Factors associated with successful answering of clinical questions using an information retrieval system

OBJECTIVES: Despite the growing use of online databases by clinicians, there has been very little research documenting how effectively they are used. This study assessed the ability of medical and nurse-practitioner students to answer clinical questions using an information retrieval system. It also attempted to identify the demographic, experience, cognitive, personality, search mechanics, and user-satisfaction factors associated with successful use of a retrieval system. METHODS: Twenty-nine students completed questionnaires of clinical and computer experience as well as tests of cognitive abilities and personality type. They were then administered three clinical questions to answer in a medical library setting using the MEDLINE database and electronic and print full-text resources. RESULTS: Medical students were able to answer more questions correctly than nurse-practitioner students before and after searching, but both had comparable improvements in the number of correct questions before and after searching. Successful ability to answer questions was also associated with having experience in literature searching and higher standardized test-score percentiles. CONCLUSIONS: Medical and nurse-practitioner students obtained comparable benefits in the ability to answer clinical questions from use of the information retrieval system. Future research must examine strategies that improve successful search and retrieval of clinical questions posed by clinicians in practice.     

A Graduate Seminar on Teaching Procedures

Problem posing is a higher-order, active-learning task that is important for students to develop. This article describes a series of interdisciplinary learning activities designed to help students strengthen their problem-posing skills, which requires that students become more responsible for their learning and that faculty move to a facilitator role. Developing students’ problem-posing skills and allowing them to grapple with course content can lead to deeper levels of understanding and improved critical thinking. In turn, students are more likely to be able to move their newfound knowledge beyond the classroom.     

Alar and apples: newspapers, risk and media responsibility

During 1989, a major environmental and health risk issue, the spraying of Alar on apples, created a furor among the American people. After hearing charges from the Natural Resources Defense Council (NRDC) that eating Alar-laden apples significantly increased a child's risk of developing cancer, numbers of school districts dropped apples from their menus and parents poured apple juice down the drains. Apple sales plummeted. The NRDC's charges, which were disseminated by a well-planned and effective public relations campaign, brought counter-charges from the US environmental Protection Agency, which accused the NRDC of basing its study on poor data, among other things. The core of the dispute was in the risk figures and risk interpretations being used by each organization.     

Young Children Give Priority to Ownership When Judging Who Should Use an Object

This study provides evidence that children give priority to ownership when judging who should use an object. Children (N = 269) and adults (N = 154) considered disputes over objects. In disputes between a character using an object and the owner of the object, children, as young as 3 years and as old as 7 years, sided with the owner, and did so more than adults. However, children aged 4 and older disregarded owners' rights in dilemmas where these were pitted against the need to prevent harm. These findings suggest that ownership is central in children's judgments about object use and constrain developmental accounts of how children acquire an appreciation of ownership.     

Primary prevention of pediatric abusive head trauma: A cost audit and cost-utility analysis

ObjectivesTo obtain comprehensive, reliable data on the direct cost of pediatric abusive head trauma in New Zealand, and to use this data to evaluate the possible cost–benefit of a national primary prevention program.MethodsA 5 year cohort of infants with abusive head trauma admitted to hospital in Auckland, New Zealand was reviewed. We determined the direct costs of hospital care (from hospital and Ministry of Health financial records), community rehabilitation (from the Accident Compensation Corporation), special education (from the Ministry of Education), investigation and child protection (from the Police and Child Protective Services), criminal trials (from the Police, prosecution and defence), punishment of offenders (from the Department of Corrections) and life-time care for moderate or severe disability (from the Accident Compensation Corporation). Analysis of the possible cost-utility of a national primary prevention program was undertaken, using the costs established in our cohort, recent New Zealand national data on the incidence of pediatric abusive head trauma, international data on quality of life after head trauma, and published international literature on prevention programs.ResultsThere were 52 cases of abusive head trauma in the sample. Hospital costs totaled $NZ2,433,340, child protection $NZ1,560,123, police investigation $NZ1,842,237, criminal trials $NZ3,214,020, punishment of offenders $NZ4,411,852 and community rehabilitation $NZ2,895,848. Projected education costs for disabled survivors were $NZ2,452,148, and the cost of projected lifetime care was $NZ33,624,297. Total costs were $NZ52,433,864, averaging $NZ1,008,344 per child. Cost-utility analysis resulted in a strongly positive economic argument for primary prevention, with expected case scenarios showing lowered net costs with improved health outcomes.ConclusionsPediatric abusive head trauma is very expensive, and on a conservative estimate the costs of acute hospitalization represent no more than 4% of lifetime direct costs. If shaken baby prevention programs are effective, there is likely to be a strong economic argument for their implementation. This study also provides robust data for future cost–benefit analysis in the field of abusive head trauma prevention.     

Preschoolers acquire general knowledge by sharing in pretense

Children acquire general knowledge about many kinds of things, but there are few known means by which this knowledge is acquired. In this article, it is proposed that children acquire generic knowledge by sharing in pretend play. In Experiment 1, twenty-two 3- to 4-year-olds watched pretense in which a puppet represented a "nerp" (an unfamiliar kind of animal). For instance, in one scenario, the nerp ate and disliked a carrot. When subsequently asked generic questions about real nerps, children's responses suggested that they had learned general facts (e.g., nerps dislike carrots). In Experiment 2, thirty-two 4- to 5-year-olds learned from scenarios lacking pretend speech or sound effects. The findings reveal a long overlooked means by which children can acquire generic knowledge.     

Recent newspaper coverage about persons with disabilities

Newspapers are considered a powerful medium for developing public opinion about issues. In a representative sample of large-city newspapers, we found that three issues--budget, expenditures, or taxes; housing or normalization; and treatment in institutions--were the most frequently featured issues about persons with disabilities. The least frequently mentioned issues were school related, such as instruction, mainstreaming, and Public Law 94-142 compliance. A suggestion was made that if articles about special education are to appear in newspapers, special educators must develop strong relationships with newspaper reporters and their editors.