Causal analysis of academic performance

Maximum likelihood methods are presented to test for the relations between causes and effects in linear path diagrams, without assuming that estimates of causes are free of error. Causal analysis is illustrated by published data of the Equal Educational Opportunity Survey, which show that American schools do not significantly modify socioeconomic differences in academic performance and that little of the observed racial difference in academic performance is causal. For two races differing by 15 IQ points, the differential if social class were randomized would be only about 3 points. The principle is stressed that a racial effect in a causal system may be environmental and that its etiology can be studied only by analysis of family resemblance in hybrid populations.PGL Paper No. 155. This work was supported by Grants GM 17173, 1-K3-GM-31, 732, GM HD16697, and HD06003 from the National Institutes of Health.     

Unipolar depression with racing thoughts: A bipolar spectrum disorder?

Major depressive disorder (MDD) with racing/crowded thoughts is understudied. Kraepelin classified 'depression with flight of ideas' in the mixed states of his manic-depressive insanity. The aim of the study was to test whether MDD with racing/crowded thoughts was close to bipolar disorders. Consecutive 379 bipolar-II disorder (BP-II) and 271 MDD depressed outpatients were interviewed using the Structured Clinical Interview for DSM-IV, the Hypomania Interview Guide, and the Family History Screen, by a senior psychiatrist in a private practice. Intra-depression hypomanic symptoms were systematically assessed. Mixed depression was defined as a major depressive episode (MDE) plus three or more intra-MDE hypomanic symptoms. MDD with racing/crowded thoughts was compared to MDD without racing/crowded thoughts on classic bipolar validators (young onset age, many recurrences, atypical and mixed depression, bipolar family history). Frequency of MDD with racing/crowded thoughts was 56.4%. MDD with racing/crowded thoughts, versus MDD without racing/crowded thoughts, had significantly lower age at onset, more MDE severity, more psychotic, melancholic, atypical, and mixed depressions, and more bipolar family history. Of the intra-MDE hypomanic symptoms, irritability, psychomotor agitation and distractibility were significantly more common in MDD with racing/crowded thoughts. Compared to BP-II on bipolar validators, validators were less common in MDD with racing/crowded thoughts. MDD with racing/crowded thoughts seemed to be a severe variant of MDD. MDD with racing/crowded thoughts versus MDD without racing/crowded thoughts, and versus BP-II, had significant differences on bipolar validators, suggesting that it may lie along a continuum linking MDD without racing/crowded thoughts and BP-II.     

Content-specificity of dysfunctional cognitions for patients with bipolar mania versus unipolar depression: a preliminary study

OBJECTIVE: Dysfunctional beliefs or cognitions are considered to be fundamental to both the phenomenology and pathogenesis of depression. However, the cognitive aspects of mania have not been as thoroughly investigated. We sought to compare the maladaptive beliefs and cognitions of 23 bipolar manic or hypomanic patients, 28 patients with unipolar major depression, and 24 normal adults. METHOD: The Cognition Checklist for Mania (CCL-M) was used to assess the beliefs. This 61-item self-report instrument is scored for seven subscales measuring (a) self-importance, (b) interpersonal grandiosity, (c) inappropriate spending, (d) excitement and risk-taking, (e) interpersonal frustrations, (f) goal-driven activity, and (g) past or future outlooks on life, and also yields a total score. RESULTS: The mean CCL-M total score of the bipolar-manic patients was significantly higher than the mean CCL-M total score of the unipolar-depressed patients, and the patients' mean CCL-M total score was also higher than that of the normal adults. The mean scores of the subscales measuring excitement and past and future memories and expectations were also significantly higher for the bipolar-manic than unipolar-depressed patients. CONCLUSIONS: Bipolar-manic patients endorse with maladaptive beliefs and cognitions that are associated with mania more than do unipolar-depressed patients and normal adults. The implications for the early identification of cognitions associated with prodromal states of mania, and for psychotherapeutic interventions, are discussed.     

《大学》《中庸》中的教育哲学思想

《大学》《中庸》是中国古代传统学术的代表著作 ,其内容涉及政治、伦理、哲学、教育等领域 ,对教育的目标、作用及过程等问题形成了理论性认识 ,构成了中国古代教育哲学的一般体系。其内容主要包括“中庸”的教育价值观 ,由“诚”至“道”的教育目的论 ,礼乐相成的教育途径说和知行合一的教学认识论。《大学》《中庸》所阐明的教育思想 ,不仅规定了中国古代教育制度和理论的走向 ,而且确定了封建时代教育与政治的密切关系 ,决定了中国知识分子的人格特征。     

Empirical investigations of thought suppression in OCD

Cognitive-behavioural models of obsessive-compulsive disorder (OCD) implicate thought suppression as a key factor in the development and persistence of the disorder. There is now more than a decade of research on thought suppression and its effects as they pertain to OCD. This paper briefly reports on initial thought suppression research and then offers a detailed review of recent thought suppression research that has directly examined the role of suppression in OCD. Theoretical and methodological issues in using thought suppression paradigms to understand OCD are discussed. It is concluded that this body of work continues to yield inconsistent findings with respect to the effects of suppression on thought frequency, although there are some consistent findings that suggest that suppression is driven by negative thought appraisal and is associated in turn with greater OCD symptomatology. Thus, there is support in this work for key tenets of cognitive-behavioural models of OCD. Suggestions for future research directions are offered.     

Looking forward to promotion

OBJECTIVES: To determine what clinician-educators consider important for promotion, and what support they find helpful and useful for success. DESIGN: Cross-sectional study. SETTING: Eighty academic medical centers in the United States. PARTICIPANTS: One hundred eighty-three participants of the Prospective Study of Promotion in Academia comprising assistant professors in departments of medicine from 80 different medical schools in 35 states. MEASUREMENTS: Differences between clinician-educators' and clinician-investigators' work activities, promotion preparedness, and faculty support needs. RESULTS: One hundred seven (58%) of the faculty were clinician-educators (CEs), and 63 (34%) were clinician-investigators (CIs); the remaining 13 fit neither category. Participants had been in their faculty position for 4.7 years. Ninety-eight percent of CIs reported a publication expectation for promotion, and 75% of CEs also reported such an expectation. More CIs had career mentors available than CEs (68% vs 32%, P <.001). Seventy-nine percent of CIs indicated >10% protected scholarly work time, compared to only 35% of CEs (P <.001). Fifty-three percent of CIs as compared to 32% of CEs (P <.01) meet more often than yearly with their chief/chair for performance review, and more CIs have seen written promotion guidelines (72% vs 51%, P <.01). Clinician educators believed out of 11 job performance areas, research, written scholarship, and reputation were the 3 most important factors that would determine the success of their application for promotion. Both CEs and CIs sense that CIs are more likely get promoted (82% vs 79%). CONCLUSIONS: Clinician educators are less familiar with promotion guidelines, meet less often with superiors for performance review, and have less protected time than CI colleagues. There is dissonance between CEs' beliefs and previously published data from promotion committee chairs in the importance given to specific aspects of job performance.     

A path model of factors influencing the academic performance of nursing students

AIMS: The aim of this study was to build and test a model describing some of the psychological processes underlying nursing students' academic performance. The model hypothesized that age and entry qualifications influence students' academic motivation (locus of control, academic worries, self-efficacy, and expectations), and that this in turn affects their decisions to seek support, which subsequently influences their academic performance. RATIONALE AND BACKGROUND: A literature search showed that previous academic motivation research is piecemeal. The present work sought to integrate previous findings into a coherent framework as a way of advancing our understanding of the complex interactive nature of the factors influencing student performance. METHOD: Path analysis was performed on data obtained from questionnaires and university records for 315 students undertaking a preregistration diploma course in nursing at a university in the Northwest of England. RESULTS: Support-seeking was more predictive of student performance than entry qualifications. Support-seeking also mediated the age-performance relationship: greater willingness to seek support led to the better academic performance of older students. Other features of the accepted model suggested that students who judged their self-efficacy to be higher expected higher grades and that these highly optimistic expectations led to less support-seeking. Academic worries and internal control beliefs were also found to have positive influences on support-seeking. The model developed accounted for 24% of the variance in students' academic performance. DISCUSSION: Implications for nurse education, and interventions that focus on improving students' academic motivation are discussed in the context of the 'personal teacher' support framework.     

Association between extent of axillary lymph node dissection and patient,tumor, surgeon,and hospital factors in patients with early breast cancer

BACKGROUND AND OBJECTIVES: Axillary lymph node dissection (ALND) in patients with breast cancer is crucial for accurate staging, provides excellent regional tumor control, and is included in the standard of care for the surgical treatment of breast cancer. However, the extent of ALND varies, and the extent of dissection and the number of lymph nodes that comprise an optimal axillary dissection are under debate. Despite conflicting evidence, several studies have shown that improved survival is correlated with more lymph nodes removed in both node-negative and node-positive patients. The purpose of this study is to determine which patient, tumor, surgeon, and hospital characteristics are associated with the number of nodes excised in early breast cancer patients. METHODS: A random sample of 938 women with node-negative breast cancer was drawn from the Ontario Cancer Registry and the data supplemented with chart reviews. The extent of axillary dissection was studied by examining the number of nodes examined in relation to the patient, tumor, surgeon, and hospital factors. RESULTS: The mean number of lymph nodes excised was 9.8 (SD = 4.8; range, 1-31), and 49% of patients had >/=10 nodes excised. Lower patient age was associated with the excision of more lymph nodes (>/=10 nodes: 63% of patients <40 years vs. 38% of patients >/=80 years). Surgeon academic affiliation and surgery in a teaching hospital were highly correlated with each other and were significantly associated with the excision of >/=10 nodes. The number of nodes excised was not associated with any tumor factors, nor with the breast operation performed. These results were confirmed with multivariable models. CONCLUSIONS: Even though the number of lymph nodes found in the pathologic specimen can be influenced by factors other than surgical technique (e.g., number of nodes present, specimen handling, and pathologic examination), this study shows significant variation of this variable and an association with several patient and surgeon/hospital factors. This variation and the association with survival warrant further study and effort at greater consistency.     

Evaluation of an Intervention for Children Experiencing Homelessness

This study evaluated a two-part intervention provided during a summer program for children experiencing homelessness. First, teachers and the mental health team implemented a behavior management system to reinforce positive classroom behaviors. Second, a team of undergraduate and graduate students delivered mental health promotion services during classroom and small group activities. Mothers' and teachers' ratings indicated that the children's emotional and behavioral functioning was within normal limits and did not change over the course of the program. Mothers reported higher than normal levels of family distress. Lower school achievement was related to poor behavioral and emotional functioning and attrition. Strategies to ensure that low achievers and children with behavior problems do not drop out of summer programs need to be developed; shelters or schools may be optimal settings for providing family-focused interventions for this population.