Hospitalized youth and child abuse: A systematic examination of psychiatric morbidity and clinical severity

Many children and adolescents who require psychiatric hospitalization have been physically or sexually abused, yet the association between reported histories of abuse and the complexity and severity of mental illness among psychiatrically hospitalized youth is poorly described with regard to current inpatient psychiatric practice. We sought to determine the association between histories of abuse and psychiatric complexity and severity in psychiatrically hospitalized youth including comorbidity patterns, psychotropic medication use, reason for admission and length of hospitalization. A systematic chart review was performed on 1433 consecutive psychiatric hospitalizations of children and adolescents that occurred over a 10-month period. Children with a history of abuse were more likely to be diagnosed with multiple DSM-IV-TR disorders than non-traumatized children. A history of sexual abuse was associated with more medication use than in their non-traumatized peers and a higher likelihood of treatment with antipsychotic medications, both at admission and discharge. Physical and sexual abuse were independently associated with increased length of stays, with exposure to both physical and sexual abuse associated with a 2-day increase in duration of hospitalization compared to non-traumatized patients. The findings from this study draw attention to the adverse impact of abuse on psychiatric morbidity and complexity and suggest the need for trauma-informed treatment in psychiatric hospital settings.     

Using generalizability analysis to estimate parameters for anatomy assessments: A multi‐institutional study

With integrated curricula and multidisciplinary assessments becoming more prevalent in medical education, there is a continued need for educational research to explore the advantages, consequences, and challenges of integration practices. This retrospective analysis investigated the number of items needed to reliably assess anatomical knowledge in the context of gross anatomy and histology. A generalizability analysis was conducted on gross anatomy and histology written and practical examination items that were administered in a discipline‐based format at Indiana University School of Medicine and in an integrated fashion at the University of Alabama School of Medicine and Rush University Medical College. Examination items were analyzed using a partially nested design in which items were nested within occasions (i:o) and crossed with students (s). A reliability standard of 0.80 was used to determine the minimum number of items needed across examinations (occasions) to make reliable and informed decisions about students' competence in anatomical knowledge. Decision study plots are presented to demonstrate how the number of items per examination influences the reliability of each administered assessment. Using the example of a curriculum that assesses gross anatomy knowledge over five summative written and practical examinations, the results of the decision study estimated that 30 and 25 items would be needed on each written and practical examination to reach a reliability of 0.80, respectively. This study is particularly relevant to educators who may question whether the amount of anatomy content assessed in multidisciplinary evaluations is sufficient for making judgments about the anatomical aptitude of students. Anat Sci Educ 10: 109–119. © 2016 American Association of Anatomists.     

Visual recognition memory in squirrel monkeys

Squirrel monkeys (Saimiri sciureus) were trained on visual recognition memory tasks in a Wisconsin General Testing Apparatus with a trial-unique procedure that used 250 objects as stimuli. In Experiment 1, acquisition of a trial-unique delayed non-match-to-sample task (DNMS) was compared with acquisition of a trial-unique delayed match-to-sample (DMS) task. The DNMS task was learned in significantly fewer trials and with significantly fewer errors. Two animals in the DNMS group demonstrated highly accurate retention of the DNMS strategy despite an 11-month hiatus in experimental testing. In Experiment 2, the same procedures were used to study the learning of lists of 3, 5, 10, or 20 serially presented items. Although the animals were able to accurately remember lists of up to 20 items, there was no evidence of serial position effects.     

Space matters: The impact of formal learning environments on student learning

The objective of this research is to identify the relationship between formal learning spaces and student learning outcomes. Using a quasi‐experimental design, researchers partnered with an instructor who taught identical sections of the same course in two radically different formal learning environments to isolate the impact of the physical environment on student learning. The results of the study reveal that, holding all factors excepting the learning spaces constant, students taking the course in a technologically enhanced environment conducive to active learning techniques outperformed their peers who were taking the same course in a more traditional classroom setting. The evidence suggests strongly that technologically enhanced learning environments, independent of all other factors, have a significant and positive impact on student learning.     

Is the supply of continuing education in the anatomical sciences keeping up with the demand? Results of a national survey

Continuing education (CE) is an essential element in the life‐long learning of health care providers and educators. Despite the importance of the anatomical sciences in the training and practice of clinicians, no studies have examined the need/state of anatomy‐related CE nationally. This study assessed the current landscape of CE in the anatomical sciences to contextualize preferences for CE, identify factors that influence the perceived need for CE, and examine the association between supply and demand. Surveys were distributed to educators in the anatomical sciences, practicing physical therapists (PTs), and anatomy training programs across the United States. Twenty‐five percent (9 of 36) of training programs surveyed offered CE, certificates, or summer series programs related to anatomy. The majority of PTs (92%) and anatomy educators (81%) felt they had a potential or actual need for anatomy related CE with the most popular formats being online videos/learning modules and intensive, hands‐on workshops. The most commonly perceived barriers to participating in CE for both groups were program location, cost, and duration, while educators also perceived time of year as a significant factor. Logistic regression analyses revealed that no investigated factor influenced the need or desire for PTs to engage in anatomy related CE (P ≤ 0.124), while teaching experience and the highest level of learner taught significantly influenced the perceived need among anatomy educators (P < 0.001). Overall, quantitative and qualitative analyses revealed a robust need for CE that strategically integrates anatomy with areas of clinical practice and education. Anat Sci Educ 11: 225–235. © 2017 American Association of Anatomists.     

“Governing by templates” through new modes of school inspection in Norway

To date, few observational studies have addressed Scandinavian school inspectors in the field, specifically how inspectors use templates to monitor the formative assessment routines of schools and local school authorities. This paper investigates how the current inspection handbook is being adopted and enacted on the municipal level and the school level in Norwegian compulsory schools. Specifically, this study illuminates through observation two empirical examples of how one of the 17 County Governors’ Offices, as part of a larger study, conducted regular, state school inspection. Conceptually, the paper focuses on how inspection guides and steers though use of fixed templates. Analysis shows that inspectors and schools under scrutiny are struggling in combining the traditional focus on legal compliance with a more performative emphasis on formative assessment of students. In addition, the examples given highlight how combining field observation and the concept of “governing by templates” contributes to school inspection studies, in a dynamic policy context undergoing substantial change.     

Screening homeless youth for histories of abuse: prevalence, enduring effects, and interest in treatment

Objectives

To identify the incidence of self-reported physical and sexual child abuse among homeless youth, the self-perceived effects of past abuse, and current interest in treatment for past abuse among homeless youth with histories of abuse.

Methods

Homeless and street-involved persons aged 18-23 filled out a questionnaire and participated in a structured assessment of histories of abuse, tobacco use and substance abuse.

Results

Sixty-four homeless youth in Salt Lake City, Utah completed the study, 43 males and 21 females. Eighty-four percent screened positive for childhood physical and/or sexual abuse occurring before the age of 18; 42% screened positive for both physical and sexual abuse; 72% reported still being affected by their abuse. Among all abuse victims, 44% were interested in treatment for their abuse history and 62% of homeless youth who reported still being affected by their abuse were interested in treatment. Individuals were more likely to be interested in treatment if they were female, had not completed high school or had been previously asked about family dysfunction. Many victims who declined treatment offered spontaneous insight into their decision. Interest in treatment was similar to interest in treatment for other behaviors such as smoking and substance abuse.

Conclusions

Histories of abuse are common among homeless youth. A majority of those reporting a history of abuse are still affected by their abuse. Interest in treatment for a history of abuse was comparable to interest in treatment for other morbidities in the homeless youth population such as tobacco use and substance abuse. Our finding that homeless youth continue to be impacted by their abuse and are interested in treatment should prompt more screening for histories of abuse.     

Listening to Mothers II: A Lamaze Educator's Response

A Lamaze Certified Childbirth Educator and labor-support doula who provides services in two major, metropolitan areas shares her reactions and education experiences in dealing with the findings of Listening to Mothers II. She found that her first response to the survey findings involved assisting a community-wide effort to raise the awareness of women about their childbirth options, with a special emphasis on providers who practice in adherence to The Coalition for Improving Maternity Service's Mother-Friendly Childbirth Initiative. In addition, she added a component to her classes to help her students proactively explore why so few women feel they can assert their rights to refuse unnecessary interventions during childbirth.     

Is an intervention using computer software effective in literacy learning? A randomised controlled trial

Background: computer software is widely used to support literacy learning. There are few randomised trials to support its effectiveness. Therefore, there is an urgent need to rigorously evaluate computer software that supports literacy learning.

Methods: we undertook a pragmatic randomised controlled trial among pupils aged 11–12 within a single state comprehensive school in the North of England. The pupils were randomised to receive 10 hours of literacy learning delivered via laptop computers or to act as controls. Both groups received normal literacy learning. A pre‐test and two post‐tests were given in spelling and literacy. The main pre‐defined outcome was improvements in spelling scores.

Results: 155 pupils were randomly allocated, 77 to the ICT group and 78 to control. Four pupils left the school before post‐testing and 25 pupils did not have both pre‐ and post‐test data. Therefore, 63 and 67 pupils were included in the main analysis for the ICT and control groups respectively. After adjusting for pre‐test scores there was a slight increase in spelling scores, associated with the ICT intervention, but this was not statistically significant (0.954, 95% confidence interval (CI) – 1.83 to 3.74, p = 0.50). For reading scores there was a statistically significant decrease associated with the ICT intervention (?2.33, 95% CI ?0.96 to ?3.71, p = 0.001).

Conclusions: we found no evidence of a statistically significant benefit on spelling outcomes using a computer program for literacy learning. For reading there seemed to be a reduction in reading scores associated with the use of the program. All new literacy software needs to be tested in a rigorous trial before it is used routinely in schools.