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The kindergarten program, Tools of the Mind (Tools), has been shown to improve executive functions (as assessed by laboratory measures) and academic performance. The objective here was to see if Tools can improve executive functions in the real world (in the classroom), academic outcomes not previously investigated, reduce bullying and peer ostracism, and increase teachers' and students' joy in being in the classroom. This first randomized controlled trial of Tools in Canada included 351 kindergarten children (mean age 5.2 years at entry; 51% female) in 18 public schools. Stratified randomization resulted in teachers and students in both groups being closely matched. Teachers in both groups received the same number of training hours and same funds for new materials. Outcome measures were pre and post standardized academic skill assessments and teacher online survey responses. This study replicated that Tools improves reading and shows for the first time that it improves writing (far exceeding levels the school districts had seen before), self-control and attention-regulation in the real world (e.g., time on task without supervision), reduces teacher burnout and children being ostracized or excluded, and increases the joy students and teachers experience in school. By Spring, Tools teachers were still enthusiastic about teaching; control teachers were exhausted. These results were not only better than the control group but also better than Tools teachers experienced the year before Tools. Thus, children in a kindergarten curriculum that emphasized play, improving self-regulation, working together and helping one another, and hands-on learning performed better academically, showed less bullying and peer ostracism and more kindness and helping behavior than students in more traditional classes, and teacher enthusiasm for teaching soared. Tools reduced initial disparities separating children, schools, and teachers.

Several studies have evaluated the effects of high-intensity aerobic training (HIAT) on pain severity and quality of life (QoL) among women with primary dysmenorrhea. However, to date, no studies have evaluated the effectiveness of HIAT on academic performance or absenteeism or examined the cost-effectiveness of HIAT relative to other treatments in women with primary dysmenorrhea. Furthermore, the mechanisms underlying aerobic exercise-induced analgesia in primary dysmenorrhea remain unclear. The objectives of this study are to: (1) evaluate the effects of HIAT on absenteeism and academic performance among university students, (2) identify the underlying mechanisms associated with aerobic exercise-induced analgesia in primary dysmenorrhea, and (3) determine the cost-effectiveness of HIAT compared with a wait-list control (WLC) group receiving usual care. A sequential, embedded, mixed-methods study design, including a crossover, randomised controlled trial (RCT) and semi-structured focus groups, will be conducted alongside an economic evaluation. A total of 130 women aged 18-24 years will be randomised into either HIAT (n = 65) or wait-list control (n = 65) groups. Primary outcomes will include average pain intensity, absenteeism from university, and academic performance. Primary mediators will include salivary progesterone and prostaglandin F2α levels. Outcome and meditator variables will be assessed at baseline and post-treatment, at 12 and 28 weeks. An economic analysis will be conducted from the societal and healthcare perspective of Hong Kong. Semi-structured focus groups will be conducted at 32 weeks. Of the 130 participants included in the RCT, 70 will be included in the focus groups. All statistical analyses will be performed on an intention-to-treat basis, using SPSS (version 24). Preliminary analysis using an independent samples t-test and a two-sided, unpaired Student's t-test will be performed to exclude carryover effects and identify within-participant differences in outcome variables between the study periods, respectively. Treatment effects will be evaluated using analysis of variance via a mixed-effects model with fixed effects for intervention, period, and sequence. In all models, random effects will include the participants nested within the sequence as a sampling cluster. The mediation effects will be assessed using the Sobel test. The EQ-5D responses will be converted into utility scores to estimate the gain or loss of quality-adjusted life-years. Seemingly unrelated regression analyses will be used to estimate the total cost differences and effect differences. Qualitative data will be analysed using the process of thematic analysis.

To compare the effects of traditional and platform-based case-based learning (CBL) on undergraduate nursing students’ academic performance, self-efficacy, clinical decision-making and critical thinking abilities. Traditional CBL can improve students’ academic performance but faces challenges in the era of “Internet + education.” It is unclear whether platform-based CBL is as effective as traditional CBL. Cluster randomized controlled trial. A total of 88 undergraduate nursing students from two classes were recruited using cluster sampling and separated into two groups by class. The control group (n = 45) received traditional CBL, and the experimental group (n = 43) received platform-based CBL. Academic performance, self-efficacy, clinical decision-making, critical thinking disposition and experimental group’s learning records from the online platform were evaluated. No difference was found between the two groups in overall academic performance, but formative evaluation and final examination scores in the course differed. Compared with the control group, the experimental group presented significant differences in self-efficacy and clinical decision-making. There was no difference between the total clinical thinking disposition scores; however, truth-seeking, systematicity and self-confidence exhibited significant differences. Concerning student progression, all experimental students advanced from “Grade I” to “Grade V” or “Grade IV”. The usability questionnaire’s average score regarding the platform was 77.03 (SD 7.43) and the top dimension was teaching utility. Compared with traditional CBL, platform-based CBL may better enhance self-efficacy and clinical decision-making abilities in nursing undergraduate students.

PurposeClinical breast examination (CBE) is an important step in the assessment of patients with breast-related complaints. We developed a standardized simulation and multimedia-based (SSMBI) curriculum using current evidenced-based recommendations. This study aimed to determine if SSMBI training resulted in better performance (examination scores and detection of abnormal findings) than the traditional teaching method.MethodsNovice fourth-year medical students were exposed to the SSMBI curriculum (n = 68) or traditional (n = 52) training. The traditional group was taught by a lecture and attending weekly clinics where they had hands-on experience. The SSMBI group underwent a structured lecture followed by an instructional video and dedicated simulated teaching. Both groups were assessed through a written knowledge exam and an objective structured clinical examination (OSCE). Student’s t test and χ2 tests were used to assess differences in CBE technique and knoweldge.ResultsStudents who underwent SSMBI training had significantly higher numbers of correct answers describing the different steps and justifications of CBE. OSCE performance was significantly higher in the SSMBI group. SSMBI-trained students were more likely to complete all the necessary CBE steps compared to traditionally-trained students (88.2% vs. 28.2%, p < 0.00001). The SSMBI group was also more systematic and more likely to perform adequate inspection, palpation, examination of the nipple-areolar complex, and identify and characterize a palpable lesion (p < 0.05).ConclusionsFormal SSMBI training is an important asset when teaching medical students how to perform a CBE. Real clinical experience is still necessary to refine this skill and the physician–patient interaction.

Proficiency-based knot-tying curricula have been developed for square knots for medical students, but, to our knowledge, no such curriculum exists for the reverse half hitch alternating-post (RHAP) knot. We aimed to compare medical students' knot-tying proficiency, knot-tying self-confidence and final knot characteristics for RHAP and square knots in a simulated deep body cavity. We performed a within-subject prospective crossover study of novice medical students who received 30 minutes of training in tying both RHAP and square knots. Participant performance was assessed via a knot-tying checklist, and knot configuration, tensile strength, tightness (loop circumference) and mechanism of failure were also assessed. Participants' self-reported confidence in knot tying was captured. Twenty-one students participated in the study. Mean scores on the knot-tying checklist were significantly higher for RHAP knots than for square knots (6.9 [standard deviation (SD) 2.1] v. 5.2 [SD 2.3], < 0.01), and RHAP knots were significantly tighter than square knots (46.8 mm [SD 0.4 mm] v. 49.3 mm [SD 0.7 mm], < 0.05). There were no differences between RHAP and square knots in correct knot configuration, breaking strength or mechanism of failure. Reverse half hitch alternating-post knots were easier to tie within a deep-body cavity, whereas square knots were easier to learn. Novice medical students were more proficient in tying RHAP knots than square knots in a simulated deep body cavity. Students were able to construct RHAP knots more securely and reported increased confidence in tying RHAP knots at depth compared to square knots.

To assess the impact of in vitro fertilization (IVF) on school performance and long-term outcomes in very preterm children aged 8-16 years. Seventy-nine children born after IVF were compared with 79 randomly selected matched controls born after spontaneous conception (SC). Information was obtained from parents via a questionnaire administered through telephone interviews looking into school performance, including preschool education, repeated grades, extra lessons, special education needs, and learning difficulties; long-term status, including incidence of attention deficit hyperactivity disorder and autism; and family profile. Gross motor function was assessed against the gross motor function classification system based on information given by the subjects' families. Mothers of IVF children were more likely to have a high educational level than mothers of SC children. Moreover, a greater proportion of IVF children had received preschool education than SC children. After adjusting for potential confounders, there was no difference in the school performance or long-term outcomes between IVF and SC children. In our study, the school performance and long-term outcomes of very preterm children born after IVF and of their spontaneously conceived peers were comparable. This information can help provide guidance to families and educators.

The underrepresentation of girls and women in science, technology, engineering, and mathematics (STEM) fields is a continual concern for social scientists and policymakers. Using an international database on adolescent achievement in science, mathematics, and reading (N = 472,242), we showed that girls performed similarly to or better than boys in science in two of every three countries, and in nearly all countries, more girls appeared capable of college-level STEM study than had enrolled. Paradoxically, the sex differences in the magnitude of relative academic strengths and pursuit of STEM degrees rose with increases in national gender equality. The gap between boys’ science achievement and girls’ reading achievement relative to their mean academic performance was near universal. These sex differences in academic strengths and attitudes toward science correlated with the STEM graduation gap. A mediation analysis suggested that life-quality pressures in less gender-equal countries promote girls’ and women’s engagement with STEM subjects.

Data mining offers strong techniques for different sectors involving education. In the education field the research is developing rapidly increasing due to huge number of student’s information which can be used to invent valuable pattern pertaining learning behavior of students. The institutions of education can utilize educational data mining to examine the performance of students which can support the institution in recognizing the student’s performance. In data mining classification is a familiar technique that has been implemented widely to find the performance of students. In this study a new prediction algorithm for evaluating student’s performance in academia has been developed based on both classification and clustering techniques and been ested on a real time basis with student dataset of various academic disciplines of higher educational institutions in Kerala, India. The result proves that the hybrid algorithm combining clustering and classification approaches yields results that are far superior in terms of achieving accuracy in prediction of academic performance of the students.

Fewer women than men pursue careers in science, technology, engineering and mathematics (STEM), despite girls outperforming boys at school in the relevant subjects. According to the ‘variability hypothesis’, this over-representation of males is driven by gender differences in variance; greater male variability leads to greater numbers of men who exceed the performance threshold. Here, we use recent meta-analytic advances to compare gender differences in academic grades from over 1.6 million students. In line with previous studies we find strong evidence for lower variation among girls than boys, and of higher average grades for girls. However, the gender differences in both mean and variance of grades are smaller in STEM than non-STEM subjects, suggesting that greater variability is insufficient to explain male over-representation in STEM. Simulations of these differences suggest the top 10% of a class contains equal numbers of girls and boys in STEM, but more girls in non-STEM subjects. Men are over-represented in the STEM (science, technology, engineering and mathematics) workforce even though girls outperform boys in these subjects at school. Here, the authors cast doubt on one leading explanation for this paradox, the ‘variability hypothesis’.

To examine whether psychosocial health mediates the association between food insecurity and grade point average (GPA) among college and university students. Data for the present study are from a longitudinal cohort study. Structural equation modelling (SEM) was used to test the proposed mediation hypothesis. Food insecurity was measured using the US Department of Agriculture's Six-Item Short Form. Psychosocial health was operationalized as a latent factor with three indicators: depression, anxiety and hope. Validated scales were used to measure each indicator. GPA was self-reported. Seven colleges and universities in Georgia, USA.ParticipantsStudents aged 18-25 years were recruited via email and surveyed every four months over a two-year period (analytic n 2377). Approximately 29 % of students were food insecure. In the final SEM, food insecurity was associated (standardized β, se) with poorer psychosocial health (0·22, 0·03, P<0·0001) and poorer psychosocial health was associated with a lower GPA (-0·21, 0·03, P<0·0001). The indirect effect of food security status on GPA, as mediated by psychosocial health, was significant (-0·05, 0·01, P<0·0001) and accounted for 73 % of the total effect. After accounting for psychosocial health, the direct effect of food security status on GPA was not significant (-0·02, 0·02, P=0·43). Psychosocial health may be an important mechanism through which food insecurity affects academic performance among college and university students. Multicomponent interventions that address immediate food security needs as well as co-occurring mental health and academic concerns are needed to ensure student success.