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PubMed2004

The electronic visual acuity tester: testability in preschool children.

PURPOSE: To evaluate the ability of preschool children to have their threshold visual acuity assessed using a standardized, computer-based letter test. METHODS: Participants were 1195 3.5- to 5-year-old children enrolled in the Vision in Preschoolers Study. Monocular visual acuity was assessed by licensed eye care professionals (optometrists and pediatric ophthalmologists experimented in the examination of children), using the Electronic Visual Acuity tester, which uses the letters H, O, T, and V with a crowded surround. RESULTS: Overall, 99.1% of children passed the training that consisted of identifying the letters H, O, T, and V by naming or matching the letters at 60 cm. Among those who passed the training, 99.6% completed the binocular pretest at 3 m, and 97.6% of those passing the training and the pretest completed monocular threshold visual acuity testing of each eye with the Electronic Visual Acuity tester. Testability increased with age for training (p = 0.03), pretesting (p = 0.04), and acuity testing (p = 0.07). Overall, 93.3% of 3.5-year-olds, 96.7% of 4-year-olds, and 98.8% of 5-year-olds completed training, pretesting, and monocular threshold acuity testing of each eye using standard letter optotypes. CONCLUSION: Using the computer-based Electronic Visual Acuity system, nearly all 3.5- to 5-year-old children can complete monocular acuity testing of each eye.

Child, Preschool↗
PubMedDate not supplied

Noninvasive diagnostic testing of coronary artery disease in women.

Noninvasive diagnostic testing of coronary artery disease (CAD) is widely recognized as an area that is less studied and less accurate with regard to women than to men. Accurate and safe diagnostic testing constitutes the crucial link between early detection and optimal management of CAD. Many noninvasive diagnostic modalities are available to the clinician, including traditional electrocardiography, the relatively novel imaging of echocardiography, the emerging nuclear perfusion technology of electron beam computed tomography, exercise testing, and pharmacologic testing. The most accurate and cost-effective diagnostic method for patients depends on the patients' pretest likelihood of the disease as determined by factors such as sex, age, and cardiovascular risk factors. Noninvasive tests are most useful in the diagnosis of CAD in patients with intermediate pretest likelihood of CAD. Patients with low pretest likelihood of CAD with normal electrocardiograms may benefit from noninvasive tests or a watchful waiting strategy. Patients with a high pretest likelihood of CAD may benefit greatly from direct referral to coronary angiography. Among the noninvasive diagnostic methods, exercise electrocardiography is the most studied and least accurate with regard to women patients. Electrocardiography improves in accuracy when combined with imaging techniques such as echocardiography or nuclear single photon emission computed tomography. Combining data from all studies has shown that exercise echocardiography yields the highest diagnostic accuracy in women among all of the exercise stress tests. Patients who are unable to achieve maximal exercise capacity may undergo pharmacologic testing using dipyridamole or adenosine radionuclide perfusion or dobutamine echocardiography. Recent development of electron beam computed tomography accurately detects coronary artery calcium but has not been validated yet as a standard diagnostic test for CAD.

Coronary Angiography↗
PubMed1991

Changes in nursing students' knowledge about and attitudes toward research following an undergraduate research course.

This study examined changes in baccalaureate nursing students' attitudes toward and knowledge about research, following completion of a research course. The teaching methods used in the course included having students critique research articles, complete objective examinations, and work in small groups to develop research proposals. The sample of 54 students completed a pretest and two post-tests measuring research knowledge, and a pretest and one post-test measuring research attitudes. The pretest was administered at the beginning of the research course, and the first post-test was administered at the end of the course. The second post-test was administered during the students' last semester in the nursing programme. Students reported more positive attitudes toward research at the end of the programme than at the beginning of the course. Knowledge scores were significantly higher at the end of the course than at the beginning of the course or at the end of the programme. There was no differences in knowledge scores on the pretest and on the second post-test. The findings raise questions about the effectiveness of traditional research curricula in preparing baccalaureate nursing students to be competent research consumers.

Attitude of Health Personnel↗
PubMed1994

In vivo properties of SB 200646A, a 5-HT2C/2B receptor antagonist.

1. SB 200646A, N-(1-methyl-5-indolyl)-N'-(3-pyridyl) urea hydrochloride, the first reported selective 5-HT2C/2B over 5-HT2A receptor antagonist, (pK1 rat 5-HT2C receptor 6.9, pA2 rat 5-HT2B receptor 7.5, pK1 rat 5-HT2A receptor 5.2) dose-dependently blocked a putative rat model of 5-HT2C receptor activation; 1-(3-chlorophenyl)piperazine (mCPP, 5 mg kg-1, i.p. 20 min pretest)-induced hypolocomotion (estimated ID50 19.2 mg kg-1, p.o.). 2. SB 200646A also blocked another putative in vivo model of 5-HT2C receptor function; mCPP (5 mg kg-1, i.p. 20 min pretest)-induced hypophagia in 23 h food-deprived rats (estimated ID50 18.3 mg kg-1, p.o.). 3. SB 200646A did not antagonize 1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane (DOI)-induced head shakes in rats at doses up to 200 mg kg-1, p.o., an effect thought to be mediated by 5-HT2A receptors for which SB 200646A has its next highest affinity (50 fold less) after the 5-HT2C and 5-HT2B sites. 4. SB 200646A (20, 40 mg kg-1, p.o., 1 h pretest) also reversed mCPP (0.5 mg kg-1, i.p., 30 min pretest)-induced anxiety in the social interaction test, under low light familiar conditions. 5. When given alone, under high light unfamiliar conditions, SB 200646A (2-40 mg kg-1, p.o.) increased active social interaction without affecting locomotor activity in the rat social interaction test. This is consistent with an anxiolytic action of SB 200646A. 6. These results indicate that SB 200646A has in vivo efficacy and that 5-HT2C or 5-HT2B receptors are indeed likely to mediate mCPP-induced hypolocomotion, hypophagia and anxiogenesis. They also suggest that 5-HT2C,2B receptor blockade induces anxiolysis.

Animals↗
PubMed1996

Effects of the 5-HT2B receptor agonist, BW 723C86, on three rat models of anxiety.

1. BW 723C86 (3 and 10 mg kg-1, s.c. 30 min pretest), a 5-HT2B receptor agonist, increased total interaction, but not locomotion in a rat social interaction test, a profile consistent with anxiolysis. 2. The effect of BW 723C86 in the social interaction test is likely to be 5-HT2B receptor-mediated as it was prevented by pretreatment with the 5-HT2C/2B receptor antagonist, SB 200646A, (1 and 2 mg kg-1, p.o., 1 h pretest) which did not affect basal levels of social interaction at the doses used. 3. An anxiolytic-like action was also observed in the rat Geller-Seifter conflict test, where BW 723C86 (0.5-50 mg kg-1, s.c. 30 min pretest) modestly, but significantly increased punished, but not unpublished responding. 4. In a rat 5 min elevated x-maze test, BW 723C86 (1-10 mg kg-1, s.c.) had no significant effect. 5. The maximal anxiolytic-like effect of BW 723C86 approached that of the benzodiazepine anxiolytic, chloradiazepoxide (5 mg kg-1, s.c. 30 min pretest) in the social interaction test, but was markedly less in the Geller-Siefter test. The effect of BW 723C86 was also clearly less than chlordiazepoxide in the elevated x-maze procedure where it had no significant effect. 6. In conclusion, BW 723C86 exerted an appreciable anxiolytic-like profile in a rat social interaction test, but had a weaker effect in the Geller-Siefter and was ineffective in the elevated x-maze test used. These effects are likely to be 5-HT2B receptor-mediated.

Animals↗
PubMed2006

Educating African pastors on mother-to-child transmission of HIV/AIDS.

PURPOSE: To educate pastors of the Assemblies of God in Burkina Faso concerning HIV/AIDS and mother-to-child transmission (MTCT). DESIGN: A pretest-posttest design was used with a convenience sample of 102 pastors attending the educational program on HIV/AIDS and MTCT in January, February, and March of 2005. The educational program was implemented in local Bible colleges in Ouagadougou, Burkina Faso. METHODS: Participants attended an 18-hour program on HIV/AIDS and MTCT. A picture booklet was designed and used to help explain the prevention of MTCT of HIV The pretest-posttest examination and follow-up evaluation were designed for this project. FINDINGS: Results of the pretest showed minimal knowledge of pastors regarding HIV/AIDS. The median composite scores on the knowledge questions increased from 16% on the pretest to 92% on the posttest. Within the 3-month follow-up period, 34 follow-up evaluations were received. Although all the responding pastors had recommended testing for expectant mothers, only 13 had discussed MTCT in their churches or communities. CONCLUSIONS: The educational program was effective in increasing the pastors' knowledge of HIV/AIDS and MTCT. Further research is needed to identify barriers to full utilization of that knowledge.

Adolescent↗
PubMedDate not supplied

Effectiveness of a genetics self-instructional module for nurses involved in egg donor screening.

OBJECTIVE: To evaluate the effectiveness of a self-instructional module in increasing nurses' knowledge of genetics. DESIGN: Pretest/posttest study design. Participants completed a pretest questionnaire used to measure baseline knowledge of basic human genetic concepts and risk assessment and collect descriptive data. Participants then reviewed a self-instructional module and completed a posttest questionnaire. SETTING: Study materials were mailed to 262 registered nurses involved in screening egg donors at 177 reproductive health centers in the United States from July to September 2000. PARTICIPANTS: Sixty-five registered nurses working at reproductive health centers. One hundred of 262 eligible nurses completed the pretest (38% return rate) and 65 of these 100 nurses also completed the posttest (65% retention rate). INTERVENTION: A 22-page self-instructional booklet on genetic risk assessment. MAIN OUTCOME MEASURES: Pretest and posttest responses. RESULTS: There was a significant increase of 20.8% in participants' mean knowledge score on the posttest (M = 89.0%, SD = 8%, range = 67%-100%) as compared with the pretest (M = 69.0%, SD = 12%, range = 42%-92%), based on paired t-test analysis (t = 11.74, SE = 0.426, p < .0001). CONCLUSION: A genetics self-instructional module for registered nurses was effective in increasing knowledge of basic human genetic concepts and risk assessment. More in-depth independent study programs in genetics for nurses are recommended.

Curriculum↗
PubMed1996

Testing the consistency of measurements of the distance between the cemento-enamel junction and the alveolar bone crest on bitewing radiographs.

UNLABELLED: The purpose of the research described in this paper is to test the consistency of measurements of the distance between the cemento-enamel junction and the alveolar bone crest (CJ-AC) on bitewing radiographs. The present paper shows how the consistency tests were organized and which statistical analyses were used. Since the actual characteristic (CJ-AC) could not alter, the variations of the results had to be due to one more of the 5 m-factors (man, material, machine, method and manipulation). To test the consistency of the measurements of CJ-AC, a pretest and an en route test were performed. Both the bitewing radiographs for the pretest and the en route test were sampled at random from the principal material. The principal material consisted of 856 sets of bitewing radiographs from persons born 1930-1949. The pretest of 40 sets of bitewing radiographs were read twice by 2 independent readers. The en route test consisted of 85 sets of bitewing radiographs which were read twice by 1 reader. Neither the results of the pretest nor the results of the en route test showed statistical or clinical differences of significance. IN CONCLUSION: the consistency of this method of measuring is satisfactory for the 2 readers.

Aged↗
PubMed2005

Likelihood ratios increase diagnostic certainty in pulmonary embolism.

Pulmonary embolism (PE) is a difficult diagnosis to confirm. The choice of tests has led to a myriad of algorithms. Diagnostic uncertainty can be quantified by the application of the tests' likelihood ratios (LR). Positive and negative LR enable the conversion of a pretest to a post-test probability, given a positive and negative test result, respectively. Thus, a pretest probability of <17% and a negative D-dimer with a negative LR of 0.05 (sensitivity 98%, specificity 40%) lead to a post-test probability of PE of <1%. Ventilation perfusion (V/Q) scans with a normal, very low, low, intermediate and high probability result have an LR of 0, 0.125, 0.25, 1 and 17, respectively. Also, patients with a V/Q scan result other than normal or high probability still have a post-test probability of PE from 3 to 65%. Positive and negative computed tomography pulmonary angiograms (CTPA) have an LR of 8.6 and 0.06, respectively (sensitivity 95%, specificity 89%). Patients with a high pretest probability and negative CTPA again still have a post-test probability of more than 10%. However, as the post-test probability after one test becomes the pretest probability for the next, test results used cumulatively progressively narrow the gap to a final diagnosis. The post-test probability after a D-dimer, V/Q scan, CTPA, leg ultrasound or pulmonary angiography, alone or in any combination or in any order, can be calculated using their LR. Use of LR thus assists in the precise interpretation of test results, such as in complex algorithms for PE.

Angiography↗
PubMed1992

Using the PRECEDE model to determine junior high school students' knowledge, attitudes, and beliefs about AIDS.

The effectiveness of a one-period school-based AIDS education program on an adolescent population of seventh and eighth grade students (N = 585) was determined. An instrument based on the PRECEDE model was used to assess program effectiveness. Three-way analysis of variance indicated significant differences (p v .01) between pretest to posttest scores for knowledge, attitude, and beliefs for those who received the program versus those who did not by grade and gender of students. The intervention group scored significantly higher than the comparison group on knowledge gain for both seventh and eighth grade students and for males and females. On attitude items, a significant increase occurred from pretest to posttest for eighth grade students who received the program, but not for seventh grade students. The experimental group of eighth grade students scored higher on the attitudes component than the comparison of eighth grade students on the posttest. When attitudes were examined by gender for females in the educational intervention, an increase occurred in attitude scores from pretest to posttest. While belief scores increased significantly from pretest to posttest for the experimental seventh and eighth grade students, significant increases occurred only for experimental group females. Findings support the contention that a one-class period AIDS education program can affect more than just knowledge since attitudes and beliefs also were partially affected.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Effects of a program to train radiologic technologists to identify abnormalities on mammograms.

PURPOSE: To assess whether radiologic technologists could be successfully trained to identify abnormalities on mammograms. MATERIALS AND METHODS: Eight radiologic technologists from two different institutions took a pretest, underwent an 8-hour training course followed by a period of preceptorship, and then took a posttest. Seven radiologists also took the pretest and posttest, which consisted of evaluating 1,238 two-view screening examinations, including 318 biopsy-proved cancers. RESULTS: Overall, technologists at institution 1 had lower sensitivity (78%) at the pretest, which improved at the posttest (90%). Technologists at institution 2 had lower specificity at the pretest (44%), which improved on the posttest (64%). Hypothetical pairing of radiologists and technologists with use of posttest results revealed an increase in sensitivity (median increase, 12% at institution 1 and 19% at institution 2). CONCLUSION: Formalized training successfully modified the technologists' skills. Radiologic technologists could be used to increase the number of breast cancers detected at screening mammography.

Breast Neoplasms↗
PubMed1990

Clonidine suppresses copulatory behavior and erectile reflexes in male rats: lack of effect of naloxone pretreatment.

Adrenergic transmitters and opioid peptides are implicated in the regulation of male sexual behavior. In the present studies we examine a possible interaction between these two neurochemical systems in the regulation of components of male sexual behavior. In mating tests, clonidine (0.25 mg/kg, 6 min pretest) induced a profound deficit in intromissive and ejaculatory behavior whereas naloxone (5 mg/kg, 20 min pretest) evinced a facilitation of ejaculatory behavior, evidenced by decreases in the ejaculation latency in the initial copulatory series and by decreases in ejaculation latency and intercopulatory interval in the second copulatory series. Importantly, prior treatment with naloxone did not prevent or attenuate the copulatory suppression induced by clonidine. In ex copula penile reflex tests, clonidine (0.25 mg/kg, 6 min pretest) decreased the incidence of seminal emission and the number of penile responses (erections, cups and flips). Naloxone (5 mg/kg, 20 min pretest) was without effect on any of the parameters of penile reflex activity and, further, failed to prevent or attenuate the erectile suppression induced by clonidine. A final study evaluated the dose-response relationship of clonidine-induced erectile dysfunction. A similar degree of erectile dysfunction was observed after 0.005, 0.025 or 0.25 mg/kg clonidine, whereas 0.0005 mg/kg was without effect. Previous studies demonstrated a dose-dependent inhibition of mounting, intromissive and ejaculatory behavior, with 0.25 mg/kg selectively eliminating ejaculatory behavior in mating tests. These data demonstrate a dose-dependent inhibition of penile reflexes, with inhibition occurring at doses lower than those required to induce copulatory dysfunction. Further, we suggest that opioid receptors sensitive to naloxone blockade are not involved in the clonidine-induced suppression of copulatory or erectile function.

Animals↗
PubMed1999

Community education for stroke awareness: An efficacy study.

BACKGROUND AND PURPOSE: This study examined the effectiveness of a slide/audio community education program aimed at increasing knowledge of stroke risk factors, stroke warning signs, and action needed when stroke warning signs occur. The program targets audiences at higher risk for stroke, especially individuals who are black or >50 years of age. METHODS: Subjects were 657 adults living in the community or in senior independent-living settings. The study examined the effectiveness of the program when presented alone and when accompanied by discussion (facilitation) led by a trained individual. Knowledge of stroke risk factors and warning signs was assessed using parallel pretests and posttests developed and validated specifically for the study. RESULTS: ANCOVA indicated that neither pretesting nor facilitation had a significant effect on posttest measures of knowledge. Paired t tests of groups receiving both the pretest and posttest demonstrated significant increase in knowledge (mean increase, 10.87%; P<0.001). ANCOVA indicated that these gains in knowledge were similar across subjects of different sex, race, age, and educational level. No significant differences could be ascribed to facilitation. CONCLUSIONS: The data indicate that the slide/audio program is effective in increasing knowledge of stroke risk factors, warning signs, and necessary action in subjects of varying ages, races, and education. Pretesting and facilitation did not significantly affect the short-term acquisition of information. The slide/audio program appears to offer a short, easily used educational experience for diverse communities, whether as a stand-alone program or with facilitated discussion.

Adult↗
PubMed2006

The effect of soft-tissue ultrasound on the management of cellulitis in the emergency department.

OBJECTIVES: To evaluate the effect of diagnostic soft-tissue ultrasound (US) on management of emergency department (ED) patients with clinical cellulitis. METHODS: This was a prospective observational study in an urban ED of adult patients with clinical soft-tissue infection without obvious abscess. The treating physician's pretest opinions regarding the need for further drainage procedures and the probability of subcutaneous fluid collection were determined. Emergency sonologists then performed US of the infected area, and the effect on management plan was recorded. RESULTS: Ultrasound changed the management of patients with cellulitis in 71/126 (56%) of cases. In the pretest group that was believed not to need further drainage, US changed the management in 39/82 (48%), with 33 receiving drainage and 6 receiving further diagnostics or consultation. In the pretest group in which further drainage was believed to be needed, US changed the management in 32/44 (73%), including 16 in whom drainage was eliminated and 16 who had further diagnostic interventions. US had a management effect in all pretest probabilities for fluid from 10% to 90%. CONCLUSIONS: Soft-tissue US changes physician management in approximately half of patients in the ED with clinical cellulitis. US may guide management of cellulitis by detection of occult abscess, prevention of invasive procedures, and guidance for further imaging or consultation.

Abscess↗
PubMed1998

Genetic counseling and testing for breast-ovarian cancer susceptibility: what do women want?

PURPOSE: To assess preferences for the content and process of genetic counseling and testing for breast-ovarian cancer susceptibility among women at high risk for breast cancer. METHODS: Ninety-eight healthy women who had a family history of breast cancer in at least two first-degree relatives participated in a structured telephone survey that evaluated preferences for type of provider and the content and process of pretest education and posttest genetic counseling. RESULTS: Forty-two percent of women preferred that pretest education be delivered by a genetic counselor, while 22% preferred an oncologist. This preference was positively associated with a desire to discuss psychosocial issues during the session (P = .001). For posttest counseling, 38% of women preferred an oncologist, while 20% preferred a genetic counselor. However, women who desired supportive counseling during this session were significantly more likely to prefer a genetic counselor to an oncologist (P = .02). Fewer women wished to see a primary care physician or gynecologist for pretest education (11%) or posttest counseling (22%). With regard to the counseling process, 82% of women wished to self-refer for genetic counseling, but 63% desired advice and recommendations about whether to be tested. CONCLUSION: When feasible, the optimal approach may be for oncologists to work with genetic counselors to provide pretest education and medical recommendations. Elicitation of patients' preferences may be useful to determine the level of counseling services needed.

Adult↗
PubMed2003

Computed tomographic angiography for detecting cerebral aneurysms: implications of aneurysm size distribution for the sensitivity, specificity, and likelihood ratios.

OBJECTIVE: This study examined the efficacy of computed tomographic angiography (CTA) for detection of ruptured and unruptured aneurysms after adjustment for their size distributions under various conditions of aneurysm prevalence. METHODS: A systematic review was used to estimate 1) the aneurysm size-specific sensitivity and specificity of CTA, and 2) the size distributions of ruptured and unruptured aneurysms. Probabilistic computer simulation was used to estimate the efficacy of CTA in the detection of aneurysms. RESULTS: The sensitivity of CTA ranged from 53% (95% confidence interval [CI], 44-62%) for 2-mm aneurysms to 95% (95% CI, 92-97%) for 7-mm aneurysms. The overall specificity was 98.9% (95% CI, 91.5-99.99%), but there was between-study heterogeneity. The estimated negative likelihood ratios for ruptured, unruptured, and at least 6-mm unruptured aneurysms were 0.081, 0.18, and 0.012, respectively. The positive likelihood ratio for CTA was sensitive to the pretest probability, the size of the positive finding, and the clinical context. With a small pretest probability, the positive likelihood ratio for unruptured aneurysms ranged from 15 for 2-mm aneurysms to 61 for 5-mm aneurysms. The positive likelihood ratio for ruptured aneurysms with an intermediate pretest probability (50%) ranged from 3.9 to 56 for 2- to 5-mm aneurysms. CONCLUSION: Small aneurysms detected on CTA should be investigated further unless there is a high pretest probability of a ruptured aneurysm. During screening for ruptured aneurysms, a negative CTA should be investigated further. During screening for unruptured aneurysms, a negative CTA results in a very low probability of a clinically important aneurysm.

Aneurysm, Ruptured↗
PubMed2005

Kids and communities count: reaching migrant children and families with the North American Guidelines for Children's Agricultural Tasks (NAGCAT).

The Kids and Communities Count Farm Safety Lesson is a follow-up to our Kids Count Lesson that used the North American Guidelines for Children's Agricultural Tasks (NAGCAT) and was previously delivered to nearly 2,000 fifth-grade students in Hillsborough County, Florida. This year, the lesson was administered in two migrant schools and included a parent survey and a presentation of the lesson in a community setting. The lesson covers animal, machinery, water, and general safety topics applicable to farming in Florida. A staggered pretest-posttest study design was followed whereby school 1 (N = 66) received a multiple-choice pretest and posttest and school 2 (N = 91) received the posttest only, for a total sample size of 157 participants. Results of the study showed a significant increase in the mean number of correct answers on the posttest compared to the pretest, such that the mean score improved from 5.0 on the pretest to 6.6 on the posttest (paired t-test, p = 0.000). The results of the parent survey and the administration of the lesson in the community showed that over 50% of the 106 parent participants reported that their children were practicing safe farm behaviors since the lesson; however, there was a particular need to address pesticide safety in the community. This study shows the efficacy of the Kids Count lesson in improving farm safety knowledge among migrant school children, and the applicability and acceptance of the lesson by parents and community members.

Accidents, Occupational↗
PubMed2004

Fostering reading comprehension in fifth grade by explicit instruction in reading strategies and peer tutoring.

BACKGROUND: Research reveals that explicit reading strategies instruction and engaging students in interaction about texts promote students' reading comprehension ability. The present intervention study combines both aspects. AIMS: The study examines the educational benefits of explicit reading strategies instruction, followed by practice in (a) teacher-led whole-class activities (STRAT), (b) reciprocal same-age (STRAT + SA), or (c) cross-age peer tutoring activities (STRAT + CA) on fifth graders' reading comprehension achievement. SAMPLE: Twenty-two fifth-grade teachers and their 454 students from 19 different schools throughout Flanders (Belgium) participated. METHOD: A quasi-experimental pretest post-test retention test design was used with three experimental (STRAT, STRAT + SA, and STRAT + CA) and a matched control group. The experimental interventions were implemented during an entire school year. RESULTS: Multilevel analysis revealed that the STRAT and STRAT + CA condition made a significantly larger pretest to retention test progress than the control group. The significant major progress was especially situated from pretest to post-test, during which the intervention took place. Concerning the STRAT + SA condition no significant differences with regard to the control group were detected. Pairwise comparisons of the experimental conditions indicated that the STRAT + CA condition's progress from pretest to retention test also exceeded the STRAT + SA condition's advancement significantly. CONCLUSION: The study corroborated the efficacy of the STRAT and STRAT + CA conditions' interventions as feasible tools to enhance fifth graders' reading comprehension achievement.

Belgium↗