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Innovative assessments of cross-curricular competencies such as complex problem solving (CPS) have currently received considerable attention in large-scale educational studies. This study investigated the nature of CPS by applying a state-of-the-art approach to assess CPS in high school. We analyzed whether two processes derived from cognitive psychology, knowledge acquisition and knowledge application, could be measured equally well across grades and how these processes differed between grades. Further, relations between CPS, general mental ability (g), academic achievement, and parental education were explored. Hungarian high school students in Grades 5 to 11 (N = 855) completed MicroDYN, which is a computer-based CPS test, and the Culture Fair Test 20-R as a measure of g. Results based on structural equation models showed that empirical modeling of CPS was in line with theories from cognitive psychology such that the two dimensions identified above were found in all grades, and that there was some development of CPS in school, although the Grade 9 students deviated from the general pattern of development. Finally, path analysis showed that CPS was a relevant predictor of academic achievement over and above g. Overall, results of the current study provide support for an understanding of CPS as a cross-curricular skill that is accessible through computer-based assessment and that yields substantial relations to school performance. Thus, the increasing attention CPS has currently received on an international level seems warranted given its high relevance for educational psychologists.

This article is about Complex Problem Solving (CPS), its history in a variety of research domains (e.g., human problem solving, expertise, decision making, and intelligence), a formal definition and a process theory of CPS applicable to the interdisciplinary field. CPS is portrayed as (a) knowledge acquisition and (b) knowledge application concerning the goal-oriented control of systems that contain many highly interrelated elements (i.e., complex systems). The impact of implicit and explicit knowledge as well as systematic strategy selection on the solution process are discussed, emphasizing the importance of (1) information generation (due to the initial intransparency of the situation), (2) information reduction (due to the overcharging complexity of the problem's structure), (3) model building (due to the interconnectedness of the variables), (4) dynamic decision making (due to the eigendynamics of the system), and (5) evaluation (due to many, interfering and/or ill-defined goals).

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AIMTo evaluate rebleeding, primary failure (PF) and mortality of patients in whom over-the-scope clips (OTSCs) were used as first-line and second-line endoscopic treatment (FLET, SLET) of upper and lower gastrointestinal bleeding (UGIB, LGIB).METHODSA retrospective analysis of a prospectively collected database identified all patients with UGIB and LGIB in a tertiary endoscopic referral center of the University of Freiburg, Germany, from 04-2012 to 05-2016 (n = 93) who underwent FLET and SLET with OTSCs. The complete Rockall risk scores were calculated from patients with UGIB. The scores were categorized as < or ≥ 7 and were compared with the original Rockall data. Differences between FLET and SLET were calculated. Univariate and multivariate analysis were performed to evaluate the factors that influenced rebleeding after OTSC placement.RESULTSPrimary hemostasis and clinical success of bleeding lesions (without rebleeding) was achieved in 88/100 (88%) and 78/100 (78%), respectively. PF was significantly lower when OTSCs were applied as FLET compared to SLET (4.9% vs 23%, P = 0.008). In multivariate analysis, patients who had OTSC placement as SLET had a significantly higher rebleeding risk compared to those who had FLET (OR 5.3; P = 0.008). Patients with Rockall risk scores ≥ 7 had a significantly higher in-hospital mortality compared to those with scores < 7 (35% vs 10%, P = 0.034). No significant differences were observed in patients with scores < or ≥ 7 in rebleeding and rebleeding-associated mortality.CONCLUSIONOur data show for the first time that FLET with OTSC might be the best predictor to successfully prevent rebleeding of gastrointestinal bleeding compared to SLET. The type of treatment determines the success of primary hemostasis or primary failure.