Experiencias de discriminación étnico-racial, neuroticismo, ira y personalidad oscura: un modelo de mediación serial / Experiences of racial-ethnic discrimination, neuroticism, anger and dark personality: A serial mediation model

Resumen Introducción: Las experiencias de discriminación étnico-raciales son estresores sociales que afectan la salud mental de quienes las sufren. A pesar de que se trata de un fenómeno vigente, los trabajos que han examinado los efectos de la discriminación en la salud mental en Perú y Latinoamérica son escasos. Por ello, el objetivo principal de este estudio es explorar el rol mediador del neuroticismo y la ira en la relación entre las experiencias de discriminación y los rasgos de personalidad oscuros en población peruana. Método: Se contó con la participación de 632 personas con edades de entre 18 y 63 años (M = 25.03; DE = 8.03). Se utilizaron la Escala de Experiencias de Discriminación (EOD), los ítems que miden neuroticismo del Big Five Inventory - 10 (BFI-10), la Escala de Propensión a la Ira (APS - G) y la Dirty Dozen Dark Triad (DDDT). Mediante regresión estructural se creó un modelo explicativo. Resultados: El ajuste del modelo fue excelente (CFI = .975, TLI = .970, RMSEA = .043 y SRMR = .051) y mostró que las experiencias de discriminación tienen un efecto directo sobre el neuroticismo, el cual predice de manera robusta la propensión a la ira, y esta, a su vez, es predictora, en mayor medida, del maquiavelismo, el narcisismo y la psicopatía, respectivamente. Conclusión: El neuroticismo y la ira son mediadores seriados en la relación entre las experiencias de discriminación y los rasgos oscuros de personalidad.

Abstract Introduction: Experiences of racial-ethnic discrimination are social stressors that affect the mental health of those who suffer it. Although it is a current phenomenon, few studies have examined the effects of discrimination on mental health in Peru and Latin America. Therefore, the aim of this study was to explore the mediating role of neuroticism and anger in the relationship between experiences of discrimination and dark personality traits in a Peruvian population. Method: A total of 632 participants between 18 and 63 years of age participated (M = 25.03; SD = 8.03). The Experiences of Discrimination Scale (EOD), the items measuring neuroticism from the Big Five Inventory - 10 (BFI-10), the Anger Propensity Scale (APS - G) and the Dirty Dozen Dark Triad (DDDT) were used. An explanatory model was created using structural regression. Results: The model fit was excellent (CFI = .975, TLI = .970, RMSEA = .043 y SRMR = .051), showing that discrimination experiences have a direct effect on neuroticism, which robustly predicts anger proneness and this, in turn, is more predictive of Machiavellianism, narcissism and psychopathy, respectively. Conclusion: Neuroticism and anger are serial mediators in the relationship between discrimination experiences and dark personality traits.

Objective Visual Acuity Estimation via the Optokinetic Response to High-pass Filtered Stimuli: An Exploratory Study

Aims: Optokinetic-based paradigms used to derive objective visual acuity suffer so far from low predictive power. Arguably, the contribution of the peripheral stimulation and the discrepancy between detection and discrimination threshold can bias the outcomes. In this respect, high-pass filtered stimuli (HPSs) have the advantage of activating only the foveal region and their detection and discrimination thresholds converge. In this exploratory study a novel optokinetic-based induction method (named “ghost oktotype”) that uses HPSs is probed. The aim was to establish whether this type of procedure is worth being extensively investigated. Study Design: Analytical transversal study. Place and Duration of Study: Department of Ophthalmology, University of Turin, Italy, between June 2023 and June 2024. Methodology: After testing for their subjective acuity (expressed as logMAR) at ten different defocusing conditions, four normal and cooperative subjects were repeatedly administered sequences of HPS-Landolt rings arranged on a serial pattern that drifted horizontally. Their angular size was logarithmically reduced and objective acuity was computed for each defocusing condition as a function of the smallest size of the rings that evoked the optokinetic reflex (logMAER). The estimate was compared to the subjective values obtained both at the conventional Landolt-C ETDRS charts and with modified ETDRS charts made up of high-pass filtered Landolt Cs. Results: The repeatability of the HPS-based optokinetic paradigm was good in the three subjects (ICC=0.77; 0.86; 0.89) and the outcomes were significantly correlated with the conventional ETDRS values (R2=0.96, R2=0.88, R2=0.81: P<0.001). Nevertheless, objective visual acuity was lower (higher logMAER) compared to the subjective, conventional assessment with the ETDRS chart, especially at the highest acuities. This difference decreased when logMAER was compared to the subjective discrimination acuity (logMAR) measured with the HPS-ETDRS charts, and, supposedly, to detection acuity. Conclusion: According to these preliminary results, high-pass filtered stimuli reduce the mismatch between subjective and objective acuity. Within this frame, the “ghost” oktotype could be a promising tool to assess visual acuity in non-collaborative patients and is worth being extensively investigated. Forthcoming studies could support our impression i.e., that detection and not resolution is the main requisite for the optokinetic response. This peculiarity must be considered when investigating the potential of the optokinetic-based paradigms to derive resolution acuity.

Camouflaged prejudice and the affirmation of skin colour differences: assessment of racism among Brazilian undergraduate dental students / Preconceito camuflado e afirmação das diferenças de cor da pele: avaliação do racismo entre estudantes brasileiros de odontología

ABSTRACT The negative oral health outcomes of disadvantaged racial groups have been well-documented, as racial disparity in oral health persists over time and in different locations1. However, it is important to note that skin colour has no biological meaning, and the observed differences can be physiological expressions of social injustice such as racism. Aim The aim of this study was to analyse the association between levels of modern racism (camouflaged prejudice and affirmation of differences) and sociodemographic characteristics of Brazilian dental students. Material and Method: An epidemiological cross-sectional online survey was conducted on 441 Brazilian undergraduate dental students using Google Forms. Participants were recruited via emails and social media, using the snowball technique. The Checklist for Reporting of Survey Studies (CROSS) was followed. The survey used sociodemographic variables, and the Brazilian version of the Modern Racism Scale (B-MRS), which measures the cognitive component of subtle racial attitudes. The scale assesses the central notion of disguised prejudice and has two domains: 'denial of prejudice' and 'affirmation of differences'. Participants' self-declared skin colour was categorized as "white" and "non-white" (black, brown, indigenous, yellow). Univariate analysis and Poisson regression with robust variance were applied. Results Participants' mean age was 24.1 years (±5.4). Most participants were self-declared as white (54%) and 46% as non-white skin colour. Higher B-MRS overall-scores were observed in male (p=0.008) and non-white (p=0.002) students. B-MRS scores for the domain 'affirmation of differences' (representation of those who believe that whites and non-whites are truly different) were higher among male dental students (PR=1.138; CI 95%: 1.019-1.271) and those from low-income families (PR=1.306; CI 95%: 1.089-1.565). Scores for the domain 'denial of prejudice' (the idea that non-whites use their race to receive legal benefits) were higher among male dental students (PR=1.328; CI 95%: 1.129-1.562). Conclusions In general, male non-white students had higher modern racism indicators. Male students from low-income families believed that whites and non-whites are truly different, accounting for the affirmation of difference in this sample.

RESUMO Os impactos negativos da saúde oral dos grupos raciais desfavorecidos têm sido bem documentados, uma vez que a disparidade racial na saúde oral persiste ao longo do tempo e em diferentes locais. No entanto, é importante notar que a cor da pele não tem significado biológico e as diferenças observadas podem ser expressões fisiológicas de injustiça social, como o racismo. Objetivo A teoria do racismo moderno afirma que as atitudes se expressam em formas preconceituosamente camufladas. Associou-se níveis de racismo moderno (afirmação de diferenças) com características sociodemográficas de universitários brasileiros. Material e Método Uma pesquisa epidemiológica transversal on-line foi realizada com 441 estudantes brasileiros de graduação em odontologia por meio do Google Forms. Os participantes foram recrutados via e-mail e redes sociais, utilizando a técnica bola de neve. Seguiu-se a Lista de Verificação para Relatórios de Estudos de Pesquisa (CROSS). Variáveis sociodemográficas, bem como a versão brasileira da Escala de Racismo Moderno (B-MRS) que mede o componente cognitivo de atitudes raciais sutis foram utilizadas. A escala acessa o preconceito disfarçado, possuindo dois domínios: 'negação do preconceito' e 'afirmação das diferenças'. A cor da pele autodeclarada dos participantes foi categorizada em "branca" e "não-branca" (preta, parda, indígena, amarela). Foram realizadas análises univariada e regressão de Poisson. Resultados A média de idade foi de 24,1 anos (±5,4). Muitos participantes se autodeclararam brancos (54%) e 46% não-brancos. Maiores escores da B-MRS foram observados em estudantes do sexo masculino (p=0,008) e não-brancos (p=0,002). Os escores da B-MRS para o domínio 'afirmação de diferenças' (representação daqueles que acreditam que brancos e não-brancos são diferentes) foram maiores entre estudantes de odontologia do sexo masculino (RP=1,138; IC 95%: 1,019- 1,271) e aqueles de famílias de baixa renda (RP=1,306; IC 95%: 1,089-1,565). Os escores do domínio 'negação do preconceito' (ideia de que os não-brancos usam sua raça para receber benefícios legais) foram maiores entre os participantes do sexo masculino (RP=1,328; IC 95%: 1,129-1,562). Conclusão Os estudantes homens, não-brancos, apresentavam indicadores de racismo mais elevados. Homens, provenientes de famílias de baixa renda, acreditavam que brancos e não-brancos são verdadeiramente diferentes, o que representa a afirmação da diferença entre o grupo desta amostra.

Stigma and discrimination in sexually diverse nursing students: a qualitative studys

Introduction: Sexually diverse nursing students often face situations of stigma and discrimination within the university environment, which can significantly affect their educational experience and well-being. Objective: To understand nursing students' experiences regarding stigma and discrimination due to their sexual orientation or gender identity during their academic training. Materials and Methods: A qualitative phenomenological approach was employed. Semi-structured interviews were conducted with eight nursing students who identify as part of the LGBTQIA+ community. The collected data were analyzed using thematic analysis with the assistance of ATLAS.ti software. Results: The participants were aged 20 to 22 years and were in their sixth to tenth academic semester. Data analysis identified three categories: stigma and discrimination, coping strategies, and university experience. Discussion: The university community, recipients of care, and workers at practicum sites display stigmatizing and discriminatory behaviors toward nursing students who are sexually diverse and break social paradigms of what is considered normal. Conclusion: Nursing students face stigma and discrimination based on their sexual orientation or gender identity during their academic training. To navigate these situations, they adopt coping strategies ranging from concealing their identity to reclaiming words insulting. The university is perceived as a safe space for expression and personal growth.

Introducción: Los estudiantes de enfermería sexualmente diversos a menudo enfrentan situaciones de estigma y discriminación dentro del ámbito universitario, lo que puede afectar significativamente su experiencia educativa y bienestar. Objetivo: Comprender la experiencia de estudiantes de enfermería frente al estigma y discriminación por su orientación sexual o su identidad de género en su formación académica. Materiales y Métodos: Se empleó un enfoque cualitativo fenomenológico. Se realizaron entrevistas semiestructuradas a ocho estudiantes de enfermería que se identifican como parte de la comunidad LGBTQIA+. Los datos recopilados fueron analizados mediante análisis temático utilizando el software ATLAS.ti. Resultados: Los participantes tenían edades comprendidas entre 20 y 22 años, y cursaban entre sexto y décimo semestre académico. El análisis de los datos permitió identificar tres categorías: estigma y discriminación, estrategias de afrontamiento y experiencia universitaria. Discusión: La comunidad universitaria, los sujetos de cuidado y los trabajadores de los sitios de prácticas formativas muestran conductas estigmatizantes y discriminatorias hacia aquellos estudiantes de enfermería sexualmente diversos que rompen con los paradigmas sociales de lo que se considera normal. Conclusión: Los estudiantes de enfermería enfrentan estigma y discriminación por su orientación sexual o identidad de género en su formación académica. Para manejar estas situaciones, emplean estrategias de afrontamiento que abarcan desde el ocultamiento de su identidad hasta la reapropiación de insultos. La universidad se presenta como un espacio seguro para la expresión y crecimiento personal.

Introdução: Os estudantes de enfermagem com diversidade sexual frequentemente enfrentam situações de estigma e discriminação no ambiente universitário, o que pode afetar significativamente sua experiência educacional e seu bem-estar. Objetivo: compreender a experiência de estigma e discriminação dos estudantes de enfermagem com base em sua orientação sexual ou identidade de gênero em sua formação acadêmica. Materiais e Métodos: Foi realizado um estudo de desenho qualitativo fenomenológico. Foram realizadas entrevistas semiestruturadas com oito estudantes de enfermagem que se identificam como parte da comunidade LGBTQIA+. Os dados coletados foram analisados por análise temática usando o software ATLAS.ti. Resultados: A idade dos participantes variou de 20 a 22 anos e eles estavam no sexto ao décimo semestre acadêmico. A análise dos dados identificou três categorias: estigma e discriminação, estratégias de enfrentamento e experiência universitária. Discussão: A comunidade universitária, os sujeitos do cuidado e os trabalhadores nos locais de prática de treinamento demonstram comportamentos estigmatizantes e discriminatórios em relação a estudantes de enfermagem sexualmente diversos que rompem com os paradigmas sociais do que é considerado normal. Conclusão: Os estudantes de enfermagem enfrentam estigma e discriminação com base em sua orientação sexual ou identidade de gênero em seu treinamento acadêmico. Para lidar com essas situações, eles empregam estratégias de enfrentamento que vão desde esconder sua identidade até se reapropriar de insultos. A universidade é apresentada como um espaço seguro para a autoexpressão e o crescimento pessoal.

Determining Sex from Thai Radius: Discriminant Function Analysis Including the Dry Bone Weight as an Effective Variant / Determinación del Sexo a Partir del Radio Tailandés: Análisis de Función Discriminante que Incluye el Peso del Hueso Seco como Variante Eficaz

SUMMARY: In forensic anthropology, the radius bone has been shown to determine the sex of human remains in a number of different populations. The dry mass and growth of long bones, including the radius, are associated with sex hormone levels; however, the use of bone weight to determine sex has not been sufficiently investigated. The aim of this study was to apply bone morphometric parameters, including maximum length of radius (MLR), circumference at the midshaft of radius (CMR), and weight of radius (WR), to 400 sample radii from a Northeastern Thai population. Univariate and multivariate discriminant functions of all parameters were systemically applied. Equations for calculating sex classification were also determined. Descriptive data analysis showed significant sexual dimorphism in all variables (p < 0.05). The canonical correlation was highest in CMR (0.772) and the ratio of weight to length (0.747). Multivariate discriminant function analysis showed that the measured indices of the right radius were slightly greater than those of the left radius. The parameters demonstrating the highest values of the standardized canonical discriminant function coefficients were CMR (Rt. = 0.496, Lt. 0.431) and WR (Rt. = 0.681, Lt. = 0.715). Moreover, the results of the multivariable (stepwise method) indicated that the best accuracy rates for using combinations of CMR and WR were 94 % (right side) and 92 % (left side). In conclusion, the weight of the radius (rather than the length) is an effective parameter in determining sex.

En antropología forense, se ha demostrado que el hueso radio determina el sexo de los restos humanos en varias poblaciones diferentes. La masa seca y el crecimiento de los huesos largos, incluido el radio, están asociados con los niveles de hormonas sexuales; sin embargo, el uso del peso de los huesos para determinar el sexo no se ha investigado suficientemente. El objetivo de este estudio fue aplicar parámetros morfométricos óseos, incluida la longitud máxima del radio (LMR), la circunferencia en la mitad del radio (CMR) y el peso del radio (PR), a 400 radios de muestra de una población del noreste de Tailandia. Se aplicaron sistémicamente funciones discriminantes univariadas y multivariadas de todos los parámetros. También se determinaron ecuaciones para calcular la clasificación por sexo. El análisis descriptivo de los datos mostró un dimorfismo sexual significativo en todas las variables (p < 0,05). La correlación canónica fue mayor en CMR (0,772) y la relación peso-longitud (0,747). El análisis de función discriminante multivariante mostró que los índices del radio derecho eran ligeramente mayores que los del radio izquierdo. Los parámetros que demostraron los valores más altos de los coeficientes de la función discriminante canónica estandarizada fueron CMR (Rt. = 0,496, Lt. 0,431) y PR (Rt. = 0,681, Lt. = 0,715). Además, los resultados del método multivariable (método paso a paso) indicaron que las mejores tasas de precisión al usar combinaciones de CMR y PR fueron del 94 % (lado derecho) y del 92 % (lado izquierdo). En conclusión, el peso del radio (más que la longitud) es un parámetro eficaz para determinar el sexo.

Post-Validation of Multiple-Choice Questions in Microbiology

Background: Multiple Choice Questions (MCQs) are used to help understand the strengths and weaknesses of students and gaps in knowledge and provide feedback to teachers on their teaching methods. MCQs, therefore, should be valid and reliable. The statistical analysis of MCQs/items is done post-validation to check that they can adequately evaluate students' learning. Methods: A retrospective observational study of 72 solved MCQs was used for item analysis. Parameters that were analyzed included Difficulty Index (DIF), Discrimination index (DI) and Distracter effectiveness (DE). Results: Difficulty Index was 54.17% easy, 34.72% acceptable and 11.11% difficult. The Discriminatory Index (DI) calculation showed that 93.05% were poor, 3% acceptable, and 4.16% good. Among the MCQs with poor discrimination, there were 37.5% MCQs had negative discrimination, as low achievers answered these MCQs more than high achievers. The total number of distractors analyzed was 216 and the number of Non-Functional Distractors was 75 (NFD, those selected by < 5% of students), and functional distractors (FD) were 141(those chosen by >5% of students). Conclusion: An MCQ is ideal when it satisfies all three criteria, such as acceptable DIF 30-70 and acceptable DI 0.21-0.35, and has three functional distractors. In our study, only one MCQ satisfied acceptable DIF, DI and had three functional distractors.

Discrimination and Access to Healthcare for People with Disabilities: An Integrative Literature Review / Discriminación y acceso a la salud de personas con discapacidad: una revisión integradora de la literatura / Discriminação e acesso à saúde de pessoas com deficiência: uma revisão integrativa da literatura

Abstract Introduction: People with disabilities face many challenges on a daily basis. Despite legislative advances and inclusion policies, discrimination against people with disabilities persists in various areas of life, including access to health services. Aim: This study aims to conduct an integrative literature review to investigate the factors associated with - discrimination faced by people with disabilities in health services. Materials and Methods: The search was conducted in February 2024 in the IBECS, Lilacs, BDEnf, Medline (PubMed), Scopus, and Web of Science databases. The health descriptors (DeCS) "people with disabilities," "social discrimination," and "health services" were used. Original % articles available in full, from the last five years, and in any language % were included. The exclusion criteria were duplicate articles and those that did not answer the guiding question. Results: A total of 162 records were identified, from which 17 studies were selected, resulting in a final sample of 10 articles. The main factors associated with the discriminatory experiences faced by people with disabilities when accessing and using the health system were "stigmatization," "negligence," "prejudice,"and "access difficulties." Conclusions: Significant drivers of discrimination were identified, including financial barriers, lack of training for health professionals, and other gaps that generate prejudice, stigmatization, and neglect. It is essential to implement public policies to ensure service accessibility, provide financial assistance for people with disabilities, establish training programs for health professionals, and conduct more research on this subject.

Resumen Introducción: Las personas con discapacidad se enfrentan a numerosos retos cotidianos. A pesar de los avances legislativos y las políticas de inclusión, la discriminación de las personas con discapacidad persiste en diversos ámbitos de la vida, incluido el acceso a los servicios de salud. Objetivo: Realizar una revisión integradora de la literatura para investigar los factores asociados a la discriminación que sufren las personas con discapacidad en los servicios de salud. Materiales y método: La búsqueda se realizó en febrero de 2024, en las bases de datos IBECS, Lilacs, BDEnf, Medine (Pub-Med), Scopus y Web of Science; se utilizaron los descriptores de salud (DeCS) "personas con discapacidad", "discriminación social" y "servicios de salud". Se incluyeron artículos originales, disponibles en su totalidad, de los últimos cinco años y en cualquier idioma. En cuanto a los criterios de exclusión, se optó por excluir los artículos duplicados y los que no respondían a la pregunta orientadora. Resultados: Se identificaron 162 registros, de los cuales se seleccionaron 17 estudios y, al final, la muestra totalizó 10 hallazgos. De estos hallazgos, los principales factores asociados a la experiencia discriminatoria a la que se enfrentan las personas con discapacidad a la hora de acceder y utilizar el sistema de salud fueron la "estigmatización", la "negligencia", los "prejuicios" y las "dificultades de acceso". Conclusiones: Se encontraron algunos factores de discriminación significativos, como las barreras financieras, la falta de formación de los profesionales de la salud y otras brechas que generan prejuicios, estigmatización y negligencia. Por lo tanto, es fundamental contar con políticas públicas que garanticen la accesibilidad de los servicios, ayudas económicas para los pacientes con discapacidad, programas de formación para los profesionales de la salud y más investigación sobre este tema.

Resumo Introdução: As pessoas com deficiência enfrentam vários desafios diários. Apesar dos avanços legislativos e das políticas de inclusão, a discriminação contra pessoas com deficiência persiste em diversas áreas da vida, incluindo o acesso aos serviços de saúde. Objetivo: Realizar uma revisão integrativa da literatura para investigar quais os fatores associados à discriminação sofrida por pessoas com deficiência nos serviços de saúde. Materiais e método: A busca ocorreu em fevereiro de 2024, nas bases de dados IBECS, Lilacs, BDEnf, Medine (PubMed), Scopus e Web of Science; foram usados os descritores em saúde (DeCS) "pessoas com deficiência", "discriminação social" e "serviços de saúde". Foram incluídos artigos originais, disponíveis na íntegra, dos últimos cinco anos e em qualquer idioma. Quanto aos critérios de exclusão, optou-se por excluir artigos duplicados e que não respondiam à questão norteadora. Resultados: Foram identificados 162 registros, dos quais foram selecionados 17 estudos e, ao final, a amostra totalizou em 10 achados. Desses achados, os principais fatores associados à experiência discriminatória enfrentada por pessoas com deficiência ao acessar e utilizar o sistema de saúde foram "estigmatização", "negligência", "preconceito" e "dificuldades de acesso". Conclusões: Alguns impulsionadores significativos da discriminação foram encontrados como barreiras financeiras, falta de treinamento dos profissionais de saúde e demais lacunas geradoras de preconceito, estigmatização e negligência. Portanto, é fundamental que se tenham políticas públicas para garantir a acessibilidade dos serviços, assistência financeira aos pacientes com deficiência, programas de capacitação para profissionais de saúde e mais pesquisas nessa temática.

Item analysis of multiple-choice questions in pharmacology among medical undergraduates

Background: Assessment plays an essential role in the evaluation of learning, and multiple-choice questions (MCQs) are one of the components of examinations. Item analysis enables identifying good MCQs based on difficulty index (DIF I), discrimination index (DI), and distractor effectiveness (DE). The assessment of learning will be more meaningful with routine item analysis. Aims and Objectives: The item analysis helps us to assess the validity and reliability of MCQs and to generate a valid MCQ question bank for future use. Materials and Methods: A set of 30 single best response type MCQs or items was used for assessment in 155 phase II MBBS students at a medical college in Mangalore. Each item was pre-validated before and later analyzed for its DIF I, DI, and DE. Results: In the study, the means of DIF I were 55.91 ± 18.48%, DI, was 0.35 ± 0.16%, and distractor efficiency was 72.19 ± 29.15%. Out of 30 items, 22 had a “good to acceptable” level of DIF I, and 18 items had “good to excellent” discrimination power. 81% were functional distractors among 120 distractors. A correlation r = 0.1968 indicates a positive correlation between DIF I and DI. Conclusion: The majority of the MCQs in this study fell within the acceptable range when measured against the three factors analyzed. This suggests that the key to developing valid and reliable MCQs is possible only when regular item analysis is done for all MCQ-based tests.

Item analysis of multiple-choice questions in summative assessment for professional examination I of an outcome-based integrated MBBS curriculum

Background: This study presents an item analysis of multiple-choice questions (MCQ-Type A) used in the summative assessment for Professional Examination I at Defence Services Medical Academy, Yangon, Myanmar. The objectives of the study were to perform item analysis using Difficulty Index (DIF I) and Discrimination Index (DI) and to correlate between DIF I and DI. Methods: A cross-sectional observational study was conducted with 200 multiple-choice questions from two written examination papers answered by 46 medical year 2 students of Defence Services Medical Academy, Yangon, Myanmar. Item analysis of multiple-choice questions were done by using DIF I and DI calculated post-exam. Results: Results showed that the majority of items were categorized as easy based on DIF I, with 63% and 60% in Papers I and II, respectively. Only about one-third of items were deemed acceptable, and few fell into the difficult category. DI ranged from negative to excellent, with 62% and 61% of MCQs in Papers I and II showing acceptable to excellent discrimination. Items with poor discrimination (35% and 34% in Papers I and II) should be revised or discarded. Moreover, items with negative DI should be re-evaluated for potential key errors or vague wording. A low negative correlation between DIF I and DI was observed, indicating that as DIF I increased, discrimination power decreased. Notably, items with easy DIF I demonstrated a moderate negative correlation with DI, consistent with previous research. Conclusions: This study underscores the importance of item analysis to enhance the validity of assessment tools and ensure the effective evaluation of student cognition levels. Consequently, reconstruction and modification of MCQs are recommended to improve assessment quality and accurately measure student abilities.

Consideraciones metodológicas en el estudio de la discriminación laboral percibida y su asociación con la salud de los trabajadores y resultados ocupacionales: revisión panorámica / Methodological considerations in the study of perceived discrimination at work and its association with workers health and occupational outcomes: a scoping review

INTRODUCCIÓN: La discriminación laboral percibida es un fenómeno complejo que implica un trato injusto en el lugar de trabajo, basado en características personales como edad, etnia, género o discapacidad. El objetivo de este estudio es explorar cómo ha sido investigada la discriminación laboral percibida, en el contexto de investigaciones acerca de su asociación con salud y resultados ocupacionales. MÉTODOS: Siguiendo la guía PRISMA-ScR y la metodología del Instituto Joanna Briggs, se realizó una revisión panorámica de artículos publicados entre los años 2000 y 2022 en bases de datos como PubMed, Scopus y PsycInfo. Los criterios de inclusión se centraron en estudios que exploraron la discriminación laboral percibida en trabajadores, excluyendo aquellos en pacientes, estudiantes o población general, y artículos no escritos en inglés o español. RESULTADOS: De los 9871 artículos identificados, 102 cumplieron con los criterios y fueron analizados. La investigación mostró un aumento progresivo en el estudio de la discriminación laboral percibida, con una mayoría de estudios en América del Norte y Europa y un predominio de diseños transversales. La mayoría no definió claramente el concepto de discriminación laboral percibida ni reportó las características psicométricas de los instrumentos de medición. Se encontró una asociación significativa entre la discriminación percibida y resultados negativos en la salud mental y física de los trabajadores, así como un impacto negativo en la satisfacción laboral y un aumento en el ausentismo. Además, las características sociodemográficas como raza/etnia, género y edad influyeron en la percepción de discriminación. CONCLUSIONES: Esta revisión confirma que la discriminación laboral percibida impacta considerablemente la salud y satisfacción laboral de los trabajadores, afectando más a minorías y mujeres. A pesar de un incremento en su investigación en las últimas dos décadas, persiste una carencia de consistencia en la definición y medición del fenómeno. La mayoría de los estudios han utilizado diseños transversales, y se observa una notable ausencia de investigaciones en el contexto latinoamericano.

INTRODUCTION: Perceived workplace discrimination is a complex phenomenon involving unfair treatment in the workplace based on personal characteristics such as age, ethnicity, gender, or disability. The objective of this study is to explore the association of perceived workplace discrimination with health and occupational outcomes. METHODS: Following the PRISMA-ScR guidelines and the Joanna Briggs Institute methodology, a scoping review of articles published between 2000 and 2022 was conducted in databases such as Pubmed, Scopus, and PsyInfo. Inclusion criteria focused on studies exploring perceived workplace discrimination among workers, excluding those on patients, students, or the general population, and articles not written in English or Spanish. RESULTS: Of the 9,871 articles identified, 102 met the criteria and were analyzed. Research showed a progressive increase in the study of perceived workplace discrimination, with a majority of studies in North America and Europe and a predominance of cross-sectional designs. Most studies did not clearly define the concept of perceived workplace discrimination nor report the psychometric characteristics of the measurement instruments. A significant association was found between perceived discrimination and negative outcomes in workers' mental and physical health, as well as a negative impact on job satisfaction and an increase in absenteeism. Additionally, sociodemographic characteristics such as race/ethnicity, gender, and age influenced the perception of discrimination. CONCLUSIONS: This review confirms that perceived workplace discrimination significantly impacts the health and job satisfaction of workers, with particular detriment in minorities and women. Despite an increase in research over the last two decades, there remains a lack of consistency in the definition and measurement of the phenomenon. Most studies have used cross-sectional designs, and there is a notable absence of research in the Latin American context.

Prevalence of psychoactive substance use in men who have sexual relationships with men, Colombia

Introduction: The use of psychoactive substances (PS) in the population is a current problem that affects a large part of humanity, with diverse consequences. Objective: To analyze the factors associated with the consumption of PS among men who have sex with other men (MSM) in three Colombian cities. Material and Methods: This cross-sectional descriptive study used the respondent-driven sampling (RDS) method and obtained a sample of 1301 MSM. The association between the sociodemographic and personal characteristics and the consumption of PS was assessed using the chi-square test. Prevalence ratios were calculated along with their 95% confidence intervals. For the multivariate analysis, a Poisson regression with a log link and robust estimator was employed to explore the factors associated with PS use. Result: The prevalence of consumption of PS in the last year was 87%, prevailing the consumption of alcohol, marijuana, and poppers. Having occasional partners (PR: 0.44; 95% CI 0.29 ­ 0.67), attending public places or establishments such as bars and saunas (PR: 3.39; 95% CI 2.34  4.91), sex work, and not using a condom in the last sexual encounter (PR: 2.10 95% CI 1.37 3.22) are factors associated with the use of these substances. Discussion: There is evidence of a high prevalence of recreational use of PS, even higher than that found in the general population. Conclusion: A high prevalence and association with risky sexual behaviors is confirmed, which requires promotion and prevention actions to reduce the use of these substances.

Introducción: El uso de sustancias psicoactivas en la población es un problema actual, que afecta a una gran parte de la humanidad, con diversas consecuencias. Objetivo: Analizar los factores asociados al consumo de sustancias psicoactivas en hombres que tienen sexo con otros hombres (HSH) en tres ciudades de Colombia. Materiales y Métodos: Este estudio descriptivo transversal utilizó el método de muestreo respondent-driven sampling y logró una muestra de 1301 HSH. Se evaluó la asociación entre las características sociodemográficas y personales y el consumo de sustancias psicoactivas mediante la prueba chi-cuadrado. Las razones de prevalencia se calcularon con sus intervalos de confianza del 95%. En el análisis multivariado, se empleó una regresión de Poisson con enlace logarítmico y estimador robusto, para explorar los factores asociados con el uso de sustancias psicoactivas. Resultados: La prevalencia de consumo de sustancias psicoactivas en el último año fue del 87%, predominando el consumo de alcohol, marihuana y poppers. Tener parejas ocasionales (RP: 0,44; IC 95% 0,29­0,67), asistir a lugares públicos o establecimientos como bares y saunas (RP: 3,39; IC 95% 2,344,91), el trabajo sexual y no usar condón en la última relación sexual (RP: 2,10; IC 95%: 1,373,22) son factores asociados con el consumo de estas sustancias. Discusión: Se evidencia una alta prevalencia de consumo recreativo de sustancias psicoactivas, incluso superior a la encontrada en población general. Conclusión: Se confirma una alta prevalencia y asociación con conductas sexuales de riesgo, lo que requiere acciones de promoción y prevención para reducir el uso de estas sustancias.

Introdução: O uso de substâncias psicoativas pela população é um problema atual que atinge grande parte da humanidade, com diversas consequências. Objetivo: Analisar os fatores associados ao uso de substâncias psicoativas em homens que fazem sexo com homens (HSH) em três cidades da Colômbia. Materiais e Métodos: Esse estudo descritivo transversal usou o método de amostras respondent-driven sampling e obteve uma amostra de 1301 HSH. A associação entre as características sociodemográficas e pessoais e o uso de substâncias psicoativas foi avaliada por meio do teste do qui-quadrado. As razões de prevalência foram obtidas com seus intervalos de confiança de 95%. Na análise multivariada, foram construídos regressão de Poisson, log link e estimador robusto para explorar os fatores associados ao uso de substâncias psicoativas. Resultado: A prevalência de consumo de substâncias psicoativas no último ano foi de 87%, prevalecendo o consumo de álcool, maconha e poppers. Ter parceiros ocasionais (RP: 0,44; IC 95% 0,29 ­ 0,67), frequentar locais e locais públicos como bares e saunas (RP: 3,39; IC 95% 2,34-4,91), trabalho sexual e não usar camisinha na última relação sexual (RP: 2,10 IC 95% 1,37-3,22) são fatores associados ao consumo dessas substâncias. Discussão: Existem evidências de elevada prevalência de uso recreativo de substâncias psicoativas, ainda maior do que as encontradas na população em geral. Conclusão: Confirma-se uma elevada prevalência e associação com comportamentos sexuais de risco, o que requer ações de promoção e prevenção para reduzir o uso destas substâncias.

The Intersection of LGBTQ+ Mental Health and the Rise of Same-Sex Marriage: Understanding Current Trends and Implications forLGBTQ+Rights and Societ

The mental health of LGBTQ+ individuals is often marred by societal stigma and discrimination. However, recent strides in LGBTQ+ rights, particularly the legalization of same-sex marriage, present promising prospects.This article examines the intersection of LGBTQ+ mental health and same-sex marriage, emphasizing the positive effects on well-being.Legal recognition of same-sex marriage is associated with improved mental health outcomes, including reduced rates of depression and anxiety, heightened social support, and enhanced self-esteem. Moreover, it fosters societal acceptance, diminishes internalized stigma, and promotes positive parenting experiences within LGBTQ+ families.Additionally ,same-sex marriage yields economic advantages, such as financial stability and increased workplace productivity among LGBTQ+ individuals. Despite these advancements, disparities persist, with many countries yet to legalize same-se x marriage and LGBTQ+ individuals facing ongoing discrimination.Continuous advocacy efforts are vital to ensure equal rights and protections for the LGBTQ+ community globall.

Estigmatización por peso en estudiantes universitarios chilenos

Antecedentes: El aumento de la obesidad ha llevado a una mayor estigmatización, con impactos en la salud psicológica y social de las víctimas. La estigmatización por peso puede expresarse en las creencias respecto al control de la obesidad. Escasos estudios han explorado el rol de la victimización por peso corporal y las creencias hacia otras personas con obesidad. Objetivo: Analizar la asociación entre la victimización por peso corporal y características de estudiantes universitarios, en relación con las creencias hacia personas con obesidad. Métodos: Estudio transversal con 281 estudiantes de Santiago, Chile. Los participantes completaron un cuestionario online con la escala Beliefs about Obese Persons Scale (BAOP), preguntas sobre discriminación por su peso corporal, y características personales. La escala BAOP fue validada mediante entrevistas cognitivas (N=8) y análisis de consistencia interna (α-Cronbach=0,814). Los resultados se analizaron con las pruebas U Mann-Whitney, Kruskal-Wallis y Chi-cuadrado. Resultados: La mayoría de los estudiantes creían que la obesidad es controlable por las personas que la padecen, pero aquellos que reportaron victimización por peso en lugares como el hogar y la universidad presentaron menores creencias sobre la controlabilidad de la obesidad (p<0,05). No se reportaron diferencias en las creencias hacia personas con obesidad según características personales, exceptuando entre los hombres de distinta cohorte de estudios. Conclusión: Este estudio indica que las víctimas de estigmatización de peso tienden a presentar menores creencias respecto a la controlabilidad de la obesidad. Futuras intervenciones debiesen incorporar estrategias para reducir los sesgos de peso entre estudiantes universitarios en formación.

Background: The rise in obesity prevalence has led to increased weight stigmatization, impacting the psychological and social health of those affected. Weight stigma can manifest in beliefs regarding individuals' control over their obesity. Few studies have explored the role of weight-based victimization and beliefs towards individuals with obesity. Objective: To analyze the association between weight-based victimization and university students' characteristics, with beliefs toward individuals with obesity. Methods: Cross-sectional study involving 281 students in Santiago, Chile. Participants completed an online questionnaire including the Beliefs about Obese Persons Scale (BAOP), questions about weight-based discrimination, and personal characteristics. The BAOP scale was validated through cognitive interviews (N=8) and internal consistency analysis (α-Cronbach=0,814). Results were analyzed using U Mann-Whitney, Kruskal-Wallis, and Chi-square tests. Results: Most students believed that obesity is controllable by those affected, but those who reported weight-based victimization in places such as home and university exhibited lower beliefs about the controllability of obesity (p<0,05). No differences in beliefs towards individuals with obesity were reported based on personal characteristics, except among male students in different study cohorts. Conclusion: This study identifies that victims of weight bias tend to exhibit lower beliefs regarding the controllability of obesity. Future interventions should incorporate strategies to reduce weight biases among university students in training.

Social stigma towards people with HIV/AIDS, in dentistry students from Concepción

Objective: Characterize HIV/AIDS Social stigma towards people with HIV/AIDS in a sample of dentistry students from Concepción. Materials and methods: Cultural adaptation and pre-test were developed for the Stigma and HIV/AIDS Scale in dental students. Researchers collected the data from the instrument, demographic (sex/age), and academic information (course/training in HIV/AIDS, knowing a person with HIV/AIDS, provision of dental services to people living with HIV/AIDS [PLHIV]). To characterize the sample, univariate and bivariate descriptive statistics were performed with absolute and relative frequencies; the reliability of the scale was assessed with Cronbach's alpha; the relationship between the quantitative and ordinal variables was analyzed with the Spearman correlation coefficient. Results: The final sample comprised 138 dental students, whereas most of them reported not having training in HIV/AIDS nor providing dental services to PLHIV. Stigma and HIV/AIDS Scale showed good reliability. Two items expressing that PLHIV must disclose their condition to health professionals so they can take precautions have the highest values. A weak inverse correlation was found between Stigma and the variables age and course. Conclusions: Dental school students from Universidad of Concepción have a low social stigma towards people with HIV/AIDS. Items regarding professional practice showed higher stigma levels.

Quantification and classification of fatty acids in marine fish oil from Southeast Sulawesi using gas chromatography and chemometrics

Marine fish oils contain various fatty acids (FAs) which are important for human health. Due to the variation of species and origins, the FA compositions were truly affected. This research aimed to quantify FAs of fish oils from various Epinephelus sp. and Lutjanus sp. obtained from different locations around Southeast Sulawesi coast Indonesia using gas chromatography with flame ionization detector and to create classification models using chemometrics techniques. Different locations affected the amounts of FAs from each type of fish oil. The FA composition of fish oil consisted of 45%–61% saturated FAs, 19.16%–39.30% monosaturated FAs, and 11.51%–30.20% polyunsaturated FAs. Supervised pattern recognition chemometrics such as partial least square-discriminant analysis (PLS-DA), sparse PLS-DA, and orthogonal PLS-DA could be used for the classification of fish oils extracted from Epinephelus sp. and Lutjanus sp. FAs of tricosanoate (C23:0), trans-9-elaidate (C18:1t), linolelaidate (C18:2t), cis-11,14,17- eicosatrienoate (C20:3), palmitate (C16:0), stearate (C18:0), cis-9 oleate (C18:1), and myristate (C14:0) were considered for their significant contributions in discriminating Epinephelus fish oils and Lutjanus fish oils (variable importance in projection score > 1). Heatmap analysis showed that the distribution of each FA in all fish oil samples. This study could be very useful for the authentication and quality control of fish oils based on their FA compositions and classification analysis using chemometrics.

Challenges and Reflections of Black Nurses in Mental Health: Navigating between Colonialist and Decolonial/Ancestral Paradigms

Introduction: Racism is considered to permeate the lives of the black population, with black nurses standing out in this context, across different stages of life, causing illness of all kinds, including mental illness. Objectives: Thus, this article aimed to understand the academic and professional experiences of black nurses working in mental health and how they perceive their care from the ancestral decolonial perspective. Methods: It was a sociopoetic qualitative study, conducted with nine black nurses working in mental health in the state of Rio de Janeiro in May 2023, with data produced in a meeting through collective construction on decolonial care, where after transcription of the audios, they were categorized with the support of MAXQDA software (2022), and the research was submitted to the Research Ethics Committee (REC) with CAAE–48959421.1.3001.5279 and approved with opinion n: 5.555.653. Results: The statements of the black nurses who participated in the sociopoetic experimentation resulted in three categories: 1) Racism as a barrier to access in academic training, 2) The experience of being a black nurse in everyday work, and 3) Decolonial/ancestral care as resistance. Discussion: Certainly, nursing education needs to be reorganized; since its inception, its theoretical-practical reading has been based solely on a single worldview, or rather, focused on caring for a single reference of "human being". Hence the need to rethink and incorporate multicultural concepts and care practices that can overcome all structures that sustain racism in contemporary society. Conclusions: Phenotypic prejudice, in addition to preventing different people from ensuring the right to access and opportunities, leads numerous professionals to suffer physically and mentally or to give up their careers. Nursing and mental health need to be prepared for current and future challenges in a world that is becoming more diverse every day. Finally, it is important for other studies to address this issue until racism is eradicated from society and especially from nursing.

Eloísa Díaz en el Primer Congreso Latinoamericano de Medicina, Santiago 1901 / Eloísa Díaz in the First Latin American Congress of Medicine, Santiago 1901

Revisando el segundo volumen de actas del Primer Congreso Latinoamericano de Medicina, reunido en Santiago los nueve primeros días del siglo XX, encontramos una conferencia de Eloísa Díaz, primera mujer chilena y latinoamericana en graduarse de médico, pese a la discriminación sufrida, que la obligó incluso a asistir a clases acompañada por su madre. Se analiza tanto esta conferencia sobre la organización del servicio médico escolar, como la introducción a su tesis de grado, y de paso las presentaciones de otros médicos participantes, haciendo hincapié en la patología infecciosa discutida y en su lenguaje verboso y florido.

Analyzing the second volume of proceedings of the First Latin American Congress of Medicine held in Santiago on the first nine days of the twentieth century, we found a lecture by Eloísa Díaz, the first Chilean and Latin American woman to graduate as a doctor, despite the discrimination she suffered, which even forced her to attend classes accompanied by her mother. This conference on the school medical service is analyzed, as well as the introduction to her degree thesis, and incidentally the presentations of other participating doctors, emphasizing the infectious pathology discussed and its verbose and flowery language.

Banco de empréstimo de instrumentais da Faculdade de Odontologia da FO-UFRGS: política afirmativa de permanência estudantil / Banco de préstamos de instrumentos FO-UFRGS: política afirmativa de retención de estudiantes / FO-UFRGS dental instrument loan bank: an affirmative policy for student permanence

Os bancos de instrumentais surgem como uma ação afirmativa de permanência estudantil importante para a formação em Odontologia. O objetivo deste artigo é descrever o processo de construção do banco de empréstimo de instrumentais (BEI) da Faculdade de Odontologia da Universidade Federal do Rio Grande do Sul (FO-UFRGS) e relatar as estratégias para o enfrentamento das desigualdades sociais durante a formação em Odontologia. A ideia do BEI surgiu em 2021, por um grupo de estudantes após uma discussão sobre desigualdades sociais durante uma aula remota, num contexto de retomada das atividades práticas com o abrandamento da pandemia de COVID-19. Em 2022 teve sua efetivação com seus primeiros empréstimos realizados. A gestão é feita por estudantes e seu acervo adquirido mediante doações. Atualmente o BEI possui um acervo de 8.630 instrumentais e1.601 materiais de consumo, tendo emprestado 3.000 itens para 109 estudantes, em 171 solicitações em quatro semestres letivos. Para além do empréstimo de instrumentais, o BEI tem desenvolvido outras ações que impactam positivamente a vida acadêmica dos estudantes. O banco tem sido um espaço de acolhida, uma vez que estimula a organização dos estudantes para trocas entre si, formando uma rede de solidariedade.Também tem participado do grupo de trabalho de revisão das listas de instrumentais, estimulando sua redução para tornar a Odontologia mais acessível e justa, permitindo que estudantes de diferentes origens possam ter a oportunidade de seguir suas carreiras acadêmicas e profissionais. O BEI se consolidou como uma potencialferramenta para democratização da formação em Odontologia na FO-UFRGS e redução das desigualdades (AU).

Los bancos de instrumentos aparecen como acciones afirmativas para la retención de estudiantes, importantes para la formación en Odontología. El objetivo de este artículo es describir el proceso de construcción del Banco de Préstamo de Instrumentos (BPI) en la Facultad de Odontología de la Universidad Federal de Rio Grande do Sul (FO-UFRGS) y reportar las estrategias para enfrentar las desigualdades sociales durante la formación en Odontología. La idea del BPI surgió en 2021, de un grupo de estudiantes después de una discusión sobre las desigualdades sociales durante una clase remota, en un contexto de reanudación de las actividades prácticas con el alivio de la pandemia de COVID-19. En 2022 se hizo efectivo con sus primeros préstamos realizados. Está gestionado por estudiantes y su colección se adquiere mediante donaciones. Actualmente, el BPI dispone de una colección de 8.630 instrumentos y 1.601 consumibles, y ha prestado 3.000artículos a 109 estudiantes, en 171 solicitudes a lo largo de cuatro semestres académicos. Además del préstamo de instrumentos, el BPI ha desarrollado otras acciones que impactan positivamente en la vida académica de los estudiantes. El banco ha sido un espacio acogedor, ya que incentiva a los estudiantes a organizar intercambios entre ellos, formando una red de solidaridad. También ha participado en el grupo de trabajo para revisar las listas de instrumentos, fomentando su reducción para hacer la Odontología más accesible y justa, permitiendo a estudiantes de diferentes procedencias tener la oportunidad de desarrollar su carrera académica y profesional. El BPI se ha consolidado como una herramienta potencial para democratizar la formación en Odontología en la FO-UFRGS y reducir las desigualdades (AU).

Dental instrument banks have emerged as an important affirmative action for student permanence in Dentistry course. This article aims to describe the building process of the dental instrument loan bank (BEI, for its acronym in Portuguese) at the School of Dentistry of the Federal University of Rio Grande do Sul (FO-UFRGS) and to report on the strategies for tackling social inequalities during dental course. The BEI idea was born in 2021 by a students' group after discussing social inequalities during a remote class in the context of resuming practical activities with the easing of the COVID-19 pandemic. In 2022, the first loans were made. Students manage it, and its collection is acquired through donations. The BEI currently has a collection of 8,630 instruments and 1,601 consumables, having lent 3,000 items to 109 students in 171 requests over four academic semesters. In addition to instrument loans, the BEI has developed other initiatives that positively impact students' educational lives. The bank has been a welcoming space, as it encourages students to organize exchanges between themselves, forming a solidarity network.It has also participated in the working group reviewing the lists of instruments, encouraging their reduction to make Dentistry more accessible and fairer, allowing students from different backgrounds to have the opportunity to pursue their academic and professional careers. The BEI has established itself as a potential tool for democratizing Dentistry education at FO-UFRGS and reducing inequalities (AU).

Measurement and evaluation of proprioception of foot and ankle complexes / 中国组织工程研究

BACKGROUND:Research on foot and ankle proprioception is crucial for the rehabilitation of chronic ankle instability and geriatric diseases as well as for the improvement of body posture control and motor performance.Previous studies have often studied the sensory evaluation of the foot and ankle joints separately,which has limitations for a comprehensive understanding of their sensory function. OBJECTIVE:The foot and ankle complex is the only part in direct contact with the support surface,and plays an important role in the collective sensory feedback and regulation and balance control.By combing the existing investigation and research of foot and ankle ontology,the measurement and evaluation methods of the sensation of the foot and ankle complex are combed,in order to pave the way and provide the theoretical basis for future related studies. METHODS:Chinese terms"(foot OR foot ankle OR ankle)AND(sensation OR proprioception)"and English terms"(foot OR ankle)AND(feel OR proprioception)"were used as the keywords for retrieving relevant literature in the Web of Science,PubMed,and CNKI.We understood the basic concepts,current status and scope of research on the foot and ankle,summarized and evaluated the proprioceptive evaluation methods of the foot and ankle,and finally included 57 papers for further review. RESULTS AND CONCLUSION:The evaluation of foot and ankle complex sensation was mainly divided into sensory evaluation of the foot and proprioceptive evaluation of the ankle joint.The sensory evaluation of the foot mainly describes the sensation of the skin and the sensory feedback under the intervention conditions.The methods mainly include the pressure sensory threshold test,the two-point discrimination test of the foot(planar and plantar),and the duration test of skin vibration sensation.Ankle joint proprioception evaluation focuses on the description of joint position,motion range,force value and functional performance.The methods are mainly divided into static joint angle reset test,motion minimum threshold test,force perception reproduction test and dynamic balance,speed and walking ability tests.The report of quantitative results is generally expressed by"an error,"which is generally divided into absolute error,relative error,constant error,etc.To conclude,the foot and ankle complex has specific sensory capabilities,including foot sensation and ankle proprioception,which affect the quality of life and athletic performance of humans.Weakness of both foot sensation and ankle proprioception is associated with reduced human balance,and the combined measurements of the two can comprehensively and effectively evaluate foot and ankle function.The combination of foot and ankle sensory measures is selected according to different research needs and various influencing factors such as environment,emotion and reporting style are fully considered,to improve the validity of measurement and evaluation.

A study on reducing nonfunctional distractors of multiple-choice questions in medical examination / 中华医学教育探索杂志

Objective:To discuss the possibility of modifying nonfunctional distractors to improve the quality of multiple-choice questions in medical examination through analyzing the changes in the difficulty and discrimination of items and the selection rate of modified distractors.Methods:Thirty-two multiple-choice questions involving nonfunctional distractors from a medical examination were studied. According to the item-writing guidelines, experts modified nonfunctional distractors based on actual measurements. We analyzed the changes in the difficulty and discrimination of items and the selection rate of modified distractors before and after item modification using the paired Wilcoxon test, and investigated the correlation of item difficulty and discrimination before and after item modification by Spearman's rank correlation analysis.Results:Six questions were modified due to technical factors, and 26 questions were modified due to weak interference in knowledge content. Before and after nonfunctional distractor modification, the difficulty values of the questions were 0.676 (0.558, 0.893) and 0.637 (0.531, 0.839), respectively; the discrimination values (point-biserial correlation) were 0.261 (0.150, 0.316) and 0.262 (0.138, 0.358), respectively; and the discrimination index values were 0.215 (0.113, 0.352) and 0.259 (0.138, 0.346), respectively. There were significant differences in the difficulty and discrimination index of items before and after modification. The difficulty and discrimination of items before and after modification were both significantly correlated. The selection rates of modified distractors were 0.009 (0.003, 0.015) and 0.044 (0.021, 0.092) before and after modification, respectively, which were significantly different.Conclusions:Nonfunctional distractors in this study were mainly caused by reasons in the contents of the test questions, less in technical defects. Through the analysis and modification of nonfunctional distractors, the selection rate of nonfunctional distractors can be effectively increased, and item difficulty and discrimination can be improved.