Cardiac autonomic neuropathy (CAN) is a common and often-underdiagnosed complication of diabetes mellitus (DM). CAN is associated with increased mortality, cardiovascular disease, chronic kidney disease, and morbidity in patients with DM, but despite these significant consequences CAN often remains undiagnosed for a prolonged period. This is commonly due to the disease being asymptomatic until the later stages, as well as a lack of easily available screening strategies. In this article, we review the latest developments in the epidemiology, pathogenesis, diagnosis, consequences, and treatments of CAN in patients with DM.
Assessment and evaluation tools and instruments are developed to measure many things from content knowledge to misconceptions to student affect. The standard validation processes for these are regularly conducted and provide strong evidence for the validity of the measurements that are made. As part of the suite of validation tools available to researchers and practitioners, response process validity studies are an important component for the development and study of multiple-choice or forced-response items. An assessment was developed to measure the scale literacy skills of students in General Chemistry. The initial validation of this instrument was reported earlier, with the response process validity work now presented here to complement the previous study. In addition to the validity work with students in General Chemistry, an additional study was conducted with students in Anatomy and Physiology, as part of the validation studies as the assessment was moved into this new discipline. The process used, threats identified, and implications of these identified threats are reported.
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