Infectious Diseases Society of America.

Dipping my toe into the water of educational research, I have recently used Likert-type rating scales to measure student views on various educational interventions. Likert scales are commonly used to measure attitude, providing a range of responses to a given question or statement . Typically, there are 5 categories of response, from (for example) 1 1⁄4 strongly disagree to 5 1⁄4 strongly agree, although there are arguments in favour of scales with 7 or with an even number of response categories.

/pdf/likert-scales-how-to-ab-use-them-au0z1nbrlb.pdf

Likert scales: how to (ab)use them

The neuroimmune system is involved in development, normal functioning, aging, and injury of the central nervous system Microglia, first described a century ago, are the main neuroimmune cells and have three essential functions: a sentinel function involved in constant sensing of changes in their environment, a housekeeping function that promotes neuronal well-being and normal operation, and a defense function necessary for responding to such changes and providing neuroprotection Microglia use a defined armamentarium of genes to perform these tasks In response to specific stimuli, or with neuroinflammation, microglia also have the capacity to damage and kill neurons Injury to neurons in Alzheimer’s, Parkinson’s, Huntington’s, and prion diseases, as well as in amyotrophic lateral sclerosis, frontotemporal dementia, and chronic traumatic encephalopathy, results from disruption of the sentinel or housekeeping functions and dysregulation of the defense function and neuroinflammation Pathways associated with such injury include several sensing and housekeeping pathways, such as the Trem2, Cx3cr1 and progranulin pathways, which act as immune checkpoints to keep the microglial inflammatory response under control, and the scavenger receptor pathways, which promote clearance of injurious stimuli Peripheral interference from systemic inflammation or the gut microbiome can also alter progression of such injury Initiation or exacerbation of neurodegeneration results from an imbalance between these microglial functions; correcting such imbalance may be a potential mode for therapy

Microglia in neurodegeneration.

Biochemical and neuropathological studies of brains from individuals with Alzheimer disease (AD) provide clear evidence for an activation of inflammatory pathways, and long-term use of anti-inflammatory drugs is linked with reduced risk to develop the disease. As cause and effect relationships between inflammation and AD are being worked out, there is a realization that some components of this complex molecular and cellular machinery are most likely promoting pathological processes leading to AD, whereas other components serve to do the opposite. The challenge will be to find ways of fine tuning inflammation to delay, prevent, or treat AD.

/pdf/inflammation-in-alzheimer-disease-a-brief-review-of-the-4mnlk1vy66.pdf

Inflammation in Alzheimer Disease—A Brief Review of the Basic Science and Clinical Literature

An amyloid protein that precipitates in the cerebral vessel walls of Dutch patients with hereditary cerebral hemorrhage with amyloidosis is similar to the amyloid protein in vessel walls and senile plaques in brains of patients with Alzheimer's disease, Down syndrome, and sporadic cerebral amyloid angiopathy. Cloning and sequencing of the two exons that encode the amyloid protein from two patients with this amyloidosis revealed a cytosine-to-guanine transversion, a mutation that caused a single amino acid substitution (glutamine instead of glutamic acid) at position 22 of the amyloid protein. The mutation may account for the deposition of this amyloid protein in the cerebral vessel walls of these patients, leading to cerebral hemorrhages and premature death.

Mutation of the Alzheimer’s disease amyloid gene in hereditary cerebral hemorrhage, Dutch type. The role of amyloid in dementia and stroke

Objective To explore the relationship between teaching scientific methodology in Year 2 of the medical curriculum and student attitudes towards and knowledge about science and scientific methodology.

Design  Anonymous questionnaire survey developed for this purpose.

Setting  Zagreb University School of Medicine, Croatia.

Participants  A total of 932 students (response rate 58%) from all 6 years were invited to participate.

Main outcome measures  Score on attitude scale with 45 Likert-type statements and score on knowledge test consisting of 8 multiple choice questions.

Results  The average attitude score for all students was 166 ± 22 out of a maximum of 225, indicating a positive attitude towards science and scientific research. The students' average score on the knowledge test was 3.2 ± 1.7 on 8 questions. Students who had finished Year 2 had the highest mean attitude (173 ± 24) and knowledge (4.7 ± 1.7) scores compared with other year groups (P < 0.001, anova and Tukey posthoc test). For students who had attended a mandatory Year 2 course on the principles of scientific research in medicine (Years 3 to 6), multiple linear regression analysis showed that knowledge test score (B = 3.4; SE = 0.4; 95% confidence interval 2.5–4.2; P < 0.001) and average grades (B = 7.6; SE = 1.5; 95% CI 4.6–10.6; P < 0.001) were significant predictors of attitude towards science, but not sex or failure to pass a year (B = − 0.6; SE = 1.7; 95% CI − 3.9–2.6; P = 0.707; and B = − 3.1; SE = 1.9; 95% CI − 6.8–5.7; P = 0.097, respectively).

Conclusion  Medical students have generally positive attitudes towards science and scientific research in medicine. Attendance of a course on research methodology is related to a positive attitude towards science.

Teaching research methodology in medical schools: students' attitudes towards and knowledge about science

The recombinant amyloid-beta peptide Abeta1-42 aggregates faster and is more neurotoxic than synthetic Abeta1-42.

Aim To assess the prevalence of, attitudes towards and willingness to report different forms of academic dishonesty among medical students in a post-communist transitional country.

Methods  An anonymous, self-administered questionnaire was distributed to medical students in Years 2−6 at the Zagreb University School of Medicine; 827 (70%) valid questionnaires were returned and analysed.

Results  Most of the students (94%) admitted cheating at least once during their studies. The most frequent type of misconduct was ‘signing in an absent student on a class attendance list’ (89.1%), and the least frequent ‘paying for passing an examination’ (0.7%). The number of committed types of misconduct out of 11 listed types increased from Year 2 (median 2) to Year 6 (median 4). Cheating behaviours could be clustered into 4 groups based on self-reported cheating, perceived prevalence of cheating, attitude towards cheating, and willingness to report cheating. The clustered behaviours that most students admitted to were perceived as the most frequent, more approved of and less likely to be reported. The strongest predictors of dishonest behaviour were attitude, perception of peer group behaviour and study year. Almost half (44%) the students said they would never report any form of cheating.

Conclusion  Academic misconduct is widespread among medical students at the largest medical school in Croatia and its prevalence is greater than that reported for developed countries. This may be related to social and cultural factors specific to a country in the midst of a post-communist transition to a market economy, and calls for measures to be instigated at an institutional level to educate against and prevent such behaviour.

Academic misconduct among medical students in a post-communist country.

GCA, the most common systemic arteritis, affects medium-sized and larger extradural arteries that have the internal elastic lamina. Involvement of the ophthalmic artery and its branches results in visual loss, which is often complete but is usually painless. Visual loss may be monocular or binocular developing simultaneously or sequentially. Rarely, it stems from occipital lobe infarct that result in homonymous hemianopia, a visual field defect involving the two identical halves (right or left) of the visual fields of both eyes. Visual hallucinations and diplopia are less common. All visual symptoms, including those that are transient, require urgent ophthalmological evaluation and treatment with high-dose glucocorticoids to avoid permanent visual loss.

Ophthalmic manifestations of giant cell arteritis.

Background Medical teaching aims to develop attitudes and behaviors underlying professional competence of future physicians. We investigated whether a mandatory course on scientific methodology in the second study year could affect students9 attitudes toward science in medicine. Method In a longitudinal study, students (n = 241) enrolling in 2001-2002 academic year at a single medical school were followed up until graduation in 2006-2007. Each year, they filled out a Likert-type questionnaire of 18 statements evaluating attitude toward science. Direct influence of the course on students9 attitudes was tested in a nonrandomized controlled trial with the 2006-2007 second year student cohort. Results Positive students9 attitudes toward science increased during study years (mean [SD] score of the maximum score of 90): from 57.6 (6.0) in the first to 69.8 (10.4) in the sixth year. There was a significant trend of increase in attitudes with the years of study (cubic trend by polynomial contrasts analysis, P = 0.011). Attendance of a course on research methodology significantly increased positive attitudes (score, 67.0 [7.0] before and 70.8 [7.5] after course, P = 0.032 vs control group), regardless of grade point average. The intervention had an effect even when the influence of the initial attitude was accounted for (F1,140 = 9.25, P = 0.003; analysis of covariance). The attitude changes after the course was greatest in students with low initial attitude scores (Spearman rinitial score, score difference, −0.44). Conclusions Medical students have positive attitudes toward science and scientific method in medicine. Attendance of a course on research methodology had positive short-term effect on students9 attitudes toward science. This positive effect should be maintained by vertical integration of the course in the medical curriculum.

https://jim.bmj.com/content/jim/58/2/282.full.pdf

Ivana Vodopivec

Papers

Teaching research methodology in medical schools: students' attitudes towards and knowledge about science

The recombinant amyloid-beta peptide Abeta1-42 aggregates faster and is more neurotoxic than synthetic Abeta1-42.

Academic misconduct among medical students in a post-communist country.

Ophthalmic manifestations of giant cell arteritis.

Can Teaching Research Methodology Influence Students' Attitude Toward Science? Cohort Study and Nonrandomized Trial in a Single Medical School