Fourth-line rescue therapy with rifabutin in patients with three Helicobacter pylori eradication failures.

PubMed

Gisbert, J P; Castro-Fernandez, M; Perez-Aisa, A; Cosme, A; Molina-Infante, J; Rodrigo, L; Modolell, I; Cabriada, J L; Gisbert, J L; Lamas, E; Marcos, E; Calvet, X

2012-04-01

In some cases, Helicobacter pylori infection persists even after three eradication treatments. To evaluate the efficacy of an empirical fourth-line rescue regimen with rifabutin in patients with three eradication failures. Multicentre, prospective study. In whom the following three treatments had consecutively failed: first (PPI + clarithromycin + amoxicillin); second (PPI + bismuth + tetracycline + metronidazole); third (PPI + amoxicillin + levofloxacin). A fourth regimen with rifabutin (150 mg b.d.), amoxicillin (1 g b.d.) and a PPI (standard dose b.d.) was prescribed for 10 days. Eradication was confirmed by (13) C-urea breath test 4-8 weeks after therapy. Compliance and tolerance: Compliance was determined through questioning and recovery of empty medication envelopes. Adverse effects were evaluated using a questionnaire. One-hundred patients (mean age 50 years, 39% men, 31% peptic ulcer/69% functional dyspepsia) were included. Eight patients did not take the medication correctly (in six cases due to adverse effects). Per-protocol and intention-to-treat eradication rates were 52% (95% CI = 41-63%) and 50% (40-60%). Adverse effects were reported in 30 (30%) patients: nausea/vomiting (13 patients), asthenia/anorexia (8), abdominal pain (7), diarrhoea (5), fever (4), metallic taste (4), myalgia (4), hypertransaminasemia (2), leucopenia (<1,500 neutrophils) (2), thrombopenia (<150,000 platelets) (2), headache (1) and aphthous stomatitis (1). Myelotoxicity resolved spontaneously in all cases. Even after three previous H. pylori eradication failures, an empirical fourth-line rescue treatment with rifabutin may be effective in approximately 50% of the cases. Therefore, rifabutin-based rescue therapy constitutes a valid strategy after multiple previous eradication failures with key antibiotics, such as clarithromycin, metronidazole, tetracycline and levofloxacin. © 2012 Blackwell Publishing Ltd.

Tolerance-like innate immunity and spleen injury: a novel discovery via the weekly administrations and consecutive injections of PEGylated emulsions

PubMed Central

Wang, Long; Wang, Chunling; Jiao, Jiao; Su, Yuqing; Cheng, Xiaobo; Huang, Zhenjun; Liu, Xinrong; Deng, Yihui

2014-01-01

There has been an increasing interest in the study of the innate immune system in recent years. However, few studies have focused on whether innate immunity can acquire tolerance. Therefore, in this study, we investigated tolerance in the innate immune system via the consecutive weekly and daily injections of emulsions modified with polyethylene glycol (PEG), referred to as PEGylated emulsions (PE). The effects of these injections of PE on pharmacokinetics and biodistribution were studied in normal and macrophage-depleted rats. Additionally, we evaluated the antigenic specificity of immunologic tolerance. Immunologic tolerance against PE developed after 21 days of consecutive daily injections or the fourth week of PE administration. Compared with a single administration, it was observed that the tolerant rats had a lower rate of PE clearance from the blood, which was independent of the stress response. In addition, weekly PE injections caused injury to the spleen. Furthermore, the rats tolerant to PEs with the methoxy group (–OCH3) of PEG, failed to respond to the PEs with a different terminal group of PEG or to non-PEG emulsions. Innate immunity tolerance was induced by PE, regardless of the mode of administration. Further study of this mechanism suggested that monocytes play an essential role in the suppression of innate immunity. These findings provide novel insights into the understanding of the innate immune system. PMID:25120362

Reinforcement Schedules in Pacing Reading Rate. Final Report.

ERIC Educational Resources Information Center

Schutz, Richard E.; And Others

Responses of individual fourth-grade children were monitored in daily 30-minute sessions for 10 consecutive school days. Individual subjects were used as their own controls. The child sat before a small table with a surface-mounted button and a wall-mounted screen upon which visual stimuli were rear-view projected, using a filmstrip projector with…

Identifying the Gaps of Fourth Year Degree Pre-Service Teachers' Pedagogical Content Knowledge in Teaching Engineering Graphics and Design

ERIC Educational Resources Information Center

Khoza, Samuel Dumazi

2017-01-01

Engineering Graphics and Design is a technological subject which is offered in the Bachelor of Education degree from third to fourth year of the degree course. Fourth year pre-service teachers find EGD difficult to teach because of various reasons. Therefore the aim of the paper was to investigate fourth year pre-service teachers' pedagogical…

Clinical picture of meningitis in the adult patient and its relationship with age.

PubMed

Magazzini, Simone; Nazerian, Peiman; Vanni, Simone; Paladini, Barbara; Pepe, Giuseppe; Casanova, Barbara; Crugnola, Carolina; Grifoni, Stefano

2012-08-01

To analyze the clinical characteristics of acute meningitis and their relationship with age in adult patients presenting to the emergency department. We retrospectively investigated consecutive adult patients admitted with a diagnosis of bacterial or viral meningitis from 2002 to 2006. Data about patient's history, symptoms and signs at presentation, etiology and clinical course were collected. To investigate the relationship of clinical presentation with age, we divided patients in four age quartiles (<30 years, between 30 and 36 years, between 37 and 56 years, >56 years). Among the 202 patients considered in the study (mean age 42.8 ± 18.7 years, range 14-90), 162 (80.2%) patients had viral and 40 (19.8%) bacterial meningitis. Specific signs, such as neck stiffness or Kernig or Brudzinski signs, were more common in the first than in the fourth quartile (73.1 vs. 45.7% P = 0.041). Conversely, altered consciousness expressed as Glasgow Coma Scale (GCS) <15 was more frequent in the fourth (80.4%) than in the first (9.6%) quartile (P < 0.001). The linear regression analysis confirmed a significant decrease of GCS with the increasing of patient's age (r = -0.69, P < 0.001). At multivariate analysis, aging was associated with altered level of consciousness (OR 16.7, P < 0.001) independent of viral or bacterial etiology of the presence of comorbidities and of clinical severity (presence of severe sepsis or septic shock). Meningitis presentation largely differs with aging in adult patients. Level of consciousness is frequently altered in the older patients, when other specific signs become more rare, independent of etiology, comorbidities and clinical severity.

Ambivalence toward palatable food and emotional eating predict weight fluctuations. Results of a longitudinal study with four waves.

PubMed

Keller, Carmen; Siegrist, Michael

2015-02-01

Weight fluctuations pose serious challenges to people's health. Research suggests that the interplay between cognitive dietary restraint and counter-regulative overeating impairs weight control. In a random sample from the general population (N = 2733, 49% male), a longitudinal survey was conducted over 4 consecutive years (2010-2013). Self-reported weight was used to calculate the variance of three weight changes from one wave to the next. Separate regression analyses for women and men were conducted. The dependent variable was weight fluctuation, and the independent variables were eating styles (emotional, external, and restrained) and ambivalence toward palatable food. Age and weight changes between the fourth and first years were controlled. A significant positive effect of emotional eating for men and women, and a significant positive effect of ambivalence for women, were found. Participants who demonstrated high levels of emotional eating, and women who had high levels of ambivalence in the beginning of the study, had more extreme relative weight fluctuations in the consecutive years than did persons with low levels of emotional eating or women with low levels of ambivalence. Restrained and external eating had no effect. The results suggest that emotional eating and ambivalence toward palatable food need to be addressed to prevent health-damaging weight fluctuations. Furthermore, ambivalence toward palatable food was revealed as an additional overeating tendency beyond emotional eating that must be considered to understand the interplay between dietary restraint and overeating. Copyright © 2014 Elsevier Ltd. All rights reserved.

Diode-quad bridge circuit means

NASA Technical Reports Server (NTRS)

Harrison, D. R.; Dimeff, J. (Inventor)

1975-01-01

Diode-quad bridge circuit means is described for use as a transducer circuit or as a discriminator circuit. It includes: (1) a diode bridge having first, second, third, and fourth bridge terminals consecutively coupled together by four diodes polarized in circulating relationship; (2) a first impedance connected between the second bridge terminal and a circuit ground; (3) a second impedance connected between the fourth bridge terminal and the circuit ground; (4) a signal source having a first source terminal capacitively coupled to the first and third bridge terminals, and a second source terminal connected to the circuit ground; and (5) an output terminal coupled to the first bridge terminal and at which an output signal may be taken.

Perspective of the Graduating Medical Student: The Ideal Curriculum for the Fourth Year of Undergraduate Medical Education.

PubMed

Andrews, Mary A; Paolino, Nathalie D; DeZee, Kent J; Hemann, Brian

2016-11-01

To explore medical students' perspective regarding the fourth year of medical school and common educational activities thereof. The authors surveyed students graduating in 2012 with a military service obligation about the importance of common fourth-year activities, the proportion of the fourth year devoted to these activities, and important considerations for the fourth-year curriculum. The authors calculated mean importance scores for educational activities and mean proportions of the fourth year that should be devoted to certain activities. Two reviewers independently coded free-text answers to identify and calculate frequencies for common themes. The response rate was 40% (376/942). Participants rated activities related to improving clinical skills and securing the residency of their choice as more than activities such as learning business skills, conducting research, and studying basic sciences. Participants indicated that electives and direct patient care should comprise the majority of the fourth year and frequently mentioned improving specialty-specific clinical skills, pursuing personal medical interests, and taking time to relax as important fourth-year themes. Students value activities related to securing and succeeding in their chosen residency and the opportunity to pursue electives and take vacation. Faculty should consider the student perspective when reforming curricula. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Principles and Practices of Occupational Safety and Health: Student Manual: Booklet Four.

ERIC Educational Resources Information Center

Occupational Safety and Health Administration, Washington, DC.

The manual is the fourth of six student manuals for use in a course on occupational health and safety for supervisory personnel. The manual contains lessons 8-11 of the 15 consecutively-numbered lessons, each of which contains study questions (and answers) interwoven with the text and review questions at the end of each section. Lesson 8 discusses…

Are Fourth-Year Medical Students Effective Teachers of the Physical Examination to First-Year Medical Students?

PubMed Central

Haist, Steven A; Wilson, John F; Fosson, Sue E; Brigham, Nancy L

1997-01-01

OBJECTIVE To determine if fourth-year medical students are as effective as faculty in teaching the physical examination to first-year medical students. DESIGN Stratified randomization of the first-year students. SETTING A public medical school. PARTICIPANTS All 100 first-year medical students in one medical school class were randomly assigned (controlling for gender) to either a faculty or a fourth-year student preceptor for the Physical Examination Module. MAIN RESULTS The first-year students of faculty preceptors scored no differently on the written examination than the students of the fourth-year medical student preceptors (82.8% vs 80.3%, p = .09) and no differently on a standardized patient practical examination (95.5% vs 95.4%, p = .92). Also, the first-year students rated the two groups of preceptors similarly on an evaluation form, with faculty rated higher on six items and the student preceptors rated higher on six items (all p > .10). The fourth-year student preceptors rated the experience favorably. CONCLUSIONS Fourth-year medical students were as successful as faculty in teaching first-year medical students the physical examination as measured by first-year student’s performances on objective measures and ratings of teaching effectiveness.

Prognostic factors for survival in 676 consecutive patients with newly diagnosed primary glioblastoma.

PubMed

Filippini, Graziella; Falcone, Chiara; Boiardi, Amerigo; Broggi, Giovanni; Bruzzone, Maria G; Caldiroli, Dario; Farina, Rita; Farinotti, Mariangela; Fariselli, Laura; Finocchiaro, Gaetano; Giombini, Sergio; Pollo, Bianca; Savoiardo, Mario; Solero, Carlo L; Valsecchi, Maria G

2008-02-01

Reliable data on large cohorts of patients with glioblastoma are needed because such studies differ importantly from trials that have a strong bias toward the recruitment of younger patients with a higher performance status. We analyzed the outcome of 676 patients with histologically confirmed newly diagnosed glioblastoma who were treated consecutively at a single institution over a 7-year period (1997-2003) with follow-up to April 30, 2006. Survival probabilities were 57% at 1 year, 16% at 2 years, and 7% at 3 years. Progression-free survival was 15% at 1 year. Prolongation of survival was significantly associated with surgery in patients with a good performance status, whatever the patient's age, with an adjusted hazard ratio of 0.55 (p < 0.001) or a 45% relative decrease in the risk of death. Radiotherapy and chemotherapy improved survival, with adjusted hazard ratios of 0.61 (p = 0.001) and 0.89 (p = 0.04), respectively, regardless of age, performance status, or residual tumor volume. Recurrence occurred in 99% of patients throughout the follow-up. Reoperation was performed in one-fourth of these patients but was not effective, whether performed within 9 months (hazard ratio, 0.86; p = 0.256) or after 9 months (hazard ratio, 0.98; p = 0.860) of initial surgery, whereas second-line chemotherapy with procarbazine, lomustine, and vincristine (PCV) or with temozolomide improved survival (hazard ratio, 0.77; p = 0.008). Surgery followed by radiotherapy and chemotherapy should be considered in all patients with glioblastoma, and these treatments should not be withheld because of increasing age alone. The benefit of second surgery at recurrence is uncertain, and new trials are needed to assess its effectiveness. Chemotherapy with PCV or temozolomide seems to be a reasonable option at tumor recurrence.

Prognostic factors for survival in 676 consecutive patients with newly diagnosed primary glioblastoma

PubMed Central

Filippini, Graziella; Falcone, Chiara; Boiardi, Amerigo; Broggi, Giovanni; Bruzzone, Maria G.; Caldiroli, Dario; Farina, Rita; Farinotti, Mariangela; Fariselli, Laura; Finocchiaro, Gaetano; Giombini, Sergio; Pollo, Bianca; Savoiardo, Mario; Solero, Carlo L.; Valsecchi, Maria G.

2008-01-01

Reliable data on large cohorts of patients with glioblastoma are needed because such studies differ importantly from trials that have a strong bias toward the recruitment of younger patients with a higher performance status. We analyzed the outcome of 676 patients with histologically confirmed newly diagnosed glioblastoma who were treated consecutively at a single institution over a 7-year period (1997 – 2003) with follow-up to April 30, 2006. Survival probabilities were 57% at 1 year, 16% at 2 years, and 7% at 3 years. Progression-free survival was 15% at 1 year. Prolongation of survival was significantly associated with surgery in patients with a good performance status, whatever the patient’s age, with an adjusted hazard ratio of 0.55 (p < 0.001) or a 45% relative decrease in the risk of death. Radiotherapy and chemotherapy improved survival, with adjusted hazard ratios of 0.61 (p = 0.001) and 0.89 (p = 0.04), respectively, regardless of age, performance status, or residual tumor volume. Recurrence occurred in 99% of patients throughout the follow-up. Reoperation was performed in one-fourth of these patients but was not effective, whether performed within 9 months (hazard ratio, 0.86; p = 0.256) or after 9 months (hazard ratio, 0.98; p = 0.860) of initial surgery, whereas second-line chemotherapy with procarbazine, lomustine, and vincristine (PCV) or with temozolomide improved survival (hazard ratio, 0.77; p = 0.008). Surgery followed by radiotherapy and chemotherapy should be considered in all patients with glioblastoma, and these treatments should not be withheld because of increasing age alone. The benefit of second surgery at recurrence is uncertain, and new trials are needed to assess its effectiveness. Chemotherapy with PCV or temozolomide seems to be a reasonable option at tumor recurrence. PMID:17993634

Primary Total Hip Arthroplasty With Fourth-Generation Ceramic-on-Ceramic: Analysis of Complications in 939 Consecutive Cases Followed for 2-10 Years.

PubMed

Buttaro, Martin A; Zanotti, Gerardo; Comba, Fernando M; Piccaluga, Francisco

2017-02-01

Delta ceramics may be the bearing of choice for younger and active patients due to its improved toughness and wear characteristics, provided there is no risk of fracture. However, ceramic fracture is the most serious complication related to this type of bearing. Although millions of Delta ceramics have been implanted worldwide, short to midterm results have been scarcely reported in the literature. The purpose of this study was to report the complication rate at short to midterm follow-up associated with the bearing surface used in a series of primary total hip arthroplasties with Delta ceramic-on-ceramic bearings performed in a single institution. A total of 939 cases (880 patients) undergoing primary total hip arthroplasty with fourth-generation Delta ceramic-on-ceramic bearings were retrospectively reviewed. They were followed for an average of 5.3 years (2-10 years). One hip experienced a liner fracture, 2 cups presented early loosening due to friction between the acetabular screw and the backside of the liner, one femoral ball head had a fracture; one case of squeaking was reported, which is impending revision. Considering revision or impending revision in relationship with the bearing surface as the end point, the mean survival rate was 99.3% (confidence interval 95%, 98.3%-99.7%) at 2-10 years. This study showed a low rate of ceramic fracture compared with others; however, it was much higher than the complication rate presented by the manufacturers. The complications observed were directly related to technical errors that surgeons should avoid when using this type of surface. Copyright © 2016 Elsevier Inc. All rights reserved.

Relation of Testosterone Levels to Mortality in Men With Heart Failure.

PubMed

Yoshihisa, Akiomi; Suzuki, Satoshi; Sato, Yu; Kanno, Yuki; Abe, Satoshi; Miyata, Makiko; Sato, Takamasa; Oikawa, Masayoshi; Kobayashi, Atsushi; Yamaki, Takayoshi; Kunii, Hiroyuki; Nakazato, Kazuhiko; Ishida, Takafumi; Takeishi, Yasuchika

2018-06-01

We aimed to investigate the impact of testosterone on the prognosis of heart failure (HF), as well as the underlying cardiac function, cardiac damage, and exercise capacity. We analyzed consecutive 618 men with HF (age 65.9 years). These patients were divided into quartiles based on their serum levels of total testosterone (TT): first (TT > 631 ng/dl, n = 154), second (462 < TT ≤ 631 ng/dl, n = 155), third (300 < TT ≤ 462 ng/dl, n = 156), and fourth (TT ≤ 300 ng/dl, n = 153) quartiles. In the Kaplan-Meier analysis (mean 1,281 days), all-cause mortality progressively increased throughout from the first to the fourth groups. In the multivariable Cox proportional hazard analysis, TT was found to be an independent predictor of all-cause mortality (hazard ratio 0.929, p = 0.042). In addition, we compared the parameters of echocardiography and cardiopulmonary exercise testing, as well as levels of B-type natriuretic peptide and cardiac troponin I, among the 4 groups. Left ventricular ejection fraction and B-type natriuretic peptide did not differ among the groups. In contrast, the fourth quartile, compared with the first, second, and third groups, had higher levels of troponin I and lower peak VO 2 (p <0.05, respectively). Decreased serum testosterone is associated with myocardial damage, lower exercise capacity, and higher mortality in men with HF. Copyright © 2018 The Author(s). Published by Elsevier Inc. All rights reserved.

Concussion assessment and management knowledge among chiropractic fourth year interns and residents

PubMed Central

Kazemi, Mohsen; Pichini, Alessandro; Scappaticci, Steven; Savic, Mitchell

2016-01-01

Objectives: To investigate the degree of knowledge chiropractic fourth year interns and post-graduate chiropractic residents have in regard to concussion diagnosis and management. Methods: A survey modified from a study conducted by Boggild and Tator (2012), was administered to fourth year chiropractic interns and post-graduate residents via SurveyMonkey.com. Results: Chiropractic fourth year interns and postgraduate chiropractic specialty college residents scored 5.2 and 5.25 out of 9 respectively, which compares well with Bogglid and Tator’s reports on medical students and residents. Several knowledge gaps were identified in the sample population. Conclusion: The results from this survey show that the concussion knowledge among Canadian fourth year chiropractic interns and specialty college residents compares favorably with the knowledge of fourth year medical students and residents in diagnosing and managing concussions. Chiropractors appear to possess the skills and knowledge to diagnose and manage concussion equal to their medical counterparts. However, knowledge gaps regarding concussion diagnosis and management were found among chiropractic students and residents. PMID:28065987

Concussion assessment and management knowledge among chiropractic fourth year interns and residents.

PubMed

Kazemi, Mohsen; Pichini, Alessandro; Scappaticci, Steven; Savic, Mitchell

2016-12-01

To investigate the degree of knowledge chiropractic fourth year interns and post-graduate chiropractic residents have in regard to concussion diagnosis and management. A survey modified from a study conducted by Boggild and Tator (2012), was administered to fourth year chiropractic interns and post-graduate residents via SurveyMonkey.com. Chiropractic fourth year interns and postgraduate chiropractic specialty college residents scored 5.2 and 5.25 out of 9 respectively, which compares well with Bogglid and Tator's reports on medical students and residents. Several knowledge gaps were identified in the sample population. The results from this survey show that the concussion knowledge among Canadian fourth year chiropractic interns and specialty college residents compares favorably with the knowledge of fourth year medical students and residents in diagnosing and managing concussions. Chiropractors appear to possess the skills and knowledge to diagnose and manage concussion equal to their medical counterparts. However, knowledge gaps regarding concussion diagnosis and management were found among chiropractic students and residents.

Incremental value of normal adenosine perfusion cardiac magnetic resonance: Long-term outcome.

PubMed

Sozzi, Fabiola B; Iacuzio, Laura; Civaia, Filippo; Canetta, Ciro; Berthier, Frederic; Rusek, Stephane; Rossi, Philippe; Lombardi, Federico; Dreyfus, Gilles; Dor, Vincent

2015-06-01

The purpose of the study was to determine the long-term prognostic value of normal adenosine stress cardiac magnetic resonance imaging (CMR) in patients referred for evaluation of myocardial ischemia. We reviewed 300 consecutive patients (age 65 ± 11 years, 74% male) with suspected or known coronary disease and normal wall motion who had undergone adenosine stress CMR negative for ischemia and scar. Most patients were at intermediate risk of coronary artery disease. The end points studied were all causes of mortality and major adverse cardiac events, including cardiac death, myocardial infarction, revascularization, and hospitalization for unstable angina. During a mean follow-up of 5.5 years (mean = 5.4 ± 1.1), 16 patients died because of various causes (cardiac death in 5 patients). Three patients had a nonfatal myocardial infarction, 7 patients were hospitalized for revascularization, and 11 were medically treated for unstable angina. The annual cardiac event rate was 1.3% (0.78% in the first 3 years and 1.9% between the fourth and sixth years). The predictors of major adverse cardiac events in a multivariate analysis model were as follows: advanced age (hazard ratio [HR] 1.15, 95% confidence interval [95% CI] 1.02-1.30), diabetes (HR 17.5, 95% CI 2.2-140), and the habit of smoking (HR 5.9, 95% CI 1.0-35.5). For all causes of mortality, the only predictor was diabetes (HR 11.4, 95% CI 1.76-74.2). Patients with normal stress CMR had an excellent outcome during the 3 years after the study. The cardiac event rate was higher between the fourth and sixth years. Over a 5.5-year period, a low event rate and excellent prognosis occurred in patients with normal adenosine stress CMR. Low- to intermediate-risk patients with a normal CMR are at low risk for subsequent cardiac events. Copyright © 2015 Elsevier Inc. All rights reserved.

Course Offerings in the Fourth Year of Medical School: How U.S. Medical Schools Are Preparing Students for Internship.

PubMed

Elnicki, D Michael; Gallagher, Susan; Willett, Laura; Kane, Gregory; Muntz, Martin; Henry, Daniel; Cannarozzi, Maria; Stewart, Emily; Harrell, Heather; Aiyer, Meenakshy; Salvit, Cori; Chudgar, Saumil; Vu, Robert

2015-10-01

The fourth year of medical school remains controversial, despite efforts to reform it. A committee from the Clerkship Directors in Internal Medicine and the Association of Program Directors in Internal Medicine examined transitions from medical school to internship with the goal of better academic advising for students. In 2013 and 2014, the committee examined published literature and the Web sites of 136 Liaison Committee on Medical Education-accredited schools for information on current course offerings for the fourth year of medical school. The authors summarized temporal trends and outcomes when available.Subinternships were required by 122 (90%) of the 136 schools and allow students to experience the intern's role. Capstone courses are increasingly used to fill curricular gaps. Revisiting basic sciences in fourth-year rotations helps to reinforce concepts from earlier years. Many schools require rotations in specific settings, like emergency departments, intensive care units, or ambulatory clinics. A growing number of schools require participation in research, including during the fourth year. Students traditionally take fourth-year clinical electives to improve skills, both within their chosen specialties and in other disciplines. Some students work with underserved populations or seek experiences that will be henceforth unavailable, whereas others use electives to "audition" at desired residency sites. Fourth-year requirements vary considerably among medical schools, reflecting different missions and varied student needs. Few objective outcomes data exist to guide students' choices. Nevertheless, both medical students and educators value the fourth year of medical school and feel it can fill diverse functions in preparing for residency.

Attitudes and performance of third- vs fourth-year neurology clerkship students.

PubMed

Dewey, Richard B; Agostini, Mark

2010-05-01

To compare student performance, attitudes, and career plans based on whether the neurology clerkship was taken in the third or fourth year. During the 1-year transition when the neurology clerkship was officially moved from the fourth to the third year at our institution, students took the identical clinical clerkship and were mixed together at each clinical site where faculty were blinded to student's year. University of Texas Southwestern Medical School. Third- and fourth-year medical students. Performance, enthusiasm, and match results were analyzed by year of medical school for differences. There was a statistical trend toward better performance of third-year students as measured by the clinical evaluation grade (88.4 vs 87.4; P = .051) but this represented only a 1% difference. No difference was noted on the National Board of Medical Examiners neurology shelf examination score (73.8 vs 74.9; P = .20). Students' enthusiasm for neurologic learning was significantly higher in third- as compared with fourth-year students (P = .004). The probability that students would choose a career in neurology was higher for third- than fourth-year students (P < .001), but there was no correlation between year and matching for a neurology residency (P = .17). Our findings support the belief among academic neurologists that students who take the neurology clerkship in the third year have greater enthusiasm for the field and look more favorably on neurology as a possible career than those taking the neurology clerkship in their fourth year. Nevertheless, our findings do not support the notion that third-year placement results in superior achievement.

Stand-Biased Versus Seated Classrooms and Childhood Obesity: A Randomized Experiment in Texas

PubMed Central

Wendel, Monica L.; Zhao, Hongwei; Jeffrey, Christina

2016-01-01

Objectives. To measure changes in body mass index (BMI) percentiles among third- and fourth-grade students in stand-biased classrooms and traditional seated classrooms in 3 Texas elementary schools. Methods. Research staff recorded the height and weight of 380 students in 24 classrooms across the 3 schools at the beginning (2011–2012) and end (2012–2013) of the 2-year study. Results. After adjustment for grade, race/ethnicity, and gender, there was a statistically significant decrease in BMI percentile in the group that used stand-biased desks for 2 consecutive years relative to the group that used standard desks during both years. Mean BMI increased by 0.1 and 0.4 kilograms per meter squared in the treatment and control groups, respectively. The between-group difference in BMI percentile change was 5.24 (SE = 2.50; P = .037). No other covariates had a statistically significant impact on BMI percentile changes. Conclusions. Changing a classroom to a stand-biased environment had a significant effect on students’ BMI percentile, indicating the need to redesign traditional classroom environments. PMID:27552276

Blinded assessment of operative performance after fundamentals of laparoscopic surgery in gynecology training.

PubMed

Antosh, Danielle D; Auguste, Tamika; George, Elizabeth A; Sokol, Andrew I; Gutman, Robert E; Iglesia, Cheryl B; Desale, Sameer Y; Park, Amy J

2013-01-01

To determine the pass rate for the Fundamentals of Laparoscopic Surgery (FLS) examination among senior gynecology residents and fellows and to find whether there is an association between FLS scores and previous laparoscopic experience as well as laparoscopic intraoperative (OR) skills assessment. Prospective cohort study (Canadian Task Force classification II-2). Three gynecology residency training programs. Third- and fourth-year gynecology residents and urogynecology fellows. All participants participated in the FLS curriculum, written and manual skills examination, and completed a survey reporting baseline characteristics and opinions. Fourth-year residents and fellows underwent unblinded and blinded pre- and post-FLS OR assessments. Objective OR assessments of fourth-year residents after FLS were compared with those of fourth-year resident controls who were not FLS trained. Twenty-nine participants were included. The overall pass rate was 76%. The pass rate for third- and fourth-year residents and fellows were 62%, 85%, and 100%, respectively. A trend toward improvement in OR assessments was observed for fourth-year residents and fellows for pre-FLS curriculum compared with post-FLS testing, and FLS-trained fourth-year residents compared with fourth-year resident controls; however, this did not reach statistical significance. Self-report of laparoscopic case load experience of >20 cases was the only baseline factor significantly associated with passing the FLS examination (p = .03). The FLS pass rate for senior residents and fellows was 76%, with higher pass rates associated with increasing levels of training and laparoscopic case experience. Copyright © 2013 AAGL. Published by Elsevier Inc. All rights reserved.

Breast Cancer Screening Knowledge and Skills of Students upon Entering and Exiting a Medical School.

ERIC Educational Resources Information Center

Kann, P. Elizabeth; Lane, Dorothy S.

1998-01-01

A study compared the breast cancer screening knowledge of 27 medical students in first and fourth years. In the fourth year additional questions were asked about training and training needs. Although students performed significantly better on knowledge-based questions in the fourth year, considerable room for improvement remained. Most students…

Burnout, depression and suicidal ideation in dental students.

PubMed

Galán, Fernando; Ríos-Santos, José-Vicente; Polo, Juan; Rios-Carrasco, Blanca; Bullón, Pedro

2014-05-01

To investigate the prevalence, gender influence, and relationships between burnout, depression and suicidal ideation within the last year among second, fourth and fifth-year dental students. A cross-sectional study was carried out in 212 dental students enrolled in the second, fourth and fifth years at the School of Dentistry of Seville using the Maslach Burnout Inventory-Student Survey and the MBI-Human Services Survey, the "Patient Health Questionnaire-2", and the "Questions about Suicidal Ideation and Attempted Suicide". The response rate among dental students was 80%. Burnout prevalence in dental students was higher in second and fourth years than in fifth year (p = 0.059 and p = 0.003, respectively). Depression prevalence in the fourth year approached significance (p = 0.051). Prevalence of suicidal ideation within the past year was higher, yet not reaching significance, in fourth year. No gender-related differences were found. A significant association was observed between burnout and depression, and between depression and suicidal ideation (p < 0.001), but no association was found between burnout and suicidal ideation. This study has brought our attention to the high prevalence of burnout and depression, and reported for the first time the prevalence of suicidal ideation among dental students in preclinical and clinical years.

Is reactivation of toxoplasmic retinochoroiditis associated to increased annual rainfall?

PubMed Central

Rudzinski, Marcelo; Meyer, Alejandro; Khoury, Marina; Couto, Cristóbal

2013-01-01

Background: Reactivation of toxoplasmic retinochoroiditis is the most frequent form of uveitis in Misiones, Argentina. Fluctuations in the number of patients consulting with this type of uveitis were detected during the last decade. Since the province was consecutively exposed to rainy and dry periods over the last years, we decided to explore whether a relationship between reactivation of toxoplasmic retinochoroiditis and rain might be established according to the data registered during the 2004–2010 period. Results: The frequency of toxoplasmic reactivation episodes increases when precipitation increases (mostly in second and fourth trimesters of each year). Analysis of the independent variables demonstrates that precipitation is a significant predictor of the frequency of reactivation episodes. Although registered toxoplasmic reactivations were more frequent during the third trimester of the year, the association between the third trimester and the reactivation episodes did not reach statistical significance. Conclusion: Prolonged and intense rainfall periods were significantly associated with the reactivation of toxoplasmic retinochoroiditis. Changes promoted by this climatic condition on both the parasite survival in the soil as well as a putative effect on the host immune response due to other comorbidities are discussed. PMID:24225023

Major adverse cardiac events during endurance sports.

PubMed

Belonje, Anne; Nangrahary, Mary; de Swart, Hans; Umans, Victor

2007-03-15

Major adverse cardiac events in endurance exercise are usually due to underlying and unsuspected heart disease. The investigators present an analysis of major adverse cardiac events that occurred during 2 consecutive annual long distance races (a 36-km beach cycling race and a 21-km half marathon) over the past 5 years. All patients with events were transported to the hospital. Most of the 62,862 participants were men (77%; mean age 40 years). Of these, 4 men (3 runners, 1 cyclist; mean age 48 years) collapsed during (n = 2) or shortly after the races, rendering a prevalence of 0.006%. Two patients collapsed after developing chest pain, 1 of whom needed resuscitation at the event site, which was successful. These patients had acute myocardial infarctions and underwent primary angioplasty. The third patient was resuscitated at the site but did not have coronary disease or inducible ventricular tachycardia or ventricular fibrillation and collapsed presumably because of catecholamine-induced ventricular fibrillation. The fourth patient experienced heat stroke and had elevated creatine kinase-MB and troponins in the absence of electrocardiographic changes. In conclusion, the risk for major adverse cardiac events during endurance sports in well-trained athletes is very low.

Fourth Year Status Report. Computerized Training Systems Project. Project ABACUS.

DTIC Science & Technology

1976-08-01

in 7 9. PERFORMING ORGANIZATION NAME AND ADOMEN ,,, 10. PROGRAM ELEMENT. PROJECT , TASK US Army Tra ining Support Center A R E A S WORK UNIT NUMBERS...transp ired during the fourth year of Project ABACUS, the A rmy ’s program for the development of a Computerized Training System. It inc l udes a...have transpired durlnq the fourth year of Project ABACUS, the Army ’s program for the developmen t o~ aprototype Computer i zed Training System. It

Effects of drinking patterns on prospective memory performance in college students.

PubMed

Zamroziewicz, Marta; Raskin, Sarah A; Tennen, Howard; Austad, Carol S; Wood, Rebecca M; Fallahi, Carolyn R; Dager, Alecia D; Sawyer, Broderick; Leen, Samantha; Pearlson, Godfrey D

2017-02-01

Traditional college students are at a critical juncture in the development of prospective memory (PM). Their brains are vulnerable to the effects of alcohol. There were 123 third and fourth year college students, 19-23 years old, who completed the Self-Rating Effects of Alcohol (SREA), Modified Timeline Follow-back (TFLB), Brief Young Adult Alcohol Consequences Scale (BYAACS), and Alcohol Effects Questionnaire (AEQ) once per month on a secure online database, as reported elsewhere (Dager et al., 2013). Data from the 6 months immediately before memory testing were averaged. In a single testing session participants were administered the Mini International Neuropsychiatric Interview-Diagnostic and Statistical Manual for Mental Disorders-Fourth Edition-Text Revision (MINI-DSM-IV-TR), measures of PM (event-based and time-based), and retrospective memory (RM). Based on the average score of six consecutive monthly responses to the SREA, TLFB, and AEQ, students were classified as nondrinkers, light drinkers, or heavy drinkers (as defined previously; Dager et al., 2013). Alcohol-induced amnesia (blackout) was measured with the BYAACS. We found a relationship between these alcohol use classifications and time-based PM, such that participants who were classified as heavier drinkers were more likely to forget to perform the time-based PM task. We also found that self-reported alcohol-induced amnesia (blackouts) during the month immediately preceding memory testing was associated with lower performance on the event-based PM task. Participants' ability to recall the RM tasks suggested the PM items were successfully encoded even when they were not carried out, and we observed no relationship between alcohol use and RM performance. Heavy alcohol use in college students may be related to impairments in PM. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Burnout, depression and suicidal ideation in dental students

PubMed Central

Ríos-Santos, José V.; Polo, Juan; Rios-Carrasco, Blanca; Bullón, Pedro

2014-01-01

Objectives: To investigate the prevalence, gender influence, and relationships between burnout, depression and suicidal ideation within the last year among second, fourth and fifth-year dental students. Study Design: A cross-sectional study was carried out in 212 dental students enrolled in the second, fourth and fifth years at the School of Dentistry of Seville using the Maslach Burnout Inventory-Student Survey and the MBI-Human Services Survey, the “Patient Health Questionnaire-2”, and the “Questions about Suicidal Ideation and Attempted Suicide”. Results: The response rate among dental students was 80%. Burnout prevalence in dental students was higher in second and fourth years than in fifth year (p= 0.059 and p= 0.003, respectively). Depression prevalence in the fourth year approached significance (p= 0.051). Prevalence of suicidal ideation within the past year was higher, yet not reaching significance, in fourth year. No gender-related differences were found. A significant association was observed between burnout and depression, and between depression and suicidal ideation (p< 0.001), but no association was found between burnout and suicidal ideation. Conclusions: This study has brought our attention to the high prevalence of burnout and depression, and reported for the first time the prevalence of suicidal ideation among dental students in preclinical and clinical years. Key words:Burnout, depression, suicidal ideation, dental students. PMID:24121916

Research knowledge in undergraduate school in Brazil: a comparison between medical and law students.

PubMed

Reis Filho, Antonio José Souza; Andrade, Bruno Bezerril; Mendonça, Vitor Rosa Ramos de; Barral-Netto, Manoel

2010-09-01

Exposure to science education during college may affect a student's profile, and research experience may be associated with better professional performance. We hypothesized that the impact of research experience obtained during graduate study differs among professional curricula and among graduate courses. A validated multiple-choice questionnaire concerning scientific concepts was given to students in the first and fourth years of medical and law school at a public Brazilian educational institution. Medical students participated more frequently in introductory scientific programs than law students, and this trend increased from the first to the fourth years of study. In both curricula, fourth-year students displayed a higher percentage of correct answers than first-year students. A higher proportion of fourth-year students correctly defined the concepts of scientific hypothesis and scientific theory. In the areas of interpretation and writing of scientific papers, fourth-year students, in both curricula, felt more confident than first-year students. Although medical students felt less confident in planning and conducting research projects than law students, they were more involved in research activities. Medical graduation seems to favor the development of critical scientific maturity than law graduation. Specific policy in medical schools is a reasonable explanation for medical students' participation in more scientific activities.

Tobacco Cessation and Prevention Practices Reported by Second and Fourth Year Students at US Medical Schools

PubMed Central

Brooks, Daniel R.; Powers, Catherine A.; Brooks, Katie R.; Rigotti, Nancy A.; Bognar, Bryan; McIntosh, Scott; Zapka, Jane

2008-01-01

Background Tobacco dependence counseling is recommended to be included as core curriculum for US medical students. To date, there has been little information on students’ self-reported skills and practice opportunities to provide 5A’s (Ask, Advise, Assess, Assist, and Arrange) counseling for tobacco cessation. Methods We conducted anonymous surveys of second year and fourth year students at multiple US medical schools between February 2004 and March 2005 (overall response rate 70%). We report on the tobacco control practices of the 860 second year and 827 fourth year students completing the survey. Measurements and Main Results Fourth year students reported multiple opportunities to learn tobacco counseling in case-based discussions, simulated patient encounters, and clinical skills courses. They reported more instruction in family medicine (79%) and Internal Medicine (70%) than Pediatrics (54%), Obstetrics/Gynecology (41%), and Surgery clerkships (16%). Compared with asking patients about smoking, advising smokers to quit, and assessing patient willingness to quit, fourth year students were less likely to have multiple practice opportunities to assist the patient with a quit plan and arrange follow-up contact. More than half of second year students reported multiple opportunities for asking patients about smoking but far fewer opportunities for practicing the other 4 As. Conclusions By the beginning of their fourth year, most students in this group of medical schools reported multiple opportunities for training and practicing basic 5A counseling, although clear deficits for assisting patients with a quit plan and arranging follow-up care exist. Addressing these deficits and integrating tobacco teaching through tailored specific instruction across all clerkships, particularly in Surgery, Pediatrics, and Obstetrics/Gynecology is a challenge for medical school education. PMID:18612747

Effective treatment of haemorrhoids: early complication and late results after 150 consecutive stapled haemorrhoidectomies.

PubMed

Bove, Aldo; Bongarzoni, Giuseppe; Palone, Gino; Chiarini, Stella; Calisesi, Enrico Maria; Corbellini, Luciano

2009-01-01

Haemorrhoidectomy according to Longo potentially reduces post-operative pain and allows an early return to work. The aim of this study was to evaluate the efficacy of the technique, the early and especially late complications, and recurrences, in 150 patients. Between January 2005 and December 2006, we performed 150 consecutive haemorrhoidectomies with the Longo technique: 82 for third degree haemorrhoids and 68 for fourth degree haemorrhoids. The mean age of patients was 42 years. Every patient had a pre-operative proctoscopy and endoscopy KIT PPH01 (Ethicon Endo Surgery) was used. We evaluated the length of the operation, the post-operative pain, the early and late complications, and the recurrence of the disease. The mean follow up was 52 months (range 36-72). There was no mortality. The mean length of the operation was 25 minutes with a range of 15 to 45 minutes. Pain, evaluated using the V.A.S. scale, was very light in 114 patients (V.A.S. 2,1) and light in 36 (V.A.S. 3.2). Only 11 (7.5%) patients took painkillers, on demand, for a week after discharge from hospital and 2 patients (1,3%) for more than one month. Early complications (6.6%) were: 5 bleeding (2 after seven days), 4 acute urinary retentions, 1 external haemorrhoid thrombosis and 1 haematoma of the rectus wall. Mean Hospital stay was 2.1 days. Late complications (10%) were: 5 "faecal urgency" which disappeared after six months, 6 moderate asymptomatic strictures, and 4 persistent skin tags. There were 8 recurrences (5.1%), 2 for haemorrhoids of grade 3 e 6 for haemorrhoids of grade 4. All the recurrences appeared within the first 24 months. The stapled procedure according to Longo is an effective treatment for haemorrhoids. The results for postoperative pain and early return to work are very good. However, special care for haemostasis is essential in order to avoid bleeding. An effective surgical technique prevents late complications, but results after long term follow up show a not insignificant percentage of recurrences that appeared especially in the fourth degree haemorrhoids. Therefore a careful pre-operative exclusion of those patients with a prominent prolax is necessary

Empowering fourth-year medical students: the value of the senior year.

PubMed

Cosgrove, Ellen M; Ryan, Michael J; Wenrich, Marjorie D

2014-04-01

In this issue of Academic Medicine, Wolf et al explore the purposes and value of the senior year of medical school as viewed by graduating students at their institution. Using data from student focus groups and questionnaires, they report that students all found there to be significant value in but identified different purposes for the fourth year. The authors of this commentary believe that study adds to the discussion of fourth-year curriculum reform an important voice that has been lacking-that of students.Previous articles focusing on the perceived lack of clarity of educational purpose in the senior year curriculum have reflected a faculty perspective and have led some to call for increasing the structure of, decreasing the elective time in, or even completely eliminating the fourth year. In this commentary, the authors ask for a pause in this debate to consider the implications of the student perspective as well as important trends in the medical education continuum that affect the senior student (e.g., milestones that will set new expectations for first-year residents, increasing pressure associated with matching to a residency). They propose that providing students with time for career exploration and for focusing on areas of interest would allow them to individualize their preparation for residency and to be more sure of their career choices. They share the University of Washington School of Medicine's planned new fourth-year approach as an example of a flexible, individualized senior year curriculum.

Procedural and interpretive skills of medical students: experiences and attitudes of fourth-year students.

PubMed

Wu, Edward H; Elnicki, D Michael; Alper, Eric J; Bost, James E; Corbett, Eugene C; Fagan, Mark J; Mechaber, Alex J; Ogden, Paul E; Sebastian, James L; Torre, Dario M

2008-10-01

Recent data do not exist regarding fourth-year medical students' performance of and attitudes toward procedural and interpretive skills, and how these differ from third-year students'. Cross-sectional survey conducted in February 2006 of 122 fourth-year students from seven U.S. medical schools, compared with their responses in summer 2005. Students estimated their cumulative performance of 22 skills and reported self-confidence and perceived importance using a five-point Likert-type scale. The response rate was 79% (96/122). A majority reported never having performed cardioversion, thoracentesis, cardiopulmonary resuscitation, blood culture, purified protein derivative placement, or paracentesis. One fifth of students had never performed peripheral intravenous catheter insertion, phlebotomy, or arterial blood sampling. Students reported increased cumulative performance of 17 skills, increased self-confidence in five skills, and decreased perceived importance in three skills (two-sided P < .05). A majority of fourth-year medical students still have never performed important procedures, and a substantial minority have not performed basic procedures.

Do Dutch nutrition and dietetics students meet nutritional requirements during education?

PubMed

van der Kruk, Joke J; Jager-Wittenaar, Harriët; Nieweg, Roos M B; van der Schans, Cees P

2014-06-01

To compare the dietary intakes of Dutch nutrition and dietetics students with the Dutch RDA and the Dutch National Food Consumption Survey (DNFCS), and to assess whether dietary intake changes during education. Cross-sectional and longitudinal research (2004-2010). Data collection by 7 d dietary record and questionnaire. Dutch nutrition and dietetics students. Three hundred and fifty-two first-year and 216 fourth-year students were included. One hundred and thirty-three students in three cohorts were assessed twice. Of first-year students, >80 % met the RDA for all macronutrients. Of these students only 37 % met the RDA for fibre and in 43 % intake of saturated fat was too high. Fourth-year students more often met the RDA for fruits (55 %) and vegetables (74 %) compared with first-year students (32 % and 40 %, respectively). Intake of fruits and vegetables of both first- and fourth-year students was much higher than that of DNFCS participants (where 2 % and 7 %, respectively, met the corresponding RDA). Only <25 % of fourth-year students met the RDA for Fe, Se and vitamin D. In the cohorts, dietary intake for all macronutrients stabilised from the first to the fourth year (>80 %). Intakes of dietary fibre, Ca, Mg, Se, riboflavin, niacin, fruits, vegetables and fish improved significantly during education. Dietary intake of nutrition and dietetics students is much better than that of DNFCS participants and improved during education. However, there is still a gap between actual dietary intake and the RDA, especially for Fe, Se and vitamin D.

7 to 10 years' follow-up of 573 patients with elevated prostate-specific antigen (>4 ng/mL) or/and suspected rectal examination: biopsies protocol and follow-up guides.

PubMed

Kravchick, Sergey; Cytron, Shmuel; Stepnov, Eugeny; Ben-Dor, David; Kravchenko, Yakov; Peled, Ronit

2009-06-01

In this study, we tried to design a scheme for performing transrectal ultrasonographic (TRUS)-biopsies that would be accurate and include the optimal number of cores. We included in this study 600 consecutive patients with suspicious findings on a per-rectum examination and/or an elevated prostate-specific antigen (PSA) (>4 ng/mL) level. Patients were followed for 7 to 10 years. In all patients, we took from 8 to 16 biopsy samples, according to the prostate volume, from the lateral aspects. In the second session, the biopsy samples were taken medially; in the third session, we included the transitional zone, while in consecutive sessions, we increased the number of cores from all areas. Only 573 of the patients remained in follow-up. TRUS-biopsy detected prostate cancer (PCa) in 257 patients (44.85% overall detection rate). The detection rate in the first and second sessions was 32.98% and 14.94%, respectively, reaching 13.2% and 2.17%, in the third and fourth sessions, respectively. Prostate volumes were significantly smaller (52.9 +/- 22.4 cc vs 58.9 +/- 23.8 cc, P < 0.002) and the PSA/adenoma/prostate volumes ratio (ad-pro) ratio was higher (18.3 +/- 9 vs 13.96, P < 0/001) in the patients with PCa. Patients with PCa underwent fewer biopsy procedures and biopsy sessions than patients without a diagnosis of PCa (14.9 +/- 8.9 vs 20.4 +/- 12, P < 0.001;1.3 +/- 0.6 vs 1.7 +/- 0.9, P < 0.001). Biopsy samples obtained from the base were positive for cancer only in larger prostates with a mean volume of 54.3 +/- 15.3 cc. Numbers of biopsy procedures and PSA/ad-pro ratio were the strongest predictive factors for PCa detection (P < 0.001). In patients with a prostate volume >or=53 cc and PSA/ad-pro ratio >or=18, the optimal biopsy cores should be >or=15. Using this scheme, the discontinuation of biopsy procedures might be considered after three consecutive sessions.

33 CFR 117.757 - Townsend Inlet.

Code of Federal Regulations, 2010 CFR

2010-07-01

... March of every year. (b) From 11 p.m. on December 24 until 11 p.m. on December 25, the draw need open... the fourth Sunday in March of every year, the draw need not open for vessels. If the fourth Sunday...

Listening to the Experts: The Views of Working-Aged Consumers with Disabilities. Consumer Needs Assessment Project Year Four: Results of the Fourth Year of a Five Year Study.

ERIC Educational Resources Information Center

Ward, Carolyn

This monograph details the findings from the fourth year of a 5-year Consumer Needs Assessment Project. Sixteen focus groups consisting of 133 working-aged persons (25 to 60 years old) with disabilities were convened in 3 different parts of the United States to discuss their personal and technological needs. Consumers identified problems they face…

Acquisition of Motor and Cognitive Skills through Repetition in Typically Developing Children

PubMed Central

Magallón, Sara; Narbona, Juan; Crespo-Eguílaz, Nerea

2016-01-01

Background Procedural memory allows acquisition, consolidation and use of motor skills and cognitive routines. Automation of procedures is achieved through repeated practice. In children, improvement in procedural skills is a consequence of natural neurobiological development and experience. Methods The aim of the present research was to make a preliminary evaluation and description of repetition-based improvement of procedures in typically developing children (TDC). Ninety TDC children aged 6–12 years were asked to perform two procedural learning tasks. In an assembly learning task, which requires predominantly motor skills, we measured the number of assembled pieces in 60 seconds. In a mirror drawing learning task, which requires more cognitive functions, we measured time spent and efficiency. Participants were tested four times for each task: three trials were consecutive and the fourth trial was performed after a 10-minute nonverbal interference task. The influence of repeated practice on performance was evaluated by means of the analysis of variance with repeated measures and the paired-sample test. Correlation coefficients and simple linear regression test were used to examine the relationship between age and performance. Results TDC achieved higher scores in both tasks through repetition. Older children fitted more pieces than younger ones in assembling learning and they were faster and more efficient at the mirror drawing learning task. Conclusions These findings indicate that three consecutive trials at a procedural task increased speed and efficiency, and that age affected basal performance in motor-cognitive procedures. PMID:27384671

Acquisition of Motor and Cognitive Skills through Repetition in Typically Developing Children.

PubMed

Magallón, Sara; Narbona, Juan; Crespo-Eguílaz, Nerea

2016-01-01

Procedural memory allows acquisition, consolidation and use of motor skills and cognitive routines. Automation of procedures is achieved through repeated practice. In children, improvement in procedural skills is a consequence of natural neurobiological development and experience. The aim of the present research was to make a preliminary evaluation and description of repetition-based improvement of procedures in typically developing children (TDC). Ninety TDC children aged 6-12 years were asked to perform two procedural learning tasks. In an assembly learning task, which requires predominantly motor skills, we measured the number of assembled pieces in 60 seconds. In a mirror drawing learning task, which requires more cognitive functions, we measured time spent and efficiency. Participants were tested four times for each task: three trials were consecutive and the fourth trial was performed after a 10-minute nonverbal interference task. The influence of repeated practice on performance was evaluated by means of the analysis of variance with repeated measures and the paired-sample test. Correlation coefficients and simple linear regression test were used to examine the relationship between age and performance. TDC achieved higher scores in both tasks through repetition. Older children fitted more pieces than younger ones in assembling learning and they were faster and more efficient at the mirror drawing learning task. These findings indicate that three consecutive trials at a procedural task increased speed and efficiency, and that age affected basal performance in motor-cognitive procedures.

Medical student and patient perceptions of quality of life associated with vision loss.

PubMed

Chaudry, Imtiaz; Brown, Gary C; Brown, Melissa M

2015-06-01

Because most medical schools in the United States and Canada require no formal ophthalmology training, the authors queried medical student and ophthalmic patients to compare their perceptions of the quality of life (QOL) associated with vision loss. Cross-sectional comparative study of consecutive medical students and patients with vision loss using a validated, reliable, time trade-off utility instrument. Consecutive Jefferson Medical College medical students (cohort 1: 145 second-year student; cohort 2: 112 third-year/fourth-year students) and 283 patients with vision loss (patient cohort). Time trade-off vision utilities with anchors of 0.0 (death) to 1.0 (normal vision permanently) were used to quantify the QOL associated with vision loss. Students were asked to assume they had: (i) mild vision loss (20/40 to 20/50 vision in the better-seeing eye), (ii) legal blindness (20/200 in the better-seeing eye), and (iii) absolute blindness (no light perception bilaterally). Mean utilities for cohort 1/cohort 2 were 0.96/0.95 (p = 0.20) for mild vision loss, 0.88/0.84 for legal blindness (p = 0.009), and 0.80/0.67 (p < 0.0001) for absolute blindness. Medical student/patient mean utilities were 0.96/0.79 (p < 0.0001) for mild vision loss, 0.85/0.62 for legal blindness (p < 0.0001), and 0.74/0.26 (p < 0.0001) for absolute blindness. Overall, medical students underestimated the QOL associated with vision loss referent to patients with vision loss by 153%-425%. Medical students dramatically underestimated the impact of vision loss on patient QOL. Clinical training slightly improved medical student perceptions. Trivialization of vision loss could result in systemic health harm, less ophthalmic research dollars, loss of the finest medical students entering ophthalmology, and overall adverse financial effects for the field. Copyright © 2015. Published by Elsevier Inc.

The effects of aromatherapy with lavender essential oil on fatigue levels in haemodialysis patients: A randomized clinical trial.

PubMed

Bagheri-Nesami, Masoumeh; Shorofi, Seyed Afshin; Nikkhah, Attieh; Espahbodi, Fatemeh; Ghaderi Koolaee, Fahimeh-Sadat

2016-02-01

This study was intended to examine the efficacy of lavender essential oil for the alleviation of fatigue in haemodialysis patients. This randomized clinical trial was conducted on 59 haemodialysis patients in two groups. The routine care group received the routine care, but the experimental group inhaled lavender essence 5% for 10 min, three times a week for 4 consecutive weeks. The Fatigue Severity Scale was used to assess fatigue before the intervention and after the last intervention in the second and fourth weeks. No statistically significant differences were observed between the two groups in terms of the fatigue scores before, and after the last intervention in the second and fourth weeks. Our result does not support other studies suggesting that lavender essential oil is effective on fatigue in haemodialysis patients. This conflicting result can mostly be ascribed to a variety of factors such as duration of aromatherapy and differences in concentrations of lavender essential oil. Copyright © 2015 Elsevier Ltd. All rights reserved.

Ectopic craniopharyngioma of the fourth ventricle in a patient with Gardner syndrome.

PubMed

Pena, Andres H; Chaudhry, Ammar; Seidman, Roberta J; Peyster, Robert; Bangiyev, Lev

2016-01-01

Ectopic craniopharyngioma is uncommon and a craniopharyngioma confined purely within the fourth ventricle is extremely rare. We report a craniopharyngioma of the fourth ventricle in a 20-year-old man with Gardner syndrome. Imaging characteristics of craniopharyngiomas and fourth ventricle lesions are discussed with a review of the literature regarding the pathogenesis of craniopharyngiomas and the possible association with Gardner syndrome. Copyright © 2015 Elsevier Inc. All rights reserved.

An outbreak of viral gastroenteritis on a cruise ship.

PubMed

McEvoy, M; Blake, W; Brown, D; Green, J; Cartwright, R

1996-12-06

Three hundred and seventy-eight passengers reported gastroenteritis during four cruises in the western Mediterranean on consecutive weeks of 1995. The rate at which cases were reported each day increased on the fourth cruise. The ship's owner commissioned an epidemiological investigation from the PHLS Communicable Disease Surveillance Centre. Cases reported explosive vomiting and diarrhoea, which lasted from 24 hours to five days, and were suggestive of viral gastroenteritis. No food handlers reported illness, but enquiries suggested that some had been ill and treated themselves. No bacterial pathogens were isolated from faecal specimens provided by cases or from water, food, and environmental samples taken from the galley. Small round structured viruses (SRSV) were identified by reverse transcriptase polymerase chain reaction in two faecal specimens and one specimen of vomit from people who became ill during the fourth cruise. SRSV was also identified in one faecal specimen by electron microscopy. Environmental inspection revealed inappropriate food handling, hygiene, and storage. During one 24 hour period no chlorine was detectable in the water. A case control study conducted on the fourth cruise sought details of exposure to various foodstuffs, unbottled water, and various parts of the ship. No significant associations were found between illness and any exposures. The evidence strongly suggested a continuing outbreak of SRSV infection transmitted from person to person. Some passengers remained on board for a second week and could have transmitted their infection to new arrivals. The ship was cleared and disinfected at the end of the fourth cruise in order to interrupt transmission. Fewer than 10 cases presented in each of the fifth and sixth cruises.

Serum betaine but not choline is inversely associated with breast cancer risk: a case-control study in China.

PubMed

Du, Yu-Feng; Lin, Fang-Yu; Long, Wei-Qing; Luo, Wei-Ping; Yan, Bo; Xu, Ming; Mo, Xiong-Fei; Zhang, Cai-Xia

2017-04-01

Choline and betaine are important for DNA methylation and synthesis, and may affect tumor carcinogenesis. To our knowledge, no previous study has examined the association between serum choline and betaine and breast cancer risk. This study aimed to examine whether serum choline and betaine were inversely associated with breast cancer risk among Chinese women. This hospital-based case-control study consecutively recruited 510 breast cancer cases and 518 frequency-matched (age and residence) controls, and blood samples were available for 500 cases and 500 controls. Serum choline and betaine were assayed by high-performance liquid chromatography-tandem mass spectrometry. Multiple unconditional logistic regression was used to estimate odds ratios (ORs) and 95 % confidence intervals (CIs). An inverse association with breast cancer risk was observed for serum betaine (fourth vs first quartile adjusted OR 0.68, 95 % CI 0.47-0.97) and for the ratio of serum betaine to choline (fourth vs first quartile adjusted OR 0.70, 95 % CI 0.48-1.00), but not for serum choline (fourth vs first quartile adjusted OR 0.80, 95 % CI 0.56-1.15). Serum betaine was inversely associated with breast cancer risk in subjects with below-median dietary folate intake (fourth vs first quartile adjusted OR 0.48, 95 % CI 0.30-0.77). This study suggested that serum betaine but not choline was inversely associated with breast cancer risk. This result needed to be further confirmed by the prospective studies.

Cultural Literacy of Fourth-Year Medical Students.

ERIC Educational Resources Information Center

King, Charles R.

1988-01-01

A survey of fourth-year students in obstetrics at one medical school confirmed the absence of a liberal undergraduate education and indicated their failure to acquire cultural knowledge during their premedical and medical education. Knowledge deficits extended beyond the humanities to nonmedical sciences and the history and philosophy of medicine.…

An Investigation on the Scientific Thinking Ability of Fourth Year University Students.

ERIC Educational Resources Information Center

Boo, Hong-Kwen; Toh, Kok-Aun

1998-01-01

Fourth-year university students (n=12) in a secondary-science-education degree program in Singapore were interviewed after demonstrations of five familiar chemical reactions. The majority of interviewees used perceptually-dominated rather than conceptually-dominated thinking and were unable to use scientific concepts consistently across the five…

Problem-Based Learning of Social Sciences and Humanities by Fourth-Year Medical Students.

ERIC Educational Resources Information Center

Colby, Kathleen K.; And Others

1986-01-01

A required fourth-year course integrating the social sciences and humanities into the required clinical medical curriculum at Dartmouth Medical School is intended to prepare students to deal with the social and humanistic issues involved in medical practice, including law, ethics, economics, and social anthropology. (MSE)

Perceptions of Mentoring from Fourth Year Medical Students

ERIC Educational Resources Information Center

Charles, Stephen C.

2014-01-01

This mixed-methods research study investigated medical students' perspectives of professional mentoring through a web-based survey/needs assessment. The participants are fourth year medical students from three large urban research institutions and two regional branch campuses. The web-based survey/needs assessment was created, peer reviewed, and…

THE SUPERFUND INNOVATIVE TECHNOLOGY EVALUATION PROGRAM: PROGRESS AND ACCOMPLISHMENTS - FISCAL YEAR 1990 A FOURTH REPORT TO CONGRESS

EPA Science Inventory

The SITE Program was the first major program for demonstrating and evaluating fullscale innovative treatment technologies at hazardous waste sites. Having concluded its fourth year, the SITE Program is recognized as a leading advocate of innovative technology development and comm...

[Disproportionately large communicating fourth ventricle--report of 2 cases].

PubMed

Matsumoto, M; Kushida, Y; Shibata, I; Seiki, Y; Terao, H

1983-11-01

A term of 'disproportionately large, communicating fourth ventricle' (DLCFV) was first proposed by in Harwood-Nash in 1980. It is somewhat different from the well known clinical entity of 'isolated or trapped fourth ventricle', because of apparent patency of aqueductal canal. Two cases of typical DLCFV encountered in our clinic were described. First patient was a 24 year old man in whom this condition developed following operations for lumber disc and second patient was 22 year old woman in whom the disease developed after subarachnoid hemorrhage. In both cases, main symptoms were attributable to hydrocephalus but three posterior fossa symptoms, nystagmus, Parinaud' sign and truncal ataxia were also characteristic. On the CT scan, the fourth ventricle was extraordinarily enlarged. Patency of the aqueductal canal was demonstrated by air study or Conray and Metrizamide ventriculography. On the other hand, occlusion was demonstrated or highly suspected in or near the foramina Magendie and Luschka. After a routine ventriculo-peritoneal shunt operation, the fourth ventricle decreased in size and the symptoms were immediately relieved. Plausible explanation for mechanism involved in occurrence of DLCFV were (1) occlusion process in or near the fourth ventricle outlets seems to be crucial in this pathologic condition. Collision of CSF pulse waves against the obstruction may yield a water hammer effect on the fourth ventricle. (2) abnormal weakness of the brain stem parenchyma around the fourth ventricle to CSF pressure may be another contributory factor.

Modified Longo's stapled hemorrhoidopexy with additional traction sutures for the treatment of residual prolapsed piles.

PubMed

Chen, Chuang-Wei; Kang, Jung-Cheng; Wu, Chang-Chieh; Hsiao, Cheng-Wen; Jao, Shu-Wen

2008-03-01

Residual prolapsed piles is a problem after the stapled hemorrhoidopexy, especially in large third- or fourth-degree hemorrhoids. We have developed a method using additional traction sutures along with modified Longo's procedure to manage this problem. From January 2005 to October 2005, 30 consecutive patients with symptomatic third- or fourth-degree hemorrhoids who underwent the modified Longo's stapled hemorrhoidopexy with additional traction sutures in a single institution were collected. The demographics, postoperative pain score, surgical features, outcomes, and early and late complications were recorded. All patients were followed for a mean duration of 8.8 (range, 4-15) months. Thirty patients (17 males) with a mean age of 45 (range, 27-63) years were identified. The mean postoperative pain score on the morning of the first postoperative day was 2.8 (range, 1-4). The mean duration of operation was 30.7 (range, 25-37) min. The mean duration of hospital stay was 2 (range, 1-3) days. The mean days for patients to resume normal work was 6.7 (range, 4-9) days. No other procedure-related complications occurred in all patients. There was no early complication except for fecal urgency found in one patient during the first postoperative days. Regarding the late complications, no residual prolapsed piles, persistent anal pain, incontinence, anal stenosis, or recurrent symptoms were found. Our preliminary experiences indicated that this modified procedures truly contributed to reduce the residual internal hemorrhoids and maintained the benefits of stapled hemorrhoidopexy. Randomized trial and long-term follow-up warrant to determine possible surgical and functional outcome.

Integrating Complementary and Alternative Medicine Education Into the Pharmacy Curriculum

PubMed Central

Wallis, Marianne

2008-01-01

Objectives To evaluate the effectiveness of an integrated approach to the teaching of evidence-based complementary and alternative medicine (CAM) in a pharmacy curriculum. Design Evidence-based CAM education was integrated throughout the third, fourth, and fifth years of the pharmacy curriculum. Specifically, an introductory module focusing on CAM familiarization was added in the third year and integrated, evidence-based teaching related to CAM was incorporated into clinical topics through lectures and clinical case studies in the fourth and fifth years. Assessment Students' self-assessed and actual CAM knowledge increased, as did their use of evidence-based CAM resources. However, only 30% of the fourth-year students felt they had learned enough about CAM. Students preferred having CAM teaching integrated into the curriculum beginning in the first year rather than waiting until later in their education. Conclusion CAM education integrated over several years of study increases students' knowledge and application. PMID:19002274

The dermatology acting internship.

PubMed

Stephens, John B; Raimer, Sharon S; Wagner, Richard F

2011-07-15

Acting internships are an important component of modern day medical school curriculum. Several specialties outside of internal medicine now offer acting internship experiences to fourth year medical students. We have found that a dermatology acting internship is a valuable experience for fourth year medical students who are interested in pursuing a residency in dermatology. Our experience with the dermatology acting internship over the 2010-2011 academic year is described.

The Mutual Relationship Between Men's Drinking and Depression: A 4-Year Longitudinal Analysis.

PubMed

Lee, Soo Bi; Chung, Sulki; Lee, HaeKook; Seo, Jeong Seok

2018-03-17

The purpose of the current study was to examine the longitudinal reciprocal relationship between depression and drinking among male adults from the general population. This study used a panel dataset from the Korean Welfare Panel (from 2011 to 2014). The subjects were 2511 male adults aged between 20 and 65 years. Based on the Korean Version of the Alcohol Use Disorders Identification Test (AUDIT-K) scores, 2191 subjects were categorized as the control group (AUDIT-K < 12) and 320 subjects were categorized as the problem drinking group (AUDIT-K ≥ 12). An autoregressive cross-lagged modelling analysis was performed to investigate the mutual relationship between problem drinking and depression measured consecutively over time. The results indicated that alcohol drinking and depression were stable over time. In the control group, there was no significant causal relationship between problem drinking and depression while in the problem drinking group, drinking in the previous year significantly influenced depression in the following second, third and fourth years. This study compared normal versus problem drinkers and showed a 4-year mutual causal relationship between depression and drinking. No longitudinal interaction between drinking and depression occurred in normal drinkers, while drinking intensified depression over time in problem drinkers. This study found that problem drinking was a risk factor for development of depression. Therefore, more attention should be given to problem alcohol use in the general population and evaluation of past alcohol use history in patients with depressive disorders.

Poor Children's Fourth-Grade Slump.

ERIC Educational Resources Information Center

Chall, Jeanne S.; Jacobs, Vicki A.

2003-01-01

In a study of second, fourth, and sixth graders who completed reading and language tests over 2 years, low-income second and third graders achieved as well as their normative peers on all subtests. However, around fourth grade, their reading scores began to decline. One possible cause for this slump may stem from lack of fluency and automaticity.…

A Corresponding Study of Water Quality Evaluation of the Pasquotank Watershed in Northeastern North Carolina

NASA Astrophysics Data System (ADS)

Stevenson, J.; Walthall, S.; McKenzie, R.; Dixon, R.

2015-12-01

The Pasquotank River Watershed covers 450 sq miles in the Coastal Plain of NE North Carolina. It flows from the Great Dismal Swamp at the VA/NC border into the Albemarle Sound. The watershed provides a transition between spawning grounds and waters of the Albemarle Sound. Forested swamp wetlands border much of the waterways. Increased agricultural and urban development has greatly affected water quality during recent years. Test were completed along the tributaries and the river itself, adding to the previously data from 2011, 2013, and 2014. Streams tested were the Newbegun Creek, Knobbs Creek, Areneuse Creek, Mill Dam Creek, and Sawyers Creek. These streams cover a large area of the watershed and provide a wide variety of shore development from swampland and farmland to industrial development. Samples were tested for pH, salinity, total dissolved solids, and conductivity. Air/water temperature, dissolved oxygen, wind speed/direction, and turbidity/clarity measurements were taken in the field. The results were placed into an online database and correlated to the location of the sample using Google Maps®. Analysis tools were developed to compare the data from all years. Excel spreadsheets were developed to look more closely at individual points and tests for each point. This database was connected to a data visualization page utilizing Google Maps®. The results show variations for the individual water quality scores, but the overall water quality score for all the tested water sources remained at a comparable level from previous years. Mill Dam Creek rose above the previous three scores of 48 (2011), 47 (2013), and 49 (2014) and achieved a medium water quality score of 57. Areneuse Creek improved in water quality with a medium water quality score of 60. Sawyers Creek became the lowest scoring waterway tested at 35. Knobbs Creek decreased from previous years with a water quality score of 42. For a fourth consecutive testing year, Newbegun Creek fell within the medium water quality range with a score of 65. Pasquotank River rose from the previous testing year's score of 35 but still remained within the bad water quality range with a score of 45. The Lower Pasquotank remained the highest scoring tributary for a second consecutive year with a score of 85. Team included authors plus Ricky Dixon and Raveen McKenzie of MVSU.

Annual Report of the Oklahoma State Advisory Council Vocational-Technical Education (Fourth).

ERIC Educational Resources Information Center

Oklahoma State Advisory Council for Vocational-Technical Education, Oklahoma City.

The fourth annual report of the Oklahoma Advisory Council for Vocational-Technical Education presents detailed evaluative comments on programs carried out under the Oklahoma State Plan for Vocational Education for the academic year 1971-72. Following last year's recommendations, health occupations programs continued to have first priority. A…

A Purpose-Driven Fourth Year of Medical School.

PubMed

Dewan, Mantosh; Norcini, John

2017-10-03

The fourth year of medical school has been repeatedly found to be ineffective, and concerns exist about its purpose and academic quality, as well as grade inflation. Since Flexner, the purpose of undergraduate medical training has moved from readiness for independent practice to readiness for postgraduate training. However, training directors report that medical graduates are inadequately prepared to enter residency. The authors propose a fourth year with two components: first, a yearlong, longitudinal ambulatory experience of at least three days each week on an interprofessional team with consistent faculty supervision and mentoring, increasing independence, and a focus on education; and second, rigorous clinical-scales-based assessment of meaningful outcomes.In the proposed model, the medical student has generous time with a limited panel of patients, and increasing autonomy, with faculty moving from supervising physicians to collaborating physicians. There is regular assessment and formative feedback. This more independent, longitudinal clinical experience uniquely allows assessment of the most meaningful work-based performance outcomes-that is, patient outcomes assessed by validated clinical scales. The proposed fourth year will require a realignment of resources and faculty time; however, models already exist. Barriers and possible solutions are discussed.A purpose-driven, assessment-rich fourth year with patient and supervisor continuity will provide real-world experience, making medical graduates more competent and confident on the first day of residency. Use of clinical scales will also allow educators new confidence that the performance-based competence of these more experienced and expert graduates leads to demonstrable collaboration, healing, and good patient outcomes.

A study of the prostate, androgens and sexual activity of male rats

PubMed Central

Hernandez, Maria Elena; Soto-Cid, Abraham; Aranda-Abreu, Gonzalo E; Díaz, Rosaura; Rojas, Fausto; Garcia, Luis I; Toledo, Rebeca; Manzo, Jorge

2007-01-01

Background The prostate is a sexual gland that produces important substances for the potency of sperm to fertilize eggs within the female reproductive tract, and is under complex endocrine control. Taking advantage of the peculiar behavioral pattern of copulating male rats, we developed experimental paradigms to determine the influence of sexual behavior on the level of serum testosterone, prostate androgen receptors, and mRNA for androgen receptors in male rats displaying up to four consecutive ejaculations. Methods The effect of four consecutive ejaculations was investigated by determining levels of (i) testosterone in serum by solid phase RIA, (ii) androgen receptors at the ventral prostate with Western Blots, and (iii) androgen receptors-mRNA with RT-PCR. Data were analyzed with a one-way ANOVA followed by a post hoc application of Dunnett's test if required. Results The constant execution of sexual behavior did not produce any change in the weight of the ventral prostate. Serum testosterone increased after the second ejaculation, and remained elevated even after four ejaculations. The androgen receptor at the ventral prostate was higher after the first to third ejaculations, but returned suddenly to baseline levels after the fourth ejaculation. The level of mRNA increased after the first ejaculation, continued to increase after the second, and reached the highest peak after the third ejaculation; however, it returned suddenly to baseline levels after the fourth ejaculation. Conclusion Four consecutive ejaculations by sexually experienced male rats had important effects on the physiological responses of the ventral prostate. Fast responses were induced as a result of sexual behavior that involved an increase and decrease in androgen receptors after one and four ejaculations, respectively. However, a progressive response was observed in the elevation of mRNA for androgen receptors, which also showed a fast decrease after four ejaculations. All of these changes with the prostate gland occurred in the presence of a sustained elevation of testosterone in the serum that started after two ejaculations. A consideration of these fast-induced changes suggests that the nerve supply plays a key role in prostate physiology during the sexual behavior of male rats. PMID:17367532

Learning by Choosing: Fourth Graders Use of an Online Multimedia Tutoring System for Math Problem Solving

ERIC Educational Resources Information Center

Maloy, Robert W.; Razzaq, Leena; Edwards, Sharon A.

2014-01-01

This study explored the use of an online mathematics tutoring system in eight fourth grade classrooms in two Massachusetts communities--a small rural city with a low 2010 Adequate Yearly Progress (AYP) math performance rating and a small suburban district with a high 2010 AYP math performance rating. 165 fourth graders completed 11 modules…

The Correlation between the Fourth Grade Students' Level of Functional Literacy and Metacognitive Awareness

ERIC Educational Resources Information Center

Özenç, Emine Gül; Dikici, Hidayet

2016-01-01

The present study aims at presenting the relationship between the fourth grade primary school students' level of functional literacy and metacognitive awareness. The study group of the research is made up of 406 fourth grade students attending school during 2015-2016 academic year in Nigde. This study adopts survey model and its data collection…

Fourth Five-Year Plan, 1969-1974. Draft.

ERIC Educational Resources Information Center

Planning Commission, New Delhi (India).

This document is an English language abstract (approximately 1,500 words) of the Fourth Indian Five Year Plan Report, Chapter 15, which deals with Education and Manpower. India's tasks in providing educational facilities for children in the 6-14 age group are immense. Only about 60% of that age group are in school today. The Plan refers to this…

The Fourth-Year Experience: Impediments to Degree Completion

ERIC Educational Resources Information Center

Donhardt, G. L.

2013-01-01

Undergraduates who persevere to the fourth year of their academic careers have invested a great deal of time, effort, and financial resources in their education. In spite of the effort, many do not succeed in graduating. Students from an entering class of first-time, full time freshmen from a large urban university were tracked through their…

Substance Use by Fourth-Year Students at 13 U.S. Medical Schools.

ERIC Educational Resources Information Center

Conard, Scott; And Others

1988-01-01

A study investigated drug use by fourth-year medical students in 13 schools and compared drug use patterns with those of an age- and sex-matched cohort. Medical students reported less use of marijuana, cocaine, cigarettes, LSD, barbiturates, and amphetamines, similar use of opiates, and slightly more use of tranquilizers and alcohol. (MSE)

Genetic characterization of an extended-spectrum AmpC cephalosporinase with hydrolysing activity against fourth-generation cephalosporins in a clinical isolate of Enterobacter aerogenes selected in vivo.

PubMed

Rodríguez-Martínez, Jose M; Fernández-Echauri, Pedro; Fernández-Cuenca, Felipe; Diaz de Alba, Paula; Briales, Alejandra; Pascual, Alvaro

2012-01-01

Extended-spectrum AmpC cephalosporinases (ESACs) have been reported in Enterobacteriaceae, Pseudomonas aeruginosa and Acinetobacter baumannii. Here, we characterize a new AmpC variant presenting a broadened substrate activity towards fourth-generation cephalosporins, selected in vivo following cefepime treatment for Enterobacter aerogenes. Two consecutive clonally related isolates of E. aerogenes were evaluated. Screening for ESAC production was performed using plates containing 200 mg/L cloxacillin. MICs were determined by microdilution (CLSI guidelines). bla(AmpC) genes were cloned into a pCR-Blunt II-TOPO vector and expressed in Escherichia coli. The ampC genes were cloned into vector pGEX-6P-1 for protein purification. Isolate Ea595 was resistant to two fourth-generation cephalosporins, cefepime and cefpirome; using plates containing cloxacillin, susceptibility to ceftazidime and cefepime was restored, suggesting overproduction of the ESAC β-lactamase. Sequencing identified a new AmpC β-lactamase variant presenting one amino acid substitution, Val291Gly, inside the H-10 helix. Recombinant plasmids harbouring this ESAC β-lactamase conferred a broadened resistance profile to cefepime and cefpirome, with resistance levels increasing from 16- to 32-fold in E. coli. AmpC-Ea595 hydrolysed ceftazidime, cefepime and cefpirome at high levels, presenting a lower K(m) and enabling us to classify the enzyme as an ESAC. Homology modelling suggested that the size of the active site could have increased. We characterized an ESAC β-lactamase selected in vivo and conferring a high level of resistance to fourth-generation cephalosporins in E. aerogenes. The broadened spectrum was caused by a new modification to the H-10 helix, which modified the active site.

Southwest Washington coastal erosion workshop report 2000

USGS Publications Warehouse

Gelfenbaum, Guy; Kaminsky, George M.

2002-01-01

This report is a compilation of abstracts that correspond to oral presentations and posters presented at the fifth principal investigators workshop of the Southwest Washington Coastal Erosion Study. The workshop was held November 15 - 17, 2000 at the Department of Ecology headquarters building in Olympia, WA. For the fourth consecutive year in November, the workshop convened the entire multi-disciplinary group of scientists and engineers working on the Study or on related projects within the Columbia River littoral cell (CRLC) (Figures 1 and 2). The workshop participants are listed in the List of Attendees section towards the end of this report. The purpose of this workshop was to bring all Study investigators and associated engineers and scientists together to discuss recent work, ongoing tasks, and future research plans in the CRLC. Investigators were asked to present recent data, preliminary interpretations, and research results to invoke discussion and correlation with parallel scientific efforts. The abstracts compiled in this report represent a wealth of information on the CRLC, but because much of the work is in progress, the reader is advised that the information provided herein is preliminary and subject to change.

Resident selection: how we are doing and why?

PubMed

Thordarson, David B; Ebramzadeh, Edward; Sangiorgio, Sophia N; Schnall, Stephen B; Patzakis, Michael J

2007-06-01

Selection of the best applicants for orthopaedic residency programs remains a difficult problem. Most quantifiable factors for residency selection evaluate test-taking ability and grades rather than other aspects, such as patient care, professionalism, moral reasoning, and integrity. Four current department members on our resident selection committee ranked four consecutive classes of orthopaedic residents interviewed for residency. We ranked incoming residents in order of best to least qualified and compared those rankings with rank lists by the same faculty on completion of residency. Rankings also were compared with the residents' United States Medical Licensing Examination (USMLE) Part I scores, American Board of Orthopaedic Surgery (ABOS) Part I scores, and fourth-year Orthopaedic-in-Training Examination (OITE) scores. We found fair or poor correlations between the residents' initial rankings, rankings on graduation, and their USMLE, ABOS, and OITE scores. The only relatively strong correlation found was between the OITE and ABOS scores. Despite the faculty's consensus regarding selection criteria, interviewers did not agree in their rankings of residents on graduation. Additional work is necessary to refine the inexact yet important science of selecting residency applicants.

Incidence and Outcomes of Patients With Oral Cavity Squamous Cell Carcinoma and Fourth Primary Tumors: A Long-term Follow-up Study in a Betel Quid Chewing Endemic Area.

PubMed

Adel, Mohamad; Liao, Chun-Ta; Lee, Li-Yu; Hsueh, Chuen; Lin, Chien-Yu; Fan, Kang-Hsing; Wang, Hung-Ming; Ng, Shu-Hang; Lin, Chih-Hung; Tsao, Chung-Kan; Huang, Shiang-Fu; Kang, Chung-Jan; Fang, Ku-Hao; Wang, Yu-Chien; Chang, Kai-Ping; Fang, Tuan-Jen; Yang, Lan Yan; Yen, Tzu-Chen

2016-03-01

The aim of this study was to explore the incidence and outcomes of patients with oral cavity squamous cell carcinoma (OSCC) and fourth primary tumors (PTs) in a betel-chewing endemic area.We retrospectively examined the records of 1836 OSCC patients who underwent radical tumor resection between 1996 and 2014. The outcome measures included the incidence and number of multiple PTs, the main risk factors, and their associations with overall survival (OS).Of the 1836 patients, 1400 (76.3%) had a single PT, 344 (18.7%) a second PT, 67 (3.6%) a third PT, and 25 (1.4%) a fourth PT. Univariate analyses (log-rank test) identified the following factors as significantly associated with a fourth PT: simultaneous first and second PTs, betel quid chewing, buccal subsite, and pT3-4 status. After allowance for the potential confounding effect of other risk factors, all of these factors retained their independent prognostic significance in stepwise multivariate analyses, the only exception being betel chewing. The incidences of second, third, and fourth PTs at 5 and 10 years were 20.2%/34.6%, 4.0%/8.6%, and 1.0%/2.3%, respectively. The 5 and 10-year OS rates (calculated from the diagnosis of each PTs) for patients with a single, second, third, and fourth PTs were 68%/61%, 43%/37%, 45%/39%%, and 30%/30%, respectively (P < 0.0001). Among patients with a fourth PT, those who underwent radical surgery showed a significantly higher 3-year OS than those who did not (57% vs 13%; P = 0.0442).Fourth PTs are rarely observed in OSCC patients in a betel quid-chewing endemic area. Long-term survival rates of patients treated with radical surgery seems acceptable, being 4-fold higher than their counterparts.

The effect of a physiotherapy education compared with a non-healthcare education on the attitudes and beliefs of students towards functioning in individuals with back pain: an observational, cross-sectional study.

PubMed

Ryan, Cormac; Murphy, Dervla; Clark, Michael; Lee, Andrew

2010-06-01

To investigate the difference in attitudes: (1) between first and fourth year physiotherapy students towards functioning in individuals with back pain; and (2) between physiotherapy students and non-healthcare students towards functioning in individuals with back pain. Observational, cross-sectional study. Glasgow Caledonian University, Scotland, UK. First year physiotherapy (n=61) and non-healthcare students (n=61), and fourth year physiotherapy (n=62) and non-healthcare students (n=62). All participants completed the Health Care Providers' Pain and Impairment Relationship Scale (range 15 to 105). This questionnaire measures attitudes towards functioning in individuals with back pain. Fourth year physiotherapy students had more positive attitudes towards functioning in individuals with back pain than first year physiotherapy students [57.4 vs 66.6 (mean difference -9.2, 95% confidence interval -12.2 to -6.1, P<0.01)]. Similarly, fourth year non-healthcare students had more positive attitudes towards functioning in individuals with back pain compared with first year non-healthcare students [69.2 vs 65.3 (mean difference -3.9, 95% confidence interval -7.2 to -0.5, P=0.03)]. Physiotherapy students had more positive attitudes than non-healthcare students in the first year [66.6 vs 69.2 (mean difference -2.6, 95% confidence interval -5.5 to 0.4, P=0.08)] and the fourth year [57.4 vs 65.3 (mean difference -7.9, 95% confidence interval -11.4 to -4.4, P<0.01)] of study. These findings suggest that physiotherapy education brings about positive student attitudes towards functioning in individuals with back pain. This may be partly attributable to receiving a university degree education, but would appear to be further enhanced by specifically receiving a physiotherapy degree. This may facilitate students to become more evidence-based practitioners following qualification. Copyright 2009 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Homologous prominence non-radial eruptions: A case study

NASA Astrophysics Data System (ADS)

Duchlev, P.; Koleva, K.; Madjarska, M. S.; Dechev, M.

2016-10-01

The present study provides important details on homologous eruptions of a solar prominence that occurred in active region NOAA 10904 on 2006 August 22. We report on the pre-eruptive phase of the homologous feature as well as the kinematics and the morphology of a forth from a series of prominence eruptions that is critical in defining the nature of the previous consecutive eruptions. The evolution of the overlying coronal field during homologous eruptions is discussed and a new observational criterion for homologous eruptions is provided. We find a distinctive sequence of three activation periods each of them containing pre-eruptive precursors such as a brightening and enlarging of the prominence body followed by small surge-like ejections from its southern end observed in the radio 17 GHz. We analyse a fourth eruption that clearly indicates a full reformation of the prominence after the third eruption. The fourth eruption although occurring 11 h later has an identical morphology, the same angle of propagation with respect to the radial direction, as well as similar kinematic evolution as the previous three eruptions. We find an important feature of the homologous eruptive prominence sequence that is the maximum height increase of each consecutive eruption. The present analysis establishes that all four eruptions observed in Hα are of confined type with the third eruption undergoing a thermal disappearance during its eruptive phase. We suggest that the observation of the same direction of the magnetic flux rope (MFR) ejections can be consider as an additional observational criterion for MFR homology. This observational indication for homologous eruptions is important, especially in the case of events of typical or poorly distinguishable morphology of eruptive solar phenomena.

Nutrient restriction induces failure of reproductive function and molecular changes in hypothalamus-pituitary-gonadal axis in postpubertal gilts.

PubMed

Zhou, Dongsheng; Zhuo, Yong; Che, Lianqiang; Lin, Yan; Fang, Zhengfeng; Wu, De

2014-07-01

People on a diet to lose weight may be at risk of reproductive failure. To investigate the effects of nutrient restriction on reproductive function and the underlying mechanism, changes of reproductive traits, hormone secretions and gene expressions in hypothalamus-pituitary-gonadal axis were examined in postpubertal gilts at anestrus induced by nutrient restriction. Gilts having experienced two estrus cycles were fed a normal (CON, 2.86 kg/d) or nutrient restricted (NR, 1 kg/d) food regimens to expect anestrus. NR gilts experienced another three estrus cycles, but did not express estrus symptoms at the anticipated fourth estrus. Blood samples were collected at 5 days' interval for consecutive three times for measurement of hormone concentrations at the 23th day of the fourth estrus cycle. Individual progesterone concentrations of NR gilts from three consecutive blood samples were below 1.0 ng/mL versus 2.0 ng/mL in CON gilts, which was considered anestrus. NR gilts had impaired development of reproductive tract characterized by absence of large follicles (diameter ≥ 6 mm), decreased number of corepus lutea and atrophy of uterus and ovary tissues. Circulating concentrations of IGF-I, kisspeptin, estradiol, progesterone and leptin were significantly lower in NR gilts than that in CON gilts. Nutrient restriction down-regulated gene expressions of kiss-1, G-protein coupled protein 54, gonadotropin-releasing hormone, estrogen receptor α, progesterone receptor, leptin receptor, follicle-stimulating hormone and luteinizing hormone and insulin-like growth factor I in hypothalamus-pituitary-gonadal axis of gilts. Collectively, nutrient restriction resulted in impairment of reproductive function and changes of hormone secretions and gene expressions in hypothalamus-pituitary-gonadal axis, which shed light on the underlying mechanism by which nutrient restriction influenced reproductive function.

Essential hypertension vs. secondary hypertension among children.

PubMed

Gupta-Malhotra, Monesha; Banker, Ashish; Shete, Sanjay; Hashmi, Syed Sharukh; Tyson, John E; Barratt, Michelle S; Hecht, Jacqueline T; Milewicz, Diane M; Boerwinkle, Eric

2015-01-01

The aim was to determine the proportions and correlates of essential hypertension among children in a tertiary pediatric hypertension clinic. We evaluated 423 consecutive children and collected demographic and clinical history by retrospective chart review. We identified 275 (65%) hypertensive children (blood pressure >95th percentile per the "Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents") from 423 children referred to the clinic for history of elevated blood pressure. The remainder of the patients had normotension (11%), white coat hypertension (11%), prehypertension (10%), and pending diagnosis (3%). Among the 275 hypertensive children, 43% (n = 119; boys = 56%; median age = 12 years; range = 3-17 years) had essential hypertension and 57% (n = 156; boys = 66%; median age = 9 years; range = 0.08-19 years) had secondary hypertension. When compared with those with secondary hypertension, those with essential hypertension had a significantly older age at diagnosis (P = 0.0002), stronger family history of hypertension (94% vs. 68%; P < 0.0001), and lower prevalence of preterm birth (20% vs. 46%; P < 0.001). There was a bimodal distribution of age of diagnosis in those with secondary hypertension. The phenotype of essential hypertension can present as early as 3 years of age and is the predominant form of hypertension in children after age of 6 years. Among children with hypertension, those with essential hypertension present at an older age, have a stronger family history of hypertension, and have lower prevalence of preterm birth. © American Journal of Hypertension, Ltd 2014. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Matching fundus photographs of classmates. An informal competition to promote learning and practice of direct ophthalmoscopy among medical students.

PubMed

Krohn, Jørgen; Kjersem, Bård; Høvding, Gunnar

2014-05-01

To present a new approach for teaching direct ophthalmoscopy to medical students. At the University of Bergen, four consecutive classes of fourth-year medical students complete a required 9-week ophthalmology course every year. In the present project, one fundus photograph was taken of each student. The photographs were randomly numbered, printed on A4 glossy photo paper, and displayed on the classroom wall. Each student was given a form to fill in the fellow students' names matching the number of the fundus photographs. They were encouraged to practise direct ophthalmoscopy on their classmates outside formal teaching hours. At the end of the course, they returned the filled-in forms, and those with the highest number of correct matches between the fundus photographs and fellow students received a reward. Between 2011 and 2013, 239 students completed their ophthalmology course. Of these, 220 students (92%) voluntarily participated in the project. The mean score was 70% correct matches between fundus photographs and fellow students (range 7 - 100%). The students' course evaluations were overall positive. We recommend the use of peer fundus photographs in the context of a learning competition as a simple, inexpensive, and effective way to improve teaching of direct ophthalmoscopy.

Four impacted fourth molars in a young patient: a case report

PubMed Central

CLEMENTINI, M.; OTTRIA, L.; PANDOLFI, C.; AGRESTINI, C.; BARLATTANI, A.

2013-01-01

Summary The occurrence of supernumerary teeth is a relatively uncommon dental anomaly and it’s rare for patients to have impacted fourth molars in all quadrant. Aim of this work is to describe the presence of bilateral fourth molars in the maxilla and the mandible in a young male patient aged 22 years came to our hospital with acute pericoronal infection around unerupted third inferior molars. Routine radiographic examination revealed impacted inferior third molars but also unerupted bilateral upper and inferior fourth molars. The acute infection was treated by local measures and the patient was subsequently admitted for removal of third and fourth impacted upper and lower molars under general anesthesia. PMID:23741604

Important Skills for Internship and the Fourth-Year Medical School Courses to Acquire Them: A National Survey of Internal Medicine Residents.

PubMed

Pereira, Anne G; Harrell, Heather E; Weissman, Arlene; Smith, Cynthia D; Dupras, Denise; Kane, Gregory C

2016-06-01

To obtain feedback from internal medicine residents, a key stakeholder group, regarding both the skills needed for internship and the fourth-year medical school courses that prepared them for residency. This feedback could inform fourth-year curriculum redesign efforts. All internal medicine residents taking the 2013-2014 Internal Medicine In-Training Examination were asked to rank the importance of learning 10 predefined skills prior to internship and to use a dropdown menu of 11 common fourth-year courses to rank the 3 most helpful in preparing for internship. The predefined skills were chosen based on a review of the literature, a national subinternship curriculum, and expert consensus. Chi-square statistics were used to test for differences in responses between training levels. Of the 24,820 internal medicine residents who completed the exam, 20,484 (83%) completed the survey, had complete identification numbers, and consented to have their responses used for research. The three skills most frequently rated as very important were identifying when to seek additional help and expertise, prioritizing clinical tasks and managing time efficiently, and communicating with other providers around care transitions. The subinternship/acting internship was most often selected as being the most helpful course in preparing for internship. These findings indicate which skills and fourth-year medical school courses internal medicine residents found most helpful in preparing for internship and confirm the findings of prior studies highlighting the perceived value of subinternships. Internal medicine residents and medical educators agree on the skills students should learn prior to internship.

Instructor's Manual for Electrical Apprentice Technical Training. Series No. D (Fourth Year). Revised to Meet 1978 Electrical Code.

ERIC Educational Resources Information Center

North Carolina State Dept. of Community Colleges, Raleigh.

Twenty-seven lesson plans for a fourth-year electrical apprentice technical training program are presented in this instructor's manual. Also included are student worksheets and information sheets for each lesson, and copies of unit tests. (Answers to the worksheets and tests are provided.) The lesson plans are generally organized into four steps:…

Related Instructional Material for Electrical Apprentice Technical Training. Student Worksheets. Series D (Fourth Year). Revised to Meet 1978 Electrical Code.

ERIC Educational Resources Information Center

North Carolina State Dept. of Community Colleges, Raleigh.

Information sheets and student worksheets for twenty-seven lesson plans designed for a fourth-year electrical apprentice technical training program are presented in this workbook. The information sheets provide summary information about the lesson topics and the worksheets contain problems to be solved and questions to be answered relating to each…

Do Fraternities and Sororities Still Enhance Socially Responsible Leadership? Evidence from the Fourth Year of College

ERIC Educational Resources Information Center

Hevel, Michael S.; Martin, Georgianna L.; Pascarella, Ernest T.

2014-01-01

We use a longitudinal national dataset to explore the effects of fraternity and sorority membership on students' socially responsible leadership in the fourth year of college. Controlling for a variety of potentially confounding variables, we find no net effect. These findings run counter to an earlier study based on the same students that found…

Science Topics for Third and Fourth Year Non-S.C.E. Courses.

ERIC Educational Resources Information Center

Scottish Education Dept., Edinburgh.

This publication contains details of 18 science topics based upon the general science objectives stated by the Working Party on Secondary School Science for pupils in the third and fourth years of Scottish secondary schools who do not intend to take courses leading to the Scottish Certificate of Education examinations (see SE 015 432). The topics…

Medical students' knowledge of ionizing radiation and radiation protection.

PubMed

Hagi, Sarah K; Khafaji, Mawya A

2011-05-01

To assess the knowledge of fourth-year medical students in ionizing radiation, and to study the effect of a 3-hour lecture in correcting their misconceptions. A cohort study was conducted on fourth-year medical students at King Abdul-Aziz University, Jeddah, Kingdom of Saudi Arabia during the academic year 2009-2010. A 7-question multiple choice test-type questionnaire administered before, and after a 3-hour didactic lecture was used to assess their knowledge. The data was collected from December 2009 to February 2010. The lecture was given to 333 (72%) participants, out of the total of 459 fourth-year medical students. It covered topics in ionizing radiation and radiation protection. The questionnaire was validated and analyzed by 6 content experts. Of the 333 who attended the lecture, only 253 (76%) students completed the pre- and post questionnaire, and were included in this study. The average student score improved from 47-78% representing a gain of 31% in knowledge (p=0.01). The results indicated that the fourth-year medical students' knowledge regarding ionizing radiation and radiation protection is inadequate. Additional lectures in radiation protection significantly improved their knowledge of the topic, and correct their current misunderstanding. This study has shown that even with one dedicated lecture, students can learn, and absorb general principles regarding ionizing radiation.

Genetic parameters for stayability to consecutive calvings in Zebu cattle.

PubMed

Silva, D O; Santana, M L; Ayres, D R; Menezes, G R O; Silva, L O C; Nobre, P R C; Pereira, R J

2017-12-22

Longer-lived cows tend to be more profitable and the stayability trait is a selection criterion correlated to longevity. An alternative to the traditional approach to evaluate stayability is its definition based on consecutive calvings, whose main advantage is the more accurate evaluation of young bulls. However, no study using this alternative approach has been conducted for Zebu breeds. Therefore, the objective of this study was to compare linear random regression models to fit stayability to consecutive calvings of Guzerá, Nelore and Tabapuã cows and to estimate genetic parameters for this trait in the respective breeds. Data up to the eighth calving were used. The models included the fixed effects of age at first calving and year-season of birth of the cow and the random effects of contemporary group, additive genetic, permanent environmental and residual. Random regressions were modeled by orthogonal Legendre polynomials of order 1 to 4 (2 to 5 coefficients) for contemporary group, additive genetic and permanent environmental effects. Using Deviance Information Criterion as the selection criterion, the model with 4 regression coefficients for each effect was the most adequate for the Nelore and Tabapuã breeds and the model with 5 coefficients is recommended for the Guzerá breed. For Guzerá, heritabilities ranged from 0.05 to 0.08, showing a quadratic trend with a peak between the fourth and sixth calving. For the Nelore and Tabapuã breeds, the estimates ranged from 0.03 to 0.07 and from 0.03 to 0.08, respectively, and increased with increasing calving number. The additive genetic correlations exhibited a similar trend among breeds and were higher for stayability between closer calvings. Even between more distant calvings (second v. eighth), stayability showed a moderate to high genetic correlation, which was 0.77, 0.57 and 0.79 for the Guzerá, Nelore and Tabapuã breeds, respectively. For Guzerá, when the models with 4 or 5 regression coefficients were compared, the rank correlations between predicted breeding values for the intercept were always higher than 0.99, indicating the possibility of practical application of the least parameterized model. In conclusion, the model with 4 random regression coefficients is recommended for the genetic evaluation of stayability to consecutive calvings in Zebu cattle.

Neurosurgical treatment of pediatric low-grade midbrain tumors: a single consecutive institutional series of 15 patients.

PubMed

Lundar, Tryggve; Due-Tønnessen, Bernt Johan; Egge, Arild; Scheie, David; Brandal, Petter; Stensvold, Einar; Due-Tønnessen, Paulina

2014-12-01

The authors delineate the long-term results of surgical treatment for pediatric low-grade midbrain glioma. A series of 15 consecutive patients (age range 0-15 years) who underwent primary tumor resection for a low-grade midbrain glioma during the years 1989-2010 were included in this retrospective study on surgical morbidity, mortality rate, academic achievement, and/or work participation. Gross motor function and activities of daily living were scored according to the Barthel Index. Of the 15 patients, 10 were in their 1st decade (age 0-9 years) and 5 were in their 2nd decade of life (age 10-15 years) at the time of surgery. The male/female ratio was 0.50 (5:10). No patients were lost to follow-up. One patient died in the postoperative period (32 days posttreatment). Another 2 patients died during follow-up. One patient succumbed to acute bleeding in the resection cavity 8 months after surgery, and the other died of shunt failure 21 years after initial treatment. Twelve patients are alive at the time of this writing, with follow-up periods from 3 to 24 years (median 8 years). Among the 12 survivors, the Barthel Index scores were normal (100) in 11 patients and 80 in 1 patient. A total of 25 tumor resections were performed. In 1 patient, further resection was performed 5 days after initial resection due to MRI-confirmed residual tumor. Another 5 patients underwent repeat tumor resection after MRI-confirmed progressive tumor disease and clinical deterioration ranging from 3 months to 4 years after the initial operation. Three of these 5 patients also underwent a third resection, and 1 of the 3 underwent a fourth operation. Six children received adjuvant therapy: local radiotherapy in 2 patients, chemotherapy in 3 patients, and both in 1 patient. Twelve (80%) of the 15 patients needed treatment for persistent hydrocephalus. Selected cases of low-grade midbrain gliomas may clearly benefit from resection with favorable results, even for prolonged periods. Three patients in the present series died, one of whom had a prolonged survival period of 21 years. Among the 12 survivors, stable long-term results appeared obtainable in at least 9. One patient died of acute hemorrhage 8 months after initial resection; otherwise, rapid tumor progression and death were not observed. Forty percent of the patients received adjuvant treatment, with local radiotherapy, chemotherapy, or both.

Magnitude and frequency of low flows in the Suwannee River Water Management District, Florida

USGS Publications Warehouse

Giese, G.L.; Franklin, M.A.

1996-01-01

Low-flow frequency statistics for 20 gaging stations having at least 10 years of continuous record and 31 other stations having less than 10 years of continu ous record or a series of at least two low- flow measurements are presented for unregulated streams in the Suwannee River Water Management District in north-central Florida. Statistics for the 20 continuous-record stations included are the annual and monthly minimum consecutive-day average low- flow magnitudes for 1, 3, 7, 14, and 30 consecutive days for recurrence intervals of 2, 5, 10, 20, and, for some long-term stations, 50 years, based on records available through the 1994 climatic year.Only theannual statistics are given for the 31 other stations; these are for the 7- and 30-consecutive day periods only and for recurrence intervals of 2 and 10 years only. Annual low-flow frequency statistics range from zero for many small streams to 5,500 cubic feet per second for the annual 30- consecutive-day average flow with a recurrenceinterval of 2 years for the Suwannee River near Wilcox (station 02323500). Monthly low-flow frequency statistics range from zero for many small streams to 13,800 cubic feet per second for the minimum 30-consecutive-day average flow with a 2-year recurrence interval for the month of March for the same station. Generally, low-flow characteristics of streams in the Suwannee River Water Management District are controlled by climatic, topographic, and geologic fac tors. The carbonate Floridan aquifer system underlies, or is at the surface of, the entire District. The terrane's karstic nature results in manysinkholes and springs. In some places, springs may contribute greatly to low streamflow and the contributing areas of such springs may include areasoutside the presumed surface drainage area of the springs. In other places, water may enter sinkholes within a drainage basin, then reappear in springs downstream from a gage. Many of the smaller streams in the District go dry or have no flow forseveral months in many years. In addition to the low-flow statistics, four synoptic low-flow measurement surveys were conducted on 161 sites during 1990, 1995, and 1996. Themeasurements were made to provide "snapshots" of flow conditions of streams throughout the Suwannee River Water Management District. Magnitudes of low flows during the 1990 series of measurements were in the range associated withminimum 7-consecutive-day 50-year recurrence interval to the minimum 7-consecutive-day 20-year recurrence interval, except in Taylor and Dixie Counties, where the magnitudes ranged from the minimum 7-consecutive-day 5-year flow level to the7-consecutive-day 2-year flow level. The magnitudes were all greater than the minimum 7- consecutive-day 2-year flow level during 1995 and 1996. Observations of no flow were recorded at many of the sites for all four series of measurements.

A Quest for Awareness: Gender-Differentiated English Language Arts Resources and Instructional Techniques to Acknowledge the Needs and Passions of Fourth and Fifth Grade Boys

ERIC Educational Resources Information Center

Feltman, Todd Jason

2013-01-01

A major educational crisis has been transpiring among fourth and fifth grade boys over the last twenty years (Eliot, 2009; Whitmire, 2010). On average, fourth and fifth grade boys, regardless of racial background or socioeconomic class, are performing below girls, both academically in reading and writing. The Center on Educational Policy reports…

Crisis-like behavior in China's stock market and its interpretation.

PubMed

Fan, Fangli; Gao, Jianbo; Liang, Shuhong

2015-01-01

In order for China to play a bigger, more positive role in the world, it is important for China to have a healthy capital market. This perception motivates us to examine the health of China's capital market, especially the severity of the overall loss of the listed companies in China and the effects of accounting irregularities on the losses. We show the overall loss of the listed companies was very severe, in particular, crisis-like behavior emerged in the fourth quarter of 2002, 2004, 2005, and 2008. We further observe that loss in the fourth quarter was much greater than the average loss of the first three quarters in the same year. The most straightforward interpretation of this loss pattern is that companies underreported losses in the first three quarters, to boost their stock values in most time of the year. However, in the fourth quarter, accounting balance of the whole year dictated that the reported loss in the fourth quarter had to be much greater than the actual loss. Fortunately, such irregularity has been greatly reduced, thanks to the accounting reforms in China in 2007.

Crisis-Like Behavior in China's Stock Market and Its Interpretation

PubMed Central

Fan, Fangli; Gao, Jianbo; Liang, Shuhong

2015-01-01

In order for China to play a bigger, more positive role in the world, it is important for China to have a healthy capital market. This perception motivates us to examine the health of China's capital market, especially the severity of the overall loss of the listed companies in China and the effects of accounting irregularities on the losses. We show the overall loss of the listed companies was very severe, in particular, crisis-like behavior emerged in the fourth quarter of 2002, 2004, 2005, and 2008. We further observe that loss in the fourth quarter was much greater than the average loss of the first three quarters in the same year. The most straightforward interpretation of this loss pattern is that companies underreported losses in the first three quarters, to boost their stock values in most time of the year. However, in the fourth quarter, accounting balance of the whole year dictated that the reported loss in the fourth quarter had to be much greater than the actual loss. Fortunately, such irregularity has been greatly reduced, thanks to the accounting reforms in China in 2007. PMID:25658454

34 CFR 682.216 - Teacher loan forgiveness program.

Code of Federal Regulations, 2011 CFR

2011-07-01

... serves low-income families as a full-time teacher for five consecutive complete academic years. The... elementary or secondary school may be counted toward the required five consecutive complete academic years only if at least one year of teaching was after the 1997-1998 academic year. (iii) Teaching at an...

34 CFR 685.217 - Teacher loan forgiveness program.

Code of Federal Regulations, 2011 CFR

2011-07-01

... serves low-income families as a full-time teacher for five consecutive complete academic years. The... elementary or secondary school may be counted toward the required five consecutive complete academic years only if at least one year of teaching was after the 1997-1998 academic year. (iii) Teaching at an...

Intraprofessional, team-based treatment planning for oral health students in the comprehensive care clinic.

PubMed

Mattheos, Nikos; Storrs, Mark; Foster, Lea; Oberholzer, Theunis

2012-12-01

In 2009, Griffith University School of Dentistry and Oral Health, in Queensland, Australia, introduced into its various curricula the concept of team-based treatment planning (TBTP), aiming to facilitate intraprofessional, interdisciplinary training and peer learning among its students. Fifty student teams were organized, each of which included students from three programs (Dental Science, Oral Health Therapy, and Dental Technology) and three years of study (third-, fourth-, and fifth-year students). This study prospectively evaluated the impact of TBTP on students' perceptions and attitudes towards teamwork and their role in a team of peers. A total of 202 students who participated in fifty TBTP teams were prospectively surveyed at baseline and at six and twelve months after introduction of TBTP. "Reliable" and "responsible" were reported to be the most important qualities of both an effective team leader and member. Fifth-year students identified "hard-working" as an important quality of the ideal leader as opposed to the fourth-year students who ranked "supportive" higher. Attitudes of the fifth-year students towards TBTP appeared to have declined significantly from the previous years, while fourth-year students remained consistently more positive. In addition, fourth-year students appeared more likely to enjoy working in a team and considered themselves more effective in a team. No gender differences were observed, other than female students' appearing less confident to lead a team. It was concluded that the function of student-directed interdisciplinary, intraprofessional treatment planning teams might pose disproportionate strain on fifth-year students, impacting their attitudes to such modes of work.

Skin cancer knowledge and sun protection behavior among nursing students.

PubMed

Yilmaz, Medine; Yavuz, Betul; Subasi, Media; Kartal, Asiye; Celebioglu, Aysun; Kacar, Halime; Adana, Filiz; Ozyurek, Pakize; Altiparmak, Saliha

2015-01-01

The objective of this study was to determine skin cancer knowledge and sun protection behavior among nursing students. A total of 1178 nursing students in the Aegean Region of Turkey took part in this descriptive study. A score for knowledge on protection against skin cancer and a score for protective behavior against skin cancer were calculated. In this study, first year students sunbathed more in the middle of the day than fourth year students, and their knowledge of skin cancer was lower. No statistical difference was determined for protective behavior between the two groups. The knowledge levels and protective behavior of first year students were alarmingly low, but the average scores for knowledge and behavior of the fourth year university students were higher. The knowledge levels of the fourth year students were average but their protective behavior was insufficient. It was found that the knowledge levels and the levels of protective behavior of light-skinned students were higher. This study revealed that the knowledge levels and protective behavior of first year nursing students against the harmful effects of the sun and for protection against skin cancer were alarmingly low. It also showed that the knowledge levels of the fourth year nursing students were average, but that their protective behavior was very insufficient. These findings suggest that it is of extreme importance to acquire knowledge and behavior for protection against skin cancers in the education of nursing students. © 2014 The Authors. Japan Journal of Nursing Science © 2014 Japan Academy of Nursing Science.

EXPLORATORY STUDY AND PLANNING FOR A FOURTH-YEAR, PAID INTERNSHIP TEACHER EDUCATION PROGRAM FOR BOTH ELEMENTARY AND SECONDARY TEACHERS. FINAL REPORT.

ERIC Educational Resources Information Center

RYERSON, NORMAN E.

THROUGH THE DEVELOPMENT OF A COOPERATIVE COLLEGE-UNIVERSITY GRADUATE STUDY PROGRAM, THE AUGMENTATION OF A PAID FOURTH-YEAR INTERNSHIP APPROACH IN A TEACHER TRAINING PROGRAM WAS EXPLORED. STEPS INCLUDED--(1) INVOLVEMENT OF THE FACULTY IN AN EVALUATION OF THE TEACHER EDUCATION PROGRAM AND THE COLLEGE CURRICULUM, (2) CHANGING WEEKLY SCHEDULES AND THE…

Variable Memory Strategy Use in Children's Adaptive Intratask Learning Behavior: Developmental Changes and Working Memory Influences in Free Recall

ERIC Educational Resources Information Center

Lehmann, Martin; Hasselhorn, Marcus

2007-01-01

Variability in strategy use within single trials in free recall was analyzed longitudinally from second to fourth grades (ages 8-10 years). To control for practice effects another sample of fourth graders was included (age 10 years). Video analyses revealed that children employed different strategies when preparing for free recall. A gradual shift…

Test Review: Wechsler, D. (2005). "Wechsler Intelligence Scale for Children-Fourth Edition Spanish." San Antonio, TX: Harcourt Assessment

ERIC Educational Resources Information Center

Braden, Jeffery P.; Iribarren, Jacqueline A.

2007-01-01

In this article, the authors review the Wechsler Intelligence Scale for Children-Fourth Edition Spanish (WISC-IV Spanish), a Spanish translation and adaptation of the WISC-IV. The test was developed to measure the intellectual ability of Spanish-speaking children in the United States ages 6 years, 0 months, through 16 years, 11 months. These…

Identification of key performance indicators for on-farm animal welfare incidents: possible tools for early warning and prevention

PubMed Central

2011-01-01

Background The objective of this study was to describe aspects of case study herds investigated by the Department of Agriculture, Fisheries and Food (DAFF) in which animal welfare incidents occurred and to identify key performance indicators (KPIs) that can be monitored to enhance the Early Warning System (EWS). Despite an EWS being in place for a number of years, animal welfare incidents continue to occur. Questionnaires regarding welfare incidents were sent to Superintending Veterinary Inspectors (SVIs), resulting in 18 herds being chosen as case study herds, 12 of which had a clearly defined welfare incident date. For each study herd, data on six potential KPIs were extracted from DAFF databases. The KPIs for those herds with a clearly defined welfare incident date were studied for a consecutive four year window, with the fourth year being the 'incident year', when the welfare incident was disclosed. For study herds without a clearly defined welfare incident date, the KPIs were determined on a yearly basis between 2001 and 2009. Results We found that the late registration of calves, the use of on-farm burial as a method of carcase disposal, an increasing number of moves to knackeries over time and records of animals moved to 'herd unknown' were notable on the case farms. Conclusion Four KPIs were prominent on the case study farms and warrant further investigation in control herds to determine their potential to provide a framework for refining current systems of early warning and prevention. PMID:21982340

Findings from the Fourth-Grade Round of the Early Childhood Longitudinal Study, Kindergarten Class of 2010-11 (ECLS-K:2011). First Look. NCES 2018-094

ERIC Educational Resources Information Center

Mulligan, Gail M.; McCaroll, Jill Carlivati; Flanagan, Kristin Denton; Potter, Daniel

2018-01-01

This report is intended to provide a snapshot of the children in the ECLS-K:2011 cohort who were in kindergarten for the first time in the 2010-11 school year and in fourth grade 4 years later during the spring of 2015. About 88 percent of children enrolled in kindergarten in 2010-11 were in kindergarten for the first time that school year and…

Surveying Fourth-Year Medical Students Regarding the Choice of Diagnostic Radiology as a Specialty.

PubMed

Arleo, Elizabeth Kagan; Bluth, Edward; Francavilla, Michael; Straus, Christopher M; Reddy, Sravanthi; Recht, Michael

2016-02-01

The aim of this study was to survey fourth-year medical students, both those choosing and those not choosing diagnostic radiology as their specialty, regarding factors influencing their choice of specialty and their perceptions of radiology. A voluntary anonymous online survey hyperlink was sent to 141 US medical schools for distribution to fourth-year students. Topics included demographics, radiology education, specialty choice and influencing factors, and opinions of radiology. A representative sampling (7%) of 2015 fourth-year medical students (n = 1,219; 51% men, 49% women) participated: 7% were applying in radiology and 93% were not. For respondents applying in radiology, the most important factor was intellectual challenge. For respondents applying in nonradiology specialties, degree of patient contact was the most important factor in the decision not to choose radiology; job market was not listed as a top-three factor. Women were less likely than men to apply in radiology (P < .001), with radiology selected by 11.8% of men (56 of 476) and only 2.8% of women (13 of 459). Respondents self-identifying as Asian had a significantly higher (P = .015) likelihood of selecting radiology (19 of 156 [12.2%]) than all other races combined (44 of 723 [6.1%]). Respondents at medical schools with required dedicated medical imaging rotations were more likely to choose radiology as a specialty, but most schools still do not require the clerkship (82%). The reasons fourth-year medical students choose, or do not choose, diagnostic radiology as a specialty are multifactorial, but noncontrollable factors, such as the job market, proved less compelling than controllable factors, such as taking a radiology rotation. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Reading Achievement of U.S. Fourth-Grade Students in an International Context: First Look at the Progress in International Reading Literacy Study (PIRLS) 2016 and ePIRLS 2016. NCES 2018-017

ERIC Educational Resources Information Center

Warner-Griffin, Catharine; Liu, Huili; Tadler, Chrystine; Herget, Debbie; Dalton, Ben

2017-01-01

The Progress in International Reading Literacy Study (PIRLS) is an international assessment of student performance in reading literacy at the fourth grade. PIRLS measures students in the fourth year of formal schooling because this is typically when students' learning transitions from a focus on "learning to read" to a focus on…

Medical student abuse: perceptions and experience.

PubMed

Bourgeois, J A; Kay, J; Rudisill, J R; Bienenfeld, D; Gillig, P; Klykylo, W M; Markert, R J

1993-07-01

A questionnaire containing 18 vignettes of common clinical educational situations with potentially abusive treatment of medical students and a 10-item attitude assessment about abusive behaviour were administered to the first- and fourth-year medical students at a mid-west US university medical school. The first- and fourth-year groups did not differ significantly on perceived abusiveness of most of the vignettes, although several of the individual vignettes were perceived significantly differently by the two groups. As hypothesized, the fourth-year students had experienced such situations more frequently. Attitudes towards abusive behaviour did not differ between the two groups. The authors contrast teaching interactions perceived as educationally useful and not abusive with those seen as abusive and not useful and offer explanations for the differences observed. Finally, the possible implications of the results for medical education are discussed.

University science students' knowledge of fats.

PubMed

Mazier, M J Patricia; McLeod, Sheena L

2007-01-01

Students entering university often lack knowledge about fats; whether students gain such information during four years at university is unclear. Students' knowledge of fat in the first and fourth years was measured and compared. The effect of a nutrition course on knowledge was also examined. A total of 215 science students at a small undergraduate university completed a 15-item, closed-ended questionnaire concerning knowledge of fats in the diet. Fourth-year science students have greater nutrition knowledge of fats than do first-year science students (p<0.005). Given that the majority of first-year students reside on campus and the majority of fourth-year students reside off campus, the purchasing of food and preparation of meals may explain the senior students' greater knowledge of fat. Students who have taken a nutrition course know more about fats than do those who have not (p<0.001). Taking even one course in nutrition greatly increases nutrition knowledge. Universities could encourage undergraduate students to take a basic nutrition course, which should emphasize the identification and understanding of different types of dietary fats.

Test Review: D. D. Hammill & S. C. Larsen "Test of Written Language-Fourth Edition." (TOWL-4). Austin, TX--PRO-ED, 2009

ERIC Educational Resources Information Center

McCrimmon, Adam W.; Climie, Emma A.

2011-01-01

This article presents a review of the "Test of Written Language-Fourth Edition" (TOWL-4), a newly updated individual or group-based measure of written language for students aged 9 years, 0 months through 17 years, 11 months. The stated purposes of the measure are to identify students in need of support or intervention in the area of…

For Profit Organizations Showing Signs of Turnaround: Twenty-Fourth Annual Status Report on for Profit Child Care

ERIC Educational Resources Information Center

Neugebauer, Roger; Hartzell, Debra

2011-01-01

The year 2010 will not be remembered as a banner year for large for profit child care organizations. But it appears that heading into 2011, optimism has returned. This article presents the twenty-fourth annual status report on for profit child care organizations. In 2010, the total capacity of the three largest for profit chains in North America,…

Does medical students’ clinical performance affect their actual performance during medical internship?

PubMed Central

Han, Eui-Ryoung; Chung, Eun-Kyung

2016-01-01

INTRODUCTION This study examines the relationship between the clinical performance of medical students and their performance as doctors during their internships. METHODS This retrospective study involved 63 applicants of a residency programme conducted at Chonnam National University Hospital, South Korea, in November 2012. We compared the performance of the applicants during their internship with their clinical performance during their fourth year of medical school. The performance of the applicants as interns was periodically evaluated by the faculty of each department, while their clinical performance as fourth-year medical students was assessed using the Clinical Performance Examination (CPX) and the Objective Structured Clinical Examination (OSCE). RESULTS The performance of the applicants as interns was positively correlated with their clinical performance as fourth-year medical students, as measured by the CPX and OSCE. The performance of the applicants as interns was moderately correlated with the patient-physician interaction items addressing communication and interpersonal skills in the CPX. CONCLUSION The clinical performance of medical students during their fourth year in medical school was related to their performance as medical interns. Medical students should be trained to develop good clinical skills through actual encounters with patients or simulated encounters using manikins, to enable them to become more competent doctors. PMID:26768172

Does medical students' clinical performance affect their actual performance during medical internship?

PubMed

Han, Eui-Ryoung; Chung, Eun-Kyung

2016-02-01

This study examines the relationship between the clinical performance of medical students and their performance as doctors during their internships. This retrospective study involved 63 applicants to a residency programme conducted at the Chonnam National University Hospital, South Korea, in November 2012. We compared the performance of the applicants during their internship with the clinical performance of the applicants during their fourth year of medical school. The performance of the applicants as interns was periodically evaluated by the faculty of each department, while the clinical performance of the applicants as fourth year medical students was assessed using the Clinical Performance Examination (CPX) and the Objective Structured Clinical Examination (OSCE). The performance of the applicants as interns was positively correlated with their clinical performance as fourth year medical students, as measured by CPX and OSCE. The performance of the applicants as interns was moderately correlated with the patient-physician interactions items addressing communication and interpersonal skills in the CPX. The clinical performance of medical students during their fourth year in medical school was related to their performance as medical interns. Medical students should be trained to develop good clinical skills, through actual encounters with patients or simulated encounters using manikins, so that they are able to become competent doctors. Copyright © Singapore Medical Association.

Automatic detection of magnetic flux emergings in the solar atmosphere from full-disk magnetogram sequences.

PubMed

Fu, Gang; Shih, Frank Y; Wang, Haimin

2008-11-01

In this paper, we present a novel method to detect Emerging Flux Regions (EFRs) in the solar atmosphere from consecutive full-disk Michelson Doppler Imager (MDI) magnetogram sequences. To our knowledge, this is the first developed technique for automatically detecting EFRs. The method includes several steps. First, the projection distortion on the MDI magnetograms is corrected. Second, the bipolar regions are extracted by applying multiscale circular harmonic filters. Third, the extracted bipolar regions are traced in consecutive MDI frames by Kalman filter as candidate EFRs. Fourth, the properties, such as positive and negative magnetic fluxes and distance between two polarities, are measured in each frame. Finally, a feature vector is constructed for each bipolar region using the measured properties, and the Support Vector Machine (SVM) classifier is applied to distinguish EFRs from other regions. Experimental results show that the detection rate of EFRs is 96.4% and of non-EFRs is 98.0%, and the false alarm rate is 25.7%, based on all the available MDI magnetograms in 2001 and 2002.

Nursing students' spiritual well-being, spirituality and spiritual care.

PubMed

Abbasi, Mojgan; Farahani-Nia, Marhamat; Mehrdad, Neda; Givari, Azam; Haghani, Hamid

2014-05-01

Spiritual care should be considered an important part of holistic and multidisciplinary care and it has not been given much importance so far. We should begin with student nurses, who will soon be clinicians, to find out about potentiality of the nursing profession to put spiritual care into practice. Little has been known about spiritual well-being, spirituality, and spiritual care perspectives among nursing students. In this study, a comparison has been made in spiritual well-being, spirituality, and spiritual care perspectives between the first and fourth year baccalaureate nursing students. This is a descriptive-comparative study that was carried out among 283 nursing students. All the students were Iranians studying in the universities of Iran, Tehran, and Shahid Beheshti medical sciences. They volunteered to participate in the study. There were 105 first year students and 178 fourth year students. The questionnaires used were on Spiritual Well-being (SWB) Scale, Spiritual Perspective Scale (SPS), and Nursing Spiritual Care Perspective Scale (NSCPS). The statistical analysis was performed using the SPSS software, version 10. The data were analyzed using descriptive statistics (distribution frequency, mean, and standard deviation). Mann-Whitney test was to compare each item and independent t-test to compare the mean values of two groups. Regarding spiritual well-being, there were no significant differences between the two groups. 98.8% of the first year students and 100% of the fourth year students were in the category of moderate spiritual well-being. Neither were there any significant differences between the two groups in spiritual perspective and spiritual care perspectives. The scores of fourth year nursing students were similar to those of first year students in spiritual well-being, spirituality, and spiritual care perspectives, though the fourth year students had already undergone 4-year nursing course. Including spiritual care in the curriculum of nursing students' courses will add to their understanding and provision of spiritual care. This will fill the present gap evident in the system in Iran. At present, the educational system here does not make use of spiritual care as part of its comprehensive curriculum.

Nursing students’ spiritual well-being, spirituality and spiritual care

PubMed Central

Abbasi, Mojgan; Farahani-Nia, Marhamat; Mehrdad, Neda; givari, Azam; Haghani, Hamid

2014-01-01

Background: Spiritual care should be considered an important part of holistic and multidisciplinary care and it has not been given much importance so far. We should begin with student nurses, who will soon be clinicians, to find out about potentiality of the nursing profession to put spiritual care into practice. Little has been known about spiritual well-being, spirituality, and spiritual care perspectives among nursing students. In this study, a comparison has been made in spiritual well-being, spirituality, and spiritual care perspectives between the first and fourth year baccalaureate nursing students. Materials and Methods: This is a descriptive–comparative study that was carried out among 283 nursing students. All the students were Iranians studying in the universities of Iran, Tehran, and Shahid Beheshti medical sciences. They volunteered to participate in the study. There were 105 first year students and 178 fourth year students. The questionnaires used were on Spiritual Well-being (SWB) Scale, Spiritual Perspective Scale (SPS), and Nursing Spiritual Care Perspective Scale (NSCPS). The statistical analysis was performed using the SPSS software, version 10. The data were analyzed using descriptive statistics (distribution frequency, mean, and standard deviation). Mann–Whitney test was to compare each item and independent t-test to compare the mean values of two groups. Results: Regarding spiritual well-being, there were no significant differences between the two groups. 98.8% of the first year students and 100% of the fourth year students were in the category of moderate spiritual well-being. Neither were there any significant differences between the two groups in spiritual perspective and spiritual care perspectives. Conclusions: The scores of fourth year nursing students were similar to those of first year students in spiritual well-being, spirituality, and spiritual care perspectives, though the fourth year students had already undergone 4-year nursing course. Including spiritual care in the curriculum of nursing students’ courses will add to their understanding and provision of spiritual care. This will fill the present gap evident in the system in Iran. At present, the educational system here does not make use of spiritual care as part of its comprehensive curriculum. PMID:24949061

The Effect of Rest Interval Length on Repetition Consistency and Perceived Exertion During Near Maximal Loaded Bench Press Sets.

PubMed

Scudese, Estevão; Willardson, Jeffrey M; Simão, Roberto; Senna, Gilmar; de Salles, Belmiro F; Miranda, Humberto

2015-11-01

The purpose of this study was to compare different rest intervals between sets on repetition consistency and ratings of perceived exertion (RPE) during consecutive bench press sets with an absolute 3RM (3 repetition maximum) load. Sixteen trained men (23.75 ± 4.21 years; 74.63 ± 5.36 kg; 175 ± 4.64 cm; bench press relative strength: 1.44 ± 0.19 kg/kg of body mass) attended 4 randomly ordered sessions during which 5 consecutive sets of the bench press were performed with an absolute 3RM load and 1, 2, 3, or 5 minutes of rest interval between sets. The results indicated that significantly greater bench press repetitions were completed with 2, 3, and 5 minutes vs. 1-minute rest between sets (p ≤ 0.05); no significant differences were noted between the 2, 3, and 5 minutes rest conditions. For the 1-minute rest condition, performance reductions (relative to the first set) were observed commencing with the second set; whereas for the other conditions (2, 3, and 5 minutes rest), performance reductions were not evident until the third and fourth sets. The RPE values before each of the successive sets were significantly greater, commencing with the second set for the 1-minute vs. the 3 and 5 minutes rest conditions. Significant increases were also evident in RPE immediately after each set between the 1 and 5 minutes rest conditions from the second through fifth sets. These findings indicate that when utilizing an absolute 3RM load for the bench press, practitioners may prescribe a time-efficient minimum of 2 minutes rest between sets without significant impairments in repetition performance. However, lower perceived exertion levels may necessitate prescription of a minimum of 3 minutes rest between sets.

Impact of a required fourth-year medical student rotation in physical medicine and rehabilitation.

PubMed

Faulk, Clinton E; Mali, Jimmy; Mendoza, Paola Maria; Musick, David; Sembrano, Roderick

2012-05-01

This study evaluated the impact of a 2-wk required rotation in Physical Medicine and Rehabilitation (PM&R) on fourth-year medical students' knowledge of PM&R and attitude toward teamwork in patient care. Survey results on attitudes toward a team approach to patient care and knowledge in PM&R were compared prerotation and postrotation. One hundred thirty-eight fourth-year medical students participated in this 2-yr study. The combined response rates for the attitude and knowledge surveys were 62% and 56%, respectively. As measured by a pretest and posttest self-reported knowledge assessment, the rotation increased knowledge of PM&R (P ≤ 0.05). Four aspects of the rotation that were rated higher by students from the second year of the rotation were role and responsibility definition, incorporation of current literature, enhancement of clinical skills, and general rotation satisfaction. The rotation provides an experience for medical students to increase their knowledge of PM&R.

Exxon Valdez Oil Spill Restoration Project final report: Monitoring for evaluation of recovery and restoration of injured nearshore resources

USGS Publications Warehouse

Ballachey, Brenda E.; Bodkin, James L.; Kloecker, Kimberly A.; Dean, Tom; Colettie, Heather A

2015-01-01

In 2012, we completed three consecutive years of full field sampling in WPWS for EVOS Restoration Project 10100750. Nearshore monitoring was conducted in collaboration with the NPS SWAN I&M program and, beginning in 2012, as part of the EVOSTC GWA program. Data collection was done in accordance with standard operating procedures set forth to monitor marine water chemistry and quality, marine intertidal invertebrates, kelps and seagrasses, marine birds, black oystercatchers, and sea otters. Summer sampling in 2012 represented the fourth year of sampling in WPWS (an initial year of sampling was done in WPWS in 2007; EVOS Restoration Project 070750). Based on our monitoring of nearshore species in WPWS, and comparisons of data from WPWS and other areas within the Gulf of Alaska, we have no evidence of continued injury to biological resources at the spatial scales we are monitoring. A key finding is that recovery of the sea otter population is no longer constrained by exposure to lingering oil; this is consistent with related EVOSTC studies on harlequin ducks (Restoration Project 12120114-Q). We anticipate continued annual nearshore monitoring in WPWS and at KATM and KEFJ under GWA, with data summaries and analyses including all three areas to provide a larger spatial and temporal context to the understanding of processes and patterns in nearshore ecosystems of the GOA which were impacted by the EVOS of 1989.

Accelerated partial breast intensity-modulated radiotherapy in women who have prior breast augmentation.

PubMed

Leonard, Charles E; Johnson, Tim; Tallhamer, Michael; Howell, Kathryn; Kercher, Jane; Kaske, Terese; Barke, Lora; Sedlacek, Scot; Hobart, Tracy; Carter, Dennis L

2011-06-01

To examine the outcome of breast cancer patients who have prior breast augmentation treated with lumpectomy followed by accelerated partial breast external intensity-modulated radiotherapy (APBIMRT) with image-guided radiotherapy (IGRT). Four patients with previous elective subpectoral breast augmentation were enrolled on this APBIMRT trial. These four patients were treated with 10 equal twice daily 3.85 Gy fractions over 5 consecutive days (total dose of 38.5 Gy) using APBIMRT and IGRT. Patients were assessed for pain and cosmetic outcome (physician and a patient self-assessment). At last follow-up, two patients reported an excellent cosmetic results (at 2 years and at 8 months, respectively), one reported good cosmetic results (at 2 years), and one reported poor cosmetic results (at 20 months). Physicians rated the cosmetic outcomes as excellent in two (CEL; at 2 years and 8 months, respectively), good in one (CEL; at 20 months) and excellent in one (KTH; at 2 years). Three patients reported no breast/chest wall pain (two at 2 years and one at 1 year) and the fourth reported mild pain (at 20 months). The mean percent volume of ipsilateral breast receiving 100%, 75%, 50%, and 25% of the prescribed dose was 7.28%, 17.55%, 24.33%, and 33.1%, respectively. The mean breast, planning target volume (PTV), and implant volumes were 399.88 cc, 43.55 cc, and 313.36 cc, respectively. The mean breast prosthesis/total volume (breast tissue plus prosthesis) ratio was 44.55%. The mean PTV/ipsilateral breast and PTV/total volume ratios were 11.1% and 6.1%, respectively. The results show that a regimen of APBIMRT with IGRT is possible in patients who have prior breast augmentation. Copyright © 2011 Elsevier Inc. All rights reserved.

Efficacy of triplet regimen antiemetic therapy for chemotherapy-induced nausea and vomiting (CINV) in bone and soft tissue sarcoma patients receiving highly emetogenic chemotherapy, and an efficacy comparison of single-shot palonosetron and consecutive-day granisetron for CINV in a randomized, single-blinded crossover study

PubMed Central

Kimura, Hiroaki; Yamamoto, Norio; Shirai, Toshiharu; Nishida, Hideji; Hayashi, Katsuhiro; Tanzawa, Yoshikazu; Takeuchi, Akihiko; Igarashi, Kentaro; Inatani, Hiroyuki; Shimozaki, Shingo; Kato, Takashi; Aoki, Yu; Higuchi, Takashi; Tsuchiya, Hiroyuki

2015-01-01

The first aim of this study was to evaluate combination antiemetic therapy consisting of 5-HT3 receptor antagonists, neurokinin-1 receptor antagonists (NK-1RAs), and dexamethasone for multiple high emetogenic risk (HER) anticancer agents in bone and soft tissue sarcoma. The second aim was to compare the effectiveness of single-shot palonosetron and consecutive-day granisetron in a randomized, single-blinded crossover study. A single randomization method was used to assign eligible patients to the palonosetron or granisetron arm. Patients in the palonosetron arm received a palonosetron regimen during the first and third chemotherapy courses and a granisetron regimen during the second and fourth courses. All patients received NK-1RA and dexamethasone. Patients receiving the palonosetron regimen were administered 0.75 mg palonosetron on day 1, and patients receiving the granisetron regimen were administered 3 mg granisetron twice daily on days 1 through 5. All 24 patients in this study received at least 4 chemotherapy courses. A total of 96 courses of antiemetic therapy were evaluated. Overall, the complete response CR rate (no emetic episodes and no rescue medication use) was 34%, while the total control rate (a CR plus no nausea) was 7%. No significant differences were observed between single-shot palonosetron and consecutive-day granisetron. Antiemetic therapy with a 3-drug combination was not sufficient to control chemotherapy-induced nausea and vomiting (CINV) during chemotherapy with multiple HER agents for bone and soft tissue sarcoma. This study also demonstrated that consecutive-day granisetron was not inferior to single-shot palonosetron for treating CINV. PMID:25533447

An exploration of fourth-year undergraduate nurses' knowledge of and attitude towards pressure ulcer prevention.

PubMed

Cullen Gill, E; Moore, Z

2013-11-01

To determine undergraduate nurses' knowledge of and attitudes towards pressure ulcer prevention. A quantitative, cross-sectional survey design was used for this study. Ethical approval was received. A convenience sample of fourth-year undergraduate nurses was selected to participate (n=60). Data were collected using a pre-designed questionnaire. Overall, the participants showed a positive attitude towards pressure ulcer prevention but displayed poor knowledge of pressure ulcer prevention. Interestingly, having a high level of competency corresponded with having a positive attitude towards pressure ulcer prevention, but did not equate to possessing knowledge of pressure ulcer prevention. The findings of this study suggest that fourth-year undergraduates have a positive attitude but lack adequate knowledge on the prevention of pressure ulcers. There were no external sources of funding for this study. The authors have no conflicts of interest to declare.

Neurosurgical treatment of oligodendroglial tumors in children and adolescents: a single-institution series of 35 consecutive patients.

PubMed

Lundar, Tryggve; Due-Tønnessen, Bernt Johan; Egge, Arild; Scheie, David; Stensvold, Einar; Brandal, Petter

2013-09-01

The object of this study was to delineate long-term results of the surgical treatment of pediatric CNS tumors classified as oligodendroglioma (OD) or oligoastrocytoma (OA) WHO Grade II or III. A cohort of 45 consecutive patients 19 years or younger who had undergone primary resection of CNS tumors originally described as oligodendroglial during the years 1970-2009 at a single institution were reviewed in this retrospective study of surgical morbidity, mortality, and academic achievement and/or work participation. Gross motor function and activities of daily living were scored using the Barthel Index (BI). Patient records for 35 consecutive children and adolescents who had undergone resection for an OA (17 patients) or OD (18 patients) were included in this study. Of the 35 patients, 12 were in the 1st decade of life at the first surgery, whereas 23 were in the 2nd decade. The male/female ratio was 1.19 (19/16). No patient was lost to follow-up. The tumor was localized to the supratentorial compartment in 33 patients, the posterior fossa in 1 patient, and the cervical medulla in 1 patient. Twenty-four tumors were considered to be WHO Grade II, and 11 were classified as WHO Grade III. Among these latter lesions were 2 tumors initially classified as WHO Grade II and later reclassified as WHO Grade III following repeat surgery. Fifty-four tumor resections were performed. Two patients underwent repeat tumor resection within 5 days of the initial procedure, after MRI confirmed residual tumor. Another 10 patients underwent a second resection because of clinical deterioration and progressive disease at time points ranging from 1 month to 10 years after the initial operation. Six patients underwent a third resection, and 1 patient underwent a fourth excision following tumor dissemination to the spinal canal. Sixteen (46%) of the 35 children received adjuvant therapy: 7, fractionated radiotherapy; 4, chemotherapy; and 5, both fractionated radiotherapy and chemotherapy. One patient with primary supratentorial disease experienced clinically malignant development with widespread intraspinal dissemination 9 years after initial treatment. Only 2 patients needed treatment for persistent hydrocephalus. In this series there was no surgical mortality, which was defined as death within 30 days of resection. However, 12 patients in the study, with follow-up times from 1 month to 33 years, died. Twenty-three patients, with follow-up times from 4 to 31 years, remained alive. Among these survivors, the BI was 100 (normal) in 22 patients and 80 in 1 patient. Nineteen patients had full- or part-time work or were in normal school programs. Pediatric oligodendroglial tumors are mainly localized to the supratentorial compartment and more often occur in the 2nd decade of life rather than the 1st. Two-thirds of the patients remained alive after follow-ups from 4 to 31 years. Twelve children succumbed to their disease, 9 of them within 3 years of resection despite combined treatment with radio- and chemotherapy. Three of them remained alive from 9 to 33 years after primary resection. Among the 23 survivors, a stable, very long-term result was attainable in at least 20. Five-, 10-, 20-, and 30-year overall survival in patients with Grade II tumors was 92%, 92%, 92%, and 88%, respectively.

In Vivo Detection of Choroidal Abnormalities Related to NF1: Feasibility and Comparison With Standard NIH Diagnostic Criteria in Pediatric Patients.

PubMed

Parrozzani, Raffaele; Clementi, Maurizio; Frizziero, Luisa; Miglionico, Giacomo; Perrini, Pierdavide; Cavarzeran, Fabiano; Kotsafti, Olympia; Comacchio, Francesco; Trevisson, Eva; Convento, Enrica; Fusetti, Stefano; Midena, Edoardo

2015-09-01

To evaluate the feasibility of near-infrared (NIR) imaging acquisition in a large sample of consecutive pediatric patients with neurofibromatosis type 1 (NF1), to evaluate the diagnostic performance of NF1-related choroidal abnormalities as a diagnostic criterion of the disease, and to compare this criterion with other standard National Institutes of Health (NIH) diagnostic criteria. A total of 140 consecutive pediatric patients (0-16 years old) affected by NF1 (at least two diagnostic criteria), 59 suspected (a single diagnostic criterion), and 42 healthy subjects (no diagnostic criterion) were consecutively included. Each patient underwent genetic, dermatologic, and ophthalmologic examination to evaluate the presence/absence of each NIH diagnostic criterion. The presence of NF1-related choroidal abnormalities was investigated using NIR confocal ophthalmoscopy. Two masked operators assessed Lisch nodules and NF1-related choroidal abnormalities. Neurofibromatosis type 1-related choroidal abnormalities were detected in 72 affected (60.5%) and 1 suspected (2.4%) child. No healthy subject had choroidal abnormalities. Feasibility rate of this sign was 82%. Sensitivity, specificity, and positive and negative predictive values of NF1-related choroidal abnormalities were 0.60, 0.97, 0.98, and 0.46, respectively. Compared with standard NIH criteria, the presence of NF1-related choroidal abnormalities was the third parameter for positive predictive value and the fourth for sensitivity, specificity, and negative predictive value. Compared with Lisch nodules, NF1-related choroidal abnormalities were characterized by higher specificity and positive predictive value. The interoperator agreement for Lisch nodules and NF1-related choroidal abnormalities was 0.67 (substantial) and 0.97 (almost perfect), respectively. The use of this sign moved one patient from the suspected to the affected group (0.5%). Neurofibromatosis type 1-related choroidal abnormalities represent a new diagnostic sign in NF1 children. The main advantage of this sign seems the theoretical possibility to anticipate NF1 diagnosis, whereas the main obstacle is the cooperation required by very young patients.

Impact of nutrition education on university students' fat consumption.

PubMed

Emrich, Teri E; Mazier, M J Patricia

2009-01-01

University science students who have taken a nutrition course possess greater knowledge of fats than do those who have not; whether students apply this knowledge to their diet is unknown. We measured and compared science students' total and saturated fat intake in the first and fourth years, and evaluated whether taking a nutrition course influenced fat consumption. A sample of 269 first- and fourth-year science students at a small undergraduate university completed a survey with both demographic questions and a semi-quantitative food frequency questionnaire about fats in the diet. Data were analyzed using chi-square tests and independent-sample t-tests. Fourth-year science students consumed fewer grams of total and saturated fat than did first-year science students (p<0.001). Science students who had taken a nutrition course consumed fewer grams of total and saturated fat than did those who had not (p<0.001). Taking a nutrition course may decrease first-year students' fat consumption, which may improve diet quality and decrease the risk of chronic disease related to fat consumption.

Development and evaluation of the evidence-based medicine program in surgery: a spiral approach

PubMed Central

Elçin, Melih; Turan, Sevgi; Odabaşı, Orhan; Sayek, İskender

2014-01-01

Background Evidence-based medicine (EBM) aims to provide skills that help physicians answer clinically important questions, determine new evidence, and incorporate the acquired knowledge in practice. EBM skills are necessary for the practice of modern medicine, since physicians should use up-to-date knowledge and information to justify their medical decisions. Purpose We aimed to evaluate the EBM program implemented at Hacettepe University School of Medicine. Methods In 2004, a spiral program for the teaching and practice of EBM was developed for the first 3 years of medical school. Following this program, a practice of EBM was included in the fourth year during the surgery clerkship, after an introductory lecture. The students worked within collaborative teams of 3–5 and practiced EBM with actual cases seen in the surgical service in which they were involved. Each student was asked to complete a questionnaire that evaluated the more theoretical program from the first 3 years and the practical application in the fourth year. Results Nearly half of the students stated that the preclinical years of the EBM program were ‘adequate’, but only 30% of the students indicated that the program was practical. They stated that ‘more practical approaches were used in the fourth year, whereas more theory-based approaches were used during the preclinical years’. More than 75% of the students declared that the practice of EBM in the fourth year was useful and appropriate for team-based learning. Conclusions The EBM program was evaluated as ‘adequate’. EBM courses should be included in the entire curriculum in an integrated manner. The students understand the main philosophy of EBM in the clinical year when involved in its practical application with actual patients. PMID:24767706

A Comparison of Fourth-Year Health Sciences Students' Knowledge of Gross Lower and Upper Limb Anatomy: A Cross-Sectional Study.

PubMed

Díaz-Mancha, Juan-Antonio; Castillo-López, José Manuel; Munuera-Martinez, Pedro V; Fernández-Seguín, Lourdes María; Polo-Padillo, Juan; Heredia-Rizo, Alberto Marcos

2016-01-01

The aim of the study was to assess and compare the knowledge of fourth-year medicine, physiotherapy (PT), nursing, and podiatry students in carpal and tarsal bone anatomy. A cross-sectional study was carried out. Based on a nonprobability convenience sampling, 177 fourth-year students (117 women and 60 men, mean age of 23.16 ± 3.82 years) from the podiatry (n = 39), nursing (n = 26), PT (n = 73), and medicine (n = 39) schools at a large Spanish university were included. Measurements were taken of their gross anatomy knowledge by means of the carpal and the tarsal bone tests. Students were asked to identify all carpal and tarsal bones in an illustration of the bony skeleton of both regions and were given a maximum of 5 minutes per test. Of a total of 15 bones to be labeled, the PT (11.07 ± 3.30) and podiatry (9.36 ± 2.93) students had the highest rate of correct answers compared with the medicine (6.13 ± 3.27) and nursing (4.04 ± 3.72) undergraduates. When assessing academic degrees and test scores, significant differences were observed between PT and podiatry participants vs those from the medicine and nursing schools (P < .001). Fourth-year students from the PT and podiatry programs correctly identified a higher number of carpal and tarsal bones than students from the nursing and medicine schools. Copyright © 2016. Published by Elsevier Inc.

Kidney retransplantation from HLA-incompatible living donors: A single-center study of 3rd/4th transplants.

PubMed

Barnes, James C H; Goodyear, Stephen J; Imray, Caitlin E A; Lam, For Tai; Kashi, Habib S; Tan, Lam Chin; Higgins, Robert; Imray, Christopher H E

2017-11-01

The demand for kidney retransplantation following graft failure is rising. Repeat transplantation is often associated with poorer outcomes due to both immunological and surgical challenges. The aim of this study was to compare surgical and functional outcomes of kidney retransplantation in recipients that had previously had at least two kidney transplants with a focus on those with antibody incompatibility. We analyzed 66 patients who underwent renal transplantation at a single center between 2003 and 2011. Consecutive patients receiving their 3rd or 4th kidney were case-matched with an equal number of 1st and 2nd transplants. Twenty-two 3rd and 4th kidney transplants were matched with 22 first and 22 seconds transplants. Operative times and length of stay were equivalent between the subgroups. Surgical complication rates were similar in all groups (22.7% in 1st and 2nd transplants, and 27.2% in 3rd/4th transplants). There was no significant difference in patient or graft survival over 5 years. Graft function was similar between transplant groups at 1, 3, and 5 years. Third and fourth kidney transplants can be performed safely with similar outcomes to 1st and 2nd transplants. Kidney retransplantation from antibody-incompatible donors may be appropriate for highly sensitized patients. © 2017 The Authors Clinical Transplantation Published by John Wiley & Sons Ltd.

Evaluation of medical students using the "qi, blood, and fluid" system of Kampo medicine.

PubMed

Arai, Makoto; Arai, Katsuhiko; Hioki, Chizuko; Takashi, Masanori; Matsumoto, Kaori; Honda, Masamitsu; Izumi, Shun-ichiro

2013-04-20

Although "qi, blood, and fluid" (QBF) is the most important concept for patients in Kampo medicine, there are few studies about the conditions of the QBF system among healthy populations. We used QBF pattern scores to determine whether or not medical students, presumed to be healthy, had any potentially pathological conditions. Six consecutive fourth-year classes totaling 652 medical students evaluated their own QBF conditions using Terasawa's QBF pattern scores. The six conditions: "qi deficiency" (QD), "qi stagnation" (QS), "qi counterflow" (QC), "blood deficiency" (BD), "blood stasis" (BS), and "fluid disturbance" (FD), were categorized according to Terasawa's criteria. The Mann-Whitney U test was used to compare the score differences between the genders, Chi-square test was used to examine gender differences in the QBF diagnoses, and the Spearman's rank-order correlation coefficient analysis was used to analyze the correlation between each category of QBF. In all, 44.6% of the students met at least one diagnostic criterion in the QBF system. QC, BD, BS, and FD were established more in females, and QD and QS were established without gender differences. Most students who were presumed to be healthy were revealed to have some potentially pathological conditions using the QBF system.

Family Outing Activities and Achievement among Fourth Graders in Compensatory Education Funded Schools.

ERIC Educational Resources Information Center

Griswold, Philip A.

This study sought to identify the relationship between operationally-defined family outing activities and measures of achievement among fourth grade students from educationally disadvantaged backgrounds. The results, collected for four successive years from 1715 students in urban Los Angeles, indicated that: (1) participation in family activities…

A Scaling Research on Faculty Characteristics That Higher Education Students Prioritize

ERIC Educational Resources Information Center

Güvendir, Meltem Acar

2014-01-01

In view of the importance of taking student preferences into account while establishing educational practices, this study explores which faculty member characteristic fourth year students mostly prefer in a higher education institution. A faculty member characteristics form that includes ten characteristics was administered to 419 fourth year…

Pithovirus sibericum, a new bona fide member of the "Fourth TRUC" club.

PubMed

Sharma, Vikas; Colson, Philippe; Chabrol, Olivier; Pontarotti, Pierre; Raoult, Didier

2015-01-01

Nucleocytoplasmic large DNA viruses, or representatives of the proposed order Megavirales, include giant viruses of Acanthamoeba that were discovered over the last 12 years and are bona fide microbes. Phylogenies based on a few genes conserved amongst these megaviruses and shared by microbes classified as Eukarya, Bacteria, and Archaea, allowed for delineation of a fourth monophylogenetic group or "TRUC" (Things Resisting Uncompleted Classification) composed of the Megavirales representatives. A new Megavirales member named Pithovirus sibericum was isolated from a >30,000-year-old dated Siberian permafrost sample. This virion is as large as recently described pandoraviruses but has a genome that is approximately three to four times shorter. Our objective was to update the classification of P. sibericum as a new member of the "Fourth TRUC" club. Phylogenetic trees were constructed based on four conserved ancient genes and a phyletic analysis was concurrently conducted based on the presence/absence patterns of a set of informational genes from members of Megavirales, Bacteria, Archaea, and Eukarya. Phylogenetic analyses based on the four conserved genes revealed that P. sibericum is part of the fourth TRUC composed of Megavirales members, and is closely related to the families Marseilleviridae and Ascoviridae/Iridoviridae. Additionally, hierarchical clustering delineated four branches, and showed that P. sibericum is part of this fourth TRUC. Overall, phylogenetic and phyletic analyses using informational genes clearly indicate that P. sibericum is a new bona fide member of the "Fourth TRUC" club composed of representatives of Megavirales, alongside Bacteria, Archaea, and Eukarya.

Fourth-year medical student opinions and basic knowledge regarding the field of radiology.

PubMed

Prezzia, Charles; Vorona, Gregory; Greenspan, Robin

2013-03-01

This study evaluates the opinions and knowledge of fourth-year US medical students regarding radiology and analyzes the influence of a required or nonrequired radiology rotation as a reflection of the effectiveness of radiology medical student education. Our institutional review board granted exempt status. An invitation e-mail was sent to 137 US medical schools. Upon receiving approval a second email was sent containing our voluntary anonymous online survey hyperlink to forward to their fourth-year class. Survey topics included demographics, radiology educational experiences, attitudes toward the field, and basic radiology knowledge. Responses were collected between August 4 and September 26, 2011. A total of 444 fourth-year medical students from 37 medical schools participated: 89% planned to enter a nonradiology specialty, 10.8% were required to take a dedicated radiology rotation, 34.9% completed one, 77% planned to complete one by graduation, 88.4% thought radiology often changes patient care or is at least as important as physical exam, 91.4% underestimated the cancer risk of an abdomen and pelvis computed tomography by at least one order of magnitude, and 72.9% by at least two orders. Seventy-seven percent had never heard of the American College of Radiology (ACR) Appropriateness Criteria. Respondents underestimated the potential risks of magnetic resonance imaging (MRI); with 58.3% aware intravenous gadolinium can cause nephrogenic systemic fibrosis and 79.4% aware of potential injury from metallic projectiles. 40.4% indicated that non-radiologist clinicians in specific medical specialties interpret their respective imaging studies at least as accurately as corresponding subspecialty radiologists. Other results include student opinions regarding teleradiology, radiologist lifestyle, and compensation. Fourth-year medical students recognize the importance of radiology but are poorly informed regarding radiation safety, MRI safety, and ACR Appropriateness Criteria, despite 34.9% having a dedicated rotation. This highlights the need for adoption of the Alliance of Medical Student Educators in Radiology curriculum. Copyright © 2013 AUR. Published by Elsevier Inc. All rights reserved.

Stability of (13) C-Urea Breath Test Samples Over Time in the Diagnosis of Helicobacter pylori.

PubMed

Perets, Tsachi Tsadok; Shporn, Einav; Boltin, Doron; Dickman, Ram; Niv, Yaron

2016-05-01

The accuracy and repeatability of breath test in the diagnosis of Helicobacter pylori infection have not been adequately investigated. Although it has been shown that storage for long periods does not affect the analysis results, no data are available on the effect of repetitive testing. In this study, our aim was to evaluate the repeatability of the analyses of breath samples at room temperature. A total of 202 positive breath samples were collected in duplicates, before and after administration of 75 mg (13) C- urea dissolved in 100 ml of orange juice. Breath test results were expressed as delta (13) CO2 . The cut-off value was 3.5 parts per thousand. Each sample was analyzed in a mass spectrometer 7, 14, 21, and 28 days after collection. The accuracy calculation was based on the comparison of the delta (13) CO2 obtained in the three consecutive weeks following the first test run to the delta (13) CO2 obtained in the first test run. Two hundred (99%), 197 (97.52%), and 196 (97%) of the 202 samples tested positive in the second, third, and fourth test runs, respectively. The accuracy of the delta (13) CO2 was 98.6%, 99.2%, and 96.7% in the three consecutive runs, respectively. Short-term storage of 1 month does not affect sample stability or the results of (13) C-urea breath tests in up to three consecutive repeats. © 2015 Wiley Periodicals, Inc.

Fourth-grade children's dietary recall accuracy is influenced by retention interval (target period and interview time).

PubMed

Baxter, Suzanne Domel; Hardin, James W; Guinn, Caroline H; Royer, Julie A; Mackelprang, Alyssa J; Smith, Albert F

2009-05-01

For a 24-hour dietary recall, two possible target periods are the prior 24 hours (24 hours immediately preceding the interview time) and previous day (midnight to midnight of the day before the interview), and three possible interview times are morning, afternoon, and evening. Target period and interview time determine the retention interval (elapsed time between to-be-reported meals and the interview), which, along with intervening meals, can influence reporting accuracy. The effects of target period and interview time on children's accuracy for reporting school meals during 24-hour dietary recalls were investigated. DESIGN AND SUBJECTS/SETTING: During the 2004-2005, 2005-2006, and 2006-2007 school years in Columbia, SC, each of 374 randomly selected fourth-grade children (96% African American) was observed eating two consecutive school meals (breakfast and lunch) and interviewed to obtain a 24-hour dietary recall using one of six conditions defined by crossing two target periods with three interview times. Each condition had 62 or 64 children (half boys). Accuracy for reporting school meals was quantified by calculating rates for omissions (food items observed eaten but unreported) and intrusions (food items reported eaten but unobserved); a measure of total inaccuracy combined errors for reporting food items and amounts. For each accuracy measure, analysis of variance was conducted with target period, interview time, their interaction, sex, interviewer, and school year in the model. There was a target-period effect and a target-period by interview-time interaction on omission rates, intrusion rates, and total inaccuracy (six P values <0.004). For prior-24-hour recalls compared to previous-day recalls, and for prior-24-hour recalls in the afternoon and evening compared to previous-day recalls in the afternoon and evening, omission rates were better by one third, intrusion rates were better by one half, and total inaccuracy was better by one third. To enhance children's dietary recall accuracy, target periods and interview times that minimize the retention interval should be chosen.

Advanced Concept

NASA Image and Video Library

2004-04-15

It is predicted that by the year 2040, there will be no distinction between a commercial airliner and a commercial launch vehicle. Fourth Generation Reusable Launch Vehicles (RLVs) will be so safe and reliable that no crew escape system will be necessary. Every year there will be in excess of 10,000 flights and the turn-around time between flights will be just hours. The onboard crew will be able to accomplish a launch without any assistance from the ground. Provided is an artist's concept of these fourth generation space vehicles.

Results for the Fourth Quarter Calendar Year 2015 Tank 50H Salt Solution Sample

DOE Office of Scientific and Technical Information (OSTI.GOV)

Crawford, C.

In this memorandum, the chemical and radionuclide contaminant results from the Fourth Quarter Calendar Year 2015 (CY15) sample of Tank 50H salt solution are presented in tabulated form. The Fourth Quarter CY15 Tank 50H samples were obtained on October 29, 2015 and received at Savannah River National Laboratory (SRNL) on October 30, 2015. The information from this characterization will be used by Defense Waste Processing Facility (DWPF) & Saltstone Facility Engineering for the transfer of aqueous waste from Tank 50H to the Salt Feed Tank in the Saltstone Production Facility, where the waste will be treated and disposed of inmore » the Saltstone Disposal Facility. This memorandum compares results, where applicable, to Saltstone Waste Acceptance Criteria (WAC) limits and targets. Data pertaining to the regulatory limits for Resource Conservation and Recovery Act (RCRA) metals will be documented at a later time per the Task Technical and Quality Assurance Plan (TTQAP) for the Tank 50H saltstone task. The chemical and radionuclide contaminant results from the characterization of the Fourth Quarter Calendar Year 2015 (CY15) sampling of Tank 50H were requested by SRR personnel and details of the testing are presented in the SRNL Task Technical and Quality Assurance Plan.« less

A resident conference for systems-based practice and practice-based learning.

PubMed

Sultana, Carmen J; Baxter, Jason K

2011-02-01

Improving patient safety and quality of care is part of systems-based practice and practice-based learning for residents. We expanded our obstetrics and gynecology department's regularly scheduled morbidity and mortality conferences to teach quality assurance concepts based on patient care on obstetrics and gynecology fourth-year resident rotations. Obstetrics and gynecology fourth-year residents on one of the two rotations each presented and analyzed a systems-based problem they encountered during patient care. They used an online learning module and proposed solutions, many of which were effectively implemented. Over 5 years, case presentations from 33 conferences were available with problems identified in emergency preparedness, coordination of care, scheduling and supervision, communication, medical practice, documentation, and lack of equipment or facilities. Twenty-two of the suggested solutions were partially or totally implemented. Barriers to implementation were identified. In conclusion, a conference presentation by fourth-year residents can identify patient safety problems, aid in their resolution, and suggest changes to patient care while teaching the principles of systems-based practice and practice-based learning.

Student Activism and Democratic Quality in Ghana's Fourth Republic

ERIC Educational Resources Information Center

Van Gyampo, Ransford Edward

2013-01-01

Student activism has been pivotal in Ghana's political and democratic history. Prior to Ghana's Fourth Republic, student activism was highly confrontational and entailed student support or opposition to the various regimes depending on the extent to which the regimes were accepted by all as being rightful or legitimate. After 23 years of…

Day of the Dead

ERIC Educational Resources Information Center

Dann, Tammy; Murphy, Amy

2012-01-01

Foreign Language in Elementary School (FLES) teachers in the West Des Moines schools incorporate the Day of the Dead into the fourth grade curriculum each year. The teachers discuss the Day of the Dead celebration at the Art Center, and many ask for volunteers from fourth grade to participate in the event. Student presentations include a wide…

Educating Children with Multiple Disabilities: A Collaborative Approach. Fourth Edition

ERIC Educational Resources Information Center

Orelove, Fred P., Ed.; Sobsey, Dick, Ed.; Silberman, Rosanne K., Ed.

2004-01-01

Now in its fourth edition, this highly respected, bestselling textbook gives undergraduate and graduate students up-to-the-minute research and strategies for educating children with severe and multiple disabilities. This popular core text--for 15 years, a staple of teacher training programs in special education and related fields--thoroughly…

PIRLS 2011 International Results in Reading

ERIC Educational Resources Information Center

Mullis, Ina V.S.; Martin, Michael O.; Foy, Pierre; Drucker, Kathleen T.

2012-01-01

PIRLS is an international assessment of reading comprehension at the fourth grade that has been conducted every five years since 2001. In 2011, nationally representative samples of students in 49 countries participated in PIRLS and prePIRLS. Forty-five countries assessed fourth grade students, and some countries participated in one or more of the…

Fourth-Grade Students' Motivational Changes in an Elementary Physical Education Running Program

ERIC Educational Resources Information Center

Xiang, Ping; McBride, Ron E.; Bruene, April

2006-01-01

Achievement goal theory and the expectancy-value model of achievement choice were used to examine fourth-grade students' motivational changes in an elementary physical education running program. In fall and spring of the school year, participants (N = 113; 66 boys, 47 girls) completed questionnaires assessing achievement goals, expectancy beliefs,…

Stanford-Binet Fourth Edition: Useful for Young Children with Language Impairment?

ERIC Educational Resources Information Center

Vig, Susan; Jedrysek, Eleanora

1996-01-01

Reviewed clinical records and test data for 103 children ages 4 to 5 years old who had been tested with the Stanford-Binet Intelligence Scale, Fourth Edition. Children were tested for multidisciplinary evaluation of developmental problems. Results suggest need for caution in using area score differences or subtest strengths or weaknesses to…

Readers' Tellings: Narrators, Settings, Flashbacks and Comprehension

ERIC Educational Resources Information Center

Kucer, Stephen B.

2010-01-01

This research explores the impact of flashbacks and changes in settings and narrators on reader comprehension. Individually, 34 fourth graders (9 and 10 years of age), mostly with above average reading abilities (5.0), orally read the first chapter of a novel. Both publisher and readability formulae estimated the text to be at a fourth- grade…

76 FR 10817 - Approval and Promulgation of Implementation Plans; State of Nevada; PM-10; Determinations...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-28

... meter ([micro]g/m\\3\\) with no more than one expected exceedance per year. The annual primary PM-10... contains three consecutive years of complete, quality-assured and certified PM-10 data for the 1999-2001... consecutive years of complete, quality-assured and certified PM-10 data for the 2007-2009 period, the most...

A National Longitudinal Survey of Medical Students' Intentions to Practice Among the Underserved.

PubMed

O'Connell, Thomas F; Ham, Sandra A; Hart, Theodore G; Curlin, Farr A; Yoon, John D

2018-01-01

To explore students' intentions to practice in medically underserved areas. In January 2011, 960 third-year medical students from 24 MD-granting U.S. medical schools were invited to participate in a survey on their intention to practice in a medically underserved area. A follow-up survey was sent to participants in September 2011. Covariates included student demographics, medical school characteristics, environmental exposures, work experiences, sense of calling, and religious characteristics. Adjusted response rates were 564/919 (61.4%, first survey) and 474/564 (84.0%, follow-up survey). Among fourth-year medical students, an estimated 34.3% had an intention to practice among the underserved. In multivariate logistic regression modeling, predictors for intentions to practice among the underserved included growing up in an underserved setting (odds ratio [OR] range: 2.96-4.81), very strong sense of calling (OR range: 1.86-3.89), and high medical school social mission score (in fourth year: OR = 2.34 [95% confidence interval (CI), 1.31-4.21]). International experience was associated with favorable change of mind in the fourth year (OR = 2.86 [95% CI, 1.13-7.24]). High intrinsic religiosity was associated with intentions to practice primary care in underserved settings (in fourth year: OR = 2.29 [95% CI = 1.13-4.64]). Growing up in medically underserved settings, work experience in religiously affiliated organizations, very strong sense of calling, and high medical school social mission score were associated with intentions to practice in underserved areas. Lack of formative educational experiences may dissuade students from considering underserved practice.

First and Fourth-Year Student's Perceptions about Importance of Nursing Care Behaviors: Socialization toward Caring.

PubMed

Zamanzadeh, Vahid; Valizadeh, Leila; Azimzadeh, Roghaieh; Aminaie, Nasim; Yousefzadeh, Sedigeh

2014-06-01

The essence of professional nursing is caring and so, nursing education must make caring as a significant part of their curricula. In this regard, little research exists about how nursing students perceive caring. The aim of this study is to investigate the nursing students' perception toward caring and thus, the impact of socialization process on their perception of caring will be determined. A cross-sectional study was done among all first and fourth-year nursing students (n=230) in Tabriz and Urmia faculties of nursing, 2012. Data were collected using Larson's Caring Questionnaire that assessed the importance of nursing care behaviors (n=50) in six dimensions: "being accessible", "explains and facilitates", "comforts", "anticipates", "trusting relationship" and "monitors and follows through". The importance of caring behaviors was evaluated by the first and fourth-year nursing students in moderate to high level and also, the both groups considered higher ranks for "monitors and follows through" and "being accessible" and lower ranks for "anticipates" and "trusting relationships". The fourth-year students only ranked "explains and facilitates" higher than the first-year students, but the "comforts" dimension is not differed significantly between groups. The findings demonstrated that nursing education in this study has not likely succeeded in producing intended changes in the nursing students' perceptions. It is recommended to exactly find the perceptual changes or in principle the professional socialization process of nursing students, more research using longitudinal designs be conducted to examine the differences in students' perceptions of caring upon entering and completing the nursing program.

Preparing Fourth-Year Medical Students to Teach During Internship

PubMed Central

Haber, Richard J; Bardach, Naomi S; Vedanthan, Rajesh; Gillum, Leslie A; Haber, Lawrence A; Dhaliwal, Gurpreet S

2006-01-01

Interns are expected to teach medical students, yet there is little formal training in medical school to prepare them for this role. To enhance the teaching skills of our graduating students we initiated a 4-hour “teaching to teach” course as part of the end of the fourth-year curriculum. Course evaluations demonstrate that students strongly support this program (overall ratings 2000 to 2005: mean = 4.4 [scale 1 to 5], n = 224). When 2004 course participants were surveyed during the last month of their internship, 84%“agree” or “strongly agree” with the statement: “The teaching to teach course helped prepare me for my role as a teacher during internship” (2005: mean 4.2 [scale 1 to 5], n = 45, response rate 60%). A course preparing fourth-year students to teach during internship is both feasible and reproducible, with a minimal commitment of faculty and resident time. Participants identify it as an important addition to their education and as useful during internship. PMID:16704402

One-on-one tutorials in private practices and clinics: four years of experience in Basel, Switzerland.

PubMed

Tschudi, Peter; Bally, Klaus; Isler, Ruedi

2003-09-01

The one-on-one tutorial is a new form of learning that is practice oriented. It is based on a teacher-student relationship continuing over two years. Since 1997, third- and fourth-year students have worked for one half day per week under the supervision of their tutor, be it in a private practice or in a hospital. This programme facilitates direct patient contact at an early stage of medical school. In addition, it allows students to apply their knowledge in everyday life. The interactive form of learning is of paramount importance in this module. The ARIVA learning model was developed specially for third-year students and the logbook for fourth-year students. After each tutorial third-year students completed the ARI VA worksheet and fourth-year students completed the logbook. They were handed in together with the structured learning report. Between 85 and 109 students per year participated in these tutorials, totalling 733 students. Each student was taught an average of 3.1 patients in the presence of the tutor. In addition students examined an average of 2.4 patients independently and fulfilled an average of 1.2 practical tasks. For the fourth-year students the number of contacts with patients and the spectrum of diseases examined are impressive. All learning goals were fulfilled The one-on-one tutorial is a practice-oriented, interactive learning method. It uses a variety of didactic methods based on the principals of problem-oriented learning. In a relatively early stage of their medical education one-on-one tutorials give students the opportunity to learn independently how to interview and examine patients. They also give students the possibility to acquaint themselves with a multitude of diseases with the aid of instructions and demonstrations. They are conducive to work with patients above all because students learn how to perform certain techniques.

76 FR 15233 - Proposed Modification to Regulation Concerning the Revocation of Antidumping and Countervailing...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-21

... an antidumping or countervailing duty order with respect to individual exporters or producers based on those individual exporters or producers having received antidumping margins of zero for three consecutive years, or countervailing duty rates of zero for five consecutive years. DATES: To be assured of...

Fluctuations in heart rate variability of health care workers during four consecutive extended work shifts and recovery during rest and sleep.

PubMed

Goffeng, Elisabeth M; Nordby, Karl-Christian; Tarvainen, Mika P; Järvelin-Pasanen, Susanna; Wagstaff, Anthony; Goffeng, Lars Ole; Bugge, Merete; Skare, Øivind; Sigstad Lie, Jenny-Anne

2018-04-07

The aim of this study was to investigate fluctuations in heart rate variability (HRV), which reflect autonomic nervous system (ANS) function and potential psychological and physical strain, among 24 health care workers during work and sleep during four consecutive extended work shifts. Data included 24/36/12 h of HRV measurements, two logbooks, and a questionnaire. A cross-shift/cross-week design was applied. HRV was measured during work, leisure time, and sleep. The HRV data included time-domain [mean RR, SD of normal to normal R-R intervals (SDNN), and root mean square of the successive differences (RMSSD)] and frequency-domain [low frequency (LF)/high frequency (HF) ratio] parameters. HRV parameters revealed significant differences among work, leisure time, and sleep. Mean RR, RMSSD, and SDNN values were lower and the LF/HF ratio was higher on the first versus last day of the work period; however, the differences were most prominent in the morning hours. The results indicate higher levels of cardiovascular stress on the first versus fourth day of the working period, and measurements at night indicate a satisfactory recovery from the extended shifts.

Community medicine in action: an integrated, fourth-year urban continuity preceptorship.

PubMed

Brill, John R; Jackson, Thomas C; Stearns, Marjorie A

2002-07-01

To provide an opportunity for fourth-year students at the University of Wisconsin Medical School in Madison to immerse in urban community medicine during a 34-week program. This experience enhances the integrity of the fourth year as well as merges medicine and public health perspectives in medical education as called for by the Medicine and Public Health Initiative. A limited number of fourth-year Wisconsin medical students have the opportunity to select a one-year, continuity-based preceptorship at the Milwaukee clinical campus with a focus in one of three domains: family medicine, internal medicine, or women's health. Students participate in the following clinical activities: a one-year, integrated preceptorship (one to three half days per week in a primary preceptor's office), medicine subinternship, senior surgery clerkship, selectives (16-20 weeks of clerkships relevant to preceptorship focus area), and one month of out-of-city electives. Complementing this community-based clinical experience is the opportunity to develop an increased appreciation for urban community health issues and resources by participating in a required urban community medicine clerkship and a mentored student scholarly project focusing on an aspect of urban community medicine and population health. All students begin the year in July with a four-week urban community medicine clerkship, which is based on the St. Luke's family practice residency's community medicine rotation and arranged by residency faculty. They conduct a "windshield survey" of a Milwaukee neighborhood, observing health hazards and identifying assets, and then present these observations to others in the clerkship. During this first month, students are introduced to the work of a variety of social service agencies, the Milwaukee City Health Department, and the Aurora Health Care/UW community clinics, which serve the state's most diverse zip codes. They meet with providers and researchers who share their expertise in infectious disease, preventive medicine, perinatal epidemiology, domestic violence, sexual assault, and disease management. Students develop increased understanding of barriers to health and personal resilience by listening to focus groups conducted with homeless men and undocumented Latino women. They participate in a resident and faculty development retreat on enhancing community medicine knowledge and skills. By August, students select an advisor and outline a project designed to expand understanding in the areas of urban population health research, community health education, professional education, or health intervention planning and evaluation. Faculty members at the Center for Urban Population Health work closely with the students throughout the year, which includes two weeks in the spring that are dedicated to intensive work on the projects. This fourth-year, urban community-based preceptorship is designed to provide students with an alternative fourth year that integrates skill development in clinical and community medicine, offers a continuity primary care experience, and showcases innovative urban health resources and role models. It is hoped that these students will pursue graduate medical education in Milwaukee, incorporate a population perspective in their practice, and choose to work in neighborhoods that are currently underserved.

The associations between peer caring behaviors and social support to nurse students' caring perceptions.

PubMed

Warshawski, Sigalit; Itzhaki, Michal; Barnoy, Sivia

2018-05-19

Caring is seen as an essential part of nursing and as a desirable competency expected of nursing students. Yet, students have difficulties in understanding the meaning and practice of caring relationships. The aim of this study was to explore the relationship between perceived social support and peer caring behaviors to nurse students' caring perceptions. A cross-sectional study was conducted among first and fourth-year nursing students (n = 246) attending a Baccalaureate nursing education program at a major university in Israel. The findings revealed first-year students significantly received more social support from family and friends than fourth-year students. Moreover, first-year students reported an increase in the use of social support through social media platforms during their first semester of studies. Social support from family, peers and social media platforms was associated to caring perception. Fourth-year students scored higher than first-year students in their caring perceptions and peer caring behaviors. Educators should consider the growing potential role of social media technologies as an accessible source of social support and as a learning tool. Moreover, nurse educators should encourage the use and practice of peer caring behaviors among students as professional means of facilitating future caring relationships with patients and their families. Copyright © 2018 Elsevier Ltd. All rights reserved.

Exploratory and Higher-Order Factor Analyses of the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) Adolescent Subsample

ERIC Educational Resources Information Center

Canivez, Gary L.; Watkins, Marley W.

2010-01-01

The factor structure of the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV; Wechsler, 2008a) with the adolescent participants (ages 16-19 years; N = 400) in the standardization sample was assessed using exploratory factor analysis, multiple factor extraction criteria, and higher-order exploratory factor analyses. Results from…

Class Size Effects on Fourth-Grade Mathematics Achievement: Evidence from TIMSS 2011

ERIC Educational Resources Information Center

Li, Wei; Konstantopoulos, Spyros

2016-01-01

Class size reduction policies have been widely implemented around the world in recent years. However, findings about the effects of class size on student achievement have been mixed. This study examines class size effects on fourth-grade mathematics achievement in 14 European countries using data from TIMSS (Trends in International Mathematics and…

Environmental Quality, the Fourth Annual Report of the Council on Environmental Quality.

ERIC Educational Resources Information Center

Council on Environmental Quality, Washington, DC.

The state of the environment and efforts to improve it are reported upon in this Fourth Annual Report of the Council on Environmental Quality. Broad in scope, the report covers federal and state activities during the past year, the urban environment, economics and environmental management, the law and land use regulation, environmental quality,…

Results from the Fourth Mathematics Assessment of the National Assessment of Educational Progress.

ERIC Educational Resources Information Center

Lindquist, Mary Montgomery, Ed.

The National Assessment of Educational Progress (NAEP) completed its fourth mathematics assessment during the 1985-86 school year and finished the analyses of the results in 1988. This monograph, prepared by an interpretive team of the National Council of Teachers of Mathematics, represents a comprehensive discussion of the results of the fourth…

Teaching Reading Skills to Learning-Disabled Fourth to Sixth Graders through Content Areas.

ERIC Educational Resources Information Center

Leung, Esther K.

The study examined the value of teaching reading skills to learning disabled (LD) fourth to sixth graders through the content areas. Four LD resource teachers implemented the year-long program with 12 experimental and 10 control subjects. Experimental subjects were taught specific reading skills through their Social Studies and/or Science…

Longitudinal Invariance of the Wechsler Intelligence Scale for Children--Fourth Edition in a Referral Sample

ERIC Educational Resources Information Center

Richerson, Lindsay P.; Watkins, Marley W.; Beaujean, A. Alexander

2014-01-01

Measurement invariance of the Wechsler Intelligence Scale for Children--Fourth Edition (WISC-IV) was investigated with a group of 352 students eligible for psychoeducational evaluations tested, on average, 2.8 years apart. Configural, metric, and scalar invariance were found. However, the error variance of the Coding subtest was not constant…

Hawaii State Senior Center. Fourth Annual Report, July 1, 1972 to June 30, 1973.

ERIC Educational Resources Information Center

Hawaii State Senior Center, Honolulu.

The activities of the Hawaii State Senior Center during its fourth year of operation are discussed. The center, which is sponsored by the Honolulu Community College, provides health services, counseling, adult education, community service, and recreation and leisure-time activities. Enrolled membership of the center is 1,776. This annual report…

Cassini Maneuver Experience for the Fourth Year of the Solstice Mission

NASA Technical Reports Server (NTRS)

Vaquero, Mar; Hahn, Yungsun; Stumpf, Paul; Valerino, Powtawche; Wagner, Sean; Wong, Mau

2014-01-01

After sixteen years of successful mission operations and invaluable scientific discoveries, the Cassini orbiter continues to tour Saturn on the most complex gravity-assist trajectory ever flown. To ensure that the end-of-mission target of September 2017 is achieved, propellant preservation is highly prioritized over maneuver cycle minimization. Thus, the maneuver decision process, which includes determining whether a maneuver is performed or canceled, designing a targeting strategy and selecting the engine for execution, is being continuously re-evaluated. This paper summarizes the maneuver experience throughout the fourth year of the Solstice Mission highlighting 27 maneuvers targeted to nine Titan flybys.

Analysis of biennial outbreak pattern of respiratory syncytial virus according to subtype (A and B) in the Zagreb region.

PubMed

Mlinaric-Galinovic, Gordana; Tabain, Irena; Kukovec, Tamara; Vojnovic, Gordana; Bozikov, Jadranka; Bogovic-Cepin, Jasna; Ivkovic-Jurekovic, Irena; Knezovic, Ivica; Tesovic, Goran; Welliver, Robert C

2012-06-01

The epidemic pattern of respiratory syncytial virus (RSV) in Croatia is biennial. In order to determine if the circulation of different RSV subtypes affects the outbreak cycle, the aim of the present study was to analyze the epidemic pattern of RSV in children in Croatia (Zagreb region) over a period of 3 consecutive years. The study group consisted of 696 inpatients, aged 0-5 years, who were hospitalized with acute respiratory tract infections caused by RSV, in Zagreb, in the period 1 January 2006-31 December 2008. The virus was identified in nasopharyngeal secretions using direct immunofluorescence. The virus subtype was determined on real-time polymerase chain reaction. Of 696 RSV infections identified in children, subtype A virus caused 374 infections, and subtype B, 318. Four patients had a dual RSV infection (subtypes A and B). The period of study was characterized by four epidemic waves of RSV infections: the first, smaller, in the spring of 2006; the second, larger, in December 2006/January 2007; the third in spring 2008, followed by a fourth outbreak beginning in November of 2008. The biennial virus cycles were persistent although the predominant RSV subtype in the first two epidemic waves was subtype B, and in the second two it was subtype A. Over a 3 year period of observation, the biennial RSV cycle in Croatia cannot be explained by a difference in the predominant circulating subtype of RSV. Other unknown factors account for the biennial cycle of RSV epidemics in Croatia. © 2011 The Authors. Pediatrics International © 2011 Japan Pediatric Society.

Assessment of posttraumatic stress disorder in Cambodian refugees using the Clinician-Administered PTSD Scale: psychometric properties and symptom severity.

PubMed

Hinton, Devon E; Chhean, Dara; Pich, Vuth; Pollack, M H; Orr, Scott P; Pitman, Roger K

2006-06-01

Posttraumatic stress disorder (PTSD) symptoms were assessed by using the Clinician-Administered PTSD Scale (CAPS) in a consecutive sample of Cambodian refugees attending a psychiatric clinic in the United States. Psychometric properties of the translated CAPS and severity of PTSD-related symptoms were examined. The CAPS demonstrated adequate psychometric properties, including coefficient alpha (.92) and item-total correlations (.48-.85). Of the sample 56% (101/179) met Diagnostic and Statistical Manual of Mental Disorders, fourth edition, criteria for current PTSD. Those patients who met criteria for current PTSD had significantly higher CAPS total scores (M = 65.3, SD = 18.1) than those who did not meet the criteria (M = 13.9, SD = 16.7).

Evaluating attention in delirium: A comparison of bedside tests of attention.

PubMed

Adamis, Dimitrios; Meagher, David; Murray, Orla; O'Neill, Donagh; O'Mahony, Edmond; Mulligan, Owen; McCarthy, Geraldine

2016-09-01

Impaired attention is a core diagnostic feature for delirium. The present study examined the discriminating properties for patients with delirium versus those with dementia and/or no neurocognitive disorder of four objective tests of attention: digit span, vigilance "A" test, serial 7s subtraction and months of the year backwards together with global clinical subjective rating of attention. This as a prospective study of older patients admitted consecutively in a general hospital. Participants were assessed using the Confusion Assessment Method, Delirium Rating Scale-98 Revised and Montreal Cognitive Assessment scales, and months of the year backwards. Pre-existing dementia was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders fourth edition criteria. The sample consisted of 200 participants (mean age 81.1 ± 6.5 years; 50% women; pre-existing cognitive impairment in 126 [63%]). A total of 34 (17%) were identified with delirium (Confusion Assessment Method +). The five approaches to assessing attention had statistically significant correlations (P < 0.05). Discriminant analysis showed that clinical subjective rating of attention in conjunction with the months of the year backwards had the best discriminatory ability to identify Confusion Assessment Method-defined delirium, and to discriminate patients with delirium from those with dementia and/or normal cognition. Both of these approaches had high sensitivity, but modest specificity. Objective tests are useful for prediction of non-delirium, but lack specificity for a delirium diagnosis. Global attentional deficits were more indicative of delirium than deficits of specific domains of attention. Geriatr Gerontol Int 2016; 16: 1028-1035. © 2015 The Authors. Geriatrics & Gerontology International published by. Wiley Publishing Asia Pty Ltd on behalf of Japanese Geriatrics Society.

The shifting seasonality of productivity in California during the 2015 drought

NASA Astrophysics Data System (ADS)

Yang, X.; Lee, J. E.

2016-12-01

Drought can significantly affect the ecosystem productivity through increasing surface temperature and reducing water availability. Accurately assessing how drought impacts the ecosystem productivity is critical to understand the terrestrial carbon cycle and food security; however, the assessment has been unclear partly because of lacking spatially-explicit means of measuring photosynthesis. The 2012-2015 California drought is considered to be one of the largest droughts in California during the last 1000 years. Here we used multiple satellite products including the ground meteorological and eddy covariance measurements and solar-induced chlorophyll fluorescence (SIF), a proxy for terrestrial productivity, to estimate the change in the seasonal gross primary productivity (GPP) in California during the drought years, especially in 2015 when the drought was at its fourth consecutive year. We show that with the decreasing water availability since 2012, SIF of all four vegetation types (forests, crops, savannas, and grasslands) showed significant decrease, shifting the peak-growing season about a month earlier, similar to the shift observed from the available flux-tower measurements. During 2015, vegetation productivity in forests and savannas increased in the spring (Jan-Apr) due to warm temperature and increased rainfall in the previous year, but the enhancement quickly diminished due to reduction in soil moisture. Overall, GPP decreased in more than 70% of the vegetation in California, and 50-70% of the vegetation display a negative abnormality beyond one standard deviation from the normal trend. Eddy covariance tower measurements suggested that the net carbon storage also decreased as a result of greater reduction in GPP comparing with the ecosystem respiration. We conclude that an increase in future drought events and intensity would likely shift the peak growing season earlier and shorten the growing season.

Neurology clerkship goals and their effect on learning and satisfaction.

PubMed

Strowd, Roy E; Salas, Rachel Marie E; Cruz, Tiana E; Gamaldo, Charlene E

2016-02-16

To define medical student goals in the neurology clerkship and explore the association between goal setting and student performance, clerkship satisfaction, self-directed learning (SDL), and interest in neurology. A 4-year prospective study of consecutive second- to fourth-year medical students rotating through a required 4-week neurology clerkship was conducted. A goal-generating cohort (first 2 years) was enrolled to describe the breadth of student-derived goals. A goal-evaluating cohort (second 2 years) was used to evaluate the frequency of goal achievement and assess associations with performance (e.g., National Board of Medical Examiners [NBME], examination), satisfaction, and SDL behaviors (both based on 5-point Likert scale). Of 440 evaluable students, 201 were goal-generating and 239 goal-evaluating. The top 3 goals were (1) improvement in neurologic examination, (2) understanding neurologic disease, and (3) deriving a differential diagnosis. More than 90% (n = 216/239) of students reported achieving goals. Achievers reported significantly higher clerkship satisfaction (4.2 ± 0.8 vs. 2.8 ± 1.0, p < 0.0001), greater interest in neurology (71% vs. 35%, p = 0.001), and higher observed tendency toward SDL (4.5 ± 0.5 vs. 4.1 ± 0.8, p < 0.0001). After adjusting for age and training, NBME scores were 1.7 points higher in achievers (95% confidence interval 0.1-3.2, p = 0.04). Students consistently generated similar goals for a required neurology clerkship. Goal achievers had better adjusted standardized test scores, higher satisfaction, and greater tendency toward SDL. This student-generated, goal-setting program may be particularly appealing to clinicians, educators, and researchers seeking resource-lean mechanisms to improve student experience and performance in the clinical clerkships. © 2015 American Academy of Neurology.

Neurology clerkship goals and their effect on learning and satisfaction

PubMed Central

Salas, Rachel Marie E.; Cruz, Tiana E.; Gamaldo, Charlene E.

2016-01-01

Objective: To define medical student goals in the neurology clerkship and explore the association between goal setting and student performance, clerkship satisfaction, self-directed learning (SDL), and interest in neurology. Methods: A 4-year prospective study of consecutive second- to fourth-year medical students rotating through a required 4-week neurology clerkship was conducted. A goal-generating cohort (first 2 years) was enrolled to describe the breadth of student-derived goals. A goal-evaluating cohort (second 2 years) was used to evaluate the frequency of goal achievement and assess associations with performance (e.g., National Board of Medical Examiners [NBME], examination), satisfaction, and SDL behaviors (both based on 5-point Likert scale). Results: Of 440 evaluable students, 201 were goal-generating and 239 goal-evaluating. The top 3 goals were (1) improvement in neurologic examination, (2) understanding neurologic disease, and (3) deriving a differential diagnosis. More than 90% (n = 216/239) of students reported achieving goals. Achievers reported significantly higher clerkship satisfaction (4.2 ± 0.8 vs 2.8 ± 1.0, p < 0.0001), greater interest in neurology (71% vs 35%, p = 0.001), and higher observed tendency toward SDL (4.5 ± 0.5 vs 4.1 ± 0.8, p < 0.0001). After adjusting for age and training, NBME scores were 1.7 points higher in achievers (95% confidence interval 0.1–3.2, p = 0.04). Conclusion: Students consistently generated similar goals for a required neurology clerkship. Goal achievers had better adjusted standardized test scores, higher satisfaction, and greater tendency toward SDL. This student-generated, goal-setting program may be particularly appealing to clinicians, educators, and researchers seeking resource-lean mechanisms to improve student experience and performance in the clinical clerkships. PMID:26718569

Fluorescence-guided resection with 5-aminolevulinic Acid of subependymomas of the fourth ventricle: report of 2 cases: technical case report.

PubMed

Bernal García, Luis Miguel; Cabezudo Artero, José Manuel; Marcelo Zamorano, María Bella; Gilete Tejero, Ignacio

2015-06-01

The usefulness of 5-aminolevulinic acid (5-ALA) for resection of malignant astrocytomas has been established in recent years. In addition to these tumors, it has been reported that 5-ALA fluorescence could be elicited in other tumors such as intracranial and spinal meningiomas or posterior fossa and spinal cord ependymomas, resulting in improved resections. Here, we present 2 cases of subependymomas of the fourth ventricle that showed intense fluorescence after 5-ALA administration. To the best of our knowledge, these are the first reported cases of subependymomas in this location in which 5-ALA elicited useful fluorescence. Case 1 was a 61-year-old woman with a history of headaches accompanied by vomiting in the last month. Magnetic resonance imaging (MRI) revealed a tumor occupying the fourth ventricle with slight irregular enhancement. She was operated on after administration of 5-ALA. The tumor emitted intense red fluorescence when illuminated with blue light. An MRI performed 48 hours after surgery confirmed complete resection of the tumor. The pathological diagnosis was subependymoma. Case 2 was a 35-year-old man with a history of several months of headaches and vomiting. An MRI revealed a tumor occupying the caudal part of the fourth ventricle with moderate and irregular enhancement. He was operated on after administration of 5-ALA. The tumor showed intense fluorescence. An MRI performed 48 hours after surgery confirmed a complete resection of the tumor. The pathological diagnosis was subependymoma. Fluorescence-guided resection with 5-ALA may be useful for resection of subependymomas of the fourth ventricle. However, further studies are needed.

Effects of consecutive monoculture of Pseudostellaria heterophylla on soil fungal community as determined by pyrosequencing

NASA Astrophysics Data System (ADS)

Wu, Linkun; Chen, Jun; Wu, Hongmiao; Wang, Juanying; Wu, Yanhong; Lin, Sheng; Khan, Muhammad Umar; Zhang, Zhongyi; Lin, Wenxiong

2016-05-01

Under consecutive monoculture, the biomass and quality of Pseudostellaria heterophylla declines significantly. In this study, a three-year field experiment was conducted to identify typical growth inhibition effects caused by extended monoculturing of P. heterophylla. Deep pyrosequencing was used to examine changes in the structure and composition of soil fungal community along a three-year gradient of monoculture. The results revealed a distinct separation between the newly planted plot and the two-year, three-year monocultured plots. The Shannon and Simpson diversity indices were significantly higher in the two-year and three-year monoculture soils than in the newly planted soil. Consecutive monoculture of this plant led to a significant increase in relative abundance of Fusarium, Trichocladium and Myrothecium and Simplicillium, etc., but a significant decrease in the relative abundance of Penicillium. Quantitative PCR analysis confirmed a significant increase in Fusarium oxysporum, an agent known to cause wilt and rot disease of P. heterophylla. Furthermore, phenolic acid mixture at a ratio similar to that found in the rhizosphere could promote mycelial growth of pathogenic F. oxysporum. Overall, this study demonstrated that consecutive monoculture of P. heterophylla can alter the fungal community in the rhizosphere, including enrichment of host-specific pathogenic fungi at the expense of plant-beneficial fungi.

Silent internal sinus of the pyriform fossa: a rare adult manifestation of a branchial anomaly.

PubMed

Lin, Chao-Jung; Lin, Yaoh-Shiang; Kang, Bor-Hwang; Lee, Jin-Chin

2003-03-01

Branchial anomalies present with a wide range of pathologic characteristics, including cysts, fistulas, and sinuses of the head and neck region. Branchial cysts are most commonly diagnosed during the second through fourth decades of life, while branchial sinuses and fistulas are diagnosed almost exclusively in children with infection episodes. Only rarely has an internal sinus of a third or fourth branchial anomaly manifested in adults as a noninfectious swelling in the neck during swallowing. In this report, we describe our experience treating a 21-year-old man with a left-sided swallowing-induced neck protrusion of 10 years' duration. Findings of physical examination, videolaryngoscopy, and a pharyngoesophagogram confirmed the diagnosis of internal sinus of the pyriform fossa, with uncertain origin of a third or fourth branchial anomaly. The patient underwent regular follow-up as an outpatient and experienced no further infectious episodes.

How we can improve patients’ comfort after Milligan-Morgan open haemorrhoidectomy

PubMed Central

ba-bai-ke-re, Ma-Mu-Ti-Jiang A; Huang, Hong-Guo; Re, Wen-Ni; Fan, Kai; Chu, Hui; Ai, Er-Ha-Ti; Li-Mu, Mai-Mai-Ti-Tu-Er-Xun KE; Wang, Yi-Rui; Wen, Hao

2011-01-01

AIM: To demonstrate the value of Diosmin (flavonidic fraction) in the management of post-haemorhoidectomic symptoms. METHODS: Eighty-six consecutive patients with grades III and IV acute mixed hemorrhoids admitted to the Anorectal Surgical Department of First Affiliated Hospital, Xinjiang Medical University from April 2009 to April 2010, were enrolled in this study. An observer-blinded, randomized trial was conducted to compare post-haemorhoidectomic symptoms with use of Diosmin flavonidic fraction vs placebo. Eighty-six patients were randomly allocated to receive Diosmin flavonidic fraction 500 mg for 1 wk (n = 43) or placebo (n = 43). The Milligan-Morgan open haemorrhoidectomy was performed by a standardized diathermy excision method. Pain, bleeding, heaviness, pruritus, wound edema and mucosal discharge were observed after surgery. The postoperative symptoms and hospitalization time were recorded. RESULTS: The mean age of the Diosmin group and controls was 53.2 and 51.3 years, respectively. In Diosmin group, haemorrhoid piles were of the third degree in 33 patients and the fourth degree in 10; and in the control group, 29 were of the third degree and 14 were of the fourth degree. There was no statistically significance in age, gender distribution, degree and number of excised haemorrhoid piles, and the mean duration of haemorrhoidal disease between the two groups. There was a statistically significant improvement in pain, heaviness, bleeding, pruritus from baseline to the 8th week after operation (P < 0.05). Patients taking Diosmin had a shorter hospitalization stay after surgery (P < 0.05). There was also a significant improvement on the proctoscopic appearance (P < 0.001). However, there was no statistical difference between the two groups in terms of wound mucosal discharge. Two patients experienced minor bleeding at the 8th week in Diosmin group, and underwent surgery. CONCLUSION: Diosmin is effective in alleviating postoperational symptoms of haemorrhoids. Therefore, it should be considered for the initial treatment after haemorrhoid surgery. However, further prospective randomized trials are needed to confirm the findings of this study. PMID:21472103

The expression and comparison of healthy and ptotic upper eyelid contours using a polynomial mathematical function.

PubMed

Mocan, Mehmet C; Ilhan, Hacer; Gurcay, Hasmet; Dikmetas, Ozlem; Karabulut, Erdem; Erdener, Ugur; Irkec, Murat

2014-06-01

To derive a mathematical expression for the healthy upper eyelid (UE) contour and to use this expression to differentiate the normal UE curve from its abnormal configuration in the setting of blepharoptosis. The study was designed as a cross-sectional study. Fifty healthy subjects (26M/24F) and 50 patients with blepharoptosis (28M/22F) with a margin-reflex distance (MRD1) of ≤2.5 mm were recruited. A polynomial interpolation was used to approximate UE curve. The polynomial coefficients were calculated from digital eyelid images of all participants using a set of operator defined points along the UE curve. Coefficients up to the fourth-order polynomial, iris area covered by the UE, iris area covered by the lower eyelid and total iris area covered by both the upper and the lower eyelids were defined using the polynomial function and used in statistical comparisons. The t-test, Mann-Whitney U test and the Spearman's correlation test were used for statistical comparisons. The mathematical expression derived from the data of 50 healthy subjects aged 24.1 ± 2.6 years was defined as y = 22.0915 + (-1.3213)x + 0.0318x(2 )+ (-0.0005x)(3). The fifth and the consecutive coefficients were <0.00001 in all cases and were not included in the polynomial function. None of the first fourth-order coefficients of the equation were found to be significantly different in male versus female subjects. In normal subjects, the percentage of the iris area covered by upper and lower lids was 6.46 ± 5.17% and 0.66% ± 1.62%, respectively. All coefficients and mean iris area covered by the UE were significantly different between healthy and ptotic eyelids. The healthy and abnormal eyelid contour can be defined and differentiated using a polynomial mathematical function.

Use of Medical Students in a Flipped Classroom Programme in Nutrition Education for Fourth-Grade School Students

ERIC Educational Resources Information Center

McEvoy, Christian S.; Cantore, Kathryn M.; Denlinger, LeAnn N.; Schleich, Michele A.; Stevens, Nicole M.; Swavely, Steven C.; Odom, Anne A.; Novick, Marsha B.

2016-01-01

Objective: The purpose of this study was to evaluate the feasibility of a flipped classroom progamme, designed and implemented by medical students, in communicating nutrition education to fourth-grade school students aged 9-10 years and to characterise teachers' assessments of the progamme, which was designed to minimise the burden placed on…

Does Relative Age Influence Motor Test Performance of Fourth Grade Pupils?

ERIC Educational Resources Information Center

Wattie, Nick; Tietjens, Maike; Schorer, Jörg; Ghanbari, Marie-Christine; Strauss, Bernd; Seidel, Ilka; Baker, Joseph

2014-01-01

The aim of the current study was to explore relative age's influence on physical and motor tests among fourth grade children (9 to 10 years) from Germany. Data from 1218 children (49% female) who had performed the German Motor Ability Test (Bös et al., 2009) were analysed. The test battery, which was comprised of physical and motor tests, included…

Use of Digital Stories to Develop Listening Comprehension Skills

ERIC Educational Resources Information Center

Cigerci, Fatih Mehmet; Gultekin, Mehmet

2017-01-01

The aim of this study was to determine the effect of digital stories on the Turkish (mother language) listening skills of fourth grade students. The study used a mixed methods and was conducted in two fourth grade classrooms (ages 9-10 years) in a primary school in Eskisehir city, Turkey, during the 2014-2015 spring semester. During the 8-week…

76 FR 79579 - Approval and Promulgation of Implementation Plans and Designation of Areas for Air Quality...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-22

... posting of the availability of the submittal on EPA's Adequacy Web site (at http://www.epa.gov/otaq... average annual fourth-highest daily maximum 8-hour average ozone concentration), if it had a 1-hour design... ozone standard is attained when the three-year average of the annual fourth-highest daily maximum 8-hour...

Fourth-Grade Primary School Students' Thought Processes and Challenges Encountered during the Butter Beans Problem

ERIC Educational Resources Information Center

Sahin, Neslihan; Eraslan, Ali

2017-01-01

In parallel with mathematical modeling studies that have gradually drawn interest in recent years, the aim of this study is to investigate the thought processes of fourth-grade students in the Butter Beans Problem and to identify possible challenges in this process. For this purpose, a qualitative study was conducted at a university-foundation…

Performing Race in Four Culturally Diverse Fourth Grade Classrooms: Silence, Race Talk, and the Negotiation of Social Boundaries

ERIC Educational Resources Information Center

Schaffer, Rebecca; Skinner, Debra G.

2009-01-01

This article addresses how preadolescents produce and perform race through an ethnographic study of 8- to 11-year-old students in four fourth grade classrooms in the southeastern United States. Although Asian, Latino, and white students tended to avoid explicit talk of race, many white students constructed black students as disruptive…

TIMSS and PIRLS 2011: Relationships among Reading, Mathematics, and Science Achievement at the Fourth Grade--Implications for Early Learning

ERIC Educational Resources Information Center

Martin, Michael O., Ed.; Mullis, Ina V. S., Ed.

2013-01-01

TIMSS (Trends in International Mathematics and Science Study) is an international assessment of mathematics and science at the fourth and eighth grades that has been conducted every four years since 1995, with the most recent assessment in 2011. PIRLS (Progress in International Reading Literacy Study) is an international assessment of reading…

A Critical Review of the "Motor-Free Visual Perception Test-Fourth Edition" (MVPT-4)

ERIC Educational Resources Information Center

Brown, Ted; Peres, Lisa

2018-01-01

The "Motor-Free Visual Perception Test-fourth edition" (MVPT-4) is a revised version of the "Motor-Free Visual Perception Test-third edition." The MVPT-4 is used to assess the visual-perceptual ability of individuals aged 4.0 through 80+ years via a series of visual-perceptual tasks that do not require a motor response. Test…

Joyous Reading: Aspects of Literature Enjoyment for Black/African American Fourth Grade Students

ERIC Educational Resources Information Center

Mosley, Sherea

2017-01-01

This study primarily explores the types of books African American children in a local fourth grade classroom like and enjoy. Books students are interested in reading and other related aspects that contribute to their literary enjoyment are also explored. It is during the upper elementary years that many students who eventually express little or no…

Near-peer role modeling: Can fourth-year medical students, recognized for their humanism, enhance reflection among second-year students in a physical diagnosis course?

PubMed

McEvoy, Mimi; Pollack, Staci; Dyche, Lawrence; Burton, William

2016-01-01

Humanism is cultivated through reflection and self-awareness. We aimed to employ fourth-year medical students, recognized for their humanism, to facilitate reflective sessions for second-year medical students with the intention of positively influencing reflective process toward humanistic development. A total of 186 students were randomly assigned to one of three comparison arms: eight groups of eight students (64 students) were facilitated by a fourth-year student who was a Gold Humanism Honor Society member (GHHS); eight groups (64 students) by a volunteer non-GHHS student; and seven groups (58 students) were non-facilitated. Before sessions, second-year students set learning goals concerning interactions with patients; fourth-year students received training materials on facilitation. Groups met twice during their 10 clinical site visits. At the last session, students completed a reflective assignment on their goal progress. Comparative mixed method analyses were conducted among the three comparison arms on reflection (reflective score on in-session assignment) and session satisfaction (survey) in addition to a thematic analysis of responses on the in-session assignment. We found significant differences among all three comparison arms on students' reflective scores (p=0.0003) and satisfaction (p=0.0001). T-tests comparing GHHS- and non-GHHS-facilitated groups showed significantly higher mean reflective scores for GHHS-facilitated groups (p=0.033); there were no differences on session satisfaction. Thematic analysis of students' reflections showed attempts at self-examination, but lacked depth in addressing emotions. There was a common focus on achieving comfort and confidence in clinical skills performance. Near peers, recognized for their humanism, demonstrated significant influence in deepening medical students' reflections surrounding patient interactions or humanistic development. Overall, students preferred facilitated to non-facilitated peer feedback forums. This model holds promise for enhancing self-reflection in medical education, but needs further exploration to determine behavioral effects.

Near-peer role modeling: Can fourth-year medical students, recognized for their humanism, enhance reflection among second-year students in a physical diagnosis course?

PubMed Central

McEvoy, Mimi; Pollack, Staci; Dyche, Lawrence; Burton, William

2016-01-01

Introduction Humanism is cultivated through reflection and self-awareness. We aimed to employ fourth-year medical students, recognized for their humanism, to facilitate reflective sessions for second-year medical students with the intention of positively influencing reflective process toward humanistic development. Methods/Analysis A total of 186 students were randomly assigned to one of three comparison arms: eight groups of eight students (64 students) were facilitated by a fourth-year student who was a Gold Humanism Honor Society member (GHHS); eight groups (64 students) by a volunteer non-GHHS student; and seven groups (58 students) were non-facilitated. Before sessions, second-year students set learning goals concerning interactions with patients; fourth-year students received training materials on facilitation. Groups met twice during their 10 clinical site visits. At the last session, students completed a reflective assignment on their goal progress. Comparative mixed method analyses were conducted among the three comparison arms on reflection (reflective score on in-session assignment) and session satisfaction (survey) in addition to a thematic analysis of responses on the in-session assignment. Results We found significant differences among all three comparison arms on students’ reflective scores (p=0.0003) and satisfaction (p=0.0001). T-tests comparing GHHS- and non-GHHS-facilitated groups showed significantly higher mean reflective scores for GHHS-facilitated groups (p=0.033); there were no differences on session satisfaction. Thematic analysis of students’ reflections showed attempts at self-examination, but lacked depth in addressing emotions. There was a common focus on achieving comfort and confidence in clinical skills performance. Discussion/Conclusions Near peers, recognized for their humanism, demonstrated significant influence in deepening medical students’ reflections surrounding patient interactions or humanistic development. Overall, students preferred facilitated to non-facilitated peer feedback forums. This model holds promise for enhancing self-reflection in medical education, but needs further exploration to determine behavioral effects. PMID:27600828

Near-peer role modeling: Can fourth-year medical students, recognized for their humanism, enhance reflection among second-year students in a physical diagnosis course?

PubMed

McEvoy, Mimi; Pollack, Staci; Dyche, Lawrence; Burton, William

2016-01-01

Introduction Humanism is cultivated through reflection and self-awareness. We aimed to employ fourth-year medical students, recognized for their humanism, to facilitate reflective sessions for second-year medical students with the intention of positively influencing reflective process toward humanistic development. Methods/Analysis A total of 186 students were randomly assigned to one of three comparison arms: eight groups of eight students (64 students) were facilitated by a fourth-year student who was a Gold Humanism Honor Society member (GHHS); eight groups (64 students) by a volunteer non-GHHS student; and seven groups (58 students) were non-facilitated. Before sessions, second-year students set learning goals concerning interactions with patients; fourth-year students received training materials on facilitation. Groups met twice during their 10 clinical site visits. At the last session, students completed a reflective assignment on their goal progress. Comparative mixed method analyses were conducted among the three comparison arms on reflection (reflective score on in-session assignment) and session satisfaction (survey) in addition to a thematic analysis of responses on the in-session assignment. Results We found significant differences among all three comparison arms on students' reflective scores (p=0.0003) and satisfaction (p=0.0001). T-tests comparing GHHS- and non-GHHS-facilitated groups showed significantly higher mean reflective scores for GHHS-facilitated groups (p=0.033); there were no differences on session satisfaction. Thematic analysis of students' reflections showed attempts at self-examination, but lacked depth in addressing emotions. There was a common focus on achieving comfort and confidence in clinical skills performance. Discussion/Conclusions Near peers, recognized for their humanism, demonstrated significant influence in deepening medical students' reflections surrounding patient interactions or humanistic development. Overall, students preferred facilitated to non-facilitated peer feedback forums. This model holds promise for enhancing self-reflection in medical education, but needs further exploration to determine behavioral effects.

The effect of illicit financial flows on time to reach the fourth Millennium Development Goal in Sub-Saharan Africa: a quantitative analysis.

PubMed

O'Hare, Bernadette; Makuta, Innocent; Bar-Zeev, Naor; Chiwaula, Levison; Cobham, Alex

2014-04-01

This paper sets out to estimate the cost of illicit financial flows (IFF) in terms of the amount of time it could take to reach the fourth Millennium Development Goal (MDG) in 34 African countries. We have calculated the percentage increase in gross domestic product (GDP) if IFFs were curtailed using IFF/GDP ratios. We applied the income (GDP) elasticity of child mortality to the increase in GDP to estimate the reduction in time to reach the fourth MDG in 34 African countries. children aged under five years. 34 countries in SSA. Reduction in time to reach the first indicator of the fourth MDG, under-five mortality rate in the absence of IFF. We found that in the 34 SSA countries, six countries will achieve their fourth MDG target at the current rates of decline. In the absence of IFF, 16 countries would reach their fourth MDG target by 2015 and there would be large reductions for all other countries. This drain on development is facilitated by financial secrecy in other jurisdictions. Rich and poor countries alike must stem the haemorrhage of IFF by taking decisive steps towards improving financial transparency.

Fourth-Generation Progestins Inhibit 3β-Hydroxysteroid Dehydrogenase Type 2 and Modulate the Biosynthesis of Endogenous Steroids

PubMed Central

Louw-du Toit, Renate; Perkins, Meghan S.; Snoep, Jacky L.; Storbeck, Karl-Heinz; Africander, Donita

2016-01-01

Progestins used in contraception and hormone replacement therapy are synthetic compounds designed to mimic the actions of the natural hormone progesterone and are classed into four consecutive generations. The biological actions of progestins are primarily determined by their interactions with steroid receptors, and factors such as metabolism, pharmacokinetics, bioavailability and the regulation of endogenous steroid hormone biosynthesis are often overlooked. Although some studies have investigated the effects of select progestins on a few steroidogenic enzymes, studies comparing the effects of progestins from different generations are lacking. This study therefore explored the putative modulatory effects of progestins on de novo steroid synthesis in the adrenal by comparing the effects of select progestins from the respective generations, on endogenous steroid hormone production by the H295R human adrenocortical carcinoma cell line. Ultra-performance liquid chromatography/tandem mass spectrometry analysis showed that the fourth-generation progestins, nestorone (NES), nomegestrol acetate (NoMAC) and drospirenone (DRSP), unlike the progestins selected from the first three generations, modulate the biosynthesis of several endogenous steroids. Subsequent assays performed in COS-1 cells expressing human 3βHSD2, suggest that these progestins modulate the biosynthesis of steroid hormones by inhibiting the activity of 3βHSD2. The Ki values determined for the inhibition of human 3βHSD2 by NES (9.5 ± 0.96 nM), NoMAC (29 ± 7.1 nM) and DRSP (232 ± 38 nM) were within the reported concentration ranges for the contraceptive use of these progestins in vivo. Taken together, our results suggest that newer, fourth-generation progestins may exert both positive and negative physiological effects via the modulation of endogenous steroid hormone biosynthesis. PMID:27706226

Impact of hyperventilation on stimulus efficiency during the early phase of an electroconvulsive therapy course: a randomized double-blind study.

PubMed

Mayur, Prashanth; Bray, Amanda; Fernandes, Joanne; Bythe, Karen; Gilbett, David

2010-06-01

The question whether hyperventilation during electroconvulsive therapy (ECT) can improve stimulus efficiency is as yet unanswered. Twenty-five consecutive consenting patients (N = 25) with major depression who were administered ECT entered into the study. Right unilateral ECT at thrice the threshold dose was administered using Mecta spECTrum 5000Q (Mecta Corp, Lake Oswego, Ore), with standard titration procedures and stimulus configurations. At the second ECT session, they were randomly allocated to ECT either with hyperventilation or with no hyperventilation. Hyperventilation was actively administered by an anesthetist just after anesthetic paralysis and before the ECT stimulus during the second, third, and fourth ECT sessions. Assessments were double-blind and performed at baseline and 24 to 48 hours after the fourth ECT session. Time to reorient after ECT was assessed during the first up to the fourth ECT session. Ictal electroencephalogram (EEG) quality was visually assessed using standard scales. There were no significant differences across the 2 groups about depression severity and global cognitive impact. However, the orientation time was 34% longer among those who did not receive hyperventilation. The ratio of orientation time without hyperventilation to that with hyperventilation equals 1.34 (95% confidence interval, 0.94-1.92; P = 0.103). There was a significant increase in threshold over time across both groups (mean difference, 16.4; SE, 5.5; P = 0.006) with no significant main effect for the groups (P = 0.399). There were no significant group differences in the EEG quality. The addition of hyperventilation during the early phase of the ECT course shows a trend to lessen the impact on immediate orientation without impeding clinical response. This does not seem to be mediated by differential threshold changes or change to the ictal EEG quality.

Greater occipital nerve block in the treatment of triptan-overuse headache: A randomized comparative study.

PubMed

Karadaş, Ö; Özön, A Ö; Özçelik, F; Özge, A

2017-04-01

This study aims to investigate the efficiency of a single and repeated greater occipital nerve (GON) block using lidocaine in the treatment of triptan-overuse headache (TOH), whose importance has increased lately. In the study, 105 consecutive subjects diagnosed with TOH were evaluated. The subjects were randomized into three groups. In Group 1 (n=35), only triptan was abruptly withdrawn. In Group 2 (n=35), triptan was abruptly withdrawn and single GON block was performed. In Group 3 (n=35), triptan was abruptly withdrawn and three-stage GON block was performed. All patients were injected bilaterally with a total amount of 5 cc 1% lidocaine in each stage. During follow-up, the number of headache days per month, the severity of pain (VAS), the number of triptans used, and hsCRP and IL-6 levels were recorded three times; in the pretreatment period, in the second month post-treatment, and in the fourth month post-treatment. They were then compared. There was a statistically significant difference in the post-treatment fourth month in comparison with the pretreatment period in Group 3 (P<.05). Compared to Group 1, the number of headache days, VAS, and decrease in triptan need in Group 3 was statistically significant compared to Group 2 (P<.05). Compared to pretreatment, in the fourth month post-treatment, both hsCRP and IL-6 levels were lower only in Group 3 (P<.05). We are of the opinion that repeated GON block in addition to the discontinuation of medication has significant efficacy for TOH cases. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Improving medical students' understanding of prehospital care through a fourth year emergency medicine clerkship.

PubMed

Merlin, Mark A; Moon, Jeffery; Krimmel, Jessica; Liu, Junfeng; Marques-Baptista, Andreia

2010-02-01

The objective of this study was to survey medical students for a measurable opinion or knowledge increase in prehospital care after a fourth-year clerkship in emergency medicine (EM). The goal of the mandatory prehospital care aspect of the clerkship was twofold: to diminish the prehospital knowledge gap in medical school by teaching students about prehospital protocols and disaster medicine and to increase student interest. The study setting was within a university-based academic EM department with a prehospital system of 250 prehospital personnel. Data were collected from two similar questionnaires administered pre- and post-rotation to 49 fourth-year medical students. Statistical analyses were applied to collected data to quantify the changes of opinion and knowledge. Questions used a Likert five-point Scale. The data verified the improvement of students' knowledge in multiple areas of assessment. Greater than 35% opinion change (two points on the Likert Scale) was found in areas of prehospital care, 911 dispatch and education differences in prehospital providers (all p<0.0001; 95% CI 0.90 to 1.02, 0.66 to 0.90 and 0.66 to 0.90, respectively). Greater than 35% opinion change was also found in understanding triage (p=0.03; 95% CI 0.29 to 0.58) and general teaching of prehospital care, fellowship opportunities and use of a monitor/defibrillator (p<0.0001, p<0.0001 and p=0.04, respectively). We found medical students developed a significantly improved understanding of prehospital care. Without extraordinary effort, academic emergency departments could easily include a significant experience and education within fourth-year EM clerkships.

Idiopathic Systemic Capillary Leak Syndrome (Clarkson's Disease): The Mayo Clinic Experience

PubMed Central

Kapoor, Prashant; Greipp, Patricia T.; Schaefer, Eric W.; Mandrekar, Sumithra J.; Kamal, Arif H.; Gonzalez-Paz, Natalia C.; Kumar, Shaji; Greipp, Philip R.

2010-01-01

OBJECTIVE: To determine clinical features, natural history, and outcome of a well-defined cohort of 25 consecutive patients with idiopathic systemic capillary leak syndrome (SCLS) evaluated at a tertiary care center. PATIENTS AND METHODS: Records of patients diagnosed as having SCLS from November 1, 1981, through April 30, 2008, were reviewed. Descriptive statistics were used to analyze patient demographics, clinical features, complications, and therapeutic interventions. RESULTS: Of the 34 patients whose records were reviewed, 25 fulfilled all diagnostic criteria for SCLS. The median age at diagnosis of SCLS was 44 years. Median follow-up of surviving patients was 4.9 years, and median time to diagnosis from symptom onset was 1.1 years (interquartile range, 0.5-4.1 years). Flulike illness or myalgia was reported by 14 patients (56%) at onset of an acute attack of SCLS, and rhabdomyolysis developed in 9 patients (36%). Patients with a greater decrease in albumin level had a higher likelihood of developing rhabdomyolysis (p=.03). Monoclonal gammopathy, predominantly of the IgG-κ type, was found in 19 patients (76%). The progression rate to multiple myeloma was 0.7% per person-year of follow-up. The overall response rate to the different therapies was 76%, and 24% of patients sustained durable (>2 years) complete remission. The estimated 5-year overall survival rate was 76% (95% confidence interval, 59%-97%). CONCLUSION: Systemic capillary leak syndrome, a rare disease that occurs in those of middle age, is usually diagnosed after a considerable delay from onset of symptoms. The degree of albumin decrement during an attack correlates with development of rhabdomyolysis. A reduction in the frequency and/or the severity of attacks was seen in nearly three-fourths of patients who were offered empirical therapies. The rate of progression to multiple myeloma appears to be comparable to that of monoclonal gammopathy of undetermined significance. PMID:20634497

Macular auto-fluorescence is a follow-up parameter for cystoids macular edema.

PubMed

Zhang, XinYuan; Gong, XiaoHong; Wang, YanHong; Wang, NingLi

2015-08-01

This study aimed to evaluate if macular autofluorescence (MAF) is a valuable, non-invasive follow-up parameter for cystoid macular edema. A total of 71 eyes (71 cases) with cystoid macular edema (CME) were included in the study. Macular pigment (MP) was evaluated using HRA2 (infrared) IF and FA models. The density of MP was graded into three categories: without, partial, and normal amount of MP. A comparison was made between the baseline (before the first administration) level and at the fourth month, following three consecutive intravitreal lucentis injections every month. The morphology and distribution of MAF, and the density and distribution of MP were regarded as the main outcome measures. At the baseline visit, all eyes with CME had petaloid/irregular-shaped MAF in the macular area (100%). No MAF was detected in the control eyes (0). There was significant difference in MAF between the CME and normal groups (P=0.000). At the fourth monthly visit, normal levels of MP density without MAF was detected in 68 eyes (95.8%) with the best corrected spectacular visual acuity increasing to at least 1 line accordingly. We conclude that macular MAF can be used as a follow-up parameter for patients with CME. MP and MAF can indirectly reflect the fovea cone function.

Effect of music intervention on burn patients' pain and anxiety during dressing changes.

PubMed

Hsu, Kuo-Cheng; Chen, Li Fen; Hsiep, Pi Hsia

2016-12-01

For burn patients, the daily dressing process causes pain and anxiety. Although drugs can relieve them, the degree of pain during dressing changes is often moderate to severe. Therefore, relevant supporting interventions, like music as an ideal intervention, could alleviate the patient's pain. This study investigated the impact of music intervention at dressing change time on burn patients' pain and anxiety. This was a prospective, randomized clinical trial; patients were randomly assigned into control (standard intervention) and experimental groups (crystal music intervention) for five consecutive days (35 patients in each group). Patients' pain and anxiety measurements were collected before, during, and after dressing changes and morphine usage was recorded. The study period was October 2014 to September 2015. There was no difference in morphine dosage for both groups. By the fourth day of music intervention, burn patients' pain before, during, and after dressing changes had significantly decreased; anxiety on the fourth day during and after dressing changes had also significantly decreased. Nurses may use ordered prescription analgesics, but if non-pharmacological interventions are increased, such as providing timely music intervention and creating a friendly, comfortable hospital environment, patients' pain and anxiety will reduce. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

An update on microsatellite genotype information of Phytophthora ramorum in Washington State nurseries

Treesearch

Katie Coats; Gary Chastagner; Norm Dart; Meg M. Larsen; Niklaus J. Grunwald

2010-01-01

Phytophthora ramorum was first detected in a Washington nursery in 2003 and has since been positively identified in 46 nurseries, three non-nursery water sites, and three landscape sites. Thirteen nurseries have tested positive for 2 consecutive years and four nurseries have been positive for 3 consecutive years, despite the completion of the U...

49 CFR 365.511 - Requirement for CVSA inspection of vehicles during first three consecutive years of permanent...

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 5 2014-10-01 2014-10-01 false Requirement for CVSA inspection of vehicles during first three consecutive years of permanent operating authority. 365.511 Section 365.511 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL MOTOR CARRIER SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION FEDERAL MOTOR...

Social Media and the Plastic Surgery Patient.

PubMed

Sorice, Sarah C; Li, Alexander Y; Gilstrap, Jarom; Canales, Francisco L; Furnas, Heather J

2017-11-01

Many plastic surgeons use social media as a marketing tool to attract and retain patients, but information about how patients use social media and their preferred types of plastic surgery posts have been lacking. To investigate patients' preferred social media networks and the type of posts they wished to see, a cross-sectional study was conducted in a single aesthetic practice of two plastic surgeons by surveying 100 consecutive patients. The age of the patients averaged 44.4 years (range, 17 to 78 years). Facebook had the greatest patient use and engagement, with YouTube second in use, and Instagram second in number of engaged users. Over half used Pinterest, but with little daily engagement. Only one-fourth used Snapchat, but the percentage of users who were highly engaged was second only to Facebook. The least popular network was Twitter, with the fewest patient users and least engagement. Social media played a minor role compared with the practice's Web site in both influencing patients to choose the practice and providing information on the day of the appointment. Patients most wanted to see posts on a plastic surgeon's social media platform related to practice information, before-and-after photographs, and contests. Articles about plastic surgery held the least interest. Among five types of Web site content, patients expressed most interest in before-and-after photographs. This study is the first to articulate the plastic surgery patient perspective regarding social media. The findings aim to help plastic surgeons maximize their influence on their target audience.

Efficacy of triplet regimen antiemetic therapy for chemotherapy-induced nausea and vomiting (CINV) in bone and soft tissue sarcoma patients receiving highly emetogenic chemotherapy, and an efficacy comparison of single-shot palonosetron and consecutive-day granisetron for CINV in a randomized, single-blinded crossover study.

PubMed

Kimura, Hiroaki; Yamamoto, Norio; Shirai, Toshiharu; Nishida, Hideji; Hayashi, Katsuhiro; Tanzawa, Yoshikazu; Takeuchi, Akihiko; Igarashi, Kentaro; Inatani, Hiroyuki; Shimozaki, Shingo; Kato, Takashi; Aoki, Yu; Higuchi, Takashi; Tsuchiya, Hiroyuki

2015-03-01

The first aim of this study was to evaluate combination antiemetic therapy consisting of 5-HT3 receptor antagonists, neurokinin-1 receptor antagonists (NK-1RAs), and dexamethasone for multiple high emetogenic risk (HER) anticancer agents in bone and soft tissue sarcoma. The second aim was to compare the effectiveness of single-shot palonosetron and consecutive-day granisetron in a randomized, single-blinded crossover study. A single randomization method was used to assign eligible patients to the palonosetron or granisetron arm. Patients in the palonosetron arm received a palonosetron regimen during the first and third chemotherapy courses and a granisetron regimen during the second and fourth courses. All patients received NK-1RA and dexamethasone. Patients receiving the palonosetron regimen were administered 0.75 mg palonosetron on day 1, and patients receiving the granisetron regimen were administered 3 mg granisetron twice daily on days 1 through 5. All 24 patients in this study received at least 4 chemotherapy courses. A total of 96 courses of antiemetic therapy were evaluated. Overall, the complete response CR rate (no emetic episodes and no rescue medication use) was 34%, while the total control rate (a CR plus no nausea) was 7%. No significant differences were observed between single-shot palonosetron and consecutive-day granisetron. Antiemetic therapy with a 3-drug combination was not sufficient to control chemotherapy-induced nausea and vomiting (CINV) during chemotherapy with multiple HER agents for bone and soft tissue sarcoma. This study also demonstrated that consecutive-day granisetron was not inferior to single-shot palonosetron for treating CINV. © 2014 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

The association between consecutive days' heat wave and cardiovascular disease mortality in Beijing, China.

PubMed

Yin, Qian; Wang, Jinfeng

2017-02-23

Although many studies have examined the effects of heat waves on the excess mortality risk (ER) posed by cardiovascular disease (CVD), scant attention has been paid to the effects of various combinations of differing heat wave temperatures and durations. We investigated such effects in Beijing, a city of over 20 million residents. A generalized additive model (GAM) was used to analyze the ER of consecutive days' exposure to extreme high temperatures. A key finding was that when extremely high temperatures occur continuously, at varying temperature thresholds and durations, the adverse effects on CVD mortality vary significantly. The longer the heat wave lasts, the greater the mortality risk is. When the daily maximum temperature exceeded 35 °C from the fourth day onward, the ER attributed to consecutive days' high temperature exposure saw an increase to about 10% (p < 0.05), and at the fifth day, the ER even reached 51%. For the thresholds of 32 °C, 33 °C, and 34 °C, from the fifth day onward, the ER also rose sharply (16, 29, and 31%, respectively; p < 0.05). In addition, extreme high temperatures appeared to contribute to a higher proportion of CVD deaths among elderly persons, females and outdoor workers. When the daily maximum temperature was higher than 33 °C from the tenth consecutive day onward, the ER of CVD death among these groups was 94, 104 and 149%, respectively (p < 0.05), which is considerably higher than the ER for the overall population (87%; p < 0.05). The results of this study may assist governments in setting standards for heat waves, creating more accurate heat alerts, and taking measures to prevent or reduce temperature-related deaths, especially against the backdrop of global warming.

Four years of training in family medicine: implications for residency redesign.

PubMed

Sigmon, J Lewis; McPherson, Vanessa; Little, John M

2012-09-01

In light of the ongoing consideration for extending the length of residency education in family medicine in the United States, this paper reports the findings from a retrospective, qualitative study of six family physicians that elected to extend their residency training from 3 to 4 years. Each participant completed a written questionnaire and a structured personal interview focusing on various aspects of career development resulting from the additional year of training. The authors independently evaluated these interviews to identify major themes. All the participants were found to have been involved in teaching medicine, valued a more flexible and expanded curriculum, and appreciated their individualized curricula-based on their respective career interests. Given the opportunity, each would opt again for a fourth year of training. There were mixed opinions as to whether the fourth year should be required of all family medicine residents. Other perceived benefits reported were: a better opportunity to find a personally satisfactory practice, additional time for gaining clarity about career plans, and a higher beginning salary as a result of the additional skills and experiences gained. This study of mid-career physicians supports that a fourth-year (PGY4) curriculum in family medicine may enhance subsequent career satisfaction. Further studies of residents in other PGY4 training programs are necessary to assess outcomes comparing our findings as well as guide the discipline's leaders in residency redesign.

[Two-and-a-half year follow-up study of strategy factors in successful learning to predict academic achievements in medical education].

PubMed

Lee, Soon Ok; Lee, Sang Yeoup; Baek, Sunyong; Woo, Jae Seok; Im, Sun Ju; Yune, So Jung; Lee, Sun Hee; Kam, Beesung

2015-06-01

We performed a two-and-a-half year follow-up study of strategy factors in successful learning to predict academic achievements in medical education. Strategy factors in successful learning were identified using a content analysis of open-ended responses from 30 medical students who were ranked in the top 10 of their class. Core words were selected among their responses in each category and the frequency of the words were counted. Then, a factors survey was conducted among year 2 students, before the second semester. Finally, we performed an analysis to assess the association between the factors score and academic achievement for the same students 2.5 years later. The core words were "planning and execution," "daily reviews" in the study schedule category; "focusing in class" and "taking notes" among class-related category; and "lecture notes," "previous exams or papers," and "textbooks" in the primary self-learning resources category. There were associations between the factors scores for study planning and execution, focusing in class, and taking notes and academic achievement, representing the second year second semester credit score, third year written exam scores and fourth year written and skill exam scores. Study planning was only one independent variable to predict fourth year summative written exam scores. In a two-and-a-half year follow-up study, associations were founded between academic achievement and the factors scores for study planning and execution, focusing in class, and taking notes. Study planning as only one independent variable is useful for predicting fourth year summative written exam score.

Titration effectiveness of two autoadjustable continuous positive airway pressure devices driven by different algorithms in patients with obstructive sleep apnoea.

PubMed

Damiani, Mario Francesco; Quaranta, Vitaliano Nicola; Tedeschi, Ersilia; Drigo, Riccardo; Ranieri, Teresa; Carratù, Pierluigi; Resta, Onofrio

2013-08-01

Nocturnal application of continuous positive airway pressure (CPAP) is the standard treatment for patients with obstructive sleep apnoea (OSA). Determination of the therapeutic pressure (CPAP titration) is usually performed by a technician in the sleep laboratory during attended polysomnography. One possible alternative to manual titration is automated titration. Indeed, during the last 15 years, devices have been developed that deliver autoadjustable CPAP (A-CPAP). The aim of the present study was to compare the titration effectiveness of two A-CPAP devices using different flow-based algorithms in patients with OSA. This is a randomized study; 79 subjects underwent two consecutive unattended home A-CPAP titration nights with two different devices (Autoset Resmed; Remstar Auto Respironics); during the third and the fourth night, patients underwent portable monitoring in the sleep laboratory during fixed CPAP at the A-CPAP recommended pressure. Bland Altman plots showed good agreement between the recommended median and maximal pressure levels obtained with the two devices. A significant improvement was observed in all the sleep parameters by both A-CPAP machines to a similar degree. It was observed that the two A-CPAP devices using different algorithms are equally effective in initial titration of CPAP. © 2013 The Authors. Respirology © 2013 Asian Pacific Society of Respirology.

Low-flow profiles of the Tallapoosa River and tributaries in Georgia

USGS Publications Warehouse

Carter, R.F.; Hopkins, E.H.; Perlman, H.A.

1988-01-01

Low flow information is provided for use in an evaluation of the capacity of streams to permit withdrawals or to accept waste loads without exceeding the limits of State water quality standards. The report is the fourth in a series of reports presenting the results of a low flow study of all stream basins north of the Fall Line in Georgia. This report covers the part of the Tallapoosa River basin in the Piedmont province of Georgia. The low flow characteristic presented is the minimum average flow for 7 consecutive days with a 10-year recurrence interval (7Q10). The data are presented in tables and shown graphically as ' low flow profiles ' (low flow plotted against distance along a stream channel), and as ' drainage area profiles ' (drainage area plotted against distance along a stream channel). Low flow profiles were constructed by interpolation or extrapolation from points of known low flow data. Low flow profiles are included for all stream reaches where low flow data of sufficient accuracy are available to justify computation of the profiles. Drainage area profiles are included for all stream basins > 5 sq mi, except for those in a few remote areas. Flow records were not adjusted for diversions or other factors that cause measured flows to represent conditions other than natural flow. (Author 's abstract)

Authors "in Residence" Make Writing Fun! Online Mentors Help Fourth Graders Compose Original Stories

ERIC Educational Resources Information Center

Hagins, Chelsea; Austin, Jackie; Jones, Raven; Timmons, Taylor

2004-01-01

Chelsea pointed to four sentences on her computer screen. "Am I done, Mrs. Weeg?" Writing was not her favorite activity. She and five other fourth-grade classmates were in the early stages of writing a story in the global classroom. For the past four years, 12 students at Delmar Elementary School have taken part in this online mentoring program,…

Fourth Annual Holiday Decorating Contest Features Sharks, Santas, Toys, and More | Poster

Cancer.gov

The 2017 holiday season brought cold temperatures and heated competition to NCI at Frederick as 14 groups faced off in the R&W Club of Frederick’s Fourth Annual Holiday Decorating Contest. Keeping with tradition, many of the competitors sought to outdo not just each other’s themed entries, but also their own decorations from previous years. Accordingly, this year’s themes

"How Should I Know What Scientists Do?--I Am Just a Kid": Fourth-Grade Students' Conceptions of Nature of Science

ERIC Educational Resources Information Center

Akerson, Valarie L.; Abd-El-Khalick, Fouad S.

2005-01-01

The purpose of this study is to explore elementary students' views of (NOS) to see how well they align with national reform recommendations (AAAS, 1993; NRC, 1996). Using an open-ended questionnaire coupled with one-on-one interviews of fourth-grade students conducted at the end of the school year, the researchers explored students' understandings…

A Scale Development for 21st Century Skills of Primary School Students: A Validity and Reliability Study

ERIC Educational Resources Information Center

Boyaci, S. Dilek Belet; Atalay, Nurhan

2016-01-01

The objective of the present study is to develop a measurement tool to assess 21st Century learning and innovation skills of primary school students. Study data was collected from 632 fourth grade students in five different primary schools during 2014-2015 academic year and data obtained from 609 fourth grade students were utilized in the study.…

Wechsler Intelligence Scale for Children-Third and -Fourth Edition: Predictors of Academic Achievement in Children with Attention-Deficit/Hyperactivity Disorder

ERIC Educational Resources Information Center

Mayes, Susan Dickerson; Calhoun, Susan L.

2007-01-01

IQ and achievement scores were analyzed for 678 children with attention-deficit/hyperactivity disorder (ADHD; 6-16 years of age, IQ=80) administered the Wechsler Intelligence Scale for Children-Third Edition (WISC-III; n=586) and Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV, n=92). Approximately 76% of children in both samples…

The State of the Cities, 2000: Megaforces Shaping the Future of the Nation's Cities. Fourth Annual Report.

ERIC Educational Resources Information Center

Department of Housing and Urban Development, Washington, DC.

This report, fourth in a series, recounts the most recent data on indicators of the social and economic vitality of U.S. cities and positions the Administration's urban policy agenda to address challenges confronting cities. This year the report identifies four megaforces that are shaping the future of U.S. cities and presents findings showing…

Development of an Applied Fisheries Science Program for Native Alaskans at Sheldon Jackson College (Sitka, Alaska). Fourth Progress Report, 1 July 1976.

ERIC Educational Resources Information Center

Seifert, Mel

Covering the period January 1 through June 30, 1976, this fourth and final semi-annual report of the first two-year grant for the Applied Fishery Science Program operating at Sheldon Jackson College in Sitka, Alaska presents the following information; Background (program objectives, advisory committee, and program staff); Program Progress…

Two Distinct Episodes Of Whooping Cough Caused By Consecutive Bordetella Pertussis And Bordetella Parapertussis Infections In A Fully Immunized Healthy Boy.

PubMed

Heininger, Ulrich; Schlassa, Detlef

2016-11-01

We describe a 5-year-old, fully immunized boy with polymerase chain reaction-proven consecutive Bordetella pertussis and Bordetella parapertussis infections causing typical whooping cough at the age of 2 and 5 years, respectively. Neither pertussis immunization nor disease provides reliable immunity against further episodes of whooping cough.

Rosette-forming glioneuronal tumor of the fourth ventricle.

PubMed

Preusser, Matthias; Dietrich, Wolfgang; Czech, Thomas; Prayer, Daniela; Budka, Herbert; Hainfellner, Johannes A

2003-11-01

Rosette-forming glioneuronal tumor (RGNT) of the fourth ventricle has been reported recently as a novel type of primary CNS neoplasm. We present the case of a 35-year-old male patient with RGNT of the fourth ventricle. The tumor was found incidentally; the patient did not suffer from any neurological symptoms. The tumor mass involved the caudal cerebellar vermis, filled the fourth ventricle and protruded into the caudal part of the mesencephalic aquaeduct. Smaller tumor nodules were visible in the adjacent right cerebellar hemisphere. Histologically, prominent neurocytic rosettes with synaptophysin expression were embedded in a glial tumor component resembling pilocytic astrocytoma. Clinicopathological features of our case closely resemble those reported in the original description. Thus, our case confirms RGNT as a new distinct type of primary CNS neoplasm. Due to its distinct features, adoption of RGNT as a new entity into the WHO classification of tumors should be considered.

Reliability of psychiatric diagnosis in hospitalized adolescents. Interrater agreement using DSM-III.

PubMed

Strober, M; Green, J; Carlson, G

1981-02-01

To determine the reliability of psychiatric diagnosis in hospitalized adolescents, 95 consecutively admitted patients were diagnosed independently by two experienced clinicians using DSM-III criteria. Diagnostic judgments were based on joint interview of the patient via a structured mental-status examination, nursing observations, and referral materials. Concordance was analyzed by the kappa coefficient. A total of 13 DSM-III categories were used to classify this cohort, with the majority of categories representing traditional syndromes of functional psychopathology. There was complete agreement between the raters for more than three fourths of the patients. Levels of agreement for the categories of schizophrenia and major affective disorder were similar to values obtained in recent studies of adult patients. The results are discussed in relation to historical conceptions of adolescent psychopathology.

N-Tosylhydrazone directed annulation via C-H/N-N bond activation in Ru(ii)/PEG-400 as homogeneous recyclable catalytic system: a green synthesis of isoquinolines.

PubMed

Deshmukh, Dewal S; Bhanage, Bhalchandra M

2018-06-21

A green and sustainable methodology for the synthesis of isoquinolines using Ru(ii)/PEG-400 as a homogeneous recyclable catalytic system has been demonstrated. N-Tosylhydrazone, a rarely explored directing group, has been successfully employed for an annulation type of reaction with alkynes via C-H/N-N activation. A short reaction time with a simple extraction procedure, a wide substrate scope with high yields of products, easily prepared substrates, biodegradable solvent, and scalability up to the gram level enhance the efficiency and sustainability of the proposed protocol. Further, the expensive ruthenium-based homogeneous catalytic system could be reused up to a fourth consecutive cycle without any loss in its activity.

Applying mathematical models to predict resident physician performance and alertness on traditional and novel work schedules.

PubMed

Klerman, Elizabeth B; Beckett, Scott A; Landrigan, Christopher P

2016-09-13

In 2011 the U.S. Accreditation Council for Graduate Medical Education began limiting first year resident physicians (interns) to shifts of ≤16 consecutive hours. Controversy persists regarding the effectiveness of this policy for reducing errors and accidents while promoting education and patient care. Using a mathematical model of the effects of circadian rhythms and length of time awake on objective performance and subjective alertness, we quantitatively compared predictions for traditional intern schedules to those that limit work to ≤ 16 consecutive hours. We simulated two traditional schedules and three novel schedules using the mathematical model. The traditional schedules had extended duration work shifts (≥24 h) with overnight work shifts every second shift (including every third night, Q3) or every third shift (including every fourth night, Q4) night; the novel schedules had two different cross-cover (XC) night team schedules (XC-V1 and XC-V2) and a Rapid Cycle Rotation (RCR) schedule. Predicted objective performance and subjective alertness for each work shift were computed for each individual's schedule within a team and then combined for the team as a whole. Our primary outcome was the amount of time within a work shift during which a team's model-predicted objective performance and subjective alertness were lower than that expected after 16 or 24 h of continuous wake in an otherwise rested individual. The model predicted fewer hours with poor performance and alertness, especially during night-time work hours, for all three novel schedules than for either the traditional Q3 or Q4 schedules. Three proposed schedules that eliminate extended shifts may improve performance and alertness compared with traditional Q3 or Q4 schedules. Predicted times of worse performance and alertness were at night, which is also a time when supervision of trainees is lower. Mathematical modeling provides a quantitative comparison approach with potential to aid residency programs in schedule analysis and redesign.

The effect of illicit financial flows on time to reach the fourth Millennium Development Goal in Sub-Saharan Africa: a quantitative analysis

PubMed Central

Makuta, Innocent; Bar-Zeev, Naor; Chiwaula, Levison; Cobham, Alex

2014-01-01

Objectives This paper sets out to estimate the cost of illicit financial flows (IFF) in terms of the amount of time it could take to reach the fourth Millennium Development Goal (MDG) in 34 African countries. Design We have calculated the percentage increase in gross domestic product (GDP) if IFFs were curtailed using IFF/GDP ratios. We applied the income (GDP) elasticity of child mortality to the increase in GDP to estimate the reduction in time to reach the fourth MDG in 34 African countries. Participants children aged under five years. Settings 34 countries in SSA. Main outcome measures Reduction in time to reach the first indicator of the fourth MDG, under-five mortality rate in the absence of IFF. Results We found that in the 34 SSA countries, six countries will achieve their fourth MDG target at the current rates of decline. In the absence of IFF, 16 countries would reach their fourth MDG target by 2015 and there would be large reductions for all other countries. Conclusions This drain on development is facilitated by financial secrecy in other jurisdictions. Rich and poor countries alike must stem the haemorrhage of IFF by taking decisive steps towards improving financial transparency. PMID:24334911

Changing interactions between physician trainees and the pharmaceutical industry: a national survey.

PubMed

Austad, Kirsten E; Avorn, Jerry; Franklin, Jessica M; Kowal, Mary K; Campbell, Eric G; Kesselheim, Aaron S

2013-08-01

Increasingly, medical school policies limit pharmaceutical representatives' access to students and gifts from drugmakers, but little is known about how these policies affect student attitudes toward industry. To assess interactions between trainees and the pharmaceutical industry, and to determine whether learning environment characteristics influence students' practices and attitudes. We conducted a cross-sectional survey with a nationally-representative sample of first- and fourth-year medical students and third-year residents, stratified by medical school, including ≥ 14 randomly selected trainees at each level per school. We measured frequency of industry interactions and attitudes regarding how such interactions affect medical training and the profession. Chi-squared tests assessed bivariate linear trend, and hierarchical logistic regression models were fitted to assess associations between trainees' attitudes and their schools' National Institutes of Health (NIH) funding levels and American Medical Student Association (AMSA) PharmFree Scorecard grades reflecting industry-related conflict of interest policies. Among 1,610 student (49.3 % response rate) and 739 resident (43.1 %) respondents, industry-sponsored gifts were common, rising from 33.0 % (first-year students) to 56.8 % (fourth-year students) and 54 % (residents) (p < 0.001). These gifts included meals outside the hospital (reported by 5 % first-year students, 13.4 % fourth-year students, 27.5 % residents (p < 0.001)) and free drug samples (reported by 7.4 % first-year students, 14.1 % fourth-year students, 14.3 % residents (p < 0.001)). The perception that industry interactions lead to bias was prevalent, but the belief that physicians receive valuable education through these interactions increased (64.1 % to 67.5 % to 79.8 %, p < 0.001). Students in schools receiving more NIH funding reported industry gifts less often (OR = 0.51, 95 % CI: 0.38-0.68, p < 0.001), but the strength of institutional conflict of interest policies was not associated with this variable. Despite recent policy changes, a substantial number of trainees continue to receive gifts from pharmaceutical representatives. We found no relation between these outcomes and a school's policies concerning interactions with industry.

Development and Evaluation of a Mandatory Course in Geriatric Medicine for Fourth Year Medical Students.

PubMed

Freter, Susan; Gordon, Janet; Mallery, Laurie

2006-12-01

As the population ages, older adults will make up an increasing proportion of the practices of most physicians. Because of this, education of medical students in Geriatric Medicine is essential, yet there is considerable variability in the amount, timing within the curriculum, and content of geriatric training in Medical Schools. Our goal was to develop and evaluate an integrated, mandatory 3-week geriatric medicine course for fourth year medical students with emphasis on knowledge acquisition. All fourth year medical students at Dalhousie Medical School underwent 2 ½ days of didactic teaching on core geriatric topics and a 2-week clinical rotation. Pre-rotation knowledge testing occurred on the first day of the rotation. On the final examination, students were retested on the 15 pre-rotation questions, as well as 5 additional questions that they had not encountered previously. There was a statistically significant improvement in examination performance from 46.9% on the pretest to 78.6% on the final examination (t=24.7, p˂.001). It is unlikely that the significant improvement in scores is simply a result of repeat testing, as students tended to score better on the five additional questions that they had not seen before. We developed a geriatric medicine course for fourth year medical students, in one integrated 3-week block, using a combination of didactic teaching and clinical encounters. We used students as their own controls, using the same questions pre- and post-rotation, and demonstrated significant knowledge acquisition on a variety of topics pertaining to geriatric medicine and care of the older patient. Future research should address the issue of translating acquired knowledge in geriatric medicine into demonstrated clinical skills when caring for the elderly.

Epidemiological evaluations of the efficacy of slow-released praziquantel-medicated bars for dogs in the prevention and control of cystic echinococcosis in man and animals.

PubMed

Wei, Jiao; Cheng, Fu; Qun, Qu; Nurbek; Xu, Shi-Dong; Sun, Li-Feng; Han, Xin-Kui; Muhan; Han, Ling-Ling; Irixiati; Jie, Peng; Zhang, Ke-Jiu; Islayin; Chai, Jun-jie

2005-12-01

To assess the epidemiological efficacy of type SRP III slow-released praziquantel-medicated bars for dogs in the prevention and control of cystic echinococcosis in man and livestock, praziquantel-medicated bars were implanted subcutaneously in over 90% of dogs in villages in north Xinjiang, China, where cystic echinococcosis is highly endemic. After implantation, infection rate of Echinococcus granulosus in dogs, specific antibodies in children and prevalence of echinococcosis in one-year-old lambs were observed for 3 years. Coproantigen of E. granulosus was positive in 41.2% of the dogs at the start of experiment. In the second and third year after medicated-bar implantation, coproantigen was undetectable in any dogs examined, while 3.0% of dogs were positive at the end of the fourth year. The antibody positive rate in 7-year-old pupils, that was 41.2% before the experiment, declined gradually and it was 5.4% in the fourth year, while children in the non-intervention control area showed 30.6% seropositivity. The prevalence of hydatid disease in children aged 7-16 years also declined significantly. The prevalence of hydatidosis in lambs one year of age was 44.8% in the first year, dropping to 10.7% in the fourth year, while in the non-intervention control area the level of infection was 46.4%. These results demonstrated not only that the slow released praziquantel-medicated bars efficiently blocked reinfection in dogs at least for 2 years, but also the measure was effective in preventing transmission of cystic echinococcosis to both man and livestock.

Test Review: Abidin, R. R. (2012) "Parenting Stress Index, Fourth Edition" ("PSI-4"). Lutz, Florida: Psychological Assessment Resources

ERIC Educational Resources Information Center

Johnson, Alyce O.

2015-01-01

The "Parenting Stress Index, Fourth Edition" (PSI-4) is a 120-item measure used to explore parental stress levels considering a parent's relationship with one of his or her children between the ages of 1 month and 12 years. The main purpose of the test is to define these stress levels and from where they originate in order to identify…

The Monitoring and Responding Behaviours of Proficient Fourth Grade Readers to Miscues on a Complex Scientific Text

ERIC Educational Resources Information Center

Kucer, Stephen B.

2017-01-01

The monitoring of meaning and the correction of miscues that fail to make sense are a hallmark of a proficient reader. Much of the research, however, has focused on the reading of fictional, narrative texts. In contrast, this research examines the monitoring and response behaviours of 35 proficient fourth grade readers (nine and 10 years of age)…

Math Scores Add Up for Hispanic Students: States and School Districts Notable for Recent Gains by Hispanic Students in Mathematics. Publication#2014-59

ERIC Educational Resources Information Center

Pane, Natalia E.

2014-01-01

This report shows significant gains in math achievement by Hispanic fourth- and eighth-graders across the nation--the equivalent of one grade level in the last ten years (2003-3013). Using data from the National Assessment of Educational Progress, Child Trends reviewed and compared fourth and eighth grade math scores in the nation, states, large…

[Longitudinal perception of the educational environment in two medical schools with traditional curricula in Chile and Spain].

PubMed

Díaz-Véliz, Gabriela; Mora G, Sergio; Escanero, Jesús F

2016-11-01

To establish an educational environment that ensures the quality of the teaching-learning process is a challenge for any educational institution. The questionnaire DREEM (Dundee Ready Educational Environment Measure) is used to identify strengths and weaknesses of an educational environment and to compare different medical schools. To evaluate the changes in the perception of educational environment by students of the Schools of Medicine of the University of Zaragoza, UZar (Spain) and the University of Chile, UCh (Chile) at two points in their curricula. DREEM questionnaire was answered by 90 students from the UZar and 87 students of the UCh, when they were in the first year (2009) and in the fourth year of their career (2012). At both universities the overall mean scores of DREAM were significantly higher in students in their first year than those obtained in the fourth year (137.5/118.3 for UZar and 128.6/118.8 for UCh). Items with worse perception in the fourth year were observed in subscales Learning Perception and Atmosphere Perception. Items with good evaluation (≥ 3.0) were the subscales Perception of teachers, academic self-perception, perception of Environment and Social Self-perception. The perception of Chilean and Spanish students about their educational environments indicates that the stage of their medical training is more important than the geographical context or educational institution.

Burnout Syndrome During Residency.

PubMed

Turgut, Namigar; Karacalar, Serap; Polat, Cengiz; Kıran, Özlem; Gültop, Fethi; Kalyon, Seray Türkmen; Sinoğlu, Betül; Zincirci, Mehmet; Kaya, Ender

2016-10-01

The aim of this study is identified the degree of Burnout Syndrome (BOS) and find out its correlation with years of recidency and sociodemograpfic chareacteristics, training, sleeping habits, such as smoking and alcohol consumption. After approval from the Hospital Ethics Committee and obtaining informed consent, First, second, third, fourth and fifth year of recidency staff (n=127) working in our hospital were involved in this study. The standardized Maslach Burnout Inventory (MBI) was used in this study. Fifty six male (44.1%) and seventy one female (55.9%) residents were enroled in this study (Coranbach Alfa(α)=0.873). 57% of the first year residents smokes cigaret and 54% of them use alcohol. 2% of them gets one day off after hospital night shift, 61% of them suffers from disturbed sleep. 60% of them had been stated that they willingly selected their profession. 61% of them prefers talking to friends and 32% of them prefers shopping to overcome stress. There were statistical difference acording to years of recidency in MBI, Emotional Burnout (EB) and desensitisation scale (DS) points. EB scale points of the second year of residency group was statisticaly higher than fourth year of residency group. DS points of second year of residency group was also statisticaly higher than the third and fourth year of residency group. There was no statistical difference between any groups in Personal Success. BOS is a frequent problem during residency in anaesthesia. Appropriate definition and awareness are the first important steps to prevent this syndrome. Further administrative approaches should be evaluated with regard to their effects.

Trigeminal neuralgia due to Dandy-Walker syndrome.

PubMed

Zhang, Wenhao; Chen, Minjie; Zhang, Weijie

2013-07-01

Trigeminal neuralgia (TN) is a common pain in the orofacial region. Dandy-Walker syndrome (DWS) is a congenital malformation of the cerebellar and the fourth ventricle foramina atresia. Dandy-Walker syndrome is rarely found in patients with TN. This article presents a 36-year-old man with the symptoms of typical TN. His physical examination was entirely normal. An enhanced magnetic resonance imaging was taken. Magnetic resonance imaging revealed the bilateral lateral ventricle, the fourth and third ventricle significantly enlarged with severe obstructive hydrocephalus, a huge posterior fossa cyst connected with the fourth ventricle, and hypoplastic vermis. The pain was controlled by Tegretol. The reported case suggests that DWS is an unusual cause of TN.

Peripheral blood stem cell collection for allogeneic hematopoietic stem cell transplantation: Practical implications after 200 consequent transplants.

PubMed

Goren Sahin, Deniz; Arat, Mutlu

2017-12-01

Proper stem cell mobilization is one of the most important steps in hematopoietic stem cell transplantation (HSCT). The aim of this paper is to share our 6 years' experience and provide practical clinical approaches particularly for stem cell mobilization and collection within the series of more than 200 successive allogeneic HSCT at our transplant center. Two hundred and seven consecutive patients who underwent allogeneic peripheral blood stem cell transplantation were included in this study. Age, sex, weight, complete blood counts, CD34 + cell counts, total collected amount of CD34 + cells, CD34 + cells per 10l processed, mobilization failure and adverse events were reviewed. Median age was 40.2±12.9 (21-68) years and 46.4±13.4 (17-67) years for donors and patients, respectively. The number of donors who had undergone adequate CD34 + cell harvesting and completed the procedure on the fourth day was 67 (32.8% of all patients). Only 12 patients required cell apheresis both on day 5 and 6. Apheresis was completed on day 4 and/or day 5 in 94.2% of all our donors. There was no significant association between CD34 + stem cell volume and age, gender and weight values of donors. Mobilization failure was not seen in our series. G-CSF is highly effective in 1/3 of the donors on the 4th day in order to collect enough number of stem cells. We propose that peripheral stem cell collection might start on day 4th of G-CSF treatment for avoiding G-CSF related side effects and complications. Copyright © 2017 Elsevier Ltd. All rights reserved.

Medical students' health behaviour and self-reported mental health status by their country of origin: a cross-sectional study.

PubMed

Terebessy, András; Czeglédi, Edit; Balla, Bettina Claudia; Horváth, Ferenc; Balázs, Péter

2016-05-28

Numerous previous studies have investigated the lifestyle and self-perceived health status of medical students. This study examined whether students' country of origin contributed to their mental health and health risk behaviour. We conducted our cross-sectional questionnaire survey over four consecutive years (2009-2012). The target population was fourth-year English- and Hungarian-language course medical students at Semmelweis University, Hungary. We gathered data on medical students' health behaviour (tobacco smoking, alcohol consumption, dietary habits and exercise) and mental health status and used analysis of variance (ANOVA) to examine the association between country of origin and mental health. The response rate was 76.1 % for the Hungarian and 63.4 % for the English course students. The mean age of our sample was 24.1 years (SD = 2.42). Only 15.3 % of students reported following dietary recommendations, but 75.0 % reported engaging in vigorous and regular physical exercise. The prevalence of tobacco smoking was 18.6 % and 13.8 % overconsumed alcoholic beverages. Hungarian and Iranian students reported lower mental well-being than Mediterranean, Israeli and Scandinavian students (F(4) = 18.943, p < 0.001, η(2) = 0.103). Results of the multiway ANOVA indicated that both country of origin and exercise showed a significant relationship with mental health: vigorous exercise was associated with better mental health status (F(1) = 5.505, p = 0.019). Medical students' mental health and health behaviour are associated with multiple factors. One of these is country of origin but exercise may also influence mental health. Health promotion programmes organised for medical students should take their country of origin into consideration and should include physical activity.

High Prevalence of Hypertension in a Danish Population Telemedical Home Measurement of Blood Pressure in Citizens Aged 55–64 Years in Holstebro County

PubMed Central

Lauritzen, Torsten; Bech, Jesper Nørgaard; Pedersen, Erling Bjerregaard

2016-01-01

BACKGROUND Home blood pressure (HBP) is prognostically superior to office BP (OBP) and similar to ambulatory BP measurements. We determined the prevalence of hypertension using HBP with telemedical data transmission in the municipality of Holstebro, Denmark (57,000 citizens). METHODS Using the Civil Registration System, we invited citizens aged 55–64 years to have their OBP and HBP measured using telemedical data transmission. Elevated OBP was defined as ≥140/90mm Hg. HBP was measured 3 times daily on 3 consecutive days with 3 measurements on each occasion. HBP was the mean of all measurements on day 1 and 3, and hypertension was defined as ≥135/85mm Hg. RESULTS We included 3,102 citizens who had performed at least 12 HBP measurements during day 2 and 3. Group 1: (n = 1,464, 47%) had both normal OBP and HBP. Group 2: (n = 838, 27%) had both elevated OBP and HBP indicating persistent hypertension. Group 3: (n = 560, 18%) had elevated OBP and normal HBP indicating white coat hypertension (WCH). Group 4: (n = 240, 8%) had normal OBP and elevated HBP indicating masked hypertension (MH). Thus, 1,078 (35%, groups 2 and 4) were untreated or insufficiently treated. Awareness of hypertension was registered in 950 patients (31%) and of these 49% had a normal HBP. CONCLUSIONS This is the first large-scale study to eliminate completely reporting bias by using telemedical transmission of BP data. One third of citizens in the age group 55–64 years had an abnormally high HBP, and one fourth either had WCH or MH. CLINICAL TRIALS REGISTRATION ClinicalTrials.gov identification number: NCT02355392 PMID:26208671

High Prevalence of Hypertension in a Danish Population Telemedical Home Measurement of Blood Pressure in Citizens Aged 55-64 Years in Holstebro County.

PubMed

Hoffmann-Petersen, Nikolai; Lauritzen, Torsten; Bech, Jesper Nørgaard; Pedersen, Erling Bjerregaard

2016-04-01

Home blood pressure (HBP) is prognostically superior to office BP (OBP) and similar to ambulatory BP measurements. We determined the prevalence of hypertension using HBP with telemedical data transmission in the municipality of Holstebro, Denmark (57,000 citizens). Using the Civil Registration System, we invited citizens aged 55-64 years to have their OBP and HBP measured using telemedical data transmission. Elevated OBP was defined as ≥140/90mm Hg. HBP was measured 3 times daily on 3 consecutive days with 3 measurements on each occasion. HBP was the mean of all measurements on day 1 and 3, and hypertension was defined as ≥135/85mm Hg. We included 3,102 citizens who had performed at least 12 HBP measurements during day 2 and 3. Group 1: (n = 1,464, 47%) had both normal OBP and HBP. Group 2: (n = 838, 27%) had both elevated OBP and HBP indicating persistent hypertension. Group 3: (n = 560, 18%) had elevated OBP and normal HBP indicating white coat hypertension (WCH). Group 4: (n = 240, 8%) had normal OBP and elevated HBP indicating masked hypertension (MH). Thus, 1,078 (35%, groups 2 and 4) were untreated or insufficiently treated. Awareness of hypertension was registered in 950 patients (31%) and of these 49% had a normal HBP. This is the first large-scale study to eliminate completely reporting bias by using telemedical transmission of BP data. One third of citizens in the age group 55-64 years had an abnormally high HBP, and one fourth either had WCH or MH. ClinicalTrials.gov identification number: NCT02355392. © American Journal of Hypertension, Ltd 2015. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Case series: Endoscopic management of fourth branchial arch anomalies.

PubMed

Watson, G J; Nichani, J R; Rothera, M P; Bruce, I A

2013-05-01

Fourth branchial arch anomalies represent <1% of all branchial anomalies and present as recurrent neck infections or suppurative thyroiditis. Traditionally, management has consisted of treatment of the acute infection followed by hemithyroidectomy, surgical excision of the tract and obliteration of the opening in the pyriform fossa. Recently, it has been suggested that endoscopic obliteration of the sinus tract alone using laser, chemo or electrocautery is a viable alternative to open surgery. To determine the results of endoscopic obliteration of fourth branchial arch fistulae in children in our institute. Retrospective case note review of all children undergoing endoscopic treatment of fourth branchial arch anomalies in the last 7 years at the Royal Manchester Children's Hospital. Patient demographics, presenting symptoms, investigations and surgical technique were analysed. The primary and secondary outcome measures were resolution of recurrent infections and incidence of surgical complications, respectively. In total 5 cases were identified (4 females and 1 male) aged between 3 and 12 years. All presented with recurrent left sided neck abscesses. All children underwent a diagnostic laryngo-tracheo-bronchoscopy which identified a sinus in the apex of the left pyriform fossa. This was obliterated using electrocautery in 1 patient, CO₂ laser/Silver Nitrate chemocautery in 2 patients and Silver Nitrate chemocautery in a further 2 patients. There were no complications and no recurrences over a mean follow-up period of 25 months (range 11-41 months). Endoscopic obliteration of pyriform fossa sinus is a safe method for treating fourth branchial arch anomalies with no recurrence. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Child Characteristics, Parent Education and Depressive Symptoms, and Marital Conflict Predicting Trajectories of Parenting Behavior from Childhood Through Early Adolescence in Taiwan.

PubMed

Hsieh, Yi-Ping; Dopkins Stright, Anne; Yen, Lee-Lan

2017-09-01

The study examined how child and parent characteristics, and contextual sources of stress, such as marital conflict predict initial status and trajectories of parent involvement, support, and harsh control, over a 4-year period in families in Taiwan (n = 4,754). Based on Belsky's (1984) ecological model of parenting, three domains predicting parenting were tested, child characteristics (age cohort and gender), father and mother characteristics (education and depressive symptoms), and contextual sources of stress (marital conflict). The study followed two cohorts of children; the younger cohort was followed from first to fourth grade and the older cohort from fourth to seventh grade. Initially, fourth graders reported more parental involvement, support, and harsh control than first graders. However, involvement, support, and harsh control decreased across the 4 years for the older cohort as they transitioned to early adolescence. In the first year, girls reported more parental involvement and support and less harsh control than boys. Across the 4 years, involvement and support increased, and harsh control decreased for boys; whereas involvement stayed the same, support slightly decreased, and harsh control slightly increased for girls. Children whose parents were more educated reported more parent involvement, support, and harsh control in the first year. Children whose fathers were chronically depressed and whose parents were experiencing marital conflict reported decreasing parent involvement and support over the years. © 2016 Family Process Institute.

Fourth United States Microgravity Payload: One Year Report

NASA Technical Reports Server (NTRS)

Ethridge, Edwin C. (Compiler); Curreri, Peter A. (Compiler); McCauley, D. E. (Compiler)

1999-01-01

This document reports the one year science results for the Fourth United States Microgravity Payload (USMP-4). The USMP-4 major experiments were on a support structure in the Space Shuttle's payload bay and operated almost completely by the Principal Investigators through telescience. The mission included a Glovebox where the crew performed additional experiments for the investigators. Together about eight major scientific experiments were performed, advancing the state of knowledge in fields such as low temperature physics, solidification, and combustion. The results demonstrate the range of quality science that can be conducted utilizing orbital laboratories in microgravity and provide a look forward to a highly productive Space Station era.

Brachymetatarsia of the Fourth Metatarsal, Lengthening Scarf Osteotomy with Bone Graft

PubMed Central

Desai, Ankit; Lidder, Surjit; R. Armitage, Andrew; S. Rajaratnam, Samuel; D. Skyrme, Andrew

2013-01-01

A 16-year-old girl presented with left fourth metatarsal shortening causing significant psychological distress. She underwent lengthening scarf osteotomy held with an Omnitech® screw (Biotech International, France) with the addition of two 1 cm cancellous cubes (RTI Biologics, United States). A lengthening zplasty of the extensor tendons and skin were also performed. At 6 weeks the patient was fully weight bearing and at one-year follow up, the patient was satisfied and discharged. A modified technique of lengthening scarf osteotomy is described for congenital brachymatatarsia. This technique allows one stage lengthening through a single incision with graft incorporation by 6 weeks. PMID:24191181

Brachymetatarsia of the fourth metatarsal, lengthening scarf osteotomy with bone graft.

PubMed

Desai, Ankit; Lidder, Surjit; R Armitage, Andrew; S Rajaratnam, Samuel; D Skyrme, Andrew

2013-01-01

A 16-year-old girl presented with left fourth metatarsal shortening causing significant psychological distress. She underwent lengthening scarf osteotomy held with an Omnitech(®) screw (Biotech International, France) with the addition of two 1 cm cancellous cubes (RTI Biologics, United States). A lengthening zplasty of the extensor tendons and skin were also performed. At 6 weeks the patient was fully weight bearing and at one-year follow up, the patient was satisfied and discharged. A modified technique of lengthening scarf osteotomy is described for congenital brachymatatarsia. This technique allows one stage lengthening through a single incision with graft incorporation by 6 weeks.

USE OF A NOVEL BOARD GAME IN A CLINICAL ROTATION FOR LEARNING THORACIC DIFFERENTIAL DIAGNOSES IN VETERINARY MEDICAL IMAGING.

PubMed

Ober, Christopher P

2017-03-01

When confronted with various findings on thoracic radiographs, fourth-year veterinary students often have difficulty generating appropriate lists of differential diagnoses. The purpose of this one-group, pretest, posttest experimental study was to determine if a game could be used as an adjunct teaching method to improve students' understanding of connections between imaging findings and differential diagnoses. A novel board game focusing on differential diagnoses in thoracic radiography was developed. One hundred fourth-year veterinary students took a brief pretest, played the board game, and took a brief posttest as a part of their respective clinical radiology rotations. Pretest results were compared to posttest results using a paired t-test to determine if playing the game impacted student understanding. Students' mean scores on the posttest were significantly higher than mean pretest scores (P < 0.0001). Thus, results indicate that playing the board game resulted in improved short-term understanding of thoracic differential diagnoses by fourth-year students, and use of the board game on a clinical rotation seems to be a beneficial part of the learning process. © 2016 American College of Veterinary Radiology.

Racial Differences in Communication Apprehension and Interprofessional Socialization in Fourth-Year Doctor of Pharmacy Students

PubMed Central

Karpinski, Aryn C.

2016-01-01

Objective. To examine racial differences in communication apprehension and interprofessional socialization in fourth-year PharmD students and to investigate the relationship between the two constructs. Methods. Two measures with reliability and validity psychometric evidence were administered to fourth-year pharmacy students at a single historically black university with a large racial minority population. The Personal Report of Communication Apprehension (PRCA-24) measures level of fear or anxiety associated with communication. The Interprofessional Socialization and Valuing Scale (ISVS) measures beliefs, attitudes, and behaviors towards interprofessional collaborative practice. Results. One hundred fourteen students completed the survey. This produced a 77.4% response rate and 45.6% of the participants were African American. There were significant differences between races (ie, White, African-American, and Asian) on both measures. The PCRA-24 and ISVS were significantly correlated in each racial group. Conclusion. As pharmacy education moves to more interprofessional collaborations, the racial differences need to be considered and further explored. Pharmacy curricula can be structured to promote students’ comfort when communicating interprofessionally across racial groups. Understanding of culture and early education in cultural competence may need to be emphasized to navigate racial or cultural differences. PMID:26941434

Assessment of knowledge about childhood autism among medical students from private and public universities in Karachi.

PubMed

Shaukat, Farah; Fatima, Ambreen; Zehra, Nosheen; Hussein, Mohammed Amirali Ghulam; Ismail, Ozair

2014-11-01

To assess the knowledge about childhood autism among fourth year medical students in public and private medical universities of a metropolitan city. The cross-sectional descriptive study was conducted in Karachi from January to August 2012. Two medical universities--one each from public and private sectors--were selected using non-probability convenience sampling technique. Fourth year medical students present at the time of data collection were included in the study. Data collection was done by Knowledge About Childhood Autism Among Health Worker questionnaire from fourth year medical students. Data was analysed using SPSS 20. Of the 157 students in the study, 62(39.6%) were males and 95(60.4%) were females; 84(43.5%) were from public medical university and 73(46.5%) were from private university. Total mean score obtained out of the maximum 25 was 12.30±4.71. The mean score obtained by public medical students was 12.40±4.69 and 12.1±4.76 by those of private university. The scores reflected shortcoming in knowledge about childhood autism among the study population. In order to bridge knowledge deficit, awareness-generation activities must be held more frequently.

The Effects of Spacing, Naps, and Fatigue on the Acquisition and Retention of Laparoscopic Skills.

PubMed

Spruit, Edward N; Band, Guido P H; van der Heijden, Kristiaan B; Hamming, Jaap F

Earlier research has shown that laparoscopic skills are trained more efficiently on a spaced schedule compared to a massed schedule. The aim of the study was to estimate to what extent the spacing interval, naps, and fatigue influenced the effectiveness of spacing laparoscopy training. Overall 4 groups of trainees (aged 17-41y; 72% female; N massed = 40; N break = 35; N break-nap = 37; N spaced = 37) without prior experience were trained in 3 laparoscopic tasks using a physical box trainer with different scheduling interventions. The first (massed) group received three 100-minute training sessions consecutively on a single day. The second (break) group received the sessions interrupted with two 45-minute breaks. The third (break-nap) group had the same schedule as the second group, but had two 35-minute powernap intervals during the breaks. The fourth (spaced) group had the 3 sessions on 3 consecutive days. A retention session was organized approximately 3 months after training. The results showed an overall pattern of superior performance at the end of training and at retention for the spaced group, followed by the break-nap, break, and massed group, respectively. The spaced and break-nap group significantly outperformed the break and massed group, with effect sizes ranging from 0.20 to 0.37. Spacing laparoscopic training over 3 consecutive days or weeks is superior to massed training, even if the massed training contains breaks. Breaks with sleep opportunity (i.e., lying, inactive, and muted sensory input) enhance performance over training with regular breaks and traditional massed training. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

The Relationship between Students' Performance on the Cognitive Abilities Test (CogAT) and the Fourth and Fifth Grade Reading and Math Achievement Tests in Ohio

ERIC Educational Resources Information Center

Warnimont, Chad S.

2010-01-01

The purpose of this quantitative study was to examine the relationship between students' performance on the Cognitive Abilities Test (CogAT) and the fourth and fifth grade Reading and Math Achievement Tests in Ohio. The sample utilized students from a suburban school district in Northwest Ohio. Third grade CogAT scores (2006-2007 school year), 4th…

Applied Meteorology Unit (AMU) Quarterly Report Fourth Quarter FY-04

NASA Technical Reports Server (NTRS)

Bauman, William; Wheeler, Mark; Lambert, Winifred; Case, Jonathan; Short, David

2004-01-01

This report summarizes the Applied Meteorology Unit (A MU) activities for the fourth quarter of Fiscal Year 2004 (July -Sept 2004). Tasks covered are: (1) Objective Lightning Probability Forecast: Phase I, (2) Severe Weather Forecast Decision Aid, (3) Hail Index, (4) Shuttle Ascent Camera Cloud Obstruction Forecast, (5) Advanced Regional Prediction System (ARPS) Optimization and Training Extension and (5) User Control Interface for ARPS Data Analysis System (ADAS) Data Ingest.

Rural Development: Part 1. Information and Technical Assistance Delivered by the Department of Agriculture in Fiscal Year 1973. Fourth Annual Report to the Congress.

ERIC Educational Resources Information Center

Department of Agriculture, Washington, DC.

As part 1 of a four part report to the U.S. Congress pursuant to Title IX, Section 901 of the Agricultural Act of 1970, this fourth annual report is limited to rural development activities of the U.S. Department of Agriculture (USDA) delivery system (the USDA National Rural Development Committee, State Rural Development Committee, and county…

[Evidence-based practice competence in undergraduate Nursing Degree students].

PubMed

Ruzafa-Martínez, María; Molina-Salas, Yolanda; Ramos-Morcillo, Antonio Jesús

2016-01-01

Evidence-based practice (EBP) learning has become a key issue for nurses. An EPB subject was included in the 4(th) year in the new syllabus of the Nursing Degree at University of Murcia (UM). To know the competence level in EBP of undergraduate nursing students at UM and compare the results between all four years. Observational descriptive study with a cross-sectional approach. undergraduate nursing students from all four years at Nursing Degree at the Faculty of Social and Healthcare Science at UM in the year 2013-14. EBP evaluation of competence of the nursing students consisted of attitude, skills and knowledge on EBP. A validated questionnaire, the EBP-COQ, was used. The scale range is 1 point «lowest level» to 5 points «higher level».The SPSS 21.0 program has been used to carry out descriptive and bivariate analyses. 144 students were included, 76.4% was female, and the median age was 23 years, 84.7% attended more than 75% class hours. The mean differences in the questionnaire between first and fourth years were 0.58 points in attitude, 0.60 in skills, 1.6 in knowledge and 0.83 in global competence in EBP. Significant differences in mean scores between the fourth and the remaining years in the global competence in EBP were observed, as well as in the three dimensions (p <0.05). The undergraduate-nursing students studied here have acquired an appropriate competence level in EBP, with a gradual increase by year. The biggest increase was in the fourth year students. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

Back to the basic sciences: an innovative approach to teaching senior medical students how best to integrate basic science and clinical medicine.

PubMed

Spencer, Abby L; Brosenitsch, Teresa; Levine, Arthur S; Kanter, Steven L

2008-07-01

Abraham Flexner persuaded the medical establishment of his time that teaching the sciences, from basic to clinical, should be a critical component of the medical student curriculum, thus giving rise to the "preclinical curriculum." However, students' retention of basic science material after the preclinical years is generally poor. The authors believe that revisiting the basic sciences in the fourth year can enhance understanding of clinical medicine and further students' understanding of how the two fields integrate. With this in mind, a return to the basic sciences during the fourth year of medical school may be highly beneficial. The purpose of this article is to (1) discuss efforts to integrate basic science into the clinical years of medical student education throughout the United States and Canada, and (2) describe the highly developed fourth-year basic science integration program at the University of Pittsburgh School of Medicine. In their critical review of medical school curricula of 126 U.S. and 17 Canadian medical schools, the authors found that only 19% of U.S. medical schools and 24% of Canadian medical schools require basic science courses or experiences during the clinical years, a minor increase compared with 1985. Curricular methods ranged from simple lectures to integrated case studies with hands-on laboratory experience. The authors hope to advance the national discussion about the need to more fully integrate basic science teaching throughout all four years of the medical student curriculum by placing a curricular innovation in the context of similar efforts by other U.S. and Canadian medical schools.

Long-term anal incontinence after obstetric anal sphincter injury-does grade of tear matter?

PubMed

Jangö, Hanna; Langhoff-Roos, Jens; Rosthøj, Susanne; Saske, Abelone

2018-02-01

Anal incontinence is a major concern following delivery with obstetric anal sphincter injury (OASIS), and has been related to the degree of sphincter tear. The aims of this study were (1) to evaluate whether women with a fourth-degree OASIS in the first delivery have an increased risk of long-term anal and fecal incontinence after a second delivery, and (2) to assess the impact of mode of second delivery on anal incontinence and related symptoms in these patients. We performed secondary analyses of a national questionnaire study in all Danish women with an OASIS in their first delivery and 1 subsequent delivery, both deliveries in 1997 to 2005. The questionnaires were sent a minimum of 5 years since the second delivery. In Denmark, women with anal incontinence after a delivery with OASIS are recommended elective cesarean deliveries in subsequent pregnancies. We performed uni- and multivariable logistic regression analyses to evaluate the outcomes. In total, 2008 patients had an OASIS, of whom 12.2% (n = 245) had a fourth-degree tear in the first delivery. The median follow-up time since the first delivery with OASIS was 11.6 years (IQR, 10.2-13.2 years) and since the second delivery 8.5 years (IQR, 7.1-10.1 years). Women with a fourth-degree sphincter injury in the first delivery were at higher risk for anal incontinence (58.8%, n = 144) as well as fecal incontinence (30.6%, n = 75) than patients with a third-degree injury in the first delivery (41.0%, n = 723, and 14.6%, n = 258, respectively). The differences between groups persisted after adjustment for important maternal, fetal, and obstetric characteristics (adjusted odds ratio [aOR], 2.14; 95% confidence interval [CI], 1.52-3.02; P < 0.001 for anal incontinence; and aOR, 2.49; 95% CI, 1.73-3.56; P < 0.001 for fecal incontinence). In subgroup analyses of patients with fourth-degree anal sphincter injury in the first delivery, the mode of second delivery was not associated with the risk of anal incontinence (aOR, 0.97; 95% CI, 0.41-1.84; P = 0.71) or fecal incontinence (aOR, 1.28; 95% CI, 0.65-2.52; P = 0.48). The effect of the mode of the second delivery did not differ between women with a fourth-degree OASIS and those with a third-degree injury with regard to both anal (P = 0.09) and fecal (P = 0.96) incontinence. After a second delivery, women with a fourth-degree OASIS in the first delivery have a higher risk of long-term anal and fecal incontinence than women with a third-degree sphincter injury. Adjusted odds of long-term anal and fecal incontinence did not differ significantly by mode of second delivery. Women with a fourth-degree OASIS should be informed about the increased risk of long-term anal incontinence and advised that subsequent elective cesarean delivery is not protective. Copyright © 2017 Elsevier Inc. All rights reserved.

Structure of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Criteria for Obsessive–Compulsive Personality Disorder in Patients With Binge Eating Disorder

PubMed Central

Ansell, Emily B; Pinto, Anthony; Edelen, Maria Orlando; Grilo, Carlos M

2013-01-01

Objective To examine 1-, 2-, and 3-factor model structures through confirmatory analytic procedures for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) obsessive–compulsive personality disorder (OCPD) criteria in patients with binge eating disorder (BED). Method Participants were consecutive outpatients (n = 263) with binge eating disorder and were assessed with semi-structured interviews. The 8 OCPD criteria were submitted to confirmatory factor analyses in Mplus Version 4.2 (Los Angeles, CA) in which previously identified factor models of OCPD were compared for fit, theoretical relevance, and parsimony. Nested models were compared for significant improvements in model fit. Results Evaluation of indices of fit in combination with theoretical considerations suggest a multifactorial model is a significant improvement in fit over the current DSM-IV single-factor model of OCPD. Though the data support both 2- and 3-factor models, the 3-factor model is hindered by an underspecified third factor. Conclusion A multifactorial model of OCPD incorporating the factors perfectionism and rigidity represents the best compromise of fit and theory in modelling the structure of OCPD in patients with BED. A third factor representing miserliness may be relevant in BED populations but needs further development. The perfectionism and rigidity factors may represent distinct intrapersonal and interpersonal attempts at control and may have implications for the assessment of OCPD. PMID:19087485

Structure of diagnostic and statistical manual of mental disorders, fourth edition criteria for obsessive-compulsive personality disorder in patients with binge eating disorder.

PubMed

Ansell, Emily B; Pinto, Anthony; Edelen, Maria Orlando; Grilo, Carlos M

2008-12-01

To examine 1-, 2-, and 3-factor model structures through confirmatory analytic procedures for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) obsessive-compulsive personality disorder (OCPD) criteria in patients with binge eating disorder (BED). Participants were consecutive outpatients (n = 263) with binge eating disorder and were assessed with semi-structured interviews. The 8 OCPD criteria were submitted to confirmatory factor analyses in Mplus Version 4.2 (Los Angeles, CA) in which previously identified factor models of OCPD were compared for fit, theoretical relevance, and parsimony. Nested models were compared for significant improvements in model fit. Evaluation of indices of fit in combination with theoretical considerations suggest a multifactorial model is a significant improvement in fit over the current DSM-IV single- factor model of OCPD. Though the data support both 2- and 3-factor models, the 3-factor model is hindered by an underspecified third factor. A multifactorial model of OCPD incorporating the factors perfectionism and rigidity represents the best compromise of fit and theory in modelling the structure of OCPD in patients with BED. A third factor representing miserliness may be relevant in BED populations but needs further development. The perfectionism and rigidity factors may represent distinct intrapersonal and interpersonal attempts at control and may have implications for the assessment of OCPD.

Concurrent validity of persian version of wechsler intelligence scale for children - fourth edition and cognitive assessment system in patients with learning disorder.

PubMed

Rostami, Reza; Sadeghi, Vahid; Zarei, Jamileh; Haddadi, Parvaneh; Mohazzab-Torabi, Saman; Salamati, Payman

2013-04-01

The aim of this study was to compare the Persian version of the wechsler intelligence scale for children - fourth edition (WISC-IV) and cognitive assessment system (CAS) tests, to determine the correlation between their scales and to evaluate the probable concurrent validity of these tests in patients with learning disorders. One-hundered-sixty-two children with learning disorder who were presented at Atieh Comprehensive Psychiatry Center were selected in a consecutive non-randomized order. All of the patients were assessed based on WISC-IV and CAS scores questionnaires. Pearson correlation coefficient was used to analyze the correlation between the data and to assess the concurrent validity of the two tests. Linear regression was used for statistical modeling. The type one error was considered 5% in maximum. There was a strong correlation between total score of WISC-IV test and total score of CAS test in the patients (r=0.75, P<0.001). The correlations among the other scales were mostly high and all of them were statistically significant (P<0.001). A linear regression model was obtained (α = 0.51, β = 0.81 and P<0.001). There is an acceptable correlation between the WISC-IV scales and CAS test in children with learning disorders. A concurrent validity is established between the two tests and their scales.

Concurrent Validity of Persian Version of Wechsler Intelligence Scale for Children - Fourth Edition and Cognitive Assessment System in Patients with Learning Disorder

PubMed Central

Rostami, Reza; Sadeghi, Vahid; Zarei, Jamileh; Haddadi, Parvaneh; Mohazzab-Torabi, Saman; Salamati, Payman

2013-01-01

Objective The aim of this study was to compare the Persian version of the wechsler intelligence scale for children - fourth edition (WISC-IV) and cognitive assessment system (CAS) tests, to determine the correlation between their scales and to evaluate the probable concurrent validity of these tests in patients with learning disorders. Methods One-hundered-sixty-two children with learning disorder who were presented at Atieh Comprehensive Psychiatry Center were selected in a consecutive non-randomized order. All of the patients were assessed based on WISC-IV and CAS scores questionnaires. Pearson correlation coefficient was used to analyze the correlation between the data and to assess the concurrent validity of the two tests. Linear regression was used for statistical modeling. The type one error was considered 5% in maximum. Findings There was a strong correlation between total score of WISC-IV test and total score of CAS test in the patients (r=0.75, P<0.001). The correlations among the other scales were mostly high and all of them were statistically significant (P<0.001). A linear regression model was obtained (α = 0.51, β = 0.81 and P<0.001). Conclusion There is an acceptable correlation between the WISC-IV scales and CAS test in children with learning disorders. A concurrent validity is established between the two tests and their scales. PMID:23724180

Children's Understanding of Lies in Elementary School Years.

PubMed

Hayashi, Hajimu

2017-01-01

The author examined whether children's understanding of lies exhibits developmental trends in the elementary school years. Four story contexts were presented to 51 first-grade students, 44 fourth-grade students, and 58 adults. These stories represented combinations of a protagonist's intention (truthful or deceptive) and the truth of the protagonist's message (true or false). The results showed that adults judged whether these messages were lies by considering the protagonist's intentions. By contrast, approximately 30% of first-grade students and some fourth-grade students did not consider intentions in making judgments, although they appropriately predicted the outcomes of the messages. These results suggest that children in the early elementary school years have a conception of lies different from that of adults, and their conception of lies becomes more sophisticated after middle childhood.

[Diagnosis and surgical operation for fourth branchial cleft anomalies].

PubMed

Zhu, Ting; Hua, Qingquan

2011-11-01

To explore diagnosis and surgical operation through analyzing clinical features of the fourth branchial cleft anomalies. Clinical materials of 10 patients with the fourth branchial cleft anomalies were retrospectively analyzed, and literatures were studied to explore the diagnosis, differential diagnosis and treatment methods of surgical operation; lesions of 10 patients were completely removed by surgical operation, and internal sinus was properly handled. All 10 cases were cured, no recurrence were observed during a follow-up of 1-3 years. 1 patient appeared low voice, and drinking cough, back to normality after 2 weeks; 1 patient appeared paralysis of left hypoglossal nerves, back to normality after 3 months. Recurrent deep neck abscess and chronic sinus infections of anterior area in the lower part of neck should be considered with the diagnosis of the fourth branchial cleft anomalies. Enhanced neck CT scan and barium sulfate meal examination aid to diagnosis, pathological examination can be confirmed. Complete surgical removal of lesions is an effective treatment of fourth branchial cleft anomalies, knowing of the courses of internal sinus and spread of infection, and use of principle of selective neck dissection is the key to ensure complete removal of lesions.

Weed Control in Black Walnut Plantations

Treesearch

Calvin F. Bey; Robert D. Williams

1976-01-01

Weeds must be controlled for at least 3 years to successfully establish walnut plantations. Whether by cultivating or applying chemicals, a strip or spot 4 feet wide is sufficient the first 2 years, followed by a 6-foot spot or strip for the third and fourth years.

Double-crested cormorant studies at Little Galloo Island, Lake Ontario in 2008: Diet composition, fish consumption and the efficacy of management activities in reducing fish predation

USGS Publications Warehouse

Johnson, James H.; McCullough, Russell D.; Farquhar, James F.

2008-01-01

The year 2008 marked the seventeenth consecutive year of study of the food habits and fish consumption of LGI cormorants, and represented the tenth consecutive year evaluating the efficacy of management activities to control the reproductive success of cormorants nesting at LGI. The program consists mainly of spraying cormorant eggs with oil as well as the culling of adult and immature birds.This paper reports the findings of work carried outin 2008 at LGI.

Early onset obsessive-compulsive disorder with and without tics.

PubMed

de Mathis, Maria Alice; Diniz, Juliana B; Shavitt, Roseli G; Torres, Albina R; Ferrão, Ygor A; Fossaluza, Victor; Pereira, Carlos; Miguel, Eurípedes; do Rosario, Maria Conceicão

2009-07-01

Research suggests that obsessive-compulsive disorder (OCD) is not a unitary entity, but rather a highly heterogeneous condition, with complex and variable clinical manifestations. The aims of this study were to compare clinical and demographic characteristics of OCD patients with early and late age of onset of obsessive-compulsive symptoms (OCS); and to compare the same features in early onset OCD with and without tics. The independent impact of age at onset and presence of tics on comorbidity patterns was investigated. Three hundred and thirty consecutive outpatients meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for OCD were evaluated: 160 patients belonged to the "early onset" group (EOG): before 11 years of age, 75 patients had an "intermediate onset" (IOG), and 95 patients were from the "late onset" group (LOG): after 18 years of age. From the 160 EOG, 60 had comorbidity with tic disorders. The diagnostic instruments used were: the Yale-Brown Obsessive Compulsive Scale and the Dimensional Yale-Brown Obsessive Compulsive Scale (DY-BOCS), Yale Global Tics Severity Scale, and Structured Clinical Interview for DSM-IV Axis I Disorders-patient edition. Statistical tests used were: Mann-Whitney, full Bayesian significance test, and logistic regression. The EOG had a predominance of males, higher frequency of family history of OCS, higher mean scores on the "aggression/violence" and "miscellaneous" dimensions, and higher mean global DY-BOCS scores. Patients with EOG without tic disorders presented higher mean global DY-BOCS scores and higher mean scores in the "contamination/cleaning" dimension. The current results disentangle some of the clinical overlap between early onset OCD with and without tics.

Feeding and gastrointestinal problems in children with cerebral palsy.

PubMed

Erkin, Gulten; Culha, Canan; Ozel, Sumru; Kirbiyik, Eylem Gulsen

2010-09-01

The aim of our study was to identify feeding and gastrointestinal system (GIS) problems in children with cerebral palsy (CP), and to evaluate the relationship between these problems and the severity of CP. A total of 120 children with CP were enrolled consecutively into the study (67 males, 53 females; mean age: 6.0±2.4 years; range: 2-12 years). The children were classified according to the Swedish classification as diplegic, hemiplegic, or quadriplegic. Severity of CP was classified based on the Gross Motor Function Classification System. The amount of time that the caregiver allocated to mealtimes, modifications of the food, as well as feeding and GIS problems was evaluated. Feeding dysfunction was classified as mild, moderate, or severe. Comparisons of GIS and feeding disorders and the severity of CP were carried out using χ test. The results indicated lack of appetite in 46 of the 120 children (38.3%), sialorrhea in 37 (30.8%), constipation in 30 (25%), difficulty in swallowing in 23 (19.2%), and feeding dysfunction in 26 (21.7%). On the basis of the Gross Motor Function Classification System (GMFCS), the incidence of GIS problems and feeding dysfunction was found to be significantly higher in the children classified in the severe group. The time taken to consume meals was significantly longer among children with feeding dysfunction. Feeding and GIS problems are frequent in children with CP, and more marked in those with severe CP. Approximately one fourth of children with CP suffer from feeding dysfunction, and more time has to be allocated to consume meals.

Role of Academic Self-efficacy and Social Support on Nursing Students' Test Anxiety.

PubMed

Warshawski, Sigalit; Bar-Lev, Oshra; Barnoy, Sivia

2018-05-25

Associations between test anxiety, academic self-efficacy (ASE), and social support through social media have not been fully explored. The purposes were to explore associations between test anxiety, ASE, and social support from social media and to examine differences in test anxiety by students' year of studies and cultural background. This study used a cross-sectional, descriptive design. The sample comprised first- and fourth-year nursing students (n = 240) attending a baccalaureate nursing program in Israel. Higher ASE and support through social media were related to lower test anxiety. Fourth-year students and Jewish students had higher ASE than first-year and Arab students, who received more support on social media than Jewish students. Developing learning strategies designed to increase students' ASE and reduce test anxiety is warranted. Social media as an educational tool can be adopted for this purpose.

Three-port laparoscopic cholecystectomy by harmonic dissection without cystic duct and artery clipping.

PubMed

Tebala, Giovanni D

2006-05-01

The technique of laparoscopic cholecystectomy (LC) still has areas of refinements. To decrease the number of ports, a cannula may be replaced by a percutaneous suture suspension of the gallbladder. The risk of tissue injury caused by repeat blind extraction and insertion of various instruments in and out of the abdomen may be decreased by the use of the multipurpose harmonic dissector. One hundred consecutive patients with symptomatic cholelithiasis underwent 3-port LC entirely performed by harmonic dissector without cystic duct and artery clipping. In 8 cases, a fourth trocar was necessary. In 2 cases, the cystic duct was clipped after an unsafe ultrasound sealing. In 1 case, continuous bleeding from the liver required the use of diathermy. No common bile duct injury was registered. The 3-port harmonic LC is a feasible, effective, and safe technique.

Fourth Annual Holiday Decorating Contest Features Sharks, Santas, Toys, and More | Poster

Cancer.gov

The 2017 holiday season brought cold temperatures and heated competition to NCI at Frederick as 14 groups faced off in the R&W Club of Frederick’s Fourth Annual Holiday Decorating Contest. Keeping with tradition, many of the competitors sought to outdo not just each other’s themed entries, but also their own decorations from previous years. Accordingly, this year’s themes ranged from childhood memories to local landscapes to the downright outlandish.

Area Handbook Series: Egypt: A Country Study

DTIC Science & Technology

1991-01-01

iI~torical Settinlg Sphinx and pyramids at Giza (Al jizah) THE ROOTS OF EGYPTIAN civilization go back more than 6,000 years to the beginning of...built by Snoferu, the first king of the Fourth Dynasty. His son and successor, Kheops, built the Great Pyramid at Giza (AlJizah); this, with its two... Pyramid and Sphinx at Giza , Fourth Dynasty, ca. 2540 B. C. Courtesy Boris Boguslavsky 19 Egypt: A Country Study In June 640, reinforcements for the Arab

Assessment of clinical reasoning: A Script Concordance test designed for pre-clinical medical students.

PubMed

Humbert, Aloysius J; Johnson, Mary T; Miech, Edward; Friedberg, Fred; Grackin, Janice A; Seidman, Peggy A

2011-01-01

The Script Concordance test (SCT) measures clinical reasoning in the context of uncertainty by comparing the responses of examinees and expert clinicians. It uses the level of agreement with a panel of experts to assign credit for the examinee's answers. This study describes the development and validation of a SCT for pre-clinical medical students. Faculty from two US medical schools developed SCT items in the domains of anatomy, biochemistry, physiology, and histology. Scoring procedures utilized data from a panel of 30 expert physicians. Validation focused on internal reliability and the ability of the SCT to distinguish between different cohorts. The SCT was administered to an aggregate of 411 second-year and 70 fourth-year students from both schools. Internal consistency for the 75 test items was satisfactory (Cronbach's alpha = 0.73). The SCT successfully differentiated second- from fourth-year students and both student groups from the expert panel in a one-way analysis of variance (F(2,508) = 120.4; p < 0.0001). Mean scores for students from the two schools were not significantly different (p = 0.20). This SCT successfully differentiated pre-clinical medical students from fourth-year medical students and both cohorts of medical students from expert clinicians across different institutions and geographic areas. The SCT shows promise as an easy-to-administer measure of "problem-solving" performance in competency evaluation even in the beginning years of medical education.

Comparison of case-based and lecture-based learning in dental education using the SOLO taxonomy.

PubMed

Ilgüy, Mehmet; Ilgüy, Dilhan; Fişekçioğlu, Erdoğan; Oktay, Inci

2014-11-01

The aim of this study was to compare the impact of case-based learning (CBL) and lecture-based learning (LBL) on fourth-year dental students' clinical decision making by using the Structure of Observed Learning Outcome (SOLO) taxonomy. Participants in the study were fourth-year dental students (n=55) in academic year 2012-13 taught in a large-group LBL context and fourth-year dental students (n=54) in academic year 2013-14 taught with the CBL methodology; both took place in the oral diseases course at Yeditepe University Faculty of Dentistry, Istanbul, Turkey. All eligible students participated, for a 100 percent response rate. A real case was presented to the students in both groups to assess their clinical decision making on the topic of oral diseases. Their performance was evaluated with the SOLO taxonomy. Student t-test was used for statistical evaluation, and significance was set at the p<0.05 level. A statistically significant difference was found between the mean scores of the relational and extended abstract categories of the CBL and LBL groups (p<0.05). Students who were taught with CBL had higher scores at the top two levels of the SOLO taxonomy than students taught with LBL. These findings suggest that an integrated case-based curriculum may be effective in promoting students' deep learning and it holds promise for better integration of clinical cases likely to be encountered during independent practice.

Diet- and body size-related attitudes and behaviors associated with vitamin supplement use in a representative sample of fourth-grade students in Texas.

PubMed

George, Goldy C; Hoelscher, Deanna M; Nicklas, Theresa A; Kelder, Steven H

2009-01-01

To examine diet- and body size-related attitudes and behaviors associated with supplement use in a representative sample of fourth-grade students in Texas. Cross-sectional data from the School Physical Activity and Nutrition study, a probability-based sample of schoolchildren. Children completed a questionnaire that assessed supplement use, food choices, diet-related attitudes, and physical activity; height and weight were measured. School classrooms. Representative sample of fourth-grade students in Texas (n = 5967; mean age = 9.7 years standard error of the mean [SEM] = .03 years, 46% Hispanic, 11% African-American). Previous day vitamin supplement consumption, diet- and body size-related attitudes, food choices, demographic factors, and physical activity. Multivariable logistic regression models, P < .05. The prevalence of supplement use was 29%. Supplement intake was associated with physical activity. Girls who used supplements were more likely to report positive body image and greater interest in trying new food. Relative to nonusers, supplement users were less likely to perceive that they always ate healthful food, although supplement use was associated with more healthful food choices in boys and girls (P < .001). The widespread use of supplements and clustering of supplement use with healthful diet and greater physical activity in fourth graders suggest that supplement use be closely investigated in studies of diet-disease precursor relations and lifestyle factors in children.

Developmental differences between boys and girls result in sex-specific physical fitness changes from fourth to fifth grade.

PubMed

Flanagan, Shawn D; Dunn-Lewis, Courtenay; Hatfield, Disa L; Distefano, Lindsay J; Fragala, Maren S; Shoap, Mark; Gotwald, Mary; Trail, John; Gomez, Ana L; Volek, Jeff S; Cortis, Cristina; Comstock, Brett A; Hooper, David R; Szivak, Tunde K; Looney, David P; DuPont, William H; McDermott, Danielle M; Gaudiose, Michael C; Kraemer, William J

2015-01-01

To better understand how developmental differences impact performance on a broad selection of common physical fitness measures, we examined changes in boys and girls from fourth to fifth grade. Subjects included 273 boys (age, 9.5 ± 0.6 years; height, 139.86 ± 7.52 cm; mass, 38.00 ± 9.55 kg) and 295 girls (age, 9.6 ± 0.5 years; height, 139.30 ± 7.19 cm; weight, 37.44 ± 9.35 kg). We compared anthropometrics, cardiorespiratory and local muscular endurance, flexibility, power, and strength. A mixed-method analysis of variance was used to compare boys and girls at the 2 time points. Pearson correlation coefficients were used to examine relationships between anthropometric and fitness measurements. Significance was set at p ≤ 0.05. Weight increased significantly (>10%) in both sexes, and girls became significantly taller than boys after growing 4.9% by fifth grade (vs. 3.5%). Both groups improved cardiorespiratory endurance and power, although boys performed better than girls at both time points. Boys were stronger in fourth grade, but girls improved more, leading to similar fifth-grade values. Girls were more flexible in fourth grade, but their significant decreases (∼32.4%) coupled with large improvements in boys (∼105%) resulted in similar fifth-grade scores. Body mass index (BMI) was positively correlated with run time regardless of grade or sex. Power was negatively correlated with BMI and run time in fourth grade. In conclusion, sex-specific differences in physical fitness are apparent before pubescence. Furthermore, this selection of measures reveals sexually dimorphic changes, which likely reflect the onset of puberty in girls. Coaches and teachers should account these developmental differences and their effects on anthropometrics and fitness in boys and girls.

Antibody persistence for up to 5 years after a fourth dose of Haemophilus influenzae type b and Neisseria meningitidis serogroups C and Y-tetanus toxoid conjugate vaccine (HibMenCY-TT) given at 12-15 months of age.

PubMed

Marshall, Gary S; Blatter, Mark; Marchant, Colin; Aris, Emmanuel; Mesaros, Narcisa; Miller, Jacqueline M

2013-06-01

A 4-dose series of recently licensed Haemophilus influenzae type b-meningococcal serogroups C and Y-tetanus toxoid conjugate vaccine (HibMenCY-TT) was immunogenic with a clinically acceptable safety profile in infants, with antibodies persisting in most participants for 1 year following dose 4. This study assessed antibody persistence up to 5 years after vaccination. Participants had received HibMenCY-TT or Hib-TT at 2, 4 and 6 months of age. At age 12-15 months, HibMenCY-TT vaccinees received a fourth HibMenCY-TT dose (HibMenCY x 4 group), whereas those who received Hib-TT received a fourth dose of either Hib-TT (Hib) or HibMenCY-TT (HibMenCY x 1). Blood samples were collected 1 month and 1, 3 and 5 years after the last dose for measurement of antipolyribosylribitol phosphate (the Hib capsular polysaccharide) antibodies and serum bactericidal activity (human complement source) against meningococcal serogroups C and Y. Five years after the fourth dose, the percentages of children with antipolyribosylribitol phosphate ≥0.15 μg/mL in HibMenCY x 4, HibMenCY x 1 and Hib groups were 98.8% (95% confidence interval: 93.5%-100%), 97.3% (85.8%-99.9%) and 92.3% (79.1%-98.4%), respectively. The percentages with human complement serum bactericidal activity ≥1:8 for meningococcal serogroup C were 82.9% (72.5%-90.6%), 73.5% (55.6%-87.1%) and 21.1% (9.6%-37.3%), respectively. The percentages with human complement serum bactericidal activity ≥1:8 for serogroup Y were 69.5% (58.4%-79.2%), 54.3% (36.6%-71.2%) and 18.4% (7.7%-34.3%), respectively. HibMenCY-TT given as a 4-dose series or as a single dose at 12-15 months of age induced immune responses for all 3 antigens that lasted for up to 5 years after vaccination in more than half of recipients.

The value of a core clinical rotation in urology for medical students.

PubMed

Patel, Premal; Nayak, Jasmir G; McGregor, Thomas B

2015-01-01

In 2013, our institution underwent a change to the undergraduate medical curriculum whereby a clinical urology rotation became mandatory. In this paper, we evaluated the perceived utility and value of this change in the core curriculum. Third year medical students, required to complete a mandatory 1-week clinical urology rotation, were asked to complete a survey before and after their rotation. Fourth year medical students, not required to complete this rotation, were also asked to complete a questionnaire. Chi-squared and Fisher's exact test were used for data analysis. In total, 108 third year students rotated through urology during the study period. Of these, 66 (61%) completed the pre-rotation survey and 54 (50%) completed the post-rotation survey. In total, there were 110 fourth year students. Of these, 44 (40%) completed the questionnaire. After completing their mandatory rotations, students felt more comfortable managing and investigating common urological problems, such as hematuria and renal colic. Students felt they had a better understanding of how to insert a Foley catheter and felt comfortable independently inserting a Foley catheter. Importantly, students felt they knew when to consult urology and were also more likely to consider a career in urology. Compared to fourth year students, third year students felt urology was an important component to a family medicine practice and felt they had a better understanding of when to consult urology. The introduction of a mandatory urology rotation for undergraduate medical students leads to a perceived improvement in fundamental urological knowledge and skill set of rotating students. This mandatory rotation provides a valuable experience that validates its inclusion.

Status of neurology medical school education: results of 2005 and 2012 clerkship director survey.

PubMed

Carter, Jonathan L; Ali, Imran I; Isaacson, Richard S; Safdieh, Joseph E; Finney, Glen R; Sowell, Michael K; Sam, Maria C; Anderson, Heather S; Shin, Robert K; Kraakevik, Jeff A; Coleman, Mary; Drogan, Oksana

2014-11-04

To survey all US medical school clerkship directors (CDs) in neurology and to compare results from a similar survey in 2005. A survey was developed by a work group of the American Academy of Neurology Undergraduate Education Subcommittee, and sent to all neurology CDs listed in the American Academy of Neurology database. Comparisons were made to a similar 2005 survey. Survey response rate was 73%. Neurology was required in 93% of responding schools. Duration of clerkships was 4 weeks in 74% and 3 weeks in 11%. Clerkships were taken in the third year in 56%, third or fourth year in 19%, and fourth year in 12%. Clerkship duration in 2012 was slightly shorter than in 2005 (fewer clerkships of ≥4 weeks, p = 0.125), but more clerkships have moved into the third year (fewer neurology clerkships during the fourth year, p = 0.051). Simulation training in lumbar punctures was available at 44% of schools, but only 2% of students attempted lumbar punctures on patients. CDs averaged 20% protected time, but reported that they needed at least 32%. Secretarial full-time equivalent was 0.50 or less in 71% of clerkships. Eighty-five percent of CDs were "very satisfied" or "somewhat satisfied," but more than half experienced "burnout" and 35% had considered relinquishing their role. Trends in neurology undergraduate education since 2005 include shorter clerkships, migration into the third year, and increasing use of technology. CDs are generally satisfied, but report stressors, including inadequate protected time and departmental support. © 2014 American Academy of Neurology.

Status of neurology medical school education

PubMed Central

Ali, Imran I.; Isaacson, Richard S.; Safdieh, Joseph E.; Finney, Glen R.; Sowell, Michael K.; Sam, Maria C.; Anderson, Heather S.; Shin, Robert K.; Kraakevik, Jeff A.; Coleman, Mary; Drogan, Oksana

2014-01-01

Objective: To survey all US medical school clerkship directors (CDs) in neurology and to compare results from a similar survey in 2005. Methods: A survey was developed by a work group of the American Academy of Neurology Undergraduate Education Subcommittee, and sent to all neurology CDs listed in the American Academy of Neurology database. Comparisons were made to a similar 2005 survey. Results: Survey response rate was 73%. Neurology was required in 93% of responding schools. Duration of clerkships was 4 weeks in 74% and 3 weeks in 11%. Clerkships were taken in the third year in 56%, third or fourth year in 19%, and fourth year in 12%. Clerkship duration in 2012 was slightly shorter than in 2005 (fewer clerkships of ≥4 weeks, p = 0.125), but more clerkships have moved into the third year (fewer neurology clerkships during the fourth year, p = 0.051). Simulation training in lumbar punctures was available at 44% of schools, but only 2% of students attempted lumbar punctures on patients. CDs averaged 20% protected time, but reported that they needed at least 32%. Secretarial full-time equivalent was 0.50 or less in 71% of clerkships. Eighty-five percent of CDs were “very satisfied” or “somewhat satisfied,” but more than half experienced “burnout” and 35% had considered relinquishing their role. Conclusion: Trends in neurology undergraduate education since 2005 include shorter clerkships, migration into the third year, and increasing use of technology. CDs are generally satisfied, but report stressors, including inadequate protected time and departmental support. PMID:25305155

Peer Mentorship Program in Dental Education

ERIC Educational Resources Information Center

Ha-Ngoc, Tien; Park, Sang E.

2015-01-01

The Senior Mentorship Program (SMP) was created to encourage the fourth year dental students to act as mentors in the clinical environment as well as facilitate learning of clinic protocols and reinforce concepts in treatment planning for the third year students. Third year dental students engaged in educational conversations and received helpful…

Teaching Business German Basics on the Second Year Level.

ERIC Educational Resources Information Center

Rockwood, Heidi M.

Most college curricula in business German are oriented to third- and fourth-year German students. Development of a course in introductory business German designed for the second year of language instruction required careful selection of materials and activities. Texts were selected for their comprehensibility for students with no business…

A Cross Sectional and Longitudinal Study of Pharmacy Student Perceptions of Readiness to Serve Diverse Populations

PubMed Central

Awé, Clara; Tawk, Rima H.; Simon Pickard, A.

2016-01-01

Objective. To examine students’ self-perceptions at different stages in a pharmacy curriculum of competence related to serving culturally diverse patients and to compare self-reported competence of a student cohort near the beginning and end of the degree program. Methods. Student perceptions across four pharmacy class years were measured in a cross-sectional survey, with a follow-up longitudinal survey of one cohort three years later. Results. Based on an 81.9% response rate (537/656), scores showed no attitude changes. Reported knowledge, skills, comfort in clinical encounters, and curricular preparedness increased across program years. Fourth-year (P4) pharmacy students reported the highest scores. Scores differed by gender, age, and race/ethnicity. Students in the fourth year scored lower on importance of diversity training. Conclusion. Improved perceptions of readiness (ie, knowledge and behavior) to serve diverse groups suggest the curriculum impacts these constructs, while the invariance of student attitudes and association of self-reports with programmatic outcomes warrant further investigation. PMID:27293229

Patterns of Treatment Utilization and Methamphetamine Use during First Ten Years after Methamphetamine Initiation

PubMed Central

Brecht, Mary-Lynn; Lovinger, Katherine; Herbeck, Diane M.; Urada, Darren

2013-01-01

The study examined joint trajectories of methamphetamine (MA) use and substance abuse treatment utilization and identified differences among pattern groups for a sample of 348 treated for MA use. Results from group-based trajectory modeling showed that treatment utilization during the first 10 years after initiation of MA use could be categorized into three distinctive patterns: about half the MA users have a pattern of low treatment utilization; one-fourth follow a quicker-to-treatment trajectory with higher probability of treatment during the first 5 years of MA use and less treatment in the next 5 years; and one-fourth have a slower-to-treatment trajectory with more treatment during the second half of the 10-year period. Four MA use patterns were identified: consistently low use, moderate, and high use, as well as a decreasing use pattern. Periods of greater likelihood of treatment participation were associated with periods of decreasing or lower frequency of MA use. PMID:23313146

A Cross Sectional and Longitudinal Study of Pharmacy Student Perceptions of Readiness to Serve Diverse Populations.

PubMed

Crawford, Stephanie Y; Awé, Clara; Tawk, Rima H; Simon Pickard, A

2016-05-25

Objective. To examine students' self-perceptions at different stages in a pharmacy curriculum of competence related to serving culturally diverse patients and to compare self-reported competence of a student cohort near the beginning and end of the degree program. Methods. Student perceptions across four pharmacy class years were measured in a cross-sectional survey, with a follow-up longitudinal survey of one cohort three years later. Results. Based on an 81.9% response rate (537/656), scores showed no attitude changes. Reported knowledge, skills, comfort in clinical encounters, and curricular preparedness increased across program years. Fourth-year (P4) pharmacy students reported the highest scores. Scores differed by gender, age, and race/ethnicity. Students in the fourth year scored lower on importance of diversity training. Conclusion. Improved perceptions of readiness (ie, knowledge and behavior) to serve diverse groups suggest the curriculum impacts these constructs, while the invariance of student attitudes and association of self-reports with programmatic outcomes warrant further investigation.

PubMed Central

Decina, Philip A; McGregor, Marion; Hagino, Carol

1990-01-01

This study set out to determine whether healthy lifestyle attitudes are different for students in different years of the chiropractic education process. The results of the FANTASTIC Lifestyle Assessment Questionnaire administered to chiropractic students enrolled in first, second and fourth years of study are presented. Significant differences in scores attained were found between the three years of study in question. A minimum sample size (N) of 81 students was used. First year subjects were significantly different from both second year and fourth year subjects’ scores (p = .012 and p < 0.001, respectively). Mean scores decreased with every year of study. The variables ‘year of study’ and ‘age’ had the most pronounced effect on outcome of scores (p < 0.001 and p < 0.001, respectively). Analyses of variance were performed to determine effect of the variables involved. A two-tailed paired t-test was used to check first year students for changes after six months of school. It is still undetermined whether the significant difference in scores between each year of study are due to the year of study, to increasing average age of the classes, or to societal attitudes about wellness. Suggestions for future study are also presented.

Management of in-flight medical emergencies: are senior medical students prepared to respond to this community need?

PubMed

Katzer, Robert J; Duong, David; Weber, Matthew; Memmer, Amy; Buchanan, Ian

2014-11-01

In-flight medical emergencies on commercial aircraft are common in both domestic and international flights. We hypothesized that fourth-year medical students feel inadequately prepared to lend assistance during in-flight medical emergencies. This multicenter study of two U.S. medical schools obtains a baseline assessment of knowledge and confidence in managing in-flight medical emergencies. A 25-question survey was administered to fourth-year medical students at two United States medical schools. Questions included baseline knowledge of in-flight medicine (10 questions) and perceived ability to respond to in-flight medical emergencies. 229 participants completed the survey (75% response rate). The average score on the fund of knowledge questions was 64%. Responses to the 5-point Likert scale questions indicated that, on average, students did not feel confident or competent responding to an in-flight medical emergency. Participants on average also disagreed with statements that they had adequate understanding of supplies, flight crew training, and ground-based management. This multicenter survey indicates that fourth-year medical students do not feel adequately prepared to respond to in-flight medical emergencies and may have sub-optimal knowledge. This study provides an initial step in identifying a deficiency in current medical education.

Use of individualized learning plans among fourth-year sub-interns in pediatrics and internal medicine.

PubMed

Shepard, Michelle E; Sastre, Elizabeth A; Davidson, Mario A; Fleming, Amy E

2012-01-01

Individualized Learning Plans (ILPs) are an effective tool for promoting self-directed learning among residents. However, no literature details ILP use among medical students. Fifty fourth-year sub-interns in pediatrics and internal medicine created ILPs, including a self-assessment of strengths and weaknesses based on ACGME core competencies and the setting of learning objectives. During weekly follow-up meetings with faculty mentors and peers, students discussed challenges and revised goals. Upon completion of the rotation, students completed a survey of Likert-scale questions addressing satisfaction with and perceived utility of ILP components. Students most often self-identified strengths in the areas of Professionalism and Interpersonal and Communication Skills and weaknesses in Patient Care and Systems-Based Practice. Eighty-two percent set at least one learning objective in an identified area of weakness. Students expressed high confidence in their abilities to create achievable learning objectives and to generate strategies to meet those objectives. Students agreed that discussions during group meetings were meaningful, and they identified the setting learning objectives and weekly meetings as the most important elements of the exercise. Fourth-year sub-interns reported that ILPs helped them to accomplish rotation goals, with the setting of learning objectives and weekly discussions being the most useful elements.

Exercise behaviour and attitudes among fourth-year medical students at the University of British Columbia.

PubMed

Holtz, Kaila A; Kokotilo, Kristen J; Fitzgerald, Barbara E; Frank, Erica

2013-01-01

To describe the physical activity (PA) levels and counseling attitudes of Canadian undergraduate medical students. Online or paper survey. The University of British Columbia (UBC). Fourth-year medical students at UBC from 2007 to 2010. Physical activity levels, relationship between exercise behaviour and attitudes toward counseling, and student perception of training in the area of exercise prescription. A total of 546 out of 883 students participated in the survey (62% response rate). Sixty-four percent of students met the Canadian Society for Exercise Physiology 2011 recommendations for PA. Attitudes toward healthy living were related to PA levels, but the rate of counseling patients about exercise was not; however, students who engaged in more strenuous PA were more likely to perceive exercise counseling as being highly relevant to future clinical practice (P = .018). Overall, 69% of students perceived exercise counseling to be highly relevant to clinical practice, but 86% thought that their training in this area was less than extensive. Fourth-year UBC medical students engage in more strenuous PA than average age-matched Canadians, which affects their attitudes toward perceived future counseling practices. Encouraging more student participation in strenuous PA and encouraging academic training in the area of exercise counseling might be important next steps in preparing future physicians to effectively prescribe exercise to their patients.

Management of In-Flight Medical Emergencies: Are Senior Medical Students Prepared to Respond to this Community Need?

PubMed Central

Katzer, Robert J.; Duong, David; Weber, Matthew; Memmer, Amy; Buchanan, Ian

2014-01-01

Introduction In-flight medical emergencies on commercial aircraft are common in both domestic and international flights. We hypothesized that fourth-year medical students feel inadequately prepared to lend assistance during in-flight medical emergencies. This multicenter study of two U.S. medical schools obtains a baseline assessment of knowledge and confidence in managing in-flight medical emergencies. Methods A 25-question survey was administered to fourth-year medical students at two United States medical schools. Questions included baseline knowledge of in-flight medicine (10 questions) and perceived ability to respond to in-flight medical emergencies. Results 229 participants completed the survey (75% response rate). The average score on the fund of knowledge questions was 64%. Responses to the 5-point Likert scale questions indicated that, on average, students did not feel confident or competent responding to an in-flight medical emergency. Participants on average also disagreed with statements that they had adequate understanding of supplies, flight crew training, and ground-based management. Conclusion This multicenter survey indicates that fourth-year medical students do not feel adequately prepared to respond to in-flight medical emergencies and may have sub-optimal knowledge. This study provides an initial step in identifying a deficiency in current medical education. PMID:25493155

Random Regression Models Using Legendre Polynomials to Estimate Genetic Parameters for Test-day Milk Protein Yields in Iranian Holstein Dairy Cattle.

PubMed

Naserkheil, Masoumeh; Miraie-Ashtiani, Seyed Reza; Nejati-Javaremi, Ardeshir; Son, Jihyun; Lee, Deukhwan

2016-12-01

The objective of this study was to estimate the genetic parameters of milk protein yields in Iranian Holstein dairy cattle. A total of 1,112,082 test-day milk protein yield records of 167,269 first lactation Holstein cows, calved from 1990 to 2010, were analyzed. Estimates of the variance components, heritability, and genetic correlations for milk protein yields were obtained using a random regression test-day model. Milking times, herd, age of recording, year, and month of recording were included as fixed effects in the model. Additive genetic and permanent environmental random effects for the lactation curve were taken into account by applying orthogonal Legendre polynomials of the fourth order in the model. The lowest and highest additive genetic variances were estimated at the beginning and end of lactation, respectively. Permanent environmental variance was higher at both extremes. Residual variance was lowest at the middle of the lactation and contrarily, heritability increased during this period. Maximum heritability was found during the 12th lactation stage (0.213±0.007). Genetic, permanent, and phenotypic correlations among test-days decreased as the interval between consecutive test-days increased. A relatively large data set was used in this study; therefore, the estimated (co)variance components for random regression coefficients could be used for national genetic evaluation of dairy cattle in Iran.

Random Regression Models Using Legendre Polynomials to Estimate Genetic Parameters for Test-day Milk Protein Yields in Iranian Holstein Dairy Cattle

PubMed Central

Naserkheil, Masoumeh; Miraie-Ashtiani, Seyed Reza; Nejati-Javaremi, Ardeshir; Son, Jihyun; Lee, Deukhwan

2016-01-01

The objective of this study was to estimate the genetic parameters of milk protein yields in Iranian Holstein dairy cattle. A total of 1,112,082 test-day milk protein yield records of 167,269 first lactation Holstein cows, calved from 1990 to 2010, were analyzed. Estimates of the variance components, heritability, and genetic correlations for milk protein yields were obtained using a random regression test-day model. Milking times, herd, age of recording, year, and month of recording were included as fixed effects in the model. Additive genetic and permanent environmental random effects for the lactation curve were taken into account by applying orthogonal Legendre polynomials of the fourth order in the model. The lowest and highest additive genetic variances were estimated at the beginning and end of lactation, respectively. Permanent environmental variance was higher at both extremes. Residual variance was lowest at the middle of the lactation and contrarily, heritability increased during this period. Maximum heritability was found during the 12th lactation stage (0.213±0.007). Genetic, permanent, and phenotypic correlations among test-days decreased as the interval between consecutive test-days increased. A relatively large data set was used in this study; therefore, the estimated (co)variance components for random regression coefficients could be used for national genetic evaluation of dairy cattle in Iran. PMID:26954192

Nesting ecology of roseate spoonbills at Nueces Bay, Texas

USGS Publications Warehouse

White, D.H.; Mitchell, C.A.

1982-01-01

We conducted a 3-year study in 1978-80 of thenesting ecology of Roseate Spoonbills (Ajaia ajaja) at Nueces Bay, Texas. Reproductive success, as well as nesting chronology, nest composition and placement, growth and development of young, egg measurements, and pollutant residues in eggs were determined. For 154 marked nests, the average clutch size was 3.0 eggs; 73% of the eggs hatched, and 87% of the nests were successful (fledged at least one young). Nest success (total fledglings: total eggs) averaged 50% during the study, or 1.5 fledglings per nest. Incubation began the day after the first egg was laid, and the incubation period for each egg was 22 days. Eggs hatched in the order that they were laid; the first and second egg hatched on consecutive days, and the second, third, and fourth egg hatched every other day. Nest composition and size were highly consistent, as was distance between nests within clusters, but nest placement varied considerably and was dependent on the vegetative configuration of the dredged-material islands. Growth rate of nestlings conformed to a 'standard' growth curve where body weight equaled that of adults at fledging. There was no difference in weight gain among siblings based on actual age. Nestlings fledged at about siz weeks of age when feather development was complete. At fledging, the bills of juveniles had almost reached adult width, but bill length was only 67% that of adults.

Identification of successive flowering phases highlights a new genetic control of the flowering pattern in strawberry

PubMed Central

Perrotte, Justine; Guédon, Yann; Gaston, Amèlia; Denoyes, Béatrice

2016-01-01

The genetic control of the switch between seasonal and perpetual flowering has been deciphered in various perennial species. However, little is known about the genetic control of the dynamics of perpetual flowering, which changes abruptly at well-defined time instants during the growing season. Here, we characterize the perpetual flowering pattern and identify new genetic controls of this pattern in the cultivated strawberry. Twenty-one perpetual flowering strawberry genotypes were phenotyped at the macroscopic scale for their course of emergence of inflorescences and stolons during the growing season. A longitudinal analysis based on the segmentation of flowering rate profiles using multiple change-point models was conducted. The flowering pattern of perpetual flowering genotypes takes the form of three or four successive phases: an autumn-initiated flowering phase, a flowering pause, and a single stationary perpetual flowering phase or two perpetual flowering phases, the second one being more intense. The genetic control of flowering was analysed by quantitative trait locus mapping of flowering traits based on these flowering phases. We showed that the occurrence of a fourth phase of intense flowering is controlled by a newly identified locus, different from the locus FaPFRU, controlling the switch between seasonal and perpetual flowering behaviour. The role of this locus was validated by the analysis of data obtained previously during six consecutive years. PMID:27664957

Birth Order and Injury-Related Infant Mortality in the U.S.

PubMed

Ahrens, Katherine A; Rossen, Lauren M; Thoma, Marie E; Warner, Margaret; Simon, Alan E

2017-10-01

The purpose of this study was to evaluate the risk of death during the first year of life due to injury, such as unintentional injury and homicide, by birth order in the U.S. Using national birth cohort-linked birth-infant death data (births, 2000-2010; deaths, 2000-2011), risks of infant mortality due to injury in second-, third-, fourth-, and fifth or later-born singleton infants were compared with first-born singleton infants. Risk ratios were estimated using log-binomial models adjusted for maternal age, marital status, race/ethnicity, and education. The statistical analyses were conducted in 2016. Approximately 40%, 32%, 16%, 7%, and 4% of singleton live births were first, second, third, fourth, and fifth or later born, respectively. From 2000 to 2011, a total of 15,866 infants died as a result of injury (approximately 1,442 deaths per year). Compared with first-born infants (2.9 deaths per 10,000 live births), second or later-born infants were at increased risk of infant mortality due to injury (second, 3.6 deaths; third, 4.2 deaths; fourth, 4.8 deaths; fifth or later, 6.4 deaths). The corresponding adjusted risk ratios were as follows: second, 1.84 (95% CI=1.76, 1.91); third, 2.42 (95% CI=2.30, 2.54); fourth, 2.96 (95% CI=2.77, 3.16); and fifth or later, 4.26 (95% CI=3.96, 4.57). Singleton infants born second or later were at increased risk of mortality due to injury during their first year of life in the U.S. This study's findings highlight the importance of investigating underlying mechanisms behind this increased risk. Published by Elsevier Inc.

Assessment of knowledge and attitudes of dental students in regard to child abuse in Turkey.

PubMed

Hazar Bodrumlu, E; Avşar, A; Arslan, S

2018-02-01

Child abuse is a serious public problem. Signs of abuse are often present in the oro-facial region and dentists are in a strategic position to recognise and report suspected cases. The aim of this study was to investigate dental students' knowledge about and attitudes towards child abuse. This study was performed at the Faculty of Dentistry of the Ondokuz Mayis University. The data were collected through a self-report questionnaire administered to dental students (137 female/111 male) in three different dental classes (third, fourth and fifth study years) and grouped by considering those students who have been training in the school year of 2013. The definition of physical and social indicators of abuse, awareness regarding legal and ethical responsibilities, students' experience and requests made by students were evaluated by the students' response to questions put in the questionnaire. Descriptive statistics and chi-square tests were performed to analyse the questionnaire data. The questionnaire completion rate was 100%. About 67.74% of the third year, 40.71% of the fourth year and 16.67% of the fifth year believed that they could detect child abuse cases. However, results indicated a major lack of knowledge of social indicators, signs of physical abuse and reporting procedure amongst all respondents. The assessment of the total correct answers exhibited significant differences amongst third-, fourth- and fifth-year students' answers. Fifth-year students had the highest rate of correct responses (P < 0.05). Most students wanted to receive more knowledge about this topic. Dental students in Turkey are not sufficiently prepared for their role in diagnosing suspected cases of child abuse. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Evidence-based dentistry skill acquisition by second-year dental students.

PubMed

Marshall, T A; McKernan, S C; Straub-Morarend, C L; Guzman-Armstrong, S; Marchini, L; Handoo, N Q; Cunningham, M A

2018-05-22

Identification and assessment of Evidence-based dentistry (EBD) outcomes have been elusive. Our objective was to describe EBD skill acquisition during the second (D2) year of pre-doctoral dental education and student competency at the end of the year. The first and fourth (final) curricular-required EBD Exercises (ie, application of the first 4 steps of the 5-Step evidence-based practice process applied to a real or hypothetical situation) completed by D2 students (n = 151) during 2014-2015 and 2015-2016 were evaluated to measure skill acquisition through use of a novel rubric with measures of performance from novice to expert. Exercises were evaluated on the performance for each step, identification of manuscript details and reflective commentary on manuscript components. Changes in performance were evaluated using the chi-square test for trend and the Wilcoxon signed-rank test. Seventy-eight per cent of students scored competent or higher on the Ask step at the beginning of the D2 year; scores improved with 58% scoring proficient or expert on the fourth Exercise (P < .001). Most students were advanced beginners or higher in the Acquire, Appraise and Apply steps at the beginning of the D2 year, with minimal growth observed during the year. Identification of manuscript details improved between the first and fourth Exercises (P = .015); however, depth of commentary skills did not change. Unlike previous investigations evaluating EBD knowledge or behaviour in a testing situation, we evaluated skill acquisition using applied Exercises. Consistent with their clinical and scientific maturity, D2 students minimally performed as advanced beginners at the end of their D2 year. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Antibiotic rotation strategies to reduce antimicrobial resistance in Gram-negative bacteria in European intensive care units: study protocol for a cluster-randomized crossover controlled trial.

PubMed

van Duijn, Pleun J; Bonten, Marc J M

2014-07-10

Intensive care units (ICU) are epicenters for the emergence of antibiotic-resistant Gram-negative bacteria (ARGNB) because of high rates of antibiotic usage, rapid patient turnover, immunological susceptibility of acutely ill patients, and frequent contact between healthcare workers and patients, facilitating cross-transmission.Antibiotic stewardship programs are considered important to reduce antibiotic resistance, but the effectiveness of strategies such as, for instance, antibiotic rotation, have not been determined rigorously. Interpretation of available studies on antibiotic rotation is hampered by heterogeneity in implemented strategies and suboptimal study designs. In this cluster-randomized, crossover trial the effects of two antibiotic rotation strategies, antibiotic mixing and cycling, on the prevalence of ARGNB in ICUs are determined. Antibiotic mixing aims to create maximum antibiotic heterogeneity, and cycling aims to create maximum antibiotic homogeneity during consecutive periods. This is an open cluster-randomized crossover study of mixing and cycling of antibiotics in eight ICUs in five European countries. During cycling (9 months) third- or fourth-generation cephalosporins, piperacillin-tazobactam and carbapenems will be rotated during consecutive 6-week periods as the primary empiric treatment in patients suspected of infection caused by Gram-negative bacteria. During mixing (9 months), the same antibiotics will be rotated for each consecutive antibiotic course. Both intervention periods will be preceded by a baseline period of 4 months. ICUs will be randomized to consecutively implement either the mixing and then cycling strategy, or vice versa. The primary outcome is the ICU prevalence of ARGNB, determined through monthly point-prevalence screening of oropharynx and perineum. Secondary outcomes are rates of acquisition of ARGNB, bacteremia and appropriateness of therapy, length of stay in the ICU and ICU mortality. Results will be adjusted for intracluster correlation, and patient- and ICU-level variables of case-mix and infection-prevention measures using advanced regression modeling. This trial will determine the effects of antibiotic mixing and cycling on the unit-wide prevalence of ARGNB in ICUs. ClinicalTrials.gov NCT01293071 December 2010.

Association Between Anaerobic Metabolic Demands During Simulated Brazilian Jiu-Jitsu Combat and Specific Jiu-Jitsu Anaerobic Performance Test.

PubMed

Villar, Rodrigo; Gillis, Jason; Santana, Givanildo; Pinheiro, Daniel S; Almeida, André L R A

2018-02-01

Villar, R, Gillis, J, Santana, G, Pinheiro, DS, and Almeida, ALRA. Association between anaerobic metabolic demands during simulated Brazilian jiu-jitsu combat and specific jiu-jitsu anaerobic performance test. J Strength Cond Res 32(2): 432-440, 2018-The aims of this study were to design a specific Jiu-Jitsu anaerobic performance test (JJAPT) and investigate the relationship between blood lactate ([La]), heart rate (HR), and rating of perceived exertion (RPE) during simulated Brazilian Jiu-Jitsu combat (SBJJC) and JJAPT. Nine male elite Brazilian medium heavy weight athletes performed a 10-minute SBJJC and JJAPT that required performance of a common BJJ technique for 5 consecutive bouts of 1-minute with 45-second rest between bouts. [La] was measured by a lactate analyzer, HR by an HR monitor, and RPE using Borg's scale, and the number of repetitions of butterfly lifts (NBL) was recorded. During JJAPT, NBL decreased in the fourth and fifth bouts (p ≤ 0.05) with increases in [La], HR, and RPE (p ≤ 0.05), indicating that the JJAPT measured anaerobic performance. [La] during SBJJC was not different than [La] at the third and fourth bouts, but was significantly different than the fifth bout (p ≤ 0.05). [La] showed strong correlation between SBJJC and JJAPT for the third (r = 0.80, p ≤ 0.05), fourth (r = 0.83, p ≤ 0.05), and fifth (r = 0.82, p ≤ 0.05) bouts, but not between the HR and RPE. The JJAPT with 4 bouts presented the best combination of stimulus and highest correlation with SBJJC, supporting its use to assess anaerobic performance of BJJ athletes. These data will aid coaches and athletes to better understand the demands of their sport and may help to monitor adaptation in sport-specific performance across periodized training plans.

Branchial anomalies in children: A report of 105 surgical cases.

PubMed

Li, Wanpeng; Xu, Hongming; Zhao, Liming; Li, Xiaoyan

2018-01-01

Branchial anomalies (BAs) account for 20% of all congenital masses in children. We sought to review the incidence of involvement of individual anomalies, diagnostic methods, surgical treatment, and complications of BAs in children. In addition, we also classified our study and analyzed a congenital lower neck cutaneous fistula near the sternoclavicular joint that was thought to be the skin-side remnant of the fourth BAs. We conducted a retrospective analysis of 105 children who were referred to our hospital from June 2009 to December 2016 for the treatment of BAs. In this series, there were 51 males and 54 females. The age at the time of operation varied from 19 days to 13 years, and the mean age was 4.5 years. A total of 33 (31.4%) cases presented with first BAs, 13 (12.4%) presented with second BAs, and 59 (56.2%) presented with third and fourth BAs, including 6 cases of congenital lower neck cutaneous fistula. Fistulectomy under general anesthesia was performed on all of them. For postoperative complications, 2 cases had temporary facial paralysis, 1 case had permanent facial paralysis, 4 cases had temporary recurrent laryngeal nerve injury. Recurrence occurred in 2 patients with first BAs after medium follow-up time of 3.6 years (6 months-8 years). BAs are common congenital head and neck lesions in children, and there are four distinct types (first, second, third and fourth anomalies). The incidence of third and fourth BAs in Asia maybe higher when compared with literature reports, second BAs seem rare in this population, but more research is needed to confirm this perspective. Diagnosis is not difficult with a proper knowledge of the anatomy of the BAs. The surgical procedures should be tailored depending on the various types, and complete excision of the fistula is the key to prevent recurrence. Copyright © 2017 Elsevier B.V. All rights reserved.

Outcomes of a proficiency-based skills curriculum at the beginning of the fourth year for senior medical students entering surgery.

PubMed

Wade, Thomas J; Lorbeer, Karly; Awad, Michael M; Woodhouse, Julie; DeClue, Angela; Brunt, L Michael

2015-10-01

We hypothesized that a proficiency-based curriculum administered early in the fourth year to senior medical students (MS4) would achieve outcomes comparable to a similar program administered during surgical internship. MS4 (n = 18) entering any surgical specialty enrolled in a proficiency-based skills curriculum at the beginning of the fourth year that included suturing/knot-tying, on-call problems, laparoscopic, and other skills (urinary catheter, sterile prep/drape, IV placement, informed consent, electrosurgical use). Assessment was at 4-12 weeks after training by a modified Objective Structured Assessment of Technical Skills (OSATS). Suturing and knot tying tasks were assessed by time and OSATS technical proficiency (TP) scores (1 [novice], 3 [proficient], 5 [expert]). Outcomes were compared with PGY-1 residents who received similar training at the beginning of internship and assessment 4-12 weeks later. Data are presented as mean values ± standard deviation; statistical significance was assessed by Student's t test. Fifteen of 18 MS4 (83%) reached proficiency on all 15 tasks, and 2 others were proficient on all but 1 laparoscopic task. Compared with PGY-1s, MS4 were significantly faster for 3 of 5 suturing and tying tasks and total task time (547 ± 63 vs 637 ± 127 s; P < .05). Mean TP scores were similar for both groups (MS4, 3.4 ± 0.5 vs PGY-1, 3.1 ± .57; P = NS). MS4 OSATS scores were higher for IV placement, informed consent, and urinary catheter placement, but lower for prep and drape and for management of on-call problems. MS4 who participate in a proficiency-based curriculum taught early in the fourth year are able to meet proficiency targets in a high percentage of cases. This approach should better prepare MS4 for surgical internship. Copyright © 2015 Elsevier Inc. All rights reserved.

Factors Influencing Fourth-Year Pharmacy Students' Decisions to Pursue a Hospital Pharmacy Residency.

PubMed

Dupuis, Sébastien; Martel, Alexis; Arfa, Taha; Valma, Joannah; Williamson, David R; Perreault, Marc M

2016-01-01

The Canadian Society of Hospital Pharmacists promotes the recruitment of residency-trained pharmacists for work in hospitals and related health care settings. However, Quebec hospitals are still hiring non-residency trained pharmacists, in part because of a severe shortage of hospital pharmacists. To date, no studies have examined the factors influencing the career choices of fourth-year pharmacy students in Canada. To identify motivating factors and barriers influencing students' decision to pursue a hospital pharmacy residency. All 186 fourth-year students in the Faculty of Pharmacy, Université de Montréal, were invited by e-mail to participate in a validated and institutionally approved survey that was available online between March and May 2014. Of the 138 respondents who returned a completed survey (74% response rate), 36 (26%) planned to apply for a hospital pharmacy residency. Those planning to apply for a residency were older (p = 0.037) and had more hospital work experience (36% versus 3%, p < 0.001) than those not planning to apply. The most important motivators for pursuing a residency were potential gains in knowledge (reported by 88% of respondents, whether or not they were planning to pursue a residency), experience (80%), and self-confidence (62%). The most frequently reported barriers were recognition that a hospital pharmacy residency is a highly demanding program (65%), having work available upon graduation from the undergraduate program (43%), and financial obligations (34%). Hospital experiential rotations influenced, either positively or negatively, 23 (72%) of the 32 students who changed their decision to pursue or not pursue residency training over the course of their studies. The potential gain in knowledge and experience acquired through residency, the fact that it is considered a highly demanding program, and having work available upon graduation from undergraduate studies were the most influential factors in fourth-year pharmacy students' decision of whether to pursue a hospital pharmacy residency.

Factors Influencing Fourth-Year Pharmacy Students’ Decisions to Pursue a Hospital Pharmacy Residency

PubMed Central

Dupuis, Sébastien; Martel, Alexis; Arfa, Taha; Valma, Joannah; Williamson, David R; Perreault, Marc M

2016-01-01

Background: The Canadian Society of Hospital Pharmacists promotes the recruitment of residency-trained pharmacists for work in hospitals and related health care settings. However, Quebec hospitals are still hiring non–residency trained pharmacists, in part because of a severe shortage of hospital pharmacists. To date, no studies have examined the factors influencing the career choices of fourth-year pharmacy students in Canada. Objectives: To identify motivating factors and barriers influencing students’ decision to pursue a hospital pharmacy residency. Methods: All 186 fourth-year students in the Faculty of Pharmacy, Université de Montréal, were invited by e-mail to participate in a validated and institutionally approved survey that was available online between March and May 2014. Results: Of the 138 respondents who returned a completed survey (74% response rate), 36 (26%) planned to apply for a hospital pharmacy residency. Those planning to apply for a residency were older (p = 0.037) and had more hospital work experience (36% versus 3%, p < 0.001) than those not planning to apply. The most important motivators for pursuing a residency were potential gains in knowledge (reported by 88% of respondents, whether or not they were planning to pursue a residency), experience (80%), and self-confidence (62%). The most frequently reported barriers were recognition that a hospital pharmacy residency is a highly demanding program (65%), having work available upon graduation from the undergraduate program (43%), and financial obligations (34%). Hospital experiential rotations influenced, either positively or negatively, 23 (72%) of the 32 students who changed their decision to pursue or not pursue residency training over the course of their studies. Conclusions: The potential gain in knowledge and experience acquired through residency, the fact that it is considered a highly demanding program, and having work available upon graduation from undergraduate studies were the most influential factors in fourth-year pharmacy students’ decision of whether to pursue a hospital pharmacy residency. PMID:27403000

Stress and stressors in the clinical environment: a comparative study of fourth-year student nurses and newly qualified general nurses in Ireland.

PubMed

Suresh, Patricia; Matthews, Anne; Coyne, Imelda

2013-03-01

To measure and compare the perceived levels of job-related stress and stressors of newly qualified nurses and fourth-year student nurses in the clinical environment and to explore the participants' views on stress and stressors. Stress in the nursing workplace has significant consequences for the person, the patient and the organisation, such as psychological and physical health deterioration and impaired professional practice. To address this problem, stress and stressors need to be measured and identified. This study used a cross-sectional survey design and self-reporting questionnaires to measure and compare levels of stress in both groups. Convenience sampling involved all newly qualified nurses (n = 120) and fourth-year student nurses (n = 128) in Dublin North-East region in Ireland. The instrument used was 'The Nursing Stress Scale' (Gray-Toft & Anderson 1981, Journal of Behavioral Assessment 3, 11-23). Descriptive, qualitative analysis was conducted on an open-ended question. Data were obtained from newly qualified nurses (n = 31) and fourth-year student nurses (n = 40) in six acute hospital sites. Levels of perceived stress and stressors were high in both groups. Themes identified from the responses to the open question by both groups included excessive workload, difficult working relationships and unmet clinical learning needs. Student nurses also reported the combination of academic demands with clinical placement as a major stressor. There was no significant difference between each group. Stress continues to be a problem for nurses in the clinical setting. Excessive workload requires urgent attention by hospital managers in view of widespread retention difficulties. Themes identified could provide a framework for possible interventions for improving the clinical environment for nurses. These results can help stakeholders in nurse education and practice to develop interventions to reduce stress for both groups and to ease the transition from student to graduate nurse. © 2012 Blackwell Publishing Ltd.

A Case Report: A Third/Fourth Branchial Pouch Anomaly Presented by Solid Thyroid and Lateral Cervical Neck Masses.

PubMed

Nasreldin, Magda H A; Ibrahim, Eman A; Saad El-Din, Somaia A

2016-01-01

Branchial pouch-derived anomalies may arise from remnants of the first, second, or third/fourth branchial arches. Branchial pouch-related structures are found within the thyroid gland in the form of solid cell rests, epithelial lined cyst with or without an associated lymphoid component, thymic and/or parathyroid tissue, and less commonly in the form of heterotopic cartilage. We present a rare case of left solid thyroid swelling nearby two cervical nodules in a seven-year-old female with a clinical diagnosis suggestive of malignant thyroid tumor with metastasis to the cervical lymph nodes. Histopathological examination revealed that it was compatible with third/fourth branchial pouch-derived anomaly composed of mature cartilage and thymic and parathyroid tissues for clinical and radiological correlations.

A Case Report: A Third/Fourth Branchial Pouch Anomaly Presented by Solid Thyroid and Lateral Cervical Neck Masses

PubMed Central

Nasreldin, Magda H. A.; Ibrahim, Eman A.; Saad El-Din, Somaia A.

2016-01-01

Branchial pouch-derived anomalies may arise from remnants of the first, second, or third/fourth branchial arches. Branchial pouch-related structures are found within the thyroid gland in the form of solid cell rests, epithelial lined cyst with or without an associated lymphoid component, thymic and/or parathyroid tissue, and less commonly in the form of heterotopic cartilage. We present a rare case of left solid thyroid swelling nearby two cervical nodules in a seven-year-old female with a clinical diagnosis suggestive of malignant thyroid tumor with metastasis to the cervical lymph nodes. Histopathological examination revealed that it was compatible with third/fourth branchial pouch-derived anomaly composed of mature cartilage and thymic and parathyroid tissues for clinical and radiological correlations. PMID:26819565

Peer Teaching as a Motivating Factor in Developing Communicative Skills.

ERIC Educational Resources Information Center

Celani, M. A. A.

1979-01-01

An English language program at Catholic University of Sao Paulo, Brazil has sought to increase student motivation for learning communicative skills by having fourth-year students work with first year students either individually or in small groups. (SW)

Longitudinal joint treatment, interim report - fourth year, March 2005.

DOT National Transportation Integrated Search

2005-03-01

Maine highways have been showing signs of longitudinal joint failure for a number of years. In an effort : to reduce the amount of joint failures the Maine Department of Transportation (MDOT) is currently : evaluating two projects. One project is mon...

Mobility. Snapshot™ Report, Spring 2014

ERIC Educational Resources Information Center

National Student Clearinghouse, 2014

2014-01-01

Just over 9% of all students attended more than one institution during the 2012-13 academic year. In each year studied, nearly three-fourths of all mobile students had at least one enrollment at a 2-year public institution. In each of the included years, students in the 20 and under age group had the highest mobility rates, followed by students in…

Different responses of rhizosphere and non-rhizosphere soil microbial communities to consecutive Piper nigrum L. monoculture

PubMed Central

Li, Zhigang; Zu, Chao; Wang, Can; Yang, Jianfeng; Yu, Huan; Wu, Huasong

2016-01-01

Soil microorganisms have important influences on plant growth and health. In this study, four black pepper fields consecutively monocultured for 12, 18, 28 and 38 years were selected for investigating the effect of planting age on rhizosphere and non-rhizosphere soil microbial communities and soil physicochemical properties. The results revealed that the relative abundance of the dominant bacterial phyla in rhizosphere soil increased considerably with long-term consecutive monoculture but decreased in non-rhizosphere soil with a significant decline in Firmicutes. For fungi, an increasing trend over time was observed in both rhizosphere and non-rhizosphere soils, with the abundance of the pathogenic fungi Fusarium increasing significantly accompanied by a decrease in the bacteria Pseudomonas and Bacillus that is beneficial for black pepper. Consecutive monoculture, especially for 38 years, considerably decreased soil microbial diversity. Additionally, the rhizosphere soil pH and organic matter and available K contents decreased with increasing planting duration, though available N and P increased. All soil nutrient contents and microbial diversity indices were higher in rhizosphere soil compared to non-rhizosphere soil. The results suggest that long-term consecutive monoculture leads to variations in soil microbial community composition and physicochemical properties in both rhizosphere and non-rhizosphere soils, thus inhibiting the black pepper growth. PMID:27775000

Different responses of rhizosphere and non-rhizosphere soil microbial communities to consecutive Piper nigrum L. monoculture.

PubMed

Li, Zhigang; Zu, Chao; Wang, Can; Yang, Jianfeng; Yu, Huan; Wu, Huasong

2016-10-24

Soil microorganisms have important influences on plant growth and health. In this study, four black pepper fields consecutively monocultured for 12, 18, 28 and 38 years were selected for investigating the effect of planting age on rhizosphere and non-rhizosphere soil microbial communities and soil physicochemical properties. The results revealed that the relative abundance of the dominant bacterial phyla in rhizosphere soil increased considerably with long-term consecutive monoculture but decreased in non-rhizosphere soil with a significant decline in Firmicutes. For fungi, an increasing trend over time was observed in both rhizosphere and non-rhizosphere soils, with the abundance of the pathogenic fungi Fusarium increasing significantly accompanied by a decrease in the bacteria Pseudomonas and Bacillus that is beneficial for black pepper. Consecutive monoculture, especially for 38 years, considerably decreased soil microbial diversity. Additionally, the rhizosphere soil pH and organic matter and available K contents decreased with increasing planting duration, though available N and P increased. All soil nutrient contents and microbial diversity indices were higher in rhizosphere soil compared to non-rhizosphere soil. The results suggest that long-term consecutive monoculture leads to variations in soil microbial community composition and physicochemical properties in both rhizosphere and non-rhizosphere soils, thus inhibiting the black pepper growth.

The SUNY Summer Internship: The First Twenty Years.

ERIC Educational Resources Information Center

Mozlin, Rochelle; Suchoff, Irwin B.

1987-01-01

The State University of New York's innovative summer internship program bringing together 18 students between their third and fourth years to study functional vision care and vision therapy is described. Its history, program structure, recruitment and selection, and evaluation are highlighted. (MSE)

1954 Annual Report

Treesearch

Philip A. Briegleb

1954-01-01

1954 completed the fiftieth year of operation of the U. S. Forest Service and the thirty-fourth year for the Southern Forest Experiment Station. The half century just past has brought dramatic changes in the forests of the South and to the people and industries dependent upon them.

Communication Skills in Dental Students: New Data Regarding Retention and Generalization of Training Effects.

PubMed

Broder, Hillary L; Janal, Malvin; Mitnick, Danielle M; Rodriguez, Jasmine Y; Sischo, Lacey

2015-08-01

Previous studies have shown that a communications program using patient instructors (PIs) facilitates data-gathering and interpersonal skills of third-year dental students. The aim of this study was to address the question of whether those skills are retained into the students' fourth year and generalized from the classroom to the clinic. In the formative training phase, three cohorts of D3 students (N=1,038) at one dental school received instruction regarding effective patient-doctor communication; interviewed three PIs and received PI feedback; and participated in a reflective seminar with a behavioral science instructor. In the follow-up competency phase, fourth-year students performed two new patient interviews in the clinic that were observed and evaluated by clinical dental faculty members trained in communications. Mean scores on a standardized communications rating scale and data-gathering assessment were compared over training and follow-up sessions and between cohorts with a linear mixed model. The analysis showed that the third-year students' mean communication and data-gathering scores increased with each additional encounter with a PI (p<0.05) and that communication scores were not only maintained but increased during the fourth-year follow-up competency evaluations (p<0.05). Based on changes in the communications curriculum, prior instruction facilitated the students' clinical communication performance at baseline (p<0.05). This study suggests that the current Clinical Communications program improved students' data-gathering and interpersonal skills. Those skills were maintained and generalized through completion of the D4 students' summative competency performance in a clinical setting.

Variable memory strategy use in children's adaptive intratask learning behavior: developmental changes and working memory influences in free recall.

PubMed

Lehmann, Martin; Hasselhorn, Marcus

2007-01-01

Variability in strategy use within single trials in free recall was analyzed longitudinally from second to fourth grades (ages 8-10 years). To control for practice effects another sample of fourth graders was included (age 10 years). Video analyses revealed that children employed different strategies when preparing for free recall. A gradual shift from labeling to cumulative rehearsal was present both with increasing age and across different list positions. Whereas cumulative rehearsal was frequent at early list positions, labeling was dominant at later list portions. Working memory capacity predicted the extent of cumulative rehearsal usage, which became more efficient with increasing age. Results are discussed in the context of the adaptive strategy choice model.

On 3-D inelastic analysis methods for hot section components. Volume 1: Special finite element models

NASA Technical Reports Server (NTRS)

Nakazawa, S.

1988-01-01

This annual status report presents the results of work performed during the fourth year of the 3-D Inelastic Analysis Methods for Hot Section Components program (NASA Contract NAS3-23697). The objective of the program is to produce a series of new computer codes permitting more accurate and efficient 3-D analysis of selected hot section components, i.e., combustor liners, turbine blades and turbine vanes. The computer codes embody a progression of math models and are streamlined to take advantage of geometrical features, loading conditions, and forms of material response that distinguish each group of selected components. Volume 1 of this report discusses the special finite element models developed during the fourth year of the contract.

A One-Year Introductory Robotics Curriculum for Computer Science Upperclassmen

ERIC Educational Resources Information Center

Correll, N.; Wing, R.; Coleman, D.

2013-01-01

This paper describes a one-year introductory robotics course sequence focusing on computational aspects of robotics for third- and fourth-year students. The key challenges this curriculum addresses are "scalability," i.e., how to teach a robotics class with a limited amount of hardware to a large audience, "student assessment,"…

Pharmokinetics in Drug Therapy as a Required Undergraduate Course

ERIC Educational Resources Information Center

Schumacher, G. E.

1976-01-01

This course is offered in the third quarter of the fourth year of the five-year curriculum in pharmacology. The year includes (1) a 350-hour clinical clerkship, (2) two courses in "Case Studies in Drug Therapy," (3) one course in "Case Studies in Pharmacy Practice," and (4) professional electives. (LBH)

How to Make a Plant Field Guide

ERIC Educational Resources Information Center

Franks, Megan; Vore, Rebecca

2010-01-01

Every year, an elementary school celebrates different aspects of Central Texas ecology. This year, they focused on Blackland Prairie, the ecoregion on which the school is located. A schoolwide event at the end of the year offers students the opportunity to teach their parents and their peers what they've learned. The Fourth- and fifth-grade…

Beneficial reuse `96: The fourth annual conference on the recycle and reuse of radioactive scrap metal

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1997-02-01

From October 22-24, 1996 the University of Tennessee`s Energy, Environment and Resources Center and the Oak Ridge National Laboratory`s Center for Risk Management cosponsored Beneficial Reuse `96: The Fourth Annual Conference on the Recycle and Reuse of Radioactive Materials. Along with the traditional focus on radioactive scrap metals, this year`s conference included a wide range of topics pertaining to naturally occurring radioactive materials (NORM), and contaminated concrete reuse applications. As with previous Beneficial Reuse conferences, the primary goal of this year`s conference was to bring together stakeholder representatives for presentations, panel sessions and workshops on significant waste minimization issues surroundingmore » the recycle and reuse of contaminated metals and other materials. A wide range of industry, government and public stakeholder groups participated in this year`s conference. An international presence from Canada, Germany and Korea helped to make Beneficial Reuse `96 a well-rounded affair. Selected papers have been processed separately for inclusion in the Energy Science and Technology Database.« less

Teaching Medicine Through the Study of Literature: Implementing a Fourth-Year Distance Learning Elective.

PubMed

Welch, Tana Jean; Harrison, Suzanne Leonard

2016-03-01

The amount of time medical students must devote to the residency application process has increased, often at the expense of students' education. The fourth year is still a crucial component of medical education, especially for preparing students for the transition to residency. To maintain flexibility during the residency interview season and provide students with the opportunity to hone critical skills, faculty at the Florida State University College of Medicine developed a literature and medicine distance learning elective for fourth-year students. The four-week course was offered five times per academic year from 2012 to 2014. Participating students and faculty chose a topic and reading list, which guided both students' written reflections and the weekly discussions held via video conference. Nineteen students participated, and 13 completed a postcourse survey to gauge their overall impressions of the elective and its effects on their learning. Participants valued the course for six principal reasons: It (1) provided the opportunity to consider others' perspectives, (2) improved their ability to think as a physician and examine personal biases, (3) provided the opportunity to discuss nonmedical literature, (4) provided the opportunity to use different cognitive skills, (5) afforded flexibility, and (6) improved their ability to communicate about difficult topics. The long-term value of a distance learning elective in the humanities remains uncertain. The authors have begun to study students' perceptions of the elective's value after entering residency. However, they believe that the initial positive feedback justifies the course's replication at other institutions.

Head and Neck Ultrasound Education-A Multimodal Educational Approach in the Predoctoral Setting: A Pilot Study.

PubMed

Bernard, Stewart; Richardson, Clare; Hamann, Carsten R; Lee, Steve; Dinh, Vi Am

2015-08-01

With the increased implementation of ultrasound in medical education, it is important to continually improve instructional methods. In this study, we demonstrate that by augmenting the traditional methods of instructor demonstration and student practice on a healthy volunteer with additional modalities, such as didactic presentation, simulated pathologic cases, and simulated procedures, students gain a more comprehensive understanding of and confidence in ultrasound technique and pathology. A multimodal curriculum was developed and applied to head and neck ultrasound sessions of our institution's Ultrasound Symposium. Participants were asked to fill out surveys rating each instructional modality as well as preinstructional and postinstructional confidence. The survey results were divided into a group of first- and second-year medical students who had previous ultrasound training and a group of third- and fourth-year students who were ultrasound "naïve." The survey showed that the first- and second-year student group (n = 8) had an average preinstructional confidence of 4.14/10 compared to 1.44/10 in the third- and fourth-year student group (n = 9) (P = .003). Following the instructional sessions, the students' confidence increased respectively to 8.14/10 and 7.78/10 (P= .53), showing a 4.00 (96%) increase in the first- and second-year group and a 6.34 (440%) increase in the third- and fourth-year group. The combined results of all student teaching modality ratings showed that instructor demonstration was rated the highest (9.47) and computerized simulation lowest (8.25). Overall, our study shows that multimodal ultrasound instruction was beneficial in increasing both ultrasound-trained and ultrasound-naïve medical students' confidence in head and neck ultrasound. © 2015 by the American Institute of Ultrasound in Medicine.

Real-Time 3D Visualization

NASA Technical Reports Server (NTRS)

1997-01-01

Butler Hine, former director of the Intelligent Mechanism Group (IMG) at Ames Research Center, and five others partnered to start Fourth Planet, Inc., a visualization company that specializes in the intuitive visual representation of dynamic, real-time data over the Internet and Intranet. Over a five-year period, the then NASA researchers performed ten robotic field missions in harsh climes to mimic the end- to-end operations of automated vehicles trekking across another world under control from Earth. The core software technology for these missions was the Virtual Environment Vehicle Interface (VEVI). Fourth Planet has released VEVI4, the fourth generation of the VEVI software, and NetVision. VEVI4 is a cutting-edge computer graphics simulation and remote control applications tool. The NetVision package allows large companies to view and analyze in virtual 3D space such things as the health or performance of their computer network or locate a trouble spot on an electric power grid. Other products are forthcoming. Fourth Planet is currently part of the NASA/Ames Technology Commercialization Center, a business incubator for start-up companies.

Exploration

USGS Publications Warehouse

Wilburn, D.R.

2002-01-01

Exploration budgets fell for a fourth successive year in 2001. These decreases reflected low mineral commodity prices, mineral-market investment reluctance, company failures and a continued trend of company mergers and takeovers.

Dandy-Walker malformation: analysis of 19 cases.

PubMed

Alexiou, George A; Sfakianos, George; Prodromou, Neofytos

2010-02-01

Dandy-Walker malformation is a congenital disorder that involves the cerebellum and fourth ventricle. Regarding treatment, there is still controversy over the optimum surgical management. In the current study, we present 19 consecutive cases of Dandy-Walker malformation diagnosed between January 1992 and January 2008 that were treated in our institute. All patients presented with hydrocephalus at the time of diagnosis and were treated surgically. Combined drainage of the ventricular system and posterior fossa cyst, using a 3-way connector was performed in 5 patients. Posterior fossa cyst drainage alone was performed in 10 patients and the remaining 4 patients were treated by ventricular drainage alone. All patients improved after treatment. Dandy-Walker malformation is a developmental abnormality of the central nervous system associated with various brain and extracranial abnormalities. Surgical treatment remains controversial, whereas prognosis varies greatly according to the severity of syndrome and associated comorbidities.

MS Lucid places samples in the TEHOF aboard the Spektr module

NASA Image and Video Library

1997-03-26

STS079-S-082 (16-26 Sept. 1996) --- Cosmonaut guest researcher Shannon W. Lucid and Valeri G. Korzun, her Mir-22 commander, are pictured on the Spektr Module aboard Russia's Earth-orbiting Mir Space Station. Korzun was the third of four commanders that Lucid served with during her record-setting 188 consecutive days in space. Later, Lucid returned to Earth with her fourth commander-astronaut William F. Readdy-and five other NASA astronauts to complete the STS-79 mission. During the STS-79 mission, the crew used an IMAX camera to document activities aboard the space shuttle Atlantis and the various Mir modules. A hand-held version of the 65mm camera system accompanied the STS-79 crew into space in Atlantis' crew cabin. NASA has flown IMAX camera systems on many Shuttle missions, including a special cargo bay camera's coverage of other recent Shuttle-Mir rendezvous and/or docking missions.

Venous thrombosis after abdominal surgery. A comparison between subcutaneous heparin and antithrombotic stockings, or both

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rasmussen, A.; Hansen, P.T.; Lindholt, J.

1988-01-01

In an open controlled study, 248 consecutive patients (age more than 40 yrs) admitted for major abdominal surgery were randomized to one of three prophylactic antithrombotic treatments. Eighty-five patients received subcutaneous heparin, 74 patients had graduated compression stockings to the knee (TED stockings), and 89 patients had both subcutaneous heparin and stockings. Treatment began on the evening before operation and continued to complete mobilization, or for not less than five days postoperatively. On the fourth or fifth postoperative day, the patients underwent a /sup 99m/Tc-plasmin test of the lower limbs as a test for deep vein thrombosis. There were 29.7%more » positive tests in the stocking group, 29.4% in the group with heparin prophylaxis, and 25.8% in the combined group. Differences between treatments were not statistically significant.« less

Actively caring to prevent bullying in an elementary school: Prompting and rewarding prosocial behavior.

PubMed

McCarty, Shane; Teie, Sophia; McCutchen, Jenna; Geller, E Scott

2016-01-01

This field study evaluated the impact of an intervention designed to prevent bullying among elementary-school students by prompting and rewarding prosocial behavior. More specifically, teachers of 404 second-, third-, fourth-, fifth-, and sixth-grade students from an elementary school in northeast Virginia asked their students to look out for other students' prosocial behaviors (termed "actively caring") and to submit their stories about actively caring. At the start of every class day, the teachers read three of these stories and recognized one story and the two associated students (i.e., the observer and the performer) by providing each with a wristband engraved with "Actively Caring for People." For six consecutive Fridays, students reported their observations of bullying and completed a single item estimate of self-esteem. Weekly surveys revealed reductions in "being bullied" and "bullying others," as well as an increase in self-esteem.

Analysis of dental arch relationships in Swedish unilateral cleft lip and palate subjects: 20-year longitudinal consecutive series treated with delayed hard palate closure.

PubMed

Lilja, Jan; Mars, Michael; Elander, Anna; Enocson, Lars; Hagberg, Catharina; Worrell, Emma; Batra, Puneet; Friede, Hans

2006-09-01

To evaluate the dental arch relationships for a consecutive series from Goteborg, Sweden, who had delayed hard palate closure. Retrospective study. Sahlgrenska University Hospital, Goteborg, Sweden. The dental study models of 104 consecutive unilateral cleft lip and palate subjects. The study cohort was born between 1979 and 1994. Longitudinal records were available at ages 5 (n = 94), 10 (n = 97), 16 (n = 59), and 19 years (n = 46). Five assessors rated models according to the GOSLON Yardstick on two separate occasions each. These patients had been operated upon according to the Goteborg protocol of delayed hard palate closure (at age 8 years). 85% of subjects were rated in groups 1 and 2 (excellent or very good outcome), 12% were rated in group 3 (satisfactory), and 3% were assigned to group 4 (poor). No patients presented in Group 5 (very poor). Weighted kappa statistics for double determination of Yardstick allocation for five assessors demonstrated values between .65 and .90 for interrater agreement (good/very good) and between .70 and .90 for intrarater agreement (very good). Delayed hard palate closure as practiced in Goteborg since 1979 has produced the best GOSLON Yardstick ratings in a consecutive series of patients ever recorded worldwide, since the Yardstick was first used in 1983. However, it is noteworthy that a new protocol has been introduced in Goteborg since 1994, in which hard palate closure is done at 3 years due to concerns regarding speech.

Subependymomas: a clinicopathological study of 6 symptomatic cases.

PubMed

Limaïem, F; Bellil, S B H; Bellil, K; Chelly, I; Jemel, H; Haouet, S; Khaldi, M; Zitouna, M; Kchir, N

2008-10-01

Subependymomas are rare, slow-growing, ependymal neoplasms that commonly occur in the fourth or lateral ventricles. A retrospective study of 6 histologically proven subependymomas was undertaken to analyse their clinicopathological characteristics. There were five male and one female patients ranging in age from 11 to 50 years (mean 35.8 years). All patients were symptomatic at diagnosis. The most common clinical presentations included headache (n=6) and vomiting (n=3). Tumours were located in the lateral ventricle in five cases and in the fourth ventricle in one case. Magnetic resonance imaging detected obstructive hydrocephalus in all cases. Five patients underwent gross total resection and one patient had subtotal excision of the tumour. Histologically, all tumours were characterised by clustering of isomorphic cells arranged against a fibrillary background. Focal cystic degeneration was seen in 5 tumours. During the follow-up period, which ranged between 2 months and 10 years, all patients were symptom-free with no evidence of recurrence.

Assessing Motor Skill Competency in Elementary School Students: A Three-Year Study.

PubMed

Chen, Weiyun; Mason, Steve; Hypnar, Andrew; Bennett, Austin

2016-03-01

This study was to examine how well fourth- and fifth-grade students demonstrated motor skill competency assessed with selected PE Metrics assessment rubrics (2009). Fourth- and fifth-grade students (n = 1,346-1,926) were assessed on their performance of three manipulative skills using the PE Metrics Assessment Rubrics during the pre-intervention year, the post-intervention year 1, and the post-intervention year 3. Descriptive statistics, independent t-test, ANOVA, and follow-up comparisons were conducted for data analysis. The results indicated that the post-intervention year 2 cohort performed significantly more competent than the pre-intervention cohort and the post-intervention year 1 cohort on the three manipulative skill assessments. The post-intervention year 1 cohort significantly outperformed the pre-intervention cohort on the soccer dribbling, passing, and receiving and the striking skill assessments, but not on the throwing skill assessment. Although the boys in the three cohorts performed significantly better than the girls on all three skills, the girls showed substantial improvement on the overhand throwing and the soccer skills from baseline to the post-intervention year 1 and the post-intervention year 2. However, the girls, in particular, need to improve striking skill. The CTACH PE was conducive to improving fourth- and fifth-grade students' motor skill competency in the three manipulative skills. This study suggest that PE Metrics assessment rubrics are feasible tools for PE teachers to assess levels of students' demonstration of motor skill competency during a regular PE lesson. Key pointsCATCH PE is an empirically-evidenced quality PE curricular that is conducive to improving students' manipulative skill competency.Boys significantly outperformed than girls in all three manipulative skills.Girls need to improve motor skill competency in striking skill. PE Metrics are feasible assessment rubrics that can be easily used by trained physical education teachers to assess students' manipulative skill competency.

Assessing Motor Skill Competency in Elementary School Students: A Three-Year Study

PubMed Central

Chen, Weiyun; Mason, Steve; Hypnar, Andrew; Bennett, Austin

2016-01-01

This study was to examine how well fourth- and fifth-grade students demonstrated motor skill competency assessed with selected PE Metrics assessment rubrics (2009). Fourth- and fifth-grade students (n = 1,346-1,926) were assessed on their performance of three manipulative skills using the PE Metrics Assessment Rubrics during the pre-intervention year, the post-intervention year 1, and the post-intervention year 3. Descriptive statistics, independent t-test, ANOVA, and follow-up comparisons were conducted for data analysis. The results indicated that the post-intervention year 2 cohort performed significantly more competent than the pre-intervention cohort and the post-intervention year 1 cohort on the three manipulative skill assessments. The post-intervention year 1 cohort significantly outperformed the pre-intervention cohort on the soccer dribbling, passing, and receiving and the striking skill assessments, but not on the throwing skill assessment. Although the boys in the three cohorts performed significantly better than the girls on all three skills, the girls showed substantial improvement on the overhand throwing and the soccer skills from baseline to the post-intervention year 1 and the post-intervention year 2. However, the girls, in particular, need to improve striking skill. The CTACH PE was conducive to improving fourth- and fifth-grade students’ motor skill competency in the three manipulative skills. This study suggest that PE Metrics assessment rubrics are feasible tools for PE teachers to assess levels of students’ demonstration of motor skill competency during a regular PE lesson. Key points CATCH PE is an empirically-evidenced quality PE curricular that is conducive to improving students’ manipulative skill competency. Boys significantly outperformed than girls in all three manipulative skills. Girls need to improve motor skill competency in striking skill. PE Metrics are feasible assessment rubrics that can be easily used by trained physical education teachers to assess students’ manipulative skill competency. PMID:26957932

Can Clinical Scenario Videos Improve Dental Students' Perceptions of the Basic Sciences and Ability to Apply Content Knowledge?

PubMed

Miller, Cynthia Jayne; Metz, Michael James

2015-12-01

Dental students often have difficulty understanding the importance of basic science classes, such as physiology, for their future careers. To help alleviate this problem, the aim of this study was to create and evaluate a series of video modules using simulated patients and custom-designed animations that showcase medical emergencies in the dental practice. First-year students in a dental physiology course formatively assessed their knowledge using embedded questions in each of the three videos; 108 to 114 of the total 120 first-year students answered the questions, for a 90-95% response rate. These responses indicated that while the students could initially recognize the cause of the medical emergency, they had difficulty in applying their knowledge of physiology to the scenario. In two of the three videos, students drastically improved their ability to answer high-level clinical questions at the conclusion of the video. Additionally, when compared to the previous year of the course, there was a significant improvement in unit exam scores on clinically related questions (6.2% increase). Surveys were administered to the first-year students who participated in the video modules and fourth-year students who had completed the course prior to implementation of any clinical material. The response rate for the first-year students was 96% (115/120) and for the fourth-year students was 57% (68/120). The first-year students indicated a more positive perception of the physiology course and its importance for success on board examinations and their dental career than the fourth-year students. The students perceived that the most positive aspects of the modules were the clear applications of physiology to real-life dental situations, the interactive nature of the videos, and the improved student comprehension of course concepts. These results suggest that online modules may be used successfully to improve students' perceptions of the basic sciences and enhance their ability to apply basic science content to clinically important scenarios.

The Relationship between the Individual Values and Critical Thinking Skills of Prospective Social Sciences Teachers

ERIC Educational Resources Information Center

Nalcaci, Ahmet

2012-01-01

The aim of this study is to determine the relationship between the individual values and critical thinking skills of prospective social sciences teachers. The sample of the research is composed of a total of 298 prospective teachers, who are first-year, second-year, third-year and fourth-year students. These prospective teachers were randomly…

Profiles of Persisting Fourth-Year STEM Majors. ACT Research Report Series 2016 (5)

ERIC Educational Resources Information Center

Westrick, Paul

2016-01-01

Using date from 120,612 students at 26 four-year institutions, this report provides a description of STEM majors entering four-year postsecondary institutions and those who persist through four years of study. The results indicate that persisting STEM majors enter college with very high levels of pre-college academic achievement as measured by the…

DISPOSAL OF BY-PRODUCTS FROM NONREGENERABLE FLUE GAS DESULFURIZATION SYSTEMS

EPA Science Inventory

The report gives results of a 4-year study to determine environmentally sound methods for disposing of wastes from nonregenerable flue gas desulfurization (FGD) systems. Data presented incorporates results obtained during the fourth year with material from report EPA-600/7-77-052...

ARITHMETIC PROGRAM FOURTH YEAR.

ERIC Educational Resources Information Center

GARBER, CLAIRE N.

THE 4TH YEAR SHOULD CONTINUE THE SEQUENTIAL PRESENTATION MATHEMATICAL UNDERSTANDINGS AND RELATIONSHIPS. NEW LEARNINGS SHOULD BE PRESENTED CONCRETELY IN SOCIAL SETTINGS WITHIN THE CHILDREN'S FRAMEWORK OF UNDERSTANDING. GRAPHIC MATERIALS MAY BE USED TO BRIDGE THE UNDERSTANDINGS FROM THE CONCRETE TO THE ABSTRACT LEVEL. THE NUMBER SYSTEM UNIT SHOULD…

Reassessment and expansion, 1981-1991

NASA Astrophysics Data System (ADS)

Grey, J.

In this, the fourth and final decade under consideration for the special issue of Acta Astronautica, an overview of the 10-year span is given rather than a congress-by-congress summary as was appropriate for the opening decades of the federation's existence. The decade was characterized by debate over the frequency of congresses, reassessment of committee structure, improved relations with COSPAR, increasing membership and administrative changes. The ten International Astronautical congresses held during the final decade of this history are listed below noting their sequential numbers, the cities and years in which they took place and their themes: XXXII—Rome, 1981: Space: Mankind's Fourth Environment XXXIII—Paris, 1982: Space 2000 XXXIV—Budapest, 1983: Cooperation in Space XXXV—Lausanne, 1984: Space Benefits for All Nations XXXVI—Stockholm, 1985: Peaceful Space and Global Problems of Mankind XXXVII—Innsbruck, 1986: Space: New Opportunities for All People XXXVIII—Brighton, 1987: Thirty years of Progress in Space XXXIX—Bangalore, 1988: Space and Humanity XL—Malaga-Torremolinos, 1989: The Next Forty Years in Space XLI—Dresden, 1990: Space for Peace and Progress

An Unusual Presentation of Neurocysticercosis: A Space-Occupying Lesion in the Fourth Ventricle Associated with Progressive Cognitive Decline.

PubMed

Kurz, Carolin; Schmidt, Veronika; Poppert, Holger; Wilkins, Patricia; Noh, John; Poppert, Sven; Schlegel, Jürgen; Delbridge, Claire; da Costa, Clarissa Prazeres; Winkler, Andrea S

2016-01-01

We communicate a case of a middle-aged Brazilian patient with an unusual presentation of fourth ventricular neurocysticercosis: occurrence of two intraventricular cysts at different locations in the brain within 2 years and cognitive decline as the only neurological symptom. Neurocysticercosis was confirmed by magnetic resonance imaging, serology, histology, and genetic analysis. Neurocysticercosis should be considered as a differential diagnosis in cases with atypical neurologic or psychiatric symptoms, atypical neuroimaging and travel history. Especially, fourth ventricular cysts carry the risk of obstructive hydrocephalus and brainstem compression and therefore should be extirpated completely. If complete removal of the cystic structures cannot be proven in cases with surgically treated neurocysticercosis, anthelminthic therapy and thorough follow-up examinations should be conducted. © The American Society of Tropical Medicine and Hygiene.

Final screening round of the NELSON lung cancer screening trial: the effect of a 2.5-year screening interval.

PubMed

Yousaf-Khan, Uraujh; van der Aalst, Carlijn; de Jong, Pim A; Heuvelmans, Marjolein; Scholten, Ernst; Lammers, Jan-Willem; van Ooijen, Peter; Nackaerts, Kristiaan; Weenink, Carla; Groen, Harry; Vliegenthart, Rozemarijn; Ten Haaf, Kevin; Oudkerk, Matthijs; de Koning, Harry

2017-01-01

In the USA annual lung cancer screening is recommended. However, the optimal screening strategy (eg, screening interval, screening rounds) is unknown. This study provides results of the fourth screening round after a 2.5-year interval in the Dutch-Belgian Lung Cancer Screening trial (NELSON). Europe's largest, sufficiently powered randomised lung cancer screening trial was designed to determine whether low-dose CT screening reduces lung cancer mortality by ≥25% compared with no screening after 10 years of follow-up. The screening arm (n=7915) received screening at baseline, after 1 year, 2 years and 2.5 years. Performance of the NELSON screening strategy in the final fourth round was evaluated. Comparisons were made between lung cancers detected in the first three rounds, in the final round and during the 2.5-year interval. In round 4, 46 cancers were screen-detected and there were 28 interval cancers between the third and fourth screenings. Compared with the second round screening (1-year interval), in round 4 a higher proportion of stage IIIb/IV cancers (17.3% vs 6.8%, p=0.02) and higher proportions of squamous-cell, bronchoalveolar and small-cell carcinomas (p=0.001) were detected. Compared with a 2-year interval, the 2.5-year interval showed a higher non-significant stage distribution (stage IIIb/IV 17.3% vs 5.2%, p=0.10). Additionally, more interval cancers manifested in the 2.5-year interval than in the intervals of previous rounds (28 vs 5 and 28 vs 19). A 2.5-year interval reduced the effect of screening: the interval cancer rate was higher compared with the 1-year and 2-year intervals, and proportion of advanced disease stage in the final round was higher compared with the previous rounds. ISRCTN63545820. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Births: preliminary data for 2000.

PubMed

Martin, J A; Hamilton, B E; Ventura, S J

2001-07-24

This report presents preliminary data for 2000 on births in the United States. U.S. data on births are shown by age, race, and Hispanic origin of mother. Data on marital status, prenatal care, cesarean delivery, and low birthweight are also presented. Data in this report are based on more than 96 percent of births for 2000. The records are weighted to independent control counts of births received in State vital statistics offices in 2000. Comparisons are made with 1999 final data. The number of births rose 3 percent between 1999 and 2000. The crude birth rate increased to 14.8 per 1,000 population in 2000, 2 percent higher than the 1999 rate. The fertility rate rose 3 percent to 67.6 per 1,000 women aged 15-44 years between 1999 and 2000. The birth rate for teenagers, which has been falling since 1991, declined 2 percent in 2000 to 48.7 births per 1,000 females aged 15-19 years, another historic low. The rate for teenagers 15-17 years fell 4 percent, and the rate for 18-19 year olds was down 1 percent. Since 1991, rates have fallen 29 percent for teenagers 15-17 years and 16 percent for teenagers 18-19 years. Birth rates for all of the older age groups increased for 1999-2000: 1 percent among women aged 20-24 years, 3 percent for women aged 25-29 years, and 5 percent for women in their thirties. Rates for women aged 40-54 years were also up for 2000. The birth rate for unmarried women increased 2 percent to 45.2 births per 1,000 unmarried women aged 15-44 years in 2000, but was still lower than the peak reached in 1994. The number of births to unmarried women was up 3 percent, the highest number ever reported in the United States. However, the number of births to unmarried teenagers declined. The proportion of women who began prenatal care in the first trimester of pregnancy (83.2 percent) did not improve for 2000, nor did the rate of low birthweight (7.6 percent). The total cesarean rate rose for the fourth consecutive year to 22.9 percent, the result of both a rise in the rate of primary cesarean deliveries and a decline in the rate of vaginal births after previous cesarean delivery.

Applied Meteorology Unit (AMU) Quarterly Report - Fourth Quarter FY-09

NASA Technical Reports Server (NTRS)

Bauman, William; Crawford, Winifred; Barrett, Joe; Watson, Leela; Wheeler, Mark

2009-01-01

This report summarizes the Applied Meteorology Unit (AMU) activities for the fourth quarter of Fiscal Year 2009 (July - September 2009). Tasks reports include: (1) Peak Wind Tool for User Launch Commit Criteria (LCC), (2) Objective Lightning Probability Tool. Phase III, (3) Peak Wind Tool for General Forecasting. Phase II, (4) Update and Maintain Advanced Regional Prediction System (ARPS) Data Analysis System (ADAS), (5) Verify MesoNAM Performance (6) develop a Graphical User Interface to update selected parameters for the Hybrid Single-Particle Lagrangian Integrated Trajectory (HYSPLlT)

Psychometric Evaluation of a 13-Point Measure of Students' Overall Competence in Community-Based Dental Education Programs.

PubMed

Ramaswamy, Vidya; Piskorowski, Wilhelm; Fitzgerald, Mark; Hamerink, Howard A; Stefanac, Stephen; Greene, Rachel; Lantz, Marilyn S

2016-10-01

Since 2006, the University of Michigan School of Dentistry has used a 13-point measure of overall competence instrument to assess fourth-year dental students' end-rotation performance at community clinics. The aim of this study was to assess the reliability and validity of this instrument used by preceptors to rate students' overall competence during community-based dental education experiences. The measure was analyzed using performance ratings for all fourth-year DDS students in the graduating classes of 2012 and 2013 (combined n=201). The results were that interrater agreement was satisfactory and the measure scored high for internal consistency; also, the measure loaded highly on a single overall competence factor. Ratings on this measure did not correlate with students' final cumulative dental school GPA, but showed a significant positive correlation with their fourth-year fall patient management grades (which signify students' conscientiousness in managing patients and their families in a professional and ethical manner). There were differences in grading systems between the 2012 cohort (which used a pass/fail system) and the 2013 cohort (which used a letter grade system) and the mean ratings they received (higher for the 2013 cohort). Overall, the study found that the 13-point measure demonstrated excellent reliability and validity, suggesting it is useful in determining a student's clinical competence in these settings.

Factors Influencing Residency Program Selection by Medical Students Pursuing Obstetrics and Gynecology.

PubMed

Alston, Meredith J; Metz, Torri D; Fothergill, Russell; Meg Autry, Amy; Wagner, Sarah A; Allshouse, Amanda A; Stephenson-Famy, Alyssa

2017-02-01

Little is known about the factors that influence medical student selection of obstetrics and gynecology (ob-gyn) residency programs. We assessed the factors influencing residency program selection by fourth-year medical students pursuing ob-gyn training. A voluntary, anonymous, 19-question survey of residency selection factors was distributed to all fourth-year medical students interviewing at 1 of 5 academic ob-gyn departments for a residency position during the 2013-2014 interview season. Participants were surveyed about the relative importance (not important, somewhat important, important) of various residency selection factors, including operative experience, exposure to subspecialties, curricular experience, access to fellowships, and administrative aspects of residency, including adherence to duty hour restrictions. Of 322 potential respondents, 262 (81%) completed the survey. Surgical training and training in laparoscopic surgery were deemed "important" by nearly all respondents (98%, 258 of 262, and 97%, 253 of 262, respectively). Factors that were considered "not important" by a significant group of respondents included maternity/paternity leave policies (22%, 58 of 259); opportunity for international rotations/electives (20%, 51 of 259); exposure to quality and safety initiatives (13%, 34 of 259); and training in abortion (13%, 34 of 262). Fourth-year medical students identified surgical training as the most important factor in selecting an ob-gyn residency, a finding that is particularly relevant as decreasing and changing surgical volumes affect residency training in this specialty.

Impact of a Revised Curriculum Focusing on Clinical Neurology and Musculoskeletal Care on a Required Fourth-Year Medical Student Physical Medicine and Rehabilitation Clerkship

PubMed Central

Faulk, Clinton E.; Harrell, Kelly M.; Lawson, Luan E.; Moore, Daniel P.

2016-01-01

Background. A Required Fourth-Year Medical Student Physical Medicine and Rehabilitation (PM&R) Clerkship was found to increase students' knowledge of PM&R; however the students' overall rotation evaluations were consistently lower than the other 8 required clerkships at the medical school. Objective. To describe the impact of a revised curriculum based upon Entrustable Professional Activities and focusing on basic pain management, musculoskeletal care, and neurology. Setting. Academic Medical Center. Participants. 73 fourth-year medical students. Methods. The curriculum changes included a shift in the required readings from rehabilitation specific topics toward more general content in the areas of clinical neurology and musculoskeletal care. Hands-on workshops on neurological and musculoskeletal physical examination techniques, small group case-based learning, an anatomy clinical correlation lecture, and a lecture on pain management were integrated into the curriculum. Main Outcome Measurements. Student evaluations of the clerkship. Results. Statistically significant improvements were found in the students' evaluations of usefulness of lecturers, development of patient interviewing skills, and diagnostic and patient management skills (p ≤ 0.05). Conclusions. This study suggests that students have a greater satisfaction with a required PM&R clerkship when lecturers utilize a variety of pedagogic methods to teach basic pain, neurology and musculoskeletal care skills in the rehabilitation setting rather than rehabilitation specific content. PMID:28025624

Impact of a Revised Curriculum Focusing on Clinical Neurology and Musculoskeletal Care on a Required Fourth-Year Medical Student Physical Medicine and Rehabilitation Clerkship.

PubMed

Norbury, John W; Faulk, Clinton E; Harrell, Kelly M; Lawson, Luan E; Moore, Daniel P

2016-01-01

Background . A Required Fourth-Year Medical Student Physical Medicine and Rehabilitation (PM&R) Clerkship was found to increase students' knowledge of PM&R; however the students' overall rotation evaluations were consistently lower than the other 8 required clerkships at the medical school. Objective . To describe the impact of a revised curriculum based upon Entrustable Professional Activities and focusing on basic pain management, musculoskeletal care, and neurology. Setting . Academic Medical Center. Participants . 73 fourth-year medical students. Methods . The curriculum changes included a shift in the required readings from rehabilitation specific topics toward more general content in the areas of clinical neurology and musculoskeletal care. Hands-on workshops on neurological and musculoskeletal physical examination techniques, small group case-based learning, an anatomy clinical correlation lecture, and a lecture on pain management were integrated into the curriculum. Main Outcome Measurements . Student evaluations of the clerkship. Results . Statistically significant improvements were found in the students' evaluations of usefulness of lecturers, development of patient interviewing skills, and diagnostic and patient management skills ( p ≤ 0.05). Conclusions . This study suggests that students have a greater satisfaction with a required PM&R clerkship when lecturers utilize a variety of pedagogic methods to teach basic pain, neurology and musculoskeletal care skills in the rehabilitation setting rather than rehabilitation specific content.

Bleeding pattern and user satisfaction in second consecutive levonorgestrel-releasing intrauterine system users: results of a prospective 5-year study.

PubMed

Heikinheimo, O; Inki, P; Schmelter, T; Gemzell-Danielsson, K

2014-06-01

What is the bleeding pattern during second consecutive levonorgestrel-releasing intrauterine system (LNG-IUS) use? Consecutive use of LNG-IUS is associated with a predictable bleeding pattern, characterized by the absence of the initial period of irregular bleeding seen after interval insertion of an LNG-IUS and a non-bleeding pattern in the vast majority of women. With increased popularity of the LNG-IUS for long-term birth control and treatment of heavy menstrual bleeding (HMB), consecutive use of the system is becoming more frequent. One previous study showed 60% amenorrhea rate in consecutive IUS users; however, the sample size was small. A prospective multicenter study in four European countries recruited women who wished to continue with LNG-IUS use immediately after the first 5-year period. A total of 204 women were followed up until the end of the first year of the second IUS. Thereafter 170 women continued into the extension phase of the study up to the full 5 years of use of the second IUS and 144 women continued to the end of the study. A total of 170 women (mean age 39 years) who had been using their first LNG-IUS for between 4 years 3 months and 4 years 9 months, either for contraception or for treatment of HMB, and who planned to replace the device with a new LNG-IUS, were recruited and followed up to 5 years of the second IUS use. A total of 17 centers in four European countries were involved in the study. Bleeding patterns were analyzed using daily bleeding diaries using 90-day reference periods (RP) for the first year of the second IUS use and for the last RP of each year during Years 2-5 of use. Approximately 70% of women were free of bleeding during Years 2-5 and up to 49% were amenorrheic. There was a slight increase in the number of bleeding/spotting days of ∼3 days during the first RP immediately after the placement of the second IUS, whereafter the number of bleeding/spotting days returned to the level preceding the second IUS insertion or below that. Absence of bleeding was associated with high overall satisfaction and continuation rates. No serious adverse events assessed as related to the LNG-IUS use occurred during the 5-year period. The cumulative expulsion rate during the 5-year study period was 1.2%. The sample size was large enough to study bleeding patterns, and subjects are likely to represent typical consecutive IUS users, and therefore, the role of chance is small. The women represent a selected group as they had already successfully used their first IUS for almost 5 years and were willing to continue its use-however, this is currently a common clinical situation. The results may therefore not be extrapolated to first-time users of the LNG-IUS. These data are of importance when counseling women who are making decisions concerning long-term contraception. This study was funded by Bayer Pharma AG. P.I. and T.S. are full-time employees of Bayer Pharma AG. O.H. and K. G-D. have received consultancy fees from Bayer Pharma AG. The publication was developed jointly by all authors without third-party involvement and no honoraria were paid for any authors for their contribution to this manuscript. NCT00393198.

Annual dynamics of wild bee densities: attractiveness and productivity effects of oilseed rape.

PubMed

Riedinger, Verena; Mitesser, Oliver; Hovestadt, Thomas; Steffan-Dewenter, Ingolf; Holzschuh, Andrea

2015-05-01

Mass-flowering crops may affect long-term population dynamics, but effects on pollinators have never been studied across several years. We monitored wild bees in oilseed rape fields in 16 landscapes in Germany in two consecutive years. Effects on bee densities of landscape oilseed rape cover in the years of monitoring and in the previous years were evaluated with landscape data from three consecutive years. We fit empirical data to a mechanistic model to provide estimates for oilseed rape attractiveness and its effect on bee productivity in comparison to the rest of the landscape, and we evaluated consequences for pollinator densities in consecutive years. Our results show that high oilseed rape cover in the previous year enhances current densities of wild bees (except for bumble bees). Moreover, we show a strong attractiveness of and dilution on (i.e., decreasing bee densities with increasing landscape oilseed rape cover) oilseed rape for bees during flowering in the current year, modifying the effect of the previous year's oilseed rape cover in the case of wild bees (excluding Bombus). As long as other factors such as nesting sites or natural enemies do not limit bee reproduction, our findings suggest long-term positive effects of mass-flowering crops on bee populations, at least for non-Bombus generalists, which possibly help to maintain crop pollination services even when crop area increases. Similar effects are conceivable for other organisms providing ecosystem services in annual crops and should be considered in future studies.

Physical activity among children: objective measurements using Fitbit One® and ActiGraph.

PubMed

Hamari, Lotta; Kullberg, Tiina; Ruohonen, Jukka; Heinonen, Olli J; Díaz-Rodríguez, Natalia; Lilius, Johan; Pakarinen, Anni; Myllymäki, Annukka; Leppänen, Ville; Salanterä, Sanna

2017-04-20

Self-quantification of health parameters is becoming more popular; thus, the validity of the devices requires assessments. The aim of this study was to evaluate the validity of Fitbit One step counts (Fitbit Inc., San Francisco, CA, USA) against Actigraph wActisleep-BT step counts (ActiGraph, LLC, Pensacola, FL, USA) for measuring habitual physical activity among children. The study was implemented as a cross-sectional experimental design in which participants carried two waist-worn activity monitors for five consecutive days. The participants were chosen with a purposive sampling from three fourth grade classes (9-10 year olds) in two comprehensive schools. Altogether, there were 34 participants in the study. From these, eight participants were excluded from the analysis due to erroneous data. Primary outcome measures for step counts were Fitbit One and Actigraph wActisleep-BT. The supporting outcome measures were based on activity diaries and initial information sheets. Classical Bland-Altman plots were used for reporting the results. The average per-participant daily difference between the step counts from the two devices was 1937. The range was [116, 5052]. Fitbit One gave higher step counts for all but the least active participant. According to a Bland-Altman plot, the hourly step counts had a relative large mean bias across participants (161 step counts). The differences were partially explained by activity intensity: higher intensity denoted higher differences, and light intensity denoted lower differences. Fitbit One step counts are comparable to Actigraph step counts in a sample of 9-10-year-old children engaged in habitual physical activity in sedentary and light physical activity intensities. However, in moderate-to-vigorous physical activity, Fitbit One gives higher step counts when compared to Actigraph.

Cardiovascular risk factors in Middle Eastern patients undergoing percutaneous coronary intervention: Results from the first Jordanian percutaneous coronary intervention study.

PubMed

Hammoudeh, Ayman J; Alhaddad, Imad A; Khader, Yousef; Tabbalat, Ramzi; Al-Mousa, Eyas; Saleh, Akram; Jarrah, Mohamad; Nammas, Assem; Izraiq, Mahmoud

2017-07-01

Background and aims: Cardiovascular disease (CVD) is the leading cause of death in the Middle East. We sought to study the prevalence and coexistence of 6 cardiovascular risk factors (RFs) among patients who underwent percutaneous coronary intervention (PCI), and to evaluate the impact of age and gender on the presence of multiple RFs. In this prospective, multicenter study, 2426 consecutive patients were enrolled. Mean age was 59.0 ± 10.1 years and 500 (20.6%) were women. Acute coronary syndrome and stable coronary disease were the indications for PCI in 77.1% and 22.9%, respectively. Hypertension was present in 62.3%, diabetes in 53.8%, hypercholesterolemia in 48.8%, smoking in 43.5%, family history of premature CVD 39.4% and obesity in 28.8%. Only 3.8% did not have any of these RFs. Presence of ⩾3 and ⩾4 RFS was observed in 57.4% and 29.5% of patients, respectively. Presence of ⩾3 RFs was more common in women than men (69.0% vs. 54.5%, p  < 0.0001), and among patients 41-65 years of age than older or younger patients (60.1% vs. 52.0% vs. 48.3%, respectively, p  = 0.017). Conclusions: Cardiovascular RFs are highly prevalent in this PCI Middle Eastern population undergoing PCI. More than half and more than one-fourth of the patients had at least 3 or 4 RFs; respectively. More women than men and more middle aged patients than older or younger patients had significantly higher rates of presence of multiple RFs.

The success rate of TED upper eyelid retraction reoperations.

PubMed

Golan, Shani; Rootman, Dan B; Goldberg, Robert A

2016-12-01

Although reoperation rates for upper lid retraction surgery for thyroid eye disease (TED) typically range between 8% and 23%, there is little literature describing the outcomes of these second operations. In this retrospective observational cohort study, all patients that underwent surgery for upper eyelid retraction over a 14-year period at a single institution were included. Cases were included if a second eyelid retraction surgery was performed during the study period. Success of surgery was defined as a marginal reflex distance (MRD1) of 2.5 to 4.5 mm in each eye and less than 1 mm difference in MRD1 between the eyes. Overcorrection and undercorrection were defined as above and below these bounds, respectively. 72 eyes in 49 patients were included in the study. The mean age was 56.6 (±11.5) years. By definition, all patients had at least 1 lid lengthening surgery for upper eyelid retraction, and at least 1 subsequent surgery. For this second surgery, 61 eyes (85%) underwent retraction surgery and 11 eyes (15%) underwent ptosis surgery. After this second operation, 31% were undercorrected and 33% were overcorrected. A third surgery was performed in 19 eyes (25%), 12 had surgery for residual retraction and 7 for ptosis. After the third operation 10% of eyes were under corrected and 11% were over corrected. Four patients underwent a fourth surgery: one for retraction and three for ptosis. Success was noted in 35% after the second surgery and 44% after the third. Surgical success in eyelid retraction surgery increases from a second to a third consecutive surgery, and residual asymmetry was roughly equally distributed between over- and undercorrection.

Gestational diabetes mellitus and the risk of metabolic syndrome: a population-based study in Lausanne, Switzerland.

PubMed

Noussitou, P; Monbaron, D; Vial, Y; Gaillard, R C; Ruiz, J

2005-09-01

To investigate the relationships between gestational diabetes mellitus (GDM) and the metabolic syndrome (MS), as it was suggested that insulin resistance was the hallmark of both conditions. To analyse post-partum screening in order to identify risk factors for the subsequent development of type 2 diabetes mellitus (DM). A retrospective analysis of all singleton pregnancies diagnosed with GDM at the Lausanne University Hospital for 3 consecutive years. Pre-pregnancy obesity, hypertension and dyslipidaemia were recorded as constituents of the MS. For 5788 deliveries, 159 women (2.7%) with GDM were identified. Constituents of the MS were present before GDM pregnancy in 26% (n = 37/144): 84% (n = 31/37) were obese, 38% (n = 14/37) had hypertension and 22% (n = 8/37) had dyslipidaemia. Gestational hypertension was associated with obesity (OR = 3.2, P = 0.02) and dyslipidaemia (OR = 5.4, P=0.002). Seventy-four women (47%) returned for post-partum OGTT, which was abnormal in 20 women (27%): 11% (n = 8) had type 2 diabetes and 16% (n = 12) had impaired glucose tolerance. Independent predictors of abnormal glucose tolerance in the post-partum were: having > 2 abnormal values on the diagnostic OGTT during pregnancy and presenting MS constituents (OR = 5.2, CI 1.8-23.2 and OR = 5.3, CI 1.3-22.2). In one fourth of GDM pregnancies, metabolic abnormalities precede the appearance of glucose intolerance. These women have a high risk of developing the MS and type 2 diabetes in later years. Where GDM screening is not universal, practitioners should be aware of those metabolic risks in every pregnant woman presenting with obesity, hypertension or dyslipidaemia, in order to achieve better diagnosis and especially better post-partum follow-up and treatment.

Acute myocardial infarction in very young adults: A clinical presentation, risk factors, hospital outcome index, and their angiographic characteristics in North India-AMIYA Study.

PubMed

Sinha, Santosh Kumar; Krishna, Vinay; Thakur, Ramesh; Kumar, Ashutosh; Mishra, Vikas; Jha, Mukesh Jitendra; Singh, Karandeep; Sachan, Mohit; Sinha, Rupesh; Asif, Mohammad; Afdaali, Nasar; Mohan Varma, Chandra

2017-03-01

India is currently in the fourth stage of epidemiological transitions where cardiovascular disease is the leading cause of mortality and morbidity. Purpose of the present study was to assess the risk factors, clinical presentation, angiographic profile including severity, and in-hospital outcome of very young adults (aged ≤ 30 years) with first acute myocardial infarction (AMI). Total of 1,116 consecutive patients with ST-segment elevation acute myocardial infarction (STEMI) were studied between March 2013 and February 2015 at LPS Institute of Cardiology, Kanpur, Uttar Pradesh, India. Mean age of the patients was 26.3 years. Risk factors were smoking (78.5%), family history of premature coronary artery disease (CAD) (46.8%), obesity (39.1%), physical inactivity (38.7%) and stressful life events (29.6%). The most common symptom and presentation was chest pain and anterior wall myocardial infarction (AWMI) in 94.8% and 58.8%, respectively. About 80.6% of patients had obstructive CAD with single vessel disease (57.6%), double-vessel disease (12.9%) and left main involvement (3.2%). Left anterior descending (LAD) was commonest culprit artery (58.1%) followed by right coronary artery in 28.2%. In-hospital mortality was 2.8%. Percutaneous coronary intervention was performed in 71.6% of patients. Median number and length of stent were 1.18 and 28 ± 16 mm, respectively. AMI in very young adult occurred most commonly in male. Smoking was the most common risk factor. AWMI owing to LAD artery involvement was the most common presentation. Mean time of presentation after symptom onset was 16.9 hours. In contrast to western population, it is characterised by earlier onset, delayed presentation, more severity, diffuse disease, and more morbidity but with favourable in-hospital mortality.

'Hip-hop' stroke: a stroke educational program for elementary school children living in a high-risk community.

PubMed

Williams, Olajide; Noble, James M

2008-10-01

Public stroke recognition is poor and poses a barrier to acute stroke treatment. We describe a stroke literacy program that teaches elementary school children in high-risk communities to recognize stroke and form an urgent action plan; we then present results of an intervention study using the program. "Hip-Hop" Stroke uses culturally and age-appropriate music and dance to enhance an interactive didactic curriculum including the FAST mnemonic (Facial droop, Arm weakness, Speech disturbance, Time to call 911). The program occurred in central Harlem, New York City, a community with high stroke risk. During the 2006 to 2007 school year, 582 fourth, fifth, and sixth graders (9 to 11 years of age) participated in 1-hour sessions over 3 consecutive days. Stroke knowledge was tested before and after the program with a 94% group participant retention. Students learned and retained knowledge well for stroke localization (20% correct before intervention, 93% correct immediately afterward, and 86% correct after 3-month delay; P<0.001 both posttests versus baseline), the term "brain attack" (16% pretest, 95% immediate, 86% delayed; P<0.001), and to call 911 for stroke (78% pretest, 99.8% immediate, 98% delayed; P<0.001). FAST stroke symptoms (facial droop and slurred speech) were better retained than non-FAST symptoms (headache and blurred vision) at 3 months (P<0.001). For stroke prevention measures, dietary change and exercise were better learned than concepts of diabetes, hypertension, and cholesterol. Elementary school children are educable about stroke, retain their knowledge well, and may be able to appropriately activate emergency services for acute stroke. Incorporating cultural elements such as hip-hop music may improve retention of stroke knowledge among the youth.

Predictors of College Attendance Patterns of Rural Youth

ERIC Educational Resources Information Center

Byun, Soo-yong; Meece, Judith L.; Agger, Charlotte A.

2017-01-01

This study investigated patterns of college attendance using data from a nationwide and contemporary sample of 2112 rural youth. We found that more than half of rural youth attended two-year institutions at some point during their college career and about a fourth initially enrolled in a two-year college before enrolling in a four-year college.…

The Boeing Company Applied Academics Project Evaluation: Year Four. Evaluation Report.

ERIC Educational Resources Information Center

Wang, Changhua; Owens, Thomas R.

This paper describes fourth-year outcomes (1993-94) of the Boeing Company-funded Applied Academics Project. Since the 1990-91 school year, the company has provided funds to improve and expand applied academics in 60 Washington high schools. Data were collected from pre- and post-surveys of students enrolled in the project's Applied Mathematics…

What Works in Student Retention? Fourth National Survey. Private Four-Year Colleges and Universities Report

ERIC Educational Resources Information Center

ACT, Inc., 2010

2010-01-01

This report presents the findings for private four-year colleges that participated in ACT's 2010 What Works in Student Retention survey. The report contains information pertinent to only these institutions. Appended are: (1) Data for Private Four-Year Colleges and Universities; and (2) What Works in Student Retention: Instrument. (Contains 15…

What Works in Student Retention? Fourth National Survey. Public Four-Year Colleges and Universities Report

ERIC Educational Resources Information Center

ACT, Inc., 2010

2010-01-01

This report presents the findings for public four-year colleges and universities that participated in ACT's 2010 What Works in Student Retention survey. The report contains information pertinent to only these institutions. Appended are: (1) Data for Public Four-Year Colleges and Universities; and (2) What Works in Student Retention: Instrument.…

Soil CO2 evolution and root respiration in 11 year-old Loblolly Pine (Pinus taeda) Plantations as Affected by Moisture and Nutrient Availability

Treesearch

Chris A. Maier; L.W. Kress

2000-01-01

We measured soil CO2 evolution rates with (Sff) and without (Sms) the forest floor litter and root respiration monthly in 11-year-old loblolly pine (Pinus taeda L.) plantations during the fourth year of fertilization and irrigation treatments. Values of Sff...

PIRLS 2016: International Results in Reading

ERIC Educational Resources Information Center

Mullis, Ina V. S.; Martin, Michael O.; Foy, Pierre; Hooper, Martin

2017-01-01

PIRLS (Progress in International Reading Literacy Study) was inaugurated in 2001 as a follow-up to International Association for the Evaluation of Educational Achievement's 1991 Reading Literacy Study. Conducted every five years, PIRLS assesses the reading achievement of young students in their fourth year of schooling--an important transition…

U.S. Department of Transportation performance report fiscal year 2000 and performance plan fiscal year 2002

DOT National Transportation Integrated Search

2001-04-01

This document affirms the U.S. Department of Transportation's (DOT) commitment to managing for results. It is DOT's second annual performance report and fourth annual performance plan. By combining the DOT performance report on 2000 results with the ...

Returning Fourth-Year Students to the Classroom/Laboratory.

ERIC Educational Resources Information Center

Markert, Ronald J.; Ogilvie, Charles D.

1980-01-01

The Eighth Semester Program of the Texas College of Osteopathic Medicine reintroduces classroom-laboratory activities into the medical students' clinical years in an attempt to "round out" students' education. Topics include development of a medical practice, government and the physician, counseling skills, and nutrition inpatient care.…

Comprehensive whole-body counter surveys of Miharu-town school children for three consecutive years after the Fukushima NPP accident.

PubMed

Hayano, Ryugo S; Tsubokura, Masaharu; Miyazaki, Makoto; Satou, Hideo; Sato, Katsumi; Masaki, Shin; Sakuma, Yu

2014-01-01

Comprehensive whole-body counter surveys covering over 93% of the school children between the ages of 6 and 15 in Miharu town, Fukushima Prefecture, have been conducted for three consecutive years, in 2011, 2012 and 2013. Although the results of a questionnaire indicate that approximately 60% of the children have been regularly eating local or home-grown rice, in 2012 and 2013 no child was found to exceed the (137)Cs detection limit of 300 Bq/body.

Critical analysis of consecutive unilateral cleft lip repairs: determining ideal sample size.

PubMed

Power, Stephanie M; Matic, Damir B

2013-03-01

Objective : Cleft surgeons often show 10 consecutive lip repairs to reduce presentation bias, however the validity remains unknown. The purpose of this study is to determine the number of consecutive cases that represent average outcomes. Secondary objectives are to determine if outcomes correlate with cleft severity and to calculate interrater reliability. Design : Consecutive preoperative and 2-year postoperative photographs of the unilateral cleft lip-nose complex were randomized and evaluated by cleft surgeons. Parametric analysis was performed according to chronologic, consecutive order. The mean standard deviation over all raters enabled calculation of expected 95% confidence intervals around a mean tested for various sample sizes. Setting : Meeting of the American Cleft Palate-Craniofacial Association in 2009. Patients, Participants : Ten senior cleft surgeons evaluated 39 consecutive lip repairs. Main Outcome Measures : Preoperative severity and postoperative outcomes were evaluated using descriptive and quantitative scales. Results : Intraclass correlation coefficients for cleft severity and postoperative evaluations were 0.65 and 0.21, respectively. Outcomes did not correlate with cleft severity (P  =  .28). Calculations for 10 consecutive cases demonstrated wide 95% confidence intervals, spanning two points on both postoperative grading scales. Ninety-five percent confidence intervals narrowed within one qualitative grade (±0.30) and one point (±0.50) on the 10-point scale for 27 consecutive cases. Conclusions : Larger numbers of consecutive cases (n > 27) are increasingly representative of average results, but less practical in presentation format. Ten consecutive cases lack statistical support. Cleft surgeons showed low interrater reliability for postoperative assessments, which may reflect personal bias when evaluating another surgeon's results.

The Impact of Consecutive Interpreting Training on the L2 Listening Competence Enhancement

ERIC Educational Resources Information Center

Zhang, Tongtong; Wu, Zhiwei

2017-01-01

In recent years, a growing number of people have taken up interpreting training, with the intention of not only developing interpreting skills, but improving language proficiency as well. The present study sets out to investigate the impact of English-Chinese consecutive interpreting (CI) training on the enhancement of the second language (L2,…

Self-Cutting: Patient Characteristics Compared with Self-Poisoners

ERIC Educational Resources Information Center

Hawton, Keith; Harriss, Louise; Simkin, Sue; Bale, Elizabeth; Bond, Alison

2004-01-01

A large (n = 14,892) consecutive sample of deliberate self-harm (attempted suicide) patients who presented to a general hospital in the United Kingdom during a 23-year study period was examined (over two consecutive time periods) in order to compare the characteristics of those who used self-cutting (n = 428) and those who self-poisoned (n =…

Discovering the Thermodynamics of Simultaneous Equilibria: An Entropy Analysis Activity Involving Consecutive Equilibria

ERIC Educational Resources Information Center

Bindel, Thomas H.

2007-01-01

An activity is presented in which the thermodynamics of simultaneous, consecutive equilibria are explored. The activity is appropriate for second-year high school or AP chemistry. Students discover that a reactant-favored (entropy-diminishing or endergonic) reaction can be caused to happen if it is coupled with a product-favored reaction of…

An evaluation of the problem-solving ability of diplomates from a comprehensive nursing programme.

PubMed

Makhathini, J T; Uys, L R

1996-10-01

The aim of this South African study was to obtain a measurement of the problem-solving ability of diplomates from a basic nursing programme with this skill included in its programme objectives. The problem-solving skills of diplomates from this programme were compared with those of first years to determine if there is an improvement in the problem-solving skills. A comparison was also made with a different basic programmes not claiming to teach problem-solving. The research design selected for this study was the ex post facto design. Data were collected using the Triple Jump Method which is an interview technique. The findings suggested that the level of the problem-solving skills of the comprehensive nursing programme diplomate is not satisfactory. There was, however, some improvement in the problem-solving ability from the first to the fourth year. The level of performance of the fourth years was slightly higher than that of the third years of the three-year nursing programme, who were used as the control group. Recommendations on selection teaching and evaluation of students, as well as further research, were made.

Students' Accounts of Grammatical Forms of German That Are Difficult, Unattainable, and Irrelevant for Self-Expression

ERIC Educational Resources Information Center

Chavez, Monika

2016-01-01

This study examined the responses of 39 first-year, 63 second-year, 20 third-year, and 19 fourth-year US college learners of German when they were asked what forms of L2 grammar they, respectively, find particularly difficult; do not expect to ever acquire fully; and believe are not necessary for self-expression. Nominal morphology--particularly…

Implementation of transcatheter aortic valve replacement in California: Influence on aortic valve surgery.

PubMed

Maximus, Steven; Milliken, Jeffrey C; Danielsen, Beate; Shemin, Richard; Khan, Junaid; Carey, Joseph S

2018-04-01

Transcatheter aortic valve replacement (TAVR) procedures were introduced in 2011. Initially, procedures were limited to patients who were not surgical candidates, but subsequently high-risk surgical candidates were considered for TAVR. The influence on aortic valve surgery in California is unknown. The California Office of Statewide Health Planning and Development hospitalized patient discharge database was queried for the years 2009 through 2014. isolated surgical aortic valve and aortic valve/coronary artery bypass graft (SAVR) and TAVR procedures were identified by International Classification of Diseases-9th revision clinical modification procedure codes. Seven TAVR programs were introduced in 2011, 12 in 2012, 3 in 2013, and 6 in 2014. SAVR procedure volumes were compared from the 2 years before institution with SAVR volumes during the year(s) after institution of the TAVR program in these 28 hospitals. Overall, surgical volumes increased during the first, second, and third years after implementation of TAVR procedures. Among 7 hospitals with 4-year programs, surgical volumes increased to a maximum of 15.5% during the third year, then began to decrease. The hospital performing the largest number of TAVR procedures showed a marked decrease in SAVR volume by the fourth year, suggesting a shift of SAVR candidates to TAVR. Among all hospitals with 4-year programs, TAVR exceeded SAVR procedures by the fourth year. In California overall, SAVR increased during 2011 through 2013, due primarily to increasing volume of isolated SAVR procedures. Statewide, isolated SAVR increased from a yearly average of 3111 procedures during 2009-2010 to 3592 (+15.5%) in 2013, then decreased slightly in 2014. SAVR plus coronary artery bypass graft procedures decreased during the same time period. After implementation of TAVR, hospital SAVR volumes increased moderately, then began to decrease by the fourth year, when TAVR volume exceeded SAVR. Surgical candidates may be identified during evaluation for TAVR, resulting in increased SAVR volume. Increasing SAVR volume may also be related to improved patient and provider awareness of aortic valve disease. Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

PREVALENCE OF HELICOBACTER PYLORI TEN YEARS AGO COMPARED TO THE CURRENT PREVALENCE IN PATIENTS UNDERGOING UPPER ENDOSCOPY

PubMed Central

FRUGIS, Sandra; CZECZKO, Nicolau Gregori; MALAFAIA, Osvaldo; PARADA, Artur Adolfo; POLETTI, Paula Bechara; SECCHI, Thiago Festa; DEGIOVANI, Matheus; RAMPANAZZO-NETO, Alécio; D´AGOSTINO, Mariza D.

2016-01-01

ABSTRACT Background: Helicobacter pylori has been extensively studied since 1982 it is estimated that 50% of the world population is affected. The literature lacks studies that show the change of its prevalence in the same population over time. Aim: To compare the prevalence of H. pylori in 10 years interval in a population that was submitted to upper endoscopy in the same endoscopy service. Method: Observational, retrospective and cross-sectional study comparing the prevalence of H. pylori in two samples with 10 years apart (2004 and 2014) who underwent endoscopy with biopsy and urease. Patients were studied in three consecutive months of 2004, compared to three consecutive months of 2014. The total number of patients was 2536, and 1406 in 2004 and 1130 in 2014. Results: There were positive for H. pylori in 17 % of the sample as a whole. There was a significant decrease in the prevalence from 19.3% in 2004 to 14.1% in 2014 (p<0.005). Conclusion: There was a 5.2% reduction in the prevalence of H. pylori comparing two periods of three consecutive months with 10 years apart in two equivalent population samples. PMID:27759776

Using Assessments of Dental Students' Entrepreneurial Self-Efficacy to Aid Practice Management Education.

PubMed

Mollica, Anthony G; Cain, Kevin; Callan, Richard S

2017-06-01

In the past, the typical practice management curriculum in U.S. dental schools was found to place a heavy emphasis on customer service, whereas areas typically stressed in business entrepreneurship and management courses (e.g., long-range planning, competing strategies, and supplier relationship) received less attention. However, future dentists will likely have many points in their careers at which they must decide whether to begin a new business or to associate with a practice, and entrepreneurial and management training can help them make and implement those decisions. The aim of this exploratory study was to investigate the impact of one dental school's practice management education on students' entrepreneurial self-efficacy (ESE), a construct examined for the first time in dental education. ESE is an individual's belief that he or she is personally capable of planning for, operating, and managing a successful business. In December 2014, all students in all four classes were asked to complete a survey measuring their ESE. The response rates for each class were D1 94%, D2 91%, D3 87%, and D4 79%. The results showed that the mean scores of the fourth-year class were higher on all five examined dimensions than those of the other three classes. The same was true for the mean for each class with the exception of the competency regarding an individual's perception of his or her abilities to deploy and manage human resources, in which the first-year class had a higher score than the fourth-year class (149.07>146.06). The fourth-year class had statistically significant higher scores than the third-year class, consistent with the implementation of practice management courses in the curriculum.

Deconstructing One Medical School's Pain Curriculum: II. Partnering with Medical Students on an Evidence-Guided Redesign.

PubMed

Bradshaw, Ylisabyth S; Patel Wacks, Neha; Perez-Tamayo, Alejandra; Myers, Brenden; Obionwu, Chukwueloka; Lee, Rebecca A; Carr, Daniel B

2017-04-01

To reshape medical education about pain to present it as a population-based public health process as well as a neuron-centered phenomenon. Collaborate with students to apply a recent inventory of pain-related preclinical curricular content and clinical training in order to modify the current multiyear presentation and offer a broadened social perspective on pain. Appraise fourth-year medical students' pain-related educational needs by surveying their knowledge, attitudes, experience with the curriculum, and self-reported assessment of pain-related competencies. University-affiliated medical school and its fourth-year medical students. Analysis of a detailed inventory of first- and second-year curricula. Survey of graduating medical students assessing attitudes, skills, and confidence. Construction of a fourth-year pain education elective and collaboration with enrollees to better integrate pain throughout the four-year curriculum. This student-faculty collaboration produced an evidence-guided proposal to reorganize pain-related content across the longitudinal medical curriculum. An attitudes/skills/confidence survey of graduating medical students (104 respondents of 200 polled) found that 70% believed chances for successful outcomes treating chronic pain were low. Self-evaluated competency was high for evaluating (82%) and managing (69%) acute pain; for chronic pain, both were lower (evaluating = 38%; managing = 6%). Self-evaluated knowledge of pain physiology and neurobiology was poor (14%), fair (54%), or good (30%), but rarely excellent (2%). To meet graduating students' desire for increased competency in pain, pain-related curricula can and should be reorganized to include pain as a disease state and a widespread public health burden, not merely a symptom. © 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Preschool physical activity and functional constipation: the Generation R study.

PubMed

Driessen, Lisa M; Kiefte-de Jong, Jessica C; Wijtzes, Anne; de Vries, Sanne I; Jaddoe, Vincent W V; Hofman, Albert; Raat, Hein; Moll, Henriette A

2013-12-01

Decreased physical activity levels in children may partly explain the rising prevalence of functional constipation in childhood. The aim of the present study, therefore, was to examine the association between physical activity and functional constipation during the preschool period. This study was embedded in the Generation R study, a large prospective birth-cohort study in Rotterdam, The Netherlands. Physical activity was measured by an Actigraph accelerometer in 347 children (182 boys, 165 girls; mean age 25.1 months) and data were expressed as counts per minute. Data were categorized into light activity (302-614 counts/15 seconds), moderate activity (615-1230 counts/15 seconds), and vigorous activity (≥1231 counts/15 seconds). Functional constipation in the third and fourth year of life was defined according to the Rome II criteria. Children spending time in the highest tertile of light (adjusted odds ratio [OR] 0.34; 95% confidence interval [CI] 0.13-0.87), moderate (adjusted OR 0.37; 95% CI 0.14-0.97), and total activity (adjusted OR 0.37; 95% CI 0.15-0.92) at the age of 2 years had significantly less functional constipation in the fourth year of life. For functional constipation in the third year of life, the results were in similar direction but not statistically significant. Additionally, children with physical activity of more than the WHO recommendation of 60 min/day had significantly less functional constipation in the fourth year of life (adjusted OR 0.48; 95% CI 0.24-0.97). Physical activity is associated with a decreased risk of functional constipation in the preschool period, but this may be time dependent.

A new serial pooling method of shifted tree ring blocks to construct millennia long tree ring isotope chronologies with annual resolution.

PubMed

Boettger, Tatjana; Friedrich, Michael

2009-03-01

The study presents a new serial pooling method of shifted tree ring blocks for the building of isotope chronologies. This method combines the advantages of traditional 'serial' and 'intertree' pooling, and can be recommended for the construction of sub-regional long isotope chronologies with sufficient replication, and on annual resolution, especially for the case of extremely narrow tree rings. For Scots pines (Pinus sylvestris L., Khibiny Low Mountains, NW Russia) and Silver firs (Abies alba Mill., Franconia, Southern Germany), serial pooling of five consecutive tree rings seems appropriate because the species- and site-specific particularities lead to blurs of climate linkages in their tree rings for the period up to ca. five years back. An equivalent to a five-year running means that curve gained on the base annual data sets of single trees can be derived from the analysis of yearly shifted five-year blocks of consecutive tree rings, and therefore, with approximately 20% of the expense. Good coherence of delta(13)C- and delta(18)O-values between calculated means of annual total rings or late wood data and means of five-year blocks of consecutive total tree rings analysed experimentally on most similar material confirms this assumption.

Reasons for Vocabulary Attrition: Revisiting the State of the Art

ERIC Educational Resources Information Center

Alharthi, Thamer

2015-01-01

This paper reports on a one year, mixed-methods longitudinal case study investigating the neglected area of the perceived reasons why participants forget vocabulary knowledge. The participants were 43 fourth year male Saudi EFL majors at King Abdulaziz University KAU, Saudi Arabia. Quantitative and qualitative data including self-reported…

Compensatory Education: Case Study

ERIC Educational Resources Information Center

Bateman, David F.

2007-01-01

Anna is a 13-year-old student who has a learning disability and is eligible for special education and related services. Anna's parents enrolled her in the Private Academy for fifth grade; her frustration, inappropriate behaviors, and inattention had increased during fourth grade. In its year-end report, the Private Academy described Anna's…

Self-Esteem and Reading Achievement.

ERIC Educational Resources Information Center

Sweet, Anne E.; Burbach, Harold J.

This study investigated the directionality of the relationship between self-esteem and reading achievement in 286 students in Lynchburg, Virginia. During the first year of the three-year study, subjects were fourth, fifth, and sixth graders. The Coopersmith Self-Esteem Inventory and the SRA Achievement Series subscales were administered; sex and…

Biomedical Knowledge and Clinical Expertise.

ERIC Educational Resources Information Center

Boshuizen, Henny P. A.; Schmidt, Henk G.

A study examined the application and availability of clinical and biomedical knowledge in the clinical reasoning of physicians as well as possible mechanisms responsible for changes in the organization of clinical and biomedical knowledge in the development from novice to expert. Subjects were 28 students (10 second year, 8 fourth year, and 10…

Genetic Stability of Cognitive Development from Childhood to Adulthood.

ERIC Educational Resources Information Center

DeFries, J. C.; And Others

1987-01-01

A path model of genetic and family environmental transmission was fitted to published twin correlations and to general cognitive ability data from adoptive and nonadoptive families in which children were tested yearly through the fourth year. Longitudinal genetic correlations from infancy to adulthood were modeled explicitly, as were effects of…

The Body as Evidence: Helping Clients Identify Decision-Making Roadblocks

ERIC Educational Resources Information Center

Synard, Jacqueline T.

2009-01-01

Grad school or Europe for a year? A highly motivated, fourth-year liberal arts student makes her decision but still has doubts. What roles do emotion and a client's personal history play in career counselling? The case study utilizes experiential process to uncover decision-making roadblocks.

The Customer is Always Right...Girls' and Boys' Reactions to Science Lessons.

ERIC Educational Resources Information Center

Kelly, Alison

1988-01-01

Explores the reactions of third-year pupils to their science lessons. Discusses the extent to which these boys' and girls' reactions can be used to predict enrollment in the different branches of science in their fourth year. Describes ways to encourage students to continue in science. (CW)

Antecedents to High Educational Achievement Among Southwestern Mexican Americans.

ERIC Educational Resources Information Center

Amodeo, Luiza B.; Martin, Jeanette

The study examined antecedents to high educational achievement of 42 selected Mexican Americans (university professors, third-year law students, and third- and fourth-year medical students) in 5 southwestern universities (4 in California and 1 in New Mexico). Two related considerations prompted the investigation: failure of many Mexican Americans…

Student Financial Aid--A Phase-In Approach.

ERIC Educational Resources Information Center

Fuller, William S.

1984-01-01

An alternative system is proposed for college students: provide grants in the freshman year, reduce grants and small loans in the second, introduce work-study in the third along with reduced grants and loans, and further increase loan and reduce the grant with work-study in the fourth year. (MSE)

Nebraska's forest resources in 2003

Treesearch

W. Keith Moser; Gary J. Brand; Mark H. Hansen; William R. Lovett

2005-01-01

Reports results of the first three yearly panels (2001-2003) of the fourth inventory of Nebraska's forest resources. Includes information on forest area; volume; biomass; growth, removals, and mortality; and forest health.

Ten years of experience with third and fourth branchial remnants.

PubMed

Liberman, Moishe; Kay, Saundra; Emil, Sherif; Flageole, Hélène; Nguyen, Luong T; Tewfik, Ted L; Oudjhane, Kamal; Laberge, Jean-Martin

2002-05-01

Third and fourth branchial remnants may result in cysts and abscesses that are in close contact with the thyroid gland. These anomalies are rare and often present diagnostic and therapeutic challenges. The charts of patients diagnosed with a branchial anomaly between July 1991 and July 2001 at the Montreal Children's Hospital were reviewed. All cases of third and fourth branchial remnants or pyriform sinus fistulae were identified. Clinical presentation, imaging, treatment, and outcome were recorded. Eight patients with a third or fourth branchial anomaly were identified and ranged in age from birth to 13 years. All anomalies were left sided. Presenting symptoms consisted of an asymptomatic cervical mass (n = 1), an infected mass (n = 5), neonatal respiratory distress (n = 1), and 1 incidental cyst found on magnetic resonance imaging. Ultrasonography was useful in suggesting the diagnosis in 7 cases. Barium swallow was performed in 3 patients with 2 positive results. Pharyngoscopy results showed the internal opening in 2 of 7 patients. A portion of the thyroid gland was resected in 6 patients. One patient has not yet undergone a definitive procedure. There was 1 recurrence in a patient whose pathology did not confirm a branchial remnant. The diagnosis and management of pyriform sinus anomalies are challenging. Ultrasound scan, computed tomography scan, barium swallow, and pharyngoscopy are all useful. The portion of thyroid involved in the fistula must be excised en bloc with the inflammatory mass, and the tract should be ligated at the level of the pharynx to minimize recurrence. Copyright 2002, Elsevier Science (USA). All rights reserved.

Anorexia: an early sign of fourth ventricle astrocytoma in children.

PubMed

Leroy, Henri-Arthur; Baroncini, Marc; Delestret, Isabelle; Florent, Vincent; Vinchon, Matthieu

2014-12-01

Paediatric low-grade astrocytomas of the fourth ventricle are rare tumours, generally revealed by hydrocephalus. However, some patients present with a history of severe anorexia. It might be a harbinger, which if recognized, could lead to earlier diagnosis. We decided to examine our database in order to evaluate the incidence and signification of anorexia in this context. Retrospective monocentric study of cases of low-grade astrocytomas of the fourth ventricle operated between 1991 and 2012 in our paediatric neurosurgery department. We particularly observed the clinical presentation and long-term clinical, oncological and radiological evolution. Non-parametrical tests were used (Mann-Whitney, Fisher). We reviewed 34 cases, 31 pilocytic astrocytomas and 3 diffuse astrocytomas, 16 boys and 18 girls, (M/F ratio 0.89). Mean age at diagnosis was 8 years old. Seven presented with notable anorexia, the average BMI in this group was ≤2 standard deviation (SD); with clinical signs evolving for 11.5 months. Twenty-seven children had no anorexia; average BMI in this group was +1 SD, with clinical evolution for 6 months on an average of p < 0.05. We found no significant difference regarding hydrocephalus or tumour location. In all children with anorexia, body mass index improved markedly in the postoperative follow-up, which lasted, on average, for 6 years. Anorexia with stunted body weight curve is a non-exceptional presentation in children with low-grade astrocytomas of the fourth ventricle. Unexplained or atypical anorexia with negative etiologic assessment should prompt cerebral imaging. Clinical improvement after surgical resection, could suggest a possible interaction between tumour tissue and appetite-suppressing peptide secretion.

Dorsal slab fracture of the fourth carpal bone in a racing greyhound.

PubMed

Rutherford, Scott; Ness, Malcolm G

2012-11-01

To report the diagnosis and surgical management of a dorsal slab fracture of the fourth carpal bone in a racing greyhound. Clinical report. Three-year-old, male racing Greyhound. The fracture was not visible on orthogonal radiographs and the diagnosis was made by computed tomography. Open reduction and internal fixation with 2 countersunk 2.0-mm screws inserted in lag fashion was performed via a dorsal approach. Outcome was analyzed objectively by comparing preinjury and postsurgery racing performances. Internal fixation resulted in fracture healing and the dog returned to racing recording times similar to those before injury. Fractures of the fourth carpal bone may not be visible on standard orthogonal radiographic views and cross-sectional imaging may be required for more accurate identification. Surgical management was successful with the dog returning to preinjury levels of competition. © Copyright 2012 by The American College of Veterinary Surgeons.

Why is digit ratio correlated to sports performance?

PubMed

Kim, Tae Beom; Kim, Khae Hawn

2016-12-01

Second to fourth digit ratio is the ratio of second to fourth digit length. It has been known that digit ratio is sexually dimorphic in humans, such that males tend to have lower digit ratio (longer fourth digits relative to second digits) than females. Digit ratio is thought to be a biomarker of the balance between fetal testosterone (FT) and fetal estrogen (FE) in a relatively narrow developmental window at the end of the first trimester of pregnancy. On the contrary, the relationships between digit ratio and levels of sex steroids in adults are not clear. Most correlational studies between digit ratio and adult sex steroids have revealed that this association is statistically not significant. However, for many years, a lot of researches showed negative relationships between digit ratio and sports performance such as rugby, surfing, rowing, sprinting, endurance, and hand grip strength. Here, we discuss possible mechanisms about the relationships between digit ratio and sports performance.

Second Mesiobuccal Canal Treatment in a Predoctoral Dental Clinic: A Retrospective Clinical Study.

PubMed

Coelho, Marcelo Santos; Parker, Jeffrey M; Tawil, Peter Z

2016-06-01

The aim of this retrospective clinical study was to evaluate the location and treatment of second canals in mesiobuccal roots (MB2) of first and second maxillary molars in a predoctoral endodontic clinic by the graduating classes of 2008 to 2015. These results were compared to similar clinical studies. Included in the study were 368 root canal treatments performed by 310 third- and fourth-year dental students at one U.S. dental school. All cases were done under faculty supervision, and the students were instructed to use dental loupe magnification. Students' evaluation sheets were used to deteremine the total MB2 canals treated in first and second maxillary molars. The results showed that, overall, 72.55% of the teeth had an MB2 canal treated. The frequency was higher in first molars (75.91%) than in second molars (56.92%) (p<0.05). Third-year students were able to detect 39 MB2 canals in 57 maxillary molars (68.42%), while fourth-year students detected 228 MB2 canals in 311 teeth (73.31%) (p>0.05). Under proper supervision by experienced endodontists, these dental students were capable of treating MB2 canals in maxillary molars. The frequency of MB2 canals located and treated by dental students with the assistance of experienced professionals was higher in first than in second molars. No significant difference was found between third- and fourth-year students. The incidence of MB2 canals located and treated in this study was found to be similar to that in other clinical studies.

Timber Volume in Indiana, 1967.

Treesearch

Arnold J. Ostrom

1969-01-01

The recently completed Second Forest Survey of Indiana shows that the State's timber volume has increased by one-fourth in the 17 years since the previous survey. Timber volume by county is presented.

Five Miles Until Friday? Addressing Misunderstandings of Light-Years

ERIC Educational Resources Information Center

Brown, Katrina; Brown, Todd; Hardy, Wendy

2015-01-01

In this fourth and fifth grade activity, students become comfortable with the concept that light-years are a measure of distance, not time, and discover how we are looking back in time when we look at stars. Since the enormous distances in space can make astronomical studies even more confusing, students explore the meaning of a light-year by…

The Changing Environment and Changing Institution: Indian Project of the Northeast Kansas Library System

ERIC Educational Resources Information Center

Cunningham, William D.

1971-01-01

The chief features of the program's first year were the establishment of a liason between the library and identifiable service needs within the community, the second year was for developing the communication center approach; and development of special services and a cultural awareness program were projected for the third and fourth years. (2…

A Failure To Reproduce the Intermediate Effect in Clinical Case Recall.

ERIC Educational Resources Information Center

van de Wiel, Margaretha W. J.; And Others

In an attempt to replicate an earlier study by H. G. Schmidt, H. P. A. Boshuizen, and P. P. M. Hobus (1988), 96 students and physicians at the University of Limburg (Netherlands) studied 4 clinical cases, produced a diagnosis, and recalled each case. Subjects were 24 second-year, 24 fourth-year, and 24 sixth-year medical students and 24 internists…

Influence of a rural family medicine rotation on residency selection: MS3 versus MS4.

PubMed

Geske, Jenenne A; Hartman, Teresa; Goodman, Barbara; Paulman, Paul

2011-09-01

Many family medicine educators feel that a required clinical rotation in family medicine has a positive influence on medical students' selection of family medicine residencies. We investigated the effect of a rural family medicine rotation on students' residency choices and examined the differences between a third-year and a fourth-year rotation. We surveyed 1,260 students before and after they participated in a required rural family medicine rotation. The rotation had a small positive effect on student interest in family medicine. Over 20 years, there was a net gain of 4.7% (93 students) from before to after the rotation. Moving the rural rotation from the MS4 to the MS3 year resulted in a significant decline in the number of students who switched their preferences toward family medicine and ultimately matched to a family medicine residency. When the rotation occurs in the third year, there is more time following the rotation for other influences to exert an impact on a student's specialty choice, resulting in a small "bleed" away from family medicine. It might be useful to develop programs that continue to pique the interest in family medicine during their fourth year.

Current management of congenital branchial cleft cysts, sinuses, and fistulae.

PubMed

Goff, Christopher J; Allred, Carly; Glade, Robert S

2012-12-01

Branchial anomalies comprise approximately 20% of pediatric congenital head and neck lesions. This study reviews current literature detailing the diagnosis and management of first, second, third and fourth branchial cysts, sinuses and fistulae. Branchial anomalies remain classified as first, second, third and fourth cysts, sinuses and fistulae. Management varies on the basis of classification. The imaging study of choice remains controversial. Computed tomography fistulography likely best demonstrates the complete course of the tract if a cutaneous opening is present. Treatment of all lesions has historically been by complete surgical excision of the entire tract. Studies of less invasive procedures for several anomalies are promising including sclerotherapy and endoscopic excision of second branchial cysts, and endoscopic cauterization or sclerotherapy at the piriform opening for third and fourth branchial sinuses. An increased risk of complications in children less than 8 years is reported in children undergoing open excision of third and fourth branchial anomalies. Branchial anomalies are common congenital pediatric head and neck lesions but are comprised by several diverse anomalies. Treatment must be tailored depending on which branchial arch is involved and whether a cyst mass or sinus/fistula tract is present.

Obesity May Be Protective against Severe Perineal Lacerations

PubMed Central

Garretto, Diana; Lin, Brian B.; Syn, Helen L.; Judge, Nancy; Beckerman, Karen; Atallah, Fouad; Friedman, Arnold; Brodman, Michael; Bernstein, Peter S.

2016-01-01

Objective. To determine if there is an association between BMI and 3rd- or 4th-degree perineal lacerations in normal spontaneous and operative vaginal deliveries. Study Design. We performed a retrospective case control study using a large obstetric quality improvement database over a six-year period. Cases were identified as singleton gestations with third- and fourth-degree lacerations. Controls were obtained randomly from the database of patients without third- or fourth-degree lacerations in a 1 : 1 ratio. Univariate and multivariate logistic regression analyses were performed. Results. Of 32,607 deliveries, 22,011 (67.5%) charts with BMI documented were identified. Third- or fourth-degree lacerations occurred in 2.74% (n = 605) of patients. 37% (n = 223) were identified in operative vaginal deliveries. In the univariate analysis, obesity, older maternal age, non-Asian race, and birth weight <4000 g were all protective against 3rd- and 4th-degree lacerations. After controlling for age, race, mode of vaginal delivery, and birth weight, obesity remained significant. Conclusion. Being obese may protect against third- and fourth-degree lacerations independent of parity, race, birth weight, and mode of delivery. PMID:27274869

Cervical Vertebral Body's Volume as a New Parameter for Predicting the Skeletal Maturation Stages.

PubMed

Choi, Youn-Kyung; Kim, Jinmi; Yamaguchi, Tetsutaro; Maki, Koutaro; Ko, Ching-Chang; Kim, Yong-Il

2016-01-01

This study aimed to determine the correlation between the volumetric parameters derived from the images of the second, third, and fourth cervical vertebrae by using cone beam computed tomography with skeletal maturation stages and to propose a new formula for predicting skeletal maturation by using regression analysis. We obtained the estimation of skeletal maturation levels from hand-wrist radiographs and volume parameters derived from the second, third, and fourth cervical vertebrae bodies from 102 Japanese patients (54 women and 48 men, 5-18 years of age). We performed Pearson's correlation coefficient analysis and simple regression analysis. All volume parameters derived from the second, third, and fourth cervical vertebrae exhibited statistically significant correlations (P < 0.05). The simple regression model with the greatest R-square indicated the fourth-cervical-vertebra volume as an independent variable with a variance inflation factor less than ten. The explanation power was 81.76%. Volumetric parameters of cervical vertebrae using cone beam computed tomography are useful in regression models. The derived regression model has the potential for clinical application as it enables a simple and quantitative analysis to evaluate skeletal maturation level.

Cervical Vertebral Body's Volume as a New Parameter for Predicting the Skeletal Maturation Stages

PubMed Central

Choi, Youn-Kyung; Kim, Jinmi; Maki, Koutaro; Ko, Ching-Chang

2016-01-01

This study aimed to determine the correlation between the volumetric parameters derived from the images of the second, third, and fourth cervical vertebrae by using cone beam computed tomography with skeletal maturation stages and to propose a new formula for predicting skeletal maturation by using regression analysis. We obtained the estimation of skeletal maturation levels from hand-wrist radiographs and volume parameters derived from the second, third, and fourth cervical vertebrae bodies from 102 Japanese patients (54 women and 48 men, 5–18 years of age). We performed Pearson's correlation coefficient analysis and simple regression analysis. All volume parameters derived from the second, third, and fourth cervical vertebrae exhibited statistically significant correlations (P < 0.05). The simple regression model with the greatest R-square indicated the fourth-cervical-vertebra volume as an independent variable with a variance inflation factor less than ten. The explanation power was 81.76%. Volumetric parameters of cervical vertebrae using cone beam computed tomography are useful in regression models. The derived regression model has the potential for clinical application as it enables a simple and quantitative analysis to evaluate skeletal maturation level. PMID:27340668

Preventing lower cranial nerve injuries during fourth ventricle tumor resection by utilizing intraoperative neurophysiological monitoring.

PubMed

Jahangiri, Faisal R; Minhas, Mazhar; Jane, John

2012-12-01

We present two cases illustrating the benefit of utilizing intraoperative neurophysiological monitoring (IONM) for prevention of injuries to the lower cranial nerves during fourth ventricle tumor resection surgeries. Multiple cranial nerve nuclei are located on the floor of the fourth ventricle with a high risk of permanent damage. Two male patients (ages 8 and 10 years) presented to the emergency department and had brain magnetic resonance imaging (MRI) scans showing brainstem/fourth ventricle tumors. During surgery, bilateral posterior tibial and median nerve somatosensory evoked potentials (SSEPs); four-limb and cranial nerves transcranial electrical motor evoked potentials (TCeMEPs); brainstem auditory evoked responses (BAERs); and spontaneous electromyography (s-EMG) were recorded. Electromyography (EMG) was monitored bilaterally from cranial nerves V VII, IX, X, XI, and XII. Total intravenous anesthesia was used. Neuromuscular blockade was used only for initial intubation. Pre-incision baselines were obtained with good morphology of waveforms. After exposure the floor of the fourth ventricle was mapped by triggered-EMG (t-EMG) using 0.4 to 1.0 mA. In both patients the tumor was entangled with cranial nerves VII to XII on the floor of the fourth ventricle. The surgeon made the decision not to resect the tumor in one case and limited the resection to 70% of the tumor in the second case on the basis of neurophysiological monitoring. This decision was made to minimize any post-operative neurological deficits due to surgical manipulation of the tumor involving the lower cranial nerves. Intraoperative spontaneous and triggered EMG was effectively utilized in preventing injuries to cranial nerves during surgical procedures. All signals remained stable during the surgical procedure. Postoperatively both patients were well with no additional cranial nerve weakness. At three months follow-up, the patients continued to have no deficits.

Parasites of domestic and wild animals in South Africa. XLV. Helminths of dairy calves on dry-land Kikuyu grass pastures in the Eastern Cape Province.

PubMed

Horak, I G; Evans, Ursula; Purnell, R E

2004-12-01

Successive pairs of approximately 4-month-old Friesland bull calves, raised under worm-free conditions, were exposed to helminth infection for 14 days on dry-land Kikuyu grass pastures at 28-day to monthly intervals, on a coastal farm in a non-seasonal rainfall region of the Eastern Cape Province. With the exception of one pair of calves exposed for 28 days, this procedure was repeated for 28 consecutive months from December 1982 to March 1985. The day after removal from the pastures one calf of each pair was slaughtered and processed for helminth recovery and the other 21 days later. Both members of the last four pairs of calves were killed 21 days after removal from the pastures. Sixteen nematode species were recovered from the calves, and infection with Ostertagia ostertagi was the most intense and prevalent, followed by Cooperia oncophora. The calves acquired the greatest number of nematodes from the pastures from June to October of the first year and from June to August of the second year of the survey. Few worms were recovered from the tracer calves examined from November or December to March or April in each year of the survey. The seasonal patterns of infection with Cooperia spp., Haemonchus placei, Nematodirus helvetianus, Oesophagostomum spp., O. ostertagi and Trichostrongylus axei were all similar and were negatively correlated to atmospheric temperature and evaporation. Slight to moderate arrest in the development of fourth stage larvae occurred from July to September in Cooperia spp., April to July in H. placei, and August to October in O. ostertagi and Trichostrongylus spp. during the first year of the survey. Too few worms were present in the second year to determine a seasonal pattern of arrest. Species survival during the hot and windy summer months appeared to be achieved via a combination of arrested larval development and an ageing residual population of adult worms in the host, and a small extant population of infective larvae on the pastures.

Should surgical novices trade their retractors for joysticks? Videogame experience decreases the time needed to acquire surgical skills.

PubMed

Shane, Matthew D; Pettitt, Barbara J; Morgenthal, Craig B; Smith, C Daniel

2008-05-01

Video game experience (VGE) has been identified as a possible predictive factor for surgical skill. We hypothesized that surgical novices with previous VGE would acquire new surgical skills faster than those without. Fourth-year medical students (M4) and first-year surgical residents (PG-1) completed a survey asking about standard demographic data and previous VGE. Gamers had high VGE, defined as more than 3 h per week of videogame playing. Nongamers had little or no VGE. Both groups trained to proficiency on two tasks (AcquirePlace and Traversal) of the MIST-VR simulator, with proficiency defined as meeting previously validated criteria on two consecutive trials. The number of trials required to achieve proficiency for each task was recorded. The 26 participants included 11 M4s and 15 PG-1s: 17 males (8 gamers/9 nongamers) and 9 females (3 gamers/6 nongamers), mean age 27.8 years. There were no differences in time to proficiency between the M4 and PG-1 residents, and there were no significant differences in the relative number of gamers per gender. All participants eventually met proficiency criteria. The 11 gamers reached proficiency more quickly than the 15 nongamers (median 0 trials versus 6 trials, p = 0.01). Gamers scored lower than nongamers on their initial attempts. Women overall took longer to reach proficiency than did men (median 10 trials versus 0 trials, p = 0.002). When stratified according to VGE, female nongamers took longer to reach proficiency than male nongamers (median 11 trials versus 1 trial, p = 0.006) but among gamers, there was no difference between females and males (median 0 trials versus 0.5 trials, NS). Previous VGE shortens time to achieve proficiency on two tasks on a validated surgical simulator. The possibility that VGE may ameliorate gender differences in length of time required to acquire surgical skills should be explored further.

Potential of pest regulation by insectivorous birds in Mediterranean woody crops.

PubMed

Rey Benayas, José M; Meltzer, Jorge; de Las Heras-Bravo, Daniel; Cayuela, Luis

2017-01-01

Regulation of agricultural pests managing their natural enemies represents an alternative to chemical pesticides. We assessed the potential of insectivorous birds as pest regulators in woody crops located in central Spain. A total of 417 nest boxes installed in five field study sites (one vineyard, two fruit orchards, and two olive groves) were monitored for use and breeding of insectivorous birds and other species for four consecutive years (2013-2016). At all field sites except the two olive groves, where birds never occupied the nest boxes, predation experiments were conducted with Greater wax moth (Galleria mellonella) sentinel caterpillars, and food consumption by birds was estimated. Nesting of insectivorous birds, chiefly Great tit (Parus major), and sparrows (Passer domesticus and P. montanus) increased over time, averaging 60% per field site in the vineyard and fruit orchards by the fourth year. Use of nest boxes by sparrows and by Garden dormouse (Eliomys quercinus) was high at the fruit orchards (70%) and the vineyard (30%), respectively. Micro-habitat characteristics (nest box level) and meso-habitat characteristics (patch level) strongly affected use of nest boxes and bird breeding (i.e. number of laid eggs and produced chicks) in different years. Distance to natural or semi-natural vegetation did not consistently affect bird breeding, nor did we see consistent evidence of competition between adjacent breeding birds. Predation rates of sentinel caterpillars were approximately one-third higher near boxes with nesting birds (31.51 ± 43.13%) than at paired distant areas without nest boxes (22.45% ± 38.58%). Food consumption by insectivorous birds per ha and breeding season were conservatively estimated to range from 0.02 kg in one fruit orchard to 0.15 kg in the vineyard. We conclude that installation of nest boxes in Mediterranean woody crops enhances populations of insectivorous birds that regulate pests, but that the effects are moderate and highly context-dependent.

Potential of pest regulation by insectivorous birds in Mediterranean woody crops

PubMed Central

Meltzer, Jorge; de las Heras-Bravo, Daniel; Cayuela, Luis

2017-01-01

Regulation of agricultural pests managing their natural enemies represents an alternative to chemical pesticides. We assessed the potential of insectivorous birds as pest regulators in woody crops located in central Spain. A total of 417 nest boxes installed in five field study sites (one vineyard, two fruit orchards, and two olive groves) were monitored for use and breeding of insectivorous birds and other species for four consecutive years (2013–2016). At all field sites except the two olive groves, where birds never occupied the nest boxes, predation experiments were conducted with Greater wax moth (Galleria mellonella) sentinel caterpillars, and food consumption by birds was estimated. Nesting of insectivorous birds, chiefly Great tit (Parus major), and sparrows (Passer domesticus and P. montanus) increased over time, averaging 60% per field site in the vineyard and fruit orchards by the fourth year. Use of nest boxes by sparrows and by Garden dormouse (Eliomys quercinus) was high at the fruit orchards (70%) and the vineyard (30%), respectively. Micro-habitat characteristics (nest box level) and meso-habitat characteristics (patch level) strongly affected use of nest boxes and bird breeding (i.e. number of laid eggs and produced chicks) in different years. Distance to natural or semi-natural vegetation did not consistently affect bird breeding, nor did we see consistent evidence of competition between adjacent breeding birds. Predation rates of sentinel caterpillars were approximately one-third higher near boxes with nesting birds (31.51 ± 43.13%) than at paired distant areas without nest boxes (22.45% ± 38.58%). Food consumption by insectivorous birds per ha and breeding season were conservatively estimated to range from 0.02 kg in one fruit orchard to 0.15 kg in the vineyard. We conclude that installation of nest boxes in Mediterranean woody crops enhances populations of insectivorous birds that regulate pests, but that the effects are moderate and highly context-dependent. PMID:28877166

A model based on temporal dynamics of fixations for distinguishing expert radiologists' scanpaths

NASA Astrophysics Data System (ADS)

Gandomkar, Ziba; Tay, Kevin; Brennan, Patrick C.; Mello-Thoms, Claudia

2017-03-01

This study investigated a model which distinguishes expert radiologists from less experienced radiologists based on features describing spatio-temporal dynamics of their eye movement during interpretation of digital mammograms. Eye movements of four expert and four less experienced radiologists were recorded during interpretation of 120 two-view digital mammograms of which 59 had biopsy proven cancers. For each scanpath, a two-dimensional recurrence plot, which represents the radiologist's refixation pattern, was generated. From each plot, six features indicating the spatio-temporal dynamics of fixations were extracted. The first feature measured the percentage of recurrent fixations; the second indicated the percentage of recurrent fixations which was fixated later in several consecutive fixations; the third measured the percentage of recurrent fixations that form a repeated sequence of fixations and the fourth assessed whether the recurrent fixations were occurring sequentially close together. The number of switches between the two mammographic views was also measured, as was the average number of consecutive fixations in each view before switching. These six features along with total time on case and average fixation duration were fed into a support vector machine whose performance was evaluated using 10-fold cross validation. The model achieved a sensitivity of 86.3% and a specificity of 85.2% for distinguishing experts' scanpaths. The obtained result suggests that spatio-temporal dynamics of eye movements can characterize expertise level and has potential applications for monitoring the development of expertise among radiologists as a result of different training regimes and continuing education schemes.

Carpentry: Apprentice Related Training. Instructor's Manual. First, Second, Third, Fourth Years of a Four-Year Series in Four Volumes.

ERIC Educational Resources Information Center

Washington State Coordinating Council for Occupational Education, Olympia.

The course of related study in the carpentry trade is designed to meet the need for organized study in the various technical aspects necessary for an apprentice to become a well-trained journeyman. Divided into four one-year programs, the instructor's manual for the first year presents lessons on familiarizing the student with the trade and its…

75 FR 68606 - Notice of Submission for OMB Review

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-08

... provides data for internationally benchmarking U.S. performance in mathematics and science at the fourth... years in more than 50 countries and provides assessment data for internationally benchmarking U.S...

Impact of continuous training through distributed practice for acquisition of minimally invasive surgical skills.

PubMed

Nakata, Bruce Negrello; Cavalini, Worens; Bonin, Eduardo A; Salvalaggio, Paolo R; Loureiro, Marcelo P

2017-10-01

Minimally invasive surgery (MIS) requires the mastery of manual skills and a specific training is required. Apart from residencies and fellowships in MIS, other learning opportunities utilize massive training, mainly with use of simulators in short courses. A long-term postgraduate course represents an opportunity to learn through training using distributed practice. The objective of this study is to assess the use of distributed practice for acquisition of basic minimally invasive skills in surgeons who participated in a long-term MIS postgraduate course. A prospective, longitudinal and quantitative study was conducted among surgeons who attended a 1-year postgraduate course of MIS in Brazil, from 2012 to 2014. They were tested through five different exercises in box trainers (peg-transfer, passing, cutting, intracorporeal knot, and suture) in the first (t0), fourth (t1) and last, eighth, (t2) meetings of this course. The time and penalties of each exercise were collected for each participant. Participant skills were assessed based on time and accuracy on a previously tested score. Fifty-seven surgeons (participants) from three consecutive groups participated in this study. There was a significant improvement in scores in all exercises. The average increase in scores between t0 and t2 was 88% for peg-transfer, 174% for passing, 149% for cutting, 130% for intracorporeal knot, and 120% for suture (p < 0.001 for all exercises). Learning through distributed practice is effective and should be integrated into a MIS postgraduate course curriculum for acquisition of core skills.

Comparison of Phenotypic Value Changes in Pure Lines of Bombyx mori (Lepidoptera: Bombycidae) During Consecutive Generations Following Initial Selection on Cocoon Weight

PubMed Central

Seidavi, Alireza; Goldsmith, Marian R.

2014-01-01

Abstract The experiments reported here were conducted to investigate the effect of selection on three quantitative traits, namely cocoon weight, cocoon shell weight, and cocoon shell percentage, during four generations by rearing six pure breeds of domesticated silkworm, Bombyx mori L. (Lepidoptera: Bombycidae) of Chinese and Japanese origin compared with random unselected groups as controls. All stages of rearing and data recording were performed over four rearing periods, with generations 1–3 during successive spring seasons and generation 4 during the autumn season in year 3. Each pure line contained two groups of selected and random (control) groups. Comparisons included the effect of selection methods, pure line, and generation on the phenotypic values. We found strong main effects of pure line, generation, sex, and group and support for nearly all interactions between these main effects for all three response traits. The results indicated that cocoon weight and cocoon shell weight in the selected group were higher than in the control or nonselected group. Both selected and nonselected groups had the lowest cocoon weight, cocoon shell weight, and cocoon shell percentage in the fourth generation when environmental conditions during the autumn season were less favorable than spring. The cocoon weight and cocoon shell weight averages were higher for nonselected groups in the second and third generations, and for the selected group in the first generation due to the direct effect of selection. PMID:25527593

Delivery of a urology online course using Moodle versus didactic lectures methods.

PubMed

Reis, Leonardo Oliveira; Ikari, Osamu; Taha-Neto, Khaled A; Gugliotta, Antonio; Denardi, Fernandes

2015-02-01

To subjectively and objectively compare an accessible interactive electronic library using Moodle with lectures for urology teaching of medical students. Forty consecutive fourth-year medical students and one urology teacher were exposed to two teaching methods (4 weeks each) in the form of problem-based learning: - lectures and - student-centered group discussion based on Moodle (modular object-oriented dynamic learning environment) full time online delivered (24/7) with video surgeries, electronic urology cases and additional basic principles of the disease process. All 40 students completed the study. While 30% were moderately dissatisfied with their current knowledge base, online learning course delivery using Moodle was considered superior to the lectures by 86% of the students. The study found the following observations: (1) the increment in learning grades ranged from 7.0 to 9.7 for students in the online Moodle course compared to 4.0-9.6 to didactic lectures; (2) the self-reported student involvement in the online course was characterized as large by over 60%; (3) the teacher-student interaction was described as very frequent (50%) and moderately frequent (50%); and (4) more inquiries and requisitions by students as well as peer assisting were observed from the students using the Moodle platform. The Moodle platform is feasible and effective, enthusing medical students to learn, improving immersion in the urology clinical rotation and encouraging the spontaneous peer assisted learning. Future studies should expand objective evaluations of knowledge acquisition and retention. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Explanatory models in patients with first episode depression: a study from north India.

PubMed

Grover, Sandeep; Kumar, Vineet; Chakrabarti, Subho; Hollikatti, Prabhakar; Singh, Pritpal; Tyagi, Shikha; Kulhara, Parmanand; Avasthi, Ajit

2012-09-01

The purpose of this work was to study the explanatory models of patients with first episode depression presenting to a tertiary care hospital located in North-western India. One hundred sixty four consecutive patients with diagnosis of first episode depression (except severe depression with psychotic symptoms) according to the International Classification of Diseases-10th Revision (ICD-10) and ≥18 years of age were evaluated for their explanatory models using the causal models section of Explanatory Model Interview Catalogue (EMIC). The most common explanations given were categorized into Karma-deed-heredity category (77.4%), followed by psychological explanations (62.2%), weakness (50%) and social causes (40.2%). Among the various specific causes the commonly reported explanations by at least one-fourth of the sample in decreasing order were: will of god (51.2%), fate/chance (40.9%), weakness of nerves (37.8%), general weakness (34.7%), bad deeds (26.2%), evil eye (24.4%) and family problems (21.9%). There was some influence of sociodemographic features on the explanations given by the patients. From the study, it can be concluded that patients with first episode depression have multiple explanatory models for their symptoms of depression which are slightly different than those reported in previous studies done from other parts of India. Understanding the multiple explanatory models for their symptoms of depression can have important treatment implications. Copyright © 2012 Elsevier B.V. All rights reserved.

The Submerged Dyslexia Iceberg: How Many School Children Are Not Diagnosed? Results from an Italian Study

PubMed Central

Barbiero, Chiara; Lonciari, Isabella; Montico, Marcella; Monasta, Lorenzo; Penge, Roberta; Vio, Claudio; Tressoldi, Patrizio Emanuele; Ferluga, Valentina; Bigoni, Anna; Tullio, Alessia; Carrozzi, Marco; Ronfani, Luca

2012-01-01

Background Although dyslexia is one of the most common neurobehavioral disorders affecting children, prevalence is uncertain and available data are scanty and dated. The objective of this study is to evaluate the prevalence of dyslexia in an unselected school population using clearly defined and rigorous diagnostic criteria and methods. Methods Cross sectional study. We selected a random cluster sample of 94 fourth grade elementary school classes of Friuli Venezia Giulia, a Region of North Eastern Italy. We carried out three consecutive levels of screening: the first two at school and the last at the Neuropsychiatry Unit of a third level Mother and Child Hospital. The main outcome measure was the prevalence of dyslexia, defined as the number of children positive to the third level of screening divided by the total number of children enrolled. Results We recruited 1774 children aged 8–10 years, of which 1528 received parents’ consent to participate. After applying exclusion criteria, 1357 pupils constituted the final working sample. The prevalence of dyslexia in the enrolled population ranged from 3.1% (95% CI 2.2–4.1%) to 3.2% (95% CI 2.4–4.3%) depending on different criteria adopted. In two out of three children with dyslexia the disorder had not been previously diagnosed. Conclusions This study shows that dyslexia is largely underestimated in Italy and underlines the need for reliable information on prevalence, in order to better allocate resources both to Health Services and Schools. PMID:23118930

Availability of Japanese Government's supplemental texts on radiation reflecting the Fukushima Daiichi Nuclear Power Plant accident for elementary and secondary education from dental students' understanding.

PubMed

Yoshida, Midori; Honda, Eiichi; Dashpuntsag, Oyunbat; Maeda, Naoki; Hosoki, Hidehiko; Sakama, Minoru; Tada, Toshiko

2016-05-01

Following the Fukushima Nuclear Power Plant accident, the Japanese government created two supplemental texts about radiation reflecting the accident for elementary, middle school, and high school students. These texts were made to explain radiation and consequently to obtain public consent for the continuation of the nuclear program. The present study aimed to evaluate the appropriateness of the content of the texts and to collect the basic data on the level of understanding necessary to improve radiation education. Lectures on radiology including nuclear energy and the Fukushima accident were given to 44 fourth-year dental students in 2013. The questionnaire was administered in 2014 when these students were in their sixth-year. The survey was also administered to 40 first-year students and 41 fourth-year students who hadn't any radiology lectures. Students rated their level of understanding of 50 phrases used in the texts on a four-point scale (understanding = 3, a little knowledge = 2, having heard = 1, no knowledge = 0). Questions on taking an advanced physics course in high school and means of learning about radiation in daily life were also asked. The level of understanding of phrases in the supplemental text for middle and high school students was significantly higher among sixth-year students (mean = 1.43) than among first-year (mean = 1.12) or fourth-year (mean = 0.93) students (p < 0.05). Overall, the level of understanding was low, with scores indicating that most students knew only a little. First-year students learning about radiation from television but four-year and six-year students learning about radiation from newspaper scored significantly higher (p < 0.05). It was concluded that radiation education should be improved by using visual material and preparing educators to teach the material for improving the public's understanding of radiation use-especially nuclear power generation because the phrases used in the supplementary texts are very difficult for students to understand. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

[Unilateral exophthalmos as the debut of a non-secretory multiple myeloma].

PubMed

Castro-Rebollo, M; Cañones-Zafra, R; Vleming-Pinilla, E N; Drake-Rodríguez-Casanova, P; Pérez-Rico, C

2009-12-01

A 56 year-old male presented blurred vision and diplopia for 2 months, left unilateral exophthalmos, restricted ocular motility and papilledema. The imaging proofs showed osteolytic lesions in the left sphenoid bone, fourth rib and fourth dorsal vertebral body with associated masses of soft tissues. Biopsy was performed and the diagnosis of plasma cell neoplasm was established. The diagnosis of non-secretory multiple myeloma was made by analytical criteria and bone marrow biopsy. Local radiotherapy and polychemotherapy was prescribed. The ophthalmologist can play an important role in the diagnosis of systemic neoplasms that require the intervention of a multidisciplinary team.

Results For The Fourth Quarter 2014 Tank 50 WAC Slurry Sample: Chemical And Radionuclide Contaminants

DOE Office of Scientific and Technical Information (OSTI.GOV)

Crawford, C.

2015-09-30

This report details the chemical and radionuclide contaminant results for the characterization of the Calendar Year (CY) 2014 Fourth Quarter sampling of Tank 50 for the Saltstone Waste Acceptance Criteria (WAC) in effect at that time. Information from this characterization will be used by DWPF & Saltstone Facility Engineering (DSFE) to support the transfer of low-level aqueous waste from Tank 50 to the Salt Feed Tank in the Saltstone Facility in Z-Area, where the waste will be immobilized. This information is also used to update the Tank 50 Waste Characterization System.

Intramedullary nailing: evolutions of femoral intramedullary nailing: first to fourth generations.

PubMed

Russell, Thomas A

2011-12-01

Intramedullary femoral nailing is the gold standard for femoral shaft fixation but only in the past 27 years. This rapid replacement of closed traction and cast techniques in North America was a controversial and contentious evolution in surgery. As we enter the fourth generation of implant design, capabilities, and surgical technique, it is important to understand the driving forces for this technology. These forces included changes in radiographic imaging capabilities, biomaterial design and computer-assisted manufacturing, and the recognition of the importance of mobilization of the trauma patient to avoid systemic complications and optimize functional recovery.

A 4-year Longitudinal Study of Well-being of Chinese University Students in Hong Kong.

PubMed

Shek, Daniel T L; Yu, Lu; Wu, Florence K Y; Zhu, Xiaoqin; Chan, Kevin H Y

2017-01-01

The present longitudinal study explored the development of personal well-being in university students over 4 years. Personal well-being was indexed by multiple indicators including life satisfaction, positive youth development qualities, and university engagement. A sample of 434 students enrolled in the new 4-year undergraduate program in one university in Hong Kong was successfully followed up for 4 years since they started their university study in 2012-2013 academic year. Students completed an online survey on a yearly basis and four waves of data were collected. Results revealed significant changes in most well-being indicators over time with three main observations. First, students' life satisfaction remained at a stable level during 4 years. Second, most students' self-reported positive youth development competencies followed a U-shaped developmental trajectory, which was characterised by a dip in the second year and a continuous rebound in the third year and fourth year. Third, students' university engagement in different aspects showed significant increments in the third and fourth year of university study. The findings underscore the disparate developmental patterns of different aspects of student well-being during university study. This suggests that there is a need to take into account students' developmental characteristics and related challenges in different stages of university life when develop and implement programs in university to promote student well-being.

7 CFR 1205.320 - Marketing year.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 10 2011-01-01 2011-01-01 false Marketing year. 1205.320 Section 1205.320 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... Research and Promotion Order Definitions § 1205.320 Marketing year. Marketing year means a consecutive 12...

7 CFR 1205.320 - Marketing year.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 10 2012-01-01 2012-01-01 false Marketing year. 1205.320 Section 1205.320 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... Research and Promotion Order Definitions § 1205.320 Marketing year. Marketing year means a consecutive 12...

7 CFR 1205.320 - Marketing year.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 10 2013-01-01 2013-01-01 false Marketing year. 1205.320 Section 1205.320 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... Research and Promotion Order Definitions § 1205.320 Marketing year. Marketing year means a consecutive 12...

7 CFR 1205.320 - Marketing year.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Marketing year. 1205.320 Section 1205.320 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... Research and Promotion Order Definitions § 1205.320 Marketing year. Marketing year means a consecutive 12...

7 CFR 1205.320 - Marketing year.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 10 2014-01-01 2014-01-01 false Marketing year. 1205.320 Section 1205.320 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... Research and Promotion Order Definitions § 1205.320 Marketing year. Marketing year means a consecutive 12...

33 CFR 117.773 - Buffalo River.

Code of Federal Regulations, 2010 CFR

2010-07-01

... DRAWBRIDGE OPERATION REGULATIONS Specific Requirements New York § 117.773 Buffalo River. (a) The draw of the... Sundays, and on New Year's Day, Memorial Day, Fourth of July, Labor Day, Thanksgiving Day, Christmas Day...

Midwest Transportation Consortium : 2010-2011 annual report.

DOT National Transportation Integrated Search

2011-01-01

In October 2010, the Midwest Transportation Consortium (MTC) began its fourth : year as a Tier I University Transportation Center (UTC). Our theme, Transportation : Safety through Improvements in Management Information Systems, continues to : r...

Reducing Suicide among Youth.

ERIC Educational Resources Information Center

NEA Today, 2000

2000-01-01

The suicide rate for children aged 10 to 14 has doubled over the last 10 years, making suicide the fourth leading cause of death for that age group. Offers important information on suicide prevention for educators. (ASK)

Illinois Crashes During Holidays : 2004-2010

DOT National Transportation Integrated Search

2011-07-01

A summary of crash data over the holidays in the state of Illinois. Includes the holidays : Memorial Day Weekend, Fourth of July Holiday, Labor Day Weekend, Thanksgiving Holiday Weekend, Christmas Holiday, New Year's Holiday.

Student scientific inquiry in the core curriculum.

PubMed

Vaidean, Georgeta D; Vansal, Sandeep S; Moore, Ronnie J; Feldman, Stuart

2013-10-14

To design and implement a required student-driven research program as a capstone experience in the doctor of pharmacy (PharmD) curriculum. A research proposal in the form of a competitive grant application was required for each of 65 fourth-year students in an inaugural PharmD class at Touro College of Pharmacy in New York. The focus of the proposals was on hypothesis-driven research in basic science, clinical research, health outcomes, and public health. Students' research proposals were graded using a standardized grading instrument. On a post-experience survey, most students rated the overall experience positively, indicating increased confidence in their research skills. About two-thirds of faculty members were satisfied with their students' performance, and the great majority thought the experience would be useful in the students' careers. The capstone research project was a positive experience for fourth-year students.

[Postdonation information: the French fourth hemovigilance sub-process].

PubMed

Py, J-Y; Sandid, I; Jbilou, S; Dupuis, M; Adda, R; Narbey, D; Djoudi, R

2014-11-01

Postdonation information is the knowledge of information about the donor or his donation, occurring after it, which challenges quality or safety of the blood products stemming from this or other donations. Classical hemovigilance sub-processes concerning donors or recipients adverse events do not cover this topic. France is just about to make it official as a fourth sub-process. Less formal management of postdonation information is already set up for more than ten years. French data of the year 2013 are presented, including the regional notification level and the national reporting one. A significant level of heterogeneity is observed as for other hemovigilance sub-processes. It is mainly due to subjective rather than objective differences in risk appreciation. A real consensual work is expected about it in the future. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Author Correction: Tropical explosive volcanic eruptions can trigger El Niño by cooling tropical Africa.

PubMed

Khodri, Myriam; Izumo, Takeshi; Vialard, Jérôme; Janicot, Serge; Cassou, Christophe; Lengaigne, Matthieu; Mignot, Juliette; Gastineau, Guillaume; Guilyardi, Eric; Lebas, Nicolas; Robock, Alan; McPhaden, Michael J

2018-02-22

The original version of this Article omitted a reference to previous work in 'Mann, M.E., Cane, M.A., Zebiak, S.E., Clement, A., Volcanic and Solar Forcing of the Tropical Pacific Over the Past 1000 Years, J. Climate 18, 447-456 (2005)'. This has been added as reference 62 at the end of the fourth sentence of the fourth paragraph of the Introduction: 'Early studies using simple coupled ocean-atmosphere models 26 proposed that following volcano-induced surface cooling, upwelling in the eastern equatorial Pacific acting on a reduced vertical temperature contrast between the ocean surface and interior leads to anomalous warming in this region, thereby favouring El Niño development the following year 12, 27, 62 .' This has been corrected in the PDF and HTML versions of the Article.

Knowledge of risk factors and the periodontal disease-systemic link in dental students' clinical decisions.

PubMed

Friesen, Lynn Roosa; Walker, Mary P; Kisling, Rebecca E; Liu, Ying; Williams, Karen B

2014-09-01

This study evaluated second-, third-, and fourth-year dental students' ability to identify systemic conditions associated with periodontal disease, risk factors most important for referral, and medications with an effect on the periodontium and their ability to apply this knowledge to make clinical decisions regarding treatment and referral of periodontal patients. A twenty-one question survey was administered at one U.S. dental school in the spring semester of 2012 to elicit the students' knowledge and confidence regarding clinical reasoning. The response rate was 86 percent. Periodontal risk factors were accurately selected by at least 50 percent of students in all three classes; these were poorly controlled diabetes, ≥6 mm pockets posteriorly, and lack of response to previous non-surgical therapy. Confidence in knowledge, knowledge of risk factors, and knowledge of medications with an effect on the periodontium improved with training and were predictive of better referral decision making. The greatest impact of training was seen on the students' ability to make correct decisions about referral and treatment for seven clinical scenarios. Although the study found a large increase in the students' abilities from the second through fourth years, the mean of 4.6 (out of 7) for the fourth-year students shows that, on average, those students missed correct treatment or referral on more than two of seven clinical cases. These results suggest that dental curricula should emphasize more critical decision making with respect to referral and treatment criteria in managing the periodontal patient.

Homeostatic Systems--Mechanisms for Survival. Science IV.

ERIC Educational Resources Information Center

Pfeiffer, Carl H.

The two student notebooks in this set provide the basic outline and assignments for the fourth and last year of a senior high school unified science program which builds on the technical third year course, Science IIIA (see SE 012 149). An introductory section considers the problems of survival inherent in living systems, matter-energy…

Anatomy Integration Blueprint: A Fourth-Year Musculoskeletal Anatomy Elective Model

ERIC Educational Resources Information Center

Lazarus, Michelle D.; Kauffman, Gordon L., Jr.; Kothari, Milind J.; Mosher, Timothy J.; Silvis, Matthew L.; Wawrzyniak, John R.; Anderson, Daniel T.; Black, Kevin P.

2014-01-01

Current undergraduate medical school curricular trends focus on both vertical integration of clinical knowledge into the traditionally basic science-dedicated curricula and increasing basic science education in the clinical years. This latter type of integration is more difficult and less reported on than the former. Here, we present an outline of…

Expertise in Auditing: Case Representation Differences between Economy Students, Novice, Intermediate and Expert Auditors.

ERIC Educational Resources Information Center

Vaatstra, Rina F.; And Others

Medical expertise research methods were used to explore the relationship between auditing expertise and case representation. Subjects were 8 first-year economy students, 8 fourth-year auditing students, 8 postgraduate students in auditing, and 8 experienced auditors in the Netherlands, ranging in experience from only a limited knowledge of…

Engineering Gender--Gendering Engineering: What About Women in Nerd-Dom?

ERIC Educational Resources Information Center

Tonso, Karen L.

This paper examines the kinds of persons that engineering education produces, focusing on cultural identities related to gender issues. It is based on survey questionnaires, interviews, and observations of 274 first-year and fourth-year engineering students at a state university known for its concern about the education of women engineers. The…

Special Education Faculty Perceptions of Participating in a Culturally Responsive Professional Development Program

ERIC Educational Resources Information Center

Devereaux, Temma Harris; Prater, Mary Anne; Jackson, Aaron; Heath, Melissa Allen; Carter, Nari J.

2010-01-01

Special education faculty members (n = 12) from a large Western university participated in a four-year professional development program centered on increasing their cultural responsiveness. During the fourth year the primary investigator interviewed faculty members regarding their perceptions and the impact of the program. Each interview was…

How Much Do Medical Students Know about Physical Income?

ERIC Educational Resources Information Center

Nicholson, Sean

2005-01-01

A comparative study of medical students who estimated physicians' income during their first and fourth years of study throws up interesting results. The medical students typically overestimated physician income by 25% on an average, with differences marked by age, women, older students, students with high MCAT scores. Final year students'…

TIMSS 2015 Assessment Frameworks

ERIC Educational Resources Information Center

Mullis, Ina V. S., Ed.; Martin, Michael O., Ed.

2013-01-01

Now entering into its 20th year of data collection, Trends in International Mathematics and Science Study, (TIMSS) is an international assessment of mathematics and science at the fourth and eighth grades. TIMSS 2015 is the most recent in the TIMSS series, which began with the first assessments in 1995 and has continued every four years--1999,…

Fostering Teacher Development to a Tetrahedral Orientation in the Teaching of Chemistry

ERIC Educational Resources Information Center

Lewthwaite, Brian; Wiebe, Rick

2011-01-01

This paper reports on the initial outcomes from the end of the fourth year of a 5 year research and professional development project to improve chemistry teaching among three cohorts of chemistry teachers in Manitoba, Canada. The project responds to a new curriculum introduction advocating a tetrahedral orientation (Mahaffy, "Journal of…

Case Study: International High School at Langley Park

ERIC Educational Resources Information Center

Wassl, Frishtah; Wilkin, Christine; Ward, Maggie

2017-01-01

The International High School at Langley Park (IHSLP) opened during the 2015-2016 school year. By the fourth year of operation, the school will be home to 400 English language learners (ELLs) new to the United States. Working in partnership with the Internationals Network for Public Schools, the school is designed around the "HELLO…

Eliciting Systematic Rule Use in Covariation Judgment [the Early Years].

ERIC Educational Resources Information Center

Shaklee, Harriet; Paszek, Donald

Related research suggests that children may show some simple understanding of event covariations by the early elementary school years. The present experiments use a rule analysis methodology to investigate covariation judgments of children in this age range. In Experiment 1, children in second, third and fourth grade judged covariations on 12…

Students' Knowledge, Opinions, and Behaviors Concerning Dental Informatics and Computer Applications.

ERIC Educational Resources Information Center

Lang, W. Paul; And Others

1992-01-01

A survey of 95 first-year and 91 fourth-year dental students concerning informatics and computer applications in dentistry investigated knowledge of terms and concepts related to hardware, software, electronic communication, and dental applications; opinions concerning use of the technology; and extent of experience in 4 areas of use. (MSE)

A Yearlong Program for New Faculty.

ERIC Educational Resources Information Center

Doyle, Terry J.; Marcinkiewicz, Henryk R.

2001-01-01

Describes the Ferris State University (Michigan) New Faculty Transition Program, in which incoming faculty members meet every two weeks during the fall and winter semesters and attend an academic retreat. Reports that the program is in its fourth year and has been recognized as an important part of first-year faculty members' transition into the…

Test Review: Wechsler Preschool and Primary Scale of Intelligence-

ERIC Educational Resources Information Center

Syeda, Maisha M.; Climie, Emma A.

2014-01-01

The "Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition" (WPPSI-IV; Wechsler, 2012a, 2012b) is a comprehensive clinical tool, intended for assessing cognitive functioning among children aged 2 years 6 months through 7 years 7 months. Published by Pearson, the WPPSI-IV is an individually administered tool, to be used by…

Computers in Bilingual Education, Project CIBE, 1987-88. Evaluation Section Report. OREA Report.

ERIC Educational Resources Information Center

Berney, Tomi D.; Alvarez, Rosalyn

Computers in Bilingual Education (Project CIBE) was fully implemented at South Bronx High School in its fourth year of federal funding. During the 1987-88 school year, students received computer-assisted and classroom instruction in English as a Second Language (ESL), native language arts (NLA), social studies, mathematics, science, computer…

The Theory of Biology and the Education of Biologists: A Case Study.

ERIC Educational Resources Information Center

Barnett, S. A.; And Others

1983-01-01

Questions on evolutionary theory and the philosophy of biology were given to zoology students at three levels: third-year undergraduates; fourth year, honours; and graduates. Responses were assessed independently by a zoologist, an educator, and a philosopher. No students had failed conventional courses, but each author failed nearly half the…

An Investigation of Prospective Music Teachers' Early Teacher Identity

ERIC Educational Resources Information Center

Koca, Sehriban

2016-01-01

This study was a descriptive study that investigated prospective music teachers' early teacher identity. The study made use of a general screening model. Participants of the research is consists of 162 fourth-year music teacher candidates. The study was conducted in the spring semester of the 2015-2016 academic year at the music teaching…

Urban Teacher Persistence: Self-Efficacy, Affect, and Values

ERIC Educational Resources Information Center

Ige, Elaine Anita

2012-01-01

The problem of teacher attrition was reviewed and a mixed-method study of motivational characteristics for years of persistence in a teaching career was conducted. Ninety-two second, third, or fourth grade urban public school teachers who taught for five years or more were surveyed in order to gather quantitative data on the five motivational…

ICT Student Teachers' Pedagogical Content Knowledge: A Case Study

ERIC Educational Resources Information Center

Yilmaz, Nuray Parlak

2016-01-01

This study aimed to identify the difficulties that information technology student teachers have in teaching concepts. This qualitative study was carried out with 12 student teachers. The student teachers were fourth-year students enrolled in the Special Teaching Methods II course in the spring semester of the 2010-2011 academic year. The research…

Clinical pharmacology of antiepileptic drug use: "clinical pearls about the perils of patty".

PubMed

Schraeder, P L; Lathers, C M

1995-12-01

This Clinical Pharmacology Problem Solving (CPPS) Unit is for use with fourth- or fifth-year pharmacy students and third- or fourth-year medical students during conferences held when they are taking either a rotation in Neurology or Clinical Pharmacology. It may also be used for house staff teaching of residents in Neurology, Pediatrics, Internal Medicine, and Family Practice and fellows in Clinical Pharmacology. This material was prepared for a Teaching Clinic in Clinical Pharmacology taught by Claire M. Lathers, PhD, FCP, Hugh J. Burford, PhD, FCP, and Cedric M. Smith, MD, FCP, and sponsored by the American College of Clinical Pharmacology, September 19-20, 1992, Washington, DC. This workbook includes: (1) an introduction to the Clinical Pharmacology Problem Solving (CPPS) Unit; (2) the learning objectives of the clinical simulation; (3) a pretest; (4) four clinical episodes occurring over many years in the life of a patient; (5) answers to the pretest; (6) a posttest; (7) answers to the posttest.

Thyroidal abscesses in third and fourth branchial anomalies: not only a paediatric diagnosis.

PubMed

Kruijff, Schelto; Sywak, Mark S; Sidhu, Stan B; Shun, Albert; Novakovic, Daniel; Lee, James C; Delbridge, Leigh W

2015-01-01

Acute suppurative thyroiditis and recurrent abscess formation due to third and fourth branchial anomalies typically present in children. However, thyroid abscesses in branchial anomalies may occur in adulthood as well. Failure to recognize and delayed drainage of a neck abscess may lead to a fulminant life-threatening outcome. This is a retrospective case series. The study group comprised all patients presenting over a 12-month period from January to December 2012 with thyroid abscesses and a branchial cleft anomaly in two centres, one adult and the other paediatric. Patient demographics, clinical presentation, imaging, surgical management, definitive histology and outcomes were documented. Five patients were identified with a history of thyroid abscesses. Only one was a child (aged 9 years) with the other four being adults (aged 20, 34, 37 and 41 years). All patients had third or fourth left branchial cleft anomalies, presenting as suppurative thyroiditis with a left-sided thyroid abscess. Management options ranged from abscess drainage on initial presentation, primary thyroid lobectomy or delayed thyroid lobectomy following abscess drainage. Acute suppurative thyroidits and thyroid abscesses is not just a paediatric diagnosis but may present at any age. In both children and adults, a thyroid abscess almost always arises from branchial cleft anomalies. © 2014 Royal Australasian College of Surgeons.

Transventricular Transvelar Approach to Trochlear Nerve Schwannoma: Novel Technique to Lesions of Inferior Pineal Region.

PubMed

Farrokhi, Majid Reza; Ghaffarpasand, Fariborz; Taghipour, Mousa; Derakhshan, Nima

2018-06-01

The schwannoma of the trochlear nerve is rare and originates mostly from the distal parts in the interpeduncular cistern. A lesion on the proximal segment in the inferior pineal region is extremely rare. Because of the rarity of the disease, the surgical approach to this region for the resection of trochlear nerve schwannoma has not been well documented in the literature. We herein describe a novel approach to successfully resect the trochlear nerve schwannoma. A 12-year-old boy presented with occipital headache, abnormal gait, and disturbed conjoined eye movement. He was diagnosed with a lesion in the inferior pineal region compressing the superior medullary velum into the roof of the fourth ventricle. A bilateral midline suboccipital craniotomy was performed, and the fourth ventricle was exposed. The lesion was approached through the fourth ventricle superior medullary velum (transventricular transvelar approach). The lesion was totally resected, and his histopathology examination revealed trochlear schwannoma. The patient's symptoms resolved, and he had no recurrence at 12-year follow-up with normal eye movement and vision. The transventricular transvelar approach is feasible and safe to treat a lesion of the lower part of the pineal region being pushed through the superior medullary velum. Copyright © 2018 Elsevier Inc. All rights reserved.

[Report of a case with Joubert syndrome and literature review].

PubMed

Yi, Ya-hui; Li, Gang; Lu, Zhong-lie; Zhou, Jian-sheng; Yao, Zhen-wei; Wang, Peng-fei; Yao, Jin-xiang

2011-12-01

To explore the clinical feature, imaging and their diagnostic value for Joubert syndrome (JS). The clinical data, imaging feature, and 31 references from China Biomedical literature database (CBMdise) were reviewed and analyzed. The age of onset of 32 patients including male 20 and female 12 ranged from 3 days to 6 years (mean 2.2 years). All the 32 patients with Joubert syndrome showed "slow growth" and "reduced muscle tension", 26 cases (81.3%) showed "gasp for breath", 26 cases (81.3%) showed "unusual motion of eyeball", 2 cases (6.3%) showed additional fingers (toes), 6 cases (18.8%) showed stretching tongue with agape. The typical imaging features of Joubert syndrome included "molar tooth sign", "midline cleavage" between cerebellar hemispheres and "bat-wing" like fourth ventricle, all the 32 patients with Joubert syndrome showed "midline cleavage", "molar tooth sign" was present in 29 cases (90.1%), and "bat-wing" like fourth ventricle in 30 cases (93.8%). Joubert syndrome is a rare congenital brain malformation. The typical clinical manifestations included "gasp for breath", "reduced tension of muscle", "slow growth" and "unusual motion of eyeball", and at the same time the patients had the following typical imaging features of brain: "molar tooth sign", "midline cleavage" and "bat-wing" like fourth ventricle.

What Works in Student Retention? Fourth National Survey. Four-Year Colleges and Universities with Twenty Percent or More Black Students Enrolled

ERIC Educational Resources Information Center

ACT, Inc., 2010

2010-01-01

This report presents the findings for four year colleges and universities with twenty percent or more Black students enrolled that participated in ACT's 2010 What Works in Student Retention survey. The report contains information pertinent to only these institutions. Appendices include: (1) Data for Four Year Colleges and Universities with greater…

State Pre-K Funding for 2015-16 Fiscal Year: National Trends in State Preschool Funding. 50-State Review

ERIC Educational Resources Information Center

Parker, Emily; Atchison, Bruce; Workman, Emily

2016-01-01

This report highlights significant investments made by both Republican and Democratic policymakers in state-funded pre-k programs for the fourth year in a row. In the 2015-16 budget year, 32 states and the District of Columbia raised funding levels of pre-k programs. This increased support for preschool funding came from both sides of the…

Predictors and Correlates of High Levels of Depression and Anxiety Symptoms among Children at Age 10

ERIC Educational Resources Information Center

Leech, Sharon L.; Larkby, Cynthia A.; Day, Richard; Day, Nancy L.

2006-01-01

Objective: To identify factors that predict or are correlated with symptoms of depression and anxiety in 10-year-olds. Method: Women and their offspring were followed from the fourth prenatal month through 10 years. There were 636 mother-child pairs at 10 years, a follow-up rate of 83% of the birth cohort. Cognitive, psychological,…

Part H of the Individuals with Disabilities Education Act (IDEA) for Infants, Toddlers, and Their Families Annual Performance Report, Year IV (1990-1992).

ERIC Educational Resources Information Center

McNulty, Brian A.; And Others

This report on the fourth year of Colorado's participation in Part H of the Individuals with Disabilities Education Act describes major accomplishments in preparing for full implementation of Part H in Year 5. Accomplishments in the following areas are discussed: state definition of developmental delay, central directory, timetables for serving…

Genetic and Environmental Etiologies of the Longitudinal Relations between Prereading Skills and Reading

ERIC Educational Resources Information Center

Christopher, Micaela E.; Hulslander, Jacqueline; Byrne, Brian; Samuelsson, Stefan; Keenan, Janice M.; Pennington, Bruce; DeFries, John C.; Wadsworth, Sally J.; Willcutt, Erik; Olson, Richard K.

2015-01-01

The present study explored the environmental and genetic etiologies of the longitudinal relations between prereading skills and reading and spelling. Twin pairs (n = 489) were assessed before kindergarten (M = 4.9 years), post-first grade (M = 7.4 years), and post-fourth grade (M = 10.4 years). Genetic influences on five prereading skills (print…

26 CFR 1.419A-1T - Qualified asset account limitation of additions to account. (Temporary)

Code of Federal Regulations, 2011 CFR

2011-04-01

... benefit fund is treated as in existence on July 18, 1984, for purposes of this transition rule only if...) provides that, in the case of a welfare benefit fund that was in existence on July 18, 1984, the account... Second taxable year 60 Third taxable year 40 Fourth taxable year 20 For purposes of this section, the...

26 CFR 1.419A-1T - Qualified asset account limitation of additions to account. (Temporary)

Code of Federal Regulations, 2010 CFR

2010-04-01

... benefit fund is treated as in existence on July 18, 1984, for purposes of this transition rule only if... that, in the case of a welfare benefit fund that was in existence on July 18, 1984, the account limit... Second taxable year 60 Third taxable year 40 Fourth taxable year 20 For purposes of this section, the...

The Relationship between SAT® Scores and Retention to the Fourth Year: 2006 SAT Validity Sample. Statistical Report 2011-6

ERIC Educational Resources Information Center

Mattern, Krista D.; Patterson, Brian F.

2011-01-01

The College Board formed a research consortium with four-year colleges and universities to build a national higher education database with the primary goal of validating the SAT® for use in college admission. The first sample included first-time, first-year students entering college in fall 2006, with 110 institutions providing students'…

A Student-Led Introduction to Lesbian, Gay, Bisexual, and Transgender Health for First-Year Medical Students.

PubMed

Grosz, Andrea M; Gutierrez, Daniel; Lui, Andrea A; Chang, Julia J; Cole-Kelly, Kathy; Ng, Henry

2017-01-01

Lesbian, gay, bisexual, and transgender (LGBT) individuals face significant health disparities. This is in part because many physicians are not sensitive to, and/or are underprepared to address, LGBT-specific concerns. To help meet this need, we, a group of second- and fourth-year medical students with faculty oversight, organized a session on LGBT health for first-year medical students. The three second-year and one fourth-year student authors designed a mandatory session for the 167 first-years at Case Western Reserve University School of Medicine in Cleveland, OH. The 2-hour session consisted of a student-delivered presentation, a patient panel, and a small-group session. Students' LGBT health knowledge and confidence in providing care were assessed anonymously before and after the session, and individuals' pre- and post-session assessments were paired using student-generated identifiers. A total of 73 complete, matched pre-/post-session assessments were received. Students' familiarity with LGBT terminology and demographics increased significantly after the session. Students' perceived preparedness and comfort in providing LGBT-specific care significantly improved in most areas as well. Students strongly praised the session, in particular the patient panel. A student-led educational session on LGBT health can effectively improve first-year medical students' LGBT knowledge and confidence to provide care.

Traffic crash statistics report, 2007

DOT National Transportation Integrated Search

2008-01-01

Fatalities as a result of traffic crashes on Florida roadways decreased to 3,221 in 2007 from 3,365 in 2006. For the second consecutive year in more than 10 years, traffic fatalities have decreased from the previous year; State mileage Death rate dec...

Changes of Antimicrobial Resistance among Staphylococcus Aureus Isolated in 8 Consecutive Years in the First Bethune Hospital

NASA Astrophysics Data System (ADS)

Xu, Wei; Zhou, Qi; Yang, Chunguang; Yao, Hanxin; Xu, Jiancheng

This study was to investigate the antimicrobial resistance of Staphylococcus aureus isolated in 8 consecutive years in the First Bethune Hospital. Disk diffusion test was used to study the antimicrobial resistance. The data were analyzed by WHONET 5 software according to Clinical and Laboratory Standards Institute (CLSI). Most of 1469 strains of Staphylococcus aureus were collected from sputum 705 (18.0%), secretions 206 (14.0%), pus 177 (12.0%) during the past 8 years. The rates of methicillin-resistant Staphylococcus aureus (MRSA) were between 50.8% and 83.3% during the past 8 years, respectively. In recent 8 years, the antimicrobial resistance of Staphylococcus aureus had increased. Monitoring the antimicrobial resistance to Staphylococcus aureus should be strengthened. The change of the antimicrobial resistance should be investigated in order to direct rational drug usage in the clinic and prevent bacterial strain of drug resistance from being transmitted.

Impact of robotics on the outcome of elderly patients with endometrial cancer.

PubMed

Lavoue, Vincent; Zeng, Xing; Lau, Susie; Press, Joshua Z; Abitbol, Jeremie; Gotlieb, Raphael; How, Jeffrey; Wang, Yifan; Gotlieb, Walter H

2014-06-01

To evaluate the impact of introducing a robotics program on clinical outcome of elderly patients with endometrial cancer. Evaluation and comparison of peri-operative morbidity and disease-free interval in 163 consecutive elderly patients (≥70years) with endometrial cancer undergoing staging procedure with traditional open surgery compared to robotic surgery. All consecutive patients ≥70years of age with endometrial cancer who underwent robotic surgery (n=113) were compared with all consecutive patients ≥70years of age (n=50) before the introduction of a robotic program in December 2007. Baseline patient characteristics were similar in both eras. Patients undergoing robotic surgery had longer mean operating times (244 compared with 217minutes, p=0.009) but fewer minor adverse events (17% compared with 60%, p<0.001). The robotics cohort had less estimated mean blood loss (75 vs 334mL, p<0.0001) and shorter mean hospital stay (3 vs 6days, p<0.0001). There was no difference in disease-free survival (p=0.61) during the mean follow-up time of 2years. Transitioning from open surgery to a robotics program for the treatment of endometrial cancer in the elderly has significant benefits, including lower minor complication rate, less operative blood loss and shorter hospitalization without compromising 2-year disease-free survival. Copyright © 2014 Elsevier Inc. All rights reserved.

Anterior versus lateral needle decompression of tension pneumothorax: comparison by computed tomography chest wall measurement.

PubMed

Sanchez, Leon D; Straszewski, Shannon; Saghir, Amina; Khan, Atif; Horn, Erin; Fischer, Christopher; Khosa, Faisal; Camacho, Marc A

2011-10-01

Recent research describes failed needle decompression in the anterior position. It has been hypothesized that a lateral approach may be more successful. The aim of this study was to identify the optimal site for needle decompression. A retrospective study was conducted of emergency department (ED) patients who underwent computed tomography (CT) of the chest as part of their evaluation for blunt trauma. A convenience sample of 159 patients was formed by reviewing consecutive scans of eligible patients. Six measurements from the skin surface to the pleural surface were made for each patient: anterior second intercostal space, lateral fourth intercostal space, and lateral fifth intercostal space on the left and right sides. The distance from skin to pleura at the anterior second intercostal space averaged 46.3 mm on the right and 45.2 mm on the left. The distance at the midaxillary line in the fourth intercostal space was 63.7 mm on the right and 62.1 mm on the left. In the fifth intercostal space the distance was 53.8 mm on the right and 52.9 mm on the left. The distance of the anterior approach was statistically less when compared to both intercostal spaces (p < 0.01). With commonly available angiocatheters, the lateral approach is less likely to be successful than the anterior approach. The anterior approach may fail in many patients as well. Longer angiocatheters may increase the chances of decompression, but would also carry a higher risk of damage to surrounding vital structures. © 2011 by the Society for Academic Emergency Medicine.

Parasites of domestic and wild animals in South Africa. XLII. Helminths of sheep on four farms in the Eastern Cape Province.

PubMed

Horak, I G

2003-09-01

At monthly intervals for periods ranging from 9 to 25 consecutive months between three and four Merino yearling-sheep and two Merino lambs on three farms in Eastern Cape Thornveld, and two Dorper yearling-sheep on a farm in Valley Bushveld were slaughtered and examined for helminths. The Merino sheep were infected with 15 nematode species, of which Haemonchus contortus, Nematodirus spathiger and Trichostrongylus spp. were the most numerous, and with four cestode species. The Dorper sheep were infected with 17 nematode species, of which Trichostrongylus rugafus and N. spathiger were the most numerous, and with two cestode species. Haemonchus contortus was most numerous in older sheep during the summer months and exhibited no tendency to over-winter as arrested fourth stage larvae. The largest numbers of N. spathiger were present in sheep on the most coastally located of the farms during autumn and winter; on a farm further inland during spring; and on an inland farm in Valley Bushveld during spring and summer. As Merino lambs progressed from birth to 9 months of age a larger proportion of their dwindling burdens of N. spathiger was present as fourth stage larvae. Dorper sheep in Valley Bushveld harboured most Teladorsagia circumcincta in May and from October to January. Trichostrongylus rugatus was most numerous in Merino sheep on one of the Thornveld farms during September, whereas all Trichostrongylus spp., including T. rugatus, were most numerous in Dorper sheep on the Valley Bushveld farm during January.

40 CFR 52.39 - What are the requirements of the Federal Implementation Plans (FIPs) for the Transport Rule (TR...

Code of Federal Regulations, 2012 CFR

2012-07-01

... June 1, 2013. 2016 June 1, 2014. 2017 June 1, 2014. 2018 June 1, 2015. 2019 June 1, 2015. 2020 and any... 1, 2014. 2017 June 1, 2014. 2018 June 1, 2015. 2019 June 1, 2015. 2020 and any year thereafter June.... 2019 June 1, 2015. 2020 and any year thereafter June 1 of the fourth year before the year of the...

Implementation of PLUTO Buoy for Monitoring Water Quality in Indonesia, Reflection and Future Plans

NASA Astrophysics Data System (ADS)

Chandra, H.; Krismono, K.; Kusumaningrum, P. D.; Sianturi, D.; Firdaus, Y.; Taukhid, I.; Borneo, B. B.

2016-02-01

Research and development of PLUTO (Perairan Selalu Termonitor/Waters Always Monitored) buoy has reached its fourth year in 2015. Try out has been done in coastal waters, fishponds, fishing port ponds, and reservoirs. In the first year (2010) try out has been performed on coastal waters with off line measurement system. The buoy used temperature, salinity, DO and pH sensors. In the second year (2013) try out was carried out on fishponds and fishing port ponds using telemetry measurement system. In the third year (2014) try out was carried out on water reservoir with telemetry measurement system. In the fourth year (2015) android application is developed to monitor 4 water reservoirs and 1 lake. Beside that, observation point is added to 3 point depth for one buoy. Parameters used are temperature, DO, and turbidity. Three PLUTO buoys are placed in each reservoir, at inlet, outlet, and at center of fish cultivation. Through Ocean Science Meeting in New Orleans it is hoped that there will be input and suggestion from the experts for future development of the monitoring system for public inland waters (especially reservoir and lake) in Indonesia. Keywords: buoy PLUTO, salinity, temperature, Dissolved Oxygen (DO), pH, turbidity, telemetry

Aggregation and Association of NDVI, Boll Injury, and Stink Bugs in North Carolina Cotton.

PubMed

Reisig, Dominic D; Reay-Jones, F P F; Meijer, A D

2015-01-01

Sampling of herbivorous stink bugs in southeastern U.S. cotton remains problematic. Remote sensing was explored to improve sampling of these pests and associated boll injury. Two adjacent 14.5-ha cotton fields were grid sampled in 2011 and 2012 by collecting stink bug adults and bolls every week during the third, fourth, and fifth weeks of bloom. Satellite remote sensing data were collected during the third week of bloom during both years, and normalized difference vegetation index (NDVI) values were calculated. Stink bugs were spatially aggregated on the third week of bloom in 2011. Boll injury from stink bugs was spatially aggregated during the fourth week of bloom in 2012. The NDVI values were aggregated during both years. There was a positive association and correlation between stink bug numbers and NDVI values, as well as injured bolls and NDVI values, during the third week of bloom in 2011. During the third week of bloom in 2012, NDVI values were negatively correlated with stink bug numbers. During the fourth week of bloom in 2011, stink bug numbers and boll injury were both positively associated and correlated with NDVI values. During the fourth week of bloom in 2012, stink bugs were negatively correlated with NDVI values, and boll injury was negatively associated and correlated with NDVI values. This study suggests the potential of remote sensing as a tool to assist with sampling stink bugs in cotton, although more research is needed using NDVI and other plant measurements to predict stink bug injury. © The Author 2015. Published by Oxford University Press on behalf of the Entomological Society of America.

The benefits of a camp designed for children with epilepsy: evaluating adaptive behaviors over 3 years.

PubMed

Cushner-Weinstein, Sandra; Berl, Madison; Salpekar, Jay A; Johnson, Jami L; Pearl, Phillip L; Conry, Joan A; Kolodgie, Marian; Scully, Audrey; Gaillard, William D; Weinstein, Steven L

2007-02-01

Children with epilepsy attending a condition-specific overnight camp were evaluated for behavioral changes over 3 consecutive years, using a modification of the Vineland Adaptive Behavioral Scale. Trained counselors completed pre- and postcamp assessments for each camper. Repeated-measures MANOVA was used to analyze effects of the camp experience for each year, with respect to gender and age. Repeated-measures ANOVA was conducted to evaluate long-term effects from year-to-year comparisons for return campers, following three successive camp experiences. A significant change in social interaction was observed over 3 years. Despite some decline at the start of camp in consecutive years, the overall trend for return campers suggests a positive cumulative impact of continued camp participation, with improvements in the domains of social interaction, responsibility, and communication. A condition-specific camp designed for children with epilepsy can improve adaptive behaviors and social interactions. Overall net gains appear to increase over time, suggesting additional benefits for return campers.

Safety Management Information Statistics (SAMIS) - 1993 Annual Report

DOT National Transportation Integrated Search

1995-05-01

The 1993 Safety Management Information Statistics (SAMIS) report, now in its fourth year of publication, is a compilation and analysis of transit accident and casualty statistics uniformly collected from approximately 400 transit agencies throughout ...

Reflective cracking control : interim report - fourth year.

DOT National Transportation Integrated Search

1999-07-01

Reflective cracking has long been considered a major problem associated with asphalt : pavements. Several methods including milling, crack sealing and fabric membranes have : been used in an attempt to eliminate or delay the reflective cracking proce...

The Impact of an Infant Oral Health Program on Dental Students' Knowledge and Attitudes.

PubMed

Nascimento, Marcelle M; Mugayar, Leda; Tomar, Scott L; Garvan, Cynthia W; Catalanotto, Frank A; Behar-Horenstein, Linda S

2016-11-01

The high prevalence of early childhood caries and many general dentists' reluctance to treat young children and pregnant women demand new educational programs to foster delivery of oral health services. The aim of this study was to evaluate the impact of an Infant Oral Health Program (IOHP) at the University of Florida College of Dentistry on dental students' knowledge about and willingness to provide dental care for infants, children up to three years of age, and pregnant women. A total of 233 dental students in the first through fourth years and recent graduates completed a survey that assessed the educational outcomes of the IOHP; only the fourth-year students had received IOHP training. The results showed that females were more likely than males to provide counseling to caregivers about dental and physical development (p=0.024) and to offer restorative treatment to young children (p=0.021). Older students were more likely than younger students to provide restorative treatment (p=0.013). A greater percentage of IOHP-trained students (96%) reported knowing how to use the lap examination technique compared with untrained students (71%; p<0.001). IOHP-trained students were the most uncomfortable dealing with a crying child in the dental chair (p=0.0175). The graduates and fourth-year students were significantly more likely than the other cohorts to provide preventive (p=0.001) and restorative (p<0.001) care for pregnant women. The graduates were least likely to use some form of caries risk assessment (p<0.001). These findings highlight the need for earlier and greater exposure to the IOHP and the importance of promoting awareness about risk assessment and oral disease management.

Effect of handoff skills training for students during the medicine clerkship: a quasi-randomized study.

PubMed

Reyes, Juan A; Greenberg, Larrie; Amdur, Richard; Gehring, James; Lesky, Linda G

2016-03-01

Continuity is critical for safe patient care and its absence is associated with adverse outcomes. Continuity requires handoffs between physicians, but most published studies of educational interventions to improve handoffs have focused primarily on residents, despite interns expected to being proficient. The AAMC core entrustable activities for graduating medical students includes handoffs as a milestone, but no controlled studies with students have assessed the impact of training in handoff skills. The purpose of this study was to assess the impact of an educational intervention to improve third-year medical student handoff skills, the durability of learned skills into the fourth year, and the transfer of skills from the simulated setting to the clinical environment. Trained evaluators used standardized patient cases and an observation tool to assess verbal handoff skills immediately post intervention and during the student's fourth-year acting internship. Students were also observed doing real time sign-outs during their acting internship. Evaluators assessed untrained control students using a standardized case and performing a real-time sign-out. Intervention students mean score demonstrated improvement in handoff skills immediately after the workshop (2.6-3.8; p < 0.0001) that persisted into their fourth year acting internship when compared to baseline performance (3.9-3.5; p = 0.06) and to untrained control students (3.5 vs. 2.5; p < 0.001, d = 1.2). Intervention students evaluated in the clinical setting also scored higher than control students when assessed doing real-time handoffs (3.8 vs. 3.3; p = 0.032, d = 0.71). These findings should be useful to others considering introducing handoff teaching in the undergraduate medical curriculum in preparation for post-graduate medical training. Trial Registration Number NCT02217241.

Factors predisposing to consecutive esotropia after surgery to correct intermittent exotropia.

PubMed

Jang, Jung Hyun; Park, Jung Min; Lee, Soo Jung

2012-10-01

To investigate the incidence of and factors predisposing to consecutive esotropia after intermittent exotropia surgery, and to prevent the onset of consecutive esotropia. We retrospectively surveyed 226 patients who had been followed up for more than 1 year after surgery for intermittent exotropia conducted between February 2005 and September 2010. Consecutive esotropia was defined as an esotropia of at least 10 prism diopters (PD) at distance or near at least once in 2 weeks after surgery. Presumed risk factors for consecutive esotropia were analyzed. Gender, age at surgery, average binocular spherical equivalent, anisometropia, high myopia, amblyopia, preoperative angle of deviation, vertical deviation, A-V pattern strabismus, exotropia type, type of surgery, stereopsis, and suppression were investigated to evaluate factors influencing the onset of consecutive esotropia. Consecutive esotropia occurred in 22 patients (9.7 %). Significant correlations with occurrence of the condition were found with high myopia (P = 0.013), amblyopia (P = 0.047), preoperative angle of deviation of 25-40 PD at distance (P = 0.016), deviation at distance - deviation at near > 10 PD (P = 0.041), lateral incomitance (P = 0.007), tenacious proximal convergence fusion type (P = 0.001), unilateral lateral rectus muscle recession and medial rectus muscle resection (P = 0.001). High myopia, amblyopia, and lateral incomitance were predisposing factors for consecutive esotropia. Furthermore, the preoperative angle of deviation at distance, differences between the angle of deviation at near and at distance, the type of intermittent exotropia, and the type of surgery affected the incidence of consecutive esotropia. More attention must be paid to patients with such factors.

76 FR 26583 - Extension of Withholding to Certain Payments Made by Government Entities

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-09

... exception for each calendar year is determined based on payments made during the accounting year ending with... accounting year, including payments that are less than the $10,000 payment threshold, must be considered... consecutive accounting years ending with the accounting year that ends with or within the second preceding...

GeoFORCE Alaska: Four-Year Field Program Brings Rural Alaskan High School Students into the STEM Pipeline

NASA Astrophysics Data System (ADS)

Fowell, S. J.; Rittgers, A.; Stephens, L.; Hutchinson, S.; Peters, H.; Snow, E.; Wartes, D.

2016-12-01

GeoFORCE Alaska is a four-year, field-based, summer geoscience program designed to raise graduation rates in rural Alaskan high schools, encourage participants to pursue college degrees, and increase the diversity of Alaska's technical workforce. Residents of predominantly Alaska Native villages holding degrees in science, technology, engineering, or math (STEM) bring valuable perspectives to decisions regarding management of cultural and natural resources. However, between 2010 and 2015 the average dropout rate for students in grades 7-12 was 8.5% per year in the North Slope School District and 7% per year in the Northwest Arctic School District. 2015 graduation rates were 70% and 75%, respectively. Statewide statistics highlight the challenge for Alaska Native students. During the 2014-2015 school year alone 37.6% of Alaska Native students dropped out of Alaskan public schools. At the college level, Alaska Native students are underrepresented in University of Alaska Fairbanks (UAF) science departments. Launched in 2012 by UAF in partnership with the longstanding University of Texas at Austin program, GeoFORCE applies the cohort model, leading the same group of high school students on geological field academies during four consecutive summers. Through a combination of active learning, teamwork, and hands-on projects at spectacular geological locations, students gain academic skills and confidence that facilitate high school and college success. To date, GeoFORCE Alaska has recruited two cohorts. 78% of these students identify as Alaska Native, reflecting community demographics. The inaugural cohort of 18 students from the North Slope Borough completed the Fourth-Year Academy in summer 2015. 94% of these students graduated from high school, at least 72% plan to attend college, and 33% will major in geoscience. A second cohort of 34 rising 9th and 10th graders entered the program in 2016. At the request of corporate sponsors, this cohort was recruited from both the Northwest Arctic and North Slope boroughs. On an exit survey following the 2016 First-Year Academy, 100% of participants indicated that they learned a lot, and 97% made new friends and/or increased their interest in science. Based on the success of the first two cohorts, UAF plans to offer the GeoFORCE experience to rural students across Alaska.

Predictors for 1-year mortality following hip fracture: a retrospective review of 465 consecutive patients.

PubMed

Heyes, G J; Tucker, A; Marley, D; Foster, A

2017-02-01

In Europe, trauma admissions and in particular hip fractures are on the rise. In recent years, health care systems have placed particular emphasis, including financial incentives, on delivering patients quickly and safely to surgery. At our unit, we have observed that hip fracture patients appear to be at significant risk of mortality even up to a year following injury. This study reviews a consecutive population of hip fracture patients to identify predictors of excess risk. Four hundred and sixty-five consecutive patients were treated over a 2-year period at our district general hospital with no ward-based orthogeriatricians. Follow-up was for 1 year following hip fracture admission. Statistical analysis of variables and their influence on 1-year mortality were performed by calculating odd's ratio (OR) using a logistic regression model and a p value <0.05 was considered statistically significant. Four patients were lost to follow-up, 18 patients (4.1 %) were managed conservatively, 16 were too unwell for surgery and their mortality rate at 1 year was 50 %. Following hip fracture, we found an overall 1-year mortality rate of 15.1 %. Patients with a time to surgery ≥36 h were at significantly increased risk of mortality even up to 1 year. We did not identify a further reduction in mortality in those operated on within 24 h. Raised ORs (p > 0.05) were found with increasing comorbidity, surgery type, independence on discharge, alcohol ingestion, history of smoking, readmission and several biochemical markers. Minimising mortality risk, even over the longer term, should begin on admission with prompt optimisation of any acute medical or biochemical abnormalities, followed by early surgery and intensive rehabilitation to maintain patients' functional independence.

Prompting methods affect the accuracy of children's school lunch recalls.

PubMed

Baxter, S D; Thompson, W O; Davis, H C

2000-08-01

To evaluate the feasibility of implementing 3 specific prompting methods among students in the first and fourth grades (mean age = 7.2 and 10.1 years, respectively), to validate recall accuracy of first- and fourth-grade students against observation, to develop a single measure of inaccuracy that cumulated errors in reporting food items and amounts without allowing underreporting and overreporting to cancel each other, and to establish information regarding the measure of inaccuracy for use in future studies. Children were interviewed the morning after they were observed eating lunch provided by the school. Interviews included free recall, nonsuggestive prompted recall, and specific prompted recall (either preference, food category, or visual). Ninety-six children (48 students per grade) were studied--32 per the specific prompting method--stratified by grade, sex, and ethnicity (African-American or white). Specific prompting method was randomly assigned to children within strata. Food items were categorized and weighted as: combination entree = 2, condiments = 1/3, and other = 1. To calculate inaccuracy of recall, absolute differences between amounts reported and observed eaten were calculated for each item and then multiplied by each item's weight; these values were then summed across all items for each child. Inaccuracy of recall was determined before specific prompting and after specific prompting and for the difference (inaccuracy after specific prompting minus inaccuracy before specific prompting). Before specific prompting, median inaccuracy was 2.7 servings for the 48 first-grade students and 1.7 servings for the 48 fourth-grade students. The median difference in inaccuracy from before to after specific prompting was 0 for both grades. Specific prompting increased recall accuracy for 9 first-graders and 12 fourth-graders, but decreased recall accuracy for 21 first-graders and 7 fourth-graders, and did not change recall accuracy for 18 first-graders and 29 fourth-graders. Among children whose recall accuracy increased after specific prompting, 5 first-graders and 8 fourth-graders received prompting for food category. Among first-grade students, specific prompting (either preference, food category, or visual) may hurt more than help recall accuracy. Among fourth-grade students, prompting for food category yields small gains in recall accuracy with minimal losses. Validation studies are needed with larger sample sizes to determine prompting methods that produce more accurate dietary recalls from children of various socioeconomic status groups, other racial/ethnic groups, and at other meals.

"Report to the Legislature on": The Implementation of the Special Education Reimbursement ("Circuit Breaker") Program. Line-Item 7061-0012

ERIC Educational Resources Information Center

Massachusetts Department of Education, 2008

2008-01-01

This paper reports on the implementation of the Special Education Reimbursement ("Circuit Breaker") Program. Fiscal Year 2007 is the fourth year implementing the Circuit Breaker reimbursement program which provides additional state support for students with disabilities. School districts are eligible for a reimbursement of eligible costs…

Academic Self-Efficacy, Faculty-Student Interactions, and Student Characteristics as Predictors of Grade Point Average

ERIC Educational Resources Information Center

Gosnell, Joan C.

2012-01-01

The purpose of the study was to explore student characteristics, academic self-efficacy, and faculty-student interactions as predictors of grade point average for upper-division (college level third and fourth year) education students at a public 4-year degree-granting community college. The study examined the effects of student characteristics…

Teaching Assembly for Disassembly; An Under-Graduate Module Experience

ERIC Educational Resources Information Center

Alexandri, Eleftheria

2014-01-01

This paper is about the experience of teaching Assembly for Disassembly to fourth year architect students within the module of sustainable design. When designing a sustainable building one should take into consideration the fact that the building is going to be demolished in some years; thus the materials should be assembled in such a way so that…

Perceptions of the Situation of Families with Children with Learning Disabilities and ADHD

ERIC Educational Resources Information Center

Robledo-Ramón, Patricia; García-Sánchez, Jesús N.

2012-01-01

The goal of this study was to determine if there were any differences in dynamic family variables, home climate, parents' attitudes towards their children and parental involvement in education, in relation to the students' typological characteristics. The sample consisted of 87 families of pupils (fourth year primary-first year secondary). The…

A Cross-Sectional Study of Student Teachers' Behaviour Management Strategies throughout Their Training Years

ERIC Educational Resources Information Center

Woodcock, Stuart; Reupert, Andrea

2012-01-01

Despite the importance of behaviour management, many student teachers report being inadequately trained in this area. The aim of this study was to identify the strategies, confidence and reported levels of success in regard to various behaviour management strategies, across 509 first, second, third and fourth year student teachers training to be…

Developing Number Knowledge: Assessment, Teaching and Intervention with 7-11 Year Olds. Math Recovery

ERIC Educational Resources Information Center

Wright, Robert J.; Ellemor-Collins, David; Tabor, Pamela D.

2011-01-01

This fourth book in the Mathematics Recovery series equips teachers with detailed pedagogical knowledge and resources for teaching number to 7 to 11-year olds. Drawing on extensive programs of research, curriculum development, and teacher development, the book offers a coherent, up-to-date approach emphasizing computational fluency and the…

Newark Public Schools: Budget Impacts of Underfunding and Rapid Charter Growth

ERIC Educational Resources Information Center

Farrie, Danielle; Johnson, Monete

2015-01-01

The budget of the State-operated Newark Public Schools (NPS) is now in its fourth year of crisis. The district is currently struggling to close a $13 million budget hole almost halfway into the school year. Most importantly, the ongoing budget crisis has eroded essential resources in district schools, depriving students of the opportunity for a…

Patterns and Predictors of Adoption Openness and Contact: 14 Years Postadoption

ERIC Educational Resources Information Center

Crea, Thomas M.; Barth, Richard P.

2009-01-01

Increased attention is being paid to open adoption arrangements between birth parents and adopted children and families. This study examines openness and contact among 469 adoptions at 14 years postadoption from the fourth wave of the California Long-Range Adoption Study (CLAS) and 378 adoptions matched across all waves. The proportion of families…

A Normative Study of Children's Drawings: Preliminary Research Findings

ERIC Educational Resources Information Center

Deaver, Sarah P.

2009-01-01

This paper describes methodology, data analysis, and initial results of a research study with the long-term goal of establishing contemporary normative data on drawings from children living in the United States. The pool of participants was composed of 316 fourth graders (mean age 9.69 years) and 151 second graders (mean age 7.56 years) who each…

Analyzing the Learning Styles of Pre-Service Primary School Teachers

ERIC Educational Resources Information Center

Özdemir, Muhammet; Kaptan, Fitnat

2017-01-01

The purpose of this research is to analyze the learning styles of pre-service primary school teachers by various variables. The universe of the research is composed of 2136 pre-service primary school teachers study in freshman (first year) and senior (fourth year) classes of Faculty of Education School Teaching department in Gazi University,…

Taking a "Reality" Check: Expanding Pre-Service Teachers' Views on Pedagogy and Diversity

ERIC Educational Resources Information Center

Ryan, Mary; Carrington, Suzanne; Selva, Gitta; Healy, Annah

2009-01-01

The outcomes of a two-pronged "real-world" learning project, which aimed to expand the views of pre-service teachers about learning, pedagogy and diversity, will be discussed in this paper. Seventy-two fourth-year and 22 first-year students, enrolled in a Bachelor of Education degree in Queensland, Australia, were engaged in community…

Oak Regeneration: Four Years After Three Harvesting Treatments in a North Alabama Upland Hardwood Stand

Treesearch

David Shostak; Michael S. Golden; Mark R. Dubois

2002-01-01

Fourth year regeneration of upland oaks (Quercus spp.) was compared within three harvesting treatments in the mountains of northern Alabama. Six four-acre experimental blocks were established on north facing slopes. Each of the three harvesting treatments (deferment cutting, strip clearcutting, and block clearcutting) was randomly assigned to two...

Development of Fourth-Grade Students' Understanding of Experimental and Theoretical Probability

ERIC Educational Resources Information Center

English, Lyn; Watson, Jane

2014-01-01

Students explored variation and expectation in a probability activity at the end of the first year of a 3-year longitudinal study across grades 4-6. The activity involved experiments in tossing coins both manually and with simulation using the graphing software, "TinkerPlots." Initial responses indicated that the students were aware of…

Bleeding pattern and user satisfaction in second consecutive levonorgestrel-releasing intrauterine system users: results of a prospective 5-year study

PubMed Central

Heikinheimo, O.; Inki, P.; Schmelter, T.; Gemzell-Danielsson, K.

2014-01-01

STUDY QUESTION What is the bleeding pattern during second consecutive levonorgestrel-releasing intrauterine system (LNG-IUS) use? SUMMARY ANSWER Consecutive use of LNG-IUS is associated with a predictable bleeding pattern, characterized by the absence of the initial period of irregular bleeding seen after interval insertion of an LNG-IUS and a non-bleeding pattern in the vast majority of women. WHAT IS KNOWN ALREADY With increased popularity of the LNG-IUS for long-term birth control and treatment of heavy menstrual bleeding (HMB), consecutive use of the system is becoming more frequent. One previous study showed 60% amenorrhea rate in consecutive IUS users; however, the sample size was small. STUDY DESIGN, SIZE, DURATION A prospective multicenter study in four European countries recruited women who wished to continue with LNG-IUS use immediately after the first 5-year period. A total of 204 women were followed up until the end of the first year of the second IUS. Thereafter 170 women continued into the extension phase of the study up to the full 5 years of use of the second IUS and 144 women continued to the end of the study. PARTICIPANTS, SETTING, METHODS A total of 170 women (mean age 39 years) who had been using their first LNG-IUS for between 4 years 3 months and 4 years 9 months, either for contraception or for treatment of HMB, and who planned to replace the device with a new LNG-IUS, were recruited and followed up to 5 years of the second IUS use. A total of 17 centers in four European countries were involved in the study. Bleeding patterns were analyzed using daily bleeding diaries using 90-day reference periods (RP) for the first year of the second IUS use and for the last RP of each year during Years 2–5 of use. MAIN RESULTS AND THE ROLE OF CHANCE Approximately 70% of women were free of bleeding during Years 2–5 and up to 49% were amenorrheic. There was a slight increase in the number of bleeding/spotting days of ∼3 days during the first RP immediately after the placement of the second IUS, whereafter the number of bleeding/spotting days returned to the level preceding the second IUS insertion or below that. Absence of bleeding was associated with high overall satisfaction and continuation rates. No serious adverse events assessed as related to the LNG-IUS use occurred during the 5-year period. The cumulative expulsion rate during the 5-year study period was 1.2%. The sample size was large enough to study bleeding patterns, and subjects are likely to represent typical consecutive IUS users, and therefore, the role of chance is small. LIMITATIONS, REASONS FOR CAUTION The women represent a selected group as they had already successfully used their first IUS for almost 5 years and were willing to continue its use—however, this is currently a common clinical situation. The results may therefore not be extrapolated to first-time users of the LNG-IUS. WIDER IMPLICATIONS OF THE FINDINGS These data are of importance when counseling women who are making decisions concerning long-term contraception. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by Bayer Pharma AG. P.I. and T.S. are full-time employees of Bayer Pharma AG. O.H. and K. G-D. have received consultancy fees from Bayer Pharma AG. The publication was developed jointly by all authors without third-party involvement and no honoraria were paid for any authors for their contribution to this manuscript. TRIAL REGISTRATION NUMBER NCT00393198. PMID:24682613

Influence of eating quickly and eating until full on anthropometric gains in girls: A population-based, longitudinal study.

PubMed

Ochiai, H; Shirasawa, T; Nanri, H; Nishimura, R; Hoshino, H; Kokaze, A

2017-11-01

In examining childhood overweight/obesity, there is a need to consider both eating quickly and eating until full. This longitudinal study investigated the influence of eating quickly and/or eating until full on anthropometric variables and becoming overweight/obese among Japanese schoolgirls. Study participants were fourth-grade schoolgirls (aged 9 or 10 years) in Ina Town, Japan. Physical examinations and a questionnaire survey were performed at baseline (fourth grade) and after 3 years (seventh grade). Height, weight, and waist circumference were measured in the physical examinations, while the data on eating quickly and eating until full were collected in the questionnaire survey. Analysis of variance and analysis of covariance were used to compare the differences in each anthropometric variable between fourth and seventh grade among groups. Data on 425 non-overweight/obese schoolgirls in fourth grade were analyzed. Gains in anthropometric variables (body mass index, waist circumference, and waist-to-height ratio) from fourth to seventh grade were significantly larger in the "eating quickly and eating until full" group than in the "not eating quickly and not eating until full" group. In contrast, there were no significant differences in the gains between the "eating quickly or eating until full" group and the "not eating quickly and not eating until full" group. The proportion of overweight/obese girls in seventh grade was higher in the "eating quickly and eating until full" group than in the other groups. Eating quickly and eating until full had a substantial impact on excess gains in anthropometric variables among schoolgirls, suggesting that modifying these eating behaviors may help prevent non-overweight/obese girls from the excess gains. Accordingly, school health programs need to focus on not eating quickly and/or not eating until full to prevent overweight/obesity; it is necessary to emphasize "the risk of overweight/obesity associated with these eating behaviors" in schools. © 2017 The Authors. Child: Care, Health and Development Published by John Wiley & Sons Ltd.

Association between median episiotomy and severe perineal lacerations in primiparous women

PubMed Central

Labrecque, M; Baillargeon, L; Dallaire, M; Tremblay, A; Pinault, J J; Gingras, S

1997-01-01

OBJECTIVE: To evaluate the association between median episiotomy and severe (third- and fourth-degree) perineal lacerations in primiparous women. DESIGN: Retrospective cohort study. SETTING: University-affiliated hospital providing secondary obstetric care in Quebec City. PATIENTS: A total of 6522 primiparous women who gave birth vaginally to a single live baby in cephalic position between 1985 and 1993. OUTCOME MEASURE: Incidence of third- and fourth-degree perineal lacerations. RESULTS: Median episiotomy was performed in 4390 women (67.3%). A total of 1002 women (15.4%) had a third- or fourth-degree laceration. The frequency of severe perineal lacerations was 20.6% with episiotomy and 4.5% without episiotomy (relative risk [RR] 4.58, 95% confidence interval [CI] 3.74-5.62). This association persisted after adjustment by stratified analysis for type of delivery and birth weight (RR 3.03, 95% CI 2.52-3.63) and by logistic regression for type of delivery, birth weight, epidural analgesia, shoulder dystocia, baby's head circumference, experience of the physician and year of delivery (odds ratio 3.58, 95% CI 2.84-4.50). CONCLUSION: Median episiotomy is strongly associated with third- and fourth-degree perineal lacerations in primiparous women. Reducing the use of this procedure could decrease the occurrence of severe perineal tears. PMID:9084384

My week: Marc Armour.

PubMed

2017-03-11

Marc Armour, is a fourth-year vet student at the Royal Veterinary College. Now on rotations, he chose to spend a week doing EMS with the BVA's journals, which are published by BMJ. Here's how he got on. British Veterinary Association.

Graduate Training in Helping Relationships: Helpful or Harmful?

ERIC Educational Resources Information Center

Spielberg, Gil

1980-01-01

Investigated graduate training experience in psychology and social work, focusing on certain therapist characteristics. Students in both programs improved throughout graduate education. Fourth-year students in psychology, however, showed a slight drop in facilitative responses. (JMF)

Carl D. Perkins Vocational and Technical Education Act of 1998, Report to Congress on State Performance, Program Year 2002-2003

ERIC Educational Resources Information Center

US Department of Education, 2005

2005-01-01

This is the fourth annual report to Congress by the US Department of Education. Among the highlights of this report are: (1) More students were reported by states as having enrolled in vocational and technical education courses in Program Year (PY) 2002-2003 than in the past three years; (2) There remain concerns about the quality and reliability…

In-Class Use of Laptop Computers to Enhance Engagement within an Undergraduate Biology Curriculum: Findings and Lessons Learned

ERIC Educational Resources Information Center

Poling, Kirsten; Smit, Julie; Higgs, Dennis

2013-01-01

Laptop computers were provided for use in three biology classes with differing formats (a second year lecture course of 100 students, a third/fourth year lecture course of 50 students, and a second year course with greater than 250 students, in groups of 25 during the laboratory portion of the class) to assess their impact on student learning and…

Student Scientific Inquiry in the Core Curriculum

PubMed Central

Vansal, Sandeep S.; Moore, Ronnie J.; Feldman, Stuart

2013-01-01

Objective. To design and implement a required student-driven research program as a capstone experience in the doctor of pharmacy (PharmD) curriculum. Design. A research proposal in the form of a competitive grant application was required for each of 65 fourth-year students in an inaugural PharmD class at Touro College of Pharmacy in New York. The focus of the proposals was on hypothesis-driven research in basic science, clinical research, health outcomes, and public health. Assessment. Students’ research proposals were graded using a standardized grading instrument. On a post-experience survey, most students rated the overall experience positively, indicating increased confidence in their research skills. About two-thirds of faculty members were satisfied with their students’ performance, and the great majority thought the experience would be useful in the students’ careers. Conclusion. The capstone research project was a positive experience for fourth-year students. PMID:24159217

Fourth User Workshop on High-Power Lasers at the Linac Coherent Light Source

DOE PAGES

Bolme, Cindy Anne; Mackinnon, Andy; Glenzer, Siegfried

2017-05-30

The fourth international user workshop focusing on high-power lasers at the Linac Coherent Light Source (LCLS) was held in Menlo Park, CA, USA, on October 3–4, 2016. The workshop was co-organized by Los Alamos National Laboratory and SLAC National Accelerator Laboratory (SLAC), and garnered the attendance of more than 110 scientists. Participants discussed the warm dense matter and high-pressure science that is being conducted using high-power lasers at the LCLS Matter in Extreme Conditions (MEC) endstation. During the past year, there have been seven journal articles published from research at the MEC instrument. Here, the specific topics discussed at thismore » workshop were experimental highlights from the past year, current status and future commissioning of MEC capabilities, and future facility upgrades that will enable the expanded science reach of the facility.« less

Fourth User Workshop on High-Power Lasers at the Linac Coherent Light Source

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bolme, Cindy Anne; Mackinnon, Andy; Glenzer, Siegfried

The fourth international user workshop focusing on high-power lasers at the Linac Coherent Light Source (LCLS) was held in Menlo Park, CA, USA, on October 3–4, 2016. The workshop was co-organized by Los Alamos National Laboratory and SLAC National Accelerator Laboratory (SLAC), and garnered the attendance of more than 110 scientists. Participants discussed the warm dense matter and high-pressure science that is being conducted using high-power lasers at the LCLS Matter in Extreme Conditions (MEC) endstation. During the past year, there have been seven journal articles published from research at the MEC instrument. Here, the specific topics discussed at thismore » workshop were experimental highlights from the past year, current status and future commissioning of MEC capabilities, and future facility upgrades that will enable the expanded science reach of the facility.« less

Experience of nursing students with standardized patients in simulation-based learning: Q-methodology study.

PubMed

Ha, Eun-Ho

2018-04-23

Standardized patients (SPs) boost self-confidence, improve problem solving, enhance critical thinking, and advance clinical judgment of nursing students. The aim of this study was to examine nursing students' experience with SPs in simulation-based learning. Q-methodology was used. Department of nursing in Seoul, South Korea. Fourth-year undergraduate nursing students (n = 47). A total of 47 fourth-year undergraduate nursing students ranked 42 Q statements about experiences with SPs into a normal distribution grid. The following three viewpoints were obtained: 1) SPs are helpful for patient care (patient-centered view), 2) SPs roles are important for nursing student learning (SPs roles-centered view), and 3) SPs can promote competency of nursing students (student-centered view). These results indicate that SPs may improve nursing students' confidence and nursing competency. Professors should reflect these three viewpoints in simulation-based learning to effectively engage SPs. Copyright © 2018 Elsevier Ltd. All rights reserved.

Patient understanding of medical jargon: a survey study of U.S. medical students.

PubMed

LeBlanc, Thomas W; Hesson, Ashley; Williams, Andrew; Feudtner, Chris; Holmes-Rovner, Margaret; Williamson, Lillie D; Ubel, Peter A

2014-05-01

With increasing exposure, medical students may forget that technical jargon is unfamiliar to laypeople. To investigate this possibility, authors assessed student perceptions of patient understanding across different years in medical school. 533 students at 4 U.S. medical schools rated the proportion of patients likely to understand each of twenty-one different jargon terms. Students were either in the first month of their first year, the middle of their first year, or the middle of their fourth year of medical school. Fourth-year students were slightly more pessimistic about patients' understanding compared to new first-year students (mean percent understanding of 55.1% vs. 58.6%, p=0.004). Students both over- and under-estimated patient understanding of specific words compared to published estimates. In a multivariate model, other factors did not explain these differences. Students do not generally presume that patients understand medical jargon. In many cases they actually underestimate patients' understanding, and these estimates may become more pessimistic longitudinally. Jargon use in communication with patients does not appear to stem from unrealistic presumptions about patients' understanding or from desensitization to jargon during medical school. Training about patient knowledge of medical jargon may be a useful addition to communication skills curricula. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

School, family and adolescent smoking.

PubMed

Yañez, Aina; Leiva, Alfonso; Gorreto, Lucia; Estela, Andreu; Tejera, Elena; Torrent, Maties

2013-01-01

The socio-cultural environment is an important factor involved with the onset of smoking during adolescence. Initiation of cigarette smoking occurs almost exclusively during this stage. In this context we aimed to analyze the association of school and family factors with adolescent smoking by a cross-sectional study of 16 secondary schools randomly selected from the Balearic Islands involved 3673 students and 530 teachers. The prevalence of regular smoking (at least one cigarette per week) was 4.8% among first year students, 11.6% among second year students, 14.1% among third year students, 20.9% among fourth year students and 22% among teachers. Among first and second year students, there were independent associations between regular smoking and adolescents' perception of being allowed to smoke at home, belonging to a single parent family, poor relationship with parents, poor academic performance, lack of interest in studies and teachers' perception of smoking in the presence of pupils. Among third and fourth year students, there were independent associations between regular smoking and poor relationship with parents, adolescents' perception of being allowed to smoke at home, poor academic performance, lack of control over student misbehavior and the school attended. The school policies and practices affect student related health behavior regarding smoking, independent of individual and family factors.