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AIM: To compare the frequency of misconceptions amongst dental students resulting from assessments in different subject areas using different types of multiple-choice questions (MCQs). We wanted to know whether misconceptions, or strongly held incorrect beliefs, differed by subject area or question type. METHODS: A total of 104 students completed two assessments that included 20 MCQs on endodontics and 20 MCQs on dental implants. On each examination, 10 questions were scenario-type questions requiring interpretation or analysis and 10 questions were factual-based, knowledge questions. Incorrect responses and confidence levels by student and subject were recorded for a comparison of average misconceptions by question type and for correlations between scenario and knowledge question types for misconceptions on both assessments. RESULTS: Students were overly confident on their incorrect responses and misconceptions for both assessments. On the endodontic examination, students held a statistically significant higher number of mean misconceptions on scenario questions than for knowledge questions, but the difference was not statistically significant for the dental implant examination. There was a moderately weak relationship between scenario and knowledge questions for misconceptions on the endodontic (r=.31) and dental implant (r=.20) assessments, suggesting students who have misconceptions on knowledge questions are somewhat more likely to have misconceptions on scenario questions. CONCLUSION: Students had a consistent rate of overconfidence (75%) in their incorrect responses regardless of question type or dental subject. Questions that prompted a higher per cent of incorrect responses were more likely to detect misconceptions, as students were highly confident in their mistakes, for both assessments.
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Educação em Odontologia , Conhecimentos, Atitudes e Prática em Saúde , Autoeficácia , Estudantes de Odontologia/psicologia , Estudos Transversais , Feminino , Humanos , Masculino , AutorrelatoRESUMO
BACKGROUND: The complexity of HIV/AIDS raises challenges for the effective delivery of care. It is important to ensure that the expertise and experience of care providers is of high quality. Training and experience of HIV/AIDS providers may impact not only individual patient outcomes but increasingly on health care costs as well. OBJECTIVE: The objective of this review is to assess the effects of provider training and experience on people living with HIV/AIDS on the following outcomes: immunological (ie. viral load, CD4 count), medical (ie. mortality, proportion on antiretrovirals), psychosocial (ie. quality of life measures) and economic outcomes (ie health care costs). CRITERIA FOR CONSIDERING STUDIES FOR THIS REVIEW: We searched MEDLINE, EMBASE, Dissertation Abstracts International (DAI), CINAHL, HealthStar, PsycInfo, PsycLit, Social Sciences Abstracts, and Sociological Abstracts from January 1, 1980 through May 29, 2009. Electronic searches were performed for abstracts from major international AIDS conferences. Reference lists from pertinent articles, books and review articles were retrieved and reviewed. SELECTION CRITERIA: Randomized controlled trials (RCTs), controlled clinical trials, cohort, case control, cross-sectional studies and controlled before and after designs that examined the qualifications/training and patient volume of HIV/AIDS care of providers caring for persons known to be infected with HIV/AIDS were included. DATA COLLECTION AND ANALYSIS: At least two authors independently assessed trial quality and extracted data. Study authors were contacted for further information as required. Assessment of confounding factors was undertaken independently by two reviewers. MAIN RESULTS: A total of four studies (one randomized controlled trial, three non- randomized studies) involving 8488 people living with HIV/AIDS were included. The main findings of this review demonstrated a trend to improved outcomes when treated by a provider with more training/expertise in HIV/AIDS care in the outpatient (clinic) setting. Due to the heterogeneity of the included studies, we could not perform a meta-analysis. We present a descriptive review of the results. AUTHORS' CONCLUSIONS: The results demonstrate improved medical outcomes when treated by a provider with more training/expertise in HIV/AIDS care in the outpatient (clinic) setting. Since all of these studies were conducted in North America, this does not address any issues regarding the level of training/expertise required by providers working in countries with more limited resources. Practitioners who do not consider themselves "experts" in HIV/AIDS care and care for few of these patients need to seriously consider this review which demonstrates a trend towards worse patient outcomes when receiving care by those with low caseloads/training in HIV/AIDS care.
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Since 1969, several classical linkage studies suggested an X-chromosome locus for bipolar affective disorder. However, methods using highly polymorphic DNA markers have provided conflicting evidence for linkage, and an X-chromosomal locus for bipolar disorder remains controversial. More recently, Pekkarinen et al. (1995) found a maximum LOD score of 3.54 at the marker DXS994 in a large bipolar Finnish kindred. In the present study, we attempted to replicate this finding using 43 families multiply affected by bipolar affective disorder. These families were selected for the absence of male-to-male transmission of the disease, and were genotyped for two microsatellte markers, DXS1227 and DXS1062 (which is about 2 cM telomeric to DXS994). Linkage to this region was excluded either using a two-point lod score method with two plausible genetic models, or by a model-free lod score analysis which does not require specification of a particular mode of transmission. We conclude that there is no evidence of a common major gene for bipolar affective disorder at Xq25-q27 in our set of families.
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Transtorno Bipolar/genética , Cromossomo X/genética , Transtorno Bipolar/epidemiologia , Brasil/epidemiologia , Inglaterra/epidemiologia , Feminino , Predisposição Genética para Doença , Genótipo , Humanos , Escore Lod , Masculino , País de Gales/epidemiologiaRESUMO
Straub et al. (1994: Nature Genet. 8. 291-296) have suggested that a susceptibility gene for bipolar affective disorder is located at chromosome 21q22.3, on the basis of linkage analysis in one large family. This result has been supported by Gurling et al. (1995: Nature Genet. 10, 8-9) who also found some evidence for linkage to this region under locus heterogeneity. In order to investigate the validity of these results and to estimate how broadly applicable they are, we performed a linkage study between bipolar affective disorder and two DNA markers (D21S171 and PFKL) from 21q22.3 using 60 bipolar pedigrees from three European centres and Brazil. The most positive result obtained was a maximised admixture lod score of 1.2 for the marker PFKI, under the assumption of locus heterogeneity, dominant transmission and a diagnostic classification which included recurrent unipolar depression. However, since lod scores obtained for both markers were substantially negative overall, we conclude that there is no common major gene for bipolar affective disorder at 21q22.3. It remains possible that a gene of major effect in this region operates in a minority of families.
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Transtorno Bipolar/genética , Cromossomos Humanos Par 21 , Ligação Genética/genética , Marcadores Genéticos/genética , Brasil , Transtorno Depressivo/genética , Europa (Continente) , Frequência do Gene/genética , Humanos , Modelos Genéticos , Fenótipo , Transtornos Psicóticos/genéticaRESUMO
In recent studies we have demonstrated that the model that better explains the genetic etiology of non syndromic cleft lip/palate (CL/P) in the Chilean population is one that postulates the existence of a major dominant autosomic locus with low penetrance, without discarding the possible influence of polygenes. Similar conclusions have been communicated by others authors in different populations. Thus, investigations have been initiated to seek possible associations between candidate genes and restriction length polymorphisms (RFLP's), specifically between Transforming Growth Factor Alpha (TGFA) gene RFLP's and CL/P, in caucasian populations. Results thus far obtained have been inconclusive. Therefore, the aim of this work was to study this association in the Chilean population, that is ethnically different. The gene and phenotype frequencies of the TGFA gene BamH1 polymorphism in CL/P probands (n = 21) and controls (n = 16) were determined. No significant differences were detected in the frequencies of the A1 and A2 alleles of the TGFA gene between probands and controls. These results do not support an association between the cleft palate phenotype and TGFA RFLP.
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Fenda Labial/genética , Fissura Palatina/genética , Desoxirribonuclease BamHI/genética , Polimorfismo Genético/genética , Fator de Crescimento Transformador alfa/genética , Autorradiografia , Chile , Frequência do Gene , Genótipo , HumanosRESUMO
This review addresses vitamin and mineral supplementation recommendations, practices and rationales, patterns of supplement use, and the relationship between supplementation and nutrient concerns for older infants. According to current recommendations, healthy infants do not need supplements if vitamin D-fortified milk is used, the diet includes adequate vitamin C, and iron-fortified cereals or formula are used. Infants fed human milk exclusively may need vitamin D supplements. Nevertheless, approximately one third to one half of 6- to 12-month-old U.S. infants receive nutrient supplements, as liquid vitamin A, D, and C preparations or multivitamin preparations, with or without iron or fluoride. Recent surveys suggest that most infants have more than adequate vitamin and mineral intakes, with the possible exception of iron. The risk of poor vitamin A status is less likely than the risk of poor water-soluble-vitamin or iron status in the United States. Possibly marginal intakes of zinc and copper (not in currently available infant supplements) suggest the need for further research. Research, infant supplement formulation reevaluation, and education are suggested so that nutrient supplements for prophylaxis can be used most effectively and appropriately.