Stable or unstable associations between learning environment factors, study approaches and exam grades: cross-sectional analyses across two consecutive program years

Studies into the relationships between learning environment perceptions, approaches to studying, and academic outcomes have largely followed cross-sectional designs. As a result, knowledge is sparse with regards to whether, or to what degree, the established associations are consistent across years of study. This study aimed to (i) examine associations between occupational therapy students’ academic performance, their approaches to studying and perceptions of the learning environment, while in their second and third years of study, and (ii) evaluate the consistency of the results across years of study. Occupational therapy students in Norway were assessed annually with regards to their perceptions of the learning environment, study approaches, and academic performance. Associations between variables, measured within each study year, were analyzed with linear regression analyses, and then compared year-overyear. In the second study year (n=162), better academic performance was associated with lower student autonomy, and higher scores on strategic approach. In the third study year (n=189), better academic performance was associated with being female and lower scores on surface approach. Having occupational therapy as the preferred line of education at enrollment was associated with better grades in both study years. Associations between grades and gender, perceptions of student autonomy, and study approaches were somewhat different between the two years. Implications for educational practice is discussed and various contents and emphasis in educational programs are proposed.publishedVersio

Stable or Unstable Associations Between Learning Environment Factors, Study Approaches and Exam Grades: Cross-Sectional Analyses Across Two Consecutive Program Years

Studies into the relationships between learning environment perceptions, approaches to studying, and academic outcomes have largely followed cross-sectional designs. As a result, knowledge is sparse with regards to whether, or to what degree, the established associations are consistent across years of study. This study aimed to (i) examine associations between occupational therapy students’ academic performance, their approaches to studying and perceptions of the learning environment, while in their second and third years of study, and (ii) evaluate the consistency of the results across years of study. Occupational therapy students in Norway were assessed annually with regards to their perceptions of the learning environment, study approaches, and academic performance. Associations between variables, measured within each study year, were analyzed with linear regression analyses, and then compared year-over-year. In the second study year (n=162), better academic performance was associated with lower student autonomy, and higher scores on strategic approach. In the third study year (n=189), better academic performance was associated with being female and lower scores on surface approach. Having occupational therapy as the preferred line of education at enrollment was associated with better grades in both study years. Associations between grades and gender, perceptions of student autonomy, and study approaches were somewhat different between the two years. Implications for educational practice is discussed and various contents and emphasis in educational programs are proposed

Inferior vestibular neuritis: 3 cases with clinical features of acute vestibular neuritis, normal calorics but indications of saccular failure

BACKGROUND: Vestibular neuritis (VN) is commonly diagnosed by demonstration of unilateral vestibular failure, as unilateral loss of caloric response. As this test reflects the function of the superior part of the vestibular nerve only, cases of pure inferior nerve neuritis will be lost. CASE PRESENTATIONS: We describe three patients with symptoms suggestive of VN, but normal calorics. All 3 had unilateral loss of vestibular evoked myogenic potential. A slight, asymptomatic position dependent nystagmus, with the pathological ear down, was observed. CONCLUSION: We believe that these patients suffer from pure inferior nerve vestibular neuritis

Myasthenia gravis

Myasthenia gravis (MG) is a rare, autoimmune neuromuscular junction disorder. Contemporary prevalence rates approach 1/5,000. MG presents with painless, fluctuating, fatigable weakness involving specific muscle groups. Ocular weakness with asymmetric ptosis and binocular diplopia is the most typical initial presentation, while early or isolated oropharyngeal or limb weakness is less common. The course is variable, and most patients with initial ocular weakness develop bulbar or limb weakness within three years of initial symptom onset. MG results from antibody-mediated, T cell-dependent immunologic attack on the endplate region of the postsynaptic membrane. In patients with fatigable muscle weakness, the diagnosis of MG is supported by: 1. pharmacologic testing with edrophonium chloride that elicits unequivocal improvement in strength; 2. electrophysiologic testing with repetitive nerve stimulation (RNS) studies and/or single-fiber electromyography (SFEMG) that demonstrates a primary postsynaptic neuromuscular junctional disorder; and 3. serologic demonstration of acetylcholine receptor (AChR) or muscle-specific tyrosine kinase (MuSK) antibodies. Differential diagnosis includes congenital myasthenic syndromes, Lambert Eaton syndrome, botulism, organophosphate intoxication, mitochondrial disorders involving progressive external ophthalmoplegia, acute inflammatory demyelinating polyradiculoneuropathy (AIDP), motor neuron disease, and brainstem ischemia. Treatment must be individualized, and may include symptomatic treatment with cholinesterase inhibitors and immune modulation with corticosteroids, azathioprine, cyclosporine, and mycophenolate mofetil. Rapid, temporary improvement may be achieved for myasthenic crises and exacerbations with plasma exchange (PEX) or intravenous immunoglobulin (IVIg). Owing to improved diagnostic testing, immunotherapy, and intensive care, the contemporary prognosis is favorable with less than five percent mortality and nearly normal life expectancy

Functional Level During the First Year After Moderate and Severe Traumatic Brain Injury: Course and Predictors of Outcome

Background: The objective of this study was to describe the functional level during the first year after moderate and severe traumatic brain injury (TBI), and to evaluate the predictive impact of pre-injury and injury-related factors. Methods: A cohort of 65 patients with moderate (N = 21) or severe (N = 44) TBI were examined with FIM (Functional Independence Measure) at admission and discharge from the rehabilitation clinic (on average two months after injury) and at 12 months, and with GOSE (Glasgow Outcome Scale Extended) at 12 months after injury. Possible predictors were analyzed in a regression model using FIM total score at 12 months as outcome. Results: All mean FIM scores improved significantly from injury to discharge from sub-acute rehabilitation. In the later period from discharge to 12 months after injury, the mean FIM motor score improved in severe TBI but not in moderate TBI patients. The mean FIM cognitive scores did not improve in any of the groups. At 12 months, 95% with moderate TBI had a FIM score from 109 - 126 (functionally independent) compared to 74% with severe TBI. Functional global outcome as assessed by GOSE was “good recovery” in 52% with moderate TBI versus 33% in severe TBI, “moderate disability” in 33% with moderate TBI versus 31% in severe TBI, and “severe disability” in 14% with moderate TBI versus 36% in severe TBI. Predictors such as PTA duration (B = -0.209), GCS admission rehabilitation (B = 5.058) and LOS rehabilitation (B = 0.458) explained 47% of the FIM variance 12 months post injury. Conclusions: The greatest improvement after moderate and severe TBI was in the sub-acute phase during the stay in a specialized rehabilitation unit. Residual disability was reported in 47% of moderate TBI patients as measured by GOSE at 12 months post injury indicating the importance of post-acute rehabilitation for these patients. Longer stays at the rehabilitation unit, a short PTA period and a high GCS score at admission to rehabilitation were positive predictors of functional level (FIM) at 12 months follow-up demonstrating that these factors are common predictors of early and late TBI phases