Upper Valley Educators Institute

Neurosurgery, an intricate and dynamic surgical specialty, faces challenges in attracting medical graduates. Despite its potential appeal, a decreasing trend in medical students opting for surgical specialties, including neurosurgery, is noted. This study aims to assess European medical students' perceptions of neurosurgery, focusing on South-East Europe, and address concerns about the declining interest in this field. A comprehensive digital survey, comprising 33 questions, was distributed to 1115 medical students across 17 European countries. The survey, conducted over 9 months, gathered responses through European neurosurgical societies, the European Association of Neurosurgical Societies (EANS), and university channels. Statistical analysis utilized IBM Statistical Package for the Social Sciences, presenting data through counts, proportions, and χ2 tests. The study reveals that, over the survey period, 834 medical students completed the questionnaire, with a predominant representation from South-East Europe. While 43.2% of participants were considering a surgical career, neurosurgery emerged as the most preferred specialty (26.37%). Despite this interest, 80.2% reported insufficient knowledge about pursuing a neurosurgical career, with limited exposure during medical education. Concerns about work-life balance, heavy workload, and hierarchical structures were prominent among respondents. The findings underscore the need for targeted interventions to address concerns influencing medical students' decisions regarding neurosurgery. Improving neurosurgical education, dispelling misconceptions, and creating a supportive work environment are crucial steps to attract and retain diverse talented individuals in neurosurgery. These efforts will be vital in narrowing the gap between the demand for neurosurgeons and the number of medical graduates entering the field, ensuring a sustainable future for this essential surgical specialty.

Early symptoms of vertebral artery dissection (VAD) may be nonspecific, including neck pain and headache. Neck pain and headache are also common reasons for patients to seek chiropractic care. We hypothesized that neck pain and/or headache would be the most prevalent symptoms among patients with undiagnosed VAD presenting to chiropractors compared to dizziness or other symptoms. We searched PubMed, Ovid, the Index to Chiropractic Literature, Google Scholar, and gray literature through September 2023 for observational studies describing patients aged ≥10 with previously undiagnosed VAD presenting to a chiropractor. Article selection, data extraction, and quality assessment were performed in duplicate. We synthesized the point prevalence of symptoms and other clinical features. We included 10 case reports describing 10 patients (mean age = 37, SD = 7, 60% female). All patients had either neck pain or headache (100%; 95% confidence interval (CI) = 100%-100%). The most prevalent individual symptoms were neck pain (90%; 95% CI = 71%-100%), headache (80%; 95% CI = 55%-100%), visual disturbance (50%; 95% CI = 19%-81%), and dizziness (40%; 95% CI = 10%-70%). The certainty of results was very low due to publication bias. While our findings suggest that neck pain and/or headache are the most prevalent symptoms among patients with undiagnosed VAD visiting a chiropractor, the small sample size and reliance on case reports preclude any definitive conclusions. Further research with larger sample sizes, control groups, and better control of confounders is required to corroborate these results. Chiropractors should be aware of VAD features and refer suspected patients for emergency care.

Abstract This paper combines reflection on my experiences as a public school principal with an analysis of two papers about safety in schools: “School Safety and Violence: Research and Clinical Understandings, Trends and Improvement Strategies” by Jonathan Cohen and “Tipping the Balance: Moving Toward School Safety While Considering Student Needs” by Nancy Rappaport. Cohen and Rappaport offer sound guidance on how to make schools safe—from macro system reforms to more micro, interpersonal interactions. I agree with Cohen's assertion that “learning how to have constructive controversial conversations is an essential foundation for healthy relationships on the one hand and democracy on the other.” Indeed, I believe that safe schools are necessarily democratic schools. And I strongly agree with Rappaport's assertion that we must “make learning deeply personal.” Just as important and true is the assertion conveyed by both Rappaport and Cohen that educators must be attuned to environmental conditions in the society—contemporary and historical—that erode safety in school communities, from systemic racism to pandemics and other threats to the wellbeing of children and families. My critique of both papers, and of many social‐emotional school reform efforts in general, is that there is not enough emphasis on the place where students and teachers spend the majority of their time: the classroom. The teaching and learning that happen in the classroom—both what is taught and how it is taught—are dominant forces in determining whether a school is healthy and safe. Drawing from my own work as a teacher and principal, I describe several essential ingredients for curriculum and pedagogy that enable classrooms to be places of trust, healthy risk‐taking, empathy, democratic practice and, ultimately, safety.

ABSTRACT To address increasing national interest in teacher candidate performance assessments, this multiple case study examined three novice teachers’ assessment literacy practices from their completion of a teacher candidate performance assessment through their first year of teaching. Drawing on the literature on assessment literacy and novice teacher learning, we analyzed multiple data sources including a performance assessment completed at the end of teacher preparation, and interviews and observations over the first year of teaching. Findings suggest that novice teachers’ practice of assessment can be traced back to the performance assessment, particularly in the areas of designing assessments, analyzing assessment data, providing feedback to students, and using assessment information to inform instructional decisions. In some instances, change in assessment practice across time was attributable to specific teacher preparation components, professional support, and personal factors. This study contributes to the limited body of research that explores the relationship of performance assessments completed at the end of teacher preparation and classroom practice during the first year of teaching.

Primary objectives: To assess long-term effects of early traumatic brain injury (TBI) on mental health, cognition, behaviour and adjustment and to identify prognostic factors.Methods and procedures: A 1-year nationwide cohort of all 0–19 year old Icelandic children and adolescents diagnosed with TBI in 1992–1993 (n = 550) received a questionnaire with clinical outcome scales and questions on TBI and socio-economic status (SES) by mail ∼16 years post-injury. A control group (n = 1232), newly selected from the National Registry, received the same questionnaire. Non-respondents answered a shorter version by telephone. Overall participation was 67%.Main outcomes and results: Medically confirmed and self-reported TBI was reflected in worse outcome. Force of impact, number and severity of TBIs predicted poorer results. Parental SES and demographic factors had limited effects. Not reporting early, medically confirmed TBI did not exclude cognitive sequelae. In self-reported disability, absence of evaluation for compensation was not linked to outcome.Conclusions: Clinical outcome was consistent with late complaints attributed to early TBI. TBI-related variables had greater prognostic value than other factors. Self-reporting of TBI sustained very early in life needs supplementary information from parents and medical records. More consistency in compensation evaluations following paediatric TBI is indicated.