Effect of sugammadex versus neostigmine/atropine combination on postoperative cognitive dysfunction after elective surgery.

This study aimed to assess the effects of sugammadex and neostigmine/atropine on postoperative cognitive dysfunction (POCD) in adult patients after elective surgery. A randomised, double-blind controlled trial was carried out on 160 American Society of Anesthesiologists physical status I to III patients who were >40 years. The Mini-Mental State Evaluation, clock-drawing test and the Isaacs Set test were used to assess cognitive function at three timepoints: 1) preoperatively, 2) one hour postoperatively, and 3) at discharge. The anaesthetic protocol was the same for all patients, except for the neuromuscular block reversal, which was administered by random allocation using either sugammadex or neostigmine/atropine after the reappearance of T2 in the train-of-four sequence. POCD was defined as a decline ≥1 standard deviation in ≥2 cognitive tests. The incidence of POCD was similar in both groups at one hour postoperatively and at discharge (28% and 10%, in the neostigmine group, 23% and 5.4% in the sugammadex group, P=0.55 and 0.27 respectively). In relation to individual tests, a significant decline of clock-drawing test in the neostigmine group was observed at one hour postoperatively and at discharge. For the Isaacs Set test, a greater decline was found in the sugammadex group. These findings suggest that there are no clinically important differences in the incidence of POCD after neostigmine or sugammadex administration.

The development and validation of a questionnaire to measure the clinical learning environment for undergraduate dental students (DECLEI).

AIM: The aim of this study was to develop and validate according to psychometric standards a self-administered instrument to measure the students' self-perceptions of the undergraduate clinical dental environment (DECLEI). MATERIALS AND METHODS: The initial questionnaire was developed using feedback from dental students, experts' opinion and an extensive literature review. Critical incident technique (CIT) analysis was used to generate items and identify domains. Thirty clinical dental students participated in a pilot validation that generated a 67-item questionnaire. To develop a shorter and more practical version of the instrument, DECLEI-67 was distributed to 153 clinical students at the University of Athens and its English version to 51 students from various dental schools, attending the 2012 European Dental Students Association meeting. This final procedure aimed to select items, identify subscales and measure internal consistency and discriminant validity. RESULTS: A total of 202 students returned the questionnaires (response rate 99%). The final instrument included 24 items divided into three subscales: (i) organisation and learning opportunities, (ii) professionalism and communication and (iii) satisfaction and commitment to the dental studies. Cronbach's α for the total questionnaire was 0.89. The interscale correlations ranged from 0.39 to 0.48. The instrument identified differences related to school of origin, age and duration of clinical experience. An interpretation of the scores (range 0­100) has been proposed. CONCLUSIONS: The 24-item DECLEI seemed to be a practical and valid instrument to measure a dental school's undergraduate clinical learning environment.

Students' perceptions of the educational environment in a Greek Dental School, as measured by DREEM.

AIM: The aim of this study was to estimate the dental students' perceptions of their educational environment and to identify any differences related both to their gender and semester of studies. MATERIALS AND METHODS: The translated and validated in Greek Dundee Ready Education Environment Measure (DREEM) questionnaire was distributed to all 2nd- to 5th-year students of the Athens Dental School. The questionnaire consisted of 50 statements organised in five subscales (perceptions of learning, teachers, atmosphere, academic self-perceptions and social self-perceptions). Internal validity was checked with Cronbach alpha. Confirmatory factor analysis (CFA) was performed under the same conditions as the original inventory. Mean statement, subscale and overall scores were calculated and given as percentages. RESULTS: The response rate was 64%. Overall Cronbach alpha was 0.93 (excellent). CFA produced five meaningful subscales, not matching the original ones. The overall DREEM mean score was 56%. Gender did not influence the findings. The students' perceptions of the educational environment with the exception of the academic self-perceptions were more positive in the pre-clinical years. Statistically significant differences were revealed only for the 'learning' subscale between the 3rd- and the 4th-year students. Seventy-eight percent of the statements were in the positive side. The lowest scores were related to students' stress, tiredness and lack of appropriate feedback from the teachers, and the highest were related to accommodation, school friends and perceptions that they feel socially comfortable in class. CONCLUSIONS: Students' perceptions of the educational environment were reasonably positive, with no gender difference. However, some weaknesses were identified, particularly in the clinical years. Further research is needed to clarify appropriate interventions.

A validation study and psychometrical evaluation of the Maastricht Upper Extremity Questionnaire (MUEQ) for the Greek-speaking population.

OBJECTIVES: The Maastricht Upper Extremity Questionnaire (MUEQ) is a tool to examine the physical, psychological and environmental risk factors in the work place that may contribute to the prevalence of complaints of arm, neck and shoulder. The aim of this study was to develop a Greek language version of the MUEQ and to assess its psychosocial parameters. METHODS: The MUEQ was translated into the Greek language and culturally adapted. Exploratory factor analysis was used to analyze interrelations among the questionnaire items and for each of the seven domains two factors were given, thus resulting in the identification of a total of 14 factors. RESULTS: The tool was handed out to 455 computer office workers (179 males, 276 females) with a mean age of 37.4 (SD 9.2). Factor analysis and Cronbach's alpha coefficient indicate that the results are generalizable to the population and the total scale has high internal consistency. The results showed that in the last year, 35.8% of respondents experienced upper extremity pain, specifically in the neck or the shoulders. CONCLUSIONS: The Greek version of the MUEQ appears to be a valid tool for the assessment of risk factors related to pain in the upper extremity among Greek computer office workers.