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Selected AbstractsInterpreting course evaluation results: insights from thinkaloud interviews with medical studentsMEDICAL EDUCATION, Issue 10 2004Susan Billings-Gagliardi Purpose, To determine whether some of the fundamental assumptions that frequently underlie interpretation of course evaluation results are justified by investigating what medical students are thinking as they complete a typical basic science course evaluation. Methods, A total of 24 students participated in thinkaloud cognitive interviews, voicing their thoughts while completing a typical evaluation instrument that included items on overall course design, educational materials and methods, and faculty teaching. Students' responses were organised to consider how they interpreted questions, formed judgements and selected response options. Major themes relevant to the meaningful interpretation of course evaluation data were identified. Results, Medical students understood educational terms such as ,independent learning' in different ways from both one another and common usage. When formulating responses, students' judgements were sometimes based on unique or unexpected criteria, and they described editing their judgements by considering factors such as effort or caring on the part of teaching faculty. Students tended to avoid using the lower end of the rating scale, used the highest rating option selectively, but chose the second highest category indiscriminately. Conclusions, These results call into question fundamental assumptions that frequently underlie interpretation of course evaluation results, such as whether students understand the intended meanings of terms used in items; whether faculty members who receive the same rating are perceived similarly; whether ratings actually reflect teaching effectiveness, and whether ,positive' ratings reflect positive opinions. This study also demonstrates how thinkaloud interviews can be used in validity studies, providing information to supplement statistical and psychometric analyses. [source] Factors associated with the temporomandibular disorder, pain dysfunction syndrome (PDS): Manchester case,control studyORAL DISEASES, Issue 6 2001TV Macfarlane OBJECTIVES:,To determine the individual and combined effects of potential risk factors in relation to the temporomandibular disorder, Pain Dysfunction Syndrome (PDS). DESIGN:,Case,control study. MATERIAL AND METHODS:,Cases were new referrals to the temporomandibular disorder clinic of the University Dental Hospital of Manchester, diagnosed with PDS. Controls were randomly selected from 24 dental practices. Using a postal questionnaire information was collected on socio-demographic, local mechanical, psychological factors, co-morbidities and illness behaviour. The adjusted participation rate was similar in cases and controls (64%), and 131 cases and 196 controls finally participated in the study. RESULTS:,Compared with the controls, the cases were more likely to report that their teeth felt as though they did not fit together properly [odds ratio (OR) 8, 95% Confidence Interval (CI) 6,13] and report history of facial trauma (OR 3, 95% CI 2,6). Both diurnal and nocturnal grinding were significantly associated with PDS, and individuals who reported grinding their teeth both during the day and at night had a risk of 6; 95% CI 3,13 for PDS compared with those who did not. A history of orthodontic treatment, having any dentures, having missing teeth, use of chewing gum or biting the fingernails did not show any relationship with PDS. People who took medication for the bowels had a higher risk of PDS (OR 2, 95% CI 1,4). Participants with frequent headaches had a threefold increase in risk of having PDS (OR 3, 95% CI 2,5) while having pain in parts of the body other than the head was associated with an OR of 3 (95% CI 2,5). An increased propensity to have PDS was seen in those individuals with higher levels of psychological distress (OR 3; 95% CI 1,4 in the highest category, test for trend P < 0.001) and sleep disturbance (OR 5; 95% CI 2,94 in the highest category, test for trend P < 0.001). Aspects of illness behaviour, such as disease conviction (OR 4; 95% CI 2,9 in the highest category) and perception of illness (0.3; 95% CI 0.2,0.5) were associated with PDS. The result for the denial scale became statistically significant after adjustment for age and gender (2; 95% CI 1,3). CONCLUSIONS:,The current case,control study provides complementary epidemiological information on oro-facial pain (OFP) and supports a multifactorial aetiology of PDS, with factors from many domains, including local mechanical factors, psychological and co-morbidities. People with PDS were characterized by frequent headaches, history of facial trauma, teeth grinding, sleep problems, pain elsewhere in the body and high levels of psychological distress. From the results of current study and available evidence it seems inappropriate to consider PDS in isolation and future research should adopt a multidisciplinary approach to OFP. [source] The use of folic acid antagonists and the risk of colorectal cancer,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 10 2007Patricia F. Coogan Abstract Purpose Since folate is associated with a reduced risk of colorectal cancer, we hypothesized that folic acid antagonists might increase the risk. We used data from a population-based case control study of medication use and colorectal cancer to evaluate the hypothesis. Methods Case patients with adenocarcinoma of the colon or rectum were ascertained from participating hospitals in Massachusetts and the Massachusetts cancer registry (MCR) from January 1, 2001, through November 30, 2004. Age-, sex-, and precinct-matched control subjects were chosen from Massachusetts town lists. Information on folic acid antagonist use and other relevant data were obtained from 1809 cases and 1809 matched controls by telephone interview and by a self-administered dietary questionnaire. We used logistic regression models to estimate odds ratios among 1229 case patients and 1165 control subjects who provided satisfactory dietary information and did not have Crohn's disease or ulcerative colitis. Results The odds ratio for colorectal cancer among regular users of folate-containing supplements was 0.7 (95%CI 0.6,0.9). The odds ratio for regular use of folic acid antagonists was 1.3 (95%CI 0.9,1.9). Contrary to expectation, the odds ratio was reduced in the highest category of alcohol consumption (OR,=,0.5, 95%CI 0.2,1.2). The odds ratio was higher among users of drugs that inhibit dihydrofolate reductase (OR,=,1.6, 95%CI 0.9,2.8) than drugs that work through other mechanisms (OR,=,1.2, 95%CI 0.7,1.9). Conclusions Our data provide little support for the hypothesis that regular folic acid antagonist use increases the risk of colorectal cancer. However, there is a suggestion that dihydrofolate reductase inhibitors specifically may increase the risk. Copyright © 2007 John Wiley & Sons, Ltd. [source] Varus foot alignment and hip conditions in older adultsARTHRITIS & RHEUMATISM, Issue 9 2007K. Douglas Gross Objective Mechanical strain on the hip can result from varus malalignment of the foot. This study was undertaken to explore the cross-sectional relationship between varus foot alignment and hip conditions in a population of older adults. Methods The Framingham Osteoarthritis Study cohort consists of a population-based sample of older adults. Within this sample, we measured forefoot and rearfoot frontal plane alignment using photographs of a non,weight-bearing view of both feet of 385 men and women (mean age 63.1 years). Each foot segment was categorized according to the distribution of forefoot and rearfoot alignment among cases of ipsilateral hip pain, trochanter tenderness, hip pain or tenderness, and total hip replacement (THR). The relationship of foot alignment to these conditions was examined using logistic regression and generalized estimating equations, adjusting for age, body mass index, sex, and physical activity. Results The mean ± SD rearfoot varus alignment was 0.7 ± 5.5 degrees, and the mean ± SD forefoot varus alignment was 9.9 ± 9.9 degrees. Subjects in the highest category of forefoot varus alignment had 1.8 times the odds of having ipsilateral hip pain (P for trend = 0.06), 1.9 times the odds of having hip pain or tenderness (P for trend < 0.01), and 5.1 times the odds of having undergone THR (P for trend = 0.04) compared with those in the lowest category. No significant associations were found between rearfoot varus alignment and any hip conditions. Conclusion Forefoot varus malalignment may be associated with ipsilateral hip pain or tenderness and THR in older adults. These findings have implications for treatment, since this risk factor is potentially modifiable with foot orthoses. [source] | ||||||||||