Valid self-assessment is fundamental to continuing professional competence but is seldom explicitly taught in health professions training. This review analyzed 18 scholarly articles published between January 1970 and February 1990 (14 articles regarding health professions trainees, and four concerning college students or graduate trainees) in which it was possible to compare performance as self-assessed by trainees with performance as assessed by experts or objective tests. The validity of self-assessed performance was found to be low to moderate and did not improve with time in conventional health professions training programs. Self-assessed performance seemed closely related to generalized self-attributions and was minimally influenced by external feedback in the form of test scores, grades, or faculty assessments. In five programs emphasizing explicit self-assessment goals and training strategies, moderate-to-high validity outcomes or improvements over time were demonstrated. Much of what passes for self-assessment in training seems the exercise of an underdeveloped skill, but effective training to improve validity and accuracy is available and feasible.

Metals that are active catalysts for methane (Ni, Pt, Pd), when dissolved in inactive low-melting temperature metals (In, Ga, Sn, Pb), produce stable molten metal alloy catalysts for pyrolysis of methane into hydrogen and carbon. All solid catalysts previously used for this reaction have been deactivated by carbon deposition. In the molten alloy system, the insoluble carbon floats to the surface where it can be skimmed off. A 27% Ni-73% Bi alloy achieved 95% methane conversion at 1065°C in a 1.1-meter bubble column and produced pure hydrogen without CO or other by-products. Calculations show that the active metals in the molten alloys are atomically dispersed and negatively charged. There is a correlation between the amount of charge on the atoms and their catalytic activity.

Despite the advanced age of many patients having total knee arthroplasty, previous attempts to quantify patient function postoperatively have not allowed for normal deterioration of musculoskeletal function that occurs with aging. We determined the effects of aging on knee function, thereby providing a realistic level of normal, healthy knee function for patients and surgeons after total knee arthroplasties. A selfadministered, validated knee function questionnaire consisting of 55 scaled multiple choice questions was used in this study. Responses were collected from 243 patients at least 1 year after they had total knee arthroplasties, and from 257 individuals (age-and gender-matched) who had no previous history of knee disorders. Many of these latter subjects reported that they could do most of the activities cited in the questionnaire without symptoms attributable to their knees. However, knee symptoms were experienced more frequently during activities that placed greater loads on the extremity. There was no difference in the knee function of men and women, and both groups had continuous deterioration in knee function with increasing age. There were large differences in the functional capacity to do activities involving the knee between the group of patients who had total knee arthroplasties and the age-and gender-matched patients with no previous knee disorders. Overall, 52% of the patients who had total knee arthroplasties reported some degree of limitation in doing functional activities, versus 22% of subjects with no previous knee disorders. Two groups of activities were identified: activities in which the patients and control subjects had essentially similar knee function (swimming, golfing, and stationary biking), and activities in which the function scores of the control group exceeded the scores of the patients who had total knee arthroplasties (kneeling, squatting, moving laterally, turning and cutting, carrying loads, stretching, leg strengthening, tennis, dancing, gardening, and sexual activity). Our data show that many of the limitations reported by patients after total knee arthroplasties are shared by individuals with no previous knee disorders. However, only approximately 40% of the functional deficit present after a total knee arthroplasty seems to be attributable to the normal physiologic effects of aging. Patients who had total knee replacements still experienced substantial functional impairment compared with their age-and gender-matched peers, especially when doing biomechanically demanding activities. This suggests that significant improvements in the procedure and prosthetic designs are needed to restore normal knee function after a total knee arthroplasty.

The purpose of this study was to compare and contrast American and Canadian teachers' knowledge and attitudes regarding ADHD. Both samples completed a self report questionnaire. The first part determined the demographic background of the teachers. The second section consisted of 20 true/false questions concerning ADHD intended to assess teachers' general knowledge of the essential concepts involved in the diagnosis and treatment of the disorder. The results indicated that both samples had little in-service training regarding ADHD. Despite this, most teachers regarded ADHD as a valid diagnosis with educational implications and wanted more formal training. While most teachers did well on knowledge-based questions regarding the etiology and educational implications of the condition, many still perceived non-medical therapies such as diets as being effective. Many regarded the condition as being outgrown at adolescence. Significantly, only 14% of the teachers had been involved in the diagnosis and ongoing monitoring of mediation by outside professionals. The implications of improved in-service training for all professionals involved with children with ADHD are discussed.

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