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PubMed2004

The effectiveness of feminist pedagogy in empowering a community of learners.

The purpose of this study was to determine whether a pedagogy grounded in feminist ideals has the potential to empower students to make changes consistent with those ideals in their personal and professional lives. In Phase I, qualitative data were collected through e-mail questionnaires from students in two nursing schools, one in Canada and one in the United States. Findings were used to identify an appropriate tool to measure the empowering influence of feminist pedagogy. In Phase 2, a pretest-posttest design used Barrett's Power as Knowing Participation in Change Tool (PKPCT) to measure student empowerment. A clinical setting was added in a third baccalaureate nursing program. A total of 218 students participated in seven course offerings-four classroom and three clinical. One hundred one matched pairs were obtained, for an overall response rate of 46%. Repeated measures ANOVA revealed that overall empowerment scores, as measured by the PKPCT, and classroom empowerment (CE), as measured by the addition of a variable (i.e., the ability to contribute in class), increased significantly from pretest to posttest. Interaction between Sites 1 and 2 was also significant. Regression analysis indicated posttest CE scores added to pretest PKPCT and CE scores provided a strong model to predict overall empowerment scores, measured by the PKPCT at Time 2 (R2 = .703). Despite limitations related to loss of follow up and low response rates at one site, the results of this study supported both hypotheses: that empowerment would increase over the course of the class in which feminist pedagogical principles were used, and that classroom empowerment is likely to extend beyond the classroom to personal and work environments.

Analysis of Variance↗
PubMed2006

[Development and application of an online alternative therapy and health promotion class].

PURPOSE: This study was to develop an online "alternative therapy and health promotion" class for university students and to evaluate its changes. METHOD: The online class was developed based on the Instructional Systems Development (ISD) model and model of Web-Based Instruction (WBI) developmental process. This was a quasi- experimental, one group pretest-posttest design. The subjects of this study were 130 students in 3 universities, and they were provided the cyber class for 16 weeks. Data was analyzed by descriptive and plural answer statistics, and paired t-test. RESULTS: The cyber class was developed in five steps: analysis, design, data collection and reconstruction, programming and publishing, and evaluation. The results of program evaluation were positive, which included learning 3.47, system 3.57, and learning satisfaction 3.64 on the scale of 5. The posttest scores of cognition and reliability of alternative therapy were higher than pretest scores. The posttest scores of health promoting lifestyle (t=-5.051, p=.000) and perceived health status (t=2.979, p=.003) were significantly higher than those of the pretest. CONCLUSION: These results suggest that the cyber class is a positive method in increasing a cognition, reliability of alternative therapy, and is effective to improve a health promotion lifestyle and perceived health status for the university students.

Complementary Therapies↗
PubMed2006

[Evaluation of a virtual class on lifelong health care for women].

PURPOSE: This study was to evaluate a virtual class, 'lifelong health care for women', for female university students. METHOD: The research design was one group pre-post design. A pretest and posttest were conducted to measure CMI, perceived health status, health promoting lifestyle, and knowledge related to women's health. The subjects of this study were 74 female students in 3 universities, and they were provided with the virtual class by K university consortium for 16 weeks. Data was analyzed by descriptive and paired t-test. RESULTS: There were statistically significant differences in CMI (t=3.367, p=.001), perceived health status (t=-2.788, p=.007), and knowledge related to women's health (t=-10,432, p=.000) between the pretest and posttest. However, there was not a statistically significant difference in a health promoting lifestyle (t=-1.431, p=.157) between the pretest and posttest. CONCLUSION: These results suggest that a virtual class on lifelong health care for women is an effective method in decreasing health problems, and improving perceived health status and knowledge related to women's health by female university students.

Adult↗
PubMed1999

A perspective on standardizing the predictive power of noninvasive cardiovascular tests by likelihood ratio computation: 1. Mathematical principles.

The current practice of reporting positive and negative predictive value (PV), sensitivity (Se), and specificity (Sp) as measures of the power of noninvasive cardiovascular tests has significant limitations. A test result's PV and its comparison with other test results are highly dependent on the pretest disease prevalence at which it is determined; the citation of sensitivity and specificity provides no succinct or explicit quantitation of the rule-in and rule-out power of a test. This article presents a rationale for the use of an alternative standard for expressing predictive power in the form of positive and negative likelihood ratios, (+)LR and (-)LR. The likelihood ratios are composite expressions of test power, which incorporate the Se and Sp and their respective complements [(1 - Se) and (1 - Sp)], thus yielding single unambiguous measures of positive and negative predictive power. The likelihood ratios are calculated as follows: (+)LR = Se/(1 - Sp) and (-)LR = Sp/(1 - Se). On analysis of the predictive value equations, the likelihood ratios equal the quotients of the posttest predictive value odds to the pretest prevalence odds for disease and no disease, respectively, as follows: (+)LR = (+)PVOd/POD and (-)LR = (-)PVOn/PON, where (+)PVOd is positive predictive value odds for disease, POD is prevalence odds for disease, (-)PVOn is negative predictive value odds for no disease, and PON is prevalence odds for no disease. Thus, the likelihood ratios are measures of the odds advantage in posttest probability of disease or no disease relative to pretest probability, independent of disease prevalence in the tested population. The quotients of the (+)LR or the (-)LR among test results studied in a common population are direct expressions of their relative predictive power in that population. The likelihood ratio principle is applicable to the evaluation of the predictive power of multiple tests performed in a common population and to estimating predictive power at multiple test thresholds.

Confidence Intervals↗
PubMed1999

A perspective on standardizing the predictive power of noninvasive cardiovascular tests by likelihood ratio computation: 2. Clinical applications.

Likelihood ratio measures may be used as a standard for expressing the predictive power of noninvasive cardiovascular tests, calculated from sensitivity and specificity measures or as ratios of the predictive value odds to pretest odds for positive and negative test results. The positive likelihood ratio, (+)LR, expresses the power of a positive test result to augment an estimate of disease probability independent of the pretest prevalence of disease in a given population; the negative likelihood ratio, (-)LR, expresses the power of a negative test result to augment an estimate of the probability of no disease independent of the pretest prevalence of no disease in the same population. The likelihood ratio principle is applicable to the evaluation of the predictive power of single or combined test results reported for either dichotomous or continuous end points. This part of the perspective exemplifies application of the likelihood ratio principle in a wide variety of testing conditions for coronary artery disease followed by a discussion of the limitations of likelihood ratio computation in test power evaluation. Likelihood ratios provide a more concise and unambiguous standard for calibrating the predictive power of single and combined noninvasive cardiovascular test results than are provided by measures of sensitivity, specificity, and predictive value.

Adrenergic beta-Agonists↗
PubMedDate not supplied

Effects of weight training on the emotional well-being and body image of females: predictors of greatest benefit.

BACKGROUND: This study was conducted to determine the extent to which participation in a weight training intervention was associated with changes in the emotional well-being and body image of females compared to non-weight trainers. An ancillary objective was to study the extent to which psychological, physical, and demographic factors accounted for changes in emotional well-being and body image. METHODS: The experimental group consisted of 60 females, and a comparison group was comprised of 92 females. Experimental subjects participated in a 15-week, two-day-per-week weight training intervention, while subjects in the comparison group did not participate in any weight training activities. Subjects were pre- and posttested on the General Well-Being Schedule and the Body Cathexis Scale. Experimental subjects were also tested in muscular strength and three skinfold measurements. RESULTS: With pretest scores controlled, the weight trainers had significantly higher General Well-Being and Body Cathexis posttest scores than the comparison group. Weight trainers also showed significant increases in muscular strength, and significant decreases in skinfold thickness. Four variables predicted 38.8% of the variance of those who improved most in General Well-Being: lower pretest General Well-Being, lower parental income, greater loss of body weight, and lower posttest skinfold. Five variables predicted 61.5% of the variance of those women who improved most in Body Cathexis: lower pretest Body Cathexis, greater body weight at the outset, shorter in height, less involvement in non-weight training exercise, and lower posttest skinfold. DISCUSSION: (ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

[Response uncertainty on rule learning by observation: effects of pre-experience on observational learning].

The present study was conducted to examine the hypothesis that children's feelings of uncertainty would mediate between pre-experience and rule acquisition in observational learning. After received a pretest, subjects were requested to estimate their response uncertainty concerning a task used in the pretest. Then they observed a model responding to a series of pictures each of which depicting one of four directions. The model's responses were governed by a rule consisted of two dimensions: the progression and the direction. After observing the demonstration, subjects received two post-tests which differed in the order of stimulus presentation and in terms of the reinforcement. Subjects enhancing their feelings of uncertainty in the pretest phase acquired a rule which contained a dimension of the progression, while subjects who did not enhance them acquired a rule used by the model. These findings were interpreted as generally supporting the hypothesis of response uncertainty as a mediator of rule learning.

Biofeedback, Psychology↗
PubMed1990

The zone of proximal development in in-hand manipulation skills of nondysfunctional 3- and 4-year-old children.

The purpose of this study was to assess the influence of verbal and visual cues on 28 nondysfunctional 3- and 4-year-old children's performance of in-hand manipulation skills. During the uncued version of the test (pretest), the children were presented with play activities known to elicit in-hand manipulation skills in young children but were given no cues for specific manipulative skill use. Within 1 week of the pretest, after the children were randomly assigned to groups, a posttest was given in which the children were provided with verbal or visual cues. The results indicate that both visual and verbal cues were effective in increasing the groups' test scores, but no significant differences were found based on the type of cue provided. Approximately 30% of the children in the study showed marked improvement on the posttest scores, whereas the others showed little change. The children who had lower pretest scores showed greater score increases on the posttest than did the children who scored somewhat higher initially. The use of an uncued test followed by a cued test may be an effective method for the identification of those children who are most likely to show improvement in these manipulation skills with intervention. This study's findings lend tentative support to Vygotsky's (1978) zone of proximal development theory and extends the application of his work into the domain of fine motor skills.

Age Factors↗
PubMed2005

[The Japanese translation and cultural adaptation of Expanded Prostate Cancer Index Composite (EPIC)].

PURPOSE: To develop a Japanese version of the Expanded Prostate Cancer Index Composite (EPIC): originally designed to measure the Quality of Life of localized prostate cancer patients, after careful assessments of cross-cultural equivalence, face validity and practically. METHODS: We translated the original version that consisted of 50 items into a preliminary Japanese version. This multi-stage procedure included a forward-translation, back-translation and discussion with the original developer. Additionally, we tested the preliminary Japanese version on 11 localized prostate cancer patients and identified problems with its cross-cultural equivalence, practicality. Based on the findings of this pretest, we revised the Japanese version. Consensus by discussion among all researchers was obtained through out this process. RESULTS: The original developer reviewed the back-translation of the preliminary Japanese version: some wording was revised. In the pretest, the average age of patients was 68.8 years old. Four of the sexual subscale showed over 10 percent missing data. In five items, all patients chose identical answers. We conducted an in-depth qualitative investigation of these items. The average response time was 11.7 minutes. We revised the Japanese to reflect patients' opinions as much as possible. Items which were showed problems in terms of cross-cultural adaptation included questions measuring 'bother' and two items of the sexual subscale. The wordings of these items were revised so that Japanese patients could easier understand them. We ensured that the original developer's intentions remained the same. The original developed approved all revisions. CONCLUSION: We translated and adapted the original EPIC to the Japanese culture. The Japanese version of EPIC was found to be functional in the pretest.

Asian People↗
PubMed1986

Standard and computed tomography in the evaluation of neoplasms of the chest. A comparative efficacy assessment.

Although in practice computed tomography (CT) has nearly replaced standard tomography in the evaluation of chest diseases, an analysis of the literature shows that standard tomography may be preferred in some settings. After a detailed review of studies on test performance, we calculated overall sensitivity and specificity values. Using Bayesian analysis, we then developed guidelines for choosing between computed and standard tomography. A test is recommended if its results might obviate the need for an invasive procedure. Standard tomography is recommended in the detection of mediastinal metastases from lung cancer. In the detection of hilar metastases, standard tomography is recommended for patients who have low pretest probabilities of metastases to this site, and computed tomography is recommended for patients who have high pretest probabilities. Computed tomography is recommended for the detection of calcification in solitary pulmonary nodules. Tomographic procedures are not recommended when the pretest probability is intermediate. The discrepancy between current practice and these guidelines highlights the need for carefully designed, multi-institutional comparative studies of radiographic procedures.

Humans↗
PubMed1998

Test-treatment strategies for patients suspected of having Lyme disease: a cost-effectiveness analysis.

PURPOSE: To examine the cost-effectiveness of test-treatment strategies for patients suspected of having Lyme disease. DATA SOURCES: The medical literature was searched for information on outcomes and costs. Expert opinion was sought for information on utilities. STUDY SELECTION: Articles that described patient population, diagnostic criteria, dose and duration of therapy, and criteria for assessment of outcomes. DATA EXTRACTION: The decision analysis evaluated the following strategies: 1) no testing-no treatment; 2) testing with enzyme-linked immunosorbent assay (ELISA) followed by antibiotic treatment of patients with positive results; 3) two-step testing with ELISA followed by Western blot and antibiotic treatment for patients with positive results on either test; and 4) empirical antibiotic therapy. Three patient scenarios were considered: myalgic symptoms, rash resembling erythema migrans, and recurrent oligoarticular inflammatory arthritis. Results were calculated as costs per quality-adjusted life-year and were subjected to sensitivity analysis. Adjustment was made for the diagnostic value of common clinical features of Lyme disease. DATA SYNTHESIS: For myalgic symptoms without other features suggestive of Lyme disease, the no testing-no treatment strategy was most economically attractive (that is, had the most favorable cost-effectiveness ratio). For rash, empirical antibiotic therapy was less costly and more effective than other strategies. For oligoarticular arthritis with a history of rash and tick bite, two-step testing was associated with the lowest cost-effectiveness ratio. Testing with ELISA and empirical antibiotic therapy cost an additional $880,000 and $34,000 per quality-adjusted life-year, respectively. For oligoarticular arthritis with one or no other features suggestive of Lyme disease, two-step testing was most economically attractive. CONCLUSIONS: Neither testing nor antibiotic treatment is cost-effective if the pretest probability of Lyme disease is low. Empirical antibiotic therapy is recommended if the pretest probability is high, and two-step testing is recommended if the pretest probability is intermediate.

Anti-Bacterial Agents↗
PubMed1999

Cost-effectiveness of alternative test strategies for the diagnosis of coronary artery disease.

BACKGROUND: The appropriate roles for several diagnostic tests for coronary disease are uncertain. OBJECTIVE: To evaluate the cost-effectiveness of alternative approaches to diagnosis of coronary disease. DESIGN: Meta-analysis of the accuracy of alternative diagnostic tests plus decision analysis to assess the health outcomes and costs of alternative diagnostic strategies for patients at intermediate pretest risk for coronary disease. DATA SOURCES: Studies of test accuracy that met inclusion criteria; published information on treatment effectiveness and disease prevalence. TARGET POPULATION: Men and women 45, 55, and 65 years of age with a 25% to 75% pretest risk for coronary disease. TIME HORIZON: 30 years. PERSPECTIVE: Societal. INTERVENTIONS: Diagnostic strategies were initial angiography and initial testing with one of five noninvasive tests--exercise treadmill testing, planar thallium imaging, single-photon emission computed tomography (SPECT), stress echocardiography, and positron emission tomography (PET)--followed by coronary angiography if noninvasive test results were positive. Testing was followed by observation, medical treatment, or revascularization. OUTCOME MEASURES: Life-years, quality-adjusted life-years (QALYs), costs, and costs per QALY. RESULTS OF BASE-CASE ANALYSIS: Life expectancy varied little with the initial diagnostic test; for a 55-year-old man, the best-performing test increased life expectancy by 7 more days than the worst-performing test. More sensitive tests increased QALYs more. Echocardiography improved health outcomes and reduced costs relative to stress testing and planar thallium imaging. The incremental cost-effectiveness ratio was $75,000/QALY for SPECT relative to echocardiography and was greater than $640,000 for PET relative to SPECT. Compared with SPECT, immediate angiography had an incremental cost-effectiveness ratio of $94,000/QALY. RESULTS OF SENSITIVITY ANALYSIS: Qualitative findings varied little with age, sex, pretest probability of disease, or the test indeterminancy rate. Results varied most with sensitivity to severe coronary disease. CONCLUSIONS: Echocardiography, SPECT, and immediate angiography are cost-effective alternatives to PET and other diagnostic approaches. Test selection should reflect local variation in test accuracy.

Adult↗
PubMed1982

Evaluation of computer-assisted self-instructional module for pharmacy continuing education.

A computer-assisted self-instructional module was developed as a method of providing continuing education to pharmacists. A prospective, nonrandomized study was conducted to investigate the effectiveness of computer-assisted instruction (CAI). Using an Apple II microcomputer and anticoagulant therapy as the content base, a series of ten case studies was written and programmed. Twenty-two staff pharmacists from a university hospital and a community hospital participated. Participants were first given a pretest, proceeded through the CAI, took the same test as a posttest, then two weeks later, took a different posttest to measure knowledge retention. The mean test scores before and immediately after the CAI were 55.8% and 80.4%. The mean test score for the two-week posttest was 74%. The mean difference was found to be highly significant for both the pretest and immediate posttest (P less than 0.0001) and the pretest and two-week posttest (P less than 0.001). The study suggested that the use of a CAI module was effective in improving, as well as maintaining, pharmacists' knowledge and that a significant portion of knowledge gained was retained after a period of two weeks. Pharmacists' evaluations of this method of continuing education were generally favorable.

Computer-Assisted Instruction↗
PubMed1982

Tricyclic antidepressant education program and its evaluation.

The objectives of this study were (1) to develop an individualized tricyclic audiovisual education program and (2) to compare the program's effectiveness with that of traditional education. The program is designed to increase short-term and long-term knowledge about tricyclic antidepressants and depression. The patient's dose was stabilized, and then a pretest was given. If the patient was in the study group, he received the seven-minute slide-tape program and a posttest within 72 hours. The control group received the posttest within five days of the pretest. Both groups were given knowledge tests at approximately four weeks. Statistical analysis of the data from this small study group revealed significance at the 95% confidence level for the following statement: the study group showed a greater increase in factual short-term and long-term knowledge about its tricyclic therapy as shown by differences in pretest, posttest, and scores of tests at four weeks. This study demonstrates an effective standardized alternative to traditional education which can be used to educate the majority of patients about tricyclic antidepressants and depression with a minimum time investment.

Antidepressive Agents, Tricyclic↗
PubMed2001

Video vs. CD-ROM for teaching pelvic anatomy to third-year medical students. A comparison.

OBJECTIVE: To compare the effectiveness and student acceptance of video and CD-ROM review of pelvic anatomy in third-year obstetrics and gynecology students. STUDY DESIGN: A 34-item pretest was administered on the first day of the clerkship. Students were then randomized to watch a 45-minute video or use an interactive CD-ROM at home. All students took a posttest identical to the pretest. Examination scores were compared by paired and unpaired t test. Students completed a questionnaire on each method's ease, appropriateness, organization, appeal and time spent and whether they would recommend the method to others. RESULTS: One hundred seventy-six students were randomized, 88 to CD and 88 to video. There was 100% compliance, although not all questionnaire items were completed. The mean pretest score for both groups was 50%. The posttest CD mean score was significantly different from the posttest video mean (64% vs. 70%). Both groups significantly improved after the intervention. The video group noted ease of use, but only 49% recommended it for the future. The CD-ROM was recommended by 80%. Student comments favored the CD-ROM. CONCLUSION: Use of video review resulted in short-term significantly higher test scores, but students preferred an interactive CD-ROM. This method should be made available to all students during the rotation.

CD-I↗
PubMed2002

The acute 1-week effects of the Zone diet on body composition, blood lipid levels, and performance in recreational endurance athletes.

The aim of this study was to examine the effects of a 7-day Zone diet compared with a normal diet on maximal oxygen uptake (V(O)2 max), running time to exhaustion during endurance performance, and body composition. Eight men, with the following physical characteristics (mean +/- SE), participated in this study: age, 26.1 +/- 1.9 years; height, 178 +/- 1.7 cm; mass, 70.7 +/- 2.1 kg; and V(O)2 max, 54.6 +/- 3.1 ml x kg(-1) x min(-1). All subjects undertook pretesting for V(O)2 max, time to exhaustion (80% V(O)2 max), and body composition (Biostat 1500) before following either the normal diet or the Zone diet for 7 days. These performance trials were performed before and after the dietary period. There was a significant (p < 0.05) decrease in total energy consumption from a mean of 2,314 +/- 334 kcal on a pretest diet to 1,994 +/- 438 kcal on the Zone diet. Subjects showed a significant reduction (p < 0.02) in body mass from 70.7 +/- 2.1 kg to 69.8 +/- 2.1 kg. In the 80% V(O)2 max time to exhaustion trial, there was a significant reduction (p < 0.05) in time to exhaustion from 37.68 +/- 8.6 minutes for the pretest diet to 34.11 +/- 7.01 minutes for the Zone diet. In conclusion, the claim of the authors of the Zone diet that performance time and V(O)2 max can be improved was not shown in this 1-week research trial. We would suggest that this is not a nutritional strategy that athletes should use until further work has been conducted.

Adult↗
PubMed1998

Student and Parent Response to Use of an Early Childhood Nutrition Education Program.

A quasi-experimental pretest-post-test design was used to evaluate the impact of an early childhood nutrition education program on kindergarten students' familiarity with and stated willingness to eat 16 test foods. Thirteen classes of students were randomly assigned to control or intervention groups. The intervention groups were introduced to eight of the test foods using the program. Sixteen plastic food models, including the foods introduced in the program, were presented to each student at pretest and post-test seven months later. Students named foods they were familiar with and stated if they were willing to eat each food. Pretest and post-test parental questionnaires queried which of the 16 foods listed they thought their child was willing to eat. Familiarity with introduced foods increased over time in the intervention (P<0.0001) and control groups (P<0.01), but there was no significant increase in stated willingness to eat either introduced or non-introduced foods for either subject group. However, significantly more parents of the intervention group (P<0.001) than control group children reported their child had mentioned exposure to a food at school when requesting it at home. Children consistently stated they were willing to eat a greater number of foods than their parents perceived. The modest impact of this program draws attention to many factors nutrition educators must consider when evaluating early childhood nutrition education programs.

Journal Article↗
PubMed2003

Mutual information as an index of diagnostic test performance.

OBJECTIVES: This paper demonstrates that diagnostic test performance can be quantified as the average amount of information the test result (R) provides about the disease state (D). METHODS: A fundamental concept of information theory, mutual information, is directly applicable to this problem. This statistic quantifies the amount of information that one random variable contains about another random variable. Prior to performing a diagnostic test, R and D are random variables. Hence, their mutual information, I(D;R), is the amount of information that R provides about D. RESULTS: I(D;R) is a function of both 1). the pretest probabilities of the disease state and 2). the set of conditional probabilities relating each possible test result to each possible disease state. The area under the receiver operating characteristic curve (AUC) is a popular measure of diagnostic test performance which, in contrast to I(D;R), is independent of the pretest probabilities; it is a function of only the set of conditional probabilities. The AUC is not a measure of diagnostic information. CONCLUSIONS: Because I(D;R) is dependent upon pretest probabilities, knowledge of the setting in which a diagnostic test is employed is a necessary condition for quantifying the amount of information it provides. Advantages of I(D;R) over the AUC are that it can be calculated without invoking an arbitrary curve fitting routine, it is applicable to situations in which multiple diagnoses are under consideration, and it quantifies test performance in meaningful units (bits of information).

Area Under Curve↗