Objectives: To determine if benefit exists in allowing students to self-test over relevant material as they progress through a professional course. Method: A total of 1,342 multiple choice questions were developed for pharmacy students to self-test for a pathophysiology course. Prior to each examination, students were allowed to take online quizzes which were randomly generated and related to the exam content. Quizzes were scored immediately, and students were shown the incorrect questions along with all answer choices. A matrix of intercorrelations and repeated measures ANOVA were generated using PASW Statistics Version 19 (IBM, Armonk, NY) to evaluate number of quiz attempts, highest attempt score, lowest attempt score, average attempt score, last attempt score, undergraduate GPA, and composite PCAT in relation to exam grade. Results: Seventy-seven of 79 students took advantage of self-testing and completed a total of 7,042 attempts. For the four exams, average quiz attempts score had the highest correlation, R = 0.591, 0.670, 0.550, and 0.373 respectively, to exam score (p ≤ 0.001 for each comparison). For each student who took advantage of self-testing, a paired analysis revealed exam score was significantly higher on the first three exams when compared with quiz attempts average. Implications: Literature indicates self-testing strategies increase recall ability as compared to more commonly employed study techniques. Self-testing opportunities in the pharmacy curriculum could increase student retention of course materials and provide feedback to educators regarding student learning while offering students an indication of their comprehension.

Patients with liver disease have an increased risk for malnutrition because of side effects of the disease. The Nutrition Focused Physical Exam (NFPE) was developed for nutrition professionals to aid physicians in a nutrition-based diagnosis of malnutrition. The purpose of this study was to examine the NFPE for its validity in liver disease patients being evaluated for transplant. In addition, the NFPE was used to assess incidence and severity of malnutrition in end stage liver disease patients and compare these results to already developed malnutrition tools such as the Patient Generated-Subjective Global Assessment (PG-SGA), Triceps Skinfolds (TSF), Mid-Arm Circumference (MAC), Lumbar Index, and Total Psoas Muscle Area (TPA). The NFPE was found to be highly correlated with PG-SGA results. There was a weak correlation between the NFPE and the TSF, MAC, and Lumbar Index/TPA, except when comparing the bottom 25% quartile of the Lumbar Index to severe malnutrition using the NFPE. This resulted in a moderate correlation. The odds-ratio for hospital admission based on malnutrition and severe malnutrition were both extremely high (14.571, 18.857 respectively). These preliminary results reinforce the significance of the NFPE and the need for additional studies using this tool.

The purpose of this study was to investigate former high school students' resilience following the administration of the State of Texas Assessments of Academic Readiness (STAAR) exam based on the comparison of male and female students who passed the STAAR exam the first time and those who failed it at least 2 times. This study fills a gap in the literature by offering additional data and increased knowledge about the relationship of resiliency to school performance. A total of 133 adults aged 18-29 years who had been enrolled in 3 high schools in a large metropolitan area in Texas were referred by the Texas Education Agency to complete the Resilience Scale online survey. A cross-sectional survey based on Resiliency Scale scores was used to quantify the degree of individual resilience, considered as a positive personality characteristic that enhances individual adaptations. The data were analyzed using 2-way (2 X 2) ANOVA with 3 dependent variables (Resiliency Scale [overall resiliency, personal competency, and acceptance of life and self]), and STAAR passing grouping and gender (male or female) serving as the independent variables. Results indicated that there were no differences between males and females or between students who passed the STAAR the first time and those who failed the STAAR at least 2 times on the dependent variables of reliance, competency, and acceptance of life and self. Positive social change may result from encouraging the teaching of other coping skills and interventions for those who experience failure on high-stakes tests.

The Affordable Care Act expanded insurance coverage to the general population; however, expanding insurance coverage to immigrants might not be sufficient to improve utilization of annual physical preventive exams. This study evaluated adult Michigan immigrants' individual demographics, perceptions, and behaviors, as well as the collective cultural and system characteristics that might act as barriers to the utilization of annual physical preventive exams. Ken Wilber's integral operating system model for medicine conceptual framework was used to create a comprehensive map of factors and bring more clarity and understanding to the barriers to annual physical preventive exam. The quantitative survey was the best approach for this study because of the large numbers of explanatory independent variables identified in the literature review. Snowball sampling was used to increase the credibility of this research by involving different immigrant communities and reaching large numbers of immigrants. Descriptive results indicate immigrants' barriers revolve around difficulty accessing health care and the cultural competency of the health care provider. Logistic regression analysis found that immigrants who are stressed and worried, self-employed, and middle class are less likely to utilize annual physical preventive exams. This study could be a force for social change by promoting healthy behaviors and encouraging immigrants to use annual physical preventive exam to reduce the occurrence of chronic conditions and increase life satisfaction in the community.

The purpose of this study is to examine the relationship between 6th grade students&rsquo / problem solving achievement scores after completing instruction on problem solving and their mathematics achievement mean scores related to Least Common Multiple (LCM), Greatest Common Factor (GCF), Sets and Whole Numbers topics obtained throughout the semester. In addition, the relationship between 6th grade students&rsquo / problem solving achievement scores after completing instruction on problem solving and their actual mathematics net scores obtained from Level Determination Exam (SBS) was investigated. In total, 170 sixth grade students from a private school in Istanbul participated in the study. The data were collected via three sources namely / Problem Solving Achievement Tests (PSATs), Mathematics Achievement Tests (MATs) and SBS exam. Quantitative methods were utilized to examine the research questions and a correlational design was used. The results of the statistical analysis showed that there was a significant positive correlation between students&rsquo / problem solving achievement scores after completing instruction on problem solving and their mathematics achievement mean scores obtained through out the semester related to LCM, GCF, Sets and Whole Numbers Topics. In addition, the findings of the analysis showed that there was a significant large positive correlation between the problem solving achievement scores after completing instruction on problem solving and students&rsquo / actual mathematics net scores obtained from SBS.

The aim of this study is to explore how middle class residents construct narratives of belonging. The study was conducted in a suburban area in the southern part of Stockholm. This is a neighborhood that undergoes a renewal and status increase. I used a method consisting of auto-photography and subsequent interviews to explore resident’s narratives of belonging. The sampled group was residents with academic exams. Participants were instructed to take five photos of their everyday life in the area and reflect upon these in the interviews. The result was analyzed within a constructive grounded theory frame. The theoretical concepts used take inspiration from Bourdieu’s cultural capital, field and social class. The results are divided into three main cores. The results suggest that a core narrative of constructive affiliation was a useful tool to understand how residents construct a sense of belonging. Residents in this study affiliated with other groups and social classes in the area, through a heightened sense of reflection on their own social position. Residents subscribed to an inclusive version of elective belonging.  Second the construction of a sense of locally based authenticity was a narrative process were they deployed a sense of belonging to the “local” and the small scale community. Third, a sense of rootless territorialism was reflected on in their sense of belonging. This was a process were residents narrative mediated between a stable and a fluid place attachment.

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Varje år placeras över 1000 ungdomar inom Statens Institutions Styrelse (SiS), varav ungefär hälften placeras för behandling. Studiens frågeställningar är: I vilken grad uppfattar behandlingsplacerade ungdomar inom SiS att de får hjälp med sina familjeproblem? Finns det synliga samband mellan ungdomarnas könstillhörighet eller etniska ursprung och deras skattade upplevelse av hjälp med familjeproblem under placeringstiden? För att besvara frågorna har kvantitativ arkivdata analyserats, material som vid in- och utskrivning av ungdomar samlats genom strukturerade ADAD-intervjuer (Adolescent Drug Abuse Diagnosis). Studien visar att ungdomarnas upplevelse av hjälp kan delas in i tre kategorier; ”över förväntan” 27%, ”motsvarar förväntan” 41%, ”mindre än förväntat”, 32%. Inskrivningsintervjuerna visar en signifikant skillnad (p<.05) att pojkarna i större grad ger uttryck för att inte behöva hjälp med familjeproblem, att flickorna i större grad önskar hjälp. Resultaten visar även en signifikant skillnad (p<.05), att utlandsfödda ungdomar i högre grad än svenskfödda uppger det vara viktigt att få hjälp med familjeproblem under placeringstiden. Vid utskrivning framträder ingen tydlig skillnad i nöjdhetsgrad avseende kön eller etnisk bakgrund. En diskrepans framträder mellan personals skattning av ungdomarnas hjälpbehov med familjeproblem vid inskrivning och ungdomarnas skattning av upplevd hjälp vid utskrivning. För 42% av ungdomarna skattade personal hjälpbehovet som ”litet” eller ”inget”, vid utskrivning skattade samma ungdomar att de fått ”ganska mycket” eller ”mycket” hjälp. För 10%, av ungdomarna skattade personal att de hade ”betydande” eller ”avsevärda” familjeproblem där hjälpinsatser var ”nödvändiga”. Vid utskrivning skattade ungdomarna graden av hjälp som ”liten” eller ”inte alls”. / Each year over 1000 adolescents are placed within the National Board of Institutional Care (SiS) of which half stay in the facilities for treatment. The essay is built from information gathered through ADAD interviews (Adolescent Drug Abuse Diagnosis) performed during registration and discharge of adolescents from SiS. The questions that are meant to be answered are; “How do the treatment placed adolescents in SiS apprehend the help they get with their family related problems?” and “Are there visible connections between gender or ethnic origin and the adolescent’s experience of help with the family related problems during the placement period?” During the registration the boys gave an expression of not being in need of help, the girls gave an expression of being in need of help, significance (p<.05). At discharge no clear differences appears in degree of satisfaction. The results also show a significant difference (p<.05). that foreign-born adolescents greater than Swedish-born stated that it is important to get help with family problems during the investment period. At discharge no clear differences appears in degree of satisfaction.

The purpose of the present study is to investigate the predictive validity of the BUEPE through the use of the three-parameter IRT model&amp / #8217 / s ability estimates. The study made use of the BUEPE September 2000 data which included the responses of 699 students. The predictive validity was established by using the departmental English courses (DEC) passing grades of a total number of 371 students. As for the prerequisite analysis the best fitted model of IRT was determined by first, checking the assumptions of IRT / second, by analyzing the invariance of ability parameters and item parameters and thirdly, by interpreting the chi-square statistics. After the prerequisite analyses, the best fitted model&amp / #8217 / s estimates were correlated with DEC passing grades to investigate the predictive power of BUEPE on DEC passing grades. The findings indicated that the minimal guessing assumption of the one- and two-parameter models was not met. In addition, the chi-square statistics indicated a better fit to the three-parameter model. Therefore, it was concluded that the best fitted model was the three-parameter model. The findings of the predictive validity analyses revealed that the best predictors for DEC passing grades were the three-parameter model ability estimates. The second best predictor was the ability estimates obtained from sixty high information items. In the third place BUEPE total scores and the total scores obtained from sixty high information items followed with nearly the same correlation coefficients. Among the three sub-tests, the reading sub-test was found to be the best predictor of DEC passing grades.

O uso inadequado de antimicrobianos é fator determinante para disseminação da resistência bacteriana. Vários países têm usado como estratégias políticas de restrição para tornar o uso mais racional. Principalmente em hospitais, onde a utilização é mais prevalente. Embora o uso empírico seja a opção de tratamento em muitas condições clínicas, sabe-se que exames microbiológicos de cultura e teste de sensibilidade antimicrobiana (TSA), podem orientar uma prescrição mais racional. Para se avaliar a adequação de prescrições de antimicrobianos de uso restrito no Hospital São Vicente de Paulo de Passo Fundo, considerando resultados de exames microbiológicos e protocolos clínicos da instituição, foram analisadas 372 prescrições de pacientes internados. O tipo de infecção foi a única justificativa apresentada para o uso de antimicrobianos, sendo a maior freqüência para infecções do trato respiratório inferior (59,4%) seguido das do trato urinário (10,8%). O tratamento inicial empírico ocorreu em 89% dos casos. Dos pacientes com uso empírico (331/372), 66,7% apresentaram pneumonia. Nesta situação, devido à dificuldade de coleta de material, o tratamento é baseado nos prováveis agentes causadores e o uso empírico é aceitável. O exame de cultura foi solicitado em menos da metade das prescrições 48,7%(181/372), e o TSA foi realizado nos casos de cultura positiva (121/181). O resultado do TSA apontou que o tratamento inicial prescrito estava adequado em 76% dos casos (92/121). A necessidade de troca do esquema terapêutico inicial foi identificada em 12,7% (23/181) dos casos que realizaram cultura e TSA. A troca de esquema ocorreu em 65,2% (15/23) dos casos, nos demais o médico optou por não alterar devido à resposta clínica do paciente. Das prescrições avaliadas conforme protocolos, 71,9% (192/267) demonstraram indicação terapêutica de acordo com a recomendação. De acordo com os protocolos, observou-se uma freqüência maior de adequação das prescrições e das condutas laboratoriais quando comparada com outros estudos. Estes resultados podem estar associados às políticas de restrição de uso adotadas pela instituição. / The inadequated use of antimicrobials is the determinant fact to the dissemination of the resistance of the bacteria. Many countries have used as a strategy the politics of the restriction to become this use more rational, mainly in the hospitals, where the utilization is more prevalent. Although the empiricist use is the option of the treatment in many clinical conditions, we know that microbiological exams of culture and the test of antimicrobial sensibility (TSA) can conduct to a more rational prescription. To evaluate the adjustment of the prescriptions of antimicrobials in restrict use at São Vicente de Paulo Hospital, in Passo Fundo, and considering the results of the microbiological exams and clinical protocols of the institution, 372 interned patients prescriptions were analyzed. The type of the infection was the unique justify showed to the use of the antimicrobials, being the biggest frequency to the infections in the lower respiratory tract (59.4%), followed by the urinary tract (10.8%). The initial empiricist treatment occurred in 89% of the cases. Within the patients with the empiricist use (331/372), 66.7% showed pneumonia. In this situation, due to the difficulty of the material collecting, the treatment is based in the probable causer agents and the empiricist use is acceptable. The exam of the culture was required in the less of the half prescriptions (48.7%) (181/372) and TSA was executed in the cases of the positive culture (121/181). The results of TSA showed that the initial treatment prescribed was adjusted in 76% of the cases (92/121). The necessity of the changing of the initial therapeutic scheme was identified in 12.7% (23/181) of the cases where the culture and TSA were found. In the others, the doctor opted to not to modify it due to the clinical answer of the patient. According protocols, evaluated prescriptions 71.9% (192/267) showed therapeutic indication according the recommendation. According with the protocols, it was observed a major frequency of adaptation of the prescriptions and of the lab behaviors when it is compared with other studies. These results can be associated with the restriction policies of adopted using for the institution.