The Big Paper Network Supporting Doctoral Students to Degree Completion

Doctoral completion rates are a concern across disciplines.  This paper describes the way in which Curriculum Leadership faculty redesigned their doctoral program from coursework through completion to include a strong support system, intellectually and emotionally.  This culminated in the creation of the “Big Paper Network,” designed to support candidates from proposal writing through defense

Formación profesional, básica o general: lo que piensan los estudiantes de una universidad pública del Brasil

En el contexto de educación superior, la participación de estudiantes en el diseño curricular es poco enfatizada. Este trabajo resulta de una investigación desarrollada con discentes de todas las carreras profesionales de la Universidad Estatal de Campinas – Unicamp - Brasil, con el objetivo de conocer la perspectiva de estos, qué aspectos del currículo de sus carreras profesionales son vistos como esenciales, y cuál sería el principal énfasis curricular que se debería abordar para prepararlos mejor para la actualidad y el futuro mundo del trabajo. Los datos revelan que los estudiantes están hoy más preocupados que en el pasado por cuestiones sociales, y resienten no ver ese énfasis abordado en los currículos. El trabajo es relevante por dar voz a la opinión de los estudiantes, una vez que ejercen un importante papel al transformar el currículo intencionado en currículo experimentado. In the context of higher education, student participation in curriculum design is little emphasized. This work results from a research developed with students from all courses at the State University of Campinas – Unicamp - Brazil, with the aim of knowing their perspective regarding which curricular aspects of profesional careers are considered to be seen as essential, and which would be the main curricular emphasis that should be applied in order to better prepare them for the current and the future world of work. The data reveal that students today are more concerned with social issues than they have been in the past and resent not see this emphasis addressed in the curriculum. The research is relevant for giving voice to students’ opinion, once they play an important role in transforming the curriculum intended to a experienced curriculum. Resumo: Em nosso contexto de educação superior, a participação de estudantes no desenho curricular é pouco enfatizada. Esse trabalho resulta de uma pesquisa desenvolvida com discentes de todos os cursos da Universidade Estadual de Campinas - Unicamp, com o objetivo de conhecer, na perspectiva destes, quais aspectos dos currículos de seus cursos são vistos como essenciais e qual seria a principal ênfase curricular que os currículos deveriam abordar para melhor prepará-los para o atual, e o futuro, mundo do trabalho. Os resultados demonstram uma mudança no comportamento e na visão do aluno sobre qual deva ser a direção de sua formação como profissional, o que desafia as políticas curriculares a tomar em consideração aspectos apontados por eles. Os dados desvelam que os estudantes hoje estão mais preocupados com questões sociais do que estiveram no passado e que se ressentem de não ver essa ênfase abordada nos currículos. A pesquisa é relevante por dar voz à opinião dos estudantes, uma vez que estes exercem importante papel ao transformar o currículo intencionado em currículo experienciado

Eliminating Amylase Testing from the Evaluation of Pancreatitis in the Emergency Department

Background: Alterations in serum biomarkers have been used to evaluate for pancreatitis in the emergency department (ED). Studies have shown lipase to be as sensitive and more specific than amylase in diagnosing pancreatitis and that amylase plus lipase does not improve accuracy over lipase alone.Objective: To determine effects of interventions to decrease ordering of amylase in the evaluation of pancreatitis.Methods: We conducted a pre- and post-cohort study. The number of amylase and lipase tests ordered in the ED was recorded prior to intervention to establish a baseline. We introduced an educational intervention to order lipase without amylase. A second intervention involved removing amylase from bedside order entry forms. We introduced a third intervention that included deleting amylase from trauma order forms, and decoupling amylase and lipase in the computer ordering system. We recorded the number of lipase and amylase tests in weekly aggregates for comparison to the baseline. Data analysis using students t-test, standard deviation and p values are reported.Results: Before interventions 93% of patients had both tests ordered. Educational interventions resulted in a decrease to 91% (p=0.06) of co-ordering. Further interventions decreased the percentage of patients evaluated with both tests to 14.3%. This translates into a decrease in patient charges of approximately $350,000 a year.Conclusion: Using simple structured interventions in the ED can reduce amylase ordering. Educational programming alone was not effective in significantly decreasing amylase ordering; however, education plus system-based interventions decreased amylase ordering. [West J Emerg Med. 2010; 11(4):344-347.

A prospective evaluation of indications for neurological consultation in the emergency department

Background: Recognizing the diverse presentation of neurological conditions that emergency physicians encounter can be challenging, and management of these patients often requires consultation with a neurologist. Accurate diagnosis is critical in neurological emergencies because patient outcomes are often dependent on timely treatment. Our primary objective was to ascertain whether consultant neurologists understood the reason for consultation in the emergency department. Methods: The authors conducted a prospective study of a non-consecutive sample of 94 patients seen in an academic tertiary care emergency department (ED) who underwent consultation by neurologist over 4 consecutive months. At the time a consult was requested, we independently surveyed the treating ED physician for their differential diagnosis. Neurologists were also queried as to whether there was a clear indication for consultation. We then followed the patients to determine their final diagnosis and outcome. Results: The median age was 57 years (interquartile range 45–78). 45.7 % were male. The clinical reasons for all the consults were 61 % focal symptom, 12 % concern about a specific diagnosis, 9 % radiological finding, 9 % diagnostic ambiguity, and 11 % other. There was no significant difference in the rate of a final neurological diagnosis based on the clinical reason for consult (p = 0.13). In the 17 % of patients for whom the treating neurologist reported a lack of a clear indication for the consultation, 25 % were later admitted to a neurological service, and 69 % ultimately had a neurological diagnosis. Conclusions: Although patients with neurological emergencies can have diverse presentations, emergency physicians appear to utilize neurologic consultation appropriately. Additionally, nearly 70 % of patients for whom the consultant did not precisely understand the need for the consultation had neurological diagnoses. Time and resource constraints in the ED create challenges in making correct diagnosis

Dual bronchodilators in Bronchiectasis study (DIBS): protocol for a pragmatic, multicentre, placebo-controlled, three-arm, double-blinded, randomised controlled trial studying bronchodilators in preventing exacerbations of bronchiectasis

INTRODUCTION: Bronchiectasis is a long-term lung condition, with dilated bronchi, chronic inflammation, chronic infection and acute exacerbations. Recurrent exacerbations are associated with poorer clinical outcomes such as increased severity of lung disease, further exacerbations, hospitalisations, reduced quality of life and increased risk of death. Despite an increasing prevalence of bronchiectasis, there is a critical lack of high-quality studies into the disease and no treatments specifically approved for its treatment. This trial aims to establish whether inhaled dual bronchodilators (long acting beta agonist (LABA) and long acting muscarinic antagonist (LAMA)) taken as either a stand-alone therapy or in combination with inhaled corticosteroid (ICS) reduce the number of exacerbations of bronchiectasis requiring treatment with antibiotics during a 12 month treatment period. METHODS: This is a multicentre, pragmatic, double-blind, randomised controlled trial, incorporating an internal pilot and embedded economic evaluation. 600 adult patients (≥18 years) with CT confirmed bronchiectasis will be recruited and randomised to either inhaled dual therapy (LABA+LAMA), triple therapy (LABA+LAMA+ICS) or matched placebo, in a 2:2:1 ratio (respectively). The primary outcome is the number of protocol defined exacerbations requiring treatment with antibiotics during the 12 month treatment period. ETHICS AND DISSEMINATION: Favourable ethical opinion was received from the North East-Newcastle and North Tyneside 2 Research Ethics Committee (reference: 21/NE/0020). Results will be disseminated in peer-reviewed publications, at national and international conferences, in the NIHR Health Technology Assessments journal and to participants and the public (using lay language). TRIAL REGISTRATION NUMBER: ISRCTN15988757

Callous-unemotional traits and anxiety in adolescents: a latent profile analysis to identify different types of antisocial behavior in a high-risk community sample

OBJECTIVE: Callous-unemotional (CU) traits are associated with a more severe and chronic trajectory of antisocial behavior. The present study aimed to identify different classes of CU and anxiety and to compare these classes on overt and covert antisocial behavior and several clinical correlates. METHOD: In a prospective high-risk cohort of adolescents (N = 679; mean age = 14.77, SD = 0.81), latent profile analysis was conducted using CU traits and anxiety symptoms as indicators, and multi-informant aggressive and rule breaking behavior as distal outcomes. Post-hoc analyses with binary logistic regression and a series of ANCOVA were performed on identified classes assessing violent aggression, property offending, and clinical correlates. RESULTS: Three classes were found, a reference group (low CU, low anxiety; N = 500), a high CU-low anxiety group (N = 98), and an intermediate CU-high anxious group (N = 81). The high CU-low anxiety group scored highest on property offenses, while the intermediate CU-high anxious group scored highest on aggressive behavior. The intermediate CU-high anxious group scored highest on psychotic experiences, while the high CU group scored highest on internet gaming addiction problems and bullying victimization. CONCLUSION: These findings provide further evidence for diverse variants of CU traits in a high-risk community sample. Future prospective studies should point out whether and to what extent adolescents with CU traits with and without anxiety develop criminal careers and psychiatric disorders in adulthood

Quantitative and qualitative evaluations of impacts and benefits of nine INHERIT case studies

The INHERIT report Quantitative and Qualitative Evaluations of Impacts and Benefits of Nine INHERIT Case Studies documents the findings relevant to potential impacts and benefits of nine case studies for health, equity and a more sustainable environment. It uses a mixed method approach with quantitative methods augmented in some cases by written responses to survey questions, or by focus group discussions on impacts, as appropriate. Each case study evaluation was led by a different INHERIT partner. In each case, partners formulated the research design appropriate to their case studies and the associated research questions identified within the framework of INHERIT. The coordinating partner, University College London (UCL), developed an evaluation framework to suit the range of case studies examined for impacts and benefits, the case specific logic models developed, and the research questions identified. The nine chapters describe the impact evaluations and findings from the nine case studies using the following format: Background; Overall aims; Context; Research Questions; Methodology; Results; Discussion; Limitations; Learning points for future research; Learning points for potential scale up and transferability