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PubMedDate not supplied

[An institutional evaluation design].

This study aims at describing the design used in the evaluation of technical nursing courses in São Paulo State's Education System by means of quantitative and qualitative institutional performance indicators. Such indicators, established by former students and by the labor market, showed to be useful in the evaluation and demonstrated the need for increasing, by means of similar evaluation studies, parameters related to the academic staff's performance as well as that of practical teaching fields. It is concluded that the use of a reasonable number of indicators allowed the articulation among data and a better understanding of the evaluated institutions.

Brazil↗
PubMed2006

Smaller white-matter volumes are associated with larger deficits in attention and learning among long-term survivors of acute lymphoblastic leukemia.

BACKGROUND: The primary objective of this study was to test the hypothesis that survivors of childhood acute lymphoblastic leukemia (ALL) have deficits in neurocognitive performance, and smaller white-matter volumes are associated with these deficits. METHODS: The patients studied included 112 ALL survivors (84 patients who had received chemotherapy only, 28 patients who had received chemotherapy and irradiation; 63 males, 49 females; mean age +/- standard deviation, 4.1 yrs +/- 2.6 yrs at diagnosis; mean +/- standard deviation yrs since diagnosis, 6.0 +/- 3.5 yrs), and 33 healthy siblings who participated as a control group. Neurocognitive tests of attention, intelligence, and academic achievement were performed; and magnetic resonance images were obtained and subsequently were segmented to yield tissue volume measurements. Comparisons of neurocognitive measures and tissue volumes between groups were performed, and the correlations between volumes and neurocognitive performance measures were assessed. RESULTS: Most performance measures demonstrated statistically significant differences from the normative test scores, but only attention measures exceeded 1.0 standard deviation from normal. Patients who had received chemotherapy alone had significantly larger volumes of white matter than patients who had received treatment that also included cranial irradiation, but their volumes remained significantly smaller than the volumes in the control group. Smaller white-matter volumes were associated significantly with larger deficits in attention, intelligence, and academic achievement. CONCLUSIONS: Survivors of childhood ALL had significant deficits in attention and smaller white-matter volumes that were associated directly with impaired neurocognitive performance. Cranial irradiation exacerbated these deficits.

Adolescent↗
PubMed1984

Influence of programmed textbook review on American Board of Surgery In-service Examination scores.

Documentation of academic achievement throughout training is an essential component to residency accreditation. Resident performance evaluations by attending staff provide good assessments of affective behavior and technical skills, but evaluation of surgical knowledge is often subjective in nature. The American Board of Surgery In-Service Examination has become the standard by which academic performance is measured. Numerous types of educational programs are used to increase the knowledge base of residents. Sporadic reading of a standard surgical text is a common part of many residency programs. In 1981, the Michigan State University/Butterworth Hospital General Surgery Residency opted to drop the surgical text reading in favor of a review of specific topics attuned to resident needs. Results of the 1982 American Board of Surgery (ABS) examination identified a significant decrease in percentile scores and average resident performance. A program requiring a systematic review of a standard surgical text was then initiated. This review involved assigned reading and administration of weekly examinations covering each assignment. Following institution of this program, a dramatic improvement in the total average scores for the entire resident group was noted. Similar improvement was noted in individual group scores (PG I, II, III, IV, and V). Results of this study indicate that reading of a standard surgical text should be a required part of each residency program.

Achievement↗
PubMed1986

Delayed feedback of physician performance versus immediate reminders to perform preventive care. Effects on physician compliance.

In an academic general medicine clinic, we performed a randomized, controlled trial to compare (1) the effects of supplying monthly feedback reports of compliance with preventive care protocols by 135 internal medicine house staff with (2) the effects of specific reminders given to them at the time of patient visits. The protocols were randomly divided into two groups, A and B, and half the house staff were given feedback for Group A and half for Group B. Thus, each group served as a control for the other. Each feedback group was also randomly assigned to receive reminders for either Group A or B protocols. House staff receiving feedback more often complied with fecal occult blood testing, mammography, pneumococcal vaccination, use of metronidazole, and combined Group A and B protocols than did controls (P less than 0.01). There was also significantly more compliance with the same protocols by house staff receiving reminders, but the increase for fecal occult blood testing, pneumococcal vaccination, and combined Group A protocols was twice that seen in physicians given feedback alone. In addition, reminders alone increased compliance with oral calcium supplementation. Overall compliance with the preventive care protocols was low: 10-15% in physicians receiving neither feedback nor reminders, increasing to 15-30% in those receiving reminders. Physician compliance with suggested preventive care protocols can be increased by both delayed feedback and immediate reminders, but reminders have a greater effect.

Clinical Competence↗
PubMed2005

Factors associated with academic achievement in children with recent-onset seizures.

Children with chronic epilepsy are more at risk for achievement problems than either children without seizures or children with other chronic disorders. Factors that lead to such problems in children with epilepsy, however, are not well understood. Exploring these factors is important because academic underachievement can lead to poor social outcomes and contribute to underemployment or unemployment in adulthood. This descriptive, cross-sectional study investigated a group of children who had been diagnosed with seizures approximately 12 months previously, providing the opportunity to describe relationships among family and child characteristics; parent, child, and teacher responses; and child academic achievement at the same point in time across the sample. Seventy-two children had standardized test total battery scores, 101 had a teacher's rating of performance, and 67 had scores for both. Data were analyzed using multivariable regression. Child adaptive competency and seizure severity were associated with higher teacher ratings of academic performance (beta=0.73, p<0.0001 and beta=2.38, p=0.0182, respectively). Child adaptive competency was associated with higher total battery scores (beta=0.73, p<0.0001). Contrary to findings in studies of children with chronic epilepsy, mean academic achievement in this sample of children with recent-onset seizures was in the average range; however, 25% of the children were at or below one standard deviation below the mean on the teacher's rating of performance and 10% on the total battery. It is therefore important for health professionals and educators to regularly assess the child's academic functioning and school performance to identify those at risk for problems. Health professionals and educators need to collaborate on assessment and interventions to help maximize child academic success.

Achievement↗
PubMed1992

Objective assessment of research performance.

Research output in academic institutions need critical and objective assessment. Publications are an important avenue by which research by an academic can be evaluated. Journals in which such publications appear may be ranked and weight age given to publications in highly ranked journals. The number of citations of an academic's work by peers is another assessment of quality of research output. Firstly subjective peer assessment although flawed by interpersonal bias has its merits especially when evaluation is by an outsider of the institution.

Humans↗
PubMed2005

Personality as a predictor of professional behavior in dental school: comparisons with dental practitioners.

The purpose of this study was to examine the use of personality measures to predict the success of dental students (N = 87) in clinical and academic courses and to compare their personality profiles to those of dental practitioners (N = 130). A second purpose of the study was to develop a new criterion measure, the Student Professionalism Scale, based on competencies previously identified as necessary for professional success. The Canadian Dental Aptitude Test (DAT) predicted first-year, preclinical academic success; the DAT Reading Comprehension component predicted third-year clinical performance; and Perceptual Ability, the ability to deal with two- and three-dimensional objects, predicted student professionalism. Results from the personality measure indicated that Conscientiousness and Neuroticism, and to a lesser extent Agreeableness, were significant predictors of both first-year academic performance and professional behavior. In comparing the personality profiles of dental students to dental practitioners, students who were more similar to the dentists did better in their first year of coursework. Implications of the findings are discussed in the context of the dental admissions process.

Canada↗
PubMed1985

Moral reasoning in dental hygiene students.

Sixty-five students participated in a study designed to identify the level of moral reasoning of dental hygiene students. Comparisons were made with typical college students and a normative group composed of individuals representing a cross-section of ages and educational levels. The relationships among level of moral reasoning and clinical performance, other selected academic measures, and cognitive style were also assessed. The results indicated that post-certificate dental hygiene students reasoned about moral dilemmas at a higher level than the normative group and at the same level as the college student group. In addition, clinical performance, National Board Dental Hygiene Examination scores, Dental Hygiene Aptitude Test (reading scores), high school rank, and cognitive style correlated positively with level of moral reasoning and specific stages of moral development for postcertificate students.

Adult↗
PubMed1998

Individual differences and the development of perceived control.

Research on individual differences demonstrates that children's perceived control exerts a strong effect on their academic achievement and that, in turn, children's actual school performance influences their sense of control. At the same time, developmental research shows systematic age-graded changes in the processes that children use to regulate and interpret control experiences. Drawing on both these perspectives, the current study examines (1) age differences in the operation of beliefs-performance cycles and (2) the effects of these cycles on the development of children's perceived control and classroom engagement from the third to the seventh grade. Longitudinal data on about 1,600 children were collected six times (every fall and spring) over 3 consecutive school years, including children's reports of their perceived control and individual interactions with teachers; teachers' reports of each student's engagement in class; and, for a subset of students, grades and achievement tests. Analyses of individual differences and individual growth curves (estimated using hierarchical linear modeling procedures) were consistent, not only with a cyclic model of context, self, action, and outcomes, but also with predictors of individual development over 5 years from grade 3 to grade 7. Children who experienced teachers as warm and contingent were more likely to develop optimal profiles of control; these beliefs supported more active engagement in the classroom, resulting in better academic performance; success in turn predicted the maintenance of optimistic beliefs about the effectiveness of effort. In contrast, children who experienced teachers as unsupportive were more likely to develop beliefs that emphasized external causes; these profiles of control predicted escalating classroom disaffection and lower scholastic achievement; in turn, these poor performances led children to increasingly doubt their own capacities and to believe even more strongly in the power of luck and unknown causes. Systematic age differences in analyses suggested that the aspects of control around which these cycles are organized change with development. The beliefs that regulated engagement shifted from effort to ability and from beliefs about the causes of school performance (strategy beliefs) to beliefs about the self's capacities. The feedback loop from individual performance to subsequent perceived control also became more pronounced and more focused on ability. These relatively linear developmental changes may have contributed to an abrupt decline in children's classroom engagement as they negotiated the transition to middle school and experienced losses in teacher support. Implications are discussed for future study of individual differences and development, especially the role of changing school contexts, mechanisms of influence, and developmentally appropriate interventions to optimize children's perceived control and engagement.

Achievement↗
PubMed2003

Angiographic improvement after rapid intermittent compression treatment [ArtAssist] for small vessel obstruction.

A case is presented of a female ex-smoker who underwent bypass or exploration of all three below-knee arteries with failed results. Three separate arteriograms, performed at other academic institutions, demonstrated progressive, severe involvement of the pedal arteries. Therefore, the patient was prepared to undergo below-knee amputation surgery for uncontrollable rest pain and progressive necrosis of the forefoot; instead, the patient underwent 4 months of intermittent compression treatment. A fourth arteriogram, performed after 4 months of intermittent compression treatment (using rapid inflation/deflation and high-pressure cycle; ArtAssist demonstrated marked improvement of the posterior tibial artery runoff and development of more extensive collateral arteries in the calf. The patient's rest pain subsided and successful limb salvage was accomplished with a modified transmetatarsal amputation. This case could encourage other practitioners to repeat arteriography after compression treatments, which may redirect the treatment plan for selected patients with critical limb ischemia and nonreconstructable peripheral vascular disease.

Adult↗
PubMed2004

Utility of 24-h ambulatory blood pressure measurement in a routine clinical setting of patients with chronic renal disease.

The objective of the study was to investigate the utility of 24 h ambulatory blood pressure measurement (ABPM) in patients with chronic renal disease (CRD). A retrospective audit was performed in an academic nephrology department. ABPMs obtained from 95 consecutive outpatients with nondiabetic renal disease were analysed for their power to stratify disease severity and to predict progression of renal insufficiency during 3 years follow-up. The average of 10 consecutive office blood pressure (BP) readings performed at baseline was used as a reference. Correlations and tabulated statistics were calculated. Baseline mean diurnal BP was 138/87 mmHg by ABPM and 146/92 mmHg by average office BP (56.8 vs 25.3% normotensives, P < 0.01). Mean serum creatinine was 154 +/- 109 micromol/l. Patients without a circadian BP pattern (61%) had significantly higher serum creatinine, urinary albumin excretion and subsequent progression rates of renal failure (P < 0.05). Systolic and pulse pressure ABP values correlated significantly with serum creatinine levels at baseline and 3 years thereafter, independent of daytime (r = 0.23-0.60; P < 0.05). Abnormal nocturnal systolic and mean ABP, and pulse pressure but not average day office BP were significantly associated with abnormal serum creatinine and the presence of coronary heart disease at baseline (relative risk 1.6-1.7, P < 0.05). In conclusion, physicians considered ABPM preferentially in patients with borderline-controlled BP. ABPM provided significant additional information relevant to the clinical decision making process compared with average office BP alone thereby justifying its use in specific situations.

Aged↗
PubMed2001

Acoustic neuromas in the elderly.

OBJECTIVE: To determine if an "observation" protocol with serial scanning is a safe and effective management paradigm for acoustic neuromas in the elderly. STUDY DESIGN: A retrospective case review was performed. SETTING: This study was performed in an academic, tertiary care center. PATIENTS: Forty-one patients over the age of 65 years were identified with the primary diagnosis of unilateral acoustic neuroma, without prior treatment or observation. INTERVENTION: The patients were followed with serial, gadolinium-enhanced magnetic resonance imaging (MRI) scans performed at 6 months and then yearly, if no significant growth occurred. MAIN OUTCOME MEASURES: The patients were monitored for tumor growth, cranial nerve deficits, and hydrocephalus. RESULTS: The patients were followed for an average of 3.5 years (range, 6 months to 9 years). The average tumor size at presentation was 1.14 cm, with a range of growth rates from 0 to 1.2 cm per year. Twenty-one patients demonstrated tumor growth at an average rate of 0.322 cm per year. Only five patients (12%) required further intervention. Three patients underwent translabyrinthine excision, and two patients were treated with radiation. No patients developed significant complications during the observation period. CONCLUSIONS: Acoustic neuromas in the older population can be managed safely using serial MRI scanning. No correlation could be made between initial tumor size and subsequent growth rate.

Aged↗
PubMed2001

Internal jugular vein versus external jugular vein anastamosis: implications for successful free tissue transfer.

BACKGROUND: Microvascular free flaps are becoming the reconstructive option of choice for many head and neck defects. Many previous studies have examined factors predicting free flap survival. No study has compared differences in free flap survival when anastomosed to the internal or external jugular systems. METHODS: Retrospective review of all free flaps performed at an academic medical center by a single head and neck microvascular surgeon during the period July 1995 to December 1999. Flaps were closely monitored postoperatively and taken back to the operating room urgently for arterial insufficiency or venous congestion. RESULTS: On hundred fifty-six free flaps were performed during this time period. Sixty-five free flaps were anastomosed to the external jugular (EJ) vein and 86 to the IJ system (62 to the proximal common facial vein, 17 end-side on the IJ, and 7 to other branches). Five had either two venous anastomoses or were anastomosed to other veins and were excluded from statistical analysis. Six (4%) vascular thromboses occurred; 5 were venous and 1 arterial. Success by group was 99% for IJ anastomosis (1 arterial thrombosis) and 92% for EJ anastomosis (5 venous thromboses, p =.03). Urgent anastomotic revision and reperfusion salvaged 5 of the 6 flaps (overall success 99%). CONCLUSIONS: Although the overall success rate (96% success with 99% success with salvage) is comparable to other large series, microvascular free flaps anastomosed to the external jugular vein failed at a significantly higher rate than those anastomosed to the IJ system. This suggests that the IJ system should be used as a recipient vessel when feasible.

Anastomosis, Surgical↗
PubMed1997

Cause and repair of flap necrosis over cochlear implant.

OBJECTIVE: The aim of this report was to study the cause and treatment of flap-related complications over cochlear implant. SETTING: The study was performed in an academic tertiary referral center. PATIENT: A 53-year-old Japanese male patient had had two retro-auricular skin incisions for tympanomastoidectomy in the postauricular region before implantation of a cochlear implant. He also had worn a helmet daily during work in his factory. INTERVENTIONS: Corrective surgery was performed for reformation of the local blood supply to the overlying skin flap and reinforcement of the tissue overlying the implant by use of a superiorly based temporal muscle and fascia flap that were sutured with an inferiorly based muscle and fascia flap. RESULTS: We successfully transposed the flap covering the implant without explantation of the implant. CONCLUSIONS: The delayed development of flap necrosis was thought to be due to pressure necrosis produced by the band in the patient's helmet lying on the skin over the implant and to poor local blood supply in the postauricular area stemming from the two previous skin incisions for mastoid surgery performed for cholesteatoma. In those patients who wear helmets, it is important to position the cochlear implant sufficiently behind the ear and to avoid the use of a helmet.

Cochlear Implants↗
PubMedDate not supplied

Responsibilities of nursing education: the lessons of Russell v Salve Regina.

In August 1985 Sharon Russell was dismissed from Salve Regina College just before her senior year of nursing education. The reasons given for her dismissal focused on Russell's obesity and her inability to lose weight. The issues raised by this case pose important questions that nursing programs and nurse educators must address. This article explores the questions raised by Russell: (1) What constitutes substantial compliance with both academic and nonacademic performance criteria in a contract between a student and an educational institution? (2) What duties to preserve the privacy interests of students may be imposed on programs and educators? Ms Russell's case has been settled. She established that she had met the terms of the contract and substantially complied with the academic and nonacademic criteria of the nursing curriculum. She was awarded monetary damages for the college's breach of contract in nonperformance of an agreement to educate. She did not prevail in her claims of intentional infliction of emotional distress or invasion of privacy. She did, however, put nursing education programs on notice that colleges and universities are not immune from these contractual challenges and must demonstrate respect and consideration for student's personal concerns.

Contract Services↗