Young professional dancers find themselves in a demanding environment. GJH within dancers is often seen as aesthetically beneficial and a sign of talent but was found to be potentially disabling. Moreover, high-performing adolescents and young adults (HPAA), in this specific lifespan, might be even more vulnerable to anxiety-related disability. Therefore, we examined the development of the association between the presence of Generalized Joint Hypermobility (GJH) and anxiety within HPAA with a one-year follow-up. In 52.3% of the HPAA, anxiety did not change significantly over time, whereas GJH was present in 28.7%. Fatigue increased significantly in all HPAA at one year follow-up (respectively, females MD (SD) 18(19), p < 0.001 and males MD (SD) 9(19), p < 0.05). A significantly lower odds ratio (ß (95% CI) 0.4 (0.2–0.9); p-value 0.039) for participating in the second assessment was present in HPAA with GJH and anxiety with a 55% dropout rate after one year. This confirms the segregation between GJH combined with anxiety and GJH alone. The fatigue levels of all HPAA increased significantly over time to a serious risk for sick leave and work disability. This study confirms the association between GJH and anxiety but especially emphasizes the disabling role of anxiety. Screening for anxiety is relevant in HPAA with GJH and might influence tailored interventions.
Background: Recent studies suggest that ethnic minority students underperform in standardised assessments commonly used to evaluate their progress. This disparity seems to also hold for postgraduate medical students and GP trainees, and may affect the quality of primary health care, which requires an optimally diverse workforce. Aims: To address the following: 1) to determine to what extent ethnic minority GP trainees are more at risk of being assessed as underperforming than their majority peers; 2) to investigate whether established underperformance appears in specific competence areas; and 3) to explore first and second-generation ethnic minority trainees’ deviations. Design & setting: Quantitative retrospective cohort design in Dutch GP specialty training (start years: 2015–2017). Method: In 2020–2021, the authors evaluated files on assessed underperformance of 1700 GP trainees at seven Dutch GP specialty training institutes after excluding five opt-outs and 165 incomplete datasets (17.4% ethnic minority trainees). Underperformance was defined as the occurrence of the following, which was prompted by the training institute: 1) preliminary dropout; 2) extension of the educational pathway; and/or 3) mandatory coaching pathways. Statistics Netherlands (CBS) anonymised the files and added data about ethnic group. Thereafter, the authors performed logistic regression for potential underperformance analysis and χ2 tests for competence area analysis. Results: Ethnic minority GP trainees were more likely to face underperformance assessments than the majority group (odds ratio [OR] 2.41, 95% confidence interval [CI] = 1.67 to 3.49). Underperformance was not significantly nested in particular competence areas. First-generation ethnic minority trainees seemed more at risk than their second-generation peers. Conclusion: Ethnic minority GP trainees seem more at risk of facing educational barriers than the majority group. Additional qualitative research on underlying factors is essential.
In this PhD thesis, we aimed to improve understanding of the study progression and success of autistic students in higher education by comparing them to students with other disabilities and students without disabilities. We studied their background and enrollment characteristics, whether barriers in progression existed, how and when possible barriers manifested themselves in their student journey, and how institutions should address these issues. We found autistic students to be different from their peers but not worse as expected based on existing findings. We expect we counterbalanced differences because we studied a large data set spanning seven cohorts and performed propensity score weighting. Most characteristics of autistic students at enrollment were similar to those of other students, but they were older and more often male. They more often followed an irregular path to higher education than students without disabilities. They expected to study full time and spend no time on extracurricular activities or paid work. They expected to need more support and were at a higher risk of comorbidity than students with other disabilities. We found no difficulties with participation in preparatory activities. Over the first bachelor year, the grade point averages (GPAs) of autistic students were most similar to the GPAs of students without disabilities. Credit accumulation was generally similar except for one of seven periods, and dropout rates revealed no differences. The number of failed examinations and no-shows among autistic students was higher at the end of the first semester. Regarding progression and degree completion, we showed that most outcomes (GPAs, dropout rates, resits, credits, and degree completion) were similar in all three groups. Autistic students had more no-shows in the second year than their peers, which affected degree completion after three years. Our analysis of student success prediction clarified what factors predicted their success or lack thereof for each year in their bachelor program. For first-year success, study choice issues were the most important predictors (parallel programs and application timing). Issues with participation in pre-education (absence of grades in pre-educational records) and delays at the beginning of autistic students’ studies (reflected in age) were the most influential predictors of second-year success and delays in the second and final year of their bachelor program. Additionally, academic performance (average grades) was the strongest predictor of degree completion within three years. Our research contributes to increasing equality of opportunities and the development of support in higher education in three ways. First, it provides insights into the extent to which higher education serves the equality of autistic students. Second, it clarifies which differences higher education must accommodate to support the success of autistic students during their student journey. Finally, we used the insights into autistic students’ success to develop a stepped, personalized approach to support their diverse needs and talents, which can be applied using existing offerings.
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