Although numerous survey studies have reported connections between sleep and cognitive function, there remains a lack of quantitative data using objective measures to directly assess the association between sleep and academic performance. In this study, wearable activity trackers were distributed to 100 students in an introductory college chemistry class (88 of whom completed the study), allowing for multiple sleep measures to be correlated with in-class performance on quizzes and midterm examinations. Overall, better quality, longer duration, and greater consistency of sleep correlated with better grades. However, there was no relation between sleep measures on the single night before a test and test performance; instead, sleep duration and quality for the month and the week before a test correlated with better grades. Sleep measures accounted for nearly 25% of the variance in academic performance. These findings provide quantitative, objective evidence that better quality, longer duration, and greater consistency of sleep are strongly associated with better academic performance in college. Gender differences are discussed.
BackgroundIncorrect, delayed and missed diagnoses can contribute to significant adverse health outcomes. Intervention options have proliferated in recent years necessitating an update to McDonald et al’s 2013 systematic review of interventions to reduce diagnostic error.Objectives(1) To describe the types of published interventions for reducing diagnostic error that have been evaluated in terms of an objective patient outcome; (2) to assess the risk of bias in the included interventions and perform a sensitivity analysis of the findings; and (3) to determine the effectiveness of included interventions with respect to their intervention type.MethodsMEDLINE, CINAHL and the Cochrane Database of Systematic Reviews were searched from 1 January 2012 to 31 December 2019. Publications were included if they delivered patient-related outcomes relating to diagnostic accuracy, management outcomes and/or morbidity and mortality. The interventions in each included study were categorised and analysed using the six intervention types described by McDonald et al (technique, technology-based system interventions, educational interventions, personnel changes, structured process changes and additional review methods).ResultsTwenty studies met the inclusion criteria. Eighteen of the 20 included studies (including three randomised controlled trials (RCTs)) demonstrated improvements in objective patient outcomes following the intervention. These three RCTs individually evaluated a technique-based intervention, a technology-based system intervention and a structured process change. The inclusion or exclusion of two higher risk of bias studies did not affect the results.ConclusionTechnique-based interventions, technology-based system interventions and structured process changes have been the most studied interventions over the time period of this review and hence are seen to be effective in reducing diagnostic error. However, more high-quality RCTs are required, particularly evaluating educational interventions and personnel changes, to demonstrate the value of these interventions in diverse settings.
Aims
Endothelial dysfunction is an early risk marker of cardiovascular disease in diabetes mellitus. Timely screening is important in reducing cardiovascular disease-associated morbidity and mortality. This cross-sectional study investigates the acceptability and preferability of non-invasive cardiovascular risk procedures (EndoPAT2000 system and the ECG-gated fundoscope) in participants with diabetes mellitus compared to controls.
Methods
A self-administered Likert scale-based questionnaire was completed by 106 controls and 117 participants with diabetes mellitus, identified through stratified random sampling, upon conclusion of an Australian Heart Eye sub-study conducted at Westmead Hospital, NSW, Australia from 2012 to 2014. Pearson’s χ2 test, independent-samples t-test and regression analysis were performed.
Results
Study participants who responded to the questionnaire had no preference for procedures (controls: 2.4 ± 1.1 vs diabetes mellitus: 2.5 ± 0.9, p = 0.38) but had an overall more negative experience with most aspects of the ECG-gated fundoscope than the EndoPAT2000 system. Of those with diabetes mellitus, participants who provided poorer self-rated health expressed discomfort with the mydriatic drops (ß 0.27, 95%CI 0.001 - 0.54, p = 0.049) and the fundoscope’s green light filter (ß 0.27, 95%CI 0.07 - 0.47, p = 0.009), as well as maintaining still (ß 0.40, 95%CI 0.08 - 0.72, p = 0.02) and not blinking (ß 0.38, 95%CI 0.07 - 0.70, p = 0.02) during photo acquisition. These participants were also less willing to repeat the ECG-gated fundoscope procedure (ß 0.29, 95%CI 0.07 - 0.52, p = 0.01).
Conclusions
Participants with diabetes mellitus, especially with poorer self-rated health, had a more negative experience with the ECG-gated fundoscope than the EndoPAT2000 system. Difficulties experienced under examination by the ECG-gated fundoscope appear related to the procedural design, which requires amendments improving patient comfort and compliance.
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