A Spoonful of Success: Undergraduate Tutor-Tutee Interactions and Performance

We explore how the dynamics of the tutor-tutee relationship influence student self- reliance, and ultimately course performance. We examine 333 tutor and tutee pairs at a student success center at a public, comprehensive, university of about 5,000 undergraduates in over 60 different courses during the spring of 2015. We find as frequency and quality of the interactions between tutor and tutees increase that the tutors increasingly foster independent study habits on the part of the tutees. The incorporation of independent study habits was then associated with better course outcomes. In other words, the development of a positive, sustained relationship by a tutor with a tutee appears to aid the development of traditional classroom norms not undermine them

The Challenges of Developing an Instrument to Assess Health Provider Motivation at Primary Care Level in Rural Burkina Faso, Ghana and Tanzania.

The quality of health care depends on the competence and motivation of the health workers that provide it. In the West, several tools exist to measure worker motivation, and some have been applied to the health sector. However, none have been validated for use in sub-Saharan Africa. The complexity of such tools has also led to concerns about their application at primary care level. To develop a common instrument to monitor any changes in maternal and neonatal health (MNH) care provider motivation resulting from the introduction of pilot interventions in rural, primary level facilities in Ghana, Burkina Faso, and Tanzania. Initially, a conceptual framework was developed. Based upon this, a literature review and preliminary qualitative research, an English-language instrument was developed and validated in an iterative process with experts from the three countries involved. The instrument was then piloted in Ghana. Reliability testing and exploratory factor analysis were used to produce a final, parsimonious version. This paper describes the actual process of developing the instrument. Consequently, the concepts and items that did not perform well psychometrically at pre-test are first presented and discussed. The final version of the instrument, which comprises 42 items for self-assessment and eight for peer-assessment, is then shown. This is followed by a presentation and discussion of the findings from first use of the instrument with MNH providers from 12 rural, primary level facilities in each of the three countries. It is possible to undertake work of this nature at primary health care level, particularly if the instruments are kept as straightforward as possible and well introduced. However, their development requires very lengthy preparatory periods. The effort needed to adapt such instruments for use in different countries within the region of sub-Saharan Africa should not be underestimated

Trauma Exposure and Transdiagnostic Distress: Examining Shared and PTSD-Specific Associations

Dimensional models of psychopathology suggest that the causes and consequences of psychopathology are attributable to a combination of syndrome specific and transdiagnostic features. There is considerable evidence that trauma exposure confers risk for a wide range of psychiatric conditions, yet no previous work has specifically examined the higher-order effects of trauma exposure within a structural model. We examined transdiagnostic and PTSD-specific associations with multiple forms of trauma exposure within a nation-wide sample (N = 1,649; 50% female) of military Veterans over-selected for posttraumatic stress disorder (PTSD). A higher-order Distress variable was estimated using PTSD, major depressive disorder (MDD), and generalized anxiety disorder (GAD) symptoms as indicators. A structural equation model spanning three measurement time points over an average of 3.85 years was then used to examine the unique roles of higher-order Distress and PTSD residual variance in accounting for the relations between trauma exposure and psychosocial impairment. Results suggest that the association between trauma exposure and PTSD symptoms is primarily mediated by higher-order Distress, but that PTSD severity does have a significant association with trauma exposure independent of Distress. Both higher-order Distress and PTSD-specific variance were necessary to account for the association between trauma exposure and future functional impairment. This work suggests there may be shared etiology linking cumulative trauma exposure and a range of internalizing symptoms. Continued application of higher-order dimensional models is needed to provide a more comprehensive understanding of the consequences of trauma exposure

Die Etablierung von Evidenzteams in SchuMaS – Eine Strategie zur systematischen Nutzung von Daten für die Schul- und Unterrichtsentwicklung

Evidenzteams bieten eine strukturelle Lösung für Schulen, um datengestützte Schul- und Unterrichtsentwicklung systematisch durchführen zu können. Im vorliegenden Beitrag werden deren Funktion, Wirksamkeit sowie Gelingensbedingungen für die Etablierung dargestellt. Daneben zeichnen wir den Prozess der Etablierung ebendieser Teams in den an Schule macht stark beteiligten Schulen nach und geben mittels einer Einzelfallanalyse Einblicke in die Umsetzung an einer Schul

Public and Private Maternal Health Service Capacity and Patient Flows in Southern Tanzania: Using a Geographic Information System to Link Hospital and National Census data.

Background : Strategies to improve maternal health in low-income countries are increasingly embracing partnership approaches between public and private stakeholders in health. In Tanzania, such partnerships are a declared policy goal. However, implementation remains challenging as unfamiliarity between partners and insufficient recognition of private health providers prevail. This hinders cooperation and reflects the need to improve the evidence base of private sector contribution. Objective : To map and analyse the capacities of public and private hospitals to provide maternal health care in southern Tanzania and the population reached with these services. Design : A hospital questionnaire was applied in all 16 hospitals (public n=10; private faith-based n=6) in 12 districts of southern Tanzania. Areas of inquiry included selected maternal health service indicators (human resources, maternity/delivery beds), provider-fees for obstetric services and patient turnover (antenatal care, births). Spatial information was linked to the 2002 Population Census dataset and a geographic information system to map patient flows and socio-geographic characteristics of service recipients. Results : The contribution of faith-based organizations (FBOs) to hospital maternal health services is substantial. FBO hospitals are primarily located in rural areas and their patient composition places a higher emphasis on rural populations. Also, maternal health service capacity was more favourable in FBO hospitals. We approximated that 19.9% of deliveries in the study area were performed in hospitals and that the proportion of c-sections was 2.7%. Mapping of patient flows demonstrated that women often travelled far to seek hospital care and where catchment areas of public and FBO hospitals overlap. Conclusions : We conclude that the important contribution of FBOs to maternal health services and capacity as well as their emphasis on serving rural populations makes them promising partners in health programming. Inclusive partnerships could increase integration of FBOs into the public health care system and improve coordination and use of scarce resources

The Prevalence and Clinical Implications of Comorbid Back Pain in Shoulder Instability: A Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Instability Cohort Study.

Background:Understanding predictors of pain is critical, as recent literature shows that comorbid back pain is an independent risk factor for worse functional and patient-reported outcomes (PROs) as well as increased opioid dependence after total joint arthroplasty. Purpose/Hypothesis:The purpose of this study was to evaluate whether comorbid back pain would be predictive of pain or self-reported instability symptoms at the time of stabilization surgery. We hypothesized that comorbid back pain will correlate with increased pain at the time of surgery as well as with worse scores on shoulder-related PRO measures. Study Design:Cross-sectional study; Level of evidence, 3. Methods:As part of the Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Instability cohort, patients consented to participate in pre- and intraoperative data collection. Demographic characteristics, injury history, preoperative PRO scores, and radiologic and intraoperative findings were recorded for patients undergoing surgical shoulder stabilization. Patients were also asked, whether they had any back pain. Results:The study cohort consisted of 1001 patients (81% male; mean age, 24.1 years). Patients with comorbid back pain (158 patients; 15.8%) were significantly older (28.1 vs 23.4 years; P < .001) and were more likely to be female (25.3% vs 17.4%; P = .02) but did not differ in terms of either preoperative imaging or intraoperative findings. Patients with self-reported back pain had significantly worse preoperative pain and shoulder-related PRO scores (American Shoulder and Elbow Surgeons score, Western Ontario Shoulder Instability Index) (P < .001), more frequent depression (22.2% vs 8.3%; P < .001), poorer mental health status (worse scores for the RAND 36-Item Health Survey Mental Component Score, Iowa Quick Screen, and Personality Assessment Screener) (P < .01), and worse preoperative expectations (P < .01). Conclusion:Despite having similar physical findings, patients with comorbid back pain had more severe preoperative pain and self-reported symptoms of instability as well as more frequent depression and lower mental health scores. The combination of disproportionate shoulder pain, comorbid back pain and mental health conditions, and inferior preoperative expectations may affect not only the patient's preoperative state but also postoperative pain control and/or postoperative outcomes

Fatal attraction: a critique of Carl Schmitt's international political and legal theory

The ongoing Schmitt revival has extended Carl Schmitt's reach over the fields of international legal and political theory. Neo-Schmittians suggest that his international thought provides a new reading of the history of international law and order, which validates the explanatory power of his theoretical premises – the concept of the political, political decisionism, and concrete-order-thinking. Against this background, this article mounts a systematic reappraisal of Schmitt's international thought in a historical perspective. The argument is that his work requires re-contextualization as the intellectual product of an ultra-intense moment in Schmitt's friend/enemy distinction. It inscribed Hitler's ‘spatial revolution’ into a full-scale reinterpretation of Europe's geopolitical history, grounded in land appropriations, which legitimized Nazi Germany's wars of conquest. Consequently, Schmitt's elevation of the early modern nomos as the model for civilized warfare – the ‘golden age’ of international law – against which American legal universalism can be portrayed as degenerated, is conceptually and empirically flawed. Schmitt devised a politically motivated set of theoretical premises to provide a historical counter-narrative against liberal normativism, which generated defective history. The reconstruction of this history reveals the explanatory limits of his theoretical vocabulary – friend/enemy binary, sovereignty-as-exception, nomos/universalism – for past and present analytical purposes. Schmitt's defective analytics and problematic history compromise the standing of his work for purposes of international theory

Working out abjection in the Panapompom bêche-de-mer fishery: Race, economic change and the future in Papua New Guinea

This is the accepted version of the following article: Rollason, W. (2010), Working out abjection in the Panapompom bêche-de-mer fishery: Race, economic change and the future in Papua New Guinea. The Australian Journal of Anthropology, 21: 149–170. doi: 10.1111/j.1757-6547.2010.00076.x, which has been published in final form at http://onlinelibrary.wiley.com/doi/10.1111/j.1757-6547.2010.00076.x/abstract.This is a paper about how men from Panapompom, an island in Milne Bay Province of Papua New Guinea (PNG), understand how they relate to white people and imagine the future. Until recently, men from Panapompom understood themselves to be engaged in a project of ‘development’, in which they would become more and more similar to white people. This was a desirable future. However, changes in the way Panapompom men work for money have resulted in a very different imagination of the future—one in which Panapompom people are not getting whiter, but blacker, and hence more and more excluded from the lives to which they aspire. Men now dive for bêche-de-mer, work which they regard as being particularly hard and dangerous. Diving has profound effects on the skin, blackening and hardening it, leading Panapompom men to liken themselves to the machines that create the wealth that white people use. These ‘mechanising’ effects that diving has on the black body lead men to see white people as the sole beneficiaries of the bêche-de-mer industry, and black people as mere tools or extensions. For bêche-de-mer divers, value and desired forms of life are lodged in Australia, Europe or America, while they find themselves excluded from this future by their growing blackness.ESR

Anterior cruciate ligament reconstruction with concomitant meniscal repair: Is graft choice predictive of meniscal repair success?

Background: When meniscal repair is performed during anterior cruciate ligament (ACL) reconstruction (ACLR), the effect of ACL graft type on meniscal repair outcomes is unclear. Hypothesis: The authors hypothesized that meniscal repairs would fail at the lowest rate when concomitant ACLR was performed with bone--patellar tendon--bone (BTB) autograft. Study Design: Cohort study; Level of evidence, 3. Methods: Patients who underwent meniscal repair at primary ACLR were identified from a longitudinal, prospective cohort. Meniscal repair failures, defined as any subsequent surgical procedure addressing the meniscus, were identified. A logistic regression model was built to assess the association of graft type, patient-specific factors, baseline Marx activity rating score, and meniscal repair location (medial or lateral) with repair failure at 6-year follow-up. Results: A total of 646 patients were included. Grafts used included BTB autograft (55.7%), soft tissue autograft (33.9%), and various allografts (10.4%). We identified 101 patients (15.6%) with a documented meniscal repair failure. Failure occurred in 74 of 420 (17.6%) isolated medial meniscal repairs, 15 of 187 (8%) isolated lateral meniscal repairs, and 12 of 39 (30.7%) of combined medial and lateral meniscal repairs. Meniscal repair failure occurred in 13.9% of patients with BTB autografts, 17.4% of patients with soft tissue autografts, and 19.4% of patients with allografts. The odds of failure within 6 years of index surgery were increased more than 2-fold with allograft versus BTB autograft (odds ratio = 2.34 [95% confidence interval, 1.12-4.92]; Conclusion: Meniscal repair location (medial vs lateral) and baseline activity level were the main drivers of meniscal repair outcomes. Graft type was ranked third, demonstrating that meniscal repairs performed with allograft were 2.3 times more likely to fail compared with BTB autograft. There was no significant difference in failure rates between BTB versus soft tissue autografts. Registration: NCT00463099 (ClinicalTrials.gov identifier)