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Effectiveness of face to face and virtual education to promote breast self-examination based on the theory of planned behavior: a randomized controlled trial study
Background
Breast cancer (BC) is the most prevalent cancer among women in both developed and developing countries. Breast self-examination (BSE) is crucial for the early detection of BC. This study aimed to assess the effectiveness of face-to-face and virtual education on BSE, based on the theory of planned behavior (TPB).
Methods
This randomized controlled trial was conducted on 240 women aged 30–55 in northern Iran from 2020 to 2022. Participants were selected using a random sampling method and were randomly assigned to three groups of 80 each (face to face, virtual, and control). The face to face educational intervention consisted of four consecutive weekly sessions (50 min each), with 20 participants per session. In the virtual training group, all teaching materials were delivered once a week via WhatsApp messenger. The control group did not receive any intervention. All participants completed questionnaires assessing demographic and fertility characteristics, BSE barriers, knowledge, and practice regarding BSE, as well as TPB constructs (attitude, subjective norm, perceived behavioral control, behavioral intention, and behavior) before, one month, and three months after the intervention. Data analysis was performed using SPSS version 23.0. Statistical tests included the chi-square test, t-test, analysis of variance, repeated measures RMANOVA, and Pearson’s correlation coefficient. The significance level was set at
P
< 0.05.
Results
The study results indicated that the mean BSE and TPB constructs increased in both the face to face and virtual education groups one and three months after the intervention (
P
< 0.001). In the face-to-face group, knowledge one month after the education was correlated with practice at both one and three months post-education (
r
= 0.304,
P
= 0.006, and
r
= 0.232,
P
= 0.038, respectively). Similarly, in the virtual group, knowledge and practice one month after the education was correlated with knowledge and practice three months post-education (
r
= 0.814,
P
= 0.001, and r = 0.722,
P
= 0.001, respectively).
Conclusions
The results of this study demonstrated that TPB is an effective theory for promoting BSE. Both face to face and virtual education interventions proved to be successful, with no significant difference between them.
Trial registration
IRCT20230130057274N4
Date of registration: 2024-04-29
Retrospectively registered
Journal Article
Advantages and pitfalls in utilizing artificial intelligence for crafting medical examinations: a medical education pilot study with GPT-4
Background
The task of writing multiple choice question examinations for medical students is complex, timely and requires significant efforts from clinical staff and faculty. Applying artificial intelligence algorithms in this field of medical education may be advisable.
Methods
During March to April 2023, we utilized GPT-4, an OpenAI application, to write a 210 multi choice questions-MCQs examination based on an existing exam template and thoroughly investigated the output by specialist physicians who were blinded to the source of the questions. Algorithm mistakes and inaccuracies, as identified by specialists were classified as stemming from age, gender or geographical insensitivities.
Results
After inputting a detailed prompt, GPT-4 produced the test rapidly and effectively. Only 1 question (0.5%) was defined as false; 15% of questions necessitated revisions. Errors in the AI-generated questions included: the use of outdated or inaccurate terminology, age-sensitive inaccuracies, gender-sensitive inaccuracies, and geographically sensitive inaccuracies. Questions that were disqualified due to flawed methodology basis included elimination-based questions and questions that did not include elements of integrating knowledge with clinical reasoning.
Conclusion
GPT-4 can be used as an adjunctive tool in creating multi-choice question medical examinations yet rigorous inspection by specialist physicians remains pivotal.
Journal Article
Reboot : leadership and the art of growing up
\"One of the startup world's most in-demand coaches--Wired magazine calls him the 'CEO Whisperer'--reveals why radical self-inquiry is critical to professional success and healthy relationships in all realms of life\"-- Provided by publisher.
Book
The effect of a virtual educational intervention based on self-efficacy theory on women’s skills of breast self- examination
Background
Correctly, performing breast self-examination (BSE) has an important role in the early diagnosis of breast cancer and prevention of women's mortality due to it. The present study aimed to investigate the effect of virtual education programs on breast self-examination, self-efficacy, and skills.
Methods
This quasi-experimental study was conducted on 146 women who were 18–59 years old (73 in each intervention, and control group) working in Fars Oil Industry. Data collection tools included the researcher-made knowledge questionnaire (10 items), the self-efficacy questionnaire of Champion and Scott (10 item), and Wood’s breast self-examination skill questionnaire (23 items). The participants were selected by systematic random sampling and divided into intervention and control groups through Permuted blocks randomization. A four-week virtual educational interventions were conducted for the intervention group through the WhatsApp messenger by sharing educational videos, booklets, and posters. The control group received no education. The questionnaires were completed by both groups, before and two months after the intervention. Data were analyzed in SPSS version 22 using frequency descriptive statistics, independent t-test, and paired t-test.
Results
The knowledge mean scores showed no significant differences in participants in the two groups before and after the intervention. The mean score of self-efficacy increased significantly, in both the intervention (
p
< 0.001) and control (
P
= 0.025) groups. After the intervention, the mean scores of BSE skills in the intervention group were significantly (
p
< 0.001) higher than the control group.
Conclusion
Virtual education using social networks alone is not able to increase and improve all aspects of BSE skills sufficiently.
Journal Article
Exenatide once weekly versus placebo in Parkinson's disease: a randomised, double-blind, placebo-controlled trial
Exenatide, a glucagon-like peptide-1 (GLP-1) receptor agonist, has neuroprotective effects in preclinical models of Parkinson's disease. We investigated whether these effects would be apparent in a clinical trial.
In this single-centre, randomised, double-blind, placebo-controlled trial, patients with moderate Parkinson's disease were randomly assigned (1:1) to receive subcutaneous injections of exenatide 2 mg or placebo once weekly for 48 weeks in addition to their regular medication, followed by a 12-week washout period. Eligible patients were aged 25–75 years, had idiopathic Parkinson's disease as measured by Queen Square Brain Bank criteria, were on dopaminergic treatment with wearing-off effects, and were at Hoehn and Yahr stage 2·5 or less when on treatment. Randomisation was by web-based randomisation with a two strata block design according to disease severity. Patients and investigators were masked to treatment allocation. The primary outcome was the adjusted difference in the Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) motor subscale (part 3) in the practically defined off-medication state at 60 weeks. All efficacy analyses were based on a modified intention-to-treat principle, which included all patients who completed any post-randomisation follow-up assessments. The study is registered at ClinicalTrials.gov (NCT01971242) and is completed.
Between June 18, 2014, and March 13, 2015, 62 patients were enrolled and randomly assigned, 32 to exenatide and 30 to placebo. Our primary analysis included 31 patients in the exenatide group and 29 patients in the placebo group. At 60 weeks, off-medication scores on part 3 of the MDS-UPDRS had improved by 1·0 points (95% CI −2·6 to 0·7) in the exenatide group and worsened by 2·1 points (−0·6 to 4·8) in the placebo group, an adjusted mean difference of −3·5 points (−6·7 to −0·3; p=0·0318). Injection site reactions and gastrointestinal symptoms were common adverse events in both groups. Six serious adverse events occurred in the exenatide group and two in the placebo group, although none in either group were judged to be related to the study interventions.
Exenatide had positive effects on practically defined off-medication motor scores in Parkinson's disease, which were sustained beyond the period of exposure. Whether exenatide affects the underlying disease pathophysiology or simply induces long-lasting symptomatic effects is uncertain. Exenatide represents a major new avenue for investigation in Parkinson's disease, and effects on everyday symptoms should be examined in longer-term trials.
Michael J Fox Foundation for Parkinson's Research.
Journal Article
Effect of MRI on preterm infants and their families: a randomised trial with nested diagnostic and economic evaluation
BackgroundWe tested the hypothesis that routine MRI would improve the care and well-being of preterm infants and their families.DesignParallel-group randomised trial (1.1 allocation; intention-to-treat) with nested diagnostic and cost evaluations (EudraCT 2009-011602-42).SettingParticipants from 14 London hospitals, imaged at a single centre.Patients511 infants born before 33 weeks gestation underwent both MRI and ultrasound around term. 255 were randomly allocated (siblings together) to receive only MRI results and 255 only ultrasound from a paediatrician unaware of unallocated results; one withdrew before allocation.Main outcome measuresMaternal anxiety, measured by the State-Trait Anxiety inventory (STAI) assessed in 206/214 mothers receiving MRI and 217/220 receiving ultrasound. Secondary outcomes included: prediction of neurodevelopment, health-related costs and quality of life.ResultsAfter MRI, STAI fell from 36.81 (95% CI 35.18 to 38.44) to 32.77 (95% CI 31.54 to 34.01), 31.87 (95% CI 30.63 to 33.12) and 31.82 (95% CI 30.65 to 33.00) at 14 days, 12 and 20 months, respectively. STAI fell less after ultrasound: from 37.59 (95% CI 36.00 to 39.18) to 33.97 (95% CI 32.78 to 35.17), 33.43 (95% CI 32.22 to 34.63) and 33.63 (95% CI 32.49 to 34.77), p=0.02. There were no differences in health-related quality of life. MRI predicted moderate or severe functional motor impairment at 20 months slightly better than ultrasound (area under the receiver operator characteristic curve (CI) 0.74; 0.66 to 0.83 vs 0.64; 0.56 to 0.72, p=0.01) but cost £315 (CI £295–£336) more per infant.ConclusionsMRI increased costs and provided only modest benefits.Trial registrationClinicalTrials.gov NCT01049594 https://clinicaltrials.gov/ct2/show/NCT01049594. EudraCT: EudraCT: 2009-011602-42 (https://www.clinicaltrialsregister.eu/).
Journal Article