Why Adults at Age 50 Seek Doctoral Degrees

Higher Education Administratio

Enhancing Critical Thinking in Clinical Laboratory Students: A Multimodal Model

The purpose of this study was to improve critical thinking skills in clinical laboratory technologists through the development, implementation, and assessment of a multimodal model targeting critical thinking skills. Clinical laboratory technologists influence patient care through the testing of laboratory samples. Employers of these entry level professionals identified a need for improved critical thinking skills. This quasi-experimental study aimed to design a multimodal critical thinking model, implement the model into the clinical laboratory educational curriculum, and assesses this skill set for students in a pre-test / post-test format. The model was delivered and assessed for 47 clinical laboratory students at the University of Texas M.D. Anderson Cancer Center’s School of Health Professions. Based on numerical results for the Health Science Reasoning Test (HSRT), no significant difference in critical thinking skills was observed for clinical laboratory students before and after the integration of the multimodal model targeting this skill set into the curriculum. For the purpose of this study, critical thinking was defined as the ability to effectively evaluate and interpret data, apply existing knowledge to solve problems in new situations, demonstrate creativity and resourcefulness in learning, and problem solving, and effectively and persuasively communicate findings. Further analysis of the results indicated that junior and community college students were more likely to improve their HSRT scores after completion of the multimodal model than 4-year university and bachelor level students. Findings also suggest a positive relationship between GPA and improved HSRT scores. The amount of time as student spent on each assessment was directly related to success, and an inverse relationship was observed for usage of the model reference material. Further studies are needed to ensure model validity and generalizability of findings. Additionally, HSRT categorical results indicate the need for model modifications to better target the areas of deduction and inference. The online, asynchronous format may benefit from the addition of mandated discussion boards, and requiring assessment and evaluation completion may reduce the effects of lack of effort due to cognitive fatigue observed for this study

A Meta-narrative Review to Investigate Psychological Distress and Coping Mechanisms Among Healthcare Workers, Related to the COVID-19 Pandemic

Objective: Determining the factors that influence psychological distress of healthcare workers during the COVID-19 pandemic. Background: Due to the sudden occurrence and high transmission rate of the virus that causes COVID-19, many hospitals became overwhelmed and had to respond quickly to the high patient demand. This caused increased burnout among healthcare workers, which we explored on this project. Methodology: PubMed search of peer reviewed articles under topics of burnout, distress, and mental health of healthcare workers during the COVID-19 pandemic yielded 11 articles that we focused on for this meta-narrative review. Discussion: Articles analyzed had a higher response from nurses and women. Burnout was evaluated by using modified versions of the Maslach Burnout Inventory-General Survey which measured emotional exhaustion, depersonalization, and personal accomplishment. Depression, anxiety, and insomnia were prevalent features discussed in the sources. Most of the articles highlighted that increasing psychological stress can lead to PTSD. Psychological distress was greatly influenced by job stress and high job demand. Coping mechanisms such as maintaining regular working hours, adequate supplies and protocols for safety, support, and encouraging resilience were seen to manage the increased psychological distress. Conclusion: We observed that during the COVID-19 pandemic healthcare workers experienced significant psychological distress. We were able to identify coping mechanisms that could aid with stress management. We urge medical institutions to incorporate these measures to prevent a negative impact on the quality of patient care, and arm healthcare workers with tools to manage distress in times of drastic increases in patient caseload.https://openworks.mdanderson.org/rmps/1005/thumbnail.jp

The Grizzly, November 22, 1994

Pew Roundtable Discusses Priorities at Ursinus • Clinton Wavers on School Prayer • Letters to the Editor: Parent Shows Concern Over Alcohol • Man Arrested for Threatening Children • Class of \u2798 Update • Iraq Recognizes Kuwait • Final Exam Schedule • Berman Features Watercolor Exhibit • Lady Bears Preseason Outlook • Ursinus\u27 All-Centennial Conference Performershttps://digitalcommons.ursinus.edu/grizzlynews/1348/thumbnail.jp

The devil is in the details: trends in avoidable hospitalization rates by geography in British Columbia, 1990–2000

BACKGROUND: Researchers and policy makers have focussed on the development of indicators to help monitor the success of regionalization, primary care reform and other health sector restructuring initiatives. Certain indicators are useful in examining issues of equity in service provision, especially among older populations, regardless of where they live. AHRs are used as an indicator of primary care system efficiency and thus reveal information about access to general practitioners. The purpose of this paper is to examine trends in avoidable hospitalization rates (AHRs) during a period of time characterized by several waves of health sector restructuring and regionalization in British Columbia. AHRs are examined in relation to non-avoidable and total hospitalization rates as well as by urban and rural geography across the province. METHODS: Analyses draw on linked administrative health data from the province of British Columbia for 1990 through 2000 for the population aged 50 and over. Joinpoint regression analyses and t-tests are used to detect and describe trends in the data. RESULTS: Generally speaking, non-avoidable hospitalizations constitute the vast majority of hospitalizations in a given year (i.e. around 95%) with AHRs constituting the remaining 5% of hospitalizations. Comparing rural areas and urban areas reveals that standardized rates of avoidable, non-avoidable and total hospitalizations are consistently higher in rural areas. Joinpoint regression results show significantly decreasing trends overall; lines are parallel in the case of avoidable hospitalizations, and lines are diverging for non-avoidable and total hospitalizations, with the gap between rural and urban areas being wider at the end of the time interval than at the beginning. CONCLUSION: These data suggest that access to effective primary care in rural communities remains problematic in BC given that rural areas did not make any gains in AHRs relative to urban areas under recent health sector restructuring initiatives. It remains important to continue to monitor the discrepancy between them as a reflection of inequity in service provision. In addition, it is important to consider alternative explanations for the observed trends paying particular attention to the needs of rural and urban populations and the factors influencing local service provision

Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study

Introduction: The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. Methods: In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. Findings: Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2–6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p<0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5–5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p<0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4–10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p<0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32–4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP >5mg/L, OR 3·55 [1·23–11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. Interpretation: After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification

Retrospective evaluation of whole exome and genome mutation calls in 746 cancer samples

Funder: NCI U24CA211006Abstract: The Cancer Genome Atlas (TCGA) and International Cancer Genome Consortium (ICGC) curated consensus somatic mutation calls using whole exome sequencing (WES) and whole genome sequencing (WGS), respectively. Here, as part of the ICGC/TCGA Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium, which aggregated whole genome sequencing data from 2,658 cancers across 38 tumour types, we compare WES and WGS side-by-side from 746 TCGA samples, finding that ~80% of mutations overlap in covered exonic regions. We estimate that low variant allele fraction (VAF < 15%) and clonal heterogeneity contribute up to 68% of private WGS mutations and 71% of private WES mutations. We observe that ~30% of private WGS mutations trace to mutations identified by a single variant caller in WES consensus efforts. WGS captures both ~50% more variation in exonic regions and un-observed mutations in loci with variable GC-content. Together, our analysis highlights technological divergences between two reproducible somatic variant detection efforts