Dual mobility versus conventional total hip arthroplasty in femoral neck fractures (DISTINCT): protocol for a registry-nested, open-label, cluster-randomised crossover trial.

INTRODUCTION: Hip fractures treated with total hip arthroplasty (THA) are at high risk of prosthesis instability, and dislocation is the most common indication for revision surgery. This study aims to determine whether dual mobility THA implants reduce the risk of dislocation compared with conventional THA in patients with hip fracture suitable to be treated with THA. METHODS AND ANALYSIS: This is a cluster-randomised, crossover, open-label trial nested within the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR). The clusters will comprise hospitals that perform at least 12 THAs for hip fracture per annum. All adults age ≥50 years who meet the Australian and New Zealand Hip Fracture Registry guidelines for THA will be included. The intervention will be dual mobility THA and the comparator will be conventional THA. Each hospital will be allocated to two consecutive periods, one of dual mobility THA and the other of conventional THA in random order, aiming for an average of 16 patients eligible for the primary analysis per group (32 total per site), allowing different recruitment totals between sites. Data will be collected through the AOANJRR and linked with patient-level discharge data acquired through government agencies. The primary outcome is dislocation within 1 year. Secondary outcomes include revision surgery for dislocation and all-cause, complications and mortality at 1, 2 and 5 years. If dual mobility THA is found to be superior, a cost-effectiveness analysis will be conducted. The study will aim to recruit 1536 patients from at least 48 hospitals over 3 years. ETHICS AND DISSEMINATION: Ethics approval has been granted (Sydney Local Health District - Royal Prince Alfred Hospital Zone (approval X20-0162 and 2020/ETH00680) and site-specific approvals). Participant recruitment is via an opt-out consent process as both treatments are considered accepted, standard practice. The trial is endorsed by the Australia and New Zealand Musculoskeletal Clinical Trials Network. TRIAL REGISTRATION NUMBER: ACTRN12621000069853.

Prostate cancer survival in South West Victoria.

OBJECTIVE: To explore reasons for survival disparities for patients with prostate cancer in the Barwon South West area of Victoria. DESIGN, SETTING AND PARTICIPANTS: We have described incidence, diagnostics, treatment pathways, and survival for four regions of the Barwon South Western Victoria. Analysis included all newly diagnosed prostate cancer patients from 2009 to 2015 in the Evaluation of Cancer Outcomes Barwon South West Registry. Regions included 1: Queenscliffe 2: Geelong, Colac Otway and Corangamite 3: Moyne, Warrnambool and Southern Grampians and 4: Glenelg. Across the four regions, variables were compared using a chi square statistic or analysis of variance and survival data was assessed with the Kaplan-Meier curves. MAIN OUTCOME MEASURES: Incidence, treatment pathways and survival for prostate cancer patients. RESULTS: A total of 1776 patients were diagnosed with prostate cancer from 2009 to 2015 in the Barwon South West area. In regions 1-4, there were 298 (1.04%), 1085 (0.92%), 273 (0.97%) and 120 (1.2%) cases, respectively. There was no significant difference in Gleason score and treatment. The 5-year survival rate was 85%, 76%, 71% and 80%, respectively, as compared with the national average of 95%. PSA scores >20 ng/ml at diagnosis, as a surrogate for high-risk disease, occurred in 23%, 29%, 22% and 21%, respectively (p < 0.01). The proportions presenting with stage IV disease were 17%, 26%, 21% and 6%, respectively (p = 0.10). CONCLUSION: Men diagnosed with prostate cancer in South West Victoria have a considerably lower 5-year survival compared with the national average with later disease at presentation in some areas.

Advancing advocacy: Lessons learned from advocates in school psychology.

Although school psychologists are called on a daily basis to advocate for the needs of our nations' schoolchildren, little is known about the factors that contribute to effective school-based advocacy. This study involved face-to-face interviews with 21 award-winning school psychology advocates. They described what led them into advocacy, obstacles faced, successes experienced, mistakes made, strategies used, resources employed, skills needed, and changes observed. The advocates discussed their definitions of advocacy, how they find balance, their advice for newcomers, and how they empower others. Following a qualitative content analysis, their collective input yielded important findings, including indispensable advice for future advocates. Most suggested that beginners' build relationships with like-minded collaborators and the targets of their advocacy, devote time to building expertise, and be patient and persistent. Common obstacles included intransigence among school psychology colleagues who were reluctant to change their roles to reflect new developments in the field or who feared participating in advocacy would destabilize their positions. To fully embrace an advocacy role, most advised advocacy education and training for both existing school psychologists and newcomers to the field. Limitations and implications that inform a foundation for advancing advocacy within school psychology are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Advocates in public service settings: Voices from the field.

Numerous conceptual pieces addressing the importance of advocacy within psychology have been published over the last 20 years. Most recently, that chorus of voices has increasingly focused on the needs of historically marginalized populations (Burney et al., 2009; Garrison, DeLeon, & Smedley, 2017; Nadal, 2017). Despite this attention, a dearth of research has explored the experiences of seasoned advocates who work with such populations. The present investigation drew from an interdisciplinary group of award-winning advocates to reveal how they define and conceptualize advocacy; the motivators and barriers they've experienced; and their recommendations about how to support newcomers to advocacy. Through semistructured face-to-face interviews that were content analyzed qualitatively, the 14 advocates describe important lessons about advocacy work. Participants' desires to become an advocate were fueled mostly by personal interests and early formative experiences. They found collaborations and building networks (i.e., building relationships with people on all sides of an issue) to be their chief advocacy strategies, and stressed the importance of interpersonal and communication skills (e.g., taking initiative, making connections with those in power) in their skill repertoire. The main barriers encountered included psychological resistance (i.e., intentional blindness toward hidden populations), funding constraints, and various other negative obstacles. Although most found creating a work-life balance elusive, they were energized by mentoring advocacy newcomers, by successes achieved in legislative/policy/program advances, and by creating systems that provide needed services. They shared wisdom about a host of issues for a new generation of advocates. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Population-based analysis of radiotherapy and chemotherapy treatment in the last month of life within regional Australia.

BACKGROUND: Cancer treatment near end of life is not likely to add meaningful benefit and minimising intervention rates has been promoted as an indicator of quality of care. Population-based analysis of treatment allows comparative analysis of treatment rates and provides insight into patterns of care. AIMS: To report a population-based analysis of both radiotherapy and active systemic therapy (AST) delivery rates along with patterns of treatment within the last 14 and 30 days of life. METHODS: The Evaluation of Cancer Outcomes Registry records clinical information on all newly diagnosed cancer patients for the Barwon South West Region of Victoria, Australia. Diagnosis details, tumour type and stage as well as core treatment details and date of death were extracted for all patients diagnosed from 2009 to 2015 inclusive. RESULTS: A total of 12 760 cases cancers were recorded. The median age of all cases was 68.8, and 53% were male. AST was received by 3699 (29%) of patients and radiotherapy by 3811 (30%). Patient deaths within 14 and 30 days of treatment for AST were 4.3 and 8.7%, respectively, and deaths within 14 and 30 days of treatment for radiotherapy 3.8 and 8.0% respectively. Factors associated with death within 30 days of AST and/or radiotherapy were male gender, age greater than 70 years and higher disease stage (all P < 0.01). Treatment rates within 30 days of death were highest for lung cancer (23% of cases) and lowest for breast cancer (2% of cases). CONCLUSIONS: This population-based analysis of AST and radiotherapy treatment within the last 30 days of life within a region of Australia has shown overall treatment rates below 10%. Treatment rates appear influenced by both patient and tumour characteristics. Future focus on subgroups with high rates of late intervention may help minimise treatment unlikely to add benefit.

Use of clinical quality indicators to improve lung cancer care in a regional/rural network of health services.

PROBLEM: Optimal lung cancer care requires multidisciplinary team input, with access to specialised diagnostic and therapeutic services that may be limited in rural or regional areas and impact clinical outcomes. Clinical quality indicators can be used to measure the quality of care delivered to patients with lung cancer in a region and identify areas for improvement. We describe the implementation of internationally recognised clinical quality indicators for lung cancer care in the Barwon South Western region. DESIGN: The consensus of an expert panel was used for the selection of clinical quality indicators. The data were retrospectively collected from the Evaluation of Cancer Outcomes Barwon South West Registry, which systematically records detailed information on all new patients with cancer in the region. SETTING: Region-based health service. KEY MEASURES FOR IMPROVEMENT: Adherence to clinical quality indicator targets. STRATEGIES FOR CHANGE: Clinical quality indicators, which fall short of the expected targets, highlight areas for improvement in the service provided to patients with lung cancer. These results have prompted changes in the service offered to these patients, such as the introduction of a multidisciplinary lung cancer clinic. EFFECTS OF CHANGE: The multidisciplinary lung cancer clinic has streamlined the access to lung cancer services, including specialist consultations, diagnostics and therapeutic services, in a regional setting. Ongoing data collection is required to determine the effect of such changes on adherence to clinical quality indicator targets. LESSONS LEARNT: The regular monitoring of clinical quality indicators serves as a useful method of quality assurance in the care of patients with lung cancer. We expect these clinical quality indicators to also be used by other health services to analyse and improve services provided to patients with lung cancer.

Developing clinical ethics support for an Australian Health Service: A survey of clinician's experiences and views.

BACKGROUND: International developments suggest that providing clinical ethics services to help clinicians negotiate ethical issues that arise in clinical practice is beneficial and reflects best practice in promoting high ethical standards and patient-centered care. The aim of this study was to explore the needs and experiences of clinical staff members to inform the development of future clinical ethics support. METHODS: Health professionals at a large regional health service completed an online survey containing questions about the frequency of ethical and legal issues encountered in clinical practice, the type of situations that gave rise to the ethical and/or legal uncertainty or concern, how clinicians currently address these issues, and what support would be welcome. RESULTS: The survey was completed by 369 staff members, including 61% with more than 10 years in the profession and 51% in nursing/midwifery. Two-thirds (66%) indicated they often considered ethical implications of their clinical decisions, and half (49%) often considered the legal implications. More than half (58%) were often/occasionally concerned about the ethically right thing to do. Patient requests for borderline treatment (47%), staff disagreements about patient care (48%), and patients declining recommended treatment (54%) were the most frequent reasons given for ethical or legal uncertainty. Sixty-nine percent of respondents indicated that the way their department addressed ethical issues could be improved and 85% agreed that there is a need for more discussion on ethical issues. The majority (82%) of respondents had encountered ethically challenging clinical situations where additional support would have helped. Common approaches to issues were discussion with colleagues/supervisor (91.1%), discussion at handover/group forums (50.8%), and consultation with guidelines/protocols (60.9%). CONCLUSIONS: A majority of clinical staff members surveyed have encountered ethically/legally challenging cases daily for which they have often sought additional advice. This study indicates that many clinical staff members would welcome some form of additional clinical ethics support including advice and education.

Oral health of adolescents in the Colac-Otway Shire.

OBJECTIVE: Altruistically, the developmental stage of adolescence poses a unique time frame to instil positive oral health behaviours. Caries are commonly associated with lower socioeconomic populations and regional or rural regions and are often prevalent in adolescents. This research project assessed the patterns of oral health and oral health behaviours of adolescents and investigated any potentially changeable behaviours or ways in which health services might support improvement in their oral health. DESIGN, SETTING AND PARTICIPANTS: Adolescents aged 11-17 years were recruited from four secondary schools in the Colac-Otway Shire (n = 143). Students were screened for dental decay and the condition of tooth surfaces was recorded. Completion of a dental anxiety screening survey and a World Health Organization oral health behaviours survey was undertaken. MAIN OUTCOME MEASURE: Early carious lesions and advanced decay. RESULTS: Early carious lesions were found in 86 (60%) of students and more advanced decay in 39 (28%). Dental decay was associated with consuming sweets and soft drinks, irregular dental check-ups and students whose mother's highest education level was primary school. Consuming fruit was protective against decay. CONCLUSION: This study identified that adolescents were experiencing high percentage of decay and not regularly visiting the dentist for dental screening. Programs that take the oral health therapists to regional and rural areas and lower socioeconomic areas might be warranted to target secondary schools.

Effectiveness of collaboration between emergency department and intensive care unit teams on mortality rates of patients presenting with critical illness: a systematic review.

BACKGROUND: The increasing volume of adult patients with critical illness entering emergency departments (EDs) burdens the resources of EDs worldwide. This subpopulation faces a high risk of mortality because they require specialized care which many EDs are not yet poised to deliver. An element crucial to delivering care and decreasing the mortality of critically ill patients in the ED is expert collaborative practice across disciplines. Several ED and intensive care unit (ICU) collaborative models exist including: emergency department intensive care units (EDICU) and medical emergency teams (MET). OBJECTIVES: To evaluate the effectiveness of collaboration between the ED and ICUs on the mortality rates of critically ill adult ED patients. INCLUSION CRITERIA TYPES OF PARTICIPANTS: Adult ED patients, 18 years and over, with non-surgical critical illness meeting the criteria for ICU admission. TYPES OF INTERVENTION(S): Collaboration between the ED and ICU in the management of critically ill patients in the ED. TYPES OF STUDIES: Observational and descriptive studies. TYPE OF OUTCOME: All-cause mortality, including 30-day mortality and in-hospital mortality rates at any time period. SEARCH STRATEGY: The comprehensive literature search included published and unpublished studies in English from the beginning of each database through November 30, 2016. Databases searched included: PubMed, CINAHL, Embase and Cochrane Central Register of Controlled Trials (CENTRAL). A search for gray literature and electronic hand searching of relevant journals was also performed. METHODOLOGICAL QUALITY: Studies were assessed for methodological quality by four independent reviewers using standardized appraisal tools from the Joanna Briggs Institute (JBI). DATA EXTRACTION: Data related to the methods, participants, interventions and findings were extracted using a standardized data extraction tool from JBI. DATA SYNTHESIS: Statistical pooling into a meta-analysis was not possible due to the clinical and methodological heterogeneity in the interventions and outcome measures of the included studies. Results are presented in a narrative form. RESULTS: Three collaborative models (EDICU, Direct Provider-Provider Collaboration and MET) were identified across five studies. Findings from these studies showed conflicting results. The reviewers were unable to synthesize the evidence to state conclusively the effectiveness of collaborative models on mortality rates of critically ill patients. CONCLUSIONS: There is limited and conflicting evidence related to the effectiveness of EDICU collaborative models on the mortality rates of critically ill patients preventing the development of practice recommendations. This review underscores the need for more research into the benefits of collaborative models between the ED and ICU.

Locating advance care planning facilitators in general practice increases consumer participation.

BACKGROUND: Advance care planning (ACP) can positively affect end-of-life care experiences. However, uptake of ACP completion is low. The aim of this study was to investigate whether co-locating ACP facilitators in general practice increased participation METHODS: Barwon Health commenced promoting its ACP program in 2008. Trained ACP facilitators assisted consumers, which usually occurred in the program's community-based consulting rooms. From 2012 onwards, ACP facilitators were co-located with 18 general practices, where they assisted consumers at the point of care. RESULTS: Referrals to the program increased from 2008-11 (n = 2520) to 2012-15 (n = 6847). Between 2012 and 2015, 48% of referrals to the program were from the 18 general practices with co-located ACP facilitators, and 93% of these referrals resulted in ACPs completed, compared with 74% from practices without co-located facilitators and 55% from all other sources (P DISCUSSION: Co-locating ACP facilitators in general practice increased the number of referrals to the program and produced higher plan completion rates.

Expanding RN Scope of Knowledge-Genetics/Genomics: The New Frontier.

Introducing a new competency into nursing practice requires the support of nursing leadership. A knowledge survey was used to assess nurses' knowledge following a yearlong genomics education initiative. Findings indicate that nurses benefit from repeated exposure to genetics-related content. Recommendations from this study include development and implementation of strategies that can be used to prepare nurses at all levels for the application of genetics and genomics. Clinical nurses with knowledge of genetics will be able to implement evidence-based interventions to manage acute and chronic illnesses. These nurses will then be able to engage patients more fully, thereby helping them to understand the relationship of genetics to healthy outcomes.

Effectiveness of collaboration between emergency department and intensive care unit teams on mortality rates of patients presenting with critical illness: a quantitative systematic review protocol.

REVIEW OBJECTIVE: The objective of this review is to identify the effectiveness of collaboration between emergency department (ED) and intensive care unit teams on mortality rates of critically ill adult patients in the ED.

Cancer diagnosed in the Emergency Department of a Regional Health Service.

OBJECTIVE: Patients diagnosed with cancer in the Emergency Department (ED) have more advanced disease at diagnosis and poorer outcomes. High rates of initial presentation to ED suggest potential problems with access to care. The aim of this project was to interpret findings in regional/rural Victoria and explore implications for practice. DESIGN: Cross-sectional study linking two independent data sets. SETTING: Regional city of Geelong and surrounding rural areas in south-west Victoria. PARTICIPANTS: All newly diagnosed cancer patients in 2009. MAIN OUTCOME MEASURES: Number of cancer patients diagnosed in the ED. RESULTS: One in five newly diagnosed cancer patients present to ED 6 months prior to cancer diagnosis. One in 10 is diagnosed as a result of their ED visit. Patients presenting to ED were older, more often men and from disadvantaged areas. Symptoms on presentation included chest complaints, bowel obstruction, abdominal pain, anaemia and generalised weakness. Cancer diagnosed in the ED is associated with advanced stage and shorter survival. CONCLUSION: Reasons for presentation to ED would be multifactorial and include complex cases with coexisting symptoms making diagnosis difficult. The general public appear to have a low level of awareness of alternative primary care services or difficulty accessing such information. Some of the changes towards reducing the number of patients presenting to ED will include patient education.

The impact of dose on naming accuracy with persons with aphasia.

BACKGROUND: Although aphasia rehabilitation has been shown to be efficacious, many questions remain regarding how best to deliver treatment to maximize functional gains for persons with aphasia. Treatment delivery variables, such as intensity and dosage, are likely to influence both behavioral and structural changes during anomia treatment. While numerous protocols have concluded that treatment intensity positively impacts functional outcomes, few studies to date have examined the role that dose plays in patient outcomes for anomia treatment. AIMS: This study sought to investigate how manipulating dose of repeated confrontation naming within sessions influences naming in persons with aphasia. Repeated practice of confrontation naming, without feedback, was hypothesized to improve trained but not untrained words, to be persistent after withdrawal, and to be sensitive to the number of trials (i.e., dose) within sessions. METHODS AND PROCEDURES: A single-subject ABA design with replication across seven participants with aphasia was used to investigate the influence of repeated confrontation naming attempts on the acquisition and maintenance of trained pictures relative to untrained pictures. Training involved repeated attempts to name pictures, along with repeated exposure to pictures of objects (nouns) and their names, without feedback. The primary independent variable was within session dose; the dependent variable was naming accuracy. OUTCOMES AND RESULTS: Naming accuracy improved for all participants for trained pictures across both acquisition and maintenance phases per visual inspection; such positive effects were not observed for untrained pictures. Effect size calculations indicate that three of seven participants demonstrated considerable change for trained items, while one of seven participants demonstrated meaningful change for untrained items. The high-dose condition elicited small effect sizes for one participant, and large effect sizes for two of seven participants, while the low-dose condition elicited small and medium effect sizes for two of seven participants. CONCLUSIONS: Participants across a variety of aphasia severity levels responded positively to two doses of repeated confrontation naming practice, without feedback, across phases of this naming protocol. Results are in line with principles of neuroplasticity and demonstrate that repeated practice, without feedback, can produce significant and persistent changes in naming ability for some persons with aphasia.

Early support visits by district nurses to cancer patients at home: a multi-perspective qualitative study.

BACKGROUND: Many palliative cancer patients spend much of their last year at home. In the UK, district nurses make frequent support visits to patients and carers at this time, yet surprisingly little is known about their supportive role in palliative care. Current studies are limited to district nurses' reports of practice, which offer limited insight into their content. Patients' and carers' views on district nurse support visits are largely unknown. AIM: To present findings of a multi-perspective study that explored how district nurse early support visits are both described and carried out. DESIGN: Focus groups with district nurses to explore views on the purpose of early support visits. Observation of support visits to identify how they are conducted. Patient and carer interviews to elucidate and verify district nurse data. SETTING AND PARTICIPANTS: Participants included 58 district nurses, 10 palliative care patients and nine carers from four Primary Care Trusts in contrasting urban and rural locations. RESULTS: District nurses had difficulty articulating early support visits. Observations however revealed a complex role comprising extensive physical and practical assessments, practical interventions, information giving, liaison, facilitation and referral. Patients and carers confirmed that they felt valued, reassured and supported by district nurses. CONCLUSIONS: A multi-perspective approach provided new insights into district nurse support visits. Monitoring work described appears to have additional psycho-social benefits for patients and carers. The supportive role of district nurses needs to be clearly articulated and recognised so that colleagues, patients and carers access this valuable resource for palliative care patients.

Symptom experience and regaining normality in the first year following a diagnosis of head and neck cancer: a qualitative longitudinal study.

INTRODUCTION: Symptom experiences and their interference with life are not well-researched in head and neck cancer patients. The aim of the study was to explore and understand the experience of receiving treatment for head and neck cancer with particular focus on symptom experiences over a one year period from diagnosis. METHODS: A qualitative study design was used with a heterogeneous sample of 16 patients with head and neck cancer. Interviews, conducted at four time points over 12 months, provided a total of 50 interview datasets. RESULTS: Key themes derived include nutritional concerns, tiredness, and experiences related to the radiotherapy mask and regaining normality. These data highlight issues of importance in the first year of living with head and neck cancer: impact of nutritional changes on the lives of patients, including weight loss, dysphagia, xerostomia and taste changes; debilitation from ongoing fatigue; unpreparedness for and distress from the radiotherapy mask; and attempts to maintain a normal life amidst the interference of symptoms. CONCLUSION: Multitude of symptoms impact the patients' life, particularly nutritional symptoms and fatigue, and interfere with the patients' survivorship and quality of life. The changing nature of symptoms over the first year from diagnosis in head and neck cancer patients and the identified issues in the attempt to normalize their lives need to be incorporated more fully into the supportive care of head and neck cancer patients in order to improve their experience and enhance their survivorship.

Measurement of social participation outcomes in rehabilitation of veterans with traumatic brain injury.

Traumatic brain injury (TBI) is a significant concern in the veteran population, and the Department of Veteran Affairs (VA) has devoted substantial healthcare resources to the rehabilitation of veterans with TBI. Evaluating the outcomes of these rehabilitation activities requires measuring whether they meaningfully improve veterans' lives, especially with regard to community and vocational participation, which are strongly linked to perceived quality of life. In January 2010, the VA Rehabilitation Research and Development Service convened an invitational conference focused on outcome measurement in rehabilitation with a specific focus on veterans' community and vocational participation. This article reports on the working group, addressing the issues of conceptualizing and operationalizing such participation outcome measures for veterans with TBI; we discuss conceptual models of participation, review participation subdomains and their instruments of measurement, and identify current research issues and needs. Two avenues are identified for advancing participation measurement in veterans with TBI. First, we describe suggestions to facilitate the immediate implementation of participation measurement into TBI clinical practice and rehabilitation (cont) research within the VA healthcare system. Second, we describe recommendations for future VA research funding initiatives specific to improving the measurement of participation in veterans with TBI.

Masked priming effects in aphasia: evidence of altered automatic spreading activation.

PURPOSE: Previous research has suggested that impairments of automatic spreading activation may underlie some aphasic language deficits. The current study further investigated the status of automatic spreading activation in individuals with aphasia as compared with typical adults. METHOD: Participants were 21 individuals with aphasia (12 fluent, 9 nonfluent) and 31 typical adults. Reaction time data were collected on a lexical decision task with masked repetition primes, assessed at 11 different interstimulus intervals (ISIs). Masked primes were used to assess automatic spreading activation without the confound of conscious processing. The various ISIs were used to assess the time to onset and duration of priming effects. RESULTS: The control group showed maximal priming in the 200-ms ISI condition, with significant priming at a range of ISIs surrounding that peak. Participants with both fluent and nonfluent aphasia showed maximal priming effects in the 250-ms ISI condition and primed across a smaller range of ISIs than did the control group. CONCLUSIONS: Results suggest that individuals with aphasia have slowed automatic spreading activation and impaired maintenance of activation over time, regardless of fluency classification. These findings have implications for understanding aphasic language impairment and for development of aphasia treatments designed to directly address automatic language processes.

Ethnicity matters for undergraduate majors in challenges, experiences, and perceptions of psychology.

In this investigation of a national sample of undergraduate psychology majors, we directly compare the experiences and perceptions of students of color with those of European Americans. Our aim was to identify factors that might contribute to our discipline's educational pipeline, in which the relative lack of ethnic diversity is a recognized problem. We found that students of color and European American majors are similar in a number of ways but also different in others. Students of color are challenged by less encouragement from and interaction with faculty, perceive a lack of respect, and wish to see more attention to diversity in curriculum, research, faculty, and textbooks. It is not surprising that students of color were significantly less satisfied than European Americans with their studies in psychology.

Experiences and perspectives of African American, Latina/o, Asian American, and European American psychology graduate students: A national study.

A national, Web-based survey of 1,219 African American, Latina/o, Asian American, and European American psychology graduate students revealed both similarities and differences in experiences and perspectives. Mentoring was found to be the strongest predictor of satisfaction across groups. Academic supports and barriers, along with perceptions of diversity within the academic environment, were also important predictors of satisfaction. Students of color perceived less fairness of representation of their ethnic group within psychology than European American students, and a greater linkage between aspects of the graduate school experience and their ethnicity. Limitations of the study and implications for future research and action are discussed.