This study investigated relationships between self-efficacy, self-esteem, previous performance accomplishments, and academic performance among a sample of 205 postgraduate students. Participants completed measures of past performance accomplishments, self-esteem, and self-efficacy at
the start of a 15-week course. Each student's average grade from modules studied was used as the performance measure. Correlation results indicated significant relationships between self-efficacy and self-esteem. Multiple regression results indicated that self-efficacy mediated the relationship
between performance accomplishments and academic performance. Findings lend support to the predictive effectiveness of self-efficacy measures in academic settings.
This article uses a survey of RCN safety representatives to examine the operation of the Safety Representatives andSafety Committees Regulations 1977. The survey's findings indicate that while NHS employers have become more supportive of such representatives, many are still failing to comply with their statutory obligations.
This article brie y explains the concept of whistleblowing and why it should be encouraged. It then describes the way in which the law both constrained and encouraged the disclosure of information prior to the introduction of the Public Interest Disclosure Act 1998. Having outlined the effect of the PIDA 1998, the authors present the background to their survey and summarise their results.
BACKGROUND:Accurate preoperative risk assessment in emergency laparotomy (EL) is valuable for informed decision making and rational use of resources. Available risk prediction tools have not been validated adequately across diverse health care settings. Herein, we report a comparative external validation of four widely cited prognostic models.
METHODS:A multicenter cohort was prospectively composed of consecutive patients undergoing EL in 11 Greek hospitals from January 2020 to May 2021 using the National Emergency Laparotomy Audit (NELA) inclusion criteria. Thirty-day mortality risk predictions were calculated using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP), NELA, Portsmouth Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (P-POSSUM), and Predictive Optimal Trees in Emergency Surgery Risk tools. Surgeons' assessment of postoperative mortality using predefined cutoffs was recorded, and a surgeon-adjusted ACS-NSQIP prediction was calculated when the original model's prediction was relatively low. Predictive performances were compared using scaled Brier scores, discrimination and calibration measures and plots, and decision curve analysis. Heterogeneity across hospitals was assessed by random-effects meta-analysis.
RESULTS:A total of 631 patients were included, and 30-day mortality was 16.3%. The ACS-NSQIP and its surgeon-adjusted version had the highest scaled Brier scores. All models presented high discriminative ability, with concordance statistics ranging from 0.79 for P-POSSUM to 0.85 for NELA. However, except the surgeon-adjusted ACS-NSQIP (Hosmer-Lemeshow test, p = 0.742), all other models were poorly calibrated (p < 0.001). Decision curve analysis revealed superior clinical utility of the ACS-NSQIP. Following recalibrations, predictive accuracy improved for all models, but ACS-NSQIP retained the lead. Between-hospital heterogeneity was minimum for the ACS-NSQIP model and maximum for P-POSSUM.
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