The graduate entry generation: a qualitative study exploring the factors influencing the career expectations and aspirations of a graduating cohort of graduate entry dental students in one London institution

Background

Dentistry in the UK has a number of new graduate-entry programmes. The aim of the study was to explore the motivation, career expectations and experiences of final year students who chose to pursue a dental career through the graduate entry programme route in one institution; and to explore if, and how, their intended career expectations and aspirations were informed by this choice.

Method

In-depth interviews of 14 graduate entry students in their final year of study. Data were transcribed verbatim and analysed using framework analysis.

Results

There were three categories of factors influencing students' choice to study dentistry through graduate entry: 'push', 'pull' and 'mediating'. Mediating factors related to students' personal concerns and circumstances, whereas push and pull factors related to features of their previous and future careers and wider social factors. Routes to Graduate Entry study comprised: 'early career changers', 'established career changers' and those pursuing 'routes to specialisation'. These routes also influenced the students' practice of dentistry, as students integrated skills in their dental studies, and encountered new challenges. Factors which students believed would influence their future careers included: vocational training; opportunities for specialisation or developing special interests and policy-related issues, together with wider professional and social concerns. The graduate entry programme was considered 'hard work' but a quick route to a professional career which had much to offer. Students' felt more could have been made of their pre-dental studies and/or experience during the programme. Factors perceived as influencing students' future contribution to dentistry included personal and social influences. Overall there was strong support for the values of the NHS and 'giving back' to the system in their future career.

Conclusion

Graduate entry students appear to be motivated to enter dentistry by a range of factors which suit their preferences and circumstances. They generally embrace the programme enthusiastically and seek to serve within healthcare, largely in the public sector. These students, who carry wider responsibilities, bring knowledge, skills and experience to dentistry which could be harnessed further during the programme. The findings suggest that graduate entry students, facilitated by varied career options, will contribute to an engaged workforce.     

Psychogeriatric day care outcome: A five-year follow-up

All 224 consecutive new patients who were admitted in 1982 through 1985 to the day care department of a skilled-care psychogeriatric nursing home were followed longitudinally until death. Dementia was diagnosed in 95.1% of the 133 women and 91 men. Their mean age at admission was 78.7 years (SD = 7.4). Every 12 months after their initial attendance the patients' status was recorded and coded as living in the community, institutionalized or dead. At one year after initial attendance 99 (44.2%) patients still resided in the community, 94 (42.0%) were admitted to a nursing home or (psychiatric) hospital and 31 (13.8%) had died. At five years only nine (4.0%) patients resided in the community, 65 (29.0%) were in long-term institutional care and 150 (67.0%) had died. Age, gender, socioeconomic status or living alone did not contribute to first-year outcome, but severity of cognitive impairment was associated with an increased risk of becoming institutionalized. Using logistic regression analysis, a model of three variables, living at home, needing help from caregiving children, and high ratings of dependency, assigned 61.4% of 176 subjects correctly as institutionalized versus residing in the community.     

Duration of survival in senile dementia

In this study 297 institutionalized patients with primary degenerative dementia were investigated. Age at onset of dementia was determined and individual longevity quotients (i.e. actual duration of survival divided by expected survival) were calculated. Expected survival was derived from the Dutch life tables for the general population. Age at onset of dementia was 75.6 +/- 7.8 years (mean +/- SD). Duration of dementia until death was 7.2 +/- 4.1 years. Dementia of early onset (before age 76) was associated with a significantly reduced life expectancy (LQ = 0.70 +/- 0.30), but this was not found for onset after age 75 (LQ = 0.91 +/- 0.58). Duration of symptoms at the time of admission into a nursing home was not associated with severity of behavioural and cognitive impairments as measured with behaviour rating scales. However, the severity of behavioural impairments predicted 1-year survival after admission, as could be shown by multivariate analysis which corrected for the effects of age and sex.     

黄皮香豆精的降血糖作用

我国南方民间常用黄皮[Clausena Lansjum(Lour.)Skeels]叶治疗肝炎、糖尿病等。黄皮香豆精是从黄皮叶分离出的一种呋喃香豆精类化合物,结构见图1,其药理作用未见报道。本文用正常小鼠及四氧嘧啶高血糖小鼠观察了黄皮香豆精的降血糖作用和对血乳酸的影响。     

Long-term follow-up of blood donors with indeterminate human immunodeficiency virus type 1 results on Western blot

BACKGROUND: At present, tens of thousands of United States blood donors who are at low risk for human immunodeficiency virus type 1 (HIV-1) infection are indefinitely deferred. These persons are repeatably reactive for HIV-1 antibody in enzyme immunoassay (EIA) and are indeterminate in Western blot. STUDY DESIGN AND METHODS: To determine the significance and persistence of anti-HIV-1 reactivity in plasma from volunteer blood donors with HIV-1-indeterminate Western blots, 66 donors were retested for HIV-1 antibody by the same manufacturers' EIA and Western blot 5 to 7 years after the initial Western blot. In addition, donors' peripheral blood mononuclear cells were tested by polymerase chain reaction (PCR) for HIV-1 DNA gag sequences. RESULTS: Thirty-five (53%) of 66 donors were still repeatedly reactive for HIV-1 on EIA and indeterminate on Western blot, 23 (35%) were negative on EIA and indeterminate on Western blot, 7 (11%) were negative in EIA and Western blot, and 1 (2%) was repeatedly reactive on EIA and negative on Western blot. Donors with persistently indeterminate Western blots had a band pattern nearly identical to that on the original Western blot. No donor was positive in Western blot, p24 antigen, or PCR testing. No donor had signs or symptoms of HIV-1 infection. CONCLUSION: Long-term follow-up of Western blot-indeterminate blood donors does not reveal evidence of HIV-infection. A mechanism to return these donors to the donor pool should be considered.     

绵羊二尖瓣置换动物模型的制作

目的:探索人工二尖瓣置换绵羊动物模型制作的外科技术。方法:实验于2006-01/04在南方医科大学动物实验中心完成。①选用健康雄性绵羊6只,制作人工机械心脏瓣膜置换动物模型;另外取6只羊每只采血1500mL后处死。②人工机械心脏瓣膜由兰州飞控医疗仪器厂生产,为C-LⅠ型短柱人工机械心脏瓣膜,瓣架为高强度耐酸铬镍合金,瓣片的内部为石墨基体,表面为沉积热解碳,瓣环为涤纶长丝织物。③二尖瓣置换模型制备:术中右颈静脉建立通路用于测静脉压、输液等;右股动脉置管连续监测动脉压;连续监测心电图、血氧饱和度;检测血气分析、血钾和全血激活凝血时间;监测鼻咽及肛温,计尿量。麻醉后气管内插管接麻醉机。降主动脉插供血管,右心耳或者上、下腔静脉插引流管,升主动脉根部插灌注管和左肺静脉插左心引流管,建立体外循环。主动脉阻断,灌注心肌保护液;阻断上下腔静脉。体外循环为新鲜羊血预充,转流降温至鼻咽温度27～30℃。经左心耳切口显露二尖瓣,切除瓣叶、腱索及部分乳头肌。放置人工瓣膜,连续缝合二尖瓣环。开放循环,心脏自动复跳,循环稳定后脱离体外循环并拔管,放置左胸引流后常规关胸。术后常规使用血管活性药,麻醉清醒后拔除气管插管,青霉素预防感染,华法令口服抗凝治疗。结果:6只羊手术过程均顺利,心脏全部自动复跳,术后全部存活且超过1个月。术中体外循环过程平稳,监测血气分析无大的波动;平均手术时间为(129±11)min,平均转流时间为(61±7)min,平均主动脉阻断时间为(30±6)min,预充血量为(700±89)mL,转流中鼻咽温为(28.7±1.3)℃。术后呼吸机辅助时间12～30h,术后血管活性药使用时间6～37h,均在24h内拔除胸腔引流管。3只羊并发肺部感染经抗炎治疗后治愈。术后口服华法令抗凝治疗,剂量6.0～12mg,国际标准化比值控制在2.1～3.2之间。结论:经左心耳入路行二尖瓣置换制作绵羊动物模型是可行的。采用同种新鲜羊血预充、术中保持良好的引流和组织灌注、术后加强呼吸道管理以及抗凝治疗是提高手术成功率的重要保证。     

意象对话诊断技术的有效性检验

目的:检验意象对话诊断技术的有效性。方法:于2006-03随机抽取贵州省贵阳市某高校大二年级46名学生为调查对象。用SPSS11.0统计软件筛选出症状自评量表躯体化、强迫症状、人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执、精神病性9个因子得分的前10%与后10%的被试,比较两组被试在朱建军首创的意象对话中的镜中人测验、心房测验中的差异。结果:共发放问卷46份,收回有效问卷42份。镜中人测验可以测查症状自评量表中的躯体化程度,心房测验可以测查强迫症状、人际关系敏感、抑郁、焦虑、恐怖和精神病性6个因子,但对于敌对、偏执两因子无法做出很好的诊断。结论:意象对话诊断技术有着较高的效度,在心理诊断中可以尝试着运用。