Doctor of Philosophy

dissertationThe purpose of this study was to examine the differences in the study skills scores, satisfaction scores and GPAs of students who were (1) classified as either Judgers or Perceivers according to their scores on the Myers-Briggs Type Indicator (METI) , and (2) enrolled in study skills classes in which either more or less structure was provided by the instructors. It was predicted that upon completion of a study skills course, Judgers would score significantly higher than Perceivers on measures of study skills, i.e., the Brown Holtzman Survey of Study Habits and Attitudes (SSHA), and the Study Habit Questionnaire (SHQ) , satisfaction, i.e., Student Satisfaction Questionnaire (SSQ), and acad8nic achievement, i. e., spring quarter GPA 0. Furthermore, it was predicted that Judgers enrolled in classes with a higher degree of class structure would score significantly higher than Judgers enrolled in classes with less structure on the SSHA, SHQ, SSQ, and GPA. In order to test these predictions, forty study skills students who volunteered to participate in the study were classified as either Judgers or Perceivers and as enrolled in study skills classes with either higher or lower class structure would score significantly higher than Judgers enrolled in classes with less structure on the SSHA, SHQ, SSQ, and GPA. In order to test these predictions, forty study skills students who volunteered to participate in the study were classified as either Judgers or Perceivers and as enrolled in study skills classes with either higher or lower class structure. Each subject was administered, in a counterbalanced order, the SSHA under both Real and Ideal directions and the SHQ prior to the beginning of the course and again upon completion of the course. Each subject's spring quarter GPA and SSQ scores were obtained ioonediately prior to the end of the course. A 11ANOVA program was used to analyze the difference between the scores of Judgers and Perceivers on the study habit measures, satisfaction ratings, and GPA. None of the multivariate F-ratios was significant although several accompanying univariate F-ratios were. The results showed that there were no significant differences in the pre-course scores of Judgers and Perceivers on the SSHA and SHQ although the post-course scores of Judgers were higher than the post-course scores of Perceivers on the Delay Avoidance-Usage and Education Acceptance Usage SSHA scales. These differences were interpreted as resulting from the personality characteristics attributed to the different personality types. The results also showed a significant symmetrical interaction of personality type and class structure on the satisfaction measure. Judgers who were enrolled in classes with higher structure reported higher satisfaction scores than Judgers enrolled in classes with less structure, while the opposite trend was found for Perceivers. These results were interpreted as a result of the characteristic differences between the Judgers' and Perceivers' preferences for structure. No differences in the GPAs of Judgers and Perceivers were found. It was concluded that although a study skills course might result in the increased use of certain study skills by students of one personality type, this increase may not account for the GPA differences between Judgers and Perceivers previously observed upon completion of study skills courses

Impact of United States Preventive Services Task Force recommendations on prostate biopsy characteristics and disease presentation at a tertiary-care medical center

Background: To evaluate early consequences of 2012 United States Preventive Services Task Force (USPSTF) recommendations for decreased prostate-specific antigen (PSA) screening on prostate biopsy characteristics and prostate cancer presentation. Materials and methods: A single tertiary-care institution, multisurgeon, prospectively maintained database was queried for patients undergoing prostate biopsy from October 2005 to September 2016. Patient demographics, biopsy characteristics, and extent of disease were reported. Patient cohorts before and after USPSTF recommendations were compared using two-sample t test, Chi-square test, and Wilcoxon rank sum test with significance at P < 0.05. Results: A total of 2,000 patients were analyzed, including 1,440 patients before and 560 patients after USPSTF recommendations. Following the recommendations, patients had higher prebiopsy PSA (5.90 vs. 6.70, P < 0.001). Overall, 817 (40.9%) patients had prostate cancer detected at biopsy with an increase from 37.0% before to 50.8% after (P < 0.001). Biopsies detected less low-risk Gleason ≤6 prostate cancer (47.4% vs. 41.1%) and more intermediate-risk Gleason 7 cancer (30.9% vs. 39.7%), with comparable findings of high-risk Gleason ≥8 cancer (21.7% vs. 19.2%), P = 0.042. In addition, greater percentage of core involvement (P < 0.001) was seen. At the time of diagnosis, extraprostatic extension identified by pelvic imaging increased from 12.6% to 18.9%, P = 0.039, with a trend toward lymph node positivity (1.1% vs. 2.2%, P = 0.078). Of those with metastatic disease, bony involvement occurred more often (1.7% vs. 3.2%, P = 0.041). Conclusions: After 2012 USPSTF guidelines, patients presented with higher PSA with prostate cancer were detected more frequently. More adverse, pathologic prostate cancer features were found on biopsy with the extent of disease implicating locally advanced/metastatic disease. These findings should be considered when counseling patients about prostate cancer screening importance. Keywords: Prostate biopsy, Prostate cancer, Prostate-specific antigen screening, United States Preventive Services Task Forc