Designing a search strategy to identify and retrieve articles onevidence-based health care using MEDLINE

Thepractice of evidence-based health care requires that information on methodology be identifiedfrom databases such as MEDLINE. Up until this year there have been no designated medicalsubject headings (MeSH) for evidence-based health care. ‘EVIDENCE-BASEDMEDICINE’ appears as a MeSH term from 1997. The absence of designated MeSH forthis concept prior to 1997 provides a challenge to the searcher. This paper describes the creationof a MEDLINE search strategy to retrieve articles on the methods of evidence-based health carepublished prior to the introduction of the new term, where an optimal combination of free-textand MeSH terms is required to identify relevant material. The study examines both free-text andsubject heading searching and attempts an optimal balance of sensitivity and specificity. It beginsby examining separate free-text and subject heading searches. Sensitivity of the subject headingsearch was 33% and specificity 80%, while the free-text search produced asensitivity of 50% and a specificity of 67%. The final strategy, combining bothapproaches, was more successful with sensitivity reaching between 82 and 90% andspecificity 83%. It is therefore possible to devise a search strategy to retrieve articles on themethods of evidence-based health care with relatively successful rates of sensitivity andspecificity. The limitations of MEDLINE, however, necessitate the use of additional approachesin identifying articles on the methods of evidence-based health care.     

The relationship between individual instructional characteristics and the overall assessment of teaching effectiveness across different instructional contexts

There is an ongoing debate in the student evaluation of teaching literature about whether an overall rating or factorial dimensions of teaching effectiveness should be used in personnel decisions. Marsh and his colleagues have advocated the use of a weighted average approach to computing overall evaluations. A policy-capturing experiment was carried out where students in three different instructional contexts made overall evaluations of hypothetical instructors based on a manipulation of the teaching factors in Marsh's SEEQ. The results indicated (1) amount learned was consistently the most important factor affecting overall evaluations; (2) course difficulty was consistently the least important factor affecting overall evaluations; and (3) there was a strong similarity among the three groups in the relative importance of the various teaching factors in arriving at an overall evaluation. The implications of this research are discussed, as well as directions for future research.     

Psychosocial correlates of child abuse potential in multiply disadvantaged adolescent mothers

OBJECTIVE: This study had two aims: First to examine psychosocial correlates of child maltreatment risk, and second to assess the validity of the CAP Inventory (Milner, 1986) with multiply disadvantaged teenage mothers. METHOD: Participants were 75 adolescent mothers who were wards of the Illinois child protection system. Mothers (aged 14-18) and infants participated in home-based psychosocial assessment of personal and parenting functioning. Group comparisons examined differences for mothers with elevated versus normal versus invalid CAP scores due to faking good. RESULTS: Findings indicated that abuse risk groups differed on emotional distress, social support satisfaction, reading achievement, and years of education, but not on parenting beliefs or quality of child stimulation. Differences favored the normal over the elevated risk group in all significant comparisons, whereas mothers with elevated faking good differed from normals only in lower reading achievement. Multiple regression analysis highlighted emotional distress, support dissatisfaction, and low achievement as significant predictors of greater abuse risk. CONCLUSIONS: Despite sharing multiple disadvantages, adolescent wards are a heterogeneous group who show different levels of psychosocial functioning corresponding to levels of child maltreatment risk. The findings provide support for the concurrent validity and clinical applicability of the CAP Inventory with disadvantaged teenage mothers.     

Managing Headship Transitions in U.S. Independent Schools

Headship transitions in U.S. independent schools represent critical organizational events that affect multiple school constituencies, including faculty, staff, and students. With recent projections forecasting a high level of impending headship transitions in independent schools, this paper seeks to capture how second-year U.S. independent school heads (n = 16) describe their transition experiences in order to provide insights into how boards, heads, and school communities can provide meaningful supports for their incoming school leaders. Further recommendations for practice and research are also provided.     

Language development: A complex,systematic, and natural process

Conclusions Although we do not understand very well what the processes are that contribute to language development, it is clear that communication plays a central role. As children strive to become increasingly skilled at communicating their ideas (White, 1959), as they have increasingly complex ideas to communicate (Piaget, 1955), and as they encounter an increasingly diverse set of people with whom to communicate (Brown, 1973), they must learn to use language which is richer and more flexible.When children come to school or to a day care center they already know a great deal about language. They have readily and actively mastered words, sentences and forms of communication which they need in their own family and community. In their new environment—the school or center—children's language development can further be fostered by adults who are receptive to children's efforts at communication. Adults who encourage children to use language in new ways, who attend to what children mean to say and who recognize that children's errors are often not mistakes, are likely to play a positive role in children's language development.Janet H. Kane and Karen Sheingold are on the Staff at Bank Street College of Education.     

Factors underlying students' decisions to use mobile devices in clinical settings

University policies prohibiting use of mobile devices by medical students during clinical placements are contradicted by regular use by physicians. Consequently, many students use their mobile devices, which can be beneficial for learning but may put patient privacy at risk. This study explores the reasons underlying students' decisions about using mobile devices in clinical settings. We used a mixed-methods sequential explanatory design involving a questionnaire and focus groups. Qualitative data from the questionnaire and focus groups was analysed through thematic analysis. We found students were aware of the risks mobile devices posed to professionalism and medical practice. Despite prohibitions, many made individual decisions to use mobile devices because the benefits outweighed the risks. These students were influenced by an organised, strategic approach to learning and a motivation to comply with the beliefs and behaviours of their medical teams and conform to physicians' directives in order to participate in their community of practice. Many students appear to be transferring everyday use of mobile devices to clinical settings. There is a need to understand and promote aspects of learning that are enhanced by mobile devices in clinical settings, while articulating clear guidelines and boundaries compatible with the professional behaviour expected of students.     

Static and dynamic accuracy of a magnetic-inertial measurement unit used to provide racket swing kinematics

Magnetic-inertial measurement units (MIMUs) are becoming more prevalent in sports biomechanics and may be a viable tool to evaluate kinematic parameters. This study examined the accuracy of a MIMU to estimate orientation angles under static conditions and dynamically from a squash racket during a forehand drive shot. A MIMU was mounted onto a goniometer and moved through 0–90°, with static data collected at 10° increments during 10 repetitions of all three axes. Typical error analyses showed the MIMU to be very reliable (TE ≤ 0.03°). MIMU accuracy was determined via intraclass correlation coefficients (ICC) (r > 0.999, p < 0.001). An ordinary least products regression showed no proportional bias and minimal fixed bias for all axes. Dynamic accuracy was assessed by comparing MIMU and optical motion capture data of squash racket swing kinematics. A MIMU was fixed onto a racket and 10 participants each hit 10 forehand shots. Mean orientation angle error at ball impact was <0.50° and ICC showed very high correlations (r ≥ 0.988, p < 0.001) for all orientations. Swing phase root mean squared errors were ≤2.20°. These results indicate that a MIMU could be used to accurately and reliably estimate selected racket swing kinematics.