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The college life experiences of African American women athletes.

The present study provides a descriptive analysis of four areas of African American women student athletes' college life experiences: academic performance; alienation and abuse; perceived social advantage as the result of athletics; and life satisfaction. Multivariate comparisons were made between the four areas of college life experiences of 154 African American women student athletes and 793 White women student athletes, 250 African American women nonathletes, and 628 African American men student athletes from a national sample of 39 NCAA Division I universities. Overall, African American women student athletes are performing adequately academically, integrating socially within the university, perceiving some social advantage as the result of being athletes, and are fairly satisfied with their life. Their experiences seem most consistent with African American women nonathletes. Results are discussed in the context of potential policy recommendations as well as the need for more research on this particular population.

Adult↗

Impact of exposure to community violence and psychological symptoms on college performance among students of color.

This study examined longitudinal relationships among exposure to chronic community violence during high school, psychological distress during the first semester of college, and academic performance during the first three semesters of college. The sample comprised 385 students of color in a large city. Exposure to community violence and psychological distress were measured with additive scales; academic performance (school persistence, grade point average) was obtained from transcripts. It was found that exposure to community violence and academic performance were not related; exposure to community violence and psychological distress were related; psychological distress and college persistence were related; and psychological distress and grade point average were not related. The findings are consistent with the causal chain model; specifically, that the effects of exposure to community violence in high school on academic performance in college are mediated by psychological distress.

Adolescent↗

Effects of diabetes on learning in children.

OBJECTIVE: Subtle neuropsychological deficits have been found in some children with type 1 diabetes. However, these data have been inconsistent, and it is not clear what the impact of these deficits might be on the learning of children with diabetes over time. The purpose of this study was to determine whether type 1 diabetes significantly interferes with the development of functional academic skills. It was hypothesized that 1) children with type 1 diabetes would demonstrate deficits in academic performance and behavior when compared with sibling or classmate control subjects and 2) that academic performance in children with type 1 diabetes would decline slightly but significantly over time whereas the performance of siblings or classmates would not. METHODS: Three groups of children from 5 pediatric diabetes clinics in a primarily rural Midwestern state participated in this study: children with type 1 diabetes (n = 244), a sibling control group (n = 110), and an anonymous matched classmate control group (n = 209). The mean age of the children with diabetes was 14.8 years (standard deviation: 3.2) and of the siblings was 14.6 years (3.2); the mean grades were 8.1 (2.9) for the children with diabetes and 7.9 (3.1) for the siblings. The Hollingshead 2-factor index revealed that the children were from primarily middle- to upper-middle-class families. The mean age of onset of diabetes for the children with diabetes was 8.3 years (3.7) with a mean disease duration of 7.1 years (3.9). Because the matched classmate data were obtained anonymously, demographic information was not available on this group. Academic achievement was measured using both standardized tests and data on classroom performance. The standardized test data included scores from the Iowa Tests of Basic Skills (ITBS) for grades 3 through 8 and the Iowa Tests of Educational Development (ITED) for grades 9 through 12. Scores in 3 broad academic areas that are obtained on children of all ages were examined: math, reading, and core total (a composite score of reading, language, and math). ITBS/ITED data were obtained on all participants. School data including the number of days absent, school years repeated, and grade point averages for math and reading were obtained on the children with diabetes and their siblings. A short, 50-item screening scale (PBS-50d), adapted from the longer 165 item Pediatric Behavior Scale (PBS), was completed by the parents to obtain information on the behavioral characteristics of the children with diabetes and their siblings. Diabetes variables measured included metabolic control (HbA1c), age at onset, and disease duration. This study looked at both the current academic performance of children with diabetes and their performance over time in relation to 2 control groups: siblings and matched classmates. A cross-sectional approach was used to evaluate current performance. Statistical differences between groups were evaluated using matched t tests or McNemar's test for differences between related samples as appropriate. Differences across time were evaluated using hierarchical linear modeling. Comparisons of ITBS/ITED test scores across grades used national percentile ranks that were converted to standard scores (SS) with a mean of 100 and a standard deviation of 15. Students in this study performed above the national average, which is typical of students in the state where this study was conducted. Data from participating clinics were compared, and no differences in current achievement scores, grade point averages, or socioeconomic status were noted for either children with diabetes or their siblings. Therefore, all subsequent analyses used data combined from all sites. RESULTS: Current academic performance on the ITBS/ITED did not show lower performance by children with diabetes compared with either control group; in fact, children with diabetes performed better than their siblings on math (mean SS: 115.0 vs 111.1) and core total scores (mean SS: 113.9 vs 110.5) and better than their matched classmates on reading (mean SS: 108.9 vs 106.8). When subgroup comparisons based on diabetes metabolic control were made among children with diabetes, poorer academic performance tended to occur in children with poorer diabetic control. However, this pattern was also noted in sibling scores when the siblings were grouped on the basis of the level of diabetic control of their brother or sister with diabetes. Children with diabetes had significantly more school absences (Mean = 7.3 per year) than their siblings (M = 5.3) and more behavioral problems. Behaviorally, the 2 groups did not differ on the 4 general factors of Aggression/Opposition, Hyperactivity/Inattention, Depression/Anxiety, and Physical Complaints. However, children with diabetes did differ significantly from their siblings on items that reflected compliance, mood variability, and fatigue, but not learning. These were 4 areas included in the PBS-50d to reflect potential concerns for children with diabetes. Academic achievement growth curves for the ITBS/ITED for each group revealed no statistically significant differences between groups when tested using hierarchical linear modeling. Individual differences in the growth trajectories were too small and inconsistent to be detected. CONCLUSIONS: For most children, type 1 diabetes is not associated with lower academic performance compared with either siblings or classmates, although increased behavioral concerns are reported by parents. The results of this study suggest that the subtle cognitive deficits often documented in children with type 1 diabetes may not significantly limit the functional academic abilities of these children over time. However, careful monitoring is still needed to ensure that episodes of hypoglycemia associated with seizures are not adversely affecting learning.

Adolescent↗

Academic profile of students who transferred to Zagreb School of Medicine from other medical schools in Croatia.

AIM: To assess the academic performance of students who transferred to the Zagreb School of Medicine from other three medical schools in Croatia. METHODS: Academic performance of medical students who moved from Rijeka, Osijek, or Split University Medical Schools to the Zagreb University School of Medicine at the second or third year was compared with academic performance of students enrolled at the Zagreb University School of Medicine. Using the Zagreb Medical School's registry, we made a list of 57 transfer students to Zagreb Medical School in the 1985-1994 period. Control group was formed of students enrolled at the Zagreb School of Medicine in the same period, whose names followed in alphabetical order after the names of transfer students. Students' performance was analyzed according to their grade average before transfer, grade average in the first year after transfer, total grade average after transfer, overall grade average, and duration of studies. We also analyzed the proportion of students in each group who did not pass the admission test at the Zagreb School of Medicine in the year before the enrollment in Zagreb, Osijek, Rijeka, and Split Medical Schools. Nineteen transfer students, transferred between 1985 and 1988, and their controls were excluded from the analysis because of incomplete data. RESULTS: Transfer students had significantly lower grade average before transfer (3.2-/+0.6 vs 3.5-/+0.7, p=0.03, Student t-test), lower grade average in the first year after transfer (3.2-/+0.6 vs 3.5-/+0.7, p=0.03), lower total grade average after transfer (3.6-/+0.5 vs 4.0-/+0.6, p<0.001), and lower overall grade average (3.5-/+0.5 vs 3.9-/+0.6, p<0.001) than control students. Median time to graduate for transfer students was 7 years (range, 5-9) and 6 years (range, 5-9) for control students (p=0.375, Mann-Whitney test). There were significantly more students among transfer students who did not pass the admission test at the Zagreb School of Medicine in the year before the final enrollment than their controls (15/38 vs 4/38, p=0.009, chi-square test). CONCLUSION: Transfer students had poorer academic performance than students who passed the admission test and were enrolled at the Zagreb School of Medicine from the first year of studies.

Career Choice↗

Determinants of school performance in children with chronic asthma.

We have documented performance on standardized academic achievement tests for reading and mathematics in 99 children with moderately severe to severe chronic asthma. Academic performance and intelligence test scores indicated that, overall, the academic capabilities of the children with asthma were average to above average. A stepwise regression analysis was used to examine relationships between the dependent variables of reading and mathematics and the independent variables of socioeconomic status, school attendance, medical factors relating to asthma, age, and emotional and behavioral problems of the children. Factors that were associated significantly with low performance scores were low socioeconomic status, older age, history of continuous oral steroid use (prednisone or methyl prednisolone taken at least every other day for the year prior to evaluation), and presence of emotional and behavioral problems. School absenteeism, use of medical resources, oral steroid dosage, other medications used to treat asthma, and pulmonary functions were not associated with academic performance. Investigation of poor classroom performance of a child with chronic asthma should include investigation of the roles of socioeconomic status, oral steroid therapy, and emotional and behavioral problems.

Absenteeism↗

Result of a national audit of bariatric surgery performed at academic centers: a 2004 University HealthSystem Consortium Benchmarking Project.

HYPOTHESIS: Bariatric surgery performed at US academic centers is safe and associated with low mortality. DESIGN: Multi-institutional consecutive cohort study. SETTING: Academic medical centers. PATIENTS AND INTERVENTIONS: We audited the medical records from 40 consecutive bariatric surgery cases performed between October 1, 2003, and March 31, 2004, at each of the 29 institutions participating in the University HealthSystem Consortium Bariatric Surgery Benchmarking Project. All medical records that met inclusion criteria (patient age, >17 and <65 years; and body mass index [calculated as weight in kilograms divided by the square of height in meters], 35-70) and exclusion criteria (previous bariatric surgery) were reviewed and data were collected on a standardized form. MAIN OUTCOME MEASURES: Demographic data, operative time, blood loss, transfusion requirement, complications, readmission, reoperation, and in-hospital and 30-day mortality. RESULTS: Data from 1144 bariatric surgery cases were reviewed from 29 University HealthSystem Consortium institutions. The specific bariatric procedures included gastric bypass (91.7%), gastroplasty or gastric banding (8.2%), and biliopancreatic diversion (0.1%). For gastric bypass procedures (n = 1049), the mean patient age was 43 years and mean body mass index was 49; 76% of procedures were performed laparoscopically, with a conversion rate of 2.2%; the overall complication rate was 16%, with an anastomotic leakage rate of 1.6%; the 30-day readmission rate was 6.6%; and the 30-day mortality rate was 0.4%. For restrictive procedures (n = 94), the mean patient age was 45 years and mean body mass index was 45; 92% of procedures were performed laparoscopically with no conversion; the overall complication rate was 3.2%; the 30-day readmission rate was 4.3%; and the 30-day mortality rate was 0%. CONCLUSIONS: Within the context of the 2004 University HealthSystem Consortium Bariatric Surgery Benchmarking Project, the risk for death within 30 days after bariatric surgery at academic centers is less than 1%. In addition, the practice of bariatric surgery at these centers has shifted from open surgery to predominately laparoscopic surgery. These quality-controlled outcome data can be used as a benchmark for the practice of bariatric surgery at most US hospitals.

Adult↗

The differential effects of intrinsic and identified motivation on well-being and performance: prospective, experimental, and implicit approaches to self-determination theory.

Self-determination theory research has demonstrated that intrinsic and identified self-regulations are associated with successful adaptation. However, few distinctions are typically made between these regulations and their outcomes. In the present studies, the associations between intrinsic and identified motivations and outcomes of psychological well-being and academic performance are compared in educational settings. In Study 1, intrinsic self-regulation predicted psychological well-being, independent of academic performance. In contrast, identified regulation predicted academic performance. Additionally, the more that students demonstrated an identified academic regulation, the more that their psychological well-being was contingent on performance. In Study 2a, priming intrinsic self-regulation led to greater psychological well-being 10 days later. In Study 2b, an implicit measure of identified regulation predicted academic performance 6 weeks later. Results indicate the need to address important distinctions between intrinsic and identified regulations.

Achievement↗

Habitual snoring, intermittent hypoxia, and impaired behavior in primary school children.

OBJECTIVES: Sleep-disordered breathing is associated with impaired behavior and poor academic performance in children. We aimed to determine the extent of behavioral problems in snoring children, clarify the role of intermittent hypoxia, and test the reversibility of impaired behavior and poor academic performance. METHODS: In 1144 children, habitual snoring (HS; snoring frequently or always) and impaired behavior were assessed using parental questionnaires. Intermittent hypoxia (ie, presence of > or =5 arterial oxygen desaturations by > or =4% or > or =1 desaturation to < or =90%) was investigated with pulse oximetry. Poor academic performance (grade 4-6 on a 6-point scale in mathematics, science, or spelling) was based on the last school report. HS, impaired behavior, and academic performance were reevaluated after 1 year. Adjusted odds ratios (ORs) were calculated using unconditional logistic regression. RESULTS: HS was significantly associated with hyperactive (OR: 2.4) and inattentive behavior (OR: 4.0), daytime tiredness (OR: 7.1), and sleepiness (OR: 2.6-4.8). These associations were independent of intermittent hypoxia. HS was also significantly associated with bad conduct (OR: 2.8), emotional symptoms (OR: 5.5), and peer problems (OR: 9.7). At follow-up, hyperactive and inattentive behavior but not academic success had significantly improved in children in whom HS had ceased. CONCLUSIONS: We suggest that impaired behavior is a key feature of HS independent of intermittent hypoxia and improves when HS ceases.

Affective Symptoms↗

[Psychological disorders of students and university results].

Many epidemiological studies demonstrate the importance of psychological disorders among college and university students. Those disorders have an impact upon the academic performance and may lead to dropping out. The aim of this research is to study the possible relations between the incidence of psychological troubles and the evolution of the academic performance. The sample is constituted by 45 first year students of the Université du Québec à Trois-Rivières. Each subject has answered the psychological and psychiatric inventory built up by Bernot et al. (1969) (Psychorater). The academic performance evolution has been scored by comparing, for each student, the mark means obtained at the first three sessions. Cross-sessions comparisons have made possible to divide the sample into four subgroups: "in regression", "with relatively stable performances", "in progression" and "dropouts". The results show a statistically significative relation between, on the one hand, the university adaptation difficulties leading to dropping out and, on the other hand, the "impulsivity-instability" dimension and the "family, professional and social adaptation troubles". Excluding the dropout subjects, it is not possible, however, to correlate the variations in the academic performance and the incidence of psychological troubles found with the Psychorater.

Achievement↗

The relationship of activity level ratings and cognitive impulsivity to task performance and academic achievement.

The relationship of activity level ratings and cognitive impulsivity were analyzed in relation to performance of second-graders on several cognitive tasks and standardized achievement tests. Vocabulary was a strong and significant covariate on most dependent measures. In general, impulsivity-reflectivity had a far stronger effect on task performance and academic achievement than did activity level ratings, even when comparisons were made for groups with extremes of activity level ratings. The authors urge further research on the task approaches and compensatory strategies of children who are behaviorally hyperactive but cognitively reflective and academically successful.

Achievement↗

Adaptive and maladaptive perfectionism in medical students: a longitudinal investigation.

OBJECTIVES: The personality of medical students may have an important impact on both their academic performance and emotional adjustment during medical school. There has been little systematic study of the impact of perfectionism on medical students. The present study sought to compare the perfectionism profile of medical students with that of a general arts student group and to examine the relationship among perfectionism, distress symptoms and academic expectations and satisfaction. DESIGN: Medical students (n=96) and arts students (n=289) completed a baseline assessment including two multidimensional perfectionism scales. The medical students also completed measures of distress symptoms, personality (neuroticism, conscientiousness) and questions about their perceptions of their academic performance. Of the medical students, 58 completed a second set of questionnaires 6 months later (time 2). SUBJECTS: First-, second- and third year medical students and first-year arts students. RESULTS: In comparison with arts students, the perfectionism profile of medical students showed higher personal standards, lower doubts about actions and lower maladaptive perfectionism scores. In the medical students adaptive perfectionism (achievement striving) was significantly correlated with baseline academic performance expectations and conscientiousness and was predictive of dissatisfaction with academic performance at time 2. Maladaptive perfectionism (excessive evaluative concerns) was significantly correlated with baseline distress symptoms and neuroticism and was predictive of symptoms of depression and hopelessness at time 2. CONCLUSIONS: Perfectionism in medical students differs systematically from perfectionism in general arts students. Distinguishing adaptive and maladaptive aspects of perfectionism is important in understanding the cross-sectional and longitudinal implications of perfectionism for medical students.

Adult↗

A multi-level analysis of cultural experience and gender influences on causal attributions to perceived performance in mathematics.

BACKGROUND: Causal attributions to academic performance are among the most important factors that influence the student's subsequent achievement behaviour. AIM: The effects of student's gender and cultural experience (region) on the ratings of previously identified causal attribution factors were investigated. SAMPLE: The participants were 341 high school students from the urban (N = 144) and the rural (N = 197) regions of Kenya. There were 205 male and 136 female students. METHODS: Causal comparative research design was used and data collected using the Causal Attribution Scale (CAS). The Hierarchical linear model (HLM) technique was used to test the hypotheses. RESULTS: There were significant gender and cultural experience variations in the mean ratings of the attribution factors. Instructional Strategy was highly rated for perceived success, and lack of Ability for perceived failure. Effort was of least importance in making attribution to either perceived success or failure. CONCLUSIONS: The findings do not concur with research findings from Western and Asian countries where Effort is considered important in making attributions for either perceived success or failure. The findings, however, agree with research findings from Asian and other non-Caucasian societies where success is attributed to external factors (e.g., task difficulty) and failure to internal factors (e.g., ability). These findings have some implications for cross-cultural research in causal attribution as it relates to academic performance. While certain causal attributions studied in 'Western' and Asian cultures differ in terms of perceived success and failure, the current study indicates that other causal attributions are important and used differently by students from Kenya.

Achievement↗

Emergency medicine career change: associations with performances in medical school and in the first postgraduate year and with indebtedness.

OBJECTIVE: Emergency medicine has been identified as the specialty that has gained the most young physicians who have changed their careers. To identify factors that may have contributed to such career changes, the authors compared the characteristics of three groups of physicians trained at their medical school: those who chose and stayed in emergency medicine, those who migrated into emergency medicine from other specialties, and those who moved out of emergency medicine. METHODS: A prospective longitudinal study was conducted. The sample consisted of physicians who chose emergency medicine as their careers at graduation and stayed in the specialty (n = 24), those who migrated from other specialties into emergency medicine (n = 51), and those who moved out of emergency medicine (n = 10). This sample was obtained from a total of 2,173 graduates of Jefferson Medical College between 1978 and 1987. The three groups of physicians were compared according to their academic performances both during medical school and after graduation. The dependent variables were freshmen and sophomore grade point averages (GPAs), written clinical examination scores, scores on National Board of Medical Examiners examination (Parts I, II, and III), and residency program directors' ratings. Age and indebtedness at medical school graduation and board certification status also were examined. RESULTS: Those physicians who stayed in emergency medicine and those who migrated from other specialties into emergency medicine had similar measures of academic performance, but both of these groups had higher academic performance measures and higher board certification rates than did the physicians who moved out of emergency medicine. Those who stayed in emergency medicine had the highest mean debt in the senior year of medical school. CONCLUSIONS: High academic performance and high indebtedness are factors associated with choosing or staying in the specialty of emergency medicine.

Adult↗

Prepharmacy predictors of success in pharmacy school: grade point averages, pharmacy college admissions test, communication abilities, and critical thinking skills.

Good admissions decisions are essential for identifying successful students and good practitioners. Various parameters have been shown to have predictive power for academic success. Previous academic performance, the Pharmacy College Admissions Test (PCAT), and specific prepharmacy courses have been suggested as academic performance indicators. However, critical thinking abilities have not been evaluated. We evaluated the connection between academic success and each of the following predictive parameters: the California Critical Thinking Skills Test (CCTST) score, PCAT score, interview score, overall academic performance prior to admission at a pharmacy school, and performance in specific prepharmacy courses. We confirmed previous reports but demonstrated intriguing results in predicting practice-based skills. Critical thinking skills predict practice-based course success. Also, the CCTST and PCAT scores (Pearson correlation [pc] = 0.448, p < 0.001) were closely related in our students. The strongest predictors of practice-related courses and clerkship success were PCAT (pc=0.237, p<0.001) and CCTST (pc = 0.201, p < 0.001). These findings and other analyses suggest that PCAT may predict critical thinking skills in pharmacy practice courses and clerkships. Further study is needed to confirm this finding and determine which PCAT components predict critical thinking abilities.

Communication↗

Prevalence of otitis media with effusion in first and second grade primary school students and its correlation with BCG vaccination.

OBJECTIVE: The object of this study was to determine the prevalence of otitis media with effusion (OME) in first and second grade primary school students, to analyze the causes of the difference in the prevalence, to define the effect of OME on the academic performance of the children and to investigate a correlation between the prevalence of OME and Bacillus Calmette-Guerin (BCG) vaccination. STUDY PLAN AND METHODS: The study was conducted during the September-November, 2002 period in Elazig. A total of 3675 clinically healthy primary school children attending primary schools in the central district of Elazig, living in the same region and of a similar socioeconomic status and age group were included in the study. Of the 3675 children, 2042 were in their first and 1633 in their second grade of primary school. The routine ear-nose and throat examinations of the children were carried out at their schools by the same medical team. The tympanometric test was performed in children diagnosed with OME following otoscopic examination. A scale measuring the academic performance of the children was developed. This scale was filled in by the student's teachers prior to physical examination. RESULTS: OME was diagnosed in 64 out of 2042 (3.1%) first grade and in 25 out of 1633 (1.5%) second grade students. The difference between the percentages of OME in first and second grade students was statistically significant (P < 0.05). The frequency of other ear-nose and throat pathologies accompanying OME was similar to those in children without OME. There was no statistically significant difference between the academic performances of children with and without OME (P > 0.05). CONCLUSION: The analysis of risk factors for OME revealed no difference between first and second grade students. The reason for the difference in the prevalence of OME between first and second grade students may be the positive effect on the immune system of the BCG vaccine which had been administered to the second grade students 4 months previously.

BCG Vaccine↗

Predicting academic and National Board Dental Hygiene Examination performance based on Academic Factors.

PURPOSE: Numerous studies have explored reliable variables that predict student success in dental hygiene programs and on the National Board Dental Hygiene Examination (NBDHE). However, no studies were found using data collected since the NBDHE format changed in 1998 to investigate if traditional predictors hold true. The objective of this study was to examine the relationship between pre-admission requirements, basic college science requirements, site of academic preparation, cumulative dental hygiene grade point average (CDHYGPA) and the NBDHE score. METHODS: Data from the academic records of 173 graduates of the dental hygiene program at The Ohio State University from 1998 through 2002 were entered into an Excel spreadsheet using identification numbers. Demographic information for the description of the subjects, course transfer data, course grades in program prerequisites and basic science requirements, CDHYGPA, and NBDHE scores were entered. Data were analyzed using the Statistical Package for the Social sciences (SPSS-version 10), Pearson's r correlations, regression analysis, and ANOVA with a predetermined level of significance at .05. RESULTS: Of the 173 records entered, 132 had complete data (76.3%). Results indicate the existing prerequisites for the dental hygiene program remain strong predictors for success. A strong correlation was noted between human nutrition courses and the CDHYGPA. Other core science courses completed while in the program-anatomy, physiology and microbiology--also rendered a moderately strong correlation to the CDHYGPA. The greatest predictors for success on the NBDHE were the student's CDHYGPA and the prerequisite three science GPA. Consistency in site of science preparation also revealed a positive correlation to the CDHYGPA. CONCLUSIONS: This study confirmed the continued use of the three science GPA pre-requisite and entering GPA for predicting success in this dental hygiene program and on the NBDHE even after the format changed to include case-based items. Other predictors for success that were identified in the study may aide dental hygiene program admission committees in their selection process. These committees may also consider the site of science preparation noting that institution consistency played a role in academic performance.

Achievement↗

Psychologic well-being of surgery residents after inception of the 80-hour workweek: a multi-institutional study.

BACKGROUND: The 80-hour workweek was adopted by US residency programs on July 1, 2003. Our published data from the preceding year indicated significant impairment in psychologic well-being among surgery residents. The purpose of this study was to determine whether psychologic well-being and academic performance of surgery residents improved after inception of the 80-hour workweek. METHODS: A single-blinded survey of general surgery residents (n=130) across 4 US training programs was conducted after July 1, 2003, with the use of validated psychometric surveys (Symptom Checklist-90-R and Perceived Stress Scale) and the American Board of Surgery In-Training Examination; comparison was done with preceding year and societal data. Primary outcomes were "psychologic distress" and "perceived stress." Secondary outcomes were "somatization," "depression," "anxiety," "interpersonal sensitivity," "hostility," "obsessive-compulsive behavior," "phobic anxiety," "paranoid ideation," "psychoticism." and "academic performance." The impact of demographic variables was assessed. RESULTS: Mean psychologic distress improved from the preceding year (P < .01) but remained elevated, compared with societal norms (P < .001). The proportion of residents meeting the criteria for clinical psychologic distress (>or=90th percentile) decreased from 38% before, to 24% after, July 2003. Mean perceived stress remained elevated, compared with norms (P < .0001) without improvement from the preceding year. Overall academic performance was unchanged. Previously elevated secondary psychologic outcomes improved after July 2003 (P < .05), although obsessive-compulsive behavior, depression, interpersonal sensitivity, hostility, and anxiety failed to normalize. Male gender and single status were independent risk factors for psychologic distress. CONCLUSIONS: Inception of the 80-hour workweek is associated with reduced psychologic distress among surgery residents. The perception of stress and academic performance remains unchanged.

Adult↗

Psychosocial adjustment and educational outcome in adolescents with a childhood diagnosis of attention deficit disorder.

OBJECTIVE: To conduct a retrospective follow-up study of psychosocial adjustment and educational outcome in adolescents with a childhood diagnosis of attention deficit disorder (ADD) and a group of clinical controls. METHODS: Groups included male and female subjects aged 14 to 18 years at time of follow-up with childhood diagnosis of ADD (cases; n = 48) versus other neurodevelopmental disorders (clinical controls; n = 37). Cases were also subdivided based on the presence of conduct disorder (CD) at follow-up. All groups were compared on measures of academic performance, self-esteem, behavior, alcohol and substance use, and adaptive functioning. RESULTS: Cases had significantly lower academic performance and poorer social, emotional, and adaptive functioning than clinical controls. Cases with CD had significantly lower academic performance, greater externalizing behaviors and emotional difficulties, and lower adaptive functioning than cases without CD. Cases with CD fared worse than clinical controls on self-report measures of behavior, socialization skills, and alcohol and substance use. CONCLUSIONS: These academic and psychosocial problems in adolescents with a childhood diagnosis of ADD suggest potential long-term ramifications for vocational and psychological functioning into adulthood. In addition, the presence of CD in some of these cases during adolescence appears to further increase the risk for maladaptive outcome.

Achievement↗