Recent trends in National Institutes of Health funding for surgery: 2003 to 2013

Background

The purpose of this study is to compare the compositions of federally funded surgical research between 2003 and 2013, and to assess differences in funding trends between surgery and other medical specialties.

Data Sources

The National Institutes of Health (NIH) Research Portfolio Online Reporting Tool database was queried for grants within core surgical disciplines during 2003 and 2013. Funding was categorized by award type, methodology, and discipline. Application success rates for surgery and 5 nonsurgical departments were trended over time.

Conclusions

Inflation-adjusted NIH funding for surgical research decreased 19% from $270M in 2003 to $219M in 2013, with a shift from R-awards to U-awards. Proportional funding to outcomes research almost tripled, while translational research diminished. Nonsurgical departments have increased NIH application volume over the last 10 years; however, surgery’s application volume has been stagnant. To preserve surgery’s role in innovative research, new efforts are needed to incentivize an increase in application volume.     

Academic advising and student support: Help-seeking behaviors among Saudi dental undergraduate students

Objective

The purpose of this study was to assess the use of and satisfaction with the academic-advising and student-support systems available to undergraduate students in the College of Dentistry at the University of Dammam. In addition, the study aimed to also identify factors that explained the help-seeking behavior of students which they used to solve academic issues.

Materials and methods

Students enrolled in the five-year Bachelor of Dental Surgery (BDS) program in 2012–13 and 2013–14 first-year students were invited to respond to a self-administered questionnaire.

Results

The results showed that 66.2% of students had discussed academic issues with their advisor at least once, with a frequency ranging from zero to six times. Most students reported that their advisors were readily available, listened intently to their needs and questions, and helped them solve their problems. However, only 7.6% of students relied primarily on advisors for help with academic issues, whereas 51% depended first on colleagues and 13.8% did not seek help and relied on themselves. In total, 17.2% of students were very or somewhat satisfied with the academic advising system. Males had lower odds of discussing issues with their advisors, and the odds were higher with advisors who were more available (OR = 0.25 and 3.74, respectively). Alerting students to important dates in the academic calendar significantly increased the odds that a student would depend primarily on academic advisors for advice related to academic issues (OR = 6.53).

Conclusions

Few students were satisfied with the academic support system. We need to train advisors to help them develop their skills and knowledge and to enable them to provide the support needed by the students.     

Impact of Sex on Comparative Outcomes of Radial Versus Femoral Access in Patients With Acute Coronary Syndromes Undergoing Invasive Management: Data From the Randomized MATRIX-Access Trial

Objectives

This study sought to assess whether transradial access (TRA) compared with transfemoral access (TFA) is associated with consistent outcomes in male and female patients with acute coronary syndrome undergoing invasive management.

Transapical Transcatheter Aortic Valve for Severe Aortic Regurgitation: Expanding the Limits

ObjectivesThis study sought to evaluate the self-expandable ACURATE TA device (Symetis SA, Ecublens, Switzerland) in a cohort of patients with pure aortic regurgitation (AR).BackgroundTranscatheter aortic valve replacement (TAVR) has been initially considered as an alternative for high-risk patients with aortic stenosis. Although the current experience is limited, TAVR might be also an alternative to treat patients with pure, severe AR.MethodsBetween April 2012 and December 2013, a total of 8 high-risk patients with pure, severe AR were enrolled (grade III+). Clinical and hemodynamic data as well as data on device and procedure parameters and outcomes were collected.ResultsPatient mean was 72.5 ± 8.4 years, and 37.5% of patients were female. Logistic EuroSCORE was 34.0 ± 7.9% and the Society of Thoracic Surgeons score was 7.3 ± 3.3% on average. Two patients had undergone emergency aortic operation before due to acute type A aortic dissection, and both were treated by replacement of the ascending aorta (including root reconstruction) and the aortic arch combined with or without E-vita Open stent graft (Jotec GmbH, Hechingen, Germany) (January 2011 and March 2012), whereas the other patients experienced primary AR. All patients underwent successful transapical TAVR with the transapical ACURATE TA device (size small, n = 1, size medium, n = 3, size large, n = 4) without any intraprocedural complications according to the Valve Academic Research Consortium 2 criteria. Post-procedure AR grade I+ or lower, as revealed by transoesophageal echocardiography and angiography, was present in all 8 patients. At 30 days, the stroke incidence and all-cause mortality rate were 0%.ConclusionsThis small single-center series demonstrates the feasibility of transapical TAVR with the self-expandable ACURATE TA device in high-risk patients with severe AR.     

Prophylactic academic intervention for children treated with cranial radiation therapy

This single case study investigated the feasibility and effectiveness of a prophylactic intervention for improving academic skills in a child with a brain tumour deemed at high risk for cognitive delay and academic failure because of cranial radiation treatment (CRT). An 8 year old boy participated in a 12 week home and hospital based tutoring programme. Standardized and non-standardized measures of academic achievement were administered at pre- and post-intervention. A follow-up assessment took place 8 months post-intervention (standardized measures only). Pre-test and follow-up neuropsychological data was collected. Significant improvement was observed on the Wechsler Individual Achievement Test–2nd Edition (WIAT-II) pseudoword decoding and spelling sub-tests and on measures of single word and grapheme knowledge. There was no improvement on the WIAT-II math sub-tests. At follow-up, gains were maintained or improved for reading-related sub-tests but declined for math and spelling sub-tests. Overall, neuropsychological data showed decreased performance. The gains in reading skills were made in the context of an overall decline in neuropsychological functioning, suggesting that the intervention helped to preserve reading skills and may be protective against difficulty with skill acquisition, but did not prevent a more global decrease in functioning. This study is the first reported prophylactic intervention delivered concurrently with intensive medical treatment.     

Improving oral healthcare using academic detailing – design of the ADVOCATE Field Studies

Background: Academic detailing (AD) is a defined form of educational outreach that can be deployed to intrinsically motivate practitioners towards improving quality of care. This paper describes the design of the ADVOCATE Field Studies. This proof of concept study aims to evaluate the feasibility, acceptability and usefulness of AD, reinforced with feedback information to promote prevention-oriented, patient-centred and evidence-based oral healthcare delivery by general dental practitioners (GDPs).

Methods: Six groups of GDPs will be recruited; two groups of six to eight GDPs in each of three countries – the Netherlands, Germany and Denmark. GDPs will meet for four Academic Detailing Group (ADG) meetings for open discussions using comparative feedback data to stimulate debate about their dental practice performance and care delivery. Group meetings will be moderated using the AD methodology. Qualitative data will be collected through focus group interviews, an online discussion forum, field notes and debriefs of ADG meetings and analysed by conventional content analysis using MaxQDA software.

Discussion: The results of the study will provide novel information on the feasibility, perceived acceptability and usefulness of AD and feedback data for GDPs to improve oral healthcare delivery.     

Professional development and leadership training opportunities for healthcare professionals

Background

Formal leadership training is a relatively recent addition to the educational armamentarium of the health care executive. Leadership training opportunities for physicians, surgeons, and scientists have gradually appeared over the past 15 to 20 years, but information about them has been scant, with few comprehensive reviews made available to the community at large. This article describes the major opportunities available to obtain formal and informal leadership training for careers in medical school administration. Programs that are specifically targeted to women are described in detail.

Data Sources

Information was obtained from the author's direct knowledge, direct communication with the leadership of each program, and the Web site of each sponsoring organization, when available.

Conclusions

Many opportunities for leadership training are now available to surgeons, with several specifically designed for women. The author strongly encourages surgeons to avail themselves of these opportunities, as both anecdotal information and published data suggest that these programs are highly effective in enhancing leadership careers.     

Self-concept in adolescence: A longitudinal study on reciprocal effects of self-perceptions in academic and social domains

Fostering social and academic self-concepts are central educational goals. During mid-adolescence academic engagement and success seem to be devalued by peers and to be negatively associated with students' social standing. For this age group, is the development of a positive academic self-concept compatible with the development of a positive social self-concept? We investigated relations among academic self-concept, social self-concept, and academic achievement. 1282 students (47.60% female) participated in three-waves of measurement in Grade 5, 6, and 8. Earlier social self-concept of acceptance negatively predicted changes in academic self-concept over time while earlier social self-concept of assertion positively predicted changes in academic self-concept. There were no significant relations between social self-concepts and achievement but positive reciprocal relations between academic self-concept and achievement. Results indicate that fostering adolescents self-concept in social and academic domains are compatible goals. However, some students need support in managing the challenge to coordinate social and academic goals.     

Academic self-concept in children with epilepsy and its relation to their quality of life

Abstract

Objectives:

Academic achievement in children with epilepsy is a highly studied topic with many important implications. However, only little attention has been devoted to academic self-concept of such children and the relation of academic self-concept to their quality of life. We aimed to examine academic self-concept in children with epilepsy, to assess its relationship to academic achievement and to determine possible correlations between academic self-concept and quality of life.

Methods:

The study group consisted of 182 children and adolescents aged 9–14 years who completed the student’s perception of ability scale (SPAS) questionnaire to determine their academic self-concept and the modified Czech version of the CHEQOL-25 questionnaire to determine their health-related quality of life.

Results:

We found that academic self-concept in children with epilepsy was on average significantly lower than in their peers without seizures, especially with regard to general school-related abilities, reading, and spelling. On the other hand, the variance in the data obtained from the group of children with epilepsy was significantly higher than in the whole population and the proportion of individuals with very high academic self-concept seems comparable among children with and without epilepsy. Moreover, it was found that correlations between academic self-concept and academic achievement are significantly lower in children with epilepsy than in the whole population.

Discussion:

The presented results suggest that considerable attention should be paid to the role of academic self-concept in education of children with epilepsy and to the factors influencing this self-concept in this group.