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Higher education institutions have evolved into a more stressful environment. Women have been experiencing higher levels of stress than their male counterparts. With higher education adopting to the onset of the pandemic, this brief report studied women’s perceived stress in relation to perceived organizational and supervisory support, and age during times of crisis. In an era of social distancing, quarantines, and lockdowns, the findings suggest that women’s perceived stress is negatively related to age, perceived organizational support, and perceived supervisory support. Society as we once knew it pre-pandemic will never be the same. Higher education is inevitably going to have to manage the aftermath, a new normal that can only be as effective as the employees that help keep the organization running.

The purpose of this investigation was to determine the extent to which testing accommodations are granted for students with disabilities in the dental predoctoral and doctoral settings. The investigator aimed to examine both the types of accommodations granted and estimate the number of students seeking accommodations due to a physical or learning disability. To address the research purpose, surveys were sent to the ADA and to each of the ten independent state and four regional dental licensing boards. During the five-year study period (1998-2003), there were 508 requests for accommodations on the Dental Admission Test (DAT) from 49,211 applicants (1.03 percent), 235 accommodation requests for the National Board Dental Examination, Part I from 54,750 applicants (0.43 percent), and 150 accommodation requests for the National Board Dental Examination, Part II from among 40,412 applicants (0.37 percent). Three of the fourteen U.S. licensing agencies (21.4 percent) kept no records, and eleven (78.6 percent) maintained some records. Unfortunately, a rigorous analysis of the impact that the Americans with Disabilities Act has had on standardized testing in dental education cannot be completed because of a lack of data available from the testing agencies.

Despite the proven efficacy of nephron sparing surgery, patients with hereditary renal cancer remain at risk for tumor recurrence. Management options for recurrent tumors include completion nephrectomy, ablation and repeat partial nephrectomy. We examine the feasibility and outcomes of repeat partial nephrectomy performed on the same renal unit.We retrospectively reviewed the records of 51 attempted repeat partial nephrectomy procedures in 47 patients from 1992 to 2006. Demographic information as well as intraoperative, perioperative and renal functional outcome data were collected. Comparison of preoperative and postoperative renal function was performed using the 2-tailed t test.Major perioperative complications or reoperations occurred in 10 of 51 (19.6%) cases that included 1 perioperative mortality (1.9%). In cases of successful repeat partial nephrectomy there was a statistically significant increase in postoperative serum creatinine (1.35 vs 1.16 mg/dl, p0.05), and a significant decrease in creatinine clearance (84.6 vs 95.3 ml per minute, p = 0.05) and renogram split function (52.3% vs 54.8%, p0.05). Two patients required long-term hemodialysis (3.9%). Of the 51 renal units 10 (19.6%) required subsequent operations for additional local recurrence or de novo tumor formations with a median time to subsequent surgery of 50 months. Of 47 patients 46 are alive at a median followup of 56 months.Repeat partial nephrectomy is technically feasible. Although there is a statistically significant decrease in postoperative renal functional studies, most patients retained sufficient function to avoid hemodialysis. Repeat partial nephrectomy may provide acceptable oncological control despite the anticipated development of locally recurrent or de novo tumors.

Patients with von Hippel-Lindau disease may require repeat partial nephrectomies to avoid the need for renal replacement therapy. We evaluated outcomes in patients who underwent third or fourth partial nephrectomies on the same kidney, which we call salvage partial nephrectomy.We retrospectively reviewed the charts of patients who underwent surgery at the National Cancer Institute from 1999 to 2006. We identified 11 of 13 patients in whom salvage partial nephrectomy was performed. Surgical outcomes were assessed by renal preservation as well as intraoperative and postoperative complications. Functional outcomes were assessed by comparing serum creatinine, 24-hour urine creatinine clearance, and nuclear renal scan before and after salvage partial nephrectomy.All patients were alive and had no radiographic evidence of metastatic disease at a median followup of 25 months (range 3 to 83). Major perioperative complications occurred in 6 of 13 patients (46%) and loss of a renal unit occurred in 3 (23%). None of the patients in whom renal units were preserved required dialysis, although there was an upward trend in serum creatinine and a downward trend in creatinine clearance at postoperative followup (p = 0.07 and 0.08, respectively).Although salvage partial nephrectomy is technically demanding and it has a high complication rate, it allows many patients to avoid dialysis. We believe that this experience can be used as a reference for surgeons and patients when considering the risks and benefits of salvage partial nephrectomy.