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

Advantages of Targeting Serum C-Telopeptide in Diagnosing Osteoporosis in Postmenopausal Women: A Meta-Narrative Review

https://openworks.mdanderson.org/rmps24/1009/thumbnail.jp

The future role of cytologists regarding Telecytology and Rapid On-Site Evaluation (ROSE), a meta-narrative review

The use of Telecytology in conjunction with rapid on-site evaluation (ROSE) is currently at the forefront of discussion among cytologists and cytopathologists. In this meta-narrative review, the advancements of Telecytology and ROSE within the discipline of Cytology are discussed. Advancements in telecytology and ROSE enable off-site cytology slide evaluation and diagnosis through digital image transfer. ROSE allows for preliminary cytological assessment during image-guided biopsy procedures to determine specimen adequacy. The meta-narrative review concluded that the combination of these two technologies increases the efficacy of patient diagnosis without sacrificing the quality of patient care. Improved communication between the presiding technician, the cytologists, and the pathologists was observed as a prominent result of the review. Additionally, the research recommends further testing in different anatomical areas to better understand how these technologies can benefit both patients and clinicians. The methodology for this review involved determining a viable search criterion to comprehensively examine the advancements in telecytology and ROSE within the field of cytology. The phrases “telecytology”, “ROSE (rapid on-site evaluation)”, and “cytotechnology” were used to bring up peer-reviewed articles within the database, PubMed. From there, articles were dismissed from use according to date of publication. All articles over 5 years old were disregarded, exception of one article was used for a chronological timeline outlining the advancement of technology. The review concluded that the combination of these two technologies increases the efficacy of patient diagnosis without sacrificing quality of care. It also noted improved communication between technicians, cytologists, and pathologists as a key benefit.https://openworks.mdanderson.org/rmps24/1005/thumbnail.jp

Evaluating the Integration of Chromosomal Microarray Analysis with Karyotyping for Improved Detection of Chromosomal Abnormalities in Recurrent Pregnancy Loss: A Meta-Narrative Review

Investigating genetic abnormalities in recurrent pregnancy loss (RPL) is critical due to the large number of unexplained cases, which account for around 50%. While routine karyotyping of products of conception (POC) is widely employed, its efficacy is limited by a high failure rate in cytogenetics laboratories. Thus, Chromosomal Microarray Analysis (CMA) offers a potential option, with a success rate of more than 90% when karyotyping fails. Unlike karyotyping, CMA allows a full genome investigation without the requirement for live cultures, allowing the discovery of a variety of genetic abnormalities linked to pregnancy loss, including copy number variations, deletions, duplications, and aneuploidy. These abnormalities are prevalent, representing 47.4% of first-trimester losses and 10.9% of second and third-trimester losses. Therefore, this study seeks to increase diagnostic accuracy and identify genetic variables contributing to RPL by evaluating the efficacy of combining CMA and karyotyping. This meta-narrative review serves to evaluate this combined approach as an improved method for developing individualized treatment programs and providing support to afflicted individuals and couples.https://openworks.mdanderson.org/rmps24/1008/thumbnail.jp

Paradigm Shift: A Meta-Narrative Review of The Intricacies and Complications That Led to Changes in Standard Protocols for Primary Human Papillomavirus Screenings

Objective: To evaluate cervical cancer screening modalities and assess the reasoning that has led to primary HPV being the preferred target for screening. Background: History of HPV infection has been found to be correlated with cervical cancer precursor cells. Early detection of the infection is advantageous in decreasing the risk for women of reproductive age acquiring cervical cancer. The general consensus places an emphasis on implementing HPV testing in accordance with cervical cancer protocol. Methods: Six methodical reviews of cervical cancer screenings were done through PubMed and the M.D. Anderson Research library. Each article was evaluated to include recently published metaanalysis reviews that spanned across multiple continents. Discussion: A primary purpose of HPV screening is to decrease the risk for women acquiring cervical cancer. Decreasing the risk is achieved through early diagnosis and genotyping of HPV, as specific strains can eventually lead to high grade cervical intraepithelial neoplasia (CIN3+). Comparatively, Pap smears screen for abnormalities already present in cells. Co-testing with both methods may compensate for the limitations of either method, but should be reserved for high-risk patients to avoid the drawbacks of over-testing and higher incurred cost. Conclusion: While each screening modality offers significant strengths in early detection and prevention of cervical cancer, primary HPV screening’s high sensitivity has proved to be an increasingly valuable diagnostic tool.https://openworks.mdanderson.org/rmps24/1004/thumbnail.jp

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

Meta-Narrative Synthesis: The Effectiveness of Diagnosing and Treating Melanoma with Micrographically Oriented Histograph Surgery MOHS Technique

This meta-narrative synthesis highlights the effectiveness of diagnosing and treating melanoma with Micrographically Oriented Histography Surgery (MOHS) technique. Initiating the questions: What techniques does MOHS surgery involve when diagnosing and treating non-metastasized Melanoma? How will it provide positive outcomes for the patient? The significance of using MOHS excision technique and diagnosis of localized facial melanoma compared to traditional cancer excision techniques is designed to remove affected tissue while preserving anatomical facial structure in an aesthetic fashion. Providing an overview of the technique’s diagnostic professional capabilities as well as its strengths, limitations, improvement for upcoming studies, and potential prognosis. Melanoma, a cancerous mutation of pigmented skin cells that quickly metastasizes, requires MOHS unique invasive surgical excision techniques. As well, a multitude of synchronous skillful dermatology surgeons and histotechnologists. MOHS comparative factors include the ability for onsite treatment and diagnosis. Individual cases that qualify for MOHS treatment include the location and development of the melanoma, histological assessment, and post-operative aid. This analysis was intended to find information on MOHS and did so utilizing a meta-analysis research process. Search parameters include the skill set of the medical professional and requirements for the surgery. The research was to investigate the involved procedures and diagnosis of non-metastasized melanoma on the face, while maintaining minimal tissue damage. Standardizing MOHS procedure and expanding access for patients seeking successful cancer removal with low risk for surgical recurrence.https://openworks.mdanderson.org/rmps24/1006/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