseline and the day after completing the 3-month treatment program. Plasma cortisol measurements at baseline and 3 months were compared within and between the treatment groups. Individual patients were classified as normal responders to ACTH or as abnormal responders if changes were >2 SD below the pretreatment value in the entire group of study patients. Results Short tests with ACTH injection were performed on 139 patients before beginning the study medication and on 134 patients after cessation of the medication. There were no changes in the placebo group. Mean plasma cortisol levels following treatment were reduced in all active treatment groups. In addition, mean values were significantly reduced for the 30-minute and 60-minute responses to ACTH. The maximum reduction (35%) occurred in the prednisolone group at 60 minutes. Following treatment, 34% of patients taking budesonide 9 mg and 46% of those taking prednisolone 7.5 mg failed to reach the normal maximum cortisol response to ACTH. Four patients failed to achieve the normal percentage increase in cortisol levels, but only 1 patient failed to meet both criteria. Conclusion Low doses of a glucocorticoid resulted in depression of baseline and ACTH-stimulated cortisol levels after 12 weeks of therapy. Although the responsiveness of the hypothalamic,pituitary,adrenal axis in individual patients generally remained within the normal range, these changes should be investigated further. [source]

Frontotemporal dementia: patient characteristics, cognition, and behaviour

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 10 2002
J. Diehl
Abstract Objectives To describe sociodemographic data of patients with frontotemporal dementia (FTD), to compare the cognitive profile of patients with FTD with that of severity-matched patients with Alzheimer's disease using the CERAD neuropsychological battery (CERAD-NP), to investigate the frequency of behavioural disturbances, and to examine the relation between FTD-specific non-cognitive behavioural symptoms of patients with FTD with age and sex. Methods Fifty outpatients were diagnosed with FTD according to the Lund-Manchester consensus criteria. Cognitive impairment was assessed in 30 patients using the CERAD-NP. Severity of dementia was rated on the Clinical Dementia Rating (CDR). Eleven non-cognitive symptoms were rated by severity. To compare CERAD-NP results between patients with FTD and AD, 30 patients with AD were matched for age, sex, and global severity of cognitive performance. Results The average age at onset of first symptoms was 57.8 years. Eighteen patients (36%) had a positive family history of dementia. On the CERAD-NP patients with FTD performed significantly better than patients with AD on word list learning, delayed verbal recall and visuoconstruction (p<0.05). There were no significant differences between FTD and AD on naming and verbal fluency tasks. The most frequent non-cognitive behavioural symptoms in FTD were loss of insight, speech abnormality, and apathy. Non-cognitive behavioural symptoms were more frequent in younger and in male than in older patients and in female patients. Conclusions The CERAD-NP is a valuable clinical instrument for the cognitive evaluation of patients with suspected FTD. Complementary short tests of attention and executive function may be recommended. To enhance diagnostic sensitivity informant interviews should focus on non-cognitive behavioural changes, taking advantage of standardised questionnaires. Copyright © 2002 John Wiley & Sons, Ltd. [source]

A Comparison of Item Fit Statistics for Mixed IRT Models

JOURNAL OF EDUCATIONAL MEASUREMENT, Issue 3 2010
Kyong Hee Chon
In this study we examined procedures for assessing model-data fit of item response theory (IRT) models for mixed format data. The model fit indices used in this study include PARSCALE's,G2,,Orlando and Thissen's,S,,,X2,and,S,,,G2,,and Stone's,,2*,and,G2*. To investigate the relative performance of the fit statistics at the item level, we conducted two simulation studies: Type I error and power studies. We evaluated the performance of the item fit indices for various conditions of test length, sample size, and IRT models. Among the competing measures, the summed score-based indices,S,,,X2,and,S,,,G2,were found to be the sensible and efficient choice for assessing model fit for mixed format data. These indices performed well, particularly with short tests. The pseudo-observed score indices, ,2*,and,G2*,,showed inflated Type I error rates in some simulation conditions. Consistent with the findings of current literature, the PARSCALE's,G2,index was rarely useful, although it provided reasonable results for long tests. [source]

Damage Phenomena Observed on PVD Coatings Submitted to Repeated Impact Tests

PLASMA PROCESSES AND POLYMERS, Issue S1 2007
Florent Ledrappier
Abstract Thin hard coatings obtained by PVD process are widely used to improve the mechanical and friction behaviour of industrial parts. Depending on the friction conditions, the failure mechanisms and resulting selection criteria may be very different. This study aims to investigate the endurance life of some PVD coatings under repeated impact conditions. Impact tests at controlled impact energy have been performed using a hemispherical tip. Long-term tests have been done to determine the coating endurance life while short tests enable us to identify the damage phenomena. Depending on the nature of the PVD coating, cracks, blisters or spalling may be observed under impact. These phenomena may worsen until the complete film rupture occurs. [source]