Participation in education abroad is frequently considered to be a high-impact educational practice that will contribute to global learning outcomes and psychosocial development. Yet inequities in participation rates and lackluster reentry outcomes remain concerning. Our purpose was to investigate what students perceived to be preparatory for the upcoming study abroad/away programs in which they were enrolled. Consensual qualitative research–modified ( Spangler, Liu, & Hill, 2012 ) was used to analyze 1,199 responses from 458 students (up to three responses per student) regarding what best prepared them for study abroad. Participants were from three institutions with a mean age 20.69 ( SD = 2.70; 72% female). Regarding race/ethnicity, 55% were White/Caucasian, 17% Asian/Asian American, 16% Hispanic/Latin#, and 4% Black/African American; 4% were international students. Responses mapped well onto social cognitive career theory’s (SCCT) model of how basic career interests develop over time ( Lent, 2013 ; Lent, Brown, & Hackett, 1994 ). The correspondence of our results with SCCT provides reciprocal support for (a) the validity of SCCT as a theoretical frame to understand choice behaviors and (b) SCCT’s predictive utility in future investigations of education abroad. Disaggregation of data permitted comparisons of readiness. Previous international travel was the most frequent preparation for White/Caucasian students, previous study abroad was for international students, and moving away from home was most cited for students who withdrew. Further investigation of these differences has implications for (a) disparate access to resources, (b) program selection, and (c) tailoring preparation to maximize student engagement in global learning.
Patients with aortic valve stenosis (AS) and left ventricular (LV) dysfunction may dramatically improve after aortic valve replacement, but operative risk is high. In an earlier study, all patients with low preoperative wall stress and low ejection fraction, or with low aortic valve gradient, died or had persistent heart failure after operation. Because wall stress is difficult to calculate, we reassessed its effect and the effect of other preoperative characteristics on outcome in 66 consecutive catheterization patients with predominant aortic stenosis referred for valve replacement. Despite ejection fraction that was inordinately low compared with afterloading wall stress in nine patients, seven patients improved with surgery. All three patients with ejection fraction less than 20% improved after surgery. Two of three patients with mean aortic valve gradients of less than 30 mm Hg improved. Mortality was 33% in patients with mean gradient less than 30 mm Hg and 19% with mean gradient less than 50 mm Hg. In the 54 patients with calculated aortic valve areas of less than or equal to 0.8 cm2, 1 (2%) had continuing heart failure, while 6 of 12 (50%, P less than .01) patients with aortic valve areas of 0.9-1.2 cm2 had continued symptoms of or died of heart failure. Patients who died or failed to improve after operation were older (71 +/- 9 years) than those who improved (65 +/- 9 years, P = .02). We conclude that wall stress calculations do not predict which patients with aortic stenosis will benefit from aortic valve replacement and that poor left ventricular function and low mean aortic valve gradient do not absolutely preclude operation. On the other hand, low gradient, non-critical valve area, and advanced age are all relative contraindications to aortic valve replacement in aortic stenosis.
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