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Students' perceptions of educational environment: a comparison of academic achievers and under-achievers at kasturba medical college, India.

CONTEXT: No country, least of all poorly resourced countries such as India, can afford to lose too many medical students in their undergraduate years. It would be useful to have an instrument to identify those students who are vulnerable to academic failure at this level of training and to identify the features of the educational environment that they perceive differently from students who are succeeding academically in order to design intervention strategies. Gender differences in perceptions of the educational environment might well emerge in particular academic or cultural contexts, with particular curricula. The present study was motivated by this concern and focused on comparisons between academic achievers and under-achievers and male and female students of Kasturba Medical College, India. OBJECTIVES: (1) To compare the perceptions of the educational environment of academic achievers and under-achievers and to identify problem areas that should be remediated. (2) To identify whether there is any gender difference in the perceptions. METHODS: The Dundee Ready Educational Environment Measure (DREEM) was administered to 508 medical students studying in the clinical years at the Kasturba Medical College in India. Item as well as scale scores were compared between academic achievers and under-achievers. FINDINGS: Overall sample of the present study rated educational environment in this institution as average. The overall mean DREEM score was significantly higher for academic achievers. Compared to under-achievers, academic achievers scored significantly higher on perceptions regarding teachers, academic atmosphere and social self-perceptions. In addition to this, the overall rating (total DREEM score) of female students was significantly less compared to males in the academically vulnerable group. CONCLUSIONS: Perceptions of poor performers are significantly different from those of better performers in the same institution. More importance should be given to the perceptions of students to improve the educational environment, as perceptions are associated positively with learning outcome, learning approach and attitude toward studying. Use of the DREEM as a monitoring tool might permit timely interventions to remediate problematic educational environments.

Achievement↗

A quantitative analysis of sensory function in lumbar radiculopathy using current perception threshold testing.

STUDY DESIGN: Peripheral sensory functions in patients with radiculopathy resulting from lumbar disc herniation and in control individuals were analyzed using current perception threshold testing. OBJECTIVE: To evaluate the severity of sensory disturbance quantitatively in patients with lumbar radiculopathy. SUMMARY OF BACKGROUND DATA: Subjective evaluation of the severity of sensory disturbance associated with spinal disorders using conventional methods often is difficult. Current perception threshold evaluation is a recently proposed method for studying peripheral nerve dysfunction. This is a quantitative sensory test for analyzing functions of A-beta, A-delta, and C fibers. METHODS: In this study, 48 patients with lumbar radiculopathy resulting from lumbar disc herniation were examined. The mean age of the patients was 37.9 years. All the patients had pain distribution from the compression of one lumbar nerve root (L5 or S1), and unequivocal unilateral disc herniation of the corresponding level was shown by magnetic resonance imaging. Eleven healthy volunteers were used as control subjects. Their mean age was 38.2 years. Current perception threshold evaluation using a Neurometer device was performed at three frequencies: 2000, 250, and 5 Hz. The stimulus sites were located on the dorsal side of the first metatarsus (the L5 dermatome) and the dorsal side of the fifth metatarsus (the S1 dermatome). These sites were investigated on both legs in all the patients and control subjects. The intensity of pain was scored using a visual analog scale. RESULTS: In the control group, there were no significant differences in current perception threshold values at any frequency between the left and right legs. In the patient group, the current perception threshold values in the affected legs were significantly higher than those in the contralateral legs at all frequencies. The current perception threshold values in the affected legs in the patient group were significantly higher than those in the control subjects at 2000 and 250 Hz, whereas there were no significant differences at 5 Hz. The current perception threshold values in the affected legs were significantly higher in patients with hypesthesia than in those without hypesthesia at 2000 and 250 Hz, and in patients with severe pain than in those with less pain at 5 Hz. CONCLUSIONS: Current perception threshold testing showed that the functions of A-beta, A-delta, and C fibers deteriorated in patients with lumbar radiculopathy. This technique may be useful for quantifying sensory nerve dysfunction in patients with radiculopathy.

Adolescent↗

Perceptions of stressful life events in Northern Irish school children: a longitudinal study.

BACKGROUND: Adults' perceptions of stressful life events have been acknowledged as important moderators of the stress adjustment relationship. Until recently, however, there has been a lack of research on children's perceptions of negative life events. This study assesses children's own perceptions of the stressfulness of negative familial, academic and social events as well as events related to the political conflict in Northern Ireland. METHOD: Developmental changes in children's perceptions of events are traced over time. One hundred and sixty 8-year-old children completed a self-report measure of the perceived stressfulness of a range of negative life events. The sample was drawn from schools in the Greater Belfast area to include children of both genders, primary religious affiliations in Northern Ireland (i.e., Protestant and Roman Catholic) and of varying socio-economic status. Three years later, 113 of these children, then aged 11, were traced through the school system and completed the same measure. RESULTS: Children's perceptions of stressful events are related to a host of social factors. Girls viewed many negative events as more stressful than their male counterparts. Roman Catholic and Protestant children differed in their perceptions of conflict-related events. Perceptions of various types of negative experiences were differentially related to socio-economic status and age. CONCLUSION: Personal, social and situational factors differentially determine children's perceptions of negative life experiences.

Adolescent↗

Automaticity in speech perception: some speech/nonspeech comparisons.

Three experiments used sine-wave replicas of speech sounds to explore some differences between speech perception and general auditory perception. The experiments compared patterns of behavior in categorization and discrimination tasks for listeners reporting either speech or nonspeech percepts of sine-wave replicas of speech. We hypothesized that the perception of speech sounds is automatized, while the perception of less familiar sounds is not. The first experiment was designed to investigate the perception of relatively long initial consonant transitions using a synthetic /wa/-/ya/ sine-wave analog continuum. Speech listeners perceived the continuum categorically, but nonspeech listeners could not consistently categorize the items in the continuum. In the second experiment, both speech and nonspeech listeners could consistently categorize stimuli having final glides (an/ay/-/aw/ sine-wave replica continuum), but differences between speech and nonspeech listeners were found in the slopes of the identification functions, in reaction times, and in the effect of context. These differences are consistent with the hypothesis that speech perception is automatized. In the third experiment, nonspeech listeners' discrimination sensitivity was greater than speech listeners'. The observed pattern of results suggests that speech perception is accomplished by a fast, obligatory, and thus automatic perceptual mechanism.

Automatism↗

Dynamical vs. judgmental comparison: hysteresis effects in motion perception.

Perceptual comparison was investigated by gradually varying the relative length of two apparent motion paths, and independently determining when an initial percept was lost during the course of attribute change and when an alternative percept emerged. Dynamical comparison was indicated by a range of attribute values for which perception was bistable. Within this range, a percept that lost stability was immediately replaced by an alternative percept. Judgmental comparison was indicated by a range of attribute values for which perception was uncertain. When an initial percept was lost, an alternative percept did not immediately emerge because the alternatives being compared could not be distinguished. Differences in the effects of random noise on dynamical vs. judgmental comparison were demonstrated with computational simulations, and implications are discussed for motion energy models and solutions to the motion correspondence problem.

Attention↗

Impairment of depth perception in multiple sclerosis is improved by treatment with AC pulsed electromagnetic fields.

Multiple sclerosis (MS) is associated with postural instability and an increased risk of falling which is facilitated by a variety of factors including diminished visual acuity, diplopia, ataxia, apraxia of gait, and peripheral neuropathy. Deficient binocular depth perception may also contribute to a higher incidence of postural instability and falling in these patients who, for example, find it an extremely difficult task to walk on uneven ground, over curbs, or up and down steps. I report a 51 year old woman with secondary progressive MS who experienced difficulties with binocular depth perception resulting in frequent falls and injuries. Deficient depth perception was demonstrated also on spontaneous drawing of a cube. Following a series of transcranial treatments with AC pulsed electromagnetic fields (EMFs) of 7,5 picotesla flux density, the patient experienced a major improvement in depth perception which was evident particularly on ascending and descending stairs. These clinical changes were associated with an improvement in spatial organization and depth perception on drawing a cube. These findings suggest that in MS impairment of depth perception, which is encoded in the primary visual cortex (area 17) and visual association cortex (areas 18 and 19), may be improved by administration of AC pulsed EMFs of picotesla flux density. The primary visual cortex is densely innervated by serotonergic neurons which modulate visual information processing. Cerebral serotonin concentrations are diminished in MS patients and at least some aspects of deficient depth perception in MS may be related to dysfunction of serotonergic transmission in the primary visual cortex. It is suggested that transcranial AC pulsed applications of EMFs improve depth perception partly by augmenting serotonergic transmission in the visual cortex.

Depth Perception↗

Switching between memory and perception: moving attention or memory retrieval?

Weber, Burt, and Noll (1986) estimated that the time needed to switch attention between memory and perception was around 300 msec. The first two experiments in the present paper estimated switching time using a variation of their task. Subjects reported aloud lists of six items. The items were read off a computer screen (perception), recited from memory, or reported alternately from the two sources. The data show that the switching-time estimate is influenced by input/output compatibility, response-initiation times, and memory load. When these factors were controlled, estimated switching time dropped to around 100-150 msec. The data suggest, however, that the switch from perception to memory might be slower than the switch from memory to perception, which would invalidate the formula used to compute switching time. Experiment 3 tested the time for a single switch from perception to memory and a single switch from memory to perception by restricting report to one pair of items in the list. When the to-be-reported pair was precued, estimated switching time dropped to zero. When the pair was not precued, the memory-to-perception switching time remained at zero, but the perception-to-memory time was more than 400 msec. The pattern of results forced a reconceptualization of the task in terms of memory retrieval rather than attention switching. The attention-switching times appear to reflect processes required to select items from memory.

Adult↗

The reality of perception in employee relations: "If it looks like a duck ...".

In employee relations, perception is as important as reality. What the employee perceives is generally what the employee believes and acts on. Employee perceptions are shaped by many factors, prominent among them organizational roles, supervisory styles, and communication styles. Employee perceptions cannot be ignored, even when they are known to be incorrect, because they are factual to the employees. Further, perceptions can be controlled to a considerable extent through effective supervision. The supervisor needs to become aware of the power of perception, learn what circumstances are likely to cause incorrect perceptions, learn how to manage employee perceptions to the extent possible, and always approach perception as the perceiver's reality.

Attitude of Health Personnel↗

[The relation between the perception of dyspnea and beta 2-agonists consumption in patients with mild-moderate asthma].

It is well documented that, in patients with asthma, there is a considerable variation in the severity of breathlessness for any particular degree of airflow obstruction. The factors underlying this variability are still to be explored. The consumption of beta 2-agonists and the perception of dyspnea were assessed in eighty asthmatic patients, with mild-moderate asthma, attending the asthma clinic. The perception of dyspnea was compared to sixty normal subjects. All patients received treatment with inhaled corticosteroid and beta 2-agonists as needed. Nine patients were excluded from the study, hence the data reported relates to 71 patients. In 55% of the patients the mean score of the perception of dyspnea during breathing against resistance was normal, it was low in 20 (28%) and high in the remaining 12 (17%). There was no correlation between the FEV1 and the perception of dyspnea. The mean +/- SEM beta 2-agonists consumption was 2.9 +/- 0.4 puffs/day (range 0-7.2). There was a statistically significant difference in beta 2-agonists consumption between the mid asthmatic and the moderate asthmatic groups (p < 0.01). In both groups the mean beta 2-agonists consumption was significantly higher in the high preception of dyspnea group than in the normal (p < 0.05) and the low (p < 0.01) perception of dyspnea groups. We conclude that about half of mild-moderate asthmatic patients have normal perception of dyspnea while the other half have either high or low perception of dyspnea. More obstructed patients have higher beta 2-agonists consumption. However, in every degree of severity there is a close relation between the perception of dyspnea and the beta 2-agonists consumption.

Adrenergic beta-Agonists↗

Perception of dyspnea in asthmatics with normal lung function.

UNLABELLED: The perception of dyspnea varies widely among asthmatics and it is influenced by many factors. The aims of our study were to investigate the perception of dyspnea during methacholine-induced bronchoconstriction in asthmatics with normal lung function and to evaluate the influence of bronchial responsiveness, age and gender to dyspnea perception in these patients. A total of 192 outpatients (aged 16-77 years) with stable asthma and normal lung function were examined. Methacholine challenge test was performed to each patient. The provocative dose of methacholine that reduces forced expiratory volume in 1 sec. (FEV1) by 20% (PD20) was estimated. Dyspnea perception of bronchoconstriction was evaluated using a Borg Scale and calculating the perception score corresponding to a fall in FEV1 of 20% (PS20). According to PS20+/-1 standard deviation subjects were divided into three groups: hypoperceivers, normoperceivers and hyperperceivers. From the hypoperceivers group we set up asthmatics with PS20=0 and defined them as nonperceivers. We found out that 43 (22.4%) patients were hypoperceivers, 116 (60.4%)--normoperceivers and 33 (17.2%)--hyperperceivers. The nonperceivers presented 6.3% (n=12) of all subjects. PD20 positively correlated with PS20 (r=0.252, p<0.001). Hypoperceivers showed significantly higher bronchial hyperesponsiveness (PD20=174+/-28 microg) comparing with hyperperceivers (PD20=323+/-50 microg, p=0.013). Bronchial responsiveness to methacholine of nonperceivers (PD20= 106+/-31 microg, range 15-253 microg) was the highest and PD20 was significantly lower comparing with normoperceivers (p=0.005) and hyperperceivers (p=0.001). Age and gender had no significant effect on the perception of bronchoconstriction. CONCLUSION: The part of asthmatics with normal lung function has impaired perception of dyspnea. Dyspnea perception depends on bronchial responsiveness, but not on age and gender of these patients.

Adolescent↗

Parents' perceptions of their newborn following structured interactions.

A study of 57 married couples and their normal-term firstborn infants investigated (a) if parents' perceptions are related to behavior of infants and (b) if a structured interaction of parent with infant positively influences parents' perceptions of their infant. Mothers, fathers, or parents in three experimental groups participated in a structured interaction with their infants. Parents and infants in a control group received no structured interaction. The interaction consisted of the parents assessing their infant using the Mother's Assessment of the Behavior of Her Infant (MABI). Infants' behaviors were measured with the Neonatal Behavioral Assessment Scale (NBAS) and parents' perceptions with the Neonatal Perception Inventories (NPI). There was no relation between infant behavior and parental perception. The factor structure of NBAS items was similar to that found by other investigators. The structured interaction differentially affected perception scores of mothers at Time 2 (F 3, 53 = 3.96, p = .013). Perceptions of mothers and fathers achieved some congruence over time (Time 1, r = .18, p = .189; Time 2, r = .45, p = .001; Time 3, r = .41, p = .002). Seven other variables contributed more to variance in mothers' than fathers' perceptions.

Adult↗

Children's color perception in relation to habitat and skin color.

Developmental color perception of negroid and caucasoid children in 3 societies is examined in relation to the theories that proximity to the equator and fundus pigmentation (as measured by skin color) reduce shortwave (blue-green) in comparison with long-wave perception. The 278 4- and 8-year-old native-born, urban, English-speaking children were from latitudes 6 degrees 27' N (Enugu, Nigeria), 17 degrees 18' N (Basseterre, Saint Kitts, East Caribbean), and 34 degrees 3' N (Los Angeles, Calif.). Equal numbers of boys and girls from middle socioeconomic homes were medically examined for normal nutritional status and near vision. Children were individually tested on the Gaines Color Perception Test. The results show that short-wavelength perception is less accurate than long-wave-length perception in all locations, but most of the variance is attributable to conditions of low value or chroma stimuli rather than to proximity to the equator. There were no significant differences between Nigerian, Saint Kittitian and California caucasoid children. In accord with the pigmentation theory, young California negroid children had less accurate short-wavelength color perception than California caucasoid children. However, Nigerian and Saint Kittitian negroid children's perceptual accuracy was at least as accurate as that of caucasoid children. Amount of pigmentation does not appear to be a universal variable in children's color perception. Socioeconomic status, nutritional variables, developmental growth of the eye, or controlled stimulus conditions of the present research could account for the lack of positive relationships between color perception and habitat or skin color.

Child↗

Cortical networks underlying mechanisms of time perception.

Precise timing of sensory information from multiple sensory streams is essential for many aspects of human perception and action. Animal and human research implicates the basal ganglia and cerebellar systems in timekeeping operations, but investigations into the role of the cerebral cortex have been limited. Individuals with focal left (LHD) or right hemisphere (RHD) lesions and control subjects performed two time perception tasks (duration perception, wherein the standard tone pair interval was 300 or 600 msec) and a frequency perception task, which controlled for deficits in time-independent processes shared by both tasks. When frequency perception deficits were controlled, only patients with RHD showed time perception deficits. Time perception competency was correlated with an independent test of switching nonspatial attention in the RHD but not the LHD patients, despite attention deficits in both groups. Lesion overlays of patients with RHD and impaired timing showed that 100% of the patients with anterior damage had lesions in premotor and prefrontal cortex (Brodmann areas 6, 8, 9, and 46), and 100% with posterior damage had lesions in the inferior parietal cortex. All LHD patients with normal timing had damage in these same regions, whereas few, if any, RHD patients with normal timing had similar lesion distributions. These results implicate a right hemisphere prefrontal-inferior parietal network in timing. Time-dependent attention and working memory functions may contribute to temporal perception deficits observed after damage to this network.

Aged↗

Modality-specific and amodal aspects of object perception in infancy: the case of active touch.

Three experiments investigated 4.5-month-old infants' perception of the unity and boundaries of haptically presented objects. When infants actively explored the two handles of an unseen object assembly, perception of the unity of the assembly depended on the handles' motion. Infants perceived a single, connected object if the handles moved rigidly together, and they perceived two distinct objects if the handles underwent relative vertical or horizontal motion. When infants passively explored the same object assembly undergoing the same motions, object perception appeared to be indeterminate. The findings of the active motion experiments accord with the findings of studies of visual object perception and suggest that object perception depends on amodal processes, operating on representations of either seen or felt surface motions. The findings of the passive motion experiments nevertheless suggest a difference between visual and haptic perception: for infants as for adults, haptic perception is enhanced by the active production of surface motion.

Adolescent↗

Perception of sweetness intensity determines women's hedonic and other perceptual responsiveness to chocolate food.

This study tested 63 women for hedonic and other perceptual responsiveness to a chocolate food. Subjects tasted four chocolate puddings varying in sugar (high and low) and fat (high and low) content and rated them for pleasantness, caloric density, fillingness and flavor intensities. Results emphasised the importance of sweetness intensity in determining women's responses to the chocolate puddings. Women's perception of sweetness intensity was accurate to sugar content and results consistently indicated that their hedonic responses to the chocolate puddings were based on the perceived sweetness. Women's perception of the caloric density of the puddings was based on their perception of the fat content of the puddings; however, interpretation of that finding must be qualified because the subjects' perception of fat content was inaccurate. The women's perception of sweetness intensity accounted for 31% of the variability in fat perception. Women's perception of the intensity of chocolate flavor was also significantly associated with perceived sweetness of the puddings. These data suggest that the women's accurate perception of the sugar content of the chocolate puddings played a primary role in determining their hedonic and other perceptual responses.

Adult↗

Tilt perception during dynamic linear acceleration.

Head tilt is a rotation of the head relative to gravity, as exemplified by head roll or pitch from the natural upright orientation. Tilt stimulates both the otolith organs, owing to shifts in gravitational orientation, and the semicircular canals in response to head rotation, which in turn drive a variety of behavioral and perceptual responses. Studies of tilt perception typically have not adequately isolated otolith and canal inputs or their dynamic contributions. True tilt cannot readily dissociate otolith from canal influences. Alternatively, centrifugation generates centripetal accelerations that simulate tilt, but still entails a rotatory (canal) stimulus during important periods of the stimulus profiles. We reevaluated the perception of head tilt in humans, but limited the stimulus to linear forces alone, thus isolating the influence of otolith inputs. This was accomplished by employing a centrifugation technique with a variable-radius spinning sled. This allowed us to accelerate the sled to a constant angular velocity (128 degrees/s), with the subject centered, and then apply dynamic centripetal accelerations after all rotatory perceptions were extinguished. These stimuli were presented in the subjects' naso-occipital axis by translating the subjects 50 cm eccentrically either forward or backward. Centripetal accelerations were thus induced (0.25 g), which combined with gravity to yield a dynamically shifting gravitoinertial force simulating pitch-tilt, but without actually rotating the head. A magnitude-estimation task was employed to characterize the dynamic perception of pitch-tilt. Tilt perception responded sluggishly to linear acceleration, typically reaching a peak after 10-30 s. Tilt perception also displayed an adaptation phenomenon. Adaptation was manifested as a per-stimulus decline in perceived tilt during prolonged stimulation and a reversal aftereffect upon return to zero acceleration (i.e., recentering the subject). We conclude that otolith inputs can produce tilt perception in the absence of canal stimulation, and that this perception is subject to an adaptation phenomenon and low-pass filtering of its otolith input.

Acceleration↗

Paramedic injury severity perception can aid trauma triage.

STUDY OBJECTIVE: To compare information contained in standard out-of-hospital trauma triage criteria and standard criteria plus advanced emergency medical technician (EMT) injury severity perception for determination of patient need for trauma center evaluation. DESIGN: Prospective, observational cohort analysis of trauma triage by advanced EMTs. PARTICIPANTS: Out-of-hospital, geographically stratified statewide sample of patients injured in Oregon. RESULTS: Advanced EMTs provided patient information on demographics, physiologic parameters, injury anatomy and mechanism, premorbid conditions, EMT injury severity perception, and trauma system entry status. A four-point scale was used to grade the injury severity perception. Need for trauma center evaluation was defined as major surgery within 6 hours of hospital arrival, admission to the ICU, death in the hospital, or Injury Severity Scale score of 16 or more. The relative triage information gain with injury severity perception was assessed by use of logistic regression, tree-based models, and receiver operating characteristic (ROC) curves. Of 1,063 patients, 307 (28.9%) warranted trauma center evaluation. With logistic regression modeling, the following standard triage parameters were associated (P < .05) with the need for trauma center evaluation after inclusion of injury severity perception: systolic blood pressure less than 90 mm Hg, abnormal respiratory rate (less than 10 or more than 29), Glasgow Coma Scale score less than 13, penetrating injury (midthigh to head), two or more obvious proximal long-bone fractures, and fall of more than 20 feet. The two largest injury severity perception categories had the greatest odds ratios (20:1 and 167:1). ROC curve areas improved with injury severity perception (.88 versus .83 without; P < .0001). CONCLUSION: Standard out-of-hospital triage criteria benefit from inclusion of advanced EMT injury severity perception information.

Emergency Medical Technicians↗

Taste perception after lingual nerve repair.

PURPOSE: This retrospective study evaluates patients' perception of taste after lingual nerve injury and repair. It is hypothesized that return of taste is a distinct neurophysiologic phenomenon related to specialized taste physiology and it does not correlate with specific, objective sensory return. PATIENTS AND METHODS: During 1995 to 1996, 30 patients underwent microsurgical repair of lingual nerve injuries. Of these, 22 patients met the inclusion criteria for this study. Chart review documented the date and cause of injury, sensory examination, injury classification, procedures, operative findings, and postoperative sensory examination. A telephone questionnaire addressed whole mouth taste perception with normal daily eating. The questions asked were: 1) Was your sense of taste changed or abnormal after your nerve injury? and 2) Did your sense of taste recover after nerve repair? RESULTS: All patients had a postinjury, prerepair sensory deficit on levels A, B, and C testing: neurotmesis (n = 14); and axonotmesis (n = 8). The mean time from injury to repair was 16 weeks (range, 3 to 41 weeks). Operative findings confirmed 12 Sunderland Class IV (partial transection) injuries and 10 Class V (complete transection) injuries. All patients had primary microsurgical repair without a nerve graft or entubulization. Postoperatively, 18 patients showed marked improvement in sensory testing at levels A, B and C, and 4 patients showed no significant change. A telephone interview regarding whole mouth taste perception indicated that 20 of 22 patients perceived changed, abnormal taste postinjury and pre-repair. Two patients reported normal taste perception. Postrepair, only 7 of 20 patients reported an increase or return of taste perception to a more normal level. The mean follow-up time was 80 weeks. CONCLUSION: Most patients (20 of 22) with lingual nerve injuries in this study perceived whole mouth taste as abnormal. After nerve repair, although 82% (18 of 22) of patients had improvement in somatosensory function, whole mouth taste was perceived as improved by only 35% (7 of 20). It is proposed that the perception of whole mouth taste may not be related to the ability to perceive multiple sensory modalities, but rather to special sensory (taste) modality perception. Also, central changes may occur in the special sensory fibers that impact on the brainstem nucleus for taste (nucleus solitarius) and therefore the patient's perception of taste.

Cranial Nerve Injuries↗