Predicting Lumbar Fusion Surgery Outcomes From Presurgical Patient Variables: The Utah Lumbar Fusion Outcome Study

Lumbar fusion surgery is a commonly used procedure to treat severe spinal pathology and associated chronic disabling low back and leg pain. Despite the common incidence of spinal fusion surgery, few studies have examined patient outcomes or predictive correlates of this procedure. The objectives of this study were to characterize Utah workers who received lumbar fusion surgery in terms of relevant presurgical and outcome variables and to identify presurgical correlates of patient outcomes. An archival prospective research design was utilized consisting of a retrospective medical chart review and a postsurgical telephone outcome survey. Subjects were 203 workers\u27 compensation patients from the state of Utah who have undergone spinal fusion surgery and who were at least 2 years postsurgery at time of follow-up. Outcomes were assessed for 144 of the 203 patients (71%). Presurgical measures _included demographic, work, compensation, disability, health, surgical, and physiological variables. Outcome measures included solid arthrosis, patient satisfaction, work disability status, functional disability due to back pain, and multidimensional health. Analysis of patient outcome data revealed that solid arthrosis was achieved in 71.9% of patients. Forty-six percent of subjects felt their back/leg pain problems were worse than what they had expected following the surgery, and 42 % felt that their quality of life had not changed or worsened as a result of lumbar fusion. Twenty-eight percent of fusion patients were work disabled at follow-up. Fusion patient mean outcome scores on multidimensional health measures reflected poorer health than comparative medical patient and nonpatient norms. The most consistent presurgical correlates across outcomes were lawyer involvement, number of prior low back operations, age at injury, and household income at time of injury. Results are compared to data from previous lumbar fusion research studies and reasons for varying findings are offered. Implications of the findings are discussed in terms of inadequate patient selection and insufficient assessment of patient outcomes in low back research studies. Limitations of the present research are discussed, including how placebo, natural history, and regression to the mean can lead to erroneous conclusions about the efficacy of lumber fusion surgery. Suggestions for improvements in low back surgery outcome research are offered

General Chemistry Student Attitudes and Success with Use of Online Homework: Traditional- Responsive versus Adaptive-Responsive

We investigated whether use of an adaptive-responsive online homework system (OHS) that tailors homework to students’ prior knowledge and periodically reassesses students to promote learning through practice retrieval has inherent advantages over traditional-responsive online homework. A quasi-experimental cohort control post-test-only design with nonequivalent groups and propensity scores with nearest neighbor matching (n = 6,114 pairs) was used. The adaptive system was found to increase the odds of a higher final letter grade for average, below average, and failing students. However, despite the learning advantages, students self-reported less favorable attitudes toward adaptive-responsive (3.15 of 5) relative to traditional-responsive OHS (3.31). Specific to the adaptive OHS, the following were found: (i) student attitudes were moderately and positively correlated (r = 0.36, p \u3c 0.01) to final letter grade, (ii) most students (95%) reported engaging in remediation of incorrect responses, (iii) a majority of students (69%) reported changes in study habits, and (iv) students recognized the benefit of using adaptive OHS by ranking its assignments and explanations or review materials as two of the top three most useful course aspects contributing to perceived learning. Instructors can use our findings to inform their choice of online homework system for formative assessment of chemistry learning by weighing the benefits, disadvantages, and learning pedagogies of traditional-responsive versus adaptive-responsive systems

Academic Performance and Behavioral Patterns

Identifying the factors that influence academic performance is an essential part of educational research. Previous studies have documented the importance of personality traits, class attendance, and social network structure. Because most of these analyses were based on a single behavioral aspect and/or small sample sizes, there is currently no quantification of the interplay of these factors. Here, we study the academic performance among a cohort of 538 undergraduate students forming a single, densely connected social network. Our work is based on data collected using smartphones, which the students used as their primary phones for two years. The availability of multi-channel data from a single population allows us to directly compare the explanatory power of individual and social characteristics. We find that the most informative indicators of performance are based on social ties and that network indicators result in better model performance than individual characteristics (including both personality and class attendance). We confirm earlier findings that class attendance is the most important predictor among individual characteristics. Finally, our results suggest the presence of strong homophily and/or peer effects among university students

Quality of life: international and domestic students studying medicine in New Zealand

International students form a significant proportion of students studying within universities in Western countries. The quality of life perceptions of international medical students in comparison with domestic medical students has not been well documented. There is some evidence to suggest that international medical students may have different educational and social experiences in relation to their domestic peers. This study investigates the levels of quality of life experienced by international and domestic students studying medicine. A total of 548 medical students completed the abbreviated version of the World Health Organization Quality of Life questionnaire. The focus of the analysis was to evaluate differences between international and domestic students in their early clinical years. The responses were analysed using multivariate analysis of variance methods. International medical students are experiencing lower social and environmental quality of life compared with domestic peers. International medical students in New Zealand have expressed quality of life concerns, which likely have an impact on their academic achievement, feelings of wellness, acculturation, and social adaptation. The findings reinforce the need for creating stronger social networks and accessible accommodation, as well as developing systems to ensure safety, peer mentorship and student support.published_or_final_versio

Spanish Teachers\u27 Sense of Humor and Student Performance on the National Spanish Exams

Research suggests that second/foreign language teachers\u27 sense of humor is directly related to many outcomes for teachers and their students. This research investigates the relationship between the perceived sense of humor of in-service Spanish teachers\u27 (n = 102) and their students\u27 (n = 5,419) score on the National Spanish Exams using the affective filter hypothesis as a conceptual framework. Statistical analyses indicate that Spanish teacher sense of humor is related to student achievement on the exams. This research has implications for language teachers and teacher educators

Attachment, infidelity, and loneliness in college students involved in a romantic relationship: the role of relationship satisfaction, morbidity and prayer for partner

This study examined the mediating effects of relationship satisfaction, prayer for a partner, and morbidity in the relationship between attachment and loneliness, infidelity and loneliness, and psychological morbidity and loneliness, in college students involved in a romantic relationship. Participants were students in an introductory course on family development. This study examined only students (n = 345) who were involved in a romantic relationship. The average age of participants was 19.46 (SD = 1.92) and 25 % were males. Short-form UCLA Loneliness Scale (ULS-8), (Hays and DiMatteo in J Pers Assess 51:69–81, doi:10.1207/s15327752jpa5101_6, 1987); Relationship Satisfaction Scale (Funk and Rogge in J Fam Psychol 21:572–583, doi:10.1037/0893-3200.21.4.572, 2007); Rotterdam Symptom Checklist (De Haes et al. in Measuring the quality of life of cancer patients with the Rotterdam Symptom Checklist (RSCL): a manual, Northern Centre for Healthcare Research, Groningen, 1996); Prayer for Partner Scale, (Fincham et al. in J Pers Soc Psychol 99:649–659, doi:10.1037/a0019628, 2010); Infidelity Scale, (Drigotas et al. in J Pers Soc Psychol 77:509–524, doi:10.1037/0022-3514.77.3.509, 1999); and the Experiences in Close Relationship Scale-short form (Wei et al. in J Couns Psychol 52(4):602–614, doi:10.1037/0022-0167.52.4.602, 2005). Results showed that relationship satisfaction mediated the relationship between avoidance attachment and loneliness and between infidelity and loneliness. Physical morbidity mediated the relationship between anxious attachment and psychological morbidity. Psychological morbidity mediated the relationship between anxious attachment and physical morbidity. The present results expand the literature on attachment by presenting evidence that anxious and avoidant partners experience loneliness differently. Implications for couple’s therapy are addressed. Future research should replicate these results with older samples and married couples.Acknowledgments This research was supported by Grant Number 90FE0022 from the United States Department of Health and Human Services awarded to the last author

Pain acceptance potentially mediates the relationship between pain catastrophizing and post-surgery outcomes among compensated lumbar fusion patients

Purpose: Chronic low back pain is highly prevalent and often treatment recalcitrant condition, particularly among workers’ compensation patients. There is a need to identify psychological factors that may predispose such patients to pain chronicity. The primary aim of this study was to examine whether pain acceptance potentially mediated the relationship between pain catastrophizing and post-surgical outcomes in a sample of compensated lumbar fusion patients. Patients and methods: Patients insured with the Workers Compensation Fund of Utah and who were at least 2 years post-lumbar fusion surgery completed an outcome survey. These data were obtained from a prior retrospective-cohort study that administered measures of pain catastrophizing, pain acceptance, mental and physical health, and disability. Results: Of the 101 patients who completed the outcome survey, 75.2% were male with a mean age of 42.42 years and predominantly identified as White (97.0%). The majority of the participants had a posterior lumbar interbody fusion surgery. Pain acceptance, including activity engagement and pain willingness, was significantly correlated with better physical health and mental health, and lower disability rates. Pain catastrophizing was inversely correlated with measures of pain acceptance (activity engagement r=–0.67, p Conclusion: This study demonstrated that the relationship between pain catastrophizing and negative patient outcomes was potentially mediated by pain acceptance. Understanding this mediating relationship offers insight into how pain acceptance may play a protective role in patients’ pain and disability and has potential implications for pain treatments