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Premedical education: the contribution of small local colleges.

CONTEXT: Small local colleges may be sources of medical students with the gender, ethnicity, and background that promote identity with and empathy for underserved populations. PURPOSE: This study examined the impact of attendance at these premedical colleges on outcomes of medical education. METHODS: Data for 2508 matriculates to the University of Alabama School of Medicine, a state-supported medical school, were examined according to premedical colleges attended. FINDINGS: Medical students who had graduated from small local colleges were more diverse in gender, race, and rural background than other students. They had slightly lower academic performance in medical school, were more likely to drop out (10.6% versus 5.3% overall), and were more likely to locate in rural areas of the host state. CONCLUSIONS: Small local colleges may be rich sources of student diversity and medical students who choose rural practice, outcomes that are gained at a cost in terms of drop-out rate. Compared with other students, minor differences in performance and larger differences in the drop-out rate raise the question of cultural context and social support during medical school as points for intervention.

Adult↗

A longitudinal study of beginning reading achievement and reading self-concept.

BACKGROUND: Although achievement-related self-perceptions are causally related to academic performance, it is not clear at what age this relationship starts to form, especially in terms of learning to read. AIMS: The aim of this longitudinal study was to examine the emerging causal interplay between reading self-concept and beginning reading performance. SAMPLE: One hundred and twelve children who started school at the age of 5 years participated in the study over a two and a half-year period. METHOD: Path analyses were used to examine the relationships between reading-related skills and reading self-concept at the start of Year 1, the middle of Year 2, and the middle of Year 3. RESULTS: Reading performance emerged as causally predominant over reading self-concept between the middle of Year 2 and the middle of Year 3. CONCLUSIONS: Initial reading-related experiences in school are associated with the development of reading self-concepts within the first two and a half years of schooling. This period may mark the time during which negative 'Matthew effects' develop for those who experience initial difficulties in learning to read.

Achievement↗

Student perceptions of a good teacher: the gender perspective.

BACKGROUND: A large-scale survey of pupils' perceptions of a good teacher in the Caribbean republic of Trinidad and Tobago is reported. An essay-based, interpretative mode of research was used to elicit and identify constructs used by boys and girls. AIMS: The study explores similarities and differences between boys and girls in their perceptions of a good teacher, in a society where girls achieve superior academic performance (than boys). SAMPLE: A total of 1756 pupils and students aged between 8 and 16 provided the sample, which was proportional, stratified, clustered. Within these constraints classrooms were randomly selected to be representative of primary and secondary schools across the two islands. METHOD: Altogether 1539 essays and 217 interviews were content analysed, coded for age development and compared between boys and girls. Content items identified by the pupils were logically grouped into: physical and personal characteristics of the teacher, quality of the relationship between the teacher and pupil, control of behaviour by the teacher, descriptions of the teaching process, and educational and other outcomes obtained by pupils due to teacher efforts. RESULTS: Female pupils identified more good teacher concepts at all age levels than males. There was some commonality between the sexes in concepts regarding interpersonal relationships and inclusiveness in the good teachers' teaching practices and boys showed significantly greater concerns regarding teacher control and use of punishment. Males as young as 8 years stated that good teachers should be sensitive to their needs. Only among the 16-year-old males were males noted as good teachers. CONCLUSION: Consideration is given to the roles of male and female teachers, how their classroom actions may set the basis for future success (or failure) of their pupils, and the needs of pupils with regard to teacher support within developing and developed countries.

Adolescent↗

The validity of 'biorhythmic' theory questioned.

The study was of the relation between three categorical independent variables (cases in the critical, positive or regenerative phase of their 'biorhythmic' cycle) and two numerical independent variables, academic performance and factor scores on the psychoneurotic component of the University College London Study Questionnaire. The sample comprised 368 Open University students. A subset was used to study the relation between cases at the peaks and troughs of their cycles. If 'biorhythms' had any effect then it would be expected that the mean scores of the three subgroups would differ significantly. Results for 18 ANOVAs showed that none of the observed relations was greater than would be expected by chance.

Biological Clocks↗

The making of a Munchausen.

The author presents a developmental case history of a Munchausen patient in an effort to understand the evolution of the behavioural patterns associated with the syndrome. The case history documents a pattern of behaviour characterized by: frequent hospitalizations for diffuse ailments, beginning in infancy and persisting into adulthood; inadequate acquisition of appropriate social values and behaviours within the context of the nuclear family; persistent difficulties in adjusting to the demands of school, as expressed in poor academic performance, delinquent behaviour, and poor peer relationships; conflicted social role behaviour regarding work performance, criminal behaviour, and increased abuse of health care services; eventual severance of family ties and the adoption of a 'hobo' life-style which utilizes hospitals for social support and personal definition. This case is compared with a similar study, recently published, and the affinities between the developmental histories and diagnostic criteria descriptive of 'antisocial personality disorder' are emphasized.

Adolescent↗

Family and parenting interventions for conduct disorder and delinquency: a meta-analysis of randomised controlled trials.

AIMS: To determine whether family and parenting interventions benefit children and adolescents with conduct disorder and delinquency. METHODS: Meta-analysis of eight randomised controlled trials involving 749 children and adolescents (aged 10-17 years) with conduct disorder and/or delinquency. Criminality, academic performance, future employment, problem behaviour, family functioning, parental mental health, and peer relations were evaluated. RESULTS: Family and parenting interventions significantly reduced the time spent by juvenile delinquents in institutions (weighted mean difference 51.34 days). There was also a significant reduction in the risk of a juvenile delinquent being rearrested (relative risk 0.66) and in their rate of subsequent arrests at 1-3 years (standardised mean difference -0.56). CONCLUSIONS: The evidence suggests that family and parenting interventions for juvenile delinquents and their families have beneficial effects on reducing time spent in institutions and their criminal activity. In addition to the obvious benefit to the participant and their family, this may result in a cost saving for society.

Adolescent↗

Neurological abnormalities in young adults born preterm.

OBJECTIVE: Individuals born before 33 weeks' gestation (very preterm, VPT) have an increased likelihood of neurological abnormality, impaired cognitive function, and reduced academic performance in childhood. It is currently not known whether neurological signs detected in VPT children persist into adulthood or become attenuated by maturation of the CNS. METHOD: We assessed 153 VPT individuals and 71 term-born controls at 17-18 years old, using a comprehensive neurological examination. This examination divides neurological signs into primary and integrative domains, the former representing the localising signs of classical neurology, and the latter representing signs requiring integration between different neural networks or systems. Integrative signs are sub-divided into three groups: sensory integration, motor confusion, and sequencing. The VPT individuals have been followed up since birth, and neonatal information is available on them, along with the results of neurological assessment at 4 and 8 years of age and neuropsychological assessment at 18 years of age. RESULTS: The total neurology score and primary and integrative scores were significantly increased in VPT young adults compared to term-born controls. Within the integrative domain, sensory integration and motor confusion scores were significantly increased in the VPT group, but sequencing was not significantly different between the VPT and term groups. Integrative neurological abnormalities at 18 were strongly associated with reduced IQ but primary abnormalities were not. CONCLUSIONS: Neurological signs are increased in VPT adults compared to term-born controls, and are strongly associated with reduced neuropsychological function.

Adolescent↗

Psychology and the study of marital processes.

The divorce rate in the United States is extremely high. It is estimated that between 50% and 67% of first marriages end in divorce. For second marriages, failure rates are even higher. There are strong negative consequences to separation and divorce on the mental and physical health of both spouses, including increased risk for psychopathology, increased rates of automobile accidents, and increased incidence of physical illness, suicide, violence, homicide, significant immunosuppression, and mortality from diseases. In children, marital distress, conflict, and disruption are associated with depression, withdrawal, poor social competence, health problems, poor academic performance, and a variety of conduct-related difficulties. Though intervention techniques might be expected to reduce these grim statistics, our best scholars have concluded that marital therapy is at a practical and theoretical impasse. This article discusses the progress of research on the study of marriage.

Journal Article↗

Classroom goal structure, student motivation, and academic achievement.

Over the past 25 years, achievement goal theory has emerged as one of the most prominent theories of achievement motivation. This chapter uses an achievement goal framework to examine the influence of classroom and school environments on students' academic motivation and achievement. Considerable evidence suggests that elementary and secondary students show the most positive motivation and learning patterns when their school settings emphasize mastery, understanding, and improving skills and knowledge. Whereas school environments that are focused on demonstrating high ability and competing for grades can increase the academic performance of some students, research suggests that many young people experience diminished motivation under these conditions. The implications of achievement goal theory for examining the impact of school reform are discussed.

Achievement↗

Treatment of chronic intractable neuropathic pain with dronabinol: case report of two adolescents.

OBJECTIVE: To evaluate the effectiveness of dronabinol for the treatment of neuropathic pain refractory to previous treatment. METHODS: We studied the response (reduction of pain intensity and functional improvement) to dronabinol (5 mg/day to 25 mg/day) in two adolescents with neuropathic pain and depression refractory to previous treatments over two and five years, respectively. RESULTS: Reduction in pain intensity (45%) was achieved in patient 2 and was unchanged in patient 1. Functional improvement was markedly increased in terms of academic performance, mood and sleep in both patients over four to five months, without major adverse effects. While these improvements dissipated over time, the patients were more reconnected with rehabilitation and focused less on the intrusiveness of their pain problem in their every day lives. CONCLUSIONS: Dronabinol appeared to be effective in improving pain affect and psychosocial functioning in the treatment of refractory neuropathic pain and may be considered as an adjuvant medication in the rehabilitation process. Well-controlled placebo studies are required for further evaluation.

Adolescent↗

Depressive symptoms and academic self-image in adolescence.

The aim of this paper was to specifically analyse the relationship between the different components of academic self-image, defined as the way adolescents represent themselves as students, and self-reported depressive symptoms, assessed with the Children's Depression Inventory (CDI), in a non-clinical sample of 298 adolescents. We considered both adolescents' beliefs about their own cognitive functioning in academic performance and beliefs about their emotional attitude in achievement situations. Our data indicate that the pattern of correlation between emotional beliefs about schooling and learning are significantly related to CDI scores, but this correlation is not evident for the cognitive beliefs. This pattern of correlation is affected by actual school functioning, because correlation between CDI and beliefs is much more significant in subjects without school failure. Differences between gender in CDI scores, beliefs about schooling and learning, and pattern of correlation are considered. These results can enable to focus supporting psychological interventions on more specific targets.

Achievement↗

Effects of growth hormone treatment on cognitive function and head circumference in children born small for gestational age.

Short stature is not the only problem faced by children born small for gestational age (SGA). Being born SGA has also been associated with lowered intelligence, poor academic performance, low social competence and behavioural problems. This paper summarizes the results of a randomized, double-blind, growth hormone (GH) dose-response study (1 or 2 mg/m2/day [ approximately 0.035 or 0.07 mg/kg/day]) on growth, intelligence quotient (IQ) and psychosocial functioning in 79 children born SGA at the start, and after 2 and 8 years of GH therapy, and addresses the associations with head circumference. Mean age at start of therapy was 7.4 years; mean duration of GH treatment was 8.0 years. In 2001, 91% of children born SGA had reached a normal height (> -2.0 standard deviation score [SDS]). Block-design s-score (Performal IQ) and Total IQ score increased (p < 0.001 for both indices) from scores significantly lower than those of Dutch peers at the start of therapy (p < 0.001) to scores that were comparable to those of Dutch peers in 2001. Vocabulary s-score (Verbal IQ) was normal at the start of therapy and remained so over time. Externalizing Problem Behaviour SDS and Total Problem Behaviour SDS improved during GH therapy (p < 0.01-0.05) to scores comparable to those of Dutch peers. Internalizing Problem Behaviour SDS was comparable to that of Dutch peers at the start of therapy and remained so, whereas Self-Perception improved from the start of GH therapy until 2001 (p < 0.001), when it reached normal scores. Head circumference SDS at the start of GH therapy and head growth during GH therapy were positively related to all IQ scores (p < 0.01), whereas neither were related to height SDS at the start of, or to its improvement during, GH therapy. A significant improvement in height and head circumference in children born SGA was seen after only 3 years of GH therapy, in contrast to randomized SGA controls. In conclusion, most children born SGA showed a normalization of height during GH therapy and, in parallel to this, a significant improvement in Performal IQ and Total IQ. In addition, problem behaviour and self-perception improved significantly. Interestingly, Performal, Verbal and Total IQ scores were positively related to head circumference, both at the start of, and during, GH therapy; head circumference increased in GH-treated children born SGA, but not in untreated SGA controls. These results are encouraging but also warrant confirmational studies and further investigations into the effects of GH on the central nervous system.

Child↗

Neuropsychological functioning in children with shunted uncomplicated hydrocephalus.

A neuropsychological battery was given to a CT-defined group of children shunted for uncomplicated hydrocephalus with estimated normal range IQs. When no other brain anomalies were present, verbal IQ estimates were inferior to age and sex matched controls, but still in the normal range. In the presence of average academic performance and normal range IQ, impairment of neuropsychological functioning in verbal and nonverbal memory, fine motor speed, and visuospatial problem solving was observed. Successful neurosurgical management of hydrocephalus is not necessarily equated with achieving normal neuropsychological functioning.

Cerebrospinal Fluid Shunts↗

Psychiatric status of adolescents who had extreme temperaments at age 7.

Two temperamentally extreme (extremely easy and extremely difficult) subgroups of children were selected at the age of 7 years from a large random sample of the general population of Quebec City. The clinical status, family functioning, IQ, and academic performance of these children were reassessed at 12 and 16 years of age. Findings suggest that extreme temperament at age 7 predicts psychiatric status in preadolescence and adolescence only when family functioning is also taken into account. The adolescents who had been temperamentally difficult children and who were living in families with dysfunctional behavior control displayed more clinical disorders.

Achievement↗

The clinical role of computerized EEG in the evaluation and treatment of learning and attention disorders in children and adolescents.

Quantitative EEG (QEEG) can play an important role in the evaluation and treatment of children and adolescents with attention deficit and learning disorders. Children with learning disorders are a heterogeneous population with QEEG abnormality in 25% to 45% of reported cases. EEG slowing is the most common abnormal finding, and the nature of the QEEG abnormality may be related to future academic performance. Children with attention disorders are a more homogeneous population, with QEEG abnormalities in up to 80%. In this population, frontal/polar regions are most likely to show deviations from normal development, with the thalamocortical and/or septal-hippocampal pathways most likely to be disturbed. QEEG shows high sensitivity and specificity for distinguishing normal children and children with learning disorders and attention disorders from each other and may provide useful information for determining the likelihood that children with attention problems will respond to treatment with stimulant medication.

Adolescent↗

Using peer-group intervention with problem students in a secondary school.

Twenty adolescent girls whose records showed poor academic performance and frequent truancies and referrals to the guidance office were selected to participate in a pilot project to provide a peer-group experience for students having difficulty at school. Half the students were placed in a control group and received regular services from the school. Students in the experimental group attended 12 discussion sessions held during the school day. A one-year follow-up showed that seven in the experimental group and one in the control group had improved.

Adolescent↗

Relationship between maternal church attendance and adolescent mental health and social functioning.

OBJECTIVE: This study compared maternal attendance at religious services with standard demographic characteristics such as race, type of religion, and mother's education in terms of their relative association with the behavioral and social functioning of young adolescents. METHODS: The Child Health and Illness Profile--Adolescent Edition and the Children's Depression Inventory were used to screen 445 youths age 11 through 13 who were randomly selected from two public middle schools in Baltimore. Based on the findings, the investigators selected a sample of 143 youths in which approximately two-thirds were at risk of having a psychiatric disorder and the remaining third were unlikely to have a psychiatric disorder. The youths and their mothers were interviewed at home to determine the mothers' frequency of participation in religious services and the youths' self-reported health and mental health status and social role functioning. RESULTS: Youths whose mothers attended religious services at least once a week had greater overall satisfaction with their lives, more involvement with their families, and better skills in solving health-related problems and felt greater support from friends compared with youths whose mothers had lower levels of participation in religious services. Maternal attendance at religious services had a strong association with the youths' outcome in overall satisfaction with health and perceived social support from friends, although family income was the strongest predictor of five other aspects of functioning, including academic performance. CONCLUSIONS: Frequent maternal participation in religious services was associated with healthy functioning and well-being in this sample of young adolescents. This association is as important as or more important than associations involving other traditional demographic variables, with the exception of family income.

Adolescent↗