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[Prevalence of attention deficit hyperactivity disorder in Colombian children and teenagers].

INTRODUCTION: Attention deficit hyperactivity disorder (ADHD) is the most common neurobehavioural disorder among schoolchildren. It may persist into adulthood and affect performance in the academic, social, occupational and familial spheres, and increase the use and abuse of alcohol and psychoactive substances and the risk of having an accident. Its prevalence throughout the world varies widely and further knowledge about this situation would be valuable for the development of policies in the sector of education. AIMS: The aim of this research was to determine the prevalence of ADHD and its distribution according to subtypes in schoolchildren from Sabaneta, Antioquia, Colombia, in 2001. SUBJECTS AND METHODS: The analysis involved a cross-sectional descriptive study using a representative randomised multistage sample (which was proportional to the size of the groups) of schoolchildren between 4 and 17 years old. Measurement was performed in two stages, first by application of a screening form according to DSM IV criteria, and later a structured interview, Conners' and Intelligence tests. RESULTS: Prevalence was found to be 20.4% and 15.8% if only children with an intelligence quotient of 80 or above were considered. The combined subtype was the most frequent, with 9.6%. In public schools it was 16.2%, private 15.3%, age group from 7-11 years 16.9%, 12-17 years old 14.2%, males 20.9%, females 10.1%, low 14.7%, medium 17.4% and high socioeconomic level 10.7%, with a male to female prevalence ratio of 3.88 to 1. CONCLUSIONS: Prevalence of ADHD in the school population in a municipality in the Metropolitan Area of Medellin, Colombia, is high. The most frequent subtype was the combined type, which was predominant in males, had repercussions on academic performance and low proportions of pharmacological interventions for the disorder (15%). Programmes must be developed for the detection of this problem and subsequent intervention in the school population.

Adolescent↗

Performance outcomes associated with medical school community service.

BACKGROUND: Providing medical students with community service opportunities during medical school is believed to foster altruism. Little is known whether voluntary community service is associated with students' academic and clinical skill performance. This study examined the relationship between students' volunteer community service hours during medical school and their medical school academic performance, measures of clinical skills, and residency performance. METHOD: Subjects were 2001 and 2002 graduates of the institution. Performance measures were: United States Medical Licensing Examination (USMLE) Step 2 score, grade point average, fourth-year clinical skills examination scores, and two types of residency director assessments. Associations between performance measures and community service hour categories were analyzed using descriptive statistics, chi-square, and t-tests. RESULTS: Students in the highest service group (>/=18.5 hours) had significantly higher grade point averages, USMLE Step 2 scores, and scores on both residency director assessment when compared to students with no community service hours. CONCLUSIONS: Community service involvement in medical school appears associated with medical school academic and residency performances.

Community Health Services↗

Baccalaureate education and NCLEX: the causes of success.

A systems framework was used to study the unusual failure rate on the National Council Licensing Examination (NCLEX) experienced by one-third of the 1983 graduates of a Northwestern Bachelor of Science Nursing (BSN) program. The study group included 176 graduates; 28 were nonsuccessful and 148 were successful candidates. All candidates experienced an integrated curriculum in the two-year nursing major. This comprehensive study addressed the conceptual and experiential areas of the curriculum as well as student academic potential and performance. It is one of the first research reports to include the new NCLEX as the dependent variable. Data were analyzed for correlational and causal relationships using regression analysis and tests of statistical inference. Results indicated that graduates who entered the program with low SAT scores, low cumulative and Science GPAs, who scored below the class mean on School of Nursing examinations and whose cumulative grade point averages drifted downward while in the School of Nursing were at a significantly high risk of failing the NCLEX. It was demonstrated that the bulk of the learners attracted to the University program fell in the B to C range of academic performance, some graduates were dissatisfied with faculty teaching skill and methods, as well as with the amount of hands-on experience available either in skills labs or clinical settings. The integrated curriculum used by the School of Nursing, threading concepts across practice areas, also presented a difficulty for students. Overall, the study indicated a concern about whether the avant-garde integrated curriculum and teaching methods used by the School of Nursing met the needs of average learners attracted to the program.

Achievement↗

Idiopathic epilepsy and school achievement.

Forty one children (20 boys, 21 girls) aged 6-10.8 years (mean age 8.6 years) who were affected with idiopathic epilepsy underwent neuropsychological (Wechsler Intelligence Scale for Children, Bender test) and behavioural assessment (Personality Inventory for Children; this was also used in a matched control group). Further information was obtained by teachers' reports. School underachievement occurred in 25 children (61%). Statistical analysis showed no influence of sex, social background, age of onset, seizure type, duration of illness, features seen on electroencephalography, and treatment. School failure was due to poor performance in almost all academic fields, and was associated with higher visuomotor impairment; children showing good school performance had a higher mean IQ and less visuomotor impairment. The behaviour of children with epilepsy who had a good academic performance did not differ from that of their healthy peers. Emotional maladjustment (social skill impairment, depression, poor motivation, and low self esteem) was associated with poor school performance. Such problems, that may complicate the course of idiopathic epilepsy and require an appropriate educational programme, should be carefully considered by the clinician.

Bender-Gestalt Test↗

Effects of an academic failure experience on subsequent performance on anagram and paired-associate tasks: differences among second-, fifth-, and eighth-grade children.

Failure on an academic task was experimentally induced in second-, fifth, and eighth-grade school children. The failure experience significantly retarded subsequent performance on an anagram task and a paired-associates task by second graders but not by fifth and eighth graders. Among the eighth-grade boys, performance on the paired-associates task was actually facilitated by the failure experience. It is suggested that the older students' greater experience with negative feedback in school accounts for their resistance to its negative effects.

Attention↗

[The evolution of Chilean universities from 1981 to 2004].

In 1981, a supreme decree allowed the creation of private universities in Chile. As a consequence, 50 new universities were created in one decade, under the surveillance of the Council for Superior Education. This paper analyzes the evolution of this expansion process, that resulted in an admission of 370,000 students to 60 universities along the country, during 2004. At the moment, 42% of the universities, designed as traditional, receive state financing and 58% are private. Twenty six percent are owned by the state, 52% are secular and 22% are confessional. The 25 traditional universities are complex organizations of a high academic level. New private universities are only devoted to teaching and some have obtained their autonomy. Some have improved the quality of their academic staff, perform research and impart doctorate degrees. However, most are small and with a limited academic staff. Traditional universities are stratified in a superior level. Eight private universities and some regional institutions, that are becoming complex and performing research activities, are stratified in a middle level. Two thirds of the private universities are in the lower level. The expansion of superior education is a sign of the social and cultural progress that Chile has experienced.

Accreditation↗

Academic emergency medicine in United States medical schools.

OBJECTIVE: To determine the current standing of academic units of emergency medicine in allopathic medical schools and to measure the attitudes of medical school deans toward the specialty. DESIGN: An investigator-blinded survey of the senior deans of 123 allopathic medical schools in the United States. RESULTS: Ninety-four of 123 (76%) survey instruments were completed. Fifty-six medical schools reported having academic units of emergency medicine (five divisions of the dean's office, 16 full departments, 35 divisions/sections of other departments). Twenty-five of 56 units were reported to be academically less productive when compared with other specialty academic units of similar size. When overall mission (academic plus clinical/administrative) was considered, 46 of 56 units were reported as adequately fulfilling or exceeding mission expectations. Thirty-eight schools reported not having an academic unit of emergency medicine. Only ten of the 38 reported have no institutional support or plans for academic emergency medicine. CONCLUSION: Medical school deans are generally satisfied with the clinical/administrative performance of academic emergency medicine units but are less so with academic productivity. Despite the small numbers of full departments and disparate status of established units, it is noteworthy that only ten of the 94 respondents to this survey reported no support whatsoever for academic emergency medicine.

Emergency Medicine↗

An academic-community cardiovascular service line affiliation: design, implementation, and performance.

Both affiliation with an academic medical center and implementation of service line management may be effective management strategies for community health care organizations. The authors describe the design, implementation, and performance of a unique combination of these two distinct strategies for cardiovascular program development in the affiliation of the University of Florida Health Science Center with Health First, a regional community-based integrated delivery system.

Academic Medical Centers↗

The relationship of academic measures in medical school to performance after graduation.

This study examined the relationship between academic variables in medical school and outcome measures in the first year of postgraduate training, using data from 947 graduates of Wright State University School of Medicine from 1980 through 1991. The medical school variables were preclinical grade-point averages (GPAs), clerkship GPAs, scores on the National Board of Medical Examiners (NBME) Part I examination, and NBME Part II scores. The outcome measures were NBME Part III scores and physician supervisors' ratings of clinical competence in residency. The medical school academic variables correlated between .46 and .71 with NBME Part III scores and between .20 and .30 with the physician supervisors' ratings. R2 values for NBME Part III scores and physician supervisors' ratings were .51 and .10. Chi-square analysis using factor-analysis-derived variables showed that top-quarter and bottom-quarter achievers in medical school were highly unlikely to change positions whether the graduate outcome measure was physician supervisors' ratings or NBME Part III scores.

Achievement↗

The effects of auditory stimulation on the arithmetic performance of children with ADHD and nondisabled children.

This study evaluated the impact of extra-task stimulation on the academic task performance of children with attention-deficit/hyperactivity disorder (ADHD). Twenty boys with ADHD and 20 nondisabled boys worked on an arithmetic task during high stimulation (music), low stimulation (speech), and no stimulation (silence). The music "distractors" were individualized for each child, and the arithmetic problems were at each child's ability level. A significant Group x Condition interaction was found for number of correct answers. Specifically, the nondisabled youngsters performed similarly under all three auditory conditions. In contrast, the children with ADHD did significantly better under the music condition than speech or silence conditions. However, a significant Group x Order interaction indicated that arithmetic performance was enhanced only for those children with ADHD who received music as the first condition. The facilitative effects of salient auditory stimulation on the arithmetic performance of the children with ADHD provide some support for the underarousal/optimal stimulation theory of ADHD.

Acoustic Stimulation↗

An instrument for determining the amount of NIH support for clinical investigations at one academic health center.

PURPOSE: Although interest in supporting clinical investigators is increasing, information regarding the quantity, spectrum, and specific types of clinical research performed in academic health centers (AHCs) is generally not available. The authors report on an instrument to quantify the National Institutes of Health (NIH)-funded component of clinical research at one institution. METHOD: A systematic review of all NIH grants awarded to Massachusetts General Hospital (MGH) in fiscal year (FY) 1997-98 was performed using public information from two NIH Internet sources. Research abstracts from all 487 grants were reviewed and the percentage and type of clinical research activity within each was estimated and compared with estimates provided by a subset of principal investigators. RESULTS: During FY 1997-98, the MGH received $134 million in total NIH funding; $39.9 million (30%) supported the broadest definition of clinical research (that using human materials). When the definition of clinical research was narrowed to direct interaction between investigator and patient for investigative purposes (patient-oriented research), the total for clinical research was $18.2 million. These numbers significantly exceeded the institution's previous estimates of $.6 million for NIH-sponsored clinical trials and $2.2 million for population-based studies. CONCLUSIONS: Clinical investigation is an important component of AHCs' research portfolios from several perspectives, not the least of which is financial. Data on the clinical component of an institution's research effort should be collected prospectively and nationally to inform the optimal allocation of research resources and the alignment of the AHC's infrastructure.

Academic Medical Centers↗

American Society of Neuroradiology research survey 2001.

RATIONALE AND OBJECTIVES: Research is a critical component of the mission of academic radiology, and success in research is necessary for the future of neuroradiology. Thus, the authors set out to establish a baseline of research activities of American Society of Neuroradiology (ASNR) members. MATERIALS AND METHODS: The authors surveyed 100 fellowship program directors. The survey was Web based, with recruitment from the ASNR Fellowship Database survey site and with e-mail and fax solicitations to the Web site. Questions focused on neuroradiologist and neuroradiology fellow involvement in research. RESULTS: Forty-eight of the 100 program directors (48%) responded. Several key findings emerged: (a) About one-third of fellowship programs require all fellows to do some research, with most fellows receiving less than 1 day per week of academic time; (b) just over half of the programs expect fellows to publish a paper; (c) about two-thirds of academic neuroradiologists get at least 1 academic day per week; (d) most academic neuroradiologists perform research, but most of this research is unfunded; and (e) about nine of 10 academic sections have at least one neuroradiologist with some extramural funding. CONCLUSION: The relative lack of extramural funding among academic neuroradiologists is a reality that is probably multifactorial; however, there may be a direct relationship between amount of academic time free from clinical duties and successful competition for funding. The time (and, thus, financial) support of research-oriented fellows and faculty should be increased.

Canada↗

Academic achievement and intelligence test performance in children with cancer at diagnosis and one year later.

Recent investigations have found significant test-retest decline in certain academic achievement and intelligence test scores in children diagnosed as having acute lymphocytic leukemia (ALL) before 8 years of age. No such effect was observed in children diagnosed at or later than age 8 years. The current study, using a sample of 77 children with ALL, failed to support these findings. No significant differences were found between groups at test or retest nor were significant declines seen for either group from test to retest 1 year later. Reasons for differences in findings between studies, including methodological and samples size differences, are discussed along with implications for future research in this area.

Achievement↗

Cognitive consequences of coexisting temporal lobe developmental malformations and hippocampal sclerosis.

OBJECTIVE: To characterize patterns of cognitive functioning in a well-defined group of patients with MRI-identified coexisting left temporal lobe developmental malformations (TLDM) and mesial temporal sclerosis (MTS), and to examine neuropsychological outcome in this dual-pathology group following epilepsy surgery. METHODS: Cognitive functioning in patients with left TLDM and MTS (n = 15) was compared with patients with isolated left MTS (n = 40). TLDM and MTS were identified by high-quality MRI protocol. Patients were administered a battery of neuropsychology tests as part of their presurgical workup for possible epilepsy surgery. Unilateral temporal lobe resection was performed on 10 of the dual-pathology patients and 34 of the isolated MTS patients. Postoperative cognitive performance was also assessed. RESULTS: Both groups displayed impairments in verbal and visual memory, language, and academic achievement. Performance on measures of psychometric intelligence, executive function, and attention were not impaired and were similar between groups. Presence of dual pathology was associated with a significantly less efficient verbal encoding strategy on the word list learning task. Postoperatively, declines were noted for both groups across tasks of verbal memory and language. Groups were not different significantly in terms of neuropsychological outcome after surgery. CONCLUSION: Patients with coexisting TLDM and MTS have impaired cognitive functioning similar to MTS patients-in particular, with regard to episodic memory and language deficits. Temporal lobe resection produces similar cognitive changes in both groups.

Adult↗

Factors associated with surgical options for breast carcinoma.

BACKGROUND: Breast conservation surgery (BCS) and mastectomy have equivalent survival outcomes for women with breast carcinoma, but treatment decisions are affected by many factors. The current study evaluated the impact of patient and physician factors on surgical decision-making. METHODS: Statistical analyses were performed on a prospective multicenter study of patients with invasive breast carcinoma. Patient, physician, and geographic factors were considered. RESULTS: Of 4086 patients, BCS was performed in 2762 (67.6%) and mastectomy was performed in 1324 (32.4%). The median tumor size was 1.5 cm (range, < 0.1-9.0 cm) in patients undergoing BCS and 1.9 cm (range, 0.1-11.0 cm) in patients undergoing mastectomy (P < 0.00001). The median age of patients undergoing BCS was 59 years (range, 27-100 yrs), whereas patients who underwent mastectomy were older (median age of 63 yrs, range, 27-96 yrs [P < 0.00001]). Physicians in academic practices performed more lumpectomies than those who were not in an academic practice (70.9% vs. 65.7%; P = 0.001). More breast conservation procedures were performed by surgeons with a higher percentage of breast practice (P = 0.012). Geographic location was found to be significant, with the Northeast having the highest rate of breast conservation (70.8%) and the Southeast having the lowest (63.2%; P = 0.002). On multivariate analysis, patient age (odds ratio [OR]: 1.455; 95% confidence interval [95% CI], 1.247-1.699 [P < 0.001]), tumor size (P < 0.001), tumor palpability (OR: 0.613; 95% CI, 0.524-0.716 [P < 0.001]), histologic subtype (P = 0.018), tumor location in the breast (P < 0.001), physician academic affiliation (OR: 1.193; 95% CI: 1.021-1.393 [P = 0.026]), and geographic location (P = 0.045) were found to be significant. CONCLUSIONS: Treatment decisions were found to be related to patient clinicopathologic features, surgeon academic affiliation, and geographic location. Future studies will elucidate the communication and psychosocial factors that may influence patient decision-making.

Academic Medical Centers↗

Selected personality and demographic variables: academic success in radiography programs.

This study was designed to investigate the feasibility of utilizing selected personality inventories and demographic variables as predictors of academic success in radiography programs. The findings of the investigation indicate that the personality and demographic variables are not related to student performance in academic courses, but that the personality variables have potential for utilization as predictors of clinical performance.

Achievement↗

Utilization of an academic nursing center.

Academic nursing centers, or nurse-managed clinics, are relatively new health care delivery systems. Little information exists as to the demographic characteristics of individuals who use academic nursing centers for health care. Moreover, little is found in the literature about the types of conditions diagnosed and the procedures and tests performed at academic nursing centers. Based on one academic nursing center, this project showed that 3,263 persons received care during an 8-month period. The types of conditions diagnosed and the demographic characteristics of individuals cared for are described. The procedures and diagnostic tests performed are identified. These data have important implications for marketing, predicting resources, and meeting the educational component of the academic nursing center.

Adolescent↗