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PubMed2005

Behavioural, academic and neuropsychological profile of normally gifted Neurofibromatosis type 1 children.

UNLABELLED: In the present study the neuropsychological, academic and social-emotional profiles were examined in Neurofibromatosis type 1 (NF1) children. SUBJECTS: 17 NF1 children (ages 7-11) with NF1 without serious medical problems and with a full scale IQ (FSIQ) above 70. METHODS: Wechsler Intelligence Scale for Children-Revised (WISC-R), academic tests and an exhaustive neuropsychological test battery were administered in all children. Parents and teachers filled out the Child Behavioural Checklist (CBCL) and Teacher Report Form (TRF), respectively, the NF1 children the Experienced Competence Scale for Children (ECSC). RESULTS AND DISCUSSION: Nearly 50% (8/17) of the children showed learning disabilities, when corrected for IQ in the academic evaluations. Isolated impaired literacy skills, particularly spelling problems, were most frequent (4/8), whereas a pure arithmetic learning disability was rare (1/8). Three children presented both learning disabilities. Results on academic and neuropsychological tests did not fit the well-known types of learning disabilities -- nonverbal learning disability (NLD) and dyslexia. Nearly all NF1 children showed visual perceptual and executive dysfunctions. In this study, teachers more frequently reported behavioural problems in NF1 children than parents, as opposed to literature data in a general population. The correspondence of the perception of internalizing problems between the children and teachers was greater than between children and their parents. No correlation was found between the performances on the WISC-R, specific neuropsychological results, academic performances and behavioural problems. The Deficiency in Attention, Motor and Perception (DAMP) concept seems most appropriate in order to describe the neuropsychological deficits and their repercussions on behavioural and academic performances seen in NF1 children.

Achievement↗
PubMed1987

Interaction of the food industry with the academic community.

Research performed by LJ Filer, Jr, MD, PhD, and his colleagues has resulted in an extensive number of publications elucidating the pharmacologic effects and biochemical fate of numerous food components and additives. This research carried out at the University of Iowa and elsewhere has provided important data on amino acids, methylxanthines, and peptides, especially when such compounds are used as food additives. Needs and suggested tactics for designing, funding, and completing food safety research are discussed. Industry must obtain reliable, high quality information regarding the safety of food additives if it is to respond to persistent consumer concerns over food and food additive safety.

Food Additives↗
PubMed1990

Can learning disabilities be determined from working memory performance?

This study assumes that children of various academic abilities may be characterized by different patterns of memory function. To test this assumption, subgroups of children were identified through a hierarchical cluster analysis based upon a test battery of sentence span, preload, and concurrent memory demand tasks. One subtype presented a profile of children with learning disabilities showing severe memory performance deficits, while another subgroup yielded high memory and high academic performance. Four additional subtypes had variations in memory performance, which in turn reflected variations in external criteria related to reading, mathematics, and spelling performance. For each subtype, performance strengths and weaknesses were characterized within Baddeley's (1986) working memory model. The study provides partial validation for the classification of children with learning disabilities on psychometric measures according to patterns of memory performance.

Achievement↗
PubMed2005

The prevalence and characteristics of incentive plans for clinical productivity among academic anesthesiology programs.

Performance-based compensation is encouraged in medical schools to improve faculty productivity. Medical specialties other than anesthesiology have used financial incentives for clinical work. The goal of this study was to determine the prevalence and the types of clinical incentive plans among academic anesthesiology departments. We performed an electronic survey of the members of the Society of Academic Anesthesiology Chairs and the Association of Anesthesiology Program Directors in the spring of 2003. The survey included questions about departmental size, presence of a clinical incentive plan, characteristics of existing incentive plans, primary quantifiers of productivity, and factors used to modify productivity measurements. An incentive plan was considered to be present if the department measured clinical productivity and varied compensation according to the measurements. The plans were grouped by the primary measure used into the following categories: None, Charges, Time, Shift, Late/Call (only late rooms and call), and Other. Eighty-eight (64%) of 138 programs responded to the survey, and 5 were excluded for incomplete data. Of the responding programs, 29% had no system, 30% used a Late/Call system, 20% used a Shift system, 11% used a Charges system, 6% used a Time system, and 3% fit in the Other category. Larger groups (>40 faculty members) had a significantly more frequent prevalence of incentive plans compared with smaller groups (<20 faculty members). Incentives were paid monthly or quarterly in 85% of the groups. In 90% of groups, incentive payments accounted for <25% of total compensation. Adjustments for operating room schedule supervisors, personally performed cases, day surgery preoperative clinics, pain-management services, and critical care services were included in less than half of the programs that reported incentive plans. Call and late room compensation was based on varied formulas. Sixty-nine percent of academic anesthesiology departments did not vary compensation according to clinical activity during regular hours. Most did vary payments on the basis of call and/or late rooms worked. Larger departments were more likely to use clinical incentive plans.

Academic Medical Centers↗
PubMed2001

Indirect institutional revenue generated from an academic primary care clinical network.

BACKGROUND AND OBJECTIVES: As the financial performances of US academic health centers have faltered under managed care and the Balanced Budget Act of 1997, increasing attention has been paid to the costs and benefits of operating primary care networks. This study examines the indirect revenues to a university hospital and faculty group practice that result from such a primary care network using a method of abstracting billing data. METHODS: A primary care patient cohort was identified by selecting all patients who generated at least one charge in any of the 10 primary care clinics in the network over a 15-month period. All charges from the hospital and the faculty practice group for this cohort were then examined during a 6-month period, and the total charges generated in the primary care setting were compared with charges generated elsewhere in the health system. RESULTS: The primary care patient cohort included 56,459 patients and generated a total of $7,243,312 in charges for primary care services, $43,559,741 of charges in the hospital billing system for non-primary care services, and $8,825,611 of charges for services from specialty faculty. This cohort accounted for 18.5% of the gross charges for hospital care and 17.6% of charges generated by the specialty physicians. CONCLUSIONS: Using a simple and replicable methodology, this study estimates a substantial financial benefit to the hospital and specialty practices from a primary care network.

Academic Medical Centers↗
PubMed1984

Accuracy versus speed in the generalized effort of learning-disabled children.

Reinforcement of effortful performance in a given academic task has been found to increase the subsequent performance of other academic tasks. The learned-effort hypothesis assumes that individuals learn which dimensions of task performance are correlated with reinforcement of high effort, and generalize across tasks. Therefore, reinforcement of increased effort in a given dimension of one task should result in greater generalized effort in the same dimension of transfer performance than in another dimension. In accord with this view, preadolescent learning-disabled students who received points for high reading accuracy subsequently produced more accurate drawings and stories than did students whose points had been based upon high reading speed or upon mere completion of the reading task. Students who received points for high reading speed subsequently constructed stories more quickly than did children whose points had been based upon high reading accuracy or upon reading-task completion. Consistent with the more explicit and frequent feedback for accuracy than for speed in most academic tasks, generalized accuracy was much more durable than generalized speed.

Child↗
PubMed1990

Traditional predictors of performance in medical school.

This paper addresses the predictive value for performance in medical school of undergraduate grades, the Medical College Admission Test (MCAT), information on the selectivity of the undergraduate institution, and selected transcript data. The performance data examined were basic science grades; clinical science grades; scores on National Board of Medical Examiners examinations, Parts I, II, and III; and information on academic difficulty. Methodological sources of differences in validity data, including restriction in range, criterion attenuation, and method specificity, are discussed. Reported validity data affirm the substantial value of traditional academic predictors of performance in medical school. Selection committees should, nevertheless, supplement academic data with nonacademic and interview information. Their inclusion is particularly important for minority and disadvantaged applicants. Medical schools should assess the validity of their selection systems. Additional research on the relations between academic predictors and performance-based indexes of clinical competence and on the role of traditional predictors with regard to the recently declining medical school applicant pool is suggested.

Achievement↗
PubMed1985

Neuropsychological and academic achievement correlates of abnormal WISC-R verbal-performance discrepancies.

This study examined neuropsychological and academic achievement correlates of statistically abnormal VIQ less than PIQ discrepancies on the WISC-R in a sample of 53 hospitalized children. Of 17 neuropsychological measures, only aphasia errors was associated with VIQ. Academic achievement measures of reading, spelling, and arithmetic were associated with abnormal VIQ less than PIQ discrepancies. The results indicate that statistically abnormal VIQ less than PIQ discrepancies reflect specific aphasia deficits rather than generalized neuropsychological dysfunction and that academic achievement deficiencies of a general nature ensue.

Achievement↗
PubMed1995

MR imaging: quality assessment method and ratings at 33 centers.

PURPOSE: To outline a quality assessment method with peer review for magnetic resonance (MR) imaging. MATERIALS AND METHODS: Thirty-three providers in the Philadelphia area were rated on a random sample of 132 brain, 124 cervical spine, and 113 lower extremity MR imaging examinations performed during 1990. Blinded peer review was performed by panels of three subspecialty-trained academic radiologists. Technical performance, completeness, and report appropriateness of each MR imaging examination were evaluated. Aggregated scores were calculated to rate provider performance for each of the three parameters of quality. RESULTS: Two or three panelists assessed technical performance as inadequate in 15 cases, completeness as incomplete in 58 cases, and the interpretative report as inappropriate and affecting treatment in 72 cases. Eleven providers received an unsatisfactory rating on one or more parameters of quality. The association between unsatisfactory ratings and the use of low-field-strength (< or = 0.6-T) imagers was statistically significant (P < .008). CONCLUSION: Substantial deficiencies were identified in the performance of examinations and interpretation of MR images in the Philadelphia area in 1990. These findings indicate the need for a program to monitor quality of MR imaging.

Brain↗
PubMed2006

Residency training as technology matures a survey of radiology residents' training experiences.

RATIONALE AND OBJECTIVES: The aim of the study is to assess radiology resident training experience in cardiac magnetic resonance imaging (MRI), positron emission tomography (PET), obstetrical (OB) ultrasound (US), carotid US, and barium esophagram. MATERIALS AND METHODS: One hundred eighteen radiology residents completed surveys. Surveys assessed resident year of residency training, hospital size, program affiliation with an academic institution, state, performance of the examinations listed, number of examinations performed per week, and number of weeks spent on rotations for each modality. The study was approved by the institutional review board and was Health Insurance Portability and Accountability Act (HIPAA) compliant. t-Test and chi-square test were performed, and results were analyzed for statistical significance. RESULTS: Most (94 respondents; 80%) respondents were third-year residents, 101 residents (86%) stated their program was affiliated with an academic institution, 92 residents (78%) performed cardiac MRI, 104 (88%) performed PET, 84 (71%) performed OB US, 71 (60%) performed carotid US (one did not respond), and all performed esophagrams (although one did not respond). Only performance of cardiac MRI and PET correlated positively with a larger average hospital size (P < .01). Residents at an academically affiliated program were significantly more likely to perform cardiac MRI (P < .05). Geographic region significantly affected likelihood of performance of cardiac MRI only. CONCLUSION: Such factors as hospital size, academic institution affiliation, and geography affect radiology resident training, particularly for such maturing applications as cardiac MRI and PET. This information may be useful in attempts to standardize radiology residency training.

Diagnostic Imaging↗
PubMed2004

Comparison of academic, application form and social factors in predicting early performance on the medical course.

OBJECTIVES: To compare the relative importance of social, academic and application form factors at admission in predicting performance in the first 3 years of a medicine course. DESIGN: Retrospective cohort study. SETTING: A single UK medical school. PARTICIPANTS: A total of 738 students who entered medical school between 1994 and 1997. MAIN OUTCOME MEASURE: Performance in Year 3 objective structured clinical examination (OSCE). RESULTS: School-leaving grades were significant predictors of success in the OSCE. Non-academic activities as assessed from the application form were associated with poorer performance. Mature students performed extremely well, and male and ethnic minority students performed less well. Socioeconomic status and type of school attended were not found to affect performance on the course. CONCLUSIONS: The relatively poor performance of male and ethnic minority students urgently needs further investigation. Our results carry no suggestion that, other things being equal, widening access to medical school for mature students and those from less affluent backgrounds would result in poorer performance.

Clinical Competence↗
PubMed1996

Resident education in laparoscopic cholecystectomy.

BACKGROUND: Resident education in laparoscopic cholecystectomy (LC) was studied in a retrospective analysis of consecutive cases performed at two academic institutions with different educational approaches. METHODS: Each procedure was performed by a resident as operating surgeon under the direct guidance of one of a small, constant group of LC-certified attendings acting as first assistant. In group I (n = 48), residents acquired LC skills by graded exposure and surgical responsibility similar to their training in other general surgical procedures. In group II (n = 48) residents were additionally certified via an intensive course (including didactic and animal model experience) prior to assuming responsibility as surgeon. RESULTS: Results were similar in each group. No technical errors were identified. Blood transfusion was not required related to surgery. Conversion to an open procedure occurred in 10% and 8% in groups I and II, respectively. The rate of complications was 4% for group I and 8% for group II. A longer operating time was noted in group I and may be attributed to nonoperative reasons. CONCLUSIONS: Education in LC via graded experience throughout residency achieves results similar to that found with the addition of an intensive course. This additional training may not be necessary for surgical residents.

Acute Disease↗
PubMed1990

MEDLINE and PsycLIT on CD-ROM: a survey of users in an academic medical library.

A survey of users of PsycLIT and MEDLINE on CD-ROM was performed at an academic medical library. The questionnaire was designed to gather information about the user population, satisfaction of the users, the assistance needed to use the systems, and the type of searches being performed. The majority of users were graduate students in the schools of medicine, nursing, and pharmacy. In general, users were satisfied with the performance of the systems. Assistance from a librarian, printed documentation, or another patron was required by 85% of users, and they were generally satisfied with this assistance. Most searches were performed to obtain information on a subject. The results were remarkably similar for both databases.

Consumer Behavior↗
PubMed1992

Early predictors of career achievement in academic medicine.

OBJECTIVE: To identify early personal and scholastic factors that predict academic career choice and long-term career achievement among academic physicians. DESIGN: A longitudinal cohort study. PARTICIPANTS: Nine hundred forty-four male physicians who graduated from The Johns Hopkins University School of Medicine, Baltimore, MD, from 1948 through 1964. OUTCOME MEASURES: Career achievement outcomes included attained faculty rank in 1990 and the number of citations (20 to 24 years after graduation) to published work. RESULTS: Of the 944 physicians, 424 (45%) had chosen academic careers. Scholastic performance and research experience in medical school were independently associated with having chosen an academic career (P less than .001). Among academicians, higher attained rank in 1990 was independently associated with the following: (1) membership in Alpha Omega Alpha (relative risk [RR] = 4.94, P = .0001); (2) rank in the top third of the graduating class (RR = 2.68, P = .01); and (3) research experience in medical school (RR = 3.11, P = .0001). These three factors were also independently associated with more citations to participants' published work (P less than .05). CONCLUSION: These data suggest that scholastic performance and research experience during medical school predict career achievement in academic medicine over 20 years in the future.

Achievement↗
PubMed1988

Cognitive training in academically deficient ADDH boys receiving stimulant medication.

This study evaluated the effectiveness of a 16-week intensive cognitive training program in stimulant-treated, academically deficient ADDH boys. Cognitive training focused exclusively on academic skills and tasks, and included attack strategy training as well as self-monitoring and self-reinforcement of problem-solving behaviors and response accuracy. Control groups included remedial tutoring plus medication, and medication alone. Despite the scope of the program, the results provided no support for the notion that academically based cognitive training ameliorates the performance and achievement of academically deficient ADDH youngsters. Further, this intervention did not enhance self-esteem or attributional perceptions of academic functioning. There was poor agreement between teacher ratings of academic competence and test score changes. The lack of concordance between measures, and the scarcity of academically deficient ADDH children are discussed.

Achievement↗