EEG Beta Power but Not Background Music Predicts the Recall Scores in a Foreign-Vocabulary Learning Task.

PubMed

Küssner, Mats B; de Groot, Annette M B; Hofman, Winni F; Hillen, Marij A

2016-01-01

As tantalizing as the idea that background music beneficially affects foreign vocabulary learning may seem, there is-partly due to a lack of theory-driven research-no consistent evidence to support this notion. We investigated inter-individual differences in the effects of background music on foreign vocabulary learning. Based on Eysenck's theory of personality we predicted that individuals with a high level of cortical arousal should perform worse when learning with background music compared to silence, whereas individuals with a low level of cortical arousal should be unaffected by background music or benefit from it. Participants were tested in a paired-associate learning paradigm consisting of three immediate word recall tasks, as well as a delayed recall task one week later. Baseline cortical arousal assessed with spontaneous EEG measurement in silence prior to the learning rounds was used for the analyses. Results revealed no interaction between cortical arousal and the learning condition (background music vs. silence). Instead, we found an unexpected main effect of cortical arousal in the beta band on recall, indicating that individuals with high beta power learned more vocabulary than those with low beta power. To substantiate this finding we conducted an exact replication of the experiment. Whereas the main effect of cortical arousal was only present in a subsample of participants, a beneficial main effect of background music appeared. A combined analysis of both experiments suggests that beta power predicts the performance in the word recall task, but that there is no effect of background music on foreign vocabulary learning. In light of these findings, we discuss whether searching for effects of background music on foreign vocabulary learning, independent of factors such as inter-individual differences and task complexity, might be a red herring. Importantly, our findings emphasize the need for sufficiently powered research designs and exact replications of theory-driven experiments when investigating effects of background music and inter-individual variation on task performance.

EEG Beta Power but Not Background Music Predicts the Recall Scores in a Foreign-Vocabulary Learning Task

PubMed Central

de Groot, Annette M. B.; Hofman, Winni F.; Hillen, Marij A.

2016-01-01

As tantalizing as the idea that background music beneficially affects foreign vocabulary learning may seem, there is—partly due to a lack of theory-driven research—no consistent evidence to support this notion. We investigated inter-individual differences in the effects of background music on foreign vocabulary learning. Based on Eysenck’s theory of personality we predicted that individuals with a high level of cortical arousal should perform worse when learning with background music compared to silence, whereas individuals with a low level of cortical arousal should be unaffected by background music or benefit from it. Participants were tested in a paired-associate learning paradigm consisting of three immediate word recall tasks, as well as a delayed recall task one week later. Baseline cortical arousal assessed with spontaneous EEG measurement in silence prior to the learning rounds was used for the analyses. Results revealed no interaction between cortical arousal and the learning condition (background music vs. silence). Instead, we found an unexpected main effect of cortical arousal in the beta band on recall, indicating that individuals with high beta power learned more vocabulary than those with low beta power. To substantiate this finding we conducted an exact replication of the experiment. Whereas the main effect of cortical arousal was only present in a subsample of participants, a beneficial main effect of background music appeared. A combined analysis of both experiments suggests that beta power predicts the performance in the word recall task, but that there is no effect of background music on foreign vocabulary learning. In light of these findings, we discuss whether searching for effects of background music on foreign vocabulary learning, independent of factors such as inter-individual differences and task complexity, might be a red herring. Importantly, our findings emphasize the need for sufficiently powered research designs and exact replications of theory-driven experiments when investigating effects of background music and inter-individual variation on task performance. PMID:27537520

Electroencephalographic identifiers of motor adaptation learning

NASA Astrophysics Data System (ADS)

Özdenizci, Ozan; Yalçın, Mustafa; Erdoğan, Ahmetcan; Patoğlu, Volkan; Grosse-Wentrup, Moritz; Çetin, Müjdat

2017-08-01

Objective. Recent brain-computer interface (BCI) assisted stroke rehabilitation protocols tend to focus on sensorimotor activity of the brain. Relying on evidence claiming that a variety of brain rhythms beyond sensorimotor areas are related to the extent of motor deficits, we propose to identify neural correlates of motor learning beyond sensorimotor areas spatially and spectrally for further use in novel BCI-assisted neurorehabilitation settings. Approach. Electroencephalographic (EEG) data were recorded from healthy subjects participating in a physical force-field adaptation task involving reaching movements through a robotic handle. EEG activity recorded during rest prior to the experiment and during pre-trial movement preparation was used as features to predict motor adaptation learning performance across subjects. Main results. Subjects learned to perform straight movements under the force-field at different adaptation rates. Both resting-state and pre-trial EEG features were predictive of individual adaptation rates with relevance of a broad network of beta activity. Beyond sensorimotor regions, a parieto-occipital cortical component observed across subjects was involved strongly in predictions and a fronto-parietal cortical component showed significant decrease in pre-trial beta-powers for users with higher adaptation rates and increase in pre-trial beta-powers for users with lower adaptation rates. Significance. Including sensorimotor areas, a large-scale network of beta activity is presented as predictive of motor learning. Strength of resting-state parieto-occipital beta activity or pre-trial fronto-parietal beta activity can be considered in BCI-assisted stroke rehabilitation protocols with neurofeedback training or volitional control of neural activity for brain-robot interfaces to induce plasticity.

An anxiogenic benzodiazepine receptor ligand induces learned helplessness.

PubMed

Drugan, R C; Maier, S F; Skolnick, P; Paul, S M; Crawley, J N

1985-07-31

Rats treated with the anxiogenic beta-carboline, N-methyl-beta-carboline-3-carboxamide (FG-7142), failed to acquire an escape response 24 h after treatment. Administration of FG-7142 resulted in a behavioral effect equivalent to a session of inescapable tailshock in this paradigm of learned helplessness. Pretreatment of rats with the selective benzodiazepine receptor antagonist Ro15-1788 blocked the development of learned helplessness elicited by FG-7142. These findings suggest that 'anxiety' may be a major factor in the development of learned helplessness.

Beta oscillations reflect supramodal information during perceptual judgment.

PubMed

Haegens, Saskia; Vergara, José; Rossi-Pool, Román; Lemus, Luis; Romo, Ranulfo

2017-12-26

Previous work on perceptual decision making in the sensorimotor system has shown population dynamics in the beta band, corresponding to the encoding of stimulus properties and the final decision outcome. Here, we asked how oscillatory dynamics in the medial premotor cortex (MPC) contribute to supramodal perceptual decision making. We recorded local field potentials (LFPs) and spikes in two monkeys trained to perform a tactile-acoustic frequency discrimination task, including both unimodal and crossmodal conditions. We studied the role of oscillatory activity as a function of stimulus properties (frequency and sensory modality), as well as decision outcome. We found that beta-band power correlated with relevant stimulus properties: there was a significant modulation by stimulus frequency during the working-memory (WM) retention interval, as well as modulation by stimulus modality-the latter was observed only in the case of a purely unimodal task, where modality information was relevant to prepare for the upcoming second stimulus. Furthermore, we found a significant modulation of beta power during the comparison and decision period, which was predictive of decision outcome. Finally, beta-band spike-field coherence (SFC) matched these LFP observations. In conclusion, we demonstrate that beta power in MPC is reflective of stimulus features in a supramodal, context-dependent manner, and additionally reflects the decision outcome. We propose that these beta modulations are a signature of the recruitment of functional neuronal ensembles, which encode task-relevant information.

Elevated circulating IL-1beta and TNF-alpha, and unaltered IL-6 in first-trimester pregnancies complicated by threatened abortion with an adverse outcome.

PubMed

Vitoratos, Nicolaos; Papadias, Constantinos; Economou, Emmanuel; Makrakis, Evangelos; Panoulis, Constantinos; Creatsas, George

2006-01-01

The purpose of the present study was to examine the profile of selected proinflammatory cytokines in maternal serum of first-trimester pregnancies complicated by threatened abortion (TACP) and its relevance to obstetric outcome. Serum levels of Th1-type cytokines interleukin-1beta (IL-1beta), tumor necrosis factor alpha (TNF-alpha), and Th2-type cytokine interleukin 6 (IL-6) were measured, by ELISA, in 22 women with TACP and adverse outcome at admission (group A) and compared with the corresponding levels of 31 gestational age-matched women with TACP and successful outcome at admission (group B1) and discharge (group B2) and 22 gestational age-matched women with first-trimester uncomplicated pregnancy (group C) who served as controls. Mann-Whitney U or Wilcoxon test was applied as appropriate to compare differences between groups. IL-1beta and TNF-alpha were detected with significantly higher levels in group A, compared to all other groups. On the contrary, IL-6 levels were detected with no significant difference among all the other groups studied. It is concluded that in first-trimester TACP with adverse outcome, a distinct immune response, as reflected by elevated maternal IL-1beta, TNF-alpha, and unaltered IL-6 levels, is relevant to a negative obstetric outcome.

Caliber Schools. Caliber: Beta Academy

ERIC Educational Resources Information Center

EDUCAUSE, 2015

2015-01-01

Caliber: Beta Academy is reimagining education as we know it, with the belief that the innovations in its model will allow 100% of its students to graduate ready to attend and succeed in a competitive four-year college and beyond. The academic model of the school features personalized learning plans, blended learning for English and math,…

Alzheimer's Prevention Education: If We Build It, Will They Come? www.AlzU.org.

PubMed

Isaacson, R S; Haynes, N; Seifan, A; Larsen, D; Christiansen, S; Berger, J C; Safdieh, J E; Lunde, A M; Luo, A; Kramps, M; McInnis, M; Ochner, C N

2014-01-01

Internet-based educational interventions may be useful for impacting knowledge and behavioral change. However, in AD prevention, little data exists about which educational tools work best in terms of learning and interest in participating in clinical trials. Primary: Assess effectiveness of interactive webinars vs. written blog-posts on AD prevention learning. Secondary: Evaluate the effect of AD prevention education on interest in participating in clinical trials; Assess usability of, and user perceptions about, an online AD education research platform; Classify target populations (demographics, learning needs, interests). Observational. Online. Men/Women, aged 25+, recruited via facebook.com. Alzheimer's Universe (www.AlzU.org) education research platform. Pre/post-test performance, self-reported Likert-scale ratings, completion rates. Over two-weeks, 4268 visits were generated. 503 signed-up for a user account (11.8% join rate), 196 participated in the lessons (39.0%) and 100 completed all beta-testing steps (19.9%). Users randomized to webinar instruction about AD prevention and the stages of AD demonstrated significant increases (p=0.01) in pre vs. post-testing scores compared to blog-post intervention. Upon joining, 42% were interested in participating in a clinical trial in AD prevention. After completing all beta-test activities, interest increased to 86%. Users were primarily women and the largest category was children of AD patients. 66.3% joined to learn more about AD prevention, 65.3% to learn more about AD treatment. Webinar-based education led to significant improvements in learning about AD prevention and the stages of AD. AlzU.org participation more than doubled interest in AD prevention clinical trial participation. Subjects were quickly and cost-effectively recruited, and highly satisfied with the AD education research platform. Based on these data, we will further refine AlzU.org prior to public launch and aim to study the effectiveness of 25 interactive webinar-based vs. blog-post style lessons on learning and patient outcomes, in a randomized, within-subjects design trial.

Fear conditioning is associated with altered integration of PLC and ERK signaling in the hippocampus.

PubMed

Buckley, Colin T; Caldwell, Kevin K

2004-12-01

The extracellular signal-regulated protein kinases (ERKs) are proline-directed, serine/threonine kinases that regulate a variety of cellular functions, including proliferation, differentiation, and plasticity. In the present report, we provide evidence that ERK2 and phosphatidylinositol-specific phospholipase C (PLC)-beta and -gamma isozymes interact in the rat hippocampal formation. We found that anti-PLC-beta1a, -beta2, -beta4, -gamma1 and -gamma2, but not -beta3, immune complexes isolated from rat hippocampal formation postnuclear fractions contain anti-ERK2 immunoreactivity. Further, we show that PLC catalytic activity is associated with anti-ERK2 immunoprecipitates isolated from the hippocampal formation, and that the amount of enzyme activity is significantly increased following fear-conditioned learning. The observed interactions may be mediated by consensus sequences conforming to an ERK2 docking site, termed a D-domain, that we identified in PLC-beta1a, -beta2, -beta4 -gamma1 and -gamma2. Based on these results, we propose that PLC-beta and PLC-gamma isozymes form signaling complexes with ERK2 in rat brain, and these complexes play critical roles in learning and memory, as well as a variety of other neuronal functions.

Willing to wait: Elevated reward-processing EEG activity associated with a greater preference for larger-but-delayed rewards.

PubMed

Pornpattananangkul, Narun; Nusslock, Robin

2016-10-01

While almost everyone discounts the value of future rewards over immediate rewards, people differ in their so-called delay-discounting. One of the several factors that may explain individual differences in delay-discounting is reward-processing. To study individual-differences in reward-processing, however, one needs to consider the heterogeneity of neural-activity at each reward-processing stage. Here using EEG, we separated reward-related neural activity into distinct reward-anticipation and reward-outcome stages using time-frequency characteristics. Thirty-seven individuals first completed a behavioral delay-discounting task. Then reward-processing EEG activity was assessed using a separate reward-learning task, called a reward time-estimation task. During this EEG task, participants were instructed to estimate time duration and were provided performance feedback on a trial-by-trial basis. Participants received monetary-reward for accurate-performance on Reward trials, but not on No-Reward trials. Reward trials, relative to No-Reward trials, enhanced EEG activity during both reward-anticipation (including, cued-locked delta power during cue-evaluation and pre-feedback alpha suppression during feedback-anticipation) and reward-outcome (including, feedback-locked delta, theta and beta power) stages. Moreover, all of these EEG indices correlated with behavioral performance in the time-estimation task, suggesting their essential roles in learning and adjusting performance to maximize winnings in a reward-learning situation. Importantly, enhanced EEG power during Reward trials, as reflected by stronger 1) pre-feedback alpha suppression, 2) feedback-locked theta and 3) feedback-locked beta, was associated with a greater preference for larger-but-delayed rewards in a separate, behavioral delay-discounting task. Results highlight the association between a stronger preference toward larger-but-delayed rewards and enhanced reward-processing. Moreover, our reward-processing EEG indices detail the specific stages of reward-processing where these associations occur. Copyright © 2016 Elsevier Ltd. All rights reserved.

Chronic aerial exposure to glucorticoids or beta-agonists affects avoidance learning and exploratory motivation in rats.

PubMed

Elías, Pedro C; Sagua, Delia; Alvarez, Edgardo O

2004-02-04

The purpose of the present work was to examine if the conventional asthma treatments in humans (inhalation of glucocorticoids or beta-agonists, administered in a chronic regimen) might affect behavioral processes (learning and exploratory motivation) in rats. Adult male rats were exposed to an atmosphere saturated with either saline, budesonide (a glucocorticoid), or salbutamol (a beta-adrenergic receptor agonist) in a forced ventilation cage, connected to a nebulizer for 5 min twice a day for 15 days at the same hours of the day. Doses of budesonide in the nebulizing solution were 0.116, 1.16, and 11.6mM. Doses of salbutamol in the nebulizing solution were 1.3, 13, and 130 mM. Forty-eight hours after treatment, the different groups were subjected to exploration of an elevated asymmetric plus-maze (APM, model of exploratory motivation), and 24h later to learning of an avoidance response to an ultrasonic tone in a two-compartment cage (model of memory and learning). Results showed that budesonide induces moderate effects on exploratory motivation. In one of the fear-inducing arms (single wall arm), exploration decreased and this effect was not dose dependent. In the cognitive model, glucocorticoids affected slightly the latency to escape but with no interference in memory efficiency. On the other hand, at the lower dose in the APM, salbutamol increased significantly the exploration of both fear-inducing arms (no walls and single wall arms). In the learning model, the beta-agonist induced two opposing effects. The lower dose (1.3mM) facilitated learning and the higher dose (13 mM) inhibited learning instead. In conclusion, results are compatible with the notion that inhaled glucocorticoids or beta-agonists might cross the lung aerial barrier into the blood compartment, exerting effects on learning and motivation functions.

Meta-analysis of studies with bivariate binary outcomes: a marginal beta-binomial model approach

PubMed Central

Chen, Yong; Hong, Chuan; Ning, Yang; Su, Xiao

2018-01-01

When conducting a meta-analysis of studies with bivariate binary outcomes, challenges arise when the within-study correlation and between-study heterogeneity should be taken into account. In this paper, we propose a marginal beta-binomial model for the meta-analysis of studies with binary outcomes. This model is based on the composite likelihood approach, and has several attractive features compared to the existing models such as bivariate generalized linear mixed model (Chu and Cole, 2006) and Sarmanov beta-binomial model (Chen et al., 2012). The advantages of the proposed marginal model include modeling the probabilities in the original scale, not requiring any transformation of probabilities or any link function, having closed-form expression of likelihood function, and no constraints on the correlation parameter. More importantly, since the marginal beta-binomial model is only based on the marginal distributions, it does not suffer from potential misspecification of the joint distribution of bivariate study-specific probabilities. Such misspecification is difficult to detect and can lead to biased inference using currents methods. We compare the performance of the marginal beta-binomial model with the bivariate generalized linear mixed model and the Sarmanov beta-binomial model by simulation studies. Interestingly, the results show that the marginal beta-binomial model performs better than the Sarmanov beta-binomial model, whether or not the true model is Sarmanov beta-binomial, and the marginal beta-binomial model is more robust than the bivariate generalized linear mixed model under model misspecifications. Two meta-analyses of diagnostic accuracy studies and a meta-analysis of case-control studies are conducted for illustration. PMID:26303591

Pregnancy outcomes among women with beta-thalassemia trait.

PubMed

Charoenboon, Chitrakan; Jatavan, Phudit; Traisrisilp, Kuntharee; Tongsong, Theera

2016-04-01

To compare the obstetric outcomes between pregnant women affected by beta-thalassemia trait and normal controls. A retrospective cohort study was conducted on singleton pregnant women complicated by beta-thalassemia trait and normal controls, randomly selected with the controls-to-case ratio of 2:1. All were low-risk pregnancies without underlying medical diseases and fetal anomalies. The pregnancies undergoing invasive prenatal diagnosis were excluded. A total of 597 pregnant women with beta-thalassemia trait and 1194 controls were recruited. Baseline characteristics and maternal outcomes in the two groups were similar, except that hemoglobin levels were slightly lower in the study group. The prevalence of small for gestational age and preterm birth tended to be higher in the study group but not reached the significant levels but the rate of low birth weight was significantly higher in the study group (relative risk 1.25; 95 % CI 1.00-1.57). Additionally, abortion rate was also significantly higher in the study group (relative risk 3.25; 95 % CI 1.35-7.80). Beta-thalassemia trait could minimally, but significantly, increase risk of low birth weight but did not increase rates of maternal adverse outcomes.

Peginterferon beta-1a versus other self-injectable disease-modifying therapies in the treatment of relapsing-remitting multiple sclerosis in Scotland: a cost-effectiveness analysis.

PubMed

Hernandez, Luis; Guo, Shien; Toro-Diaz, Hector; Carroll, Stuart; Syed Farooq, Syed Feisal

2017-03-01

Peginterferon beta-1a 125 mcg administered subcutaneously every 2 weeks, a new disease-modifying therapy (DMT) for relapsing-remitting multiple sclerosis (RRMS), was approved in January 2015 by the Scottish Medicines Consortium. This study assesses long-term clinical and economic outcomes of peginterferon beta-1a compared with other self-injectable DMTs (interferon beta-1a [22 mcg, 30 mcg, and 44 mcg], interferon beta-1b, and glatiramer acetate 20 mg) in the treatment of RRMS, from the National Health Service and Personal Social Services perspective in Scotland. A previously published, validated Markov cohort model was adapted for this analysis. The model estimates changes in patient disability, occurrence of relapses, and other adverse events, and translates them into quality-adjusted life years and costs. Natural history data came from the ADVANCE trial of peginterferon beta-1a, the London Ontario (Canada) database, and a large population-based MS survey in the UK. The comparative efficacy of each DMT vs placebo was obtained from a network meta-analysis. Costs (2015 British Pounds) were obtained from public databases and literature. Clinical and economic outcomes were projected over 30 years and discounted at 3.5% per year. Over 30 years, peginterferon beta-1a was dominant compared with interferon beta-1a (22, 30, and 44 mcg), and interferon beta-1b, and cost-effective compared with glatiramer acetate 20 mg. Results were most sensitive to variations in each DMT's efficacy and acquisition costs. Deterministic and probabilistic sensitivity analyses confirmed the robustness of the results. The impact of improved adherence with peginterferon beta-1a on clinical and economic outcomes and the impact of subsequent DMTs after treatment discontinuation were not considered. Oral and infused DMTs were not included as comparators. Conclusion Long-term treatment with peginterferon beta-1a improves clinical outcomes, while its cost profile makes it either dominant or cost-effective compared with other self-injectable DMTs for the treatment of RRMS in Scotland.

Meta-analysis of studies with bivariate binary outcomes: a marginal beta-binomial model approach.

PubMed

Chen, Yong; Hong, Chuan; Ning, Yang; Su, Xiao

2016-01-15

When conducting a meta-analysis of studies with bivariate binary outcomes, challenges arise when the within-study correlation and between-study heterogeneity should be taken into account. In this paper, we propose a marginal beta-binomial model for the meta-analysis of studies with binary outcomes. This model is based on the composite likelihood approach and has several attractive features compared with the existing models such as bivariate generalized linear mixed model (Chu and Cole, 2006) and Sarmanov beta-binomial model (Chen et al., 2012). The advantages of the proposed marginal model include modeling the probabilities in the original scale, not requiring any transformation of probabilities or any link function, having closed-form expression of likelihood function, and no constraints on the correlation parameter. More importantly, because the marginal beta-binomial model is only based on the marginal distributions, it does not suffer from potential misspecification of the joint distribution of bivariate study-specific probabilities. Such misspecification is difficult to detect and can lead to biased inference using currents methods. We compare the performance of the marginal beta-binomial model with the bivariate generalized linear mixed model and the Sarmanov beta-binomial model by simulation studies. Interestingly, the results show that the marginal beta-binomial model performs better than the Sarmanov beta-binomial model, whether or not the true model is Sarmanov beta-binomial, and the marginal beta-binomial model is more robust than the bivariate generalized linear mixed model under model misspecifications. Two meta-analyses of diagnostic accuracy studies and a meta-analysis of case-control studies are conducted for illustration. Copyright © 2015 John Wiley & Sons, Ltd.

[Predicting the outcome in severe injuries: an analysis of 2069 patients from the trauma register of the German Society of Traumatology (DGU)].

PubMed

Rixen, D; Raum, M; Bouillon, B; Schlosser, L E; Neugebauer, E

2001-03-01

On hospital admission numerous variables are documented from multiple trauma patients. The value of these variables to predict outcome are discussed controversially. The aim was the ability to initially determine the probability of death of multiple trauma patients. Thus, a multivariate probability model was developed based on data obtained from the trauma registry of the Deutsche Gesellschaft für Unfallchirurgie (DGU). On hospital admission the DGU trauma registry collects more than 30 variables prospectively. In the first step of analysis those variables were selected, that were assumed to be clinical predictors for outcome from literature. In a second step a univariate analysis of these variables was performed. For all primary variables with univariate significance in outcome prediction a multivariate logistic regression was performed in the third step and a multivariate prognostic model was developed. 2069 patients from 20 hospitals were prospectively included in the trauma registry from 01.01.1993-31.12.1997 (age 39 +/- 19 years; 70.0% males; ISS 22 +/- 13; 18.6% lethality). From more than 30 initially documented variables, the age, the GCS, the ISS, the base excess (BE) and the prothrombin time were the most important prognostic factors to predict the probability of death (P(death)). The following prognostic model was developed: P(death) = 1/1 + e(-[k + beta 1(age) + beta 2(GCS) + beta 3(ISS) + beta 4(BE) + beta 5(prothrombin time)]) where: k = -0.1551, beta 1 = 0.0438 with p < 0.0001, beta 2 = -0.2067 with p < 0.0001, beta 3 = 0.0252 with p = 0.0071, beta 4 = -0.0840 with p < 0.0001 and beta 5 = -0.0359 with p < 0.0001. Each of the five variables contributed significantly to the multifactorial model. These data show that the age, GCS, ISS, base excess and prothrombin time are potentially important predictors to initially identify multiple trauma patients with a high risk of lethality. With the base excess and prothrombin time value, as only variables of this multifactorial model that can be therapeutically influenced, it might be possible to better guide early and aggressive therapy.

Learning curves of theta/beta neurofeedback in children with ADHD.

PubMed

Janssen, Tieme W P; Bink, Marleen; Weeda, Wouter D; Geladé, Katleen; van Mourik, Rosa; Maras, Athanasios; Oosterlaan, Jaap

2017-05-01

Neurofeedback is widely applied as non-pharmacological intervention aimed at reducing symptoms of ADHD, even though efficacy has not been unequivocally established. Neuronal changes during the neurofeedback intervention that resemble learning can provide crucial evidence for the feasibility and specificity of this intervention. A total of 38 children (aged between 7 and 13 years) with a DSM-IV-TR diagnosis of ADHD, completed on average 29 sessions of theta (4-8 Hz)/beta (13-20 Hz) neurofeedback training. Dependent variables included training-related measures as well as theta and beta power during baseline and training runs for each session. Learning effects were analyzed both within and between sessions. To further specify findings, individual learning curves were explored and correlated with behavioral changes in ADHD symptoms. Over the course of the training, there was a linear increase in participants' mean training level, highest obtained training level and the number of earned credits (range b = 0.059, -0.750, p < 0.001). Theta remained unchanged over the course of the training, while beta activity increased linearly within training sessions (b = 0.004, 95% CI = [0.0013-0.0067], p = 0.005) and over the course of the intervention (b = 0.0052, 95% CI = [0.0039-0.0065], p < 0.001). In contrast to the group analyses, significant individual learning curves were found for both theta and beta over the course of the intervention in 39 and 53%, respectively. Individual learning curves were not significantly correlated with behavioral changes. This study shows that children with ADHD can gain control over EEG states during neurofeedback, although a lack of behavioral correlates may indicate insufficient transfer to daily functioning, or to confounding reinforcement of electromyographic activity. This trial is registered at the US National Institutes of Health (ClinicalTrials.gov, ref. no: NCT01363544); https://clinicaltrials.gov/show/NCT01363544 .

They just don't get enough! Variable intern experience in bedside procedural skills.

PubMed

Boots, R J; Egerton, W; McKeering, H; Winter, H

2009-04-01

Medical school and resident training programmes offer different learning opportunities and outcomes. The aim of the study was to assess medical student and intern experience in common clinical procedures. Interns employed in a metropolitan teaching hospital from 2000 to 2004 completed a survey of experience and confidence in clinical procedures at the beginning and end of their intern year. Attendance at and the contribution to procedural confidence of a voluntary procedural skill-training programme were examined. For the 314 interns, clinical experience before and during internship varied for each procedure and between year cohorts as did training programme attendance (44-84%). Student procedural confidence was predicted by pre-intern experience either on patients or by simulation (beta = 0.17, 95% confidence interval (CI) 0.02-0.21, P = 0.03) and age >30 years on commencing internship (beta = 8.44, 95%CI 3.03-14.06, P = 0.003. Adjusted R(2) = 0.08, P = 0.002). Intern procedural confidence by year's end was predicted by attendance at the training programme (beta = 0.48, 95%CI 0.34-0.62, P < 0.001), intern experience with patient procedures (beta = 0.34, 95%CI 0.21-0.47, P < 0.001) and a clear decision to enter a postgraduate training programme (beta = 0.13, 95%CI 0.04-0.22, P = 0.007, Adjusted R(2) = 0.50, P < 0.001). Interns and students receive variable experience to carry out procedural skills on patients. This makes designing training programmes difficult as training needs vary each year. Both mandatory supervision of key skills and opportunities to supplement limited experience are needed during the intern year to ensure a uniform experience.

The Importance of Comprehensive Cam Correction: Radiographic Parameters Are Predictive of Patient-Reported Outcome Measures at 2 Years After Hip Arthroscopy.

PubMed

Lansdown, Drew A; Kunze, Kyle; Ukwuani, Gift; Waterman, Brian R; Nho, Shane J

2018-06-01

The specific influence of preoperative and postoperative radiographic measurements on patient-reported outcome measures after hip arthroscopy for femoroacetabular impingement (FAI) remains unclear. To investigate the relationship between radiographic measurements and 2-year outcomes after hip arthroscopy for the treatment of FAI. Case series; Level of evidence, 4. A clinical registry of patients undergoing primary hip arthroscopy for FAI between January 1, 2012, and December 31, 2014, was queried. Outcome measures included the Hip Outcome Score (HOS) Activities of Daily Living (ADL), HOS Sport-Specific Subscale (SSS), modified Harris Hip Score (mHHS), and visual analog scale (VAS) for pain and satisfaction. Preoperative and postoperative radiographic measurements were recorded. Univariate analysis was conducted to identify relationships between all radiographic and demographic variables and outcome scores. A multivariate regression analysis, controlling for demographic factors, was used to identify independent associations between radiographic measurements on plain radiographs and patient-reported outcomes. The authors identified 707 patients who underwent primary hip arthroscopic management for FAI who were included for analysis. Two-year outcome surveys were completed for 78% to 84% of patients. The mean age of the patients was 33.2 ± 12.3 years, and 64.4% of the patients (n = 456) were female. The mean anteroposterior (AP) alpha angle decreased by 34.3° ( P < .0001), false profile alpha angle by 25.2° ( P < .0001), Dunn lateral alpha angle by 28.9° ( P < .0001), lateral center edge angle by 2.6° ( P < .0001), and anterior center edge angle by 3.4° ( P < .0001). The HOS-ADL score increased from 65.7 ± 18.7 preoperatively to 85.9 ± 16.7 postoperatively ( P < .0001), HOS-SSS increased from 43.4 ± 23.1 to 72.6 ± 27.2 ( P < .0001), and mHHS increased from 57.7 ± 14.0 to 79.1 ± 17.2 ( P < .0001). With multivariate analysis, independent predictors of the postoperative HOS-ADL score included the preoperative false profile alpha angle (beta = -0.16, P = .028). Independent predictors of HOS-SSS score were preoperative AP alpha angle (beta = -0.33, P = .032) and preoperative false profile alpha angle (beta = -0.28, P = .041). For the postoperative mHHS score, independent predictors included preoperative AP alpha angle (beta = -0.18, P = .046), preoperative false profile alpha angle (beta = -0.20, P = .014), and postoperative false profile alpha angle (beta = -0.48, P = .035). The preoperative AP alpha angle (beta = 0.28, P = .024) was a significant predictor for the postoperative VAS pain score. The preoperative false profile alpha angle (beta = -0.34, P = .040) was a significant predictor for the postoperative VAS satisfaction score. The authors observed that radiographic measurements, specifically the preoperative false profile alpha angle, AP alpha angle, and postoperative false profile alpha angle, are independent predictors of 2-year clinical outcomes. The femoral-side measurements were the strongest independent predictors of outcomes, especially measurements of the anterior and lateral-based CAM lesion.

Soluble donor HLA class I and beta 2m-free heavy chain in serum of lung transplant recipients: steady-state levels and increases in patients with recurrent CMV infection, acute rejection episodes, and poor outcome.

PubMed

DeVito-Haynes, L D; Jankowska-Gan, E; Meyer, K C; Cornwell, R D; Zeevi, A; Griffith, B; Dauber, J; Iacono, A; Burlingham, W J; Love, R B

2000-12-01

We determined the concentration of donor sHLA/beta(2)m and total beta(2)m-free heavy chain (HC) in the serum of lung transplant recipients with ELISA assays. While we were unable to detect specific donor beta(2)m-free HCs due to a lack of available antibodies, we could determine if events that led to an increase in the release of beta(2)m-free HC also led to an increase in the release of donor sHLA/beta(2)m, particularly the 36 kDa, proteolytically cleaved form. We found that lung transplants constituitively release donor sHLA/beta(2)m at ng/ml levels. The levels (both of donor sHLA/beta(2)m and total beta(2)m-free HC) were significantly increased in CMV-sero-negative recipients (but not in CMV-sero-positive recipients) at the onset of post-transplant CMV disease. Acute rejection episodes were also associated with an increased release of donor sHLA/beta(2)m, but not of beta(2)m-free HC. However, in patients with particularly poor outcome (i.e., graft loss within 1 year) there was a significant release of beta(2)m-free HC. Analysis of one such patient showed a predominance of 36 kDa forms of donor-sHLA/beta(2)m. Our data are consistent with the hypothesis that the metalloproteinase that cleaves beta(2)m-free HC is active during uncontrolled CMV infection and acute rejection. However, recall responses to CMV and controlled immune responses to donor may result in little or no activation of sHLA class I release.

A review and comparison of Bayesian and likelihood-based inferences in beta regression and zero-or-one-inflated beta regression.

PubMed

Liu, Fang; Eugenio, Evercita C

2018-04-01

Beta regression is an increasingly popular statistical technique in medical research for modeling of outcomes that assume values in (0, 1), such as proportions and patient reported outcomes. When outcomes take values in the intervals [0,1), (0,1], or [0,1], zero-or-one-inflated beta (zoib) regression can be used. We provide a thorough review on beta regression and zoib regression in the modeling, inferential, and computational aspects via the likelihood-based and Bayesian approaches. We demonstrate the statistical and practical importance of correctly modeling the inflation at zero/one rather than ad hoc replacing them with values close to zero/one via simulation studies; the latter approach can lead to biased estimates and invalid inferences. We show via simulation studies that the likelihood-based approach is computationally faster in general than MCMC algorithms used in the Bayesian inferences, but runs the risk of non-convergence, large biases, and sensitivity to starting values in the optimization algorithm especially with clustered/correlated data, data with sparse inflation at zero and one, and data that warrant regularization of the likelihood. The disadvantages of the regular likelihood-based approach make the Bayesian approach an attractive alternative in these cases. Software packages and tools for fitting beta and zoib regressions in both the likelihood-based and Bayesian frameworks are also reviewed.

Beta Hebbian Learning as a New Method for Exploratory Projection Pursuit.

PubMed

Quintián, Héctor; Corchado, Emilio

2017-09-01

In this research, a novel family of learning rules called Beta Hebbian Learning (BHL) is thoroughly investigated to extract information from high-dimensional datasets by projecting the data onto low-dimensional (typically two dimensional) subspaces, improving the existing exploratory methods by providing a clear representation of data's internal structure. BHL applies a family of learning rules derived from the Probability Density Function (PDF) of the residual based on the beta distribution. This family of rules may be called Hebbian in that all use a simple multiplication of the output of the neural network with some function of the residuals after feedback. The derived learning rules can be linked to an adaptive form of Exploratory Projection Pursuit and with artificial distributions, the networks perform as the theory suggests they should: the use of different learning rules derived from different PDFs allows the identification of "interesting" dimensions (as far from the Gaussian distribution as possible) in high-dimensional datasets. This novel algorithm, BHL, has been tested over seven artificial datasets to study the behavior of BHL parameters, and was later applied successfully over four real datasets, comparing its results, in terms of performance, with other well-known Exploratory and projection models such as Maximum Likelihood Hebbian Learning (MLHL), Locally-Linear Embedding (LLE), Curvilinear Component Analysis (CCA), Isomap and Neural Principal Component Analysis (Neural PCA).

Computerized tomography platform using beta rays

NASA Astrophysics Data System (ADS)

Paetkau, Owen; Parsons, Zachary; Paetkau, Mark

2017-12-01

A computerized tomography (CT) system using a 0.1 μCi Sr-90 beta source, Geiger counter, and low density foam samples was developed. A simple algorithm was used to construct images from the data collected with the beta CT scanner. The beta CT system is analogous to X-ray CT as both types of radiation are sensitive to density variations. This system offers a platform for learning opportunities in an undergraduate laboratory, covering topics such as image reconstruction algorithms, radiation exposure, and the energy dependence of absorption.

Pregnancy outcome in dairy and beef cattle after artificial insemination and treatment with seminal plasma or transforming growth factor beta-1.

PubMed

Odhiambo, J F; Poole, D H; Hughes, L; Dejarnette, J M; Inskeep, E K; Dailey, R A

2009-09-01

Reduced capability of the uterus to support pregnancy in the absence of its interaction with secretions from male accessory glands has been demonstrated in rodents and to some extent in pigs. However, in cattle, the role of postmating inflammatory response on pregnancy success has not been studied. The current study examined the influence of uterine presensitization with seminal antigens at breeding on pregnancy outcome in cows. Lactating beef (n=1090) and dairy (n=800) cows received 0.5 mL seminal plasma (SP), 40 ng recombinant human transforming growth factor-beta1 (rhTGF-beta1), or 0.5 mL bovine serum albumin (BSA), or were left untreated before or at insemination. Semen was deposited into the anterior cervix using a second insemination gun. Pregnancy was diagnosed at 35 to 40 d postinsemination by transrectal ultrasonography or from records of calves born the subsequent calving season. Pregnancy rates in beef cows did not differ among treatments but differed among trials (69.8%, 52.5% vs. 40.3%; P<0.05). In trials where average pregnancy rates were below 50%, treatments with TGF-beta1 but not SP tended (P<0.07) to increase pregnancy rates in beef cows. In dairy cows, SP and TGF-beta1 improved pregnancy outcome by 10 percentage points, but these increments did not achieve statistical significance. In conclusion, this study did not find any conclusive evidence for the effect of TGF-beta1 or seminal plasma on pregnancy outcome in lactating dairy or beef cows but realized marginal improvements when pregnancy rates were below 50% (compromised fertility).

Serum oestradiol and beta-HCG measurements after day 3 or 5 embryo transfers in interpreting pregnancy outcome.

PubMed

Kumbak, Banu; Oral, Engin; Karlikaya, Guvenc; Lacin, Selman; Kahraman, Semra

2006-10-01

The aim of this study was to assess the clinical value of serum oestradiol concentration 8 days after embryo transfer (D8E2) and beta-human chorionic gonadotrophin (HCG-beta) concentration 12 days after embryo transfer (D12HCG-beta) in the prediction of pregnancy and the outcome of pregnancy following assisted reproduction, taking into account the day of transfer, which was either day 3 (D3) or day 5 (D5). The objective was to improve patient counselling by giving quantitative and reliable predictive information instead of non-specific uncertainties. A total of 2035 embryo transfer cycles performed between January 2003 and June 2005 were analysed retrospectively. Biochemical pregnancy, ectopic pregnancy and first-trimester abortions were classified as non-viable pregnancies; pregnancies beyond 12 weeks gestation were classified as ongoing pregnancies (OP). Significantly higher D8E2 and D12HCG-beta were obtained in D5 transfers compared with D3 transfers with regard to pregnancy and OP (P

Effects of problem-based learning by learning style in medical education.

PubMed

Chae, Su-Jin

2012-12-01

Although problem-based learning (PBL) has been popularized in many colleges, few studies have analyzed the relationship between individual differences and PBL. The purpose of this study was to analyze the relationship between learning style and the perception on the effects of PBL. Grasha-Riechmann Student Learning Style Scales was used to assess the learning styles of 38 students at Ajou University School of Medicine who were enrolled in a respiratory system course in 2011. The data were analyzed by regression analysis and Spearman correlation analysis. By regression analysis, dependent beta=0.478) and avoidant styles (beta=-0.815) influenced the learner's satisfaction with PBL. By Spearman correlation analysis, there was significant link between independent, dependent, and avoidant styles and the perception of the effect of PBL. There are few significant relationships between learning style and the perception of the effects of PBL. We must determine how to teach students with different learning styles and the factors that influence PBL.

Birth outcomes in a disaster recovery environment: New Orleans women after Katrina

PubMed Central

Harville, Emily W.; Giarratano, Gloria; Savage, Jane; de Mendoza, Veronica Barcelona; Zotkiewicz, TrezMarie

2015-01-01

Objectives To examine how the recovery following Hurricane Katrina affected pregnancy outcomes. Methods 308 New Orleans area pregnant women were interviewed 5-7 years after Hurricane Katrina about their exposure to the disaster (danger, damage, and injury); current disruption; and perceptions of recovery. Birthweight, gestational age, birth length, and head circumference were examined in linear models, and low birthweight (<2500 g) and preterm birth (<37 weeks) in logistic models, with adjustment for confounders. Results Associations were found between experiencing damage during Katrina and birthweight (adjusted beta for high exposure = −158 g) and between injury and gestational age (adjusted beta= −0.5 days). Of the indicators of recovery experience, most consistently associated with worsened birth outcomes was worry that another hurricane would hit the region (adjusted beta for birthweight: −112 g, p=0.08; gestational age: −3.2 days, p=0.02; birth length: −0.65 cm, p=0.06) Conclusions Natural disaster may have long-term effects on pregnancy outcomes. Alternately, women who are most vulnerable to disaster may be also vulnerable to poor pregnancy outcome. PMID:26122255

Birth Outcomes in a Disaster Recovery Environment: New Orleans Women After Katrina.

PubMed

Harville, Emily W; Giarratano, Gloria; Savage, Jane; Barcelona de Mendoza, Veronica; Zotkiewicz, TrezMarie

2015-11-01

To examine how the recovery following Hurricane Katrina affected pregnancy outcomes. 308 New Orleans area pregnant women were interviewed 5-7 years after Hurricane Katrina about their exposure to the disaster (danger, damage, and injury); current disruption; and perceptions of recovery. Birthweight, gestational age, birth length, and head circumference were examined in linear models, and low birthweight (<2500 g) and preterm birth (<37 weeks) in logistic models, with adjustment for confounders. Associations were found between experiencing damage during Katrina and birthweight (adjusted beta for high exposure = -158 g) and between injury and gestational age (adjusted beta = -0.5 days). Of the indicators of recovery experience, most consistently associated with worsened birth outcomes was worry that another hurricane would hit the region (adjusted beta for birthweight: -112 g, p = 0.08; gestational age: -3.2 days, p = 0.02; birth length: -0.65 cm, p = 0.06). Natural disaster may have long-term effects on pregnancy outcomes. Alternately, women who are most vulnerable to disaster may be also vulnerable to poor pregnancy outcome.

Legionella pneumophila-induced visual learning impairment reversed by anti-interleukin-1 beta.

PubMed

Gibertini, M; Newton, C; Klein, T W; Friedman, H

1995-10-01

Infecting mice with the opportunistic intracellular pathogen Legionella pneumophila markedly inhibited place learning of infected C57BL/6 mice as determined by the Morris water maze test. Mice infected with L. pneumophila evinced much less ability to learn the position of a hidden platform than did normal noninfected mice, which quickly learned the location of the hidden platform and escaped from the cool water of the pool with increasing efficiency. However, infected mice treated with anti-interleukin-1 (anti-IL-1) neutralizing antibody learned the task with about the same efficiency as the controls. When the animals were tested 1 week after learning, control animals remembered the task well and were able to escape with near maximal efficacy. On the other hand, L. pneumophila-infected mice performed as poorly after the 1 week rest as during the training period, indicating that infection blocked learning and not merely performance. Mice infected with L. pneumophila and given the antibody treatment were found to be indistinguishable from controls in that they remembered the task and escaped with good efficiency. Thus, the results of this study suggest that the pro-inflammatory cytokine, IL-1 beta, is involved, at least partly, in the attenuation of spatial navigational learning in mice infected acutely with a sublethal concentration of L. pneumophila. These results, therefore, suggest that cognitive impairment of L. pneumophila-infected mice may be related to the cytokine IL-1 beta and, furthermore, that cytokines may be related to learning and memory changes experienced by individuals suffering acute bacterial infections.

Energy-confinement scaling for high-beta plasmas in the W7-AS stellarator.

PubMed

Preuss, R; Dinklage, A; Weller, A

2007-12-14

High-beta energy-confinement data are subjected to comparisons of scaling invariant, first-principles physical models. The models differ in the inclusion of basic equations indicating the nature of transport. The result for high-beta data of the W7-AS stellarator is that global transport is described best with a collisional high-beta model, which is different from previous outcomes for low-beta data. Model predictive calculations indicate the validation of energy-confinement prediction with respect to plasma beta and collisionality nu*. The finding of different transport behaviors in distinct beta regimes is important for the development of fusion energy based on magnetic confinement and for the assessment of different confinement concepts.

Social modulation of associative fear learning by pheromone communication.

PubMed

Bredy, Timothy W; Barad, Mark

2009-01-01

Mice communicate through visual, vocal, and olfactory cues that influence innate, nonassociative behavior. We here report that exposure to a recently fear-conditioned familiar mouse impairs acquisition of conditioned fear and facilitates fear extinction, effects mimicked by both an olfactory chemosignal emitted by a recently fear-conditioned familiar mouse and by the putative stress-related anxiogenic pheromone beta-phenylethylamine (beta-PEA). Together, these findings suggest social modulation of higher-order cognitive processing through pheromone communication and support the concurrent excitor hypothesis of extinction learning.

Imatinib prevents beta cell death in vitro but does not improve islet transplantation outcome

PubMed Central

Griffiths, Lisa A.; Persaud, Shanta J.; Jones, Peter M.; Howell, Simon L.; Welsh, Nils

2016-01-01

Introduction Improving islet transplantation outcome could not only bring benefits to individual patients but also widen the patient pool to which this life-changing treatment is available. Imatinib has previously been shown to protect beta cells from apoptosis in a variety of in vitro and in vivo models. The aim of this study was to investigate whether imatinib could be used to improve islet transplantation outcome. Methods Islets were isolated from C57Bl/6 mice and pre-cultured with imatinib prior to exposure to streptozotocin and cytokines in vitro. Cell viability and glucose-induced insulin secretion were measured. For transplantation experiments, islets were pre-cultured with imatinib for either 72 h or 24 h prior to transplantation into streptozotocin-diabetic C57Bl/6 mice. In one experimental series mice were also administered imatinib after islet transplantation. Results Imatinib partially protected islets from beta cell death in vitro. However, pre-culturing islets in imatinib or administering the drug to the mice in the days following islet transplantation did not improve blood glucose concentrations more than control-cultured islets. Conclusion Although imatinib protected against beta cell death from cytokines and streptozotocin in vitro, it did not significantly improve syngeneic islet transplantation outcome. PMID:26953716

Imatinib prevents beta cell death in vitro but does not improve islet transplantation outcome.

PubMed

King, Aileen J F; Griffiths, Lisa A; Persaud, Shanta J; Jones, Peter M; Howell, Simon L; Welsh, Nils

2016-05-01

Introduction Improving islet transplantation outcome could not only bring benefits to individual patients but also widen the patient pool to which this life-changing treatment is available. Imatinib has previously been shown to protect beta cells from apoptosis in a variety of in vitro and in vivo models. The aim of this study was to investigate whether imatinib could be used to improve islet transplantation outcome. Methods Islets were isolated from C57Bl/6 mice and pre-cultured with imatinib prior to exposure to streptozotocin and cytokines in vitro. Cell viability and glucose-induced insulin secretion were measured. For transplantation experiments, islets were pre-cultured with imatinib for either 72 h or 24 h prior to transplantation into streptozotocin-diabetic C57Bl/6 mice. In one experimental series mice were also administered imatinib after islet transplantation. Results Imatinib partially protected islets from beta cell death in vitro. However, pre-culturing islets in imatinib or administering the drug to the mice in the days following islet transplantation did not improve blood glucose concentrations more than control-cultured islets. Conclusion Although imatinib protected against beta cell death from cytokines and streptozotocin in vitro, it did not significantly improve syngeneic islet transplantation outcome.

Factors associated to clinical learning in nursing students in primary health care: an analytical cross-sectional study

PubMed Central

Serrano-Gallardo, Pilar; Martínez-Marcos, Mercedes; Espejo-Matorrales, Flora; Arakawa, Tiemi; Magnabosco, Gabriela Tavares; Pinto, Ione Carvalho

2016-01-01

ABSTRACT Objective: to identify the students' perception about the quality of clinical placements and asses the influence of the different tutoring processes in clinical learning. Methods: analytical cross-sectional study on second and third year nursing students (n=122) about clinical learning in primary health care. The Clinical Placement Evaluation Tool and a synthetic index of attitudes and skills were computed to give scores to the clinical learning (scale 0-10). Univariate, bivariate and multivariate (multiple linear regression) analyses were performed. Results: the response rate was 91.8%. The most commonly identified tutoring process was "preceptor-professor" (45.2%). The clinical placement was assessed as "optimal" by 55.1%, relationship with team-preceptor was considered good by 80.4% of the cases and the average grade for clinical learning was 7.89. The multiple linear regression model with more explanatory capacity included the variables "Academic year" (beta coefficient = 1.042 for third-year students), "Primary Health Care Area (PHC)" (beta coefficient = 0.308 for Area B) and "Clinical placement perception" (beta coefficient = - 0.204 for a suboptimal perception). Conclusions: timeframe within the academic program, location and clinical placement perception were associated with students' clinical learning. Students' perceptions of setting quality were positive and a good team-preceptor relationship is a matter of relevance. PMID:27627124

Improved survival outcomes with the incidental use of beta-blockers among patients with non-small-cell lung cancer treated with definitive radiation therapy

PubMed Central

Wang, H. M.; Liao, Z. X.; Komaki, R.; Welsh, J. W.; O'Reilly, M. S.; Chang, J. Y.; Zhuang, Y.; Levy, L. B.; Lu, C.; Gomez, D. R.

2013-01-01

Background Preclinical studies have shown that norepinephrine can directly stimulate tumor cell migration and that this effect is mediated by the beta-adrenergic receptor. Patients and methods We retrospectively reviewed 722 patients with non-small-cell lung cancer (NSCLC) who received definitive radiotherapy (RT). A Cox proportional hazard model was utilized to determine the association between beta-blocker intake and locoregional progression-free survival (LRPFS), distant metastasis-free survival (DMFS), disease-free survival (DFS), and overall survival (OS). Results In univariate analysis, patients taking beta-blockers (n = 155) had improved DMFS (P < 0.01), DFS (P < 0.01), and OS (P = 0.01), but not LRPFS (P = 0.33) compared with patients not taking beta-blockers (n = 567). In multivariate analysis, beta-blocker intake was associated with a significantly better DMFS [hazard ratio (HR), 0.67; P = 0.01], DFS (HR, 0.74; P = 0.02), and OS (HR, 0.78; P = 0.02) with adjustment for age, Karnofsky performance score, stage, histology type, concurrent chemotherapy, radiation dose, gross tumor volume, hypertension, chronic obstructive pulmonary disease and the use of aspirin. There was no association of beta-blocker use with LRPFS (HR = 0.91, P = 0.63). Conclusion Beta-blocker use is associated with improved DMFS, DFS, and OS in this large cohort of NSCLC patients. Future prospective trials can validate these retrospective findings and determine whether the length and timing of beta-blocker use influence survival outcomes. PMID:23300016

Fabry disease and enzyme replacement therapy in classic patients with same mutation: different formulations--different outcome?

PubMed

Politei, J; Schenone, A B; Cabrera, G; Heguilen, R; Szlago, M

2016-01-01

We describe the results of the multidisciplinary evaluation in patients with Fabry disease and the same genetic mutation and their outcomes using different approved enzyme replacement therapy (ERT). We measured baseline data and serial results of neuropathic pain assessment and renal, cardiac and cerebrovascular functioning. Pain scale showed improvement in all male cases treated with agalsidasa beta. A mild improvement was detected in agalsidasa alfa-treated patients after 1 year with posterior increase. During the agalsidase beta shortage, two male patients were switched to agalsidasa alfa, after 1 year both cases presented an increase in scale values. Renal evolution showed a tendency toward a decrease in proteinuria in patients using agalsidase beta and worsening with agalsidase alfa. We found improvement in two females using agalsidase beta and no changes in the other cases regarding cardiac functioning. Brain magnetic resonance imaging (MRI) showed increase of white matter lesions in four patients. Improvement and stabilization in neuropathic pain, renal and cardiac functioning and brain MRI were found mainly in patients treated with agalsidase beta. Following the reported recommendations on reintroduction of agalsidase beta after the enzyme shortage, we decided to switch all patients to agalsidase beta. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Influences of deep learning, need for cognition and preparation time on open- and closed-book test performance.

PubMed

Heijne-Penninga, Marjolein; Kuks, Jan B M; Hofman, W H Adriaan; Cohen-Schotanus, Janke

2010-09-01

The ability to master discipline-specific knowledge is one of the competencies medical students must acquire. In this context, 'mastering' means being able to recall and apply knowledge. A way to assess this competency is to use both open- and closed-book tests. Student performance on both tests can be influenced by the way the student processes information. Deep information processing is expected to influence performance positively. The personal preferences of students in relation to how they process information in general (i.e. their level of need for cognition) may also be of importance. In this study, we examined the inter-relatedness of deep learning, need for cognition and preparation time, and scores on open- and closed-book tests. This study was conducted at the University Medical Centre Groningen. Participants were Year 2 students (n = 423). They were asked to complete a questionnaire on deep information processing, a scale for need for cognition on a questionnaire on intellectualism and, additionally, to write down the time they spent on test preparation. We related these measures to the students' scores on two tests, both consisting of open- and closed-book components and used structural equation modelling to analyse the data. Both questionnaires were completed by 239 students (57%). The results showed that need for cognition positively influenced both open- and closed-book test scores (beta-coefficients 0.05 and 0.11, respectively). Furthermore, study outcomes measured by open-book tests predicted closed-book test results better than the other way around (beta-coefficients 0.72 and 0.11, respectively). Students with a high need for cognition performed better on open- as well as closed-book tests. Deep learning did not influence their performance. Adding open-book tests to the regularly used closed-book tests seems to improve the recall of knowledge that has to be known by heart. Need for cognition may provide a valuable addition to existing theories on learning.

Second-trimester maternal serum marker screening: maternal serum alpha-fetoprotein, beta-human chorionic gonadotropin, estriol, and their various combinations as predictors of pregnancy outcome.

PubMed

Yaron, Y; Cherry, M; Kramer, R L; O'Brien, J E; Hallak, M; Johnson, M P; Evans, M I

1999-10-01

We evaluated the value of all 3 common biochemical serum markers, maternal serum alpha-fetoprotein, beta-human chorionic gonadotropin, and unconjugated estriol, and combinations thereof as predictors of pregnancy outcome. A total of 60,040 patients underwent maternal serum screening. All patients had maternal serum alpha-fetoprotein measurements; beta-human chorionic gonadotropin was measured in 45,565 patients, and 24,504 patients had determination of all 3 markers, including unconjugated estriol. The incidences of various pregnancy outcomes were evaluated according to the serum marker levels by using clinically applied cutoff points. In confirmation of previous observations, increased maternal serum alpha-fetoprotein levels (>2.5 multiples of the median) were found to be significantly associated with pregnancy-induced hypertension, miscarriage, preterm delivery, intrauterine growth restriction, intrauterine fetal death, oligohydramnios, and abruptio placentae. Increased beta-human chorionic gonadotropin levels (>2.5 multiples of the median [MoM]) were significantly associated with pregnancy-induced hypertension, miscarriage, preterm delivery, and intrauterine fetal death. Finally, decreased unconjugated estriol levels (<0.5 MoM) were found to be significantly associated with pregnancy-induced hypertension, miscarriage, intrauterine growth restriction, and intrauterine fetal death. As with increased second-trimester maternal serum alpha-fetoprotein levels, increased serum beta-human chorionic gonadotropin and low unconjugated estriol levels are significantly associated with adverse pregnancy outcomes. These are most likely attributed to placental dysfunction. Multiple-marker screening can be used not only for the detection of fetal anomalies and aneu-ploidy but also for detection of high-risk pregnancies.

Experience with beta-blockers in long term management of peripartum cardiomyopathy.

PubMed

Mohsin, Kiren; Akhtar, Naveed

2004-01-01

Peripartum cardiomyopathy (PPCM) is an ominous complication of pregnancy, about which little is known. Although the role of Beta Blockers is well established in heart failure, there is limited data evaluating their use in Peripartum cardiomyopathy. We report the use of Beta-Blockers (metoprolol) in conjunct with standard heart failure therapy in two patients of PPCM with favorable long-term outcome. Our experience, although limited, highlights the significance of use of Beta-Blockers in this rare life threatening condition.

Aging reduces experience-induced sensorimotor plasticity. A magnetoencephalographic study.

PubMed

Mary, Alison; Bourguignon, Mathieu; Wens, Vincent; Op de Beeck, Marc; Leproult, Rachel; De Tiège, Xavier; Peigneux, Philippe

2015-01-01

Modulation of the mu-alpha and mu-beta spontaneous rhythms reflects plastic neural changes within the primary sensorimotor cortex (SM1). Using magnetoencephalography (MEG), we investigated how aging modifies experience-induced plasticity after learning a motor sequence, looking at post- vs. pre-learning changes in the modulation of mu rhythms during the execution of simple hand movements. Fifteen young (18-30 years) and fourteen older (65-75 years) right-handed healthy participants performed auditory-cued key presses using all four left fingers simultaneously (Simple Movement task - SMT) during two separate sessions. Following both SMT sessions, they repeatedly practiced a 5-elements sequential finger-tapping task (FTT). Mu power calculated during SMT was averaged across 18 gradiometers covering the right sensorimotor region and compared before vs. after sequence learning in the alpha (9/10/11Hz) and the beta (18/20/22Hz) bands separately. Source power maps in the mu-alpha and mu-beta bands were localized using Dynamic Statistical Parametric Mapping (dSPM). The FTT sequence was performed faster at retest than at the end of the learning session, indicating an offline boost in performance. Analyses conducted on SMT sessions revealed enhanced rebound after learning in the right SM1, 3000-3500ms after the initiation of movement, in young as compared to older participants. Source reconstruction indicated that mu-beta is located in the precentral gyrus (motor processes) and mu-alpha is located in the postcentral gyrus (somatosensory processes) in both groups. The enhanced post-movement rebound in young subjects potentially reflects post-training plastic changes in SM1. Age-related decreases in post-training modulatory effects suggest reduced experience-dependent plasticity in the aging brain. Copyright © 2014 Elsevier Inc. All rights reserved.

N-Methyl-D-aspartate receptor antagonist MK-801 and radical scavengers protect cholinergic nucleus basalis neurons against beta-amyloid neurotoxicity.

PubMed

Harkany, T; Mulder, J; Sasvári, M; Abrahám, I; Kónya, C; Zarándi, M; Penke, B; Luiten, P G; Nyakas, C

1999-04-01

Previous experimental data indicate the involvement of Ca(2+)-related excitotoxic processes, possibly mediated by N-Methyl-D-Aspartate (NMDA) receptors, in beta-amyloid (beta A) neurotoxicity. On the other hand, other lines of evidence support the view that free radical generation is a critical step in the beta A-induced neurodegenerative cascade. In the present study, therefore, a neuroprotective strategy was applied to explore the contributions of each of these pathways in beta A toxicity. beta A(1-42) was injected into the magnocellular nucleus basalis of rats, while neuroprotection was achieved by either single or combined administration of the NMDA receptor antagonist MK-801 (2.5 mg/kg) and/or a vitamin E and C complex (150 mg/kg). The degree of neurodegeneration was determined by testing the animals in consecutive series of behavioral tasks, including elevated plus maze, passive avoidance learning, small open-field and open-field paradigms, followed by acetylcholinesterase (AChE), choline-acetyltransferase (ChAT), and superoxide dismutase (SOD) biochemistry. beta A injected in the nucleus basalis elicited significant anxiety in the elevated plus maze, derangement of passive avoidance learning, and altered spontaneous behaviors in both open-field tasks. A significant decrease in both AChE and ChAT accompanied by a similar decrement of MnSOD, but not of Cu/ZnSOD provided neurochemical substrates for the behavioral changes. Each of the single drug administrations protected against the neurotoxic events, whereas the combined treatment failed to ameliorate beta A toxicity.

Efficacy of beta-blockade after isolated blunt head injury: does race matter?

PubMed

Bukur, Marko; Mohseni, Shahin; Mosheni, Shahin; Ley, Eric; Salim, Ali; Margulies, Daniel; Talving, Peep; Demetriades, Demetrios; Inaba, Kenji

2012-04-01

Several retrospective clinical studies and recent prospective animal models demonstrate improved outcomes with beta-blocker administration after isolated blunt head injury. However, no investigations to date have examined the influence of race on the potential therapeutic effectiveness of these medications. Our hypothesis was that mortality benefits associated with beta-blocker exposure after isolated blunt head injury varies based on ethnicity. The trauma registry and the surgical intensive care unit (ICU) databases of an academic Level I trauma center were used to identify all patients sustaining blunt head injury requiring ICU admission from July 1998 to December 2009. Patients sustaining major associated extracranial injuries (Abbreviated Injury Scale [AIS] score ≥ 3 in any body region) were excluded. Patient demographics, injury profile, Injury Severity Score, and beta-blocker exposure were abstracted. The primary outcome evaluated was in-hospital mortality stratified by ethnicity. During the 11-year study period, 3,750 patients were admitted to the Los Angeles County + University of Southern California Medical Center trauma ICU because of blunt trauma. Of these, 65% (n = 2,446) had an "isolated" head injury. When stratified by race, most patients were Hispanics (60%), followed by Whites (21%), Asians (11%), and African Americans (8%). After adjusting for confounding variables with multivariate regression, only those of Asian and Hispanic descent demonstrated significantly improved outcomes associated with beta-blocker administration. Our results indicate that beta-blockade after traumatic brain injury may not benefit all races equally. Further prospective research is necessary to assess this discrepancy in treatment benefit and explore other possible therapeutic interventions.

A Meta-Analysis Suggests Different Neural Correlates for Implicit and Explicit Learning.

PubMed

Loonis, Roman F; Brincat, Scott L; Antzoulatos, Evan G; Miller, Earl K

2017-10-11

A meta-analysis of non-human primates performing three different tasks (Object-Match, Category-Match, and Category-Saccade associations) revealed signatures of explicit and implicit learning. Performance improved equally following correct and error trials in the Match (explicit) tasks, but it improved more after correct trials in the Saccade (implicit) task, a signature of explicit versus implicit learning. Likewise, error-related negativity, a marker for error processing, was greater in the Match (explicit) tasks. All tasks showed an increase in alpha/beta (10-30 Hz) synchrony after correct choices. However, only the implicit task showed an increase in theta (3-7 Hz) synchrony after correct choices that decreased with learning. In contrast, in the explicit tasks, alpha/beta synchrony increased with learning and decreased thereafter. Our results suggest that explicit versus implicit learning engages different neural mechanisms that rely on different patterns of oscillatory synchrony. Copyright © 2017 Elsevier Inc. All rights reserved.

Information needs of mothers regarding communicating BRCA1/2 cancer genetic test results to their children.

PubMed

Tercyak, Kenneth P; Peshkin, Beth N; Demarco, Tiffani A; Patenaude, Andrea Farkas; Schneider, Katherine A; Garber, Judy E; Valdimarsdottir, Heiddis B; Schwartz, Marc D

2007-01-01

Mothers who participate in genetic testing for hereditary breast/ovarian cancer risk must decide if, when, and how to ultimately share their BRCA1 and BRCA2 (BRCA1/2) test results with their minor-age children. One of the primary aides for mothers in making this decision is cancer genetic counseling. However, counseling is limited in how well it can educate mothers about such decisions without the availability of resources that are specific to family communication and genetic testing per se. In an effort to fill this gap and identify mothers most likely to benefit from such resources, surveys were conducted with 187 mothers undergoing BRCA1/2 testing who had children 8-21 years old. Data were collected weeks after genetic testing but prior to mothers' learning of their test results; quantitative assessments of informational resource needs (i.e., speaking with previous BRCA1/2 testing participants who are parents regarding their experiences, reading educational literature about options and what to expect, speaking with a family counselor, attending a family support group, and self-nominated other resources), testing motivations, decision making vigilance, and decisional conflict regarding communicating test results to children were included. Mothers' most-to-least frequently cited information resource needs were: literature (93.4%), family counseling (85.8%), prior participants (79.0%), support groups (53.9%), and other (28.9%; e.g., pediatricians and psychologists). Seventy-eight percent of mothers were interested in accessing three or more resources. In multivariate regression analyses, testing motivations (beta = 0.35, p = 0.03), decision-making vigilance (beta = 0.16, p = 0.00), and decisional conflict (beta = 0.10, p = 0.00) were associated with mothers' need level; mothers with a greater interest in testing to learn about their children's risks, those with more vigilant decision-making styles, and those with higher decisional conflict had the greatest need. In conjunction with enhanced genetic counseling focusing on family disclosure, educational literature, and psychosocial support may promote improved outcomes.

Beneficial outcome from EEG-neurofeedback on creative music performance, attention and well-being in school children.

PubMed

Gruzelier, J H; Foks, M; Steffert, T; Chen, M J-L; Ros, T

2014-01-01

We earlier reported benefits for creativity in rehearsed music performance from alpha/theta (A/T) neurofeedback in conservatoire studies (Egner & Gruzelier, 2003) which were not found with SMR, Beta1, mental skills, aerobics or Alexander training, or in standby controls. Here the focus was the impact on novice music performance. A/T and SMR training were compared in 11-year old school children along with non-intervention controls with outcome measures not only of rehearsed music performance but also of creative improvisation, as well as sustained attention and phenomenology. Evidence of effective learning in the school setting was obtained for A/T and SMR/beta2 ratios. Preferential benefits from A/T for rehearsed music performance were replicated in children for technique and communication ratings. Benefits extended to creativity and communication ratings for creative improvisation which were shared with SMR training, disclosing an influence of SMR on unrehearsed music performance at a novice level with its greater cognitive demands. In a first application of A/T for improving sustained attention (TOVA), it was found to be more successful than SMR training, with a notable reduction in commission errors in the children, 15/33 of whom had attention indices in the ADHD range. Phenomenological reports were in favour of neurofeedback and well-being benefits. Implementing neurofeedback in the daily school setting proved feasible and holds pedagogic promise. Copyright © 2013 Elsevier B.V. All rights reserved.

Costs and clinical outcomes of primary prophylaxis of variceal bleeding in patients with hepatic cirrhosis: a decision analytic model.

PubMed

Saab, Sammy; DeRosa, Vincent; Nieto, Jose; Durazo, Francisco; Han, Steven; Roth, Bennett

2003-04-01

Current guidelines recommend upper endoscopic screening for patients with hepatic cirrhosis and primary prophylaxis with a nonselective beta-blocker for those with large varices. However, only 25% of cirrhotics develop large varices. Thus, the aim of this study is to evaluate the most cost-effective approach for primary prophylaxis of variceal hemorrhage. Using a Markov model, we compared the costs and clinical outcomes of three strategies for primary prophylaxis of variceal bleeding. In the first strategy, patients were given a beta-blocker without undergoing upper endoscopy. In the second strategy, patients underwent upper endoscopic screening; those found to have large varices were treated with a beta-blocker. In the third strategy, no prophylaxis was used. Selected sensitivity analyses were performed to validate outcomes. Our results show screening prophylaxis was associated with a cost of $37,300 and 5.72 quality-adjusted life yr (QALYs). Universal prophylaxis was associated with a cost of $34,100 and 6.65 QALYs. The no prophylaxis strategy was associated with a cost of $36,600 and 4.84 QALYs. The incremental cost-effectiveness ratio was $800/QALY for the endoscopic strategy relative to the no prophylaxis strategy. Screening endoscopy was cost saving when the compliance, bleed risk without beta-blocker, and variceal bleed costs were increased, and when the discount rate, bleed risk on beta-blockers, and cost of upper endoscopy were decreased. In contrast, the universal prophylaxis strategy was persistently cost saving relative to the no prophylaxis strategy. In comparing the strategies, sensitivity analysis on the death rates from variceal hemorrhage did not alter outcomes. Our results provide economic and clinical support for primary prophylaxis of esophageal variceal bleeding in patients with hepatic cirrhosis. Universal prophylaxis with beta-blocker is preferred because it is consistently associated with the lowest costs and highest QALYs.

ATOMIC PHYSICS, AN AUTOINSTRUCTIONAL PROGRAM, VOLUME 3, SUPPLEMENT.

ERIC Educational Resources Information Center

DETERLINE, WILLIAM A.; KLAUS, DAVID J.

THE AUTOINSTRUCTIONAL MATERIALS IN THIS TEXT WERE PREPARED FOR USE IN AN EXPERIMENTAL STUDY, OFFERING SELF-TUTORING MATERIAL FOR LEARNING ATOMIC PHYSICS. THE TOPICS COVERED ARE (1) NUCLEAR BINDING ENERGY, (2) DISCOVERY OF RADIOACTIVITY, (3) RADIOACTIVE RADIATIONS, (4) ALPHA AND BETA DECAY, (5) BETA DECAY REACTIONS, (6) RADIOACTIVE DATING AND…

Immediate effects of Alpha/theta and Sensory-Motor Rhythm feedback on music performance.

PubMed

Gruzelier, J H; Hirst, L; Holmes, P; Leach, J

2014-07-01

This is one of a series of investigations comparing two EEG-neurofeedback protocols - Alpha/theta (A/T) and Sensory-Motor Rhythm (SMR) - for performance enhancement in the Arts, here with the focus on music. The original report (Egner and Gruzelier, 2003) established a beneficial outcome for elite conservatoire musicians following A/T training in two investigations. Subsequently this A/T advantage was replicated for both advanced instrumental and novice singing abilities, including improvisation, while SMR training benefited novice performance only (Gruzelier, Holmes et al., 2014). Here we report a replication of the latter study in university instrumentalists who as before were novice singers with one design change - post-training performances were conducted within the tenth final session instead of on a subsequent occasion. As before expert judges rated the domains of Creativity/Musicality, Communication/Presentation and Technique. The proximity to training of the music performances within the last session likely compromised gains from A/T learning, but perhaps reinforced the impact of SMR training efficacy. In support of validation there was evidence of strong within- and across-session A/T learning and positive linear trends for across-session SMR/theta and SMR/beta-2 ratio learning. In support of mediation learning correlated with music performance. The A/T outcome was markedly discrepant from previous studies and should dispel any impression that the hypnogogic state itself is transferred to the performance context. The effects of SMR ratio training are consistent with an impact on lower-order abilities required in novice performance such as sustained attention and memory, and benefiting all three domains of music assessment. Copyright © 2014 Elsevier B.V. All rights reserved.

Matching-adjusted comparisons demonstrate better clinical outcomes with SC peginterferon beta-1a every two weeks than with SC interferon beta-1a three times per week.

PubMed

Coyle, Patricia K; Shang, Shulian; Xiao, Zhen; Dong, Qunming; Castrillo-Viguera, Carmen

2018-05-01

Subcutaneous (SC) peginterferon beta-1a and SC interferon beta-1a (IFN beta-1a) have demonstrated efficacy in treating relapsing-remitting multiple sclerosis (RRMS) but have never been compared in direct head-to-head clinical trials, the gold-standard comparison. A well-balanced matching-adjusted comparison of weighted individual patient data on SC peginterferon beta-1a, and aggregate data from published phase 3 clinical trials of SC IFN beta-1a, was conducted to provide additional information on the comparative efficacy of these two agents. Individual patient data from a study of SC peginterferon beta-1a 125 mcg every two weeks (ADVANCE) and pooled summary data from four published studies of SC IFN beta-1a 44 mcg three times per week (OPERA I and II, CARE-MS I and II) with similar populations were utilized. A comparison was conducted by weighting individual peginterferon beta-1a-treated patients, using estimated propensity of enrolling in SC IFN beta-1a treatment to match multiple key aggregate baseline characteristics of SC IFN beta-1a-treated patients. After matching, weighted annualized relapse rate (ARR), 24-week confirmed disability worsening (CDW), and clinical no evidence of disease activity (clinical-NEDA) were calculated and compared for peginterferon beta-1a and SC IFN beta-1a. After matching, baseline characteristics were well balanced across treatment groups. At 2 years, ARR after matching was 0.256 for patients receiving peginterferon beta-1a (effective n = 376) and 0.335 for those receiving SC IFN beta-1a (n = 1218) (P = 0.0901). The percentage of patients who were relapse free over 2 years was significantly higher with peginterferon beta-1a than with SC IFN beta-1a (75.1% vs. 57.4% [after matching], P < 0.0001). The peginterferon beta-1a treatment group had a significantly lower proportion of patients with 24-week CDW compared with SC IFN beta-1a (after matching 6.5% vs. 13.2%; P = 0.0007). Clinical-NEDA occurred in a significantly higher proportion of patients treated with SC peginterferon beta-1a versus SC IFN beta-1a (74.1% vs. 48.1%; P < 0.0001). This matching-adjusted comparison using data from four phase 3 trials with SC IFN beta-1a formulations demonstrated that patients with RRMS treated with SC peginterferon beta-1a 125 mcg every two weeks achieved better clinical outcomes than patients who received SC IFN beta-1a 44 mcg three times per week. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

Continuous infusion vs. bolus dosing: implications for beta-lactam antibiotics.

PubMed

Mohd Hafiz, Abdul-Aziz; Staatz, C E; Kirkpatrick, C M J; Lipman, J; Roberts, J A

2012-01-01

Beta-lactam antibiotics display time-dependant pharmacodynamics whereby constant antibiotic concentrations rather than high peak concentrations are most likely to result in effective treatment of infections caused by susceptible bacteria. Continuous administration has been suggested as an alternative strategy, to conventional intermittent dosing, to optimise beta-lactam pharmacokinetic/pharmacodynamic (PK/PD) properties. With the availability of emerging data, we elected to systematically investigate the published literature describing the comparative PK/PD and clinical outcomes of beta-lactam antibiotics administered by continuous or intermittent infusion. We found that the studies have been performed in various patient populations including critically ill, cancer and cystic fibrosis patients. Available in vitro PK/PD data conclusively support the administration of beta-lactams via continuous infusion for maximizing bacterial killing from consistent attainment of pharmacodynamic end-points. In addition, clinical outcome data supports equivalence, even with the use of a lower dose by continuous infusion. However, the present clinical data is limited with small sample sizes common with insufficient power to detect advantages in favour of either dosing strategy. With abundant positive pre-clinical data as well as document in vivo PK/PD advantages, large multi-centre trials are needed to describe whether continuous administration of beta-lactams is truly more effective than intermittent dosing.

Gamma and Beta Oscillations Define a Sequence of Neurocognitive Modes Present in Odor Processing

PubMed Central

Frederick, Donald E.; Brown, Austin; Brim, Elizabeth; Mehta, Nisarg; Vujovic, Mark

2016-01-01

Olfactory system beta (15–35 Hz) and gamma (40–110 Hz) oscillations of the local field potential in mammals have both been linked to odor learning and discrimination. Gamma oscillations represent the activity of a local network within the olfactory bulb, and beta oscillations represent engagement of a systemwide network. Here, we test whether beta and gamma oscillations represent different cognitive modes using the different demands of go/no-go and two-alternative choice tasks that previously were suggested to favor beta or gamma oscillations, respectively. We reconcile previous studies and show that both beta and gamma oscillations occur in both tasks, with gamma dominating the early odor sampling period (2–4 sniffs) and beta dominating later. The relative power and coherence of both oscillations depend separately on multiple factors within both tasks without categorical differences across tasks. While the early/gamma-associated period occurs in all trials, rats can perform above chance without the later/beta-associated period. Longer sampling, which includes beta oscillations, is associated with better performance. Gamma followed by beta oscillations therefore represents a sequence of cognitive and neural states during odor discrimination, which can be separately modified depending on the demands of a task and odor discrimination. Additionally, fast (85 Hz) and slow (70 Hz) olfactory bulb gamma oscillation sub-bands have been hypothesized to represent tufted and mitral cell networks, respectively (Manabe and Mori, 2013). We find that fast gamma favors the early and slow gamma the later (beta-dominated) odor-sampling period and that the relative contributions of these oscillations are consistent across tasks. SIGNIFICANCE STATEMENT Olfactory system gamma (40–110 Hz) and beta (15–35 Hz) oscillations of the local field potential indicate different neural firing statistics and functional circuits. We show that gamma and beta oscillations occur in stereotyped sequence during odor sampling in associative tasks, with local gamma dominating the first 250 ms of odor sniffing, followed by systemwide beta as behavioral responses are prepared. Oscillations and coupling strength between brain regions are modulated by task, odor, and learning, showing that task features can dramatically adjust the dynamics of a cortical sensory system, which changes state every ∼250 ms. Understanding cortical circuits, even at the biophysical level, depends on careful use of multiple behavioral contexts and stimuli. PMID:27445151

Gamma and Beta Oscillations Define a Sequence of Neurocognitive Modes Present in Odor Processing.

PubMed

Frederick, Donald E; Brown, Austin; Brim, Elizabeth; Mehta, Nisarg; Vujovic, Mark; Kay, Leslie M

2016-07-20

Olfactory system beta (15-35 Hz) and gamma (40-110 Hz) oscillations of the local field potential in mammals have both been linked to odor learning and discrimination. Gamma oscillations represent the activity of a local network within the olfactory bulb, and beta oscillations represent engagement of a systemwide network. Here, we test whether beta and gamma oscillations represent different cognitive modes using the different demands of go/no-go and two-alternative choice tasks that previously were suggested to favor beta or gamma oscillations, respectively. We reconcile previous studies and show that both beta and gamma oscillations occur in both tasks, with gamma dominating the early odor sampling period (2-4 sniffs) and beta dominating later. The relative power and coherence of both oscillations depend separately on multiple factors within both tasks without categorical differences across tasks. While the early/gamma-associated period occurs in all trials, rats can perform above chance without the later/beta-associated period. Longer sampling, which includes beta oscillations, is associated with better performance. Gamma followed by beta oscillations therefore represents a sequence of cognitive and neural states during odor discrimination, which can be separately modified depending on the demands of a task and odor discrimination. Additionally, fast (85 Hz) and slow (70 Hz) olfactory bulb gamma oscillation sub-bands have been hypothesized to represent tufted and mitral cell networks, respectively (Manabe and Mori, 2013). We find that fast gamma favors the early and slow gamma the later (beta-dominated) odor-sampling period and that the relative contributions of these oscillations are consistent across tasks. Olfactory system gamma (40-110 Hz) and beta (15-35 Hz) oscillations of the local field potential indicate different neural firing statistics and functional circuits. We show that gamma and beta oscillations occur in stereotyped sequence during odor sampling in associative tasks, with local gamma dominating the first 250 ms of odor sniffing, followed by systemwide beta as behavioral responses are prepared. Oscillations and coupling strength between brain regions are modulated by task, odor, and learning, showing that task features can dramatically adjust the dynamics of a cortical sensory system, which changes state every ∼250 ms. Understanding cortical circuits, even at the biophysical level, depends on careful use of multiple behavioral contexts and stimuli. Copyright © 2016 the authors 0270-6474/16/367750-18$15.00/0.

Changes of motor-cortical oscillations associated with motor learning.

PubMed

Pollok, B; Latz, D; Krause, V; Butz, M; Schnitzler, A

2014-09-05

Motor learning results from practice but also between practice sessions. After skill acquisition early consolidation results in less interference with other motor tasks and even improved performance of the newly learned skill. A specific significance of the primary motor cortex (M1) for early consolidation has been suggested. Since synchronized oscillatory activity is assumed to facilitate neuronal plasticity, we here investigate alterations of motor-cortical oscillations by means of event-related desynchronization (ERD) at alpha (8-12 Hz) and beta (13-30 Hz) frequencies in healthy humans. Neuromagnetic activity was recorded using a 306-channel whole-head magnetoencephalography (MEG) system. ERD was investigated in 15 subjects during training on a serial reaction time task and 10 min after initial training. The data were compared with performance during a randomly varying sequence serving as control condition. The data reveal a stepwise decline of alpha-band ERD associated with faster reaction times replicating previous findings. The amount of beta-band suppression was significantly correlated with reduction of reaction times. While changes of alpha power have been related to lower cognitive control after initial skill acquisition, the present data suggest that the amount of beta suppression represents a neurophysiological marker of early cortical reorganization associated with motor learning. Copyright © 2014 IBRO. Published by Elsevier Ltd. All rights reserved.

Heart rate response to post-learning stress predicts memory consolidation.

PubMed

Larra, Mauro F; Schulz, André; Schilling, Thomas M; Ferreira de Sá, Diana S; Best, Daniel; Kozik, Bartlomiej; Schächinger, Hartmut

2014-03-01

Stressful experiences are often well remembered, an effect that has been explained by beta-adrenergic influences on memory consolidation. Here, we studied the impact of stress induced heart rate (HR) responses on memory consolidation in a post-learning stress paradigm. 206 male and female participants saw 52 happy and angry faces immediately before being exposed to the Cold Pressor Test or a non-stressful control procedure. Memory for the faces and their respective expression was tested twice, after 30 min and on the next day. High HR responders (in comparison to low HR responders as well as to the non-stressful control group) showed enhanced recognition memory one day after learning. Our results show that beta-adrenergic activation elicited shortly after learning enhances memory consolidation and that the stress induced HR response is a predictor for this effect. Copyright © 2013 Elsevier Inc. All rights reserved.

The effect of polymorphisms of the beta(2)-adrenergic receptor on the response to regular use of albuterol in asthma.

PubMed

Israel, E; Drazen, J M; Liggett, S B; Boushey, H A; Cherniack, R M; Chinchilli, V M; Cooper, D M; Fahy, J V; Fish, J E; Ford, J G; Kraft, M; Kunselman, S; Lazarus, S C; Lemanske, R F; Martin, R J; McLean, D E; Peters, S P; Silverman, E K; Sorkness, C A; Szefler, S J; Weiss, S T; Yandava, C N

2000-07-01

Inhaled beta-adrenergic agonists are the most commonly used medications for the treatment of asthma although there is evidence that regular use may produce adverse effects in some patients. Polymorphisms of the beta(2)-adrenergic receptor (beta(2)-AR) can affect regulation of the receptor. Smaller studies examining the effects of such polymorphisms on the response to beta-agonist therapy have produced inconsistent results. We examined whether polymorphisms at codon 16 (beta(2)-AR-16) and codon 27 (beta(2)-AR-27) of the beta(2)-AR might affect the response to regular versus as-needed use of albuterol by genotyping the 190 asthmatics who had participated in a trial examining the effects of regular versus as needed albuterol use. During the 16-wk treatment period there was a small decline in morning peak expiratory flow in patients homozygous for arginine at B(2)-AR-16 (Arg/Arg) who used albuterol regularly. This effect was magnified during a 4-wk run out period, during which all patients returned to using as-needed albuterol, so that by the end of the study Arg Arg patients who had regularly used albuterol had a morning peak expiratory flow 30. 5 +/- 12.1 L/min lower (p = 0.012) than Arg/Arg patients who had used albuterol on an as needed basis. There was no decline in peak flow with regular use of albuterol in patients who were homozygous for glycine at beta(2)-AR-16. Evening peak expiratory flow also declined in the Arg/Arg patients who used albuterol regularly but not in those who used albuterol on an as-needed basis. No significant differences in outcomes between regular and as-needed treatment were associated with polymorphisms at position 27 of the beta(2)-AR. No other differences in asthma outcomes that we investigated occurred in relation to these beta(2)-AR polymorphisms. Polymorphisms of the beta(2)-AR may influence airway responses to regular inhaled beta-agonist treatment.

Frontal Oscillatory Dynamics Predict Feedback Learning and Action Adjustment

ERIC Educational Resources Information Center

van de Vijver, Irene; Ridderinkhof, K. Richard; Cohen, Michael X.

2011-01-01

Frontal oscillatory dynamics in the theta (4-8 Hz) and beta (20-30 Hz) frequency bands have been implicated in cognitive control processes. Here we investigated the changes in coordinated activity within and between frontal brain areas during feedback-based response learning. In a time estimation task, participants learned to press a button after…

Smoothing of cost function leads to faster convergence of neural network learning

NASA Astrophysics Data System (ADS)

Xu, Li-Qun; Hall, Trevor J.

1994-03-01

One of the major problems in supervised learning of neural networks is the inevitable local minima inherent in the cost function f(W,D). This often makes classic gradient-descent-based learning algorithms that calculate the weight updates for each iteration according to (Delta) W(t) equals -(eta) (DOT)$DELwf(W,D) powerless. In this paper we describe a new strategy to solve this problem, which, adaptively, changes the learning rate and manipulates the gradient estimator simultaneously. The idea is to implicitly convert the local- minima-laden cost function f((DOT)) into a sequence of its smoothed versions {f(beta t)}Ttequals1, which, subject to the parameter (beta) t, bears less details at time t equals 1 and gradually more later on, the learning is actually performed on this sequence of functionals. The corresponding smoothed global minima obtained in this way, {Wt}Ttequals1, thus progressively approximate W-the desired global minimum. Experimental results on a nonconvex function minimization problem and a typical neural network learning task are given, analyses and discussions of some important issues are provided.

How Should Beta-Diversity Inform Biodiversity Conservation?

PubMed

Socolar, Jacob B; Gilroy, James J; Kunin, William E; Edwards, David P

2016-01-01

To design robust protected area networks, accurately measure species losses, or understand the processes that maintain species diversity, conservation science must consider the organization of biodiversity in space. Central is beta-diversity--the component of regional diversity that accumulates from compositional differences between local species assemblages. We review how beta-diversity is impacted by human activities, including farming, selective logging, urbanization, species invasions, overhunting, and climate change. Beta-diversity increases, decreases, or remains unchanged by these impacts, depending on the balance of processes that cause species composition to become more different (biotic heterogenization) or more similar (biotic homogenization) between sites. While maintaining high beta-diversity is not always a desirable conservation outcome, understanding beta-diversity is essential for protecting regional diversity and can directly assist conservation planning. Copyright © 2015 Elsevier Ltd. All rights reserved.

Beta-Blockers for Exams Identify Students at High Risk of Psychiatric Morbidity.

PubMed

Butt, Jawad H; Dalsgaard, Søren; Torp-Pedersen, Christian; Køber, Lars; Gislason, Gunnar H; Kruuse, Christina; Fosbøl, Emil L

2017-04-01

Beta-blockers relieve the autonomic symptoms of exam-related anxiety and may be beneficial in exam-related and performance anxiety, but knowledge on related psychiatric outcomes is unknown. We hypothesized that beta-blocker therapy for exam-related anxiety identifies young students at risk of later psychiatric events. Using Danish nationwide administrative registries, we studied healthy students aged 14-30 years (1996-2012) with a first-time claimed prescription for a beta-blocker during the exam period (May-June); students who were prescribed a beta-blocker for medical reasons were excluded. We matched these students on age, sex, and time of year to healthy and study active controls with no use of beta-blockers. Risk of incident use of antidepressants, incident use of other psychotropic medications, and suicide attempts was examined by cumulative incidence curves for unadjusted associations and multivariable cause-specific Cox proportional hazard analyses for adjusted hazard ratios (HRs). We identified 12,147 healthy students with exam-related beta-blocker use and 12,147 matched healthy students with no current or prior use of beta-blockers (median age, 19 years; 80.3% women). Among all healthy students, 0.14% had a first-time prescription for a beta-blocker during the exam period with the highest proportion among students aged 19 years (0.39%). Eighty-one percent of the students filled only that single prescription for a beta-blocker during follow-up. During follow-up, 2225 (18.3%) beta-blocker users and 1400 (11.5%) nonbeta-blocker users were prescribed an antidepressant (p < 0.0001); 1225 (10.1%) beta-blocker users and 658 (5.4%) nonbeta-blocker users were prescribed a psychotropic drug (p < 0.0001); and 16 (0.13%) beta-blocker users and 6 (0.05%) nonbeta-blocker users attempted suicide (p = 0.03). Exam-related beta-blocker use was associated with an increased risk of antidepressant use (adjusted HRs, 1.68 [95% confidence intervals (CIs), 1.57-1.79], p < 0.0001), other psychotropic medication use (HR, 1.93 [95% CI, 1.76-2.12] p < 0.0001), and suicide attempts (HR, 2.67 [95% CI, 1.04-6.82] p = 0.04). In healthy students, use of beta-blockers during the exam period was associated with an increased risk of psychiatric outcomes and might identify psychologically vulnerable students who need special attention.

Prediction of beta-turns and beta-turn types by a novel bidirectional Elman-type recurrent neural network with multiple output layers (MOLEBRNN).

PubMed

Kirschner, Andreas; Frishman, Dmitrij

2008-10-01

Prediction of beta-turns from amino acid sequences has long been recognized as an important problem in structural bioinformatics due to their frequent occurrence as well as their structural and functional significance. Because various structural features of proteins are intercorrelated, secondary structure information has been often employed as an additional input for machine learning algorithms while predicting beta-turns. Here we present a novel bidirectional Elman-type recurrent neural network with multiple output layers (MOLEBRNN) capable of predicting multiple mutually dependent structural motifs and demonstrate its efficiency in recognizing three aspects of protein structure: beta-turns, beta-turn types, and secondary structure. The advantage of our method compared to other predictors is that it does not require any external input except for sequence profiles because interdependencies between different structural features are taken into account implicitly during the learning process. In a sevenfold cross-validation experiment on a standard test dataset our method exhibits the total prediction accuracy of 77.9% and the Mathew's Correlation Coefficient of 0.45, the highest performance reported so far. It also outperforms other known methods in delineating individual turn types. We demonstrate how simultaneous prediction of multiple targets influences prediction performance on single targets. The MOLEBRNN presented here is a generic method applicable in a variety of research fields where multiple mutually depending target classes need to be predicted. http://webclu.bio.wzw.tum.de/predator-web/.

Ellagic acid ameliorates learning and memory deficits in a rat model of Alzheimer's disease: an exploration of underlying mechanisms.

PubMed

Kiasalari, Zahra; Heydarifard, Rana; Khalili, Mohsen; Afshin-Majd, Siamak; Baluchnejadmojarad, Tourandokht; Zahedi, Elham; Sanaierad, Ashkan; Roghani, Mehrdad

2017-06-01

Alzheimer's disease (AD) is a neurodegenerative disorder with irreversible loss of intellectual abilities. Current therapies for AD are still insufficient. In this study, the effect of ellagic acid on learning and memory deficits was evaluated in intrahippocampal amyloid beta (Aβ 25-35 )-microinjected rats and its modes of action were also explored. AD rat model was induced by bilateral intrahippocampal microinjection of Aβ 25-35 and ellagic acid was daily administered (10, 50, and 100 mg/kg), and learning, recognition memory, and spatial memory were evaluated in addition to histochemical assessment, oxidative stress, cholinesterases activity, and level of nuclear factor-kappaB (NF-κB), Toll-like receptor 4 (TLR4), and nuclear factor (erythroid-derived 2)-like 2 (Nrf2). The amyloid beta-microinjected rats showed a lower discrimination ratio in novel object and alternation score in Y maze tasks and exhibited an impairment of retention and recall capability in passive avoidance paradigm and higher working and reference memory errors in radial arm maze (RAM). In addition, amyloid beta group showed a lower number of Nissl-stained neurons in CA1 area in addition to enhanced oxidative stress, higher activity of cholinesterases, greater level of NF-κB and TLR4, and lower level of nuclear/cytoplasmic ratio for Nrf2 and ellagic acid at a dose of 100 mg/kg significantly prevented most of these abnormal alterations. Ellagic acid pretreatment of intrahippocampal amyloid beta-microinjected rats could dose-dependently improve learning and memory deficits via neuronal protection and at molecular level through mitigation of oxidative stress and acetylcholinesterase (AChE) activity and modulation of NF-κB/Nrf2/TLR4 signaling pathway.

Maternal breast milk transforming growth factor beta and feeding intolerance in preterm infants

PubMed Central

Frost, Brandy L.; Jilling, Tamas; Lapin, Brittany; Maheshwari, Akhil; Caplan, Michael S.

2015-01-01

Background Feeding intolerance occurs commonly in the NICU. Breast milk contains a large pool of transforming growth factor-beta (TGF-beta). Few studies describe TGF-beta levels in preterm milk, and the relationship to feeding intolerance (FI) remains unexplored. We measured TGF-beta levels in preterm breast milk to investigate a correlation with FI in preterm infants. Methods Prospective observational trial of 100 mother-infant pairs, enrolling infants born below 32 weeks gestation and less than 1500 grams, and mothers who planned to provide breast milk. TGF-beta levels were measured using ELISA. Infant charts were reviewed for outcomes. Results TGF-beta declined postnatally, most elevated in colostrum (p<0.01). TGF-beta 2 levels were higher than TGF-beta 1 at all time points (p<0.01). Colostrum TGF-beta levels correlated inversely with birth weight (p<0.01) and gestational age (p<0.05). One week TGF-beta 2 levels were reduced in growth-restricted infants with FI (p<0.01). Of infants with NEC, TGF-beta 2 levels appeared low, but small sample size precluded meaningful statistical comparisons. Conclusions TGF-beta levels decline temporally in preterm milk. TGF-beta 1 colostrum levels correlate inversely with birth weight and gestational age. TGF-beta 2 may play a role in FI in growth-restricted infants. The relationship of TGF-beta 2 and NEC merits future investigation. PMID:24995914

Optimization of pharmacotherapy in chronic heart failure: is heart rate adequately addressed?

PubMed

Franke, Jennifer; Wolter, Jan Sebastian; Meme, Lillian; Keppler, Jeannette; Tschierschke, Ramon; Katus, Hugo A; Zugck, Christian

2013-01-01

The aim of the study is to evaluate the use of beta-blockers in chronic heart failure (CHF) and the extent of heart rate reduction achieved in clinical practice and to determine differences in outcome of patients who fulfilled select inclusion criteria of the SHIFT study according to resting heart rate modulated by beta-blocker therapy. We evaluated an all-comer population of our dedicated CHF outpatient clinic between 2006 and 2010. For inclusion, individually optimized doses of guideline-recommended pharmacotherapy including beta-blockers had to be maintained for at least 3 months and routine follow-up performed at our outpatient CHF-clinic thereafter. Treatment dosages of beta-blockers, and demographic and clinical profiles including resting heart rate were assessed. The outcome of patients who fulfilled select inclusion criteria of the SHIFT study (left-ventricular ejection fraction (LVEF) ≤35 %, sinus rhythm, NYHA II-IV) and were followed-up for at least 1 year was stratified according to resting heart rates: ≥75 versus <75 bpm and ≥70 versus <70 bpm. The composite primary endpoint was defined as all-cause death or hospital admission for worsening heart failure during 12-month follow-up. In total, 3,181 patients were assessed in regard to treatment dosages of beta-blockers, and demographic and clinical profiles including resting heart rate. Of the overall studied population, 443 patients fulfilled all inclusion criteria and entered outcome analysis. Median observation time of survivors was 27.5 months with 1,039.7 observation-years in total. Up-titration to at least half the evidence-based target dose of beta-blockers was achieved in 69 % and full up-titration in 29 % of these patients. Patients with increased heart rates were younger, more often male, exhibited a higher NYHA functional class and lower LVEF. The primary endpoint occurred in 21 % of patients in the ≥70 bpm group versus 9 % of patients in the group with heart rates <70 bpm (p <0.01). Likewise, comparing the groups ≥75 and <75 bpm, the primary endpoint was significantly increased in the group of patients with heart rates ≥75 bpm 27 vs. 12.2 %; p < 0.01). 5-year event-free survival was significantly lower among patients with heart rates ≥70 bpm as compared to those with <70 bpm (log-rank test p < 0.05) and among patients in the ≥75 bpm group versus <75 bpm group (log-rank test p < 0.01). In conclusion, in clinical practice, 53 % of CHF patients have inadequate heart rate control (heart rates ≥75 bpm) despite concomitant beta-blocker therapy. In this non-randomized cohort, adequate heart rate control under individually optimized beta-blocker therapy was associated with improved mid- and long-term clinical outcome up to 5 years. As further up titration of beta-blockers is not achievable in many patients, the administration of a selective heart rate lowering agent, such as ivabradine adjuvant to beta-blockers may pose an opportunity to further modulate outcome.

Alemtuzumab improves quality-of-life outcomes compared with subcutaneous interferon beta-1a in patients with active relapsing-remitting multiple sclerosis.

PubMed

Arroyo González, Rafael; Kita, Mariko; Crayton, Heidi; Havrdova, Eva; Margolin, David H; Lake, Stephen L; Giovannoni, Gavin

2017-09-01

Alemtuzumab was superior on clinical and magnetic resonance imaging (MRI) outcomes versus subcutaneous interferon beta-1a in phase 3 trials in patients with relapsing-remitting multiple sclerosis. To examine quality-of-life (QoL) outcomes in the alemtuzumab phase 3 trials. Patients who were treatment naive (Comparison of Alemtuzumab and Rebif ® Efficacy in Multiple Sclerosis I [CARE-MS I]) or had an inadequate response to prior therapy (CARE-MS II) received annual courses of alemtuzumab 12 mg/day at baseline (5 days) and Month 12 (3 days) or subcutaneous interferon beta-1a 44 µg three times/week. QoL was measured every 6 or 12 months using Functional Assessment of Multiple Sclerosis (FAMS), European Quality of Life-5 Dimensions (EQ-5D) and its visual analog scale (EQ-VAS), and 36-Item Short-Form Survey (SF-36). Statistically significant improvements from baseline with alemtuzumab were observed on all three QoL instruments at the earliest post-baseline assessment and sustained through Year 2. Statistically significant greater QoL improvements over subcutaneous interferon beta-1a were seen at all time points in CARE-MS II with FAMS, EQ-VAS and SF-36 physical component summary, and in CARE-MS I with FAMS. Patients treated with alemtuzumab had improvements in physical, mental, and emotional QoL regardless of treatment history. Improvements were significantly greater with alemtuzumab versus subcutaneous interferon beta-1a on both disease-specific and general measures of QoL.

From the Experience of Interactivity and Entertainment to Lower Intention to Smoke: A Randomized Controlled Trial and Path Analysis of a Web-Based Smoking Prevention Program for Adolescents

PubMed Central

Wang, Hua; Calabro, Karen Sue; Mitra, Natasha; Shegog, Ross

2017-01-01

Background Web-based programs for smoking prevention are being increasingly used with some success among adolescents. However, little is known about the mechanisms that link the experience of such programs to intended nicotine or tobacco control outcomes. Objective Based on the experiential learning theory and extended elaboration likelihood model, this study aimed to evaluate the impact of a Web-based intervention, A Smoking Prevention Interactive Experience (ASPIRE), on adolescents’ intention to smoke, while considering the experience of interactivity and entertainment as predictors of reduced intention to smoke, under a transitional user experience model. Methods A total of 101 adolescents were recruited from after-school programs, provided consent, screened, and randomized in a single-blinded format to 1 of 2 conditions: the full ASPIRE program as the experimental condition (n=50) or an online , text-based version of ASPIRE as the control condition (n=51). Data were collected at baseline and immediate follow-up. Repeated-measures mixed-effects models and path analyses were conducted. Results A total of 82 participants completed the study and were included in the analysis. Participants in the experimental condition were more likely to show a decrease in their intention to smoke than those in the control condition (beta=−0.18, P=.008). Perceived interactivity (beta=−0.27, P=.004) and entertainment (beta=−0.20, P=.04) were each associated with a decrease in intention to smoke independently. Results of path analyses indicated that perceived interactivity and perceived entertainment mediated the relationship between ASPIRE use and emotional involvement. Furthermore, perceived presence mediated the relationship between perceived interactivity and emotional involvement. There was a direct relationship between perceived entertainment and emotional involvement. Emotional involvement predicted a decrease in intention to smoke (beta=−0.16, P=.04). Conclusions Adolescents’ experience of interactivity and entertainment contributed to the expected outcome of lower intention to smoke. Also, emphasis needs to be placed on the emotional experience during Web-based interventions in order to maximize reductions in smoking intentions. Going beyond mere evaluation of the effectiveness of a Web-based smoking prevention program, this study contributes to the understanding of adolescents’ psychological experience and its effect on their intention to smoke. With the results of this study, researchers can work to (1) enhance the experience of interactivity and entertainment and (2) amplify concepts of media effects (eg, presence and emotional involvement) in order to better reach health behavior outcomes. Trial Registration Clinicaltrials.gov NCT02469779; https://clinicaltrials.gov/ct2/show/NCT02469779 (Archived by WebCite at http://www.webcitation.org/6nxyZVOf0) PMID:28209560

Introducing global health into the undergraduate medical school curriculum using an e-learning program: a mixed method pilot study.

PubMed

Gruner, Douglas; Pottie, Kevin; Archibald, Douglas; Allison, Jill; Sabourin, Vicki; Belcaid, Imane; McCarthy, Anne; Brindamour, Mahli; Augustincic Polec, Lana; Duke, Pauline

2015-09-02

Physicians need global health competencies to provide effective care to culturally and linguistically diverse patients. Medical schools are seeking innovative approaches to support global health learning. This pilot study evaluated e-learning versus peer-reviewed articles to improve conceptual knowledge of global health. A mixed methods study using a randomized-controlled trial (RCT) and qualitative inquiry consisting of four post-intervention focus groups. Outcomes included pre/post knowledge quiz and self-assessment measures based on validated tools from a Global Health CanMEDS Competency Model. RCT results were analyzed using SPSS-21 and focus group transcripts coded using NVivo-9 and recoded using thematic analysis. One hundred and sixty-one pre-clerkship medical students from three Canadian medical schools participated in 2012-2013: 59 completed all elements of the RCT, 24 participated in the focus groups. Overall, comparing pre to post results, both groups showed a significant increase in the mean knowledge (quiz) scores and for 5/7 self-assessed competencies (p < 0.05). These quantitative data were triangulated with the focus groups findings that revealed knowledge acquisition with both approaches. There was no statistically significant difference between the two approaches. Participants highlighted their preference for e-learning to introduce new global health knowledge and as a repository of resources. They also mentioned personal interest in global health, online convenience and integration into the curriculum as incentives to complete the e-learning. Beta version e-learning barriers included content overload and technical difficulties. Both the e-learning and the peer reviewed PDF articles improved global health conceptual knowledge. Many students however, preferred e-learning given its interactive, multi-media approach, access to links and reference materials and its capacity to engage and re-engage over long periods of time.

Salivary Actinomyces naeslundii genospecies 2 and Lactobacillus casei levels predict pregnancy outcomes.

PubMed

Dasanayake, Ananda P; Li, Yihong; Wiener, Howard; Ruby, John D; Lee, Men-Jean

2005-02-01

Gravida's poor periodontal health is emerging as a modifiable independent risk factor for preterm delivery and low birth weight. To test the hypothesis that oral bacteria other than periodontal pathogens are also associated with pregnancy outcomes, specific oral bacterial levels measured during pregnancy were evaluated in relation to gestational age and birth weight while controlling for demographic, medical, and dental variables. The study population consisted of 297 predominantly African- American women who were pregnant for the first time. The salivary bacterial levels evaluated were Streptococcus mutans, Streptococcus sobrinus, Streptococcus sanguinus, Lactobacillus acidophilus, Lactobacillus casei, Actinomyces naeslundii genospecies (gsp) 1 and 2, total streptococci, and total cultivable organisms. For 1 unit increase in log(10) A. naeslundii gsp 2 levels, there was a 60 gm decrease in birth weight (beta = -59.7 g; SE = 29.1; P = 0.04), and a 0.17 week decrease in gestational age (beta = -0.17 wk; SE = 0.09; P = 0.05). In contrast, per 1 unit increase in log(10) L. casei levels, there was a 42 gm increase in birth weight (beta = 42.2 g; SE = 19.3; P = 0.03), and a 0.13 week increase in gestational age (beta = 0.13 week; SE = 0.06; P = 0.04). We conclude that other oral bacterial species can also be related to pregnancy outcomes in addition to previously reported periodontal pathogens. These organism levels may not only predict poor pregnancy outcomes, but also be used as modifiable risk factors in reducing prematurity and low birth weight.

Beta-blockers for prevention and treatment of retinopathy of prematurity in preterm infants.

PubMed

Kaempfen, Siree; Neumann, Roland P; Jost, Kerstin; Schulzke, Sven M

2018-03-02

Retinopathy of prematurity (ROP) is a vision-threatening disease of preterm neonates. The use of beta-adrenergic blocking agents (beta-blockers), which modulate the vasoproliferative retinal process, may reduce the progression of ROP or even reverse established ROP. To determine the effect of beta-blockers on short-term structural outcomes, long-term functional outcomes, and the need for additional treatment, when used either as prophylaxis in preterm infants without ROP, stage 1 ROP (zone I), or stage 2 ROP (zone II) without plus disease or as treatment in preterm infants with at least prethreshold ROP. We searched the Cochrane Neonatal Review Group Specialized Register; CENTRAL (in the Cochrane Library Issue 7, 2017); Embase (January 1974 to 7 August 2017); PubMed (January 1966 to 7 August 2017); and CINAHL (January 1982 to 7 August 2017). We checked references and cross-references and handsearched abstracts from the proceedings of the Pediatric Academic Societies Meetings. We considered for inclusion randomised or quasi-randomised clinical trials that used beta-blockers for prevention or treatment of ROP in preterm neonates of less than 37 weeks' gestational age. We used the standard methods of Cochrane and the Cochrane Neonatal Review Group. We used the GRADE approach to assess the quality of evidence. We included three randomised trials (N = 366) in this review. Two of these studies were at high risk of bias. All studies reported on prevention of ROP and compared oral propranolol with placebo or no treatment. We found no trials assessing beta-blockers in infants with established stage 2 or higher ROP with plus disease.In one trial, study medication was started after one week of life, i.e. prior to the first ROP screening. The other two trials included preterm infants if they had stage 2 or lower ROP without plus disease. Based on the GRADE assessment, we considered evidence to be of low quality for the following outcomes: rescue treatment with anti-VEGF or laser therapy; and arterial hypotension or bradycardia requiring inotropic support. Evidence was of moderate quality for the following outcomes: progression to stage 2 with plus disease; progression to stage 3 ROP; and progression to stage 4 or 5 ROP.Meta-analysis of three trials (N = 366) suggested beneficial effects of oral beta-blockers on the risk of requiring anti-VEGF agents (typical risk ratio (RR) 0.32, 95% confidence interval (CI) 0.12 to 0.86; I² = 0%; typical risk difference (RD) -0.06, 95% CI -0.10 to -0.01; I² = 75%; number needed to treat for an additional beneficial outcome (NNTB) 18, 95% CI 14 to 84) and laser therapy (typical RR 0.54, 95% CI 0.32 to 0.89; typical RD -0.09, 95% CI -0.16 to -0.02; I² = 31%; NNTB 12, 95% CI 8 to 47). Meta-analysis of two trials (N = 161) demonstrated a beneficial effect of oral beta-blockers on progression to stage 3 ROP (typical RR 0.60, 95% CI 0.37 to 0.96; I² = 0%; typical RD -0.15, 95% CI -0.28 to -0.02; I² = 73%; NNTB 7, 95% CI 5 to 67). There was no significant effect of oral beta-blockers on progression to stage 2 ROP with plus disease or to stage 4 or 5 ROP. Although meta-analysis did not indicate a significant effect of beta-blockers on arterial hypotension or bradycardia, propranolol dosage in one study was reduced by 50% in infants of less than 26 weeks' gestational age due to severe hypotension, bradycardia, and apnoea in several participants. Analyses did not indicate significant effects of beta-blockers on complications of prematurity or mortality. None of the trials reported on long-term visual impairment. Limited evidence of low-to-moderate quality suggests that prophylactic administration of oral beta-blockers might reduce progression towards stage 3 ROP and decrease the need for anti-VEGF agents or laser therapy. The clinical relevance of those findings is unclear as no data on long-term visual impairment were reported. Adverse events attributed to oral propranolol at a dose of 2 mg/kg/d raise concerns regarding systemic administration of this drug for prevention of ROP at the given dose. There is insufficient evidence to determine the efficacy and safety of beta-blockers for prevention of ROP due to high risk of bias in two included trials and the lack of long-term functional outcomes. We would encourage researchers to conduct large, well-designed trials to confirm or refute the role of beta-blockers for prevention and treatment of ROP in preterm infants. Trials should report on long-term visual impairment. Researchers should consider dose-finding studies of systemic beta-blockers and topical administration of beta-blockers, in order to optimise drug delivery and minimise adverse events.

Carotenoids: more than just beta-carotene.

PubMed

Gellenbeck, K W

1998-12-01

Fruits and vegetables of the human diet contain many of the over 600 carotenoid pigments that have been identified in plants. Led by work with beta-carotene, researchers have constantly been learning more about the metabolism of these compounds in the human body. Research work is now expanding beyond beta-carotene in an effort to understand what happens to all the pigments found in the human diet. This discussion briefly looks at research results on the carotenoids found in human serum as well as the effects of supplementation. Recent confusing results from large intervention trials with beta-carotene and lung cancer incidence are emphasized in relation to supplementation doses and beta-carotene source (synthetic vs. natural). The summation of results emphasizes the importance of the broad spectrum of carotenoids in the diet and relates to supplementation products currently being designed for the marketplace.

Chemical factors determine olfactory system beta oscillations in waking rats.

PubMed

Lowry, Catherine A; Kay, Leslie M

2007-07-01

Recent studies have pointed to olfactory system beta oscillations of the local field potential (15-30 Hz) and their roles both in learning and as specific responses to predator odors. To describe odorant physical properties, resultant behavioral responses and changes in the central olfactory system that may induce these oscillations without associative learning, we tested rats with 26 monomolecular odorants spanning 6 log units of theoretical vapor pressure (estimate of relative vapor phase concentration) and 10 different odor mixtures. We found odorant vapor phase concentration to be inversely correlated with investigation time on the first presentation, after which investigation times were brief and not different across odorants. Analysis of local field potentials from the olfactory bulb and anterior piriform cortex shows that beta oscillations in waking rats occur specifically in response to the class of volatile organic compounds with vapor pressures of 1-120 mmHg. Beta oscillations develop over the first three to four presentations and are weakly present for some odorants in anesthetized rats. Gamma oscillations show a smaller effect that is not restricted to the same range of odorants. Olfactory bulb theta oscillations were also examined as a measure of effective afferent input strength, and the power of these oscillations did not vary systematically with vapor pressure, suggesting that it is not olfactory bulb drive strength that determines the presence of beta oscillations. Theta band coherence analysis shows that coupling strength between the olfactory bulb and piriform cortex increases linearly with vapor phase concentration, which may facilitate beta oscillations above a threshold.

Management and outcome of topical beta-blockerinduced atrioventricular block

PubMed Central

Özcan, Kazım Serhan; Güngör, Barış; Tekkeşin, Ahmet İlker; Altay, Servet; Ekmekçi, Ahmet; Toprak, Ercan; Yıldırım, Ersin; Çalık, Nazmi; Alper, Ahmet Taha; Gürkan, Kadir; Erdinler, İzzet; Osmonov, Damirbek

2015-01-01

Summary Background Topical beta-blockers have a well-established role in the treatment of glaucoma. We aimed to investigate the outcome of patients who developed symptomatic atrioventricular (AV) block induced by topical beta-blockers. Methods All patients admitted or discharged from our institution, the Siyami Ersek Training and Research Hospital, between January 2009 and January 2013 with a diagnosis of AV block were included in the study. Subjects using ophthalmic beta-blockers were recruited and followed for permanent pacemaker requirement during hospitalisation and for three months after discontinuation of the drug. A permanent pacemaker was implanted in patients in whom AV block persisted beyond 72 hours or recurred during the follow-up period. Results A total of 1 122 patients were hospitalised with a diagnosis of AV block and a permanent pacemaker was implanted in 946 cases (84.3%) during the study period. Thirteen patients using ophthalmic beta-blockers for the treatment of glaucoma and no other rate-limiting drugs were included in the study. On electrocardiography, eight patients had complete AV block and five had high-degree AV block. The ophthalmic beta-blockers used were timolol in seven patients (55%), betaxolol in four (30%), and cartelol in two cases (15%). The mean duration of ophthalmic beta-blocker treatment was 30.1 ± 15.9 months. After drug discontinuation, in 10 patients the block persisted and a permanent pacemaker was implanted. During follow up, one more patient required pacemaker implantation. Therefore in total, pacemakers were implanted in 11 out of 13 patients (84.6%). The pacemaker implantation rate did not differ according to the type of topical beta-blocker used (p = 0.37). The presence of infra-nodal block on electrocardiography was associated with higher rates of pacemaker implantation. Conclusion Our results indicate that topical beta-blockers for the treatment of glaucoma may cause severe conduction abnormalities and when AV block occurs, pacemaker implantation is required in a high percentage of the patients. PMID:26659434

Maternal and neonatal outcomes in labor and at delivery when long QT syndrome is present.

PubMed

Tanaka, Hiroaki; Katsuragi, Shinji; Tanaka, Kayo; Sawada, Masami; Iwanaga, Naoko; Yoshimatsu, Jun; Ikeda, Tomoaki

2016-01-01

Women during labor may be susceptible to torsades de pointes (TdP), which may cause the fetal condition to deteriorate. The aim of the present investigation was to analyze maternal and fetal outcomes during labor when long QT syndrome (LQTS) was present. We examined the maternal and neonatal outcomes of 25 pregnancies (18 women) with LQT between 1995 and 2012 at the Department of Perinatology, National Cardiovascular Center, Japan. Maternal and neonatal outcomes including cardiovascular events, cardiovascular events within a week after delivery, caesarean delivery rate, still births, preterm births, and non-reassuring fetal heart rate pattern (NRFHR) during labor were investigated. All the mothers survived, and no cardiovascular events occurred in labor or postpartum due to LQTS in either vaginal delivery or caesarean delivery. A total of 23 women (92%) had used beta blockers in this study. Caesarean delivery was performed due to NRFHR during labor in 5 pregnancies (20%). Delivery when LQTS is present has a low likelihood of cardiovascular events, but pregnancy with LQTS had a higher caesarean delivery rate due to NRFHR in labor. Most women used beta blockers in this study, and it is possible that beta blocker use prevents cardiovascular events during labor. NRFHR during labor may be related with inherited LQT through the mother.

Effects of vitamin A or beta carotene supplementation on pregnancy-related mortality and infant mortality in rural Bangladesh: a cluster randomized trial.

PubMed

West, Keith P; Christian, Parul; Labrique, Alain B; Rashid, Mahbubur; Shamim, Abu Ahmed; Klemm, Rolf D W; Massie, Allan B; Mehra, Sucheta; Schulze, Kerry J; Ali, Hasmot; Ullah, Barkat; Wu, Lee S F; Katz, Joanne; Banu, Hashina; Akhter, Halida H; Sommer, Alfred

2011-05-18

Maternal vitamin A deficiency is a public health concern in the developing world. Its prevention may improve maternal and infant survival. To assess efficacy of maternal vitamin A or beta carotene supplementation in reducing pregnancy-related and infant mortality. Cluster randomized, double-masked, placebo-controlled trial among pregnant women 13 to 45 years of age and their live-born infants to 12 weeks (84 days) postpartum in rural northern Bangladesh between 2001 and 2007. Interventions Five hundred ninety-six community clusters (study sectors) were randomized for pregnant women to receive weekly, from the first trimester through 12 weeks postpartum, 7000 μg of retinol equivalents as retinyl palmitate, 42 mg of all-trans beta carotene, or placebo. Married women (n = 125,257) underwent 5-week surveillance for pregnancy, ascertained by a history of amenorrhea and confirmed by urine test. Blood samples were obtained from participants in 32 sectors (5%) for biochemical studies. All-cause mortality of women related to pregnancy, stillbirth, and infant mortality to 12 weeks (84 days) following pregnancy outcome. Groups were comparable across risk factors. For the mortality outcomes, neither of the supplement group outcomes was significantly different from the placebo group outcomes. The numbers of deaths and all-cause, pregnancy-related mortality rates (per 100,000 pregnancies) were 41 and 206 (95% confidence interval [CI], 140-273) in the placebo group, 47 and 237 (95% CI, 166-309) in the vitamin A group, and 50 and 250 (95% CI, 177-323) in the beta carotene group. Relative risks for mortality in the vitamin A and beta carotene groups were 1.15 (95% CI, 0.75-1.76) and 1.21 (95% CI, 0.81-1.81), respectively. In the placebo, vitamin A, and beta carotene groups the rates of stillbirth and infant mortality were 47.9 (95% CI, 44.3-51.5), 45.6 (95% CI, 42.1-49.2), and 51.8 (95% CI, 48.0-55.6) per 1000 births and 68.1 (95% CI, 63.7-72.5), 65.0 (95% CI, 60.7-69.4), and 69.8 (95% CI, 65.4-72.3) per 1000 live births, respectively. Vitamin A compared with either placebo or beta carotene supplementation increased plasma retinol concentrations by end of study (1.46 [95% CI, 1.42-1.50] μmol/L vs 1.13 [95% CI, 1.09-1.17] μmol/L and 1.18 [95% CI, 1.14-1.22] μmol/L, respectively; P < .001) and reduced, but did not eliminate, gestational night blindness (7.1% for vitamin A vs 9.2% for placebo and 8.9% for beta carotene [P < .001 for both]). Use of weekly vitamin A or beta carotene in pregnant women in Bangladesh, compared with placebo, did not reduce all-cause maternal, fetal, or infant mortality. clinicaltrials.gov Identifier: NCT00198822.

Analysing learning outcomes in an Electrical Engineering curriculum using illustrative verbs derived from Bloom's Taxonomy

NASA Astrophysics Data System (ADS)

Meda, Lawrence; Swart, Arthur James

2018-05-01

Learning outcomes are essential to any curriculum in education, where they need to be clear, observable and measurable. However, some academics structure learning outcomes in a way that does not promote student learning. The purpose of this article is to present the analyses of learning outcomes of an Electrical Engineering curriculum offered at a University of Technology in South Africa, in order to determine if academics are structuring them in a way that enables student learning. A qualitative case study is used where the learning outcomes from 33 study guides are reviewed using illustrative verbs derived from Bloom's Taxonomy. Results indicate that 9% of all the learning outcomes are unclear, 10% are unobservable and 23% are unmeasurable. A key recommendation is to provide regular workshops to assist academics in reviewing their learning outcomes using the illustrative verbs derived from Bloom's Taxonomy, thereby ensuring that their learning outcomes promote student learning.

Learning Outcomes Assessment: Extrapolating from Study Abroad to International Service-Learning

ERIC Educational Resources Information Center

Rubin, Donald L.; Matthews, Paul H.

2013-01-01

For international service-learning to thrive, it must document student learning outcomes that accrue to participants. The approaches to international service-learning assessment must be compelling to a variety of stakeholders. Recent large-scale projects in study abroad learning outcomes assessment--including the Georgia Learning Outcomes of…

Predictors of Physical Activity among Adolescent Girl Students Based on the Social Cognitive Theory.

PubMed

Ardestani, Monasadat; Niknami, Shamsaddin; Hidarnia, Alireza; Hajizadeh, Ebrahim

2015-01-01

The importance of increasing adolescence girl's level of physical activity is recognized as a priority for having a healthy lifestyle. However, adolescent girls especially Iranian, are at high risk for physical inactivity. Social Cognitive Theory (SCT) is a successful theory to explain physical activity behavior. The aim of this study was to determine the predictors of physical activity based on the SCT. This cross-sectional study was conducted among 400 adolescent girls (15-16 yr old) in Tehran, Iran (2013). The participants were randomly chosen with multistage sampling. The SCT constructs consisted of self-efficacy, self-regulation, social support, outcome expectancy, and self-efficacy to overcoming impediments. Statistical analysis was carried out applying SPSS: 16, LISREL 8.8. Stepwise regression was used to test predictors of behavior. Pearson correlation was assessed. Self efficacy to overcoming impediments was the main construct to predict physical activity (Beta=0.37). Other determinants were self-efficacy (Beta=0.29), family support (beta=0.14), outcome expectancy (beta=0.13), friend support (beta=0.12), and self-regulation (beta=0.11), respectively. In general, the SCT questionnaire determined 0.85 variation of physical activity behavior. All of the constructs had direct significant relation to physical activity behavior (P<0.001). The constructs of SCT provide a suitable framework to perform promoting physical activity programs and self-efficacy to overcoming impediments and self-efficacy are the best predictors of physical activity in adolescent girls.

Preserved Fronto-Striatal Plasticity and Enhanced Procedural Learning in a Transgenic Mouse Model of Alzheimer's Disease Overexpressing Mutant "hAPPswe"

ERIC Educational Resources Information Center

Middei, Silvia; Geracitano, Raffaella; Caprioli, Antonio; Mercuri, Nicola; Ammassari-Teule, Martine

2004-01-01

Mutations in the amyloid precursor protein (APP) gene inducing abnormal processing and deposition of [beta]-amyloid protein in the brain have been implicated in the pathogenesis of Alzheimer's disease (AD). Although Tg2576 mice with the Swedish mutation ("hAPPswe") exhibit age-related [Alpha][beta]-plaque formation in brain regions like the…

Entrainment of prefrontal beta oscillations induces an endogenous echo and impairs memory formation.

PubMed

Hanslmayr, Simon; Matuschek, Jonas; Fellner, Marie-Christin

2014-04-14

Brain oscillations across all frequency bands play a key role for memory formation. Specifically, desynchronization of local neuronal assemblies in the left inferior prefrontal cortex (PFC) in the beta frequency (∼18 Hz) has been shown to be central for encoding of verbal memories. However, it remains elusive whether prefrontal beta desynchronization is causally relevant for memory formation and whether these endogenous beta oscillations can be entrained by external stimulation. By using combined EEG-TMS (transcranial magnetic stimulation), we here address these fundamental questions in human participants performing a word-list learning task. Confirming our predictions, memory encoding was selectively impaired when the left inferior frontal gyrus (IFG) was driven at beta (18.7 Hz) compared to stimulation at other frequencies (6.8 Hz and 10.7 Hz) and to ineffective sham stimulation (18.7 Hz). Furthermore, a sustained oscillatory "echo" in the left IFG, which outlasted the stimulation period by approximately 1.5 s, was observed solely after beta stimulation. The strength of this beta echo was related to memory impairment on a between-subjects level. These results show endogenous oscillatory entrainment effects and behavioral impairment selectively in beta frequency for stimulation of the left IFG, demonstrating an intimate causal relationship between prefrontal beta desynchronization and memory formation. Copyright © 2014 Elsevier Ltd. All rights reserved.

Integrating Learning Outcome Typologies for HRD: Review and Current Status

ERIC Educational Resources Information Center

Lim, Doo Hun; Yoon, Seung Won; Park, Sunyoung

2013-01-01

This study reports the result of literature review in regards to learning outcome studies and presents a framework that integrates content types with learning outcomes. Analysis of learning outcome studies between 1992 and 2006 using the ERIC database indicated that most empirical studies have assessed the learning outcome at lower levels of…

Instilling Service Learning to Undergraduate Business Students: A Case Study Approach to Understanding Business-Related Concepts with the Use of Kiva

ERIC Educational Resources Information Center

Grotrian-Ryan, Sheri; Ryan, Kyle; Jackson, Alan

2016-01-01

Higher education continues to place an emphasis on service-learning, specifically within business and management sciences (Kenworthy-U'Ren & Peterson, 2005). A local academic business organization at a small institution chose to embark on a service-learning endeavor. The purpose of this study was for business majors, active in Phi Beta Lambda…

Learning Activity Package, Physical Science. LAP Numbers 8, 9, 10, and 11.

ERIC Educational Resources Information Center

Williams, G. J.

These four units of the Learning Activity Packages (LAPs) for individualized instruction in physical science cover nuclear reactions, alpha and beta particles, atomic radiation, medical use of nuclear energy, fission, fusion, simple machines, Newton's laws of motion, electricity, currents, electromagnetism, Oersted's experiment, sound, light,…

Incidence, predictors and clinical outcomes of residual stenosis after aortic valve-in-valve.

PubMed

Bleiziffer, Sabine; Erlebach, Magdalena; Simonato, Matheus; Pibarot, Philippe; Webb, John; Capek, Lukas; Windecker, Stephan; George, Isaac; Sinning, Jan-Malte; Horlick, Eric; Napodano, Massimo; Holzhey, David M; Petursson, Petur; Cerillo, Alfredo; Bonaros, Nikolaos; Ferrari, Enrico; Cohen, Mauricio G; Baquero, Giselle; Jones, Tara L; Kalra, Ankur; Reardon, Michael J; Chhatriwalla, Adnan; Gama Ribeiro, Vasco; Alnasser, Sami; Van Mieghem, Nicolas M; Rustenbach, Christian Jörg; Schofer, Joachim; Garcia, Santiago; Zeus, Tobias; Champagnac, Didier; Bekeredjian, Raffi; Kornowski, Ran; Lange, Rüdiger; Dvir, Danny

2018-05-01

We aimed to analyse the incidence of prosthesis-patient mismatch (PPM) and elevated gradients after aortic valve in valve (ViV), and to evaluate predictors and associations with clinical outcomes of this adverse event. A total of 910 aortic ViV patients were investigated. Elevated residual gradients were defined as ≥20 mm Hg. PPM was identified based on the indexed effective orifice area (EOA), measured by echocardiography, and patient body mass index (BMI). Moderate and severe PPM (cases) were defined by European Association of Cardiovascular Imaging (EACVI) criteria and compared with patients without PPM (controls). Moderate or greater PPM was found in 61% of the patients, and severe in 24.6%. Elevated residual gradients were found in 27.9%. Independent risk factors for the occurrence of lower indexed EOA and therefore severe PPM were higher gradients of the failed bioprosthesis at baseline (unstandardised beta -0.023; 95% CI -0.032 to -0.014; P<0.001), a stented (vs a stentless) surgical bioprosthesis (unstandardised beta -0.11; 95% CI -0.161 to -0.071; P<0.001), higher BMI (unstandardised beta -0.01; 95% CI -0.013 to -0.007; P<0.001) and implantation of a SAPIEN/SAPIEN XT/SAPIEN 3 transcatheter device (unstandardised beta -0.064; 95% CI -0.095 to -0.032; P<0.001). Neither severe PPM nor elevated gradients had an association with VARC II-defined outcomes or 1-year survival (90.9% severe vs 91.5% moderate vs 89.3% none, P=0.44). Severe PPM and elevated gradients after aortic ViV are very common but were not associated with short-term survival and clinical outcomes. The long-term effect of poor post-ViV haemodynamics on clinical outcomes requires further evaluation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Interleukin 1 beta inhibits synaptic strength and long-term potentiation in the rat CA1 hippocampus.

PubMed

Bellinger, F P; Madamba, S; Siggins, G R

1993-11-19

Cytokines such as interleukin-1 beta (IL-1 beta) are released in the nervous system following inflammation or infection. Recently, IL-1 beta was shown to enhance synaptic inhibitory mechanisms. We therefore investigated the effect of IL-1 beta superfusion on long-term potentiation (LTP), the cellular model of memory and learning, evoked in the CA1 region by tetanic stimulation of the stratum radiatum in the rat hippocampal slice. IL-1 beta (150 pM-1.5 nM) superfused 10 min before tetanic stimulation significantly reduced LTP of the slope of the population excitatory postsynaptic potential (pEPSP) and the population spike (PS) amplitude in CA1 in a concentration-dependent manner. IL-1 beta (1.5 nM) applied for 10 min 1 h before tetanus significantly inhibited LTP of the PS amplitude and pEPSP slope and reduced pEPSP and PS values before tetanus as well, although the PS returned to control values before tetanus. Heat-inactivated IL-1 beta had no effect on pre-tetanus pEPSP or PS values or the induction of LTP. These data demonstrate that IL-1 beta modulates synaptic potentials and reduces LTP. These findings have important implications for the role of IL-1 beta in neuronal disorders following infection, perhaps best exemplified by HIV-1-associated dementia.

Beta-hydroxy-beta-methylbutyrate (HMB) ameliorates age-related deficits in water maze performance, especially in male rats.

PubMed

Kougias, Daniel G; Hankosky, Emily R; Gulley, Joshua M; Juraska, Janice M

2017-03-01

Beta-hydroxy-beta-methylbutyrate (HMB) is commonly supplemented to maintain muscle in elderly and clinical populations and has potential as a nootropic. Previously, we have shown that in both male and female rats, long-term HMB supplementation prevents age-related dendritic shrinkage within the medial prefrontal cortex (mPFC) and improves cognitive flexibility and working memory performance that are both age- and sex-specific. In this study, we further explore the cognitive effects by assessing visuospatial learning and memory with the Morris water maze. Female rats were ovariectomized at 11months of age to model human menopause. At 12months of age, male and female rats received relatively short- or long-term (1- or 7-month) dietary HMB (450mg/kg/dose) supplementation twice a day prior to testing. Spatial reference learning and memory was assessed across four days in the water maze with four trials daily and a probe trial on the last day. Consistent with previous work, there were age-related deficits in water maze performance in both sexes. However, these deficits were ameliorated in HMB-treated males during training and in both sexes during probe trial performance. Thus, HMB supplementation prevented the age-related decrement in water maze performance, especially in male rats. Copyright © 2016 Elsevier Inc. All rights reserved.

Continuous infusion of beta-lactam antibiotics in severe infections: a review of its role.

PubMed

Roberts, Jason A; Paratz, Jennifer; Paratz, Elizabeth; Krueger, Wolfgang A; Lipman, Jeffrey

2007-07-01

Continuous infusion of beta-lactam antibiotics has been widely promoted to optimise their time-dependent activity. Increasing evidence is emerging suggesting potential benefits in patient populations with altered pathophysiology, such as seriously ill patients. From a pharmacokinetic viewpoint, much information supports higher trough concentrations of beta-lactam antibiotics when administered by continuous infusion. This advantage of continuous infusion translates into a superior ability to achieve pharmacodynamic targets, particularly when the minimum inhibitory concentration (MIC) of the pathogen is >or=4 mg/L. One drawback of continuous infusion may be limited physicochemical stability. This issue exists particularly for carbapenem antibiotics whereby prolonged infusions (i.e. >3h) can be used to improve the time above the MIC compared with conventional bolus dosing. Few studies have examined clinical outcomes of bolus and continuous dosing of beta-lactam antibiotics in seriously ill patients. No statistically significant differences have been shown for: mortality; time to normalisation of leukocytosis or pyrexia; or duration of mechanical ventilation, intensive care unit stay or hospital stay. Some evidence suggests improved clinical cure and resolution of illness with continuous infusion in seriously ill patients. Pharmacoeconomic advantages of continuous infusion of beta-lactam antibiotics are well characterised. Available data suggest that seriously ill patients with severe infections requiring significant antibiotic courses (>or=4 days) may be the subgroup that will achieve better outcomes with continuous infusion.

Physicians' reactions to uncertainty in the context of shared decision making.

PubMed

Politi, Mary C; Légaré, France

2010-08-01

Physicians' reactions towards uncertainty may influence their willingness to engage in shared decision making (SDM). This study aimed to identify variables associated with physician's anxiety from uncertainty and reluctance to disclose uncertainty to patients. We conducted a cross-sectional secondary analysis of longitudinal data of an implementation study of SDM among primary care professionals (n=122). Outcomes were anxiety from uncertainty and reluctance to disclose uncertainty to patients. Hypothesized factors that would be associated with outcomes included attitude, social norm, perceived behavioral control, intention to implement SDM in practice, and socio-demographics. Stepwise linear regression was used to identify predictors of anxiety from uncertainty and reluctance to disclose uncertainty to patients. In multivariate analyses, anxiety from uncertainty was influenced by female gender (beta=0.483; p=0.0039), residency status (1st year: beta=0.600; p=0.001; 2nd year: beta=0.972; p<0.001), and number of hours worked per week (beta=-0.012; p=0.048). Reluctance to disclose uncertainty to patients was influenced by having more years in formal education (beta=-1.996; p=0.012). Variables associated with anxiety from uncertainty differ from those associated with reluctance to disclose uncertainty to patients. Given the importance of communicating uncertainty during SDM, measuring physicians' reactions to uncertainty is essential in SDM implementation studies. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

Impact of worsening renal function related to medication in heart failure.

PubMed

Brunner-La Rocca, Hans-Peter; Knackstedt, Christian; Eurlings, Luc; Rolny, Vinzent; Krause, Friedemann; Pfisterer, Matthias E; Tobler, Daniel; Rickenbacher, Peter; Maeder, Micha T

2015-02-01

Renal failure is a major challenge in treating heart failure (HF) patients. HF medication may deteriorate renal function, but the impact thereof on outcome is unknown. We investigated the effects of HF medication on worsening renal function (WRF) and the relationship to outcome. This post-hoc analysis of TIME-CHF (NT-proBNP-guided vs. symptom-guided management in chronic HF) included patients with LVEF ≤45% and ≥1 follow-up visit (n = 462). WRF III was defined as a rise in serum creatinine ≥0.5 mg/dL (i.e. 44.2 µmol/L) at any time during the first 6 months. Four classes of medication were considered: loop diuretics, beta-blockers, renin-angiotensin system (RAS)-blockers, and spironolactone. Functional principal component analysis of daily doses was used to comprehend medication over time. All-cause mortality after 18 months was the primary outcome. Interactions between WRF, medication, and outcome were tested. Patients with WRF III received on average higher loop diuretic doses (P = 0.0002) and more spironolactone (P = 0.02), whereas beta-blockers (P = 0.69) did not differ and lower doses of RAS-blockers were given (P = 0.09). There were significant interactions between WRF III, medicationn and outcome. Thus, WRF III was associated with poor prognosis if high loop diuretic doses were given (P = 0.001), but not with low doses (P = 0.29). The opposite was found for spironolactone (poor prognosis in the case of WRF III with no spironolactone, P <0.0001; but not with spironolactone, P = 0.31). Beta-blockers were protective in all patients (P <0.001), but most in those with WRF III (P <0.05 for interaction). RAS-blockade was associated with improved outcome (P = 0.006), irrespective of WRF III. Based on this analysis, it may be hypothesized that high doses of loop diuretics might have detrimental effects, particularly in combination with significant WRF, whereas spironolactone and beta-blockers might be protective in patients with WRF. © 2014 The Authors. European Journal of Heart Failure © 2014 European Society of Cardiology.

Parent Engagement With a Telehealth-Based Parent-Mediated Intervention Program for Children With Autism Spectrum Disorders: Predictors of Program Use and Parent Outcomes

PubMed Central

Berger, Natalie I

2015-01-01

Background There has been growing interest in using telehealth to increase access to parent-mediated interventions for children with ASD. However, little is known about how parents engage with such programs. Objective This paper presents program engagement data from a pilot study comparing self-directed and therapist-assisted versions of a novel telehealth-based parent-mediated intervention for young children with autism spectrum disorders (ASD). Methods Parents of young children with ASD were randomly assigned to receive a self-directed or therapist-assisted version of ImPACT Online. Parent engagement and satisfaction with the different components of the program website were examined using the program’s automated data collection and a post-treatment evaluation survey. We examined the relationship between program engagement and changes in parent knowledge and implementation and participant characteristics associated with program engagement. Results Of the 27 parent participants, the majority were female (26/27, 96%), married (22/27, 81%), with a college degree or higher (15/27, 56%), and less than half were not employed outside of the home (10/27, 37%). The mean chronological age of the child participants was 43.26 months, and the majority were male (19/27, 70%) and white (21/27, 78%). Most of the families (19/27, 70%) resided in a rural or medically underserved area. Parents logged into the website an average of 46.85 times, spent an average of 964.70 minutes on the site, and completed an average of 90.17% of the lesson learning activities. Participants in the therapist-assisted group were more likely to engage with the website than those in the self-directed group: F 2,24=17.65, P<.001. In total, 85% of participants completed the program, with a significantly greater completion rate in the therapist-assisted group (N=27): χ2 1=5.06, P=.03. Lesson learning activities were visited significantly more often than the supplemental activities (all Ps<.05). Multiple regression controlling for pretreatment performance indicated that program completion (beta=.51, P=.02) predicted post-treatment intervention knowledge, and program completion (beta=.43, P=.03) and group assignment (beta=-.37, P=.045) predicted post-treatment intervention fidelity. Partial correlations indicated that parent depressive symptoms at pretreatment were negatively associated with program completion (r=-.40, P=.04), but other key parent and child demographic factors were not. Post-treatment measures of website usability (r=.65, P<.001), treatment acceptability (r=.58, P=.002), and overall satisfaction (r=.58, P=.002) were all related to program completion. Conclusions Parent engagement and satisfaction with ImPACT Online was high for both self-directed and therapist-assisted versions of the program, although therapist assistance increased engagement. Program completion was associated with parent outcomes, providing support for the role of the website in parent learning. This program has the potential to increase access to parent-mediated intervention for families of children with ASD. PMID:26443557

Musical Sequence Learning and EEG Correlates of Audiomotor Processing

PubMed Central

Schalles, Matt D.; Pineda, Jaime A.

2015-01-01

Our motor and auditory systems are functionally connected during musical performance, and functional imaging suggests that the association is strong enough that passive music listening can engage the motor system. As predictive coding constrains movement sequence selections, could the motor system contribute to sequential processing of musical passages? If this is the case, then we hypothesized that the motor system should respond preferentially to passages of music that contain similar sequential information, even if other aspects of music, such as the absolute pitch, have been altered. We trained piano naive subjects with a learn-to play-by-ear paradigm, to play a simple melodic sequence over five days. After training, we recorded EEG of subjects listening to the song they learned to play, a transposed version of that song, and a control song with different notes and sequence from the learned song. Beta band power over sensorimotor scalp showed increased suppression for the learned song, a moderate level of suppression for the transposed song, and no suppression for the control song. As beta power is associated with attention and motor processing, we interpret this as support of the motor system's activity during covert perception of music one can play and similar musical sequences. PMID:26527118

Are They Learning? Are We? Learning Outcomes and the Academic Library

ERIC Educational Resources Information Center

Oakleaf, Megan

2011-01-01

Since the 1990s, the assessment of learning outcomes in academic libraries has accelerated rapidly, and librarians have come to recognize the necessity of articulating and assessing student learning outcomes. Initially, librarians developed tools and instruments to assess information literacy student learning outcomes. Now, academic librarians are…

Discovery of nonsteroidal 17beta-hydroxysteroid dehydrogenase 1 inhibitors by pharmacophore-based screening of virtual compound libraries.

PubMed

Schuster, Daniela; Nashev, Lyubomir G; Kirchmair, Johannes; Laggner, Christian; Wolber, Gerhard; Langer, Thierry; Odermatt, Alex

2008-07-24

17Beta-hydroxysteroid dehydrogenase type 1 (17beta-HSD1) plays a pivotal role in the local synthesis of the most potent estrogen estradiol. Its expression is a prognostic marker for the outcome of patients with breast cancer and inhibition of 17beta-HSD1 is currently under consideration for breast cancer prevention and treatment. We aimed to identify nonsteroidal 17beta-HSD1 inhibitor scaffolds by virtual screening with pharmacophore models built from crystal structures containing steroidal compounds. The most promising model was validated by comparing predicted and experimentally determined inhibitory activities of several flavonoids. Subsequently, a virtual library of nonsteroidal compounds was screened against the 3D pharmacophore. Analysis of 14 selected compounds yielded four that inhibited the activity of human 17beta-HSD1 (IC 50 below 50 microM). Specificity assessment of identified 17beta-HSD1 inhibitors emphasized the importance of including related short-chain dehydrogenase/reductase (SDR) members to analyze off-target effects. Compound 29 displayed at least 10-fold selectivity over the related SDR enzymes tested.

Can Cooperative Learning Achieve the Four Learning Outcomes of Physical Education? A Review of Literature

ERIC Educational Resources Information Center

Casey, Ashley; Goodyear, Victoria A.

2015-01-01

Physical learning, cognitive learning, social learning, and affective learning are positioned as the legitimate learning outcomes of physical education. It has been argued that these four learning outcomes go toward facilitating students' engagement with the physically active life (Bailey et al., 2009; Kirk, 2013). With Cooperative Learning…

Support vector machines for prediction and analysis of beta and gamma-turns in proteins.

PubMed

Pham, Tho Hoan; Satou, Kenji; Ho, Tu Bao

2005-04-01

Tight turns have long been recognized as one of the three important features of proteins, together with alpha-helix and beta-sheet. Tight turns play an important role in globular proteins from both the structural and functional points of view. More than 90% tight turns are beta-turns and most of the rest are gamma-turns. Analysis and prediction of beta-turns and gamma-turns is very useful for design of new molecules such as drugs, pesticides, and antigens. In this paper we investigated two aspects of applying support vector machine (SVM), a promising machine learning method for bioinformatics, to prediction and analysis of beta-turns and gamma-turns. First, we developed two SVM-based methods, called BTSVM and GTSVM, which predict beta-turns and gamma-turns in a protein from its sequence. When compared with other methods, BTSVM has a superior performance and GTSVM is competitive. Second, we used SVMs with a linear kernel to estimate the support of amino acids for the formation of beta-turns and gamma-turns depending on their position in a protein. Our analysis results are more comprehensive and easier to use than the previous results in designing turns in proteins.

Outcomes-Based Assessment and Learning: Trialling Change in a Postgraduate Civil Engineering Course

ERIC Educational Resources Information Center

El-Maaddawy, Tamer; Deneen, Christopher

2017-01-01

This paper aims to demonstrate how assessment tasks can function within an outcomes-based learning framework to evaluate student attainment of learning outcomes. An outcomes-based learning framework designed to integrate teaching, learning, and assessment activities was developed and implemented in a civil engineering master-level course. The…

From the Experience of Interactivity and Entertainment to Lower Intention to Smoke: A Randomized Controlled Trial and Path Analysis of a Web-Based Smoking Prevention Program for Adolescents.

PubMed

Khalil, Georges Elias; Wang, Hua; Calabro, Karen Sue; Mitra, Natasha; Shegog, Ross; Prokhorov, Alexander V

2017-02-16

Web-based programs for smoking prevention are being increasingly used with some success among adolescents. However, little is known about the mechanisms that link the experience of such programs to intended nicotine or tobacco control outcomes. Based on the experiential learning theory and extended elaboration likelihood model, this study aimed to evaluate the impact of a Web-based intervention, A Smoking Prevention Interactive Experience (ASPIRE), on adolescents' intention to smoke, while considering the experience of interactivity and entertainment as predictors of reduced intention to smoke, under a transitional user experience model. A total of 101 adolescents were recruited from after-school programs, provided consent, screened, and randomized in a single-blinded format to 1 of 2 conditions: the full ASPIRE program as the experimental condition (n=50) or an online , text-based version of ASPIRE as the control condition (n=51). Data were collected at baseline and immediate follow-up. Repeated-measures mixed-effects models and path analyses were conducted. A total of 82 participants completed the study and were included in the analysis. Participants in the experimental condition were more likely to show a decrease in their intention to smoke than those in the control condition (beta=-0.18, P=.008). Perceived interactivity (beta=-0.27, P=.004) and entertainment (beta=-0.20, P=.04) were each associated with a decrease in intention to smoke independently. Results of path analyses indicated that perceived interactivity and perceived entertainment mediated the relationship between ASPIRE use and emotional involvement. Furthermore, perceived presence mediated the relationship between perceived interactivity and emotional involvement. There was a direct relationship between perceived entertainment and emotional involvement. Emotional involvement predicted a decrease in intention to smoke (beta=-0.16, P=.04). Adolescents' experience of interactivity and entertainment contributed to the expected outcome of lower intention to smoke. Also, emphasis needs to be placed on the emotional experience during Web-based interventions in order to maximize reductions in smoking intentions. Going beyond mere evaluation of the effectiveness of a Web-based smoking prevention program, this study contributes to the understanding of adolescents' psychological experience and its effect on their intention to smoke. With the results of this study, researchers can work to (1) enhance the experience of interactivity and entertainment and (2) amplify concepts of media effects (eg, presence and emotional involvement) in order to better reach health behavior outcomes. Clinicaltrials.gov NCT02469779; https://clinicaltrials.gov/ct2/show/NCT02469779 (Archived by WebCite at http://www.webcitation.org/6nxyZVOf0). ©Georges Elias Khalil, Hua Wang, Karen Sue Calabro, Natasha Mitra, Ross Shegog, Alexander V Prokhorov. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 16.02.2017.

Relationship of pass/fail grading and curriculum structure with well-being among preclinical medical students: a multi-institutional study.

PubMed

Reed, Darcy A; Shanafelt, Tait D; Satele, Daniel W; Power, David V; Eacker, Anne; Harper, William; Moutier, Christine; Durning, Steven; Massie, F Stanford; Thomas, Matthew R; Sloan, Jeff A; Dyrbye, Liselotte N

2011-11-01

Psychological distress is common among medical students. Curriculum structure and grading scales are modifiable learning environment factors that may influence student well-being. The authors sought to examine relationships among curriculum structures, grading scales, and student well-being. The authors surveyed 2,056 first- and second-year medical students at seven U.S. medical schools in 2007. They used the Perceived Stress Scale, Maslach Burnout Inventory, and Medical Outcomes Study Short Form (SF-8) to measure stress, burnout, and quality of life, respectively. They measured curriculum structure using hours spent in didactic, clinical, and testing experiences. Grading scales were categorized as two categories (pass/fail) versus three or more categories (e.g., honors/pass/fail). Of the 2,056 students, 1,192 (58%) responded. In multivariate analyses, students in schools using grading scales with three or more categories had higher levels of stress (beta 2.65; 95% CI 1.54-3.76, P<.0001), emotional exhaustion (beta 5.35; 95% CI 3.34-7.37, P<.0001), and depersonalization (beta 1.36; 95% CI 0.53-2.19, P=.001) and were more likely to have burnout (OR 2.17; 95% CI 1.41-3.35, P=.0005) and to have seriously considered dropping out of school (OR 2.24; 95% CI 1.54-3.27, P<.0001) compared with students in schools using pass/fail grading. There were no relationships between time spent in didactic and clinical experiences and well-being. How students are evaluated has a greater impact than other aspects of curriculum structure on their well-being. Curricular reform intended to enhance student well-being should incorporate pass/fail grading.

Perioperative beta-blockers for preventing surgery-related mortality and morbidity.

PubMed

Blessberger, Hermann; Kammler, Juergen; Domanovits, Hans; Schlager, Oliver; Wildner, Brigitte; Azar, Danyel; Schillinger, Martin; Wiesbauer, Franz; Steinwender, Clemens

2018-03-13

Randomized controlled trials have yielded conflicting results regarding the ability of beta-blockers to influence perioperative cardiovascular morbidity and mortality. Thus routine prescription of these drugs in unselected patients remains a controversial issue. The objective of this review was to systematically analyse the effects of perioperatively administered beta-blockers for prevention of surgery-related mortality and morbidity in patients undergoing any type of surgery while under general anaesthesia. We identified trials by searching the following databases from the date of their inception until June 2013: MEDLINE, Embase , the Cochrane Central Register of Controlled Trials (CENTRAL), Biosis Previews, CAB Abstracts, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Derwent Drug File, Science Citation Index Expanded, Life Sciences Collection, Global Health and PASCAL. In addition, we searched online resources to identify grey literature. We included randomized controlled trials if participants were randomly assigned to a beta-blocker group or a control group (standard care or placebo). Surgery (any type) had to be performed with all or at least a significant proportion of participants under general anaesthesia. Two review authors independently extracted data from all studies. In cases of disagreement, we reassessed the respective studies to reach consensus. We computed summary estimates in the absence of significant clinical heterogeneity. Risk ratios (RRs) were used for dichotomous outcomes, and mean differences (MDs) were used for continuous outcomes. We performed subgroup analyses for various potential effect modifiers. We included 88 randomized controlled trials with 19,161 participants. Six studies (7%) met the highest methodological quality criteria (studies with overall low risk of bias: adequate sequence generation, adequate allocation concealment, double/triple-blinded design with a placebo group, intention-to-treat analysis), whereas in the remaining trials, some form of bias was present or could not be definitively excluded (studies with overall unclear or high risk of bias). Outcomes were evaluated separately for cardiac and non-cardiac surgery.CARDIAC SURGERY (53 trials)We found no clear evidence of an effect of beta-blockers on the following outcomes.• All-cause mortality: RR 0.73, 95% CI 0.35 to 1.52, 3783 participants, moderate quality evidence.• Acute myocardial infarction (AMI): RR 1.04, 95% CI 0.71 to 1.51, 3553 participants, moderate quality evidence.• Myocardial ischaemia: RR 0.51, 95% CI 0.25 to 1.05, 166 participants, low quality evidence.• Cerebrovascular events: RR 1.52, 95% CI 0.58 to 4.02, 1400 participants, low quality evidence.• Hypotension: RR 1.54, 95% CI 0.67 to 3.51, 558 participants, low quality evidence.• Bradycardia: RR 1.61, 95% CI 0.97 to 2.66, 660 participants, low quality evidence.• Congestive heart failure: RR 0.22, 95% CI 0.04 to 1.34, 311 participants, low quality evidence.Beta-blockers significantly reduced the occurrence of the following endpoints.• Ventricular arrhythmias: RR 0.37, 95% CI 0.24 to 0.58, number needed to treat for an additional beneficial outcome (NNTB) 29, 2292 participants, moderate quality evidence.• Supraventricular arrhythmias: RR 0.44, 95% CI 0.36 to 0.53, NNTB five, 6420 participants, high quality evidence.• On average, beta-blockers reduced length of hospital stay by 0.54 days (95% CI -0.90 to -0.19, 2450 participants, low quality evidence).NON-CARDIAC SURGERY (35 trials)Beta-blockers significantly increased the occurrence of the following adverse events.• All-cause mortality: RR 1.25, 95% CI 1.00 to 1.57, 11,413 participants, low quality of evidence, number needed to treat for an additional harmful outcome (NNTH) 167.• Hypotension: RR 1.50, 95% CI 1.38 to 1.64, NNTH 16, 10,947 participants, high quality evidence.• Bradycardia: RR 2.23, 95% CI 1.48 to 3.36, NNTH 21, 11,033 participants, moderate quality evidence.We found a potential increase in the occurrence of the following outcomes with the use of beta-blockers.• Cerebrovascular events: RR 1.59, 95% CI 0.93 to 2.71, 9150 participants, low quality evidence.Whereas no clear evidence of an effect was found when all studies were analysed, restricting the meta-analysis to low risk of bias studies revealed a significant increase in cerebrovascular events with the use of beta-blockers: RR 2.09, 95% CI 1.14 to 3.82, NNTH 265, 8648 participants.Beta-blockers significantly reduced the occurrence of the following endpoints.• AMI: RR 0.73, 95% CI 0.61 to 0.87, NNTB 76, 10,958 participants, high quality evidence.• Myocardial ischaemia: RR 0.51, 95% CI 0.34 to 0.77, NNTB nine, 978 participants, moderate quality evidence.• Supraventricular arrhythmias: RR 0.73, 95% CI 0.57 to 0.94, NNTB 112, 8744 participants, high quality evidence.We found no clear evidence of an effect of beta-blockers on the following outcomes.• Ventricular arrhythmias: RR 0.68, 95% CI 0.31 to 1.49, 476 participants, moderate quality evidence.• Congestive heart failure: RR 1.18, 95% CI 0.94 to 1.48, 9173 participants, moderate quality evidence.• Length of hospital stay: mean difference -0.45 days, 95% CI -1.75 to 0.84, 551 participants, low quality evidence. According to our findings, perioperative application of beta-blockers still plays a pivotal role in cardiac surgery, as they can substantially reduce the high burden of supraventricular and ventricular arrhythmias in the aftermath of surgery. Their influence on mortality, AMI, stroke, congestive heart failure, hypotension and bradycardia in this setting remains unclear.In non-cardiac surgery, evidence shows an association of beta-blockers with increased all-cause mortality. Data from low risk of bias trials further suggests an increase in stroke rate with the use of beta-blockers. As the quality of evidence is still low to moderate, more evidence is needed before a definitive conclusion can be drawn. The substantial reduction in supraventricular arrhythmias and AMI in this setting seems to be offset by the potential increase in mortality and stroke.

Drug treatment effects on outcomes in heart failure with preserved ejection fraction: a systematic review and meta-analysis

PubMed Central

Zheng, Sean Lee; Chan, Fiona T; Nabeebaccus, Adam A; Shah, Ajay M; McDonagh, Theresa; Okonko, Darlington O; Ayis, Salma

2018-01-01

Background Clinical drug trials in patients with heart failure and preserved ejection fraction have failed to demonstrate improvements in mortality. Methods We systematically searched Medline, Embase and the Cochrane Central Register of Controlled Trials for randomised controlled trials (RCT) assessing pharmacological treatments in patients with heart failure with left ventricular (LV) ejection fraction≥40% from January 1996 to May 2016. The primary efficacy outcome was all-cause mortality. Secondary outcomes were cardiovascular mortality, heart failure hospitalisation, exercise capacity (6-min walk distance, exercise duration, VO2 max), quality of life and biomarkers (B-type natriuretic peptide, N-terminal pro-B-type natriuretic peptide). Random-effects models were used to estimate pooled relative risks (RR) for the binary outcomes, and weighted mean differences for continuous outcomes, with 95% CI. Results We included data from 25 RCTs comprising data for 18101 patients. All-cause mortality was reduced with beta-blocker therapy compared with placebo (RR: 0.78, 95%CI 0.65 to 0.94, p=0.008). There was no effect seen with ACE inhibitors, aldosterone receptor blockers, mineralocorticoid receptor antagonists and other drug classes, compared with placebo. Similar results were observed for cardiovascular mortality. No single drug class reduced heart failure hospitalisation compared with placebo. Conclusion The efficacy of treatments in patients with heart failure and an LV ejection fraction≥40% differ depending on the type of therapy, with beta-blockers demonstrating reductions in all-cause and cardiovascular mortality. Further trials are warranted to confirm treatment effects of beta-blockers in this patient group. PMID:28780577

Congenital hypothyroidism: influence of disease severity and L-thyroxine treatment on intellectual, motor, and school-associated outcomes in young adults.

PubMed

Oerbeck, Beate; Sundet, Kjetil; Kase, Bengt F; Heyerdahl, Sonja

2003-10-01

To describe intellectual, motor, and school-associated outcome in young adults with early treated congenital hypothyroidism (CH) and to study the association between long-term outcome and CH variables acting at different points in time during early development (CH severity and early L-thyroxine treatment levels [0-6 years]). Neuropsychological tests were administered to all 49 subjects with CH identified during the first 3 years of the Norwegian neonatal screening program (1979-1981) at a mean age of 20 years and to 41 sibling control subjects (mean age: 21 years). The CH group attained significantly lower scores than control subjects on intellectual, motor, and school-associated tests (total IQ: 102.4 [standard deviation: 13] vs 111.4 [standard deviation: 13]). Twelve (24%) of the 49 CH subjects had not completed senior high school, in contrast to 6% of the control subjects. CH severity (pretreatment serum thyroxine [T4]) correlated primarily with motor tests, whereas early L-thyroxine treatment levels were related to verbal IQ and school-associated tests. In multiple regression analysis, initial L-thyroxine dose (beta = 0.32) and mean serum T4 level during the second year (beta = 0.48) predicted Verbal IQ, whereas mean serum T4 level during the second year (beta = 0.44) predicted Arithmetic. Long-term outcome revealed enduring cognitive and motor deficits in young adults with CH relative to control subjects. Verbal functions and Arithmetic were associated with L-thyroxine treatment variables, suggesting that more optimal treatment might be possible. Motor outcome was associated with CH severity, indicating a prenatal effect.

Coping strategies, emotional outcomes and spiritual quality of life in palliative care nurses.

PubMed

Desbiens, Jean-Francois; Fillion, Lise

2007-06-01

It is in accompanying the dying that palliative care nurses say they find meaning in their work. To further explore this phenomenon, consideration of coping strategies is proposed. The main objective of this correlational study was to describe the association between coping strategies (using a revised version of the COPE scale (Carver et al, 1999)), emotional outcomes (distress and vigour; profile of mood states (POMS)), and spiritual quality of life (using the Functional Assessment of Chronic Illness Therapy - Spiritual Wellbeing Scale (FACIT-sp)). A sample of 120 nurses providing palliative care in acute care hospitals and the community in Quebec was included. Positive reinterpretation (beta=.27; p<.01) and turning to religion (beta=.33; p<.001), two strategies related to meaning-making coping and disengagement (beta=-.19; p<.05), were the best predictors, accounting for 22% of variance of spiritual quality of life. These findings are consistent with recent studies and highlight the importance of meaning-making strategies in psychological adjustment to bereavement for palliative care nurses.

Understanding Cognitive Presence in an Online and Blended Community of Inquiry: Assessing Outcomes and Processes for Deep Approaches to Learning

ERIC Educational Resources Information Center

Akyol, Zehra; Garrison, D. Randy

2011-01-01

This paper focuses on deep and meaningful learning approaches and outcomes associated with online and blended communities of inquiry. Applying mixed methodology for the research design, the study used transcript analysis, learning outcomes, perceived learning, satisfaction, and interviews to assess learning processes and outcomes. The findings for…

Interhemispheric EEG differences in olfactory bulbectomized rats with different cognitive abilities and brain beta-amyloid levels.

PubMed

Bobkova, Natalia; Vorobyov, Vasily; Medvinskaya, Natalia; Aleksandrova, Irina; Nesterova, Inna

2008-09-26

Alterations in electroencephalogram (EEG) asymmetry and deficits in interhemispheric integration of information have been shown in patients with Alzheimer's disease (AD). However, no direct evidence of an association between EEG asymmetry, morphological markers in the brain, and cognition was found either in AD patients or in AD models. In this study we used rats with bilateral olfactory bulbectomy (OBX) as one of the AD models and measured their learning/memory abilities, brain beta-amyloid levels and EEG spectra in symmetrical frontal and occipital cortices. One year after OBX or sham-surgery, the rats were tested with the Morris water paradigm and assigned to three groups: sham-operated rats, SO, and OBX rats with virtually normal, OBX(+), or abnormal, OBX(-), learning (memory) abilities. In OBX vs. SO, the theta EEG activity was enhanced to a higher extent in the right frontal cortex and in the left occipital cortex. This produced significant interhemispheric differences in the frontal cortex of the OBX(-) rats and in the occipital cortex of both OBX groups. The beta1 EEG asymmetry in SO was attenuated in OBX(+) and completely eliminated in OBX(-). OBX produced highly significant beta2 EEG decline in the right frontal cortex, with OBX(-)>OBX(+) rank order of strength. The beta-amyloid level, examined by post-mortem immunological DOT-analysis in the cortex-hippocampus samples, was about six-fold higher in OBX(-) than in SO, but significantly less (enhanced by 82% vs. SO) in OBX(+) than in OBX(-). The involvement of the brain mediatory systems in the observed EEG asymmetry differences is discussed.

Association between use of interferon beta and progression of disability in patients with relapsing-remitting multiple sclerosis.

PubMed

Shirani, Afsaneh; Zhao, Yinshan; Karim, Mohammad Ehsanul; Evans, Charity; Kingwell, Elaine; van der Kop, Mia L; Oger, Joel; Gustafson, Paul; Petkau, John; Tremlett, Helen

2012-07-18

Interferon beta is widely prescribed to treat multiple sclerosis (MS); however, its relationship with disability progression has yet to be established. To investigate the association between interferon beta exposure and disability progression in patients with relapsing-remitting MS. Retrospective cohort study based on prospectively collected data (1985-2008) from British Columbia, Canada. Patients with relapsing-remitting MS treated with interferon beta (n = 868) were compared with untreated contemporary (n = 829) and historical (n = 959) cohorts. The main outcome measure was time from interferon beta treatment eligibility (baseline) to a confirmed and sustained score of 6 (requiring a cane to walk 100 m; confirmed at >150 days with no measurable improvement) on the Expanded Disability Status Scale (EDSS) (range, 0-10, with higher scores indicating higher disability). A multivariable Cox regression model with interferon beta treatment included as a time-varying covariate was used to assess the hazard of disease progression associated with interferon beta treatment. Analyses also included propensity score adjustment to address confounding by indication. The median active follow-up times (first to last EDSS measurement) were as follows: for the interferon beta-treated cohort, 5.1 years (interquartile range [IQR], 3.0-7.0 years); for the contemporary control cohort, 4.0 years (IQR, 2.1-6.4 years); and for the historical control cohort, 10.8 years (IQR, 6.3-14.7 years). The observed outcome rates for reaching a sustained EDSS score of 6 were 10.8%, 5.3%, and 23.1% in the 3 cohorts, respectively. After adjustment for potential baseline confounders (sex, age, disease duration, and EDSS score), exposure to interferon beta was not associated with a statistically significant difference in the hazard of reaching an EDSS score of 6 when either the contemporary control cohort (hazard ratio, 1.30; 95% CI, 0.92-1.83; P = .14) or the historical control cohort (hazard ratio, 0.77; 95% CI, 0.58-1.02; P = .07) were considered. Further adjustment for comorbidities and socioeconomic status, where possible, did not change interpretations, and propensity score adjustment did not substantially change the results. Among patients with relapsing-remitting MS, administration of interferon beta was not associated with a reduction in progression of disability.

Diarrhea, stimulation and growth predict neurodevelopment in young North Indian children.

PubMed

Kvestad, Ingrid; Taneja, Sunita; Hysing, Mari; Kumar, Tivendra; Bhandari, Nita; Strand, Tor A

2015-01-01

Infants and young children in low to middle-income countries are at risk for adverse neurodevelopment due to multiple risk factors. In this study, we sought to identify stimulation and learning opportunities, growth, and burden of respiratory infections and diarrhea as predictors for neurodevelopment. We visited 422 North Indian children 6 to 30 months old weekly for six months. Childhood illnesses were assessed biweekly. At end study, we assessed neurodevelopment using the Ages and Stages Questionnaire 3rd ed. (ASQ-3) and gathered information on stimulation and learning opportunities. We identified predictors for ASQ-3 scores in multiple linear and logistic regression models. We were able to explain 30.5% of the variation in the total ASQ-3 score by the identified predictors. When adjusting for child characteristics and annual family income, stimulation and learning opportunities explained most of the variation by 25.1%. Height for age (standardized beta: 0.12, p<.05) and weight for height z-scores (std. beta: 0.09, p<.05) were positively associated with the total ASQ-3 score, while number of days with diarrhea was negatively associated with these scores (std. beta: -0.13, p<0.01). Our results support the importance of early child stimulation and general nutrition for child development. Our study also suggests that diarrhea is an additional risk factor for adverse neurodevelopment in vulnerable children.

Effect of beta-blockers on exacerbation rate and lung function in chronic obstructive pulmonary disease (COPD).

PubMed

Duffy, Sean; Marron, Robert; Voelker, Helen; Albert, Richard; Connett, John; Bailey, William; Casaburi, Richard; Cooper, J Allen; Curtis, Jeffrey L; Dransfield, Mark; Han, MeiLan K; Make, Barry; Marchetti, Nathaniel; Martinez, Fernando; Lazarus, Stephen; Niewoehner, Dennis; Scanlon, Paul D; Sciurba, Frank; Scharf, Steven; Reed, Robert M; Washko, George; Woodruff, Prescott; McEvoy, Charlene; Aaron, Shawn; Sin, Don; Criner, Gerard J

2017-06-19

Beta-blockers are commonly prescribed for patients with cardiovascular disease. Providers have been wary of treating chronic obstructive pulmonary disease (COPD) patients with beta-blockers due to concern for bronchospasm, but retrospective studies have shown that cardio-selective beta-blockers are safe in COPD and possibly beneficial. However, these benefits may reflect symptom improvements due to the cardiac effects of the medication. The purpose of this study is to evaluate associations between beta-blocker use and both exacerbation rates and longitudinal measures of lung function in two well-characterized COPD cohorts. We retrospectively analyzed 1219 participants with over 180 days of follow up from the STATCOPE trial, which excluded most cardiac comorbidities, and from the placebo arm of the MACRO trial. Primary endpoints were exacerbation rates per person-year and change in spirometry over time in association with beta blocker use. Overall 13.9% (170/1219) of participants reported taking beta-blockers at enrollment. We found no statistically significant differences in exacerbation rates with respect to beta-blocker use regardless of the prevalence of cardiac comorbidities. In the MACRO cohort, patients taking beta-blockers had an exacerbation rate of 1.72/person-year versus a rate of 1.71/person-year in patients not taking beta-blockers. In the STATCOPE cohort, patients taking beta-blockers had an exacerbation rate of 1.14/person-year. Patients without beta-blockers had an exacerbation rate of 1.34/person-year. We found no detrimental effect of beta blockers with respect to change in lung function over time. We found no evidence that beta-blocker use was unsafe or associated with worse pulmonary outcomes in study participants with moderate to severe COPD.

Quantifiable outcomes from corporate and higher education learning collaborations

NASA Astrophysics Data System (ADS)

Devine, Thomas G.

The study investigated the existence of measurable learning outcomes that emerged out of the shared strengths of collaborating sponsors. The study identified quantifiable learning outcomes that confirm corporate, academic and learner participation in learning collaborations. Each of the three hypotheses and the synergy indicator quantitatively and qualitatively confirmed learning outcomes benefiting participants. The academic-indicator quantitatively confirmed that learning outcomes attract learners to the institution. The corporate-indicator confirmed that learning outcomes include knowledge exchange and enhanced workforce talents for careers in the energy-utility industry. The learner-indicator confirmed that learning outcomes provide professional development opportunities for employment. The synergy-indicator confirmed that best learning practices in learning collaborations emanate out of the sponsors' shared strengths, and that partnerships can be elevated to strategic alliances, going beyond response to the desires of sponsors to create learner-centered cultures. The synergy-indicator confirmed the value of organizational processes that elevate sponsors' interactions to sharing strength, to create a learner-centered culture. The study's series of qualitative questions confirmed prior success factors, while verifying the hypothesis results and providing insight not available from quantitative data. The direct benefactors of the study are the energy-utility learning-collaboration participants of the study, and corporation, academic institutions, and learners of the collaboration. The indirect benefactors are the stakeholders of future learning collaborations, through improved knowledge of the existence or absence of quantifiable learning outcomes.

Analysing Learning Outcomes in an Electrical Engineering Curriculum Using Illustrative Verbs Derived from Bloom's Taxonomy

ERIC Educational Resources Information Center

Meda, Lawrence; Swart, Arthur James

2018-01-01

Learning outcomes are essential to any curriculum in education, where they need to be clear, observable and measurable. However, some academics structure learning outcomes in a way that does not promote student learning. The purpose of this article is to present the analyses of learning outcomes of an Electrical Engineering curriculum offered at a…

Peginterferon beta-1a reduces the evolution of MRI lesions to black holes in patients with RRMS: a post hoc analysis from the ADVANCE study.

PubMed

Arnold, Douglas L; You, Xiaojun; Castrillo-Viguera, Carmen

2017-08-01

The presence of chronic black holes, i.e., chronic lesions that are hypointense on T1-weighted images and are indicative of more severe tissue injury, has been increasingly utilized as a surrogate marker of therapeutic outcome in multiple sclerosis. The ADVANCE study was a 2-year, double-blind, pivotal trial evaluating the safety and efficacy of subcutaneous peginterferon beta-1a 125 mcg in 1512 patients with relapsing-remitting multiple sclerosis (RRMS). This report describes the correlation of clinical outcomes with the evolution of acute lesions into chronic black holes in ADVANCE, and the efficacy of peginterferon beta-1a in reducing this evolution. Treatment with peginterferon beta-1a significantly reduced the mean number of new/enlarging T2-weighted (NET2) lesions (0.76 vs. 1.03 from week 24, p = 0.0037; 0.44 vs. 0.99 from week 48, p < 0.0001) and new gadolinium-enhancing (Gd+) lesions (0.15 vs. 0.32 from week 24, p < 0.0001; 0.09 vs. 0.19 from week 48) that evolved into chronic black holes by 2 years. Patients with NET2 or Gd+ lesions at 24 weeks that evolved into chronic black holes showed significantly worse clinical outcomes, including a greater proportion with 12-week (14.9 vs. 8.4%; p = 0.0167) and 24-week (12.3 vs. 7.0%; p = 0.0333) confirmed disability worsening and higher mean annualized relapse rate (0.62 vs. 0.43; p = 0.0118), compared with patients with lesions that did not evolve into black holes. The correlation was independent of treatment. Reduced risk of evolution of new lesions into chronic black holes with peginterferon beta-1a treatment suggests potential to reduce long-term disability in RRMS by preventing irreversible tissue damage.

Antioxidant Vitamin Status in the Serum and Amniotic Fluid of Women with Premature Rupture of the Fetal Membranes.

NASA Astrophysics Data System (ADS)

Barrett, Bridget M.

The purpose of this study was to examine the status of antioxidant vitamins in women with premature rupture of the fetal membranes. Specimens of blood and amniotic fluid were obtained from 80 pregnant subjects included both smokers and non-smokers during the third trimester. The concentrations of ascorbic acid (ASA), beta -carotene, retinol and alpha -tocopherol in serum and amniotic fluid were determined. The experimental group consisted of those subjects with PROM while the control subjects were those with normal pregnancy. No statistical differences were found between the PROM and control groups in retinol and vitamin E concentrations in amniotic fluid and serum. Serum ASA concentrations of PROM subjects were not different from controls, but the PROM subjects had significantly lower amniotic fluid ASA concentrations. However, in a study with fewer subjects a lower serum ASA concentration in the PROM subjects was observed. The ratio of amniotic fluid ASA concentration to ASA serum concentration was significantly lower in PROM patients than in controls in both studies. This suggests that low levels of ASA in the amniotic fluid, but not in serum is better associated with PROM. A low amniotic fluid concentration of ASA may reflect an inefficient transfer and/or increased fetal utilization. Alterations in ASA concentration in the amniotic fluid may affect the integrity of the chorioamnion leading to PROM. beta -Carotene was not found in the amniotic fluid. Serum beta-carotene levels were significantly lower in the PROM group compared to the control group. Low concentrations of beta-carotene in maternal serum in smokers not only associated with poor maternal outcome (PROM) but also compromised the fetal outcome (decreased birth weight). Maintenance of adequate serum beta-carotene concentration and amniotic fluid ASA in smokers may result in better maternal and fetal outcome. This study demonstrated that nutrition is an important factor in the prevention of PROM.

Comparative efficacy of disease-modifying therapies for patients with relapsing remitting multiple sclerosis: Systematic review and network meta-analysis.

PubMed

Fogarty, Emer; Schmitz, Susanne; Tubridy, Niall; Walsh, Cathal; Barry, Michael

2016-09-01

Randomised studies have demonstrated efficacy of disease-modifying therapies in relapsing remitting multiple sclerosis (RRMS). However it is unclear how the magnitude of treatment efficacy varies across all currently available therapies. To perform a systematic review and network meta-analysis to evaluate the comparative efficacy of available therapies in reducing relapses and disability progression in RRMS. A systematic review identified 28 randomised, placebo-controlled and direct comparative trials. A network meta-analysis was conducted within a Bayesian framework to estimate comparative annualised relapse rates (ARR) and risks of disability progression (defined by both a 3-month, and 6-month confirmation interval). Potential sources of treatment-effect modification from study-level covariates and baseline risk were evaluated through meta-regression methods. The Surface Under the Cumulative RAnking curve (SUCRA) method was used to provide a ranking of treatments for each outcome. The magnitude of ARR reduction varied between 15-36% for all interferon-beta products, glatiramer acetate and teriflunomide, and from 50 to 69% for alemtuzumab, dimethyl fumarate, fingolimod and natalizumab. The risk of disability progression (3-month) was reduced by 19-28% with interferon-beta products, glatiramer acetate, fingolimod and teriflunomide, by 38-45% for pegylated interferon-beta, dimethyl fumarate and natalizumab and by 68% with alemtuzumab. Broadly similar estimates for the risk of disability progression (6-month), with the exception of interferon-beta-1b 250mcg which was much more efficacious based on this definition. Alemtuzumab and natalizumab had the highest SUCRA scores (97% and 95% respectively) for ARR, while ranking for disability progression varied depending on the definition of the outcome. Interferon-beta-1b 250mcg ranked among the most efficacious treatments for disability progression confirmed after six months (92%) and among the least efficacious when the outcome was confirmed after three months (30%). No significant modification of relative treatment effects was identified from study-level covariates or baseline risk. Compared with placebo, clear reductions in ARR with disease-modifying therapies were accompanied by more uncertain changes in disability progression. The magnitude of the reduction and the uncertainty associated with treatment effects varied between DMTs. While natalizumab and alemtuzumab demonstrated consistently high ranking across outcomes, with older interferon-beta and glatiramer acetate products ranking lowest, variation in disability progression definitions lead to variation in the relative ranking of treatments. Rigorously conducted comparative studies are required to fully evaluate the comparative treatment effects of disease modifying therapies for RRMS. Copyright © 2016 Elsevier B.V. All rights reserved.

Secret Destinations

ERIC Educational Resources Information Center

Buss, David

2008-01-01

"All journeys have secret destinations of which the traveller is unaware" (Martin Buber). All learning results in learning outcomes of some form, planned or otherwise, but the term is now widely used to refer only to those learning outcomes that predetermine what those outcomes will be--the "intended" or "specified" learning outcomes of the…

Cholesterol and Copper Affect Learning and Memory in the Rabbit

PubMed Central

Schreurs, Bernard G.

2013-01-01

A rabbit model of Alzheimer's disease based on feeding a cholesterol diet for eight weeks shows sixteen hallmarks of the disease including beta amyloid accumulation and learning and memory changes. Although we have shown that feeding 2% cholesterol and adding copper to the drinking water can retard learning, other studies have shown that feeding dietary cholesterol before learning can improve acquisition and feeding cholesterol after learning can degrade long-term memory. We explore the development of this model, the issues surrounding the role of copper, and the particular contributions of the late D. Larry Sparks. PMID:24073355

Beta-Blockers (Carvedilol) in Children with Systemic Ventricle Systolic Dysfunction - Systematic Review and Meta-Analysis.

PubMed

Prijic, Sergej; Buchhorn, Reiner; Kosutic, Jovan; Vukomanovic, Vladislav; Prijic, Andreja; Bjelakovic, Bojko; Zdravkovic, Marija

2014-01-01

Numerous prospective randomized clinical trials demonstrated favorable effect of beta-blockers in adults with chronic heart failure. However, effectiveness of beta blockers in pediatric patients with systemic ventricle systolic dysfunction was not recognized sufficiently. Limited number of pediatric patients might be the course of unrecognized carvediolol treatment benefit. Currently, no meta-analysis has examined the impact of carvedilol and conventional therapy on the clinical outcome in children with chronic heart failure due to impaired systemic ventricle systolic function. We have systematically searched the Medline/PubMed and Cochrane Library for the controlled clinical trials that examine carvedilol and standard treatment efficacy in pediatric patients with systemic ventricle systolic dysfunction. Mean differences for continuous variables, odds ratios for dichotomous outcomes, heterogeneity between studies and publication bias were calculated using Cochrane Review Manager (Rev Man 5.2). Total of 8 prospective/observational studies met established criteria. Odds ratio for chronic heart failure related mortality/heart transplantation secondary to carvedilol was 0.52 (95% CI: 0.28-0.97, I(2) = 0%). Our analysis showed that carvedilol could prevent 1 death/ heart transplantation by treating 14 pediatric patients with impaired systemic ventricle systolic function. Meta-analysis demonstrated clinical outcome benefit of carvedilol in children with chronic heart failure.

The Effectiveness of Inquiry Learning Method to Enhance Students' Learning Outcome: A Theoritical and Empirical Review

ERIC Educational Resources Information Center

Andrini, Vera Septi

2016-01-01

The necessities of the 21st century requires education to continue creating the young generation to have life skills. Life skills are trained through the learning process and identified through the learning outcomes of students. One of the affecting factors for low learning outcomes is learning models. The learning model is a design study that…

Blended Learning Based on Schoology: Effort of Improvement Learning Outcome and Practicum Chance in Vocational High School

ERIC Educational Resources Information Center

Irawan, Vincentius Tjandra; Sutadji, Eddy; Widiyanti

2017-01-01

The aims of this study were to determine: (1) the differences in learning outcome between Blended Learning based on Schoology and Problem-Based Learning, (2) the differences in learning outcome between students with prior knowledge of high, medium, and low, and (3) the interaction between Blended Learning based on Schoology and prior knowledge to…

Road Testing Graduate Attributes and Course Learning Outcomes of an Environmental Science Degree via a Work-Integrated Learning Placement

ERIC Educational Resources Information Center

Whelan, Michael

2017-01-01

Graduate attributes and course learning outcomes are an integral part of higher education in Australia. Testing the performance of graduates in the workplace with regard to graduate attributes and course learning outcomes is a not a common occurrence. This study has road tested the graduate attributes and course learning outcomes of a bachelor…

New life to an old treatment: pegylated Interferon beta 1a in the management of multiple sclerosis.

PubMed

Ortiz, Miguel Angel; Espino-Paisan, Laura; Nunez, Concepcion; Alvarez-Lafuente, Roberto; Urcelay, Elena

2018-02-25

In the 1990s, the betainterferons and glatiramer acetate were introduced for treating relapsing-remitting multiple sclerosis. These medications have a demonstrated record of efficacy and safety, although they require frequent administration via injection and are only partially effective. The optimization of treatment in patients who do not respond adequately to this first-line therapy is essential for attaining the best long-term outcomes. Switching to the recently approved emergent therapies is a strategy to consider for treatment of patients with a suboptimal response. This review summarizes the mechanisms of action, clinical benefits, and safety profiles of current multiple sclerosis disease-modifying therapies, including highly efficacious monoclonal antibodies or convenient oral therapies. Although the first-line interferon beta exhibits a favorable benefit-to-risk profile, treatment compliance is compromised potentially due to its known adverse events and frequent injectable administration. Less frequent dosing and improved pharmacological properties have been achieved by reaction of interferon beta with chemically activated polyethylene glycol. Provided that none of the available therapies shows better effectiveness for all outcomes and their safety in clinical practice is a fundamental concern, the pegylated form of interferon beta seems to keep its place as a competitive therapeutic option. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Children at risk for developmental delay can be recognised by stunting, being underweight, ill health, little maternal schooling or high gravidity.

PubMed

Abubakar, Amina; Holding, Penny; Van de Vijver, Fons J R; Newton, Charles; Van Baar, Anneloes

2010-06-01

To investigate markers of risk status that can be easily monitored in resource-limited settings for the identification of children in need of early developmental intervention. Eighty-five children in Kilifi, Kenya, aged between 2 and 10 months at recruitment, were involved in a 10-month follow-up. Data on developmental outcome were collected through parental report using a locally developed checklist. We tested for the unique and combined influence of little maternal schooling and higher gravidity, anthropometric status (being underweight and stunting) and poor health on the level of developmental achievement and the rate of acquisition of developmental milestones. A model with all five predictors showed a good fit to the data (chi(2)(21, N = 85) = 23.00, p = .33). Maternal schooling and gravidity and child's stunting were found to predict the rate of developmental achievements (beta = .24, beta = .31, and beta = .41, respectively). Being underweight, ill-health, stunting and gravidity predicted initial developmental status (beta = -.26, beta = -.27, beta = -.43, and beta = -.27). Slow rates of developmental achievement can be predicted using these easy-to-administer measures and the strongest relationship with risk was based on a combination of all measures.

A Randomized Factorial Trial of Vitamins C, E, and Beta-Carotene in the Secondary Prevention of Cardiovascular Events in Women

PubMed Central

Cook, Nancy R.; Albert, Christine M.; Gaziano, J. Michael; Zaharris, Elaine; MacFadyen, Jean; Danielson, Eleanor; Buring, Julie E.; Manson, JoAnn E.

2007-01-01

Background Randomized trials have largely failed to support an effect of antioxidant vitamins on risk of cardiovascular disease (CVD). Few trials have examined interactions among antioxidants, and no previous trial has examined the individual effect of vitamin C on CVD. Methods WACS tested the effects of vitamins C (500 mg daily), E (600 IU every other day), and beta-carotene (50 mg every other day) on the combined outcome of myocardial infarction (MI), stroke, coronary revascularization, or CVD death among 8,171 female health professionals at increased risk in a 2×2×2 factorial design. Participants were 40 years or older with a prior history of CVD or three or more CVD risk factors, and were followed an average 9.4 years, from 1995-96 to 2005. Results 1,450 women experienced one or more CVD outcomes. There was no overall effect of vitamin C (RR=1.02, 95% CI=0.92-1.13, p=0.71), vitamin E (RR=0.94, 95% CI=0.85-1.04, p=0.23), or beta-carotene (RR=1.02, 95% CI=0.92-1.13, p=0.71) on the primary combined endpoint, or on the individual secondary outcomes of MI, stroke, coronary revascularization, or CVD death. A marginally significant reduction in the primary outcome with active vitamin E was observed among the pre-specified subgroup of women with prior CVD (RR=0.89, 95% CI=0.79-1.00, p=0.04; p-interaction=0.07). There were no significant interactions between agents for the primary endpoint, but those randomized to both active vitamin C and E experienced fewer strokes (p for interaction=0.03). Conclusion There were no overall effects of vitamins C, E or beta-carotene on cardiovascular events among women at high risk for CVD. Trial Registration clinicaltrials.gov Identifier: NCT00000541 PMID:17698683

Using AMLO to Improve the Quality of Teacher Education Outcomes

ERIC Educational Resources Information Center

Al-Shammari, Zaid

2012-01-01

This study aims to find ways to improve learning outcomes in teacher education courses by using an Analysis Model for Learning Outcomes (AMLO). It addresses the improvement of the quality of teacher education by analyzing learning outcomes and implementing curriculum modifications related to specific learning objectives and their effects on…

Project BETA: Biological Education Through Animals.

ERIC Educational Resources Information Center

Abramson, Charles I.; Wallisch, Kristy; Huss, Jeanine M.; Payne, Delissa

1999-01-01

Describes a program in which biology students study animals in pet shops to learn about animal behavior. Lists general guidelines for starting a partnership and presents two sample student activities. (WRM)

Beta-Catenin and Epithelial Tumors: A Study Based on 374 Oropharyngeal Cancers

PubMed Central

Santoro, Angela; Pannone, Giuseppe; Papagerakis, Silvana; McGuff, H. Stan; Cafarelli, Barbara; Lepore, Silvia; De Maria, Salvatore; Rubini, Corrado; Mattoni, Marilena; Staibano, Stefania; Mezza, Ernesto; De Rosa, Gaetano; Aquino, Gabriella; Losito, Simona; Loreto, Carla; Crimi, Salvatore; Bufo, Pantaleo

2014-01-01

Introduction. Although altered regulation of the Wnt pathway via beta-catenin is a frequent event in several human cancers, its potential implications in oral/oropharyngeal squamous cell carcinomas (OSCC/OPSCC) are largely unexplored. Work purpose was to define association between beta-catenin expression and clinical-pathological parameters in 374 OSCCs/OP-SCCs by immunohistochemistry (IHC). Materials and Methods. Association between IHC detected patterns of protein expression and clinical-pathological parameters was assessed by statistical analysis and survival rates by Kaplan-Meier curves. Beta-catenin expression was also investigated in OSCC cell lines by Real-Time PCR. An additional analysis of the DNA content was performed on 22 representative OSCCs/OPSCCs by DNA-image-cytometric analysis. Results and Discussion. All carcinomas exhibited significant alterations of beta-catenin expression (P < 0.05). Beta-catenin protein was mainly detected in the cytoplasm of cancerous cells and only focal nuclear positivity was observed. Higher cytoplasmic expression correlated significantly with poor histological differentiation, advanced stage, and worst patient outcome (P < 0.05). By Real-Time PCR significant increase of beta-catenin mRNA was detected in OSCC cell lines and in 45% of surgical specimens. DNA ploidy study demonstrated high levels of aneuploidy in beta-catenin overexpressing carcinomas. Conclusions. This is the largest study reporting significant association between beta-catenin expression and clinical-pathological factors in patients with OSCCs/OPSCCs. PMID:24511551

Early clinical experience: do students learn what we expect?

PubMed

Helmich, Esther; Bolhuis, Sanneke; Laan, Roland; Koopmans, Raymond

2011-07-01

Early clinical experience is thought to contribute to the professional development of medical students, but little is known about the kind of learning processes that actually take place. Learning in practice is highly informal and may be difficult to direct by predefined learning outcomes. Learning in medical practice includes a socialisation process in which some learning outcomes may be valued, but others neglected or discouraged. This study describes students' learning goals (prior to a Year 1 nursing attachment) and learning outcomes (after the attachment) in relation to institutional educational goals, and evaluates associations between learning outcomes, student characteristics and place of attachment. A questionnaire containing open-ended questions about learning goals and learning outcomes was administered to all Year 1 medical students (n = 347) before and directly after a 4-week nursing attachment in either a hospital or a nursing home. Two confirmatory focus group interviews were conducted and data were analysed using qualitative and quantitative content analyses. Students' learning goals corresponded with educational goals with a main emphasis on communication and empathy. Other learning goals included gaining insight into the organisation of health care and learning to deal with emotions. Self-reported learning outcomes were the same, but students additionally mentioned reflection on professional behaviour and their own future development. Women and younger students mentioned communication and empathy more often than men and older students. Individual learning goals, with the exception of communicating and empathising with patients, did not predict learning outcomes. Students' learning goals closely match educational goals, which are adequately met in early nursing attachments in both hospitals and nursing homes. Learning to deal with emotions was under-represented as a learning goal and learning outcome, which may indicate that emotional aspects of medical students' professional development are neglected in the first year of medical education. © Blackwell Publishing Ltd 2011.

Determinants and clinical outcome of uptitration of ACE-inhibitors and beta-blockers in patients with heart failure: a prospective European study.

PubMed

Ouwerkerk, W; Voors, A A; Anker, S D; Cleland, J G; Dickstein, K; Filippatos, G; van der Harst, P; Hillege, H L; Lang, C C; Ter Maaten, J M; Ng, L L; Ponikowski, P; Samani, N J; van Veldhuisen, D J; Zannad, F; Metra, M; Zwinderman, A H

2017-06-21

Despite clear guidelines recommendations, most patients with heart failure and reduced ejection-fraction (HFrEF) do not attain guideline-recommended target doses. We aimed to investigate characteristics and for treatment-indication-bias corrected clinical outcome of patients with HFrEF that did not reach recommended treatment doses of ACE-inhibitors/Angiotensin receptor blockers (ARBs) and/or beta-blockers. BIOSTAT-CHF was specifically designed to study uptitration of ACE-inhibitors/ARBs and/or beta-blockers in 2516 heart failure patients from 69 centres in 11 European countries who were selected if they were suboptimally treated while initiation or uptitration was anticipated and encouraged. Patients who died during the uptitration period (n = 151) and patients with a LVEF > 40% (n = 242) were excluded. Median follow up was 21 months. We studied 2100 HFrEF patients (76% male; mean age 68 ±12), of which 22% achieved the recommended treatment dose for ACE-inhibitor/ARB and 12% of beta-blocker. There were marked differences between European countries. Reaching <50% of the recommended ACE-inhibitor/ARB and beta-blocker dose was associated with an increased risk of death and/or heart failure hospitalization. Patients reaching 50-99% of the recommended ACE-inhibitor/ARB and/or beta-blocker dose had comparable risk of death and/or heart failure hospitalization to those reaching ≥100%. Patients not reaching recommended dose because of symptoms, side effects and non-cardiac organ dysfunction had the highest mortality rate (for ACE-inhibitor/ARB: HR 1.72; 95% CI 1.43-2.01; for beta-blocker: HR 1.70; 95% CI 1.36-2.05). Patients with HFrEF who were treated with less than 50% of recommended dose of ACE-inhibitors/ARBs and beta-blockers seemed to have a greater risk of death and/or heart failure hospitalization compared with patients reaching ≥100%. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

PRogram In Support of Moms (PRISM): Development and Beta Testing.

PubMed

Byatt, Nancy; Pbert, Lori; Hosein, Safiyah; Swartz, Holly A; Weinreb, Linda; Allison, Jeroan; Ziedonis, Douglas

2016-08-01

Most women with perinatal depression do not receive depression treatment. The authors describe the development and beta testing of a new program, PRogram In Support of Moms (PRISM), to improve treatment of perinatal depression in obstetric practices. A multidisciplinary work group of seven perinatal and behavioral health professionals was convened to design, refine, and beta-test PRISM in an obstetric practice. Iterative feedback and problem solving facilitated development of PRISM components, which include provider training and a toolkit, screening procedures, implementation assistance, and access to immediate psychiatric consultation. Beta testing with 50 patients over two months demonstrated feasibility and suggested that PRISM may improve provider screening rates and self-efficacy to address depression. On the basis of lessons learned, PRISM will be enhanced to integrate proactive patient engagement and monitoring into obstetric practices. PRISM may help overcome patient-, provider-, and system-level barriers to managing perinatal depression in obstetric settings.

Isoproterenol reduces ischemia-reperfusion lung injury despite beta-blockade.

PubMed

Takashima, Seiki; Schlidt, Scott A; Koukoulis, Giovanna; Sevala, Mayura; Egan, Thomas M

2005-06-01

If lungs could be retrieved from non-heart-beating donors (NHBDs), the shortage of lungs for transplantation could be alleviated. The use of lungs from NHBDs is associated with a mandatory warm ischemic interval, which results in ischemia-reperfusion injury upon reperfusion. In an earlier study, rat lungs retrieved 2-h postmortem from NHBDs had reduced capillary leak measured by filtration coefficient (Kfc) when reperfused with isoproterenol (iso), associated with an increase in lung tissue levels of cyclic AMP (cAMP). The objective was to determine if this decrease in Kfc was because of beta-stimulation, or would persist despite beta-blockade. Donor rats were treated intraperitoneally with beta-blockade (propranolol or pindolol) or carrier, sacrificed, and lungs were retrieved immediately or 2 h postmortem. The lungs were reperfused with or without iso and the beta-blockers in the reperfusate. Outcome measures were Kfc, wet:dry weight ratio (W/D), lung levels of adenine nucleotides and cAMP. Lungs retrieved immediately after death had normal Kfc and W/D. After 2 h of ischemia, Kfc and W/D were markedly elevated in controls (no drug) and lungs reperfused with beta-blockers alone. Isoproterenol-reperfusion decreased Kfc and W/D significantly (P < 0.01) even in the presence of beta-blockade. Lung cAMP levels were increased only with iso in the absence of beta-blockade. The attenuation of ischemia-reperfusion injury because of iso occurs even in the presence of beta-blockade, and may not be a result of beta-stimulated increased cAMP.

Quantitative EEG and functional outcome following acute ischemic stroke.

PubMed

Bentes, Carla; Peralta, Ana Rita; Viana, Pedro; Martins, Hugo; Morgado, Carlos; Casimiro, Carlos; Franco, Ana Catarina; Fonseca, Ana Catarina; Geraldes, Ruth; Canhão, Patrícia; Pinho E Melo, Teresa; Paiva, Teresa; Ferro, José M

2018-06-18

To identify the most accurate quantitative electroencephalographic (qEEG) predictor(s) of unfavorable post-ischemic stroke outcome, and its discriminative capacity compared to already known demographic, clinical and imaging prognostic markers. Prospective cohort of 151 consecutive anterior circulation ischemic stroke patients followed for 12 months. EEG was recorded within 72 h and at discharge or 7 days post-stroke. QEEG (global band power, symmetry, affected/unaffected hemisphere and time changes) indices were calculated from mean Fast Fourier Transform and analyzed as predictors of unfavorable outcome (mRS ≥ 3), at discharge and 12 months poststroke, before and after adjustment for age, admission NIHSS and ASPECTS. Higher delta, lower alpha and beta relative powers (RP) predicted outcome. Indices with higher discriminative capacity were delta-theta to alpha-beta ratio (DTABR) and alpha RP. Outcome models including either of these and other clinical/imaging stroke outcome predictors were superior to models without qEEG data. In models with qEEG indices, infarct size was not a significant outcome predictor. DTAABR and alpha RP are the best qEEG indices and superior to ASPECTS in post-stroke outcome prediction. They improve the discriminative capacity of already known clinical and imaging stroke outcome predictors, both at discharge and 12 months after stroke. qEEG indices are independent predictors of stroke outcome. Copyright © 2018 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

Drug treatment effects on outcomes in heart failure with preserved ejection fraction: a systematic review and meta-analysis.

PubMed

Zheng, Sean Lee; Chan, Fiona T; Nabeebaccus, Adam A; Shah, Ajay M; McDonagh, Theresa; Okonko, Darlington O; Ayis, Salma

2018-03-01

Clinical drug trials in patients with heart failure and preserved ejection fraction have failed to demonstrate improvements in mortality. We systematically searched Medline, Embase and the Cochrane Central Register of Controlled Trials for randomised controlled trials (RCT) assessing pharmacological treatments in patients with heart failure with left ventricular (LV) ejection fraction≥40% from January 1996 to May 2016. The primary efficacy outcome was all-cause mortality. Secondary outcomes were cardiovascular mortality, heart failure hospitalisation, exercise capacity (6-min walk distance, exercise duration, VO 2 max), quality of life and biomarkers (B-type natriuretic peptide, N-terminal pro-B-type natriuretic peptide). Random-effects models were used to estimate pooled relative risks (RR) for the binary outcomes, and weighted mean differences for continuous outcomes, with 95% CI. We included data from 25 RCTs comprising data for 18101 patients. All-cause mortality was reduced with beta-blocker therapy compared with placebo (RR: 0.78, 95%CI 0.65 to 0.94, p=0.008). There was no effect seen with ACE inhibitors, aldosterone receptor blockers, mineralocorticoid receptor antagonists and other drug classes, compared with placebo. Similar results were observed for cardiovascular mortality. No single drug class reduced heart failure hospitalisation compared with placebo. The efficacy of treatments in patients with heart failure and an LV ejection fraction≥40% differ depending on the type of therapy, with beta-blockers demonstrating reductions in all-cause and cardiovascular mortality. Further trials are warranted to confirm treatment effects of beta-blockers in this patient group. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Synthetic Beta-Lactam Antibiotics as a Selective Breast Cancer Cell Apoptosis Inducer: Significance in Breast Cancer Prevention and Treatment

DTIC Science & Technology

2008-03-01

Learned from Diet-Gene-Environment Interaction. Environmental Toxicology Graduate Program and Department of Chemistry , University of California at...College of Chemistry , Central China Normal University, Wuhan, China, June 29, 2007 Dou QP. Invited Speaker. Molecular Prevention of Human Cancer: Role of...Discovery Today 2002; 7: 471-8. 3. Morin RB and Gorman M. Chemistry and Biology of beta-Lactam Antibiotics, Vol. 1-3. New York: Academic Press, 1982. 4

Training with Differential Outcomes Enhances Discriminative Learning and Visuospatial Recognition Memory in Children Born Prematurely

ERIC Educational Resources Information Center

Martinez, Lourdes; Mari-Beffa, Paloma; Roldan-Tapia, Dolores; Ramos-Lizana, Julio; Fuentes, Luis J.; Estevez, Angeles F.

2012-01-01

Previous studies have demonstrated that discriminative learning is facilitated when a particular outcome is associated with each relation to be learned. When this training procedure is applied (the differential outcome procedure; DOP), learning is faster and more accurate than when the more common non-differential outcome procedure is used. This…

Using Cross-Cultural Dimensions Exercises to Improve and Measure Learning Outcomes in International Business Courses

ERIC Educational Resources Information Center

Zainuba, Mohamed; Rahal, Ahmad

2012-01-01

This article proposes an approach for using cross-cultural dimensions exercises to improve and measure learning outcomes in international business courses. The following key issues are highlighted: (a) what are the targeted learning outcomes to be assessed, (b) how to measure the accomplishment of these learning outcomes, (c) the input measures…

Measuring motivation and volition of nursing students in nontraditional learning environments.

PubMed

Nagelsmith, Laurie; Bryer, Jason; Yan, Zheng

2012-01-01

The purpose of this study was to identify the best fitting model to represent interrelationships between motivation, volition, and academic success for adult nursing students learning in nontraditional environments. Participants (N=297) completed a survey that incorporated two measures: the Motivated Strategies for Learning Questionnaire (MSLQ) and the academic volitional strategies inventory (AVSI) as well as demographic information. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and structural equation modeling (SEM) were used for data analysis. In phase 1, EFA resulted in factors that generally aligned with previous theoretical factors as defined by the psychometrics used. In Phase 2 of the analysis, CFA validated the use of predefined factor structures. In Phase 3, SEM analysis revealed that motivation has a larger effect on grade point average (GPA; beta = .28, p < .01) than volition (beta = .15, p < .05). The covariance between motivation and volition (r = .42, p < .01) was also found to be significant. These results suggest that there is a significant relationship among motivation, volition, and academic success for adult learners studying in nontraditional learning environments. These findings are consistent with and elaborate the relationship between motivation and volition with a population and setting underrepresented in the research.

The Effect of Integrated Learning Model and Critical Thinking Skill of Science Learning Outcomes

NASA Astrophysics Data System (ADS)

Fazriyah, N.; Supriyati, Y.; Rahayu, W.

2017-02-01

This study aimed to determine the effect of integrated learning model and critical thinking skill toward science learning outcomes. The study was conducted in SDN Kemiri Muka 1 Depok in fifth grade school year 2014/2015 using cluster random sampling was done to 80 students. Retrieval of data obtained through tests and analysis by Variance (ANOVA) and two lines with the design treatment by level 2x2. The results showed that: (1) science learning outcomes students that given thematic integrated learning model is higher than in the group of students given fragmented learning model, (2) there is an interaction effect between critical thinking skills with integrated learning model, (3) for students who have high critical thinking skills, science learning outcomes students who given by thematic integrated learning model higher than fragmented learning model and (4) for students who have the ability to think critically low yield higher learning science fragmented model. The results of this study indicate that thematic learning model with critical thinking skills can improve science learning outcomes of students.

Using computer-assisted learning to engage diverse learning styles in understanding business management principles.

PubMed

Frost, Mary E; Derby, Dustin C; Haan, Andrea G

2013-01-01

Objective : Changes in small business and insurance present challenges for newly graduated chiropractors. Technology that reaches identified, diverse learning styles may assist the chiropractic student in business classes to meet course outcomes better. Thus, the purpose of our study is to determine if the use of technology-based instructional aids enhance students' mastery of course learning outcomes. Methods : Using convenience sampling, 86 students completed a survey assessing course learning outcomes, learning style, and the helpfulness of lecture and computer-assisted learning related to content mastery. Quantitative analyses occurred. Results : Although respondents reported not finding the computer-assisted learning as helpful as the lecture, significant relationships were found between pre- and post-assisted learning measures of the learning outcomes 1 and 2 for the visual and kinesthetic groups. Surprisingly, however, all learning style groups exhibited significant pre- and post-assisted learning appraisal relationships with learning outcomes 3 and 4. Conclusion : While evidence exists within the current study of a relationship between students' learning of the course content corollary to the use of technologic instructional aids, the exact nature of the relationship remains unclear.

Using computer-assisted learning to engage diverse learning styles in understanding business management principles.

PubMed

Frost, Mary E; Derby, Dustin C; Haan, Andrea G

2013-06-27

Objective : Changes in small business and insurance present challenges for newly graduated chiropractors. Technology that reaches identified, diverse learning styles may assist the chiropractic student in business classes to meet course outcomes better. Thus, the purpose of our study is to determine if the use of technology-based instructional aids enhance students' mastery of course learning outcomes. Methods : Using convenience sampling, 86 students completed a survey assessing course learning outcomes, learning style, and the helpfulness of lecture and computer-assisted learning related to content mastery. Quantitative analyses occurred. Results : Although respondents reported not finding the computer-assisted learning as helpful as the lecture, significant relationships were found between pre- and post-assisted learning measures of the learning outcomes 1 and 2 for the visual and kinesthetic groups. Surprisingly, however, all learning style groups exhibited significant pre- and post-assisted learning appraisal relationships with learning outcomes 3 and 4. Conclusion : While evidence exists within the current study of a relationship between students' learning of the course content corollary to the use of technologic instructional aids, the exact nature of the relationship remains unclear.

When Service-Learning Is Not a "Border-Crossing" Experience: Outcomes of a Graduate Spanish Online Course

ERIC Educational Resources Information Center

Carracelas-Juncal, Carmen

2013-01-01

Research on Spanish service-learning has focused mainly on the outcomes of service-learning for undergraduate students learning Spanish as a second language. This article examines the role of service-learning in a graduate online course for practicing Spanish teachers and the outcomes of the service-learning experience for three participants who…

The Biggs and Moore Model in E-Learning: The Role of Motivation and Collaboration as Moderators

ERIC Educational Resources Information Center

Haverila, Matti J.

2012-01-01

The purpose of this paper is to report the findings of a research conducted to evaluate the effect of e-learning experience on students' perceived learning outcomes, and more specifically the role of motivation and collaboration as moderators between the e-learning experience and the learning outcome. The perceived learning outcome was measured…

Teaching Quality and Learning Creativity in Technical and Vocational Schools

NASA Astrophysics Data System (ADS)

Kembuan, D. R. E.; Rompas, P. T. D.; Mintjelungan, M.; Pantondate, T.; Kilis, B. M. H.

2018-02-01

The purpose of this study is to obtain information about the teacher quality of teaching and learning creativity with the outcomes of student learning in a vocational high school in Indonesia. This research is a survey research. The sample used in this research is 50 teachers, selected by simple random sampling. Data were analyzed by using correlation analysis. The findings of this study are as follows: (1) There is a significant and positive correlation between teacher quality of teaching with the outcomes of student learning at the vocational high school; (2) There is a significant and positive correlation between learning creativity with the outcomes of student learning at the vocational high school, and (3) there is a significant and positive correlation between the teacher quality of teaching and learning creativity with the outcomes of student learning at the school. That is, if the use of appropriate the teacher quality of teaching and learning creativity, then the outcomes of student learning at the school. Finally it can be concluded that to improve the outcomes of student learning, it has to be followed by an improvement of teacher quality of teaching and learning creativity.

User Assessment of "InsuOnLine," a Game to Fight Clinical Inertia in Diabetes: A Pilot Study.

PubMed

Diehl, Leandro Arthur; de Souza, Rodrigo Martins; Gordan, Pedro Alejandro; Esteves, Roberto Zonato; Coelho, Izabel Cristina Meister

2015-10-01

We performed a pilot study to assess usability and playability of "InsuOnLine," a serious game for education of primary care physicians on insulin therapy for diabetes mellitus. A multidisciplinary team has designed and developed "InsuOnLine," using Andragogy and Problem-Based Learning principles, with game elements to improve players' motivation. The prototype was tested by four medical doctors and two medical students, using the System Usability Scale (SUS) and a questionnaire to assess playability. These results were used to guide corrections, after which the beta version was retested by 14 medical students and 6 residents. Out of a maximum score of 100 on the SUS, the "InsuOnLine" prototype was rated 88, and some areas for improvement were identified (game instructions, controls). After corrections, the beta version was rated 92.5 on the SUS. Users have found the beta version to be fun, engaging, challenging, relevant, and realistic. Users said that the game has increased their knowledge on diabetes and insulin, that it has made them feel more confident for prescribing insulin, and that it would have impact on how they treated patients with diabetes. Most users said they have learned more from the game than they would have from a lecture. Lessons learned were the need of early piloting, preferably by users with very little or very much gaming experience, on their own computers and free patterns of use. "InsuOnLine" was rated by users as easy to play, fun, and useful for learning. Further studies will assess its educational effectiveness. "InsuOnLine" is a promising tool for large-scale continuing medical education on insulin, helping to fight clinical inertia in diabetes.

Formoterol versus short-acting beta-agonists as relief medication for adults and children with asthma

PubMed Central

Welsh, Emma J; Cates, Christopher J

2014-01-01

Background Formoterol is a long-acting beta2-agonist but because it has a fast onset of action it can also be used as a relief medication. Objectives To asses the efficacy and safety of formoterol as reliever therapy in comparison to short-acting beta2-agonists in adults and children with asthma. Search methods We searched the Cochrane Airways Group Specialised Register and websites of clinical trial registers (for unpublished trial data), and we checked the Food and Drug Administration (FDA) submissions in relation to formoterol. The date of the most recent search was February 2010. Selection criteria Randomised, parallel-arm trials of at least 12 weeks duration in patients of any age and severity of asthma. Studies randomised patients to any dose of as-needed formoterol versus short-acting beta2-agonist. Concomitant use of inhaled corticosteroids or other maintenance medication was allowed, as long as this was not part of the randomised treatment regimen. Data collection and analysis Two authors independently selected trials for inclusion in the review. Outcome data were extracted by one author and checked by the second author. We sought unpublished data on primary outcomes. Main results This review includes eight studies conducted in 22,604 participants (mostly adults). Six studies compared formoterol as-needed to terbutaline whilst two studies compared formoterol with salbutamol as-needed. Background maintenance therapy varied across the trials. Asthma exacerbations and serious adverse events showed a direction of treatment effect favouring formoterol, of which one outcome reached statistical significance (exacerbations requiring a course of oral corticosteroids). In patients on short-acting beta2-agonists, 117 people out of 1000 had exacerbations requiring oral corticosteroids over 30 weeks, compared to 101 (95% CI 93 to 108) out of 1000 for patients on formoterol as-needed. In patients on maintenance inhaled corticosteroids there were also significantly fewer exacerbations requiring a course of oral corticosteroids on formoterol as-needed (Peto OR 0.75; 95% CI 0.62 to 0.91). There was one death per 1000 people on formoterol or on short-acting beta2-agonists. Authors’ conclusions In adults, formoterol was similar to short-acting beta2-agonists when used as a reliever, and showed a reduction in the number of exacerbations requiring a course of oral corticosteroids. Clinicians should weigh the relatively modest benefits of formoterol as-needed against the benefits of single inhaler therapy and the potential danger of long-term use of long-acting beta2-agonists in some patients. We did not find evidence to recommend changes to guidelines that suggest that long-acting beta2-agonists should be given only to patients already taking inhaled corticosteroids. There was insufficient information reported from children in the included trials to come to any conclusion on the safety or efficacy of formoterol as relief medication for children with asthma. PMID:20824877

Music mnemonics aid Verbal Memory and Induce Learning – Related Brain Plasticity in Multiple Sclerosis

PubMed Central

Thaut, Michael H.; Peterson, David A.; McIntosh, Gerald C.; Hoemberg, Volker

2014-01-01

Recent research on music and brain function has suggested that the temporal pattern structure in music and rhythm can enhance cognitive functions. To further elucidate this question specifically for memory, we investigated if a musical template can enhance verbal learning in patients with multiple sclerosis (MS) and if music-assisted learning will also influence short-term, system-level brain plasticity. We measured systems-level brain activity with oscillatory network synchronization during music-assisted learning. Specifically, we measured the spectral power of 128-channel electroencephalogram (EEG) in alpha and beta frequency bands in 54 patients with MS. The study sample was randomly divided into two groups, either hearing a spoken or a musical (sung) presentation of Rey’s auditory verbal learning test. We defined the “learning-related synchronization” (LRS) as the percent change in EEG spectral power from the first time the word was presented to the average of the subsequent word encoding trials. LRS differed significantly between the music and the spoken conditions in low alpha and upper beta bands. Patients in the music condition showed overall better word memory and better word order memory and stronger bilateral frontal alpha LRS than patients in the spoken condition. The evidence suggests that a musical mnemonic recruits stronger oscillatory network synchronization in prefrontal areas in MS patients during word learning. It is suggested that the temporal structure implicit in musical stimuli enhances “deep encoding” during verbal learning and sharpens the timing of neural dynamics in brain networks degraded by demyelination in MS. PMID:24982626

Evidence of Deeper Learning Outcomes. Findings from the Study of Deeper Learning Opportunities and Outcomes: Report 3

ERIC Educational Resources Information Center

Zeiser, Kristina L.; Taylor, James; Rickles, Jordan; Garet, Michael S.; Segeritz, Michael

2014-01-01

The "Study of Deeper Learning: Opportunities and Outcomes"--funded by the William and Flora Hewlett Foundation--aimed to determine whether students attending high schools with a mature and at least moderately well implemented approach to promoting deeper learning actually experienced greater deeper learning opportunities and outcomes…

[Perioperative betablockade].

PubMed

Skarvan, K

2007-01-01

Adverse cardiac outcomes continue to be an important cause of perioperative morbidity and mortality in the non-cardiac surgery. This is related to the high prevalence of coronary artery disease in the aging surgical population. Beta-blockers were proved useful and efficacious in the treatment of perioperative myocardial ischaemia and arrhythmia. Early studies suggested that the prophylactic perioperative beta-blockade could also reduce perioperative and long-term morbidity and mortality. The administration of beta-blockers to patients with coronary artery disease or with risk factors who undergo major noncardiac surgery is now recommended in the published guidelines. However, one recent meta-analysis and several new studies have not confirmed the postulated beneficial effects of perioperative betablockade and gave rise to an animated controversy. Until the finalization of ongoing large trials in the next two years, the decision to start prophylactic perioperative beta-blockade remains at the discretion of the responsible physicians. This decision should be based on the patient's risk, the type of surgery and on the consideration of potential interactions and side-effects of the selected beta-blocker.

Impairments in action-outcome learning in schizophrenia.

PubMed

Morris, Richard W; Cyrzon, Chad; Green, Melissa J; Le Pelley, Mike E; Balleine, Bernard W

2018-03-03

Learning the causal relation between actions and their outcomes (AO learning) is critical for goal-directed behavior when actions are guided by desire for the outcome. This can be contrasted with habits that are acquired by reinforcement and primed by prevailing stimuli, in which causal learning plays no part. Recently, we demonstrated that goal-directed actions are impaired in schizophrenia; however, whether this deficit exists alongside impairments in habit or reinforcement learning is unknown. The present study distinguished deficits in causal learning from reinforcement learning in schizophrenia. We tested people with schizophrenia (SZ, n = 25) and healthy adults (HA, n = 25) in a vending machine task. Participants learned two action-outcome contingencies (e.g., push left to get a chocolate M&M, push right to get a cracker), and they also learned one contingency was degraded by delivery of noncontingent outcomes (e.g., free M&Ms), as well as changes in value by outcome devaluation. Both groups learned the best action to obtain rewards; however, SZ did not distinguish the more causal action when one AO contingency was degraded. Moreover, action selection in SZ was insensitive to changes in outcome value unless feedback was provided, and this was related to the deficit in AO learning. The failure to encode the causal relation between action and outcome in schizophrenia occurred without any apparent deficit in reinforcement learning. This implies that poor goal-directed behavior in schizophrenia cannot be explained by a more primary deficit in reward learning such as insensitivity to reward value or reward prediction errors.

[Pregnancy-specific beta-glycoprotein in the serum of women with a complicated early pregnancy].

PubMed

Radikov, N

1989-01-01

The author determined pregnancy specific beta 1-glycoprotein in 109 women with threatened early pregnancy as 32 of the women suffered from abortus imminens with several unsuccessful pregnancies in the past as well as 67 women with abortus incipiens with bleeding ex utero. The author established that 87% of women with abortus imminens and preserved pregnancies had values of beta 1-glycoprotein close to those of normal pregnancy for the respective gestational week. 93% of women with abortus incipiens preserved pregnancies till term, but the specific glycoprotein was with in normal ranges. Spontaneous abortion occurred in 7% of women with low values under the 10th percentile. The present study show that examination of pregnancy specific beta 1-glycoprotein in women with threatened early pregnancy is of prognostic significance for the outcome of pregnancy.

The Effect of Plan Type and Comprehensive Medication Reviews on High-Risk Medication Use.

PubMed

Almodovar, Armando Silva; Axon, David Rhys; Coleman, Ashley M; Warholak, Terri; Nahata, Milap C

2018-05-01

In 2007, the Centers for Medicare & Medicaid Services (CMS) instituted a star rating system using performance outcome measures to assess Medicare Advantage Prescription Drug (MAPD) and Prescription Drug Plan (PDP) providers. To assess the relationship between 2 performance outcome measures for Medicare insurance providers, comprehensive medication reviews (CMRs), and high-risk medication use. This cross-sectional study included Medicare Part C and Part D performance data from the 2014 and 2015 calendar years. Performance data were downloaded per Medicare contract from the CMS. We matched Medicare insurance provider performance data with the enrollment data of each contract. Mann Whitney U and Spearman rho tests and a hierarchical linear regression model assessed the relationship between provider characteristics, high-risk medication use, and CMR completion rate outcome measures. In 2014, an inverse correlation between CMR completion rate and high-risk medication use was identified among MAPD plan providers. This relationship was further strengthened in 2015. No correlation was detected between the CMR completion rate and high-risk medication use among PDP plan providers in either year. A multivariate regression found an inverse association with high-risk medication use among MAPD plan providers in comparison with PDP plan providers in 2014 (beta = -0.358, P < 0.001) and 2015 (beta = -0.350, P < 0.001), the CMR completion rate in 2015 (beta = -0.221, P < 0.001), and enrollee population size in 2015 (beta = -0.203, P = 0.001). This study found that MAPD plan providers and higher CMR completion rates were associated with lower use of high-risk medications among beneficiaries. No outside funding supported this study. Silva Almodovar reports a fellowship funded by SinfoniaRx, Tucson, Arizona, during the time of this study. The other authors have nothing to disclose.

Theta oscillations promote temporal sequence learning.

PubMed

Crivelli-Decker, Jordan; Hsieh, Liang-Tien; Clarke, Alex; Ranganath, Charan

2018-05-17

Many theoretical models suggest that neural oscillations play a role in learning or retrieval of temporal sequences, but the extent to which oscillations support sequence representation remains unclear. To address this question, we used scalp electroencephalography (EEG) to examine oscillatory activity over learning of different object sequences. Participants made semantic decisions on each object as they were presented in a continuous stream. For three "Consistent" sequences, the order of the objects was always fixed. Activity during Consistent sequences was compared to "Random" sequences that consisted of the same objects presented in a different order on each repetition. Over the course of learning, participants made faster semantic decisions to objects in Consistent, as compared to objects in Random sequences. Thus, participants were able to use sequence knowledge to predict upcoming items in Consistent sequences. EEG analyses revealed decreased oscillatory power in the theta (4-7 Hz) band at frontal sites following decisions about objects in Consistent sequences, as compared with objects in Random sequences. The theta power difference between Consistent and Random only emerged in the second half of the task, as participants were more effectively able to predict items in Consistent sequences. Moreover, we found increases in parieto-occipital alpha (10-13 Hz) and beta (14-28 Hz) power during the pre-response period for objects in Consistent sequences, relative to objects in Random sequences. Linear mixed effects modeling revealed that single trial theta oscillations were related to reaction time for future objects in a sequence, whereas beta and alpha oscillations were only predictive of reaction time on the current trial. These results indicate that theta and alpha/beta activity preferentially relate to future and current events, respectively. More generally our findings highlight the importance of band-specific neural oscillations in the learning of temporal order information. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Impaired verbal learning in forensic inpatients with Schizophrenia Spectrum Disorder.

PubMed

Corbett, Lasha; Karyadi, Kenny A; Kinney, Dominique; Nitch, Stephen R; Bayan, Stacey Marie; Williams, Mark

2018-01-01

The present study aimed to: (a) examine verbal learning performances among forensic inpatients diagnosed with Schizophrenia Spectrum Disorder (SSD); and (b) compare verbal learning performances among forensic SSD inpatients, SSD outpatients, and a small control sample. Participants included forensic SSD inpatients (n = 71), SSD outpatients (n = 305; see Stone et al.), and a control sample from the California Verbal Learning Test-II (CVLT-II) manual (n = 78; see Delis, Kramer, Kaplan, & Ober). Five verbal learning outcomes were measured using the CVLT-II. The average forensic SSD inpatients performed 1 to 1.5 standard deviations below the mean across the five verbal learning outcomes, many of whom (26.8% to 36.6%) performed in the impaired range across the five outcomes. Forensic SSD inpatients performed significantly lower than the SSD outpatients on three verbal learning outcomes and significantly lower than healthy controls on all five verbal learning outcomes. Results indicated forensically committed SSD inpatients have diminished verbal learning performances. Study findings could help define normative verbal learning performances in different types of SSD patients, may guide the development of compensatory strategies for verbal learning deficits, and could subsequently lead to more successful clinical outcomes in this population.

Does tight heart rate control improve beta-blocker efficacy? An updated analysis of the noncardiac surgical randomized trials.

PubMed

Beattie, W Scott; Wijeysundera, Duminda N; Karkouti, Keyvan; McCluskey, Stuart; Tait, Gordon

2008-04-01

Recent meta-analyses assessing the efficacy of perioperative beta-blockade trials have failed to show a reduction in postoperative morbidity and mortality. Tight control of heart rate (HR) has been suggested to improve these outcomes. Meta-analyses have not considered the influence of tight HR control on the efficacy of perioperative beta-blockade. Using previously published search strategies, we identified all randomized trials evaluating perioperative beta-blockers after noncardiac surgery. This search yielded 10 trials with 2176 patients. We used the data from these studies to correlate measures of HR control with major postoperative outcomes, primarily in-hospital myocardial infarction (MI). Odds ratio (OR) and 95% confidence intervals (CI) were calculated, and metaregression was performed correlating measures of HR control with MI. The combined results of all studies did not show a significant cardioprotective effect of beta-blockers, with considerable heterogeneity among the studies (OR = 0.76; 95% CI = 0.4-1.4; P = 0.38 heterogeneity: I(2) = 34%). However, grouping the trials on the basis of maximal HR showed that trials where the estimated maximal HR was <100 bpm were associated with cardioprotection (OR = 0.23; 95% CI = 0.08-0.65; P = 0.005) whereas trials where the estimated maximal HR was >100 bpm did not demonstrate cardioprotection (OR = 1.17; 95% CI = 0.79-1.80; P = 0.43) with no heterogeneity. Moreover, metaregression of the HR response to beta-blockade against the log OR of postoperative MI demonstrated a linear association between the effect of beta-blockade on the mean, maximal, and variation in HR and the OR of an MI (r(2) = 0.63; P < 0.001) where a larger effect of beta-blockers on HR was associated with a decreased incidence of postoperative MI. Across all studies, beta-blockade resulted in a reduction in postoperative HR (weighted mean difference: 8.6 bpm; 95% CI = -9.6 to -7.6; I(2) = 85.3%) with considerable heterogeneity. This large heterogeneity in HR response to beta-blockade was found to be related, in part, to the type of beta-blocker, specifically, metoprolol, and the concomitant use of calcium channel blockers. Calcium channel blocker use and beta-blockers other than metoprolol resulted in more effective control of HR. There was wide variability in the HR response to beta-blockade. Twenty-five percent of patients receiving beta-blockers had episodes when the HRs were more than 100 bpm, although 15% of placebo patients also had bradycardia, which would have required a dose reduction had they been administered beta-blockers. Finally, this analysis found that perioperative beta-blockade was associated with an increased incidence of bradycardia (OR = 3.49; 95% CI = 2.4-5.9) and congestive heart failure (OR = 1.68; 95% CI = 1.00-2.8). The trials that achieve the most effective control of HR are associated with a reduced incidence of postoperative MI, suggesting that effective control of HR is important for achieving cardioprotection. Second, this analysis demonstrates that administration of beta-blockers does not reliably decrease HRs in all patients, and may be associated with increased side effects. Judicious use of combination therapy with other drugs may be necessary to achieve effective postoperative control of HR.

Characterization of a Commercial Silicon Beta Cell

DOE Office of Scientific and Technical Information (OSTI.GOV)

Foxe, Michael P.; Hayes, James C.; Mayer, Michael F.

Silicon detectors are of interest for the verification of the Comprehensive Nuclear-Test-Ban Treaty (CTBT) due to their enhanced energy resolution compared to plastic scintillators beta cells. Previous work developing a figure-of-merit (FOM) for comparison of beta cells suggests that the minimum detectable activity (MDA) could be reduced by a factor of two to three with the use of silicon detectors. Silicon beta cells have been developed by CEA (France) and Lares Ltd. (Russia), with the PIPSBox developed by CEA being commercially available from Canberra for approximately $35k, but there is still uncertainty about the reproducibility of the capabilities in themore » field. PNNL is developing a high-resolution beta-gamma detector system in the shallow underground laboratory, which will utilize and characterize the operation of the PIPSBox detector. Throughout this report, we examine the capabilities of the PIPSBox as developed by CEA. The lessons learned through the testing and use of the PIPSBox will allow PNNL to strategically develop a silicon detector optimized to better suit the communities needs in the future.« less

Factors of Learner-Instructor Interaction Which Predict Perceived Learning Outcomes in Online Learning Environment

ERIC Educational Resources Information Center

Kang, M.; Im, T.

2013-01-01

Interaction in the online learning environment has been regarded as one of the most critical elements that affect learning outcomes. This study examined what factors in learner-instructor interaction can predict the learner's outcomes in the online learning environment. Learners in K Online University participated by answering the survey, and data…

The Effects of Different Computer-Supported Collaboration Scripts on Students' Learning Processes and Outcome in a Simulation-Based Collaborative Learning Environment

ERIC Educational Resources Information Center

Wieland, Kristina

2010-01-01

Students benefit from collaborative learning activities, but they do not automatically reach desired learning outcomes when working together (Fischer, Kollar, Mandl, & Haake, 2007; King, 2007). Learners need instructional support to increase the quality of collaborative processes and individual learning outcomes. The core challenge is to find…

Effects of Cooperative E-Learning on Learning Outcomes

ERIC Educational Resources Information Center

Yeh, Shang-Pao; Fu, Hsin-Wei

2014-01-01

This study aims to discuss the effects of E-Learning and cooperative learning on learning outcomes. E-Learning covers the dimensions of Interpersonal communication, abundant resources, Dynamic instruction, and Learning community; and, cooperative learning contains three dimensions of Cooperative motive, Social interaction, and Cognition…

Student outcomes of distance learning in nursing education: an integrative review.

PubMed

Patterson, Barbara J; Krouse, Anne M; Roy, Linda

2012-09-01

Distance learning offers a distinctive environment to educate nursing students. While there is a significant body of evidence in the literature related to course, program, and faculty outcomes of distance education, little attention has been given by researchers to evaluate student outcomes, with the exception of student satisfaction. There is a need to evaluate and translate findings related to student outcomes in distance learning into educational practice. Integrative reviews offer one strategy to contribute to evidence-based teaching practice initiatives. A search of available published qualitative and quantitative research on student outcomes of distance learning from 1999 to 2009 was conducted using a number of databases. Astin's Input-Environment-Output conceptual model provided a framework for this review. Thirty-three studies met the inclusion criteria. Bothcognitive and affective student outcomes emerged. The cognitive outcomes were student learning, learning process, and technology proficiency. Affective outcomes included personal and professional growth, satisfaction, and connectedness. Implications, recommendations, and future research are discussed.

Effect of Chemistry Triangle Oriented Learning Media on Cooperative, Individual and Conventional Method on Chemistry Learning Result

NASA Astrophysics Data System (ADS)

Latisma D, L.; Kurniawan, W.; Seprima, S.; Nirbayani, E. S.; Ellizar, E.; Hardeli, H.

2018-04-01

The purpose of this study was to see which method are well used with the Chemistry Triangle-oriented learning media. This quasi experimental research involves first grade of senior high school students in six schools namely each two SMA N in Solok city, in Pasaman and two SMKN in Pariaman. The sampling technique was done by Cluster Random Sampling. Data were collected by test and analyzed by one-way anova and Kruskall Wallish test. The results showed that the high school students in Solok learning taught by cooperative method is better than the results of student learning taught by conventional and Individual methods, both for students who have high initial ability and low-ability. Research in SMK showed that the overall student learning outcomes taught by conventional method is better than the student learning outcomes taught by cooperative and individual methods. Student learning outcomes that have high initial ability taught by individual method is better than student learning outcomes that are taught by cooperative method and for students who have low initial ability, there is no difference in student learning outcomes taught by cooperative, individual and conventional methods. Learning in high school in Pasaman showed no significant difference in learning outcomes of the three methods undertaken.

[eLearning service for home palliative care].

PubMed

Sakuyama, Toshikazu; Komatsu, Kazuhiro; Inoue, Daisuke; Fukushima, Osamu

2008-12-01

In order to support the home palliative care learning, we made the eLearning service for home palliative care (beta version) and tried to teach the palliative care to the medical staffs in the community. The various learners (such as nurses, pharmacists and the like) accessed to the online learning and used this eLearning service. After the learners finished eLearning for home palliative care, some questionnaires were distributed to the learners and analyzed by us. The analysis of questionnaires revealed that almost all were satisfied with our eLearning services. Especially the learners were not only interested in using the skills of opioids and the management of pain control, but they had a good cognition for the usage of opioids.

Individual Differences in Behavioural Despair Predict Brain GSK-3beta Expression in Mice: The Power of a Modified Swim Test

PubMed Central

Markova, Nataliia; Shevtsova, Elena; Bakhmet, Anastassia; Steinbusch, Harry M.

2016-01-01

While deficient brain plasticity is a well-established pathophysiologic feature of depression, little is known about disorder-associated enhanced cognitive processing. Here, we studied a novel mouse paradigm that potentially models augmented learning of adverse memories during development of a depressive-like state. We used a modification of the classic two-day protocol of a mouse Porsolt test with an additional session occurring on Day 5 following the initial exposure. Unexpectedly, floating behaviour and brain glycogen synthase kinase-3 beta (GSK-3beta) mRNA levels, a factor of synaptic plasticity as well as a marker of distress and depression, were increased during the additional swimming session that was prevented by imipramine. Observed increases of GSK-3beta mRNA in prefrontal cortex during delayed testing session correlated with individual parameters of behavioural despair that was not found in the classic Porsolt test. Repeated swim exposure was accompanied by a lower pGSK-3beta/GSK-3beta ratio. A replacement of the second or the final swim sessions with exposure to the context of testing resulted in increased GSK-3beta mRNA level similar to the effects of swimming, while exclusion of the second testing prevented these changes. Together, our findings implicate the activation of brain GSK-3beta expression in enhanced contextual conditioning of adverse memories, which is associated with an individual susceptibility to a depressive syndrome. PMID:27478647

Individual Differences in Behavioural Despair Predict Brain GSK-3beta Expression in Mice: The Power of a Modified Swim Test.

PubMed

Strekalova, Tatyana; Markova, Nataliia; Shevtsova, Elena; Zubareva, Olga; Bakhmet, Anastassia; Steinbusch, Harry M; Bachurin, Sergey; Lesch, Klaus-Peter

2016-01-01

While deficient brain plasticity is a well-established pathophysiologic feature of depression, little is known about disorder-associated enhanced cognitive processing. Here, we studied a novel mouse paradigm that potentially models augmented learning of adverse memories during development of a depressive-like state. We used a modification of the classic two-day protocol of a mouse Porsolt test with an additional session occurring on Day 5 following the initial exposure. Unexpectedly, floating behaviour and brain glycogen synthase kinase-3 beta (GSK-3beta) mRNA levels, a factor of synaptic plasticity as well as a marker of distress and depression, were increased during the additional swimming session that was prevented by imipramine. Observed increases of GSK-3beta mRNA in prefrontal cortex during delayed testing session correlated with individual parameters of behavioural despair that was not found in the classic Porsolt test. Repeated swim exposure was accompanied by a lower pGSK-3beta/GSK-3beta ratio. A replacement of the second or the final swim sessions with exposure to the context of testing resulted in increased GSK-3beta mRNA level similar to the effects of swimming, while exclusion of the second testing prevented these changes. Together, our findings implicate the activation of brain GSK-3beta expression in enhanced contextual conditioning of adverse memories, which is associated with an individual susceptibility to a depressive syndrome.

Beta-adrenergic blockade for the treatment of hyperthyroidism.

PubMed

Geffner, D L; Hershman, J M

1992-07-01

To review the clinical and biochemical effects of beta-adrenergic blocking drugs on hyperthyroidism. Studies published since 1972 were identified through a computerized search of MEDLINE and extensive searching of the bibliographies of the articles identified. Based on an understanding of the differences in beta-blocker metabolism in euthyroid and hyperthyroid patients, we reviewed the differences in pharmacokinetics and metabolic and clinical outcomes during their use in hyperthyroidism, as reported in the articles reviewed. beta Blockers have been used to modify the severity of the hyperadrenergic symptoms of hyperthyroidism for the past 20 years. The clinical efficacy of these agents is affected by hyperthyroid-induced alterations in their gastrointestinal absorption, hepatic metabolism, and renal excretion. The mechanisms whereby these clinical changes are effected is unknown. The agents differ in their beta 1 cardioselectivity, membrane-stabilizing activity, intrinsic sympathomimetic activity, and lipid solubility. They do not appear to alter synthesis or secretion of thyroid hormone by the thyroid gland. Their effects on thyroxine metabolism are contradictory. Decreased thyroxine to triiodothyronine conversion is caused by some, but not all, beta blockers, and this appears to correlate with membrane-stabilizing activity. There does not appear to be any alteration in catecholamine sensitivity during beta-adrenergic blockade. The principal mechanism of action of beta blockers in hyperthyroidism is to antagonize beta-receptor-mediated effects of catecholamines. beta Blockers are effective in treating hypermetabolic symptoms in a variety of hyperthyroid states. Used alone, they offer significant symptomatic relief. They are also useful adjuvants to antithyroid medications, surgery, and radioactive iodide treatment in patients with Graves' disease and toxic nodular goiters.

Methodological aspects of rat beta-endorphin analysis-influence of diurnal variation.

PubMed

Finn, Anja; Fabre, Susanne Froelich; Hellström, Per M; Brené, Stefan

2006-05-30

Beta-endorphin radioimmunoassays (RIAs) are widely performed following physical, emotional and environmental challenges in the rat. In the literature, a wide range of techniques have been described, but in the present study, we have focused on methodological aspects of beta-endorphin RIAs, investigating various characteristics of human and rat specific antibodies. Initial studies verified that the RIA outcome was not appropriate when using non-species compatible components. Novel rat beta-endorphin antibodies, r 4114 and r 4268, were raised in rabbits and characterised in terms of specificity, avidity and titer. Both of the new antisera showed 68.1% cross-reactivity with human beta-endorphin. The ED50 was 50+/-8 pmol/l, and the mean ED80 was 17 pmol/l for r 4268 but three-fold higher for r 4114. The intra-assay coefficient of variation (CV) was 7% at 100 pmol/l and the inter-assay CV was 10% at the same level for r 4268 and similar for r 4114. Using this novel rat beta-endorphin RIA for analyses of diurnal influence and removal from the Animal House cage, no significant changes were observed in either the hypothalamus or peri-aqueductal grey regions. These results suggest that rat beta-endorphin concentrations in these brain areas are not affected by order of removal or diurnal variation.

Conceptualizing impact assessment as a learning process

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sánchez, Luis E., E-mail: lsanchez@usp.br; Mitchell, Ross, E-mail: ross.mitchell@ualberta.net

This paper explores how project developers and their consultants, government regulators and stakeholders can learn from the impact assessment (IA) process, thus potentially improving its effectiveness and enhancing project sustainability. Despite the benefits that learning can bring to an organization, failure to learn appears commonplace both within the IA process and, once approved, subsequent industrial development. To nurture organizational learning through IA, enabling structures that foster information sharing and interpretation and enhance organizational memory are needed. In this paper learning outcomes are grouped into three categories: acquisition of knowledge and skills, developing new behaviors and developing sustainability-oriented norms and values.more » Means to achieve such outcomes include education and training, experiential learning, learning through public participation (social learning) and a ‘learning organization approach’. Societal expectations increasingly demand not only projects that ‘pass’ the review criteria of regulators, financiers and the community, but IA processes capable of delivering sustainable outcomes that include learning and sharing of knowledge. It is proposed that learning be treated as a purposeful – not as an accidental – outcome of IA, and facilitated by adopting a ‘learning organization approach’ coupled with best practice such as early stakeholder engagement. - Highlights: • Proponents are challenged to develop projects that deliver sustainable outcomes. • Passing the test of government approval may be insufficient to obtain a social license. • Learning by all stakeholders is vital to meet these challenges. • Learning outcomes have to go beyond instrumental learning to reach new behaviors, norms and values. • A “learning organization approach” can promote mutual learning and improve project design.« less

Phenotypic differences between oral and skin fibroblasts in wound contraction and growth factor expression.

PubMed

Shannon, Diane B; McKeown, Scott T W; Lundy, Fionnuala T; Irwin, Chris R

2006-01-01

Wounds of the oral mucosa heal in an accelerated fashion with reduced scarring compared with cutaneous wounds. The differences in healing outcome between oral mucosa and skin could be because of phenotypic differences between the respective fibroblast populations. This study compared paired mucosal and dermal fibroblasts in terms of collagen gel contraction, alpha-smooth muscle actin expression (alpha-SMA), and production of the epithelial growth factors: keratinocyte growth factor (KGF) and hepatocyte growth factor/scatter factor (HGF). The effects of transforming growth factor -beta1 and -beta3 on each parameter were also determined. Gel contraction in floating collagen lattices was determined over a 7-day period. alpha-SMA expression by fibroblasts was determined by Western blotting. KGF and HGF expression were determined by an enzyme-linked immunosorbent assay. Oral fibroblasts induced accelerated collagen gel contraction, yet surprisingly expressed lower levels of alpha-SMA. Oral cells also produced significantly greater levels of both KGF and HGF than their dermal counterparts. Transforming growth factor-beta1 and -beta3, over the concentration range of 0.1-10 ng/mL, had similar effects on cell function, stimulating both gel contraction and alpha-SMA production, but inhibiting KGF and HGF production by both cell types. These data indicate phenotypic differences between oral and dermal fibroblasts that may well contribute to the differences in healing outcome between these two tissues.

Motivation Matters? The Relationship among Different Types of Learning Motivation, Engagement Behaviors and Learning Outcomes of Undergraduate Students in Taiwan

ERIC Educational Resources Information Center

Hsieh, Tzu-Ling

2014-01-01

The purpose of this study is to understand predictors of different learning outcomes among various student background characteristics, types of learning motivation and engagement behaviors. 178 junior students were surveyed at a 4-year research university in Taiwan. The scales of motivation, engagement and perceived learning outcomes were adapted…

Improving the Students' Activity and Learning Outcomes on Social Sciences Subject Using Round Table and Rally Coach of Cooperative Learning Model

ERIC Educational Resources Information Center

Ningsih; Soetjipto, Budi Eko; Sumarmi

2017-01-01

The purpose of this study was: (1) to analyze increasing students' learning activity and learning outcomes. Student activities which were observed include the visual, verbal, listening, writing and mental visual activity; (2) to analyze the improvement of student learning outcomes using "Round Table" and "Rally Coach" Model of…

Quality of Learning Outcomes in an Online Video-Based Learning Community: Potential and Challenges for Student Teachers

ERIC Educational Resources Information Center

So, Winnie Wing-mui

2012-01-01

This study investigates the learning outcomes of 25 student teachers in an online video-based learning community (VBLC). Data were drawn from the student teachers' written comments and feedback recorded in the VBLC and the post-course interviews. Based on Biggs and Collis's Structure of Observed Learning Outcomes (SOLO) taxonomy, the majority of…

Outcomes-Based Collaborative Teaching and Learning in Asian Higher Education

ERIC Educational Resources Information Center

van Schalkwyk, Gertina J.

2015-01-01

This chapter explores the background and development of outcomes-based collaborative teaching and learning, and provides guidance for writing learning outcomes and engaging students in the Asian higher education context.

Interactions and Learning Outcomes in Online Language Courses

ERIC Educational Resources Information Center

Lin, Chin-Hsi; Zheng, Binbin; Zhang, Yining

2017-01-01

Interactions are the central emphasis in language learning. An increasing number of K-12 students take courses online, leading some critics to comment that reduced opportunities for interaction may affect learning outcomes. This study examined the relationship between online interactions and learning outcomes for 466 students who were taking…

Students Talking about Assessment: Insights on Program Learning Outcomes

ERIC Educational Resources Information Center

Donohue, William J.

2017-01-01

This study examines the student writer perspective of a first-year composition program's student learning outcomes. Student descriptions of learning are a valuable, yet often overlooked data source. The student voice broadens a first-year composition program's outcomes-based, student learning assessment process as program assessment data is often…

Evaluating Learning Outcomes: In Search of Lost Knowledge

ERIC Educational Resources Information Center

O'Brien, Stephen; Brancaleone, David

2011-01-01

This paper examines the concept, pervasive policy and practice of learning outcomes, as increasingly adopted and officially supported in third-level educational institutions. It begins by outlining the context and development of learning outcomes from European and Irish educational policy perspectives. We go on to explore how learning outcomes…

Transforming growth factor-beta and nitrates in epithelial ovarian cancer.

PubMed

Khalifa, A; Kassim, S K; Ahmed, M I; Fayed, S T

1999-12-01

The role of transforming growth factor-beta (TGF-beta) and nitric oxide (NO) in ovarian neoplasia is still not clear. We studied the expression of TGF-beta by enzyme immunoassay, and nitrates (as a stable end product of NO) in 127 ovarian tissues (36 normal, 37 benign, and 54 malignant). Ploidy status and synthetic phase fraction (SPF) were also assessed by flow cytometry. Mean ranks of TGF-beta, nitrate, and SPF were significant among different groups (X2 = 12.01, P = 0.0025, X2 = 67.42, P = 0.000, X2 = 9.06, P = 0.011 respectively). Nitrate mean ranks were significant among different FIGO stages of the disease (X2 = 17.6, P = 0.000). A significant correlation was shown between TGF-beta, and nitrate levels in all tissues (r = 0.24, P = 0.01), as well as in malignant tissues (r = 0.3, P = 0.026). Cutoff values were determined for both TGF-beta (290 pg/mg protein), and nitrates (310 nmole/mg non protein nitrogenous substances). At these cut-offs, nitrates showed a sensitivity of 93% and 84% specificity for malignant versus normal cases, while TGF-beta had 76% sensitivity, and 82.4% specificity for poor versus good outcome. Patients with epithelial ovarian cancer were followed up for a total of 40 months. Survival analysis showed that patients with TGF-beta above the cut-off had worse prognosis (X2 = 12.69, P = 0.004). The present results suggest that malignant transformation of ovarian tissues is associated with increased TGF-beta and NO production. NO level is related to the development and progression of epithelial ovarian cancer, while high levels of TGF-beta could be of prognostic significance.

Learned predictiveness and outcome predictability effects are not simply two sides of the same coin.

PubMed

Thorwart, Anna; Livesey, Evan J; Wilhelm, Francisco; Liu, Wei; Lachnit, Harald

2017-10-01

The Learned Predictiveness effect refers to the observation that learning about the relationship between a cue and an outcome is influenced by the predictive relevance of the cue for other outcomes. Similarly, the Outcome Predictability effect refers to a recent observation that the previous predictability of an outcome affects learning about this outcome in new situations, too. We hypothesize that both effects may be two manifestations of the same phenomenon and stimuli that have been involved in highly predictive relationships may be learned about faster when they are involved in new relationships regardless of their functional role in predictive learning as cues and outcomes. Four experiments manipulated both the relationships and the function of the stimuli. While we were able to replicate the standard effects, they did not survive a transfer to situations where the functional role of the stimuli changed, that is the outcome of the first phase becomes a cue in the second learning phase or the cue of the first phase becomes the outcome of the second phase. Furthermore, unlike learned predictiveness, there was little indication that the distribution of overt attention in the second phase was influenced by previous predictability. The results suggest that these 2 very similar effects are not manifestations of a more general phenomenon but rather independent from each other. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

National Curricula in Norway and Finland: The Role of Learning Outcomes

ERIC Educational Resources Information Center

Mølstad, Christina Elde; Karseth, Berit

2016-01-01

The core curricular category of "learning outcomes" has entered the educational policy scene in Europe. While content-oriented curricula have dominated the Nordic countries, a shift towards outcomes can also be observed. In this article, we describe the fundamental distinctions between "Didaktik" and learning outcomes and…

Antiamnesic Effect of Broccoli (Brassica oleracea var. italica) Leaves on Amyloid Beta (Aβ)1-42-Induced Learning and Memory Impairment.

PubMed

Park, Seon Kyeong; Ha, Jeong Su; Kim, Jong Min; Kang, Jin Yong; Lee, Du Sang; Guo, Tian Jiao; Lee, Uk; Kim, Dae-Ok; Heo, Ho Jin

2016-05-04

To examine the antiamnesic effects of broccoli (Brassica oleracea var. italica) leaves, we performed in vitro and in vivo tests on amyloid beta (Aβ)-induced neurotoxicity. The chloroform fraction from broccoli leaves (CBL) showed a remarkable neuronal cell-protective effect and an inhibition against acetylcholinesterase (AChE). The ameliorating effect of CBL on Aβ1-42-induced learning and memory impairment was evaluated by Y-maze, passive avoidance, and Morris water maze tests. The results indicated improving cognitive function in the CBL group. After the behavioral tests, antioxidant effects were detected by superoxide dismutase (SOD), oxidized glutathione (GSH)/total GSH, and malondialdehyde (MDA) assays, and inhibition against AChE was also presented in the brain. Finally, oxo-dihydroxy-octadecenoic acid (oxo-DHODE) and trihydroxy-octadecenoic acid (THODE) as main compounds were identified by quadrupole time-of-flight ultraperformance liquid chromatography (Q-TOF UPLC-MS) analysis. Therefore, our studies suggest that CBL could be used as a natural resource for ameliorating Aβ1-42-induced learning and memory impairment.

Variables affecting learning in a simulation experience: a mixed methods study.

PubMed

Beischel, Kelly P

2013-02-01

The primary purpose of this study was to test a hypothesized model describing the direct effects of learning variables on anxiety and cognitive learning outcomes in a high-fidelity simulation (HFS) experience. The secondary purpose was to explain and explore student perceptions concerning the qualities and context of HFS affecting anxiety and learning. This study used a mixed methods quantitative-dominant explanatory design with concurrent qualitative data collection to examine variables affecting learning in undergraduate, beginning nursing students (N = 124). Being ready to learn, having a strong auditory-verbal learning style, and being prepared for simulation directly affected anxiety, whereas learning outcomes were directly affected by having strong auditory-verbal and hands-on learning styles. Anxiety did not quantitatively mediate cognitive learning outcomes as theorized, although students qualitatively reported debilitating levels of anxiety. This study advances nursing education science by providing evidence concerning variables affecting learning outcomes in HFS.

The health and well-being of caregivers of children with cerebral palsy.

PubMed

Raina, Parminder; O'Donnell, Maureen; Rosenbaum, Peter; Brehaut, Jamie; Walter, Stephen D; Russell, Dianne; Swinton, Marilyn; Zhu, Bin; Wood, Ellen

2005-06-01

Most children enjoy healthy childhoods with little need for specialized health care services. However, some children experience difficulties in early childhood and require access to and utilization of considerable health care resources over time. Although impaired motor function is the hallmark of the cerebral palsy (CP) syndromes, many children with this development disorder also experience sensory, communicative, and intellectual impairments and may have complex limitations in self-care functions. Although caregiving is a normal part of being the parent of a young child, this role takes on an entirely different significance when a child experiences functional limitations and possible long-term dependence. One of the main challenges for parents is to manage their child's chronic health problems effectively and juggle this role with the requirements of everyday living. Consequently, the task of caring for a child with complex disabilities at home might be somewhat daunting for caregivers. The provision of such care may prove detrimental to both the physical health and the psychological well-being of parents of children with chronic disabilities. It is not fully understood why some caregivers cope well and others do not. The approach of estimating the "independent" or "direct" effects of the care recipient's disability on the caregiver's health is of limited value because (1) single-factor changes are rare outside the context of constrained experimental situations; (2) assumptions of additive relationships and perfect measurements rarely hold; and (3) such approaches do not provide a complete perspective, because they fail to examine indirect pathways that occur between predictor variables and health outcomes. A more detailed analytical approach is needed to understand both direct and indirect effects simultaneously. The primary objective of the current study was to examine, within a single theory-based multidimensional model, the determinants of physical and psychological health of adult caregivers of children with CP. We developed a stress process model and applied structural equation modeling with data from a large cohort of caregivers of children with CP. This design allowed the examination of the direct and indirect relationships between a child's health, behavior and functional status, caregiver characteristics, social supports, and family functioning and the outcomes of caregivers' physical and psychological health. Families (n = 468) of children with CP were recruited from 19 regional children's rehabilitation centers that provide outpatient disability management and supports in Ontario, Canada. The current study drew on a population available to the investigators from a previous study, the Ontario Motor Growth study, which explored patterns of gross motor development in children with CP. Data on demographic variables and caregivers' physical and psychological health were assessed using standardized, self-completed parent questionnaires as well as a face-to-face home interview. Structural equation modeling was used to test specific hypotheses outlined in our conceptual model. This analytic approach involved a 2-step process. In the first step, observed variables that were hypothesized to measure the underlying constructs were tested using confirmatory factor analysis; this step led to the so-called measurement model. The second step tested hypotheses about relationships among the variables in the structural model. All of the hypothesized paths in the conceptual model were tested and included in the structural model. However, only paths that were significant were shown in the final results. The direct, indirect, and total effects of theoretical constructs on physical and psychological health were calculated using the structural model. The most important predictors of caregivers' well-being were child behavior, caregiving demands, and family function. A higher level of behavior problems was associated with lower levels of both psychological (beta = -.22) and physical health (beta = -.18) of the caregivers, whereas fewer child behavior problems were associated with higher self-perception (beta = -.37) and a greater ability to manage stress (beta = -.18). Less caregiving demands were associated with better physical (beta = .23) and psychological (beta = .12) well-being of caregivers, respectively. Similarly, higher reported family functioning was associated with better psychological health (beta = .33) and physical health (beta = .33). Self-perception and stress management were significant direct predictors of caregivers' psychological health but did not directly influence their physical well-being. Caregivers' higher self-esteem and sense of mastery over the caregiving situation predicted better psychological health (beta = .23). The use of more stress management strategies was also associated with better psychological health of caregivers (beta = .11). Gross income (beta = .08) and social support (beta = .06) had indirect overall effects only on psychological health outcome, whereas self-perception (beta = .22), stress management (beta = .09), gross income (beta = .07), and social support (beta = .06) had indirect total effects only on physical health outcomes. The psychological and physical health of caregivers, who in this study were primarily mothers, was strongly influenced by child behavior and caregiving demands. Child behavior problems were an important predictor of caregiver psychological well-being, both directly and indirectly, through their effect on self-perception and family function. Caregiving demands contributed directly to both the psychological and the physical health of the caregivers. The practical day-to-day needs of the child created challenges for parents. The influence of social support provided by extended family, friends, and neighbors on health outcomes was secondary to that of the immediate family working closely together. Family function affected health directly and also mediated the effects of self-perception, social support, and stress management. In families of children with CP, strategies for optimizing caregiver physical and psychological health include supports for behavioral management and daily functional activities as well as stress management and self-efficacy techniques. These data support clinical pathways that require biopsychosocial frameworks that are family centered, not simply technical and short-term rehabilitation interventions that are focused primarily on the child. In terms of prevention, providing parents with cognitive and behavioral strategies to manage their child's behaviors may have the potential to change caregiver health outcomes. This model also needs to be examined with caregivers of children with other disabilities.

Extended release amoxicillin/clavulanate: optimizing a product for respiratory infections based on pharmacodynamic principles.

PubMed

Jacobs, Michael R

2005-06-01

Acute bacterial respiratory tract infections cause a great deal of human morbidity and mortality. Treatment guidelines for these infections include macrolides, doxycycline, beta-lactams and beta-lactam/beta-lactamase inhibitor combinations such as amoxicillin/clavulanic acid to provide coverage for the common respiratory pathogens, including penicillin and macrolide nonsusceptible Streptococcus pneumoniae, as well as beta-lactamase-producing Haemophilus influenzae and Moraxella catarrhalis. In response to recent guidelines recommending higher dose amoxicillin to extend coverage to a higher percentage of S. pneumoniae, a new formulation of amoxicillin/clavulanic acid was developed. This formulation includes a higher amoxicillin dose, with part of the amoxicillin dose being in an extended release formulation, without increasing the clavulanate dose, for twice-daily oral treatment of these infections. Clinical studies of community-acquired pneumonia and acute rhinosinusitis have shown that the new formulation is well tolerated and highly efficacious, with clinical outcomes equivalent to comparators.

Thalassemia major and consanguinity in Shiraz city, Iran.

PubMed

Asadi-Pooya, Ali Akbar; Doroudchi, Mehrnoosh

2004-09-05

Beta-thalassemia is among the most common genetic disorders in the world and in Iran, with widespread occurrence. A cross-sectional study on 648 beta-thalassemia patients in Shiraz, Iran was carried out to determine the demography of beta-thalassemia major in Shiraz city, Fars province, Iran and also the rate of consanguinity and the significance of pre-marriage counseling in decreasing familial marriages and consequently preventing this autosomal recessive genetic disease. All interviewed patients had thalassemia major and their age, sex, and the consanguinity between parents were recorded. 40.6% of beta-thalassemia patients were outcomes of first-cousin marriages. Comparison of the percentages of familial marriages (consanguinity) between parents of beta-thalassemia patients and a sample of normal population, revealed a statistically significant difference (p< 0.00001). A nonstatistically significant difference was observed between male (53.5%) and female (46.5%) thalassemia patients. Comparison of data with the situation in 22 years ago revealed a 16.4% decrease in familial marriages among thalassemic families, however, more education and awareness of young women and men about the increased risk of beta-thalassemia after familial marriage through pre-marriage counseling is still necessary.

An e-learning course in medical immunology: does it improve learning outcome?

PubMed

Boye, Sondre; Moen, Torolf; Vik, Torstein

2012-01-01

E-learning is used by most medical students almost daily and several studies have shown e-learning to improve learning outcome in small-scale interventions. However, few studies have explored the effects of e-learning in immunology. To study the effect of an e-learning package in immunology on learning outcomes in a written integrated examination and to examine student satisfaction with the e-learning package. All second-year students at a Norwegian medical school were offered an animated e-learning package in basic immunology as a supplement to the regular teaching. Each student's log-on-time was recorded and linked with the student's score on multiple choice questions included in an integrated end-of-the-year written examination. Student satisfaction was assessed through a questionnaire. The intermediate-range students (interquartile range) on average scored 3.6% better on the immunology part of the examination per hour they had used the e-learning package (p = 0.0046) and log-on-time explained 17% of the variance in immunology score. The best and the less skilled students' examination outcomes were not affected by the e-learning. The e-learning was well appreciated among the students. Use of an e-learning package in immunology in addition to regular teaching improved learning outcomes for intermediate-range students.

The Development of Learning Management System Using Edmodo

NASA Astrophysics Data System (ADS)

Joko; Septia Wulandari, Gayuh

2018-04-01

The development of Learning Management System (LMS) can be used as an online learning media by managing the teacher in delivering the material and giving a task. This study aims to: 1) to know the validity of learning devices using LMS with Edmodo, 2) know the student’s response to LMS implementation using Edmodo, and 3) to know the difference of the learning outcome that is students who learned by using LMS with Edmodo and Direct Learning Model (DLM). This research method is quasi experimental by using control group pretest-posttest design. The population of the study was the student at SMKN 1 Sidoarjo. Research sample X TITL 1 class as control goup, and X TITL 2 class as experimental group. The researcher used scale rating to analyze the data validity and students’ respon, and t-test was used to examine the difference of learning outcomes with significant 0.05. The result of the research shows: 1) the average learning device validity use Edmodo 88.14%, lesson plan validity is 92.45%, pretest-posttest validity is 89.15%, learning material validity is 84.64%, and affective and psychomotor-portfolio observation sheets validity is 86.33 included very good criteria or very suitable to be used for research; 2) the result of students’ response questionnaire after taught by using LMS with Edmodo 86.03% in very good category and students agreed that Edmodo can be used in learning; and 3) the learning outcome of LMS by using Edmodo with DLM are: a) there are significant difference of the student cognitive learning outcome which is taught by using Edmodo with the student who use DLM. The average of student learning outcome that is taught LMS using Edmodo is 81.69 compared to student with DLM outcome 76.39, b) there is difference of affective learning outcome that is taught LMS using Edmodo compared to student using DLM. The average of student learning outcomeof affective that is taught LMS by using Edmodo is 83.50 compared students who use DLM 80.34, and c) there is difference of student psychomotor learning outcome that is taught with LMS using Edmodo compared student who use DLM. The average of student learning outcome that is taught with LMS using Edmodo is 85.60 compared to student who uses DLM 82.31.

Science Learning Outcomes in Alignment with Learning Environment Preferences

NASA Astrophysics Data System (ADS)

Chang, Chun-Yen; Hsiao, Chien-Hua; Chang, Yueh-Hsia

2011-04-01

This study investigated students' learning environment preferences and compared the relative effectiveness of instructional approaches on students' learning outcomes in achievement and attitude among 10th grade earth science classes in Taiwan. Data collection instruments include the Earth Science Classroom Learning Environment Inventory and Earth Science Learning Outcomes Inventory. The results showed that most students preferred learning in a classroom environment where student-centered and teacher-centered instructional approaches coexisted over a teacher-centered learning environment. A multivariate analysis of covariance also revealed that the STBIM students' cognitive achievement and attitude toward earth science were enhanced when the learning environment was congruent with their learning environment preference.

Outcomes of an Academic Service-Learning Project on Four Urban Community Colleges

ERIC Educational Resources Information Center

Greenwood, Debra Abston

2015-01-01

Service-learning has a rich history in higher education, with a multitude of studies indicating positive learning, community engagement, and moral development outcomes of student participants. The majority of the research findings, however, have represented four-year colleges. And while there are limited outcome studies of service-learning in…

Addressing the Learning Outcomes and Assessment Methods Associated with Participation in Student Government Associations: A Qualitative Study of California Community Colleges

ERIC Educational Resources Information Center

Nevin, Miles J.

2017-01-01

This document analysis synthesized student learning outcomes (SLOs) and assessment methods from a sample of 36 student government associations in the California Community College system. Student learning outcomes were grouped according to "governance, ethical and civic behavior", and "experiential learning functions." Using…

Relationship between Learning Outcomes and Online Accesses

ERIC Educational Resources Information Center

Suanpang, Pannee; Petocz, Peter; Reid, Anna

2004-01-01

This paper reports on a study carried out in Thailand investigating the relationship between students' use of an e-learning system and their learning outcomes in a course on Business Statistics. The results show a clear relationship between accesses to the e-learning system, as measured by number of "hits", and outcomes, as measured by…

Teachers' Everyday Professional Development: Mapping Informal Learning Activities, Antecedents, and Learning Outcomes

ERIC Educational Resources Information Center

Kyndt, Eva; Gijbels, David; Grosemans, Ilke; Donche, Vincent

2016-01-01

Although a lot is known about teacher development by means of formal learning activities, research on teachers' everyday learning is limited. In the current systematic review, we analyzed 74 studies focusing on teachers' informal learning to identify teachers' learning activities, antecedents for informal learning, and learning outcomes. In…

Effects of congruence between preferred and perceived learning environments in nursing education in Taiwan: a cross-sectional study

PubMed Central

Yeh, Ting-Kuang; Huang, Hsiu-Mei; Chan, Wing P; Chang, Chun-Yen

2016-01-01

Objective To investigate the effects of congruence between preferred and perceived learning environments on learning outcomes of nursing students. Setting A nursing course at a university in central Taiwan. Participants 124 Taiwanese nursing students enrolled in a 13-week problem-based Fundamental Nursing curriculum. Design and methods Students' preferred learning environment, perceptions about the learning environment and learning outcomes (knowledge, self-efficacy and attitudes) were assessed. On the basis of test scores measuring their preferred and perceived learning environments, students were assigned to one of two groups: a ‘preferred environment aligned with perceived learning environment’ group and a ‘preferred environment discordant with perceived learning environment’ group. Learning outcomes were analysed by group. Outcome measures Most participants preferred learning in a classroom environment that combined problem-based and lecture-based instruction. However, a mismatch of problem-based instruction with students' perceptions occurred. Learning outcomes were significantly better when students' perceptions of their instructional activities were congruent with their preferred learning environment. Conclusions As problem-based learning becomes a focus of educational reform in nursing, teachers need to be aware of students' preferences and perceptions of the learning environment. Teachers may also need to improve the match between an individual student's perception and a teacher's intention in the learning environment, and between the student's preferred and actual perceptions of the learning environment. PMID:27207620

Reduction of Plasma Globotriaosylsphingosine Levels After Switching from Agalsidase Alfa to Agalsidase Beta as Enzyme Replacement Therapy for Fabry Disease.

PubMed

Goker-Alpan, Ozlem; Gambello, Michael J; Maegawa, Gustavo H B; Nedd, Khan J; Gruskin, Daniel J; Blankstein, Larry; Weinreb, Neal J

2016-01-01

Agalsidase alfa and agalsidase beta, recombinant enzyme preparations for treatment of Fabry disease (FD), have different approved dosing schedules: 0.2 mg/kg and 1.0 mg/kg every other week (EOW), respectively. This open-label, multicenter, exploratory phase 4 study evaluated plasma globotriaosylsphingosine (lyso-GL-3) and plasma and urine globotriaosylceramide (GL-3) levels at baseline and 2, 4, and 6 months after the switch from agalsidase alfa (0.2 mg/kg EOW for ≥12 months) to agalsidase beta (1.0 mg/kg EOW) in 15 male patients with FD. Immunoglobulin (Ig)G antidrug antibody titers were assessed, and safety was monitored throughout the study. Plasma lyso-GL-3 concentrations decreased significantly within 2 months after switch and reductions continued through month 6 (mean absolute changes, -12.8, -16.1, and -16.7 ng/mL at 2, 4, and 6 months, respectively; all P < 0.001). The mean percentage reduction from baseline was 39.5% (P < 0.001) at month 6. For plasma GL-3, the mean absolute change from baseline (-0.9 μg/mL) and percentage reduction (17.9%) at month 6 were both significant (P < 0.05). Urine GL-3 measurements showed intra-patient variability and changes from baseline were not significant. No clinical outcomes were assessed in this 6-month study, and, therefore, no conclusions can be drawn regarding the correlation of observed reductions in glycosphingolipid concentrations with clinically relevant outcomes. There were no differences in IgG antidrug antibody titers between the two enzymes. The switch from agalsidase alfa to agalsidase beta was well tolerated. Plasma lyso-GL-3 and GL-3 levels reduced after switching from agalsidase alfa to agalsidase beta, indicating that agalsidase beta has a greater pharmacodynamic effect on these markers at the recommended dose. These data further support the use of agalsidase beta 1.0 mg/kg EOW as enzyme replacement therapy in FD.

Program Evaluation of Outcomes Based Orthotic and Prosthetic Education

DTIC Science & Technology

2008-12-01

the Student Learning Outcomes Assessment group (SLOAC) at California State University Dominguez Hills. She is an assessment expert and consultant...identified in the program-level outcomes (Essential Elements of Learning Outcomes Assessment, Indicators 4 & 5, University Student Learning Outcomes...A short 70-mile trip is changing the lives of O&P students and impacting future care of returning military service members. By Jennifer Hoydicz

A Pedagogical Alliance for Academic Achievement: Socio-Emotional Effects on Assessment Outcomes

ERIC Educational Resources Information Center

Leighton, Jacqueline P.; Guo, Qi; Chu, Man-Wai; Tang, Wei

2018-01-01

Assessment of student learning outcomes is often discussed in relation to curriculum, standards and even administration practices. However, assessment of learning outcomes is rarely discussed in light of students' socio-emotional contexts, which might help or hinder learning outcomes. For example, do students' perceptions of the teacher as…

The role of outcome inhibition in interference between outcomes: a contingency-learning analogue of retrieval-induced forgetting.

PubMed

Vadillo, Miguel A; Orgaz, Cristina; Luque, David; Cobos, Pedro L; López, Francisco J; Matute, Helena

2013-05-01

Current associative theories of contingency learning assume that inhibitory learning plays a part in the interference between outcomes. However, it is unclear whether this inhibitory learning results in the inhibition of the outcome representation or whether it simply counteracts previous excitatory learning so that the outcome representation is neither activated nor inhibited. Additionally, these models tend to conceptualize inhibition as a relatively transient and cue-dependent state. However, research on retrieval-induced forgetting suggests that the inhibition of representations is a real process that can be relatively independent of the retrieval cue used to access the inhibited information. Consistent with this alternative view, we found that interference between outcomes reduces the retrievability of the target outcome even when the outcome is associated with a novel (non-inhibitory) cue. This result has important theoretical implications for associative models of interference and shows that the empirical facts and theories developed in studies of retrieval-induced forgetting might be relevant in contingency learning and vice versa. © 2012 The British Psychological Society.

Relations among Resources in Professional Learning Communities and Learning Outcomes

ERIC Educational Resources Information Center

Christ, Tanya; Arya, Poonam; Chiu, Ming Ming

2017-01-01

This study focused on two professional learning communities (PLCs) situated in literacy education practica courses. How four PLC resources (colleagues, facilitators, readings, and videos) were related to outcomes, including teachers' learning, teachers' application of this learning, and subsequent students' learning, was examined. Participants…

Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Glucagon for the treatment of symptomatic beta blocker overdose.

PubMed

Boyd, R; Ghosh, A

2003-05-01

A short cut review was carried out to establish whether the intravenous glucagon can support blood pressure in beta blocker overdose. A total of 51 papers were found using the reported search, of which six presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.

Neurodegenerative cerebrospinal fluid biomarkers tau and amyloid beta predict functional, quality of life, and neuropsychological outcomes after aneurysmal subarachnoid hemorrhage.

PubMed

Joswig, Holger; Korte, Wolfgang; Früh, Severin; Epprecht, Lorenz; Hildebrandt, Gerhard; Fournier, Jean-Yves; Stienen, Martin Nikolaus

2018-04-01

Cerebrospinal fluid (CSF) biomarkers might be useful in predicting outcome after aneurysmal subarachnoid hemorrhage (aSAH). It was the aim to determine whether tau and amyloid beta CSF concentrations predict functional, health-related quality of life (hrQoL), and neuropsychological outcomes after aSAH. Ventricular CSF was obtained from n = 24 aSAH patients at admission (D0), day 2 (D2), and day 6 (D6). CSF total (t)Tau, phosphorylated (p)Tau (181P) , and amyloid beta (1-40 and 1-42) (Aβ40/Aβ42) levels were compared between patients with favorable and unfavorable functional (modified Rankin Scale (mRS)), hrQoL (Euro-Qol (EQ-5D)), and neuropsychological outcomes at 3 (3 m) and 12 months (12 m). Patients with unfavorable functional (mRS 4-6) and hrQoL outcome (EQ-5D z-score ≤ - 1.0) at 3 and 12 m had higher CSF tTau/pTau and lower Aβ40/Aβ42 at D0, D2, and D6 with varying degrees of statistical significance. In terms of predicting neuropsychological outcome, CSF pTau showed a statistically significant correlation with the z-scores of executive function (r = - 0.7486, p = 0.008), verbal memory (r = - 0.8101, p = 0.002), attention (r = - 0.6498, p = 0.030), and visuospatial functioning (r = - 0.6944, p = 0.017) at 3 m. At 12 m, CSF pTau had statistically significant correlations with the z-scores of verbal memory (r = - 0.7473, p = 0.008) and visuospatial functioning (r = - 0.6678, p = 0.024). In conclusion, higher tTau/pTau and lower Aβ40/Aβ42 CSF levels predict unfavorable long-term functional and hrQoL outcomes. Neuropsychological deficits correlate with increased CSF tTau and pTau concentrations.

The Effect of Cognitive Load and Outcome Congruency on the Learned Predictiveness Effect in Human Predictive Learning

ERIC Educational Resources Information Center

Jorge A. Pinto,; Vogel, Edgar H.; Núñez, Daniel E.

2017-01-01

The learned predictiveness effect or LPE is the finding that when people learn that certain cues are reliable predictors of an outcome in an initial stage of training (phase 1), they exhibit a learning bias in favor of these cues in a subsequent training involving new outcomes (phase 2) despite all cues being equally reliable in phase 2. In…

Feasibility and Association of Neurohumoral Blocker Up-titration After Cardiac Resynchronization Therapy.

PubMed

Martens, Pieter; Verbrugge, Frederik H; Nijst, Petra; Bertrand, Philippe B; Dupont, Matthias; Tang, Wilson H; Mullens, Wilfried

2017-08-01

Cardiac resynchronization therapy (CRT) improves mortality and morbidity on top of optimal medical therapy in heart failure with reduced ejection fraction (HFrEF). This study aimed to elucidate the association between neurohumoral blocker up-titration after CRT implantation and clinical outcomes. Doses of angiotensin-converting enzyme inhibitors (ACE-Is), angiotensin receptor blockers (ARBs), and beta-blockers were retrospectively evaluated in 650 consecutive CRT patients implanted from October 2008 to August 2015 and followed in a tertiary multidisciplinary CRT clinic. All 650 CRT patients were on a maximal tolerable dose of ACE-I/ARB and beta-blocker at the time of CRT implantation. However, further up-titration was successful in 45.4% for ACE-I/ARB and in 56.8% for beta-blocker after CRT-implantation. During a mean follow-up of 37 ± 22 months, a total of 139 events occurred for the combined end point of heart failure admission and all-cause mortality. Successful, versus unsuccessful, up-titration was associated with adjusted hazard ratios of 0.537 (95% confidence interval 0.316-0.913; P = .022) for ACE-I/ARB and 0.633 (0.406-0.988; P = .044) for beta-blocker on the combined end point heart failure admission and all-cause mortality. Patients in the up-titration group exhibited a similar risk for death or heart failure admission as patients treated with the maximal dose (ACE-I/ARB: P = .133; beta-blockers: P = .709). After CRT, a majority of patients are capable of tolerating higher dosages of neurohumoral blockers. Up-titration of neurohumoral blockers after CRT implantation is associated with improved clinical outcomes, similarly to patients treated with the guideline-recommended target dose at the time of CRT implantation. Copyright © 2017 Elsevier Inc. All rights reserved.

A preliminary path analysis of expectancy and patient-provider encounter in an open-label randomized controlled trial of spinal manipulation for cervicogenic headache.

PubMed

Haas, Mitchell; Aickin, Mikel; Vavrek, Darcy

2010-01-01

The purpose of this article was to present a preliminary model to identify the effects of expectancy of treatment success and the patient-provider encounter (PPE) on outcomes in an open-label randomized trial. Eighty participants with chronic cervicogenic headache (CGH) were randomized to 4 groups: 2 levels of treatment dose (8 or 16) and 2 levels of therapy from a chiropractor (spinal manipulation or light massage). Providers were instructed to have equal enthusiasm for all care. Structural equation modeling with standardized path coefficients (beta) was used in a path analysis to identify the effects of patient expectancy and the PPE on CGH pain. The model included monthly pain from baseline to 12 weeks. Expectancy and PPE were evaluated on Likert scales. The patient-provider encounter was measured as patient perception of chiropractor enthusiasm, confidence, and comfort with care. Baseline patient expectancy was balanced across groups. The PPE measures were balanced across groups and consistent over the 8-week treatment period. Treatment and baseline pain had the strongest effects on pain outcomes (|beta| = .46-.59). Expectations had little effect on pain (abs value(beta) < .15). The patient-provider encounter had a weak effect on pain (abs value(beta)= .03-.27) and on subsequent confidence in treatment success (abs value(beta)= .09 and .12). Encouraging equipoise in the PPE and balancing expectancy across treatment groups may protect against some confounding related to the absence of blinding in a randomized controlled trial of pain. In this trial, their effects were found to be small relative to the effects of treatment and baseline values. Copyright 2010 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

Developing the OBTL Curriculum with Blended Learning to Enhance Student Learning Effectiveness in the Undergraduate ECE Program

ERIC Educational Resources Information Center

Leung, Chi-hung

2012-01-01

Background: The project included continuous assessment, group presentation, self-learning, and individual assignment to assess students' learning outcomes. A self-learning system was set up as e-learning for students to monitor their learning progress during the semester, including two online exercises and a checklist of learning outcomes. The…

Incorporating Learning Outcomes in Transfer Credit: The Way Forward for Campus Alberta?

ERIC Educational Resources Information Center

Kennepohl, Dietmar K.

2016-01-01

Learning outcomes have become an integral part of the global trend in higher education reform and are employed in three interconnected areas: (1) quality assurance, (2) teaching and learning, and (3) transfer credit. The article touches briefly on the first two areas, but focuses discussion on employing learning outcomes in transfer credit. Using…

Twenty Years of MALL Project Implementation: A Meta-Analysis of Learning Outcomes

ERIC Educational Resources Information Center

Burston, Jack

2015-01-01

Despite the hundreds of Mobile-Assisted Language Learning (MALL) publications over the past twenty years, statistically reliable measures of learning outcomes are few and far between. In part, this is due to the fact that well over half of all MALL-related studies report no objectively quantifiable learning outcomes, either because they did not…

The Role of Readiness Factors in E-Learning Outcomes: An Empirical Study

ERIC Educational Resources Information Center

Keramati, Abbas; Afshari-Mofrad, Masoud; Kamrani, Ali

2011-01-01

Although many researchers have studied different factors which affect E-Learning outcomes, there is little research on assessment of the intervening role of readiness factors in E-Learning outcomes. This study proposes a conceptual model to determine the role of readiness factors in the relationship between E-Learning factors and E-Learning…

Enhancing Learning Outcomes through Application Driven Activities in Marketing

ERIC Educational Resources Information Center

Stegemann, Nicole; Sutton-Brady, Catherine

2013-01-01

This paper introduces an activity used in class to allow students to apply previously acquired information to a hands-on task. As the authors have previously shown active learning is a way to effectively facilitate and improve students' learning outcomes. As a result to improve learning outcomes we have overtime developed a series of learning…

A Planning Tool for Incorporating Backward Design, Active Learning, and Authentic Assessment in the College Classroom

ERIC Educational Resources Information Center

Reynolds, Heather L.; Kearns, Katherine Dowell

2017-01-01

Backward course design is a compelling strategy for achieving results-based, student-centered learning. The backward course-design approach is first to identify student-learning outcomes, then the means of assessing the outcomes, and lastly the classroom activities that would support the learning outcomes. With demonstrated success at improving…

A Beta Oscillation Network in the Rat Olfactory System During a 2-Alternative Choice Odor Discrimination Task

PubMed Central

Beshel, Jennifer

2010-01-01

We previously showed that in a two-alternative choice (2AC) task, olfactory bulb (OB) gamma oscillations (∼70 Hz in rats) were enhanced during discrimination of structurally similar odorants (fine discrimination) versus discrimination of dissimilar odorants (coarse discrimination). In other studies (mostly employing go/no-go tasks) in multiple labs, beta oscillations (15–35 Hz) dominate the local field potential (LFP) signal in olfactory areas during odor sampling. Here we analyzed the beta frequency band power and pairwise coherence in the 2AC task. We show that in a task dominated by gamma in the OB, beta oscillations are also present in three interconnected olfactory areas (OB and anterior and posterior pyriform cortex). Only the beta band showed consistently elevated coherence during odor sniffing across all odor pairs, classes (alcohols and ketones), and discrimination types (fine and coarse), with stronger effects in first than in final criterion sessions (>70% correct). In the first sessions for fine discrimination odor pairs, beta power for incorrect trials was the same as that for correct trials for the other odor in the pair. This pattern was not repeated in coarse discrimination, in which beta power was elevated for correct relative to incorrect trials. This difference between fine and coarse odor discriminations may relate to different behavioral strategies for learning to differentiate similar versus dissimilar odors. Phase analysis showed that the OB led both pyriform areas in the beta frequency band during odor sniffing. We conclude that the beta band may be the means by which information is transmitted from the OB to higher order areas, even though task specifics modify dominance of one frequency band over another within the OB. PMID:20538778

Beta-catenin signaling plays a disparate role in different phases of fracture repair: implications for therapy to improve bone healing.

PubMed

Chen, Yan; Whetstone, Heather C; Lin, Alvin C; Nadesan, Puviindran; Wei, Qingxia; Poon, Raymond; Alman, Benjamin A

2007-07-31

Delayed fracture healing causes substantial disability and usually requires additional surgical treatments. Pharmacologic management to improve fracture repair would substantially improve patient outcome. The signaling pathways regulating bone healing are beginning to be unraveled, and they provide clues into pharmacologic management. The beta-catenin signaling pathway, which activates T cell factor (TCF)-dependent transcription, has emerged as a key regulator in embryonic skeletogenesis, positively regulating osteoblasts. However, its role in bone repair is unknown. The goal of this study was to explore the role of beta-catenin signaling in bone repair. Western blot analysis showed significant up-regulation of beta-catenin during the bone healing process. Using a beta-Gal activity assay to observe activation during healing of tibia fractures in a transgenic mouse model expressing a TCF reporter, we found that beta-catenin-mediated, TCF-dependent transcription was activated in both bone and cartilage formation during fracture repair. Using reverse transcription-PCR, we observed that several WNT ligands were expressed during fracture repair. Treatment with DKK1 (an antagonist of WNT/beta-catenin pathway) inhibited beta-catenin signaling and the healing process, suggesting that WNT ligands regulate beta-catenin. Healing was significantly repressed in mice conditionally expressing either null or stabilized beta-catenin alleles induced by an adenovirus expressing Cre recombinase. Fracture repair was also inhibited in mice expressing osteoblast-specific beta-catenin null alleles. In stark contrast, there was dramatically enhanced bone healing in mice expressing an activated form of beta-catenin, whose expression was restricted to osteoblasts. Treating mice with lithium activated beta-catenin in the healing fracture, but healing was enhanced only when treatment was started subsequent to the fracture. These results demonstrate that beta-catenin functions differently at different stages of fracture repair. In early stages, precise regulation of beta-catenin is required for pluripotent mesenchymal cells to differentiate to either osteoblasts or chondrocytes. Once these undifferentiated cells have become committed to the osteoblast lineage, beta-catenin positively regulates osteoblasts. This is a different function for beta-catenin than has previously been reported during development. Activation of beta-catenin by lithium treatment has potential to improve fracture healing, but only when utilized in later phases of repair, after mesenchymal cells have become committed to the osteoblast lineage.

Treatment of retroauricular keloids: Revision of cases treated at the ENT service of HC/UFPR.

PubMed

Carvalho, Bettina; Ballin, Annelyse Cristine; Becker, Renata Vecentin; Ribeiro, Talita Beithum; Cavichiolo, Juliana Benthien; Ballin, Carlos Roberto; Mocellin, Marcos

2012-04-01

 Keloids are benign tumors arising from abnormal healing of the skin, and there are several procedures available for their treatment.  The objective of this study was to evaluate the outcomes of patients undergoing treatment of keloids after ear, nose, and throat (ENT) surgeries at our service center.  We conducted thorough, retrospective and prospective analysis of records of patients undergoing treatment of retroauricular keloids at our center.  Nine patients were evaluated, and 6 underwent resection and adjuvant beta-therapy, 2 underwent resection with local application of corticosteroids, and only 1 underwent resection without adjuvant therapy. There was no recurrence of keloids in patients that were treated with beta-therapy in the early postoperative period. One patient had relapsed despite corticosteroid administration and late beta-therapy.  Several techniques have been used for the treatment of retroauricular keloids, and beta-therapy is thought to yield the best results, followed by the use of intralesional corticosteroids.  Treatment of retroauricular keloids remains a challenge. While new techniques are being developed, resection followed by early beta-therapy is still the best treatment option.

Amyloid-beta oligomers impair fear conditioned memory in a calcineurin-dependent fashion in mice.

PubMed

Dineley, Kelly T; Kayed, Rakez; Neugebauer, Volker; Fu, Yu; Zhang, Wenru; Reese, Lindsay C; Taglialatela, Giulio

2010-10-01

Soluble oligomeric aggregates of the amyloid-beta (A beta) peptide are believed to be the most neurotoxic A beta species affecting the brain in Alzheimer disease (AD), a terminal neurodegenerative disorder involving severe cognitive decline underscored by initial synaptic dysfunction and later extensive neuronal death in the CNS. Recent evidence indicates that A beta oligomers are recruited at the synapse, oppose expression of long-term potentiation (LTP), perturb intracellular calcium balance, disrupt dendritic spines, and induce memory deficits. However, the molecular mechanisms behind these outcomes are only partially understood; achieving such insight is necessary for the comprehension of A beta-mediated neuronal dysfunction. We have investigated the role of the phosphatase calcineurin (CaN) in these pathological processes of AD. CaN is especially abundant in the CNS, where it is involved in synaptic activity, LTP, and memory function. Here, we describe how oligomeric A beta treatment causes memory deficits and depresses LTP expression in a CaN-dependent fashion. Mice given a single intracerebroventricular injection of A beta oligomers exhibited increased CaN activity and decreased pCREB, a transcription factor involved in proper synaptic function, accompanied by decreased memory in a fear conditioning task. These effects were reversed by treatment with the CaN inhibitor FK506. We further found that expression of hippocampal LTP in acutely cultured rodent brain slices was opposed by A beta oligomers and that this effect was also reversed by FK506. Collectively, these results indicate that CaN activation may play a central role in mediating synaptic and memory disruption induced by acute oligomeric A beta treatment in mice. (c) 2010 Wiley-Liss, Inc.

Expression of class III beta tubulin in cervical cancer patients administered preoperative radiochemotherapy: correlation with response to treatment and clinical outcome.

PubMed

Ferrandina, Gabriella; Martinelli, Enrica; Zannoni, Gian Franco; Distefano, Mariagrazia; Paglia, Amelia; Ferlini, Cristiano; Scambia, Giovanni

2007-02-01

Alterations of the beta subunit of tubulin have been reported to be predictive of resistance to radiation and antitubulin agents in several solid tumors. The aim of the study was to investigate the clinical role of beta III tubulin expression as prognostic factor for survival and as a predictive parameter of response to preoperative radiochemotherapy in a single institutional series of locally advanced cervical cancer (LACC) patients. The study included 98 LACC patients admitted to the Gynecologic Oncology Unit, Catholic University of Rome and Campobasso between January 1998 and January 2005. Immunohistochemistry was performed by using the polyclonal rabbit anti-beta III tubulin antibody (Covance, Princeton, NJ, USA). The value of 10% immunostained tumor cells was arbitrarily chosen as cut-off value to distinguish cases with high versus low beta III tubulin content. In the whole series, beta III tubulin immunoreaction was detectable in 66/98 cases (67.3%), and the percentage of positively stained cells ranged from 0 to 100% (median=10%). The percentages of cases with high beta III tubulin expression were shown not to be differently distributed according to clinico-pathological characteristics. There was no statistically significant difference in the distribution of cases with high beta III tubulin expression according to clinical and pathological response to treatment. During the follow-up period, recurrence and death of disease occurred in 15 and 13 cases, respectively. There was no difference in disease-free and overall survival in cases with high versus low beta III tubulin expression. The assessment of class III beta tubulin status seems of little usefulness in order to identify LACC patients with poor chance of response to concomitant radiochemotherapy and unfavorable prognosis.

The Influence of Investment in Workplace Learning on Learning Outcomes and Organizational Performance

ERIC Educational Resources Information Center

Park, Yoonhee; Jacobs, Ronald L.

2011-01-01

Although the importance of workplace learning has been recognized in research and practice, there is little empirical support that describes how workplace learning, including both formal and informal learning, is linked to organizational performance. This study investigated the influence of investment in workplace learning on learning outcomes and…

But Does It Work? Reflective Activities, Learning Outcomes and Instrumental Learning in Continuing Professional Development

ERIC Educational Resources Information Center

Roessger, Kevin M.

2015-01-01

This paper examines the relationship between reflective practice and instrumental learning within the context of continuing professional development (CPD). It is argued that instrumental learning is a unique process of adult learning, and reflective practice's impact on learning outcomes in instrumental learning contexts remains unclear. A…

Exploring the Link between Experienced Teachers' Learning Outcomes and Individual and Professional Learning Community Characteristics

ERIC Educational Resources Information Center

Vanblaere, Bénédicte; Devos, Geert

2016-01-01

The continuous professional development of teachers is crucial in our current knowledge-based society, yet empirical research on experienced teachers' learning outcomes is scarce. In this study, we examine perceived changes in classroom practices and in competence as outcomes. By making these outcomes measurable, we can relate them to several…

Lessons learned in acquiring new regulations for shipping advanced electric vehicle batteries

NASA Astrophysics Data System (ADS)

Henriksen, Gary; Hammel, Carol; Altemos, Edward A.

1994-12-01

In 1990, the Electric and Hybrid Propulsion Division of the US Department of Energy established its ad hoc EV Battery Readiness Working Group to identify regulatory barriers to the commercialization of advanced EV battery technologies and facilitate the removal of these barriers. A Shipping Sub-Working Group (SSWG) was formed to address the regulatory issues associated with the domestic and international shipment of these new battery technologies. The SSWG invites major industrial developers of advanced battery technologies to join as members and work closely with appropriate domestic and international regulatory authorities to develop suitable regulations and procedures for the safe transport of these new battery technologies. This paper describes the domestic and international regulatory processes for the transport of dangerous goods; reviews the status of shipping regulations for sodium-beta and lithium batteries; and delineates the lessons learned to date in this process. The sodium-beta battery family was the first category of advanced EV batteries to be addressed by the SSWG. It includes both sodium/sulfur and sodium/metal chloride batteries. Their efforts led to the establishment of a UN number (UN 3292) in the UN Recommendations, for cold cells and batteries, and establishment of a US Department of Transportation general exemption (DOT-E-10917) covering cold and hot batteries, as well as cold cells. The lessons learned for sodium-beta batteries, over the period of 1990--94, are now being applied to the development of regulations for shipping a new generation of lithium battery technologies (lithium-polymer and lithium-aluminum/iron sulfide batteries).

The problem with outcomes-based curricula in medical education: insights from educational theory.

PubMed

Rees, Charlotte E

2004-06-01

Educators across the world are charged with the responsibility of producing core learning outcomes for medical curricula. However, much educational theory exists which deliberates the value of learning outcomes in education. This paper aims to discuss the problems surrounding outcomes-based curricula in medical education, using insights from educational theory. The paper begins with a discussion of the traditions, values and ideologies of medical curricula. It continues by analysing the issue of control within the curriculum and argues that curriculum designers and teachers control product-orientated curricula, leading to student disempowerment. The paper debates outcomes-based curricula from an ideological perspective and argues that learning outcomes cannot specify exactly what is to be achieved as a result of learning. The paper argues that medical schools should adopt a model for co-operative control of the curriculum, thus empowering learners. The paper also suggests that medical educators should determine the value of precise learning outcomes before blindly adopting an outcomes-based model.

Anatomical Society core regional anatomy syllabus for undergraduate medicine: the Delphi process.

PubMed

Smith, C F; Finn, G M; Stewart, J; McHanwell, S

2016-01-01

A modified Delphi method was employed to seek consensus when revising the UK and Ireland's core syllabus for regional anatomy in undergraduate medicine. A Delphi panel was constructed involving 'expert' (individuals with at least 5 years' experience in teaching medical students anatomy at the level required for graduation). The panel (n = 39) was selected and nominated by members of Council and/or the Education Committee of the Anatomical Society and included a range of specialists including surgeons, radiologists and anatomists. The experts were asked in two stages to 'accept', 'reject' or 'modify' (first stage only) each learning outcome. A third stage, which was not part of the Delphi method, then allowed the original authors of the syllabus to make changes either to correct any anatomical errors or to make minor syntax changes. From the original syllabus of 182 learning outcomes, removing the neuroanatomy component (163), 23 learning outcomes (15%) remained unchanged, seven learning outcomes were removed and two new learning outcomes added. The remaining 133 learning outcomes were modified. All learning outcomes on the new core syllabus achieved over 90% acceptance by the panel. © 2015 Anatomical Society.

Classical sickle beta-globin haplotypes exhibit a high degree of long-range haplotype similarity in African and Afro-Caribbean populations.

PubMed

Hanchard, Neil; Elzein, Abier; Trafford, Clare; Rockett, Kirk; Pinder, Margaret; Jallow, Muminatou; Harding, Rosalind; Kwiatkowski, Dominic; McKenzie, Colin

2007-08-10

The sickle (betas) mutation in the beta-globin gene (HBB) occurs on five "classical" betas haplotype backgrounds in ethnic groups of African ancestry. Strong selection in favour of the betas allele - a consequence of protection from severe malarial infection afforded by heterozygotes - has been associated with a high degree of extended haplotype similarity. The relationship between classical betas haplotypes and long-range haplotype similarity may have both anthropological and clinical implications, but to date has not been explored. Here we evaluate the haplotype similarity of classical betas haplotypes over 400 kb in population samples from Jamaica, The Gambia, and among the Yoruba of Nigeria (Hapmap YRI). The most common betas sub-haplotype among Jamaicans and the Yoruba was the Benin haplotype, while in The Gambia the Senegal haplotype was observed most commonly. Both subtypes exhibited a high degree of long-range haplotype similarity extending across approximately 400 kb in all three populations. This long-range similarity was significantly greater than that seen for other haplotypes sampled in these populations (P < 0.001), and was independent of marker choice and marker density. Among the Yoruba, Benin haplotypes were highly conserved, with very strong linkage disequilibrium (LD) extending a megabase across the betas mutation. Two different classical betas haplotypes, sampled from different populations, exhibit comparable and extensive long-range haplotype similarity and strong LD. This LD extends across the adjacent recombination hotspot, and is discernable at distances in excess of 400 kb. Although the multi-centric geographic distribution of betas haplotypes indicates strong subdivision among early Holocene sub-Saharan populations, we find no evidence that selective pressures imposed by falciparum malaria varied in intensity or timing between these subpopulations. Our observations also suggest that cis-acting loci, which may influence outcomes in sickle cell disease, could lie considerable distances away from beta-globin.

Effects of beta-adrenergic antagonist, propranolol on spatial memory and exploratory behavior in mice.

PubMed

Sun, Huaying; Mao, Yu; Wang, Jianhong; Ma, Yuanye

2011-07-08

The beta-adrenergic system has been suggested to be involved in novelty detection and memory modulation. The present study aimed to investigate the role of beta-adrenergic receptors on novelty-based spatial recognition memory and exploratory behavior in mice using Y-maze test and open-field respectively. Mice were injected with three doses of beta-adrenergic receptor antagonist, propranolol (2, 10 and 20 mg/kg) or saline at three different time points (15 min prior to training, immediately after training and 15 min before test). The results showed that higher doses of propranolol (10 and 20 mg/kg) given before the training trial impaired spatial recognition memory while those injected at other two time points did not. A detailed analysis of exploratory behavior in open-field showed that lower dose (2 mg/kg) of propranolol reduced exploratory behavior of mice. Our findings indicate that higher dose of propranolol can impair acquisition of spatial information in the Y-maze without altering locomotion, suggesting that the beta-adrenergic system may be involved in modulating memory processes at the time of learning. Copyright © 2011. Published by Elsevier Ireland Ltd.

Board development in two hospitals: lessons from a demonstration.

PubMed

Kovner, A R; Ritvo, R A; Holland, T P

1997-01-01

A recently concluded demonstration project examined efforts to improve the effectiveness of nonprofit boards. This article focuses on the interventions at two participating healthcare organizations and examines the outcomes of these efforts. Changes made at the Alpha Health Care system included: reduction in the number of boards, term limits established for board members, election of new board chairs for two of the fewer boards, reduction in the size of those boards, implementation of a consent agenda, and reorganization of the boards' committee structure. Fewer changes were implemented at the Beta Hospital, where several initiatives were started but only some of which were retained by the projects' conclusion. Key factors limiting the extent of changes there were the modest interest in an active board by a new CEO and the limited investment of trustees in change. The article concludes with a discussion of lessons learned about board assessment, the use of retreats to initiate board development, and the importance of time management and CEO support to strengthen board effectiveness.

Beta and gamma oscillatory activities associated with olfactory memory tasks: different rhythms for different functional networks?

PubMed Central

Martin, Claire; Ravel, Nadine

2014-01-01

Olfactory processing in behaving animals, even at early stages, is inextricable from top down influences associated with odor perception. The anatomy of the olfactory network (olfactory bulb, piriform, and entorhinal cortices) and its unique direct access to the limbic system makes it particularly attractive to study how sensory processing could be modulated by learning and memory. Moreover, olfactory structures have been early reported to exhibit oscillatory population activities easy to capture through local field potential recordings. An attractive hypothesis is that neuronal oscillations would serve to “bind” distant structures to reach a unified and coherent perception. In relation to this hypothesis, we will assess the functional relevance of different types of oscillatory activity observed in the olfactory system of behaving animals. This review will focus primarily on two types of oscillatory activities: beta (15–40 Hz) and gamma (60–100 Hz). While gamma oscillations are dominant in the olfactory system in the absence of odorant, both beta and gamma rhythms have been reported to be modulated depending on the nature of the olfactory task. Studies from the authors of the present review and other groups brought evidence for a link between these oscillations and behavioral changes induced by olfactory learning. However, differences in studies led to divergent interpretations concerning the respective role of these oscillations in olfactory processing. Based on a critical reexamination of those data, we propose hypotheses on the functional involvement of beta and gamma oscillations for odor perception and memory. PMID:25002840

Comparing Learning Outcomes of Blended Learning and Traditional Face-to-Face Learning of University Students in ESL Courses

ERIC Educational Resources Information Center

Zhang, Wei; Zhu, Chang

2018-01-01

Combining elements of online and face-to-face education, blended learning is emerging as an important teaching and learning model in higher education. In order to examine the effectiveness of blended learning, as compared to the traditional face-to-face learning mode, this research investigated the learning outcomes of students following English…

A review of assertions about the processes and outcomes of social learning in natural resource management.

PubMed

Cundill, G; Rodela, R

2012-12-30

Social learning has become a central theme in natural resource management. This growing interest is underpinned by a number of assertions about the outcomes of social learning, and about the processes that support these outcomes. Yet researchers and practitioners who seek to engage with social learning through the natural resource management literature often become disorientated by the myriad processes and outcomes that are identified. We trace the roots of current assertions about the processes and outcomes of social learning in natural resource management, and assess the extent to which there is an emerging consensus on these assertions. Results suggest that, on the one hand, social learning is described as taking place through deliberative interactions amongst multiple stakeholders. During these interactions, it is argued that participants learn to work together and build relationships that allow for collective action. On the other hand, social learning is described as occurring through deliberate experimentation and reflective practice. During these iterative cycles of action, monitoring and reflection, participants learn how to cope with uncertainty when managing complex systems. Both of these processes, and their associated outcomes, are referred to as social learning. Where, therefore, should researchers and practitioners focus their attention? Results suggest that there is an emerging consensus that processes that support social learning involve sustained interaction between stakeholders, on-going deliberation and the sharing of knowledge in a trusting environment. There is also an emerging consensus that the key outcome of such learning is improved decision making underpinned by a growing awareness of human-environment interactions, better relationships and improved problem-solving capacities for participants. Copyright © 2012 Elsevier Ltd. All rights reserved.

An Outcome Evaluation of a Problem-Based Learning Approach with MSW Students

ERIC Educational Resources Information Center

Westhues, Anne; Barsen, Chia; Freymond, Nancy; Train, Patricia

2014-01-01

In this article, we report the findings from a study exploring the effects of a problem-based learning (PBL) approach to teaching and learning on learning outcomes for master's of social work (MSW) students. Students who participated in a PBL pilot project were compared with students who did not participate in 5 outcome areas: social work…

Creativity of Biology Students in Online Learning: Case Study of Universitas Terbuka, Indonesia

NASA Astrophysics Data System (ADS)

Diki, Diki

This is a study about the effect of students' attitudes of creativity toward their learning achievement and persistence in an online learning program. The study also investigated if there was an effect of indirect effect of attitudes of creativity toward learning achievement and persistence through learning strategies. There are three learning strategies, which are deep-learning, strategic-learning, and surface-learning. The participants were students of the department of biology and the department of biology teacher training in Universitas Terbuka (UT -- Indonesia Open University), a distance learning university in Indonesia. The researcher sent the questionnaire through email to students who lived throughout Indonesia. There were 102 students participated in the survey. The instruments were rCAB test for value and attitudes toward creativity (Runco, 2012) and approaches and Study Skills Inventory for Students (ASSIST) test (Speth, 2013). There were four research questions (RQ) in this study. The first was if there was a relationship between attitudes of creativity and persistence. The researcher used independent samples t test technique for RQ 1. The second was if there is a relationship between attitudes of creativity and learning outcome. The researcher used multiple regressions for RQ2. The third was if there was an indirect relationship between attitudes of creativity and persistence through learning strategy. The fourth question was if there is an indirect relationship between attitudes of creativity and learning outcome through learning strategy. The researcher used multiple regression for RQ3 and path analysis for RQ 4. Controlling variables were age, income, departments, gender, high school GPA, and daily online activities. The result showed that fun, and being unconventional negatively predicted learning outcomes while high school GPA positively predicted learning outcome. Age and high school GPA negatively predicted persistence while being unconventional positively predicted persistence. Two variables of deep-learning strategy predicted learning outcome. There were indirect relationships between attitudes of creativity and learning outcomes through deep-learning strategy.

[Concentration of proinflammatory cytokines (TNF-alpha, IL-8) in the cerebrospinal fluid and the course of bacterial meningitis].

PubMed

Bociaga-Jasik, Monika; Garlicki, Aleksander; Kalinowska-Nowak, Anna; Mach, Tomasz

2004-01-01

Bacterial meningitis is still associated with high mortality rate and severe neurological sequels. The aim of the study was to assess correlation between concentration of proinflammatory cytokines (TNF-alpha, IL-1 beta, IL-8) in the cerebrospinal fluid (CSF) and patient condition described on the basis of Glasgow Coma Scale (GCS), changes in the CSF (pleocytosis, protein and glucose level), mortality rate and occurrence of neurological complications. 42 patients with bacterial meningitis have been analysed. Control group consisted of 25 patients with viral meningitis and 23 patients without meningitis. In analysed group with bacterial meningitis the correlation between number of scores aggregated by patients in GCS and outcome has been observed. Concentration of TNF-alpha, IL-1 beta, IL-8 in CSF of patient with bacterial meningitis was significantly higher (mean value; 705.2 pg/ml, 401.1 pg/ml and 1696.0 pg/ml) than in control group (viral meningitis: 7.93 pg/ml, 31.89 pg/ml, 405.28 pg/ml, without meningitis: 0.38 pg/ml, 2.55 pg/ml, 32.56 pg/ml). Negative correlation between concentration of investigated cytokines in the CSF of patient with bacterial meningitis and GCS has been observed. Furthermore TNF-alpha and IL-8 levels correlated with pleocytosis, and protein and glucose levels, whereas IL-1 beta correlated with pleocytosis and protein level in CSF. Connection between TNF-alpha and IL-1 beta but not IL-8 level and outcome of bacterial meningitis has been observed. High TNF-alpha in the CSF (median value 953 pg/ml) was associated with significant risk of patient death. IL-1 beta has been better prognostic indicator. Patients who developed neurological sequels had median value of IL-1 beta level 401.3 pg/ml, and those who died had 585.9 pg/ml vs 244.7 pg/ml in the group who survived without any complications. Analysis of the ROC curve-revealed, that concentration of IL-1 beta > or = 289.9 pg/ml with 88.9% sensitivity and 67.7% specifity differentiate cases who at risk for death. For TNF-alpha the cut-off was > or = 538.9 pg/ml. The sensitivity for determined critical point was 77%, and specificity was 68.7%. Our investigation confirm that TNF alpha, IL-1 beta, IL-8 are useful in differential diagnosis of neuroinfections. Assessment of patients with bacterial meningitis on the basis of GCS is helpful to establish prognosis, and CGS seems to correlate with the intensity of inflammation in the CSF. High concentration of TNF-alpha, and IL-1 beta in the CSF are associated with the risk of patient death during the course of bacterial meningitis, but IL-1 beta has been the better prognostic marker.

Pioglitazone and exenatide enhance cognition and downregulate hippocampal beta amyloid oligomer and microglia expression in insulin-resistant rats.

PubMed

Gad, Enas S; Zaitone, Sawsan A; Moustafa, Yasser M

2016-08-01

Insulin resistance is known to be a risk factor for cognitive impairment, most likely linked to insulin signaling, microglia overactivation, and beta amyloid (Aβ) deposition in the brain. Exenatide, a long lasting glucagon-like peptide-1 (GLP-1) analogue, enhances insulin signaling and shows neuroprotective properties. Pioglitazone, a peroxisome proliferated-activated receptor-γ (PPAR-γ) agonist, was previously reported to enhance cognition through its effect on Aβ accumulation and clearance. In the present study, insulin resistance was induced in male rats by drinking fructose for 12 weeks. The effect of monotherapy with pioglitazone (10 mg·kg(-1)) and exenatide or their combination on memory dysfunction was determined and some of the probable underlying mechanisms were studied. The current results confirmed that (1) feeding male rats with fructose syrup for 12 weeks resulted in a decline of learning and memory registered in eight-arm radial maze test; (2) treatment with pioglitazone or exenatide enhanced cognition, reduced hippocampal neurodegeneration, and reduced hippocampal microglia expression and beta amyloid oligomer deposition in a manner that is equal to monotherapies. These results may give promise for the use of pioglitazone or exenatide for ameliorating the learning and memory deficits associated with insulin resistance in clinical setting.

College Students Attitudes toward Learning Process and Outcome of Online Instruction and Distance Learning across Learning Styles

ERIC Educational Resources Information Center

Nguyen, Dat-Dao; Zhang, Yue

2011-01-01

This study uses the Learning-Style Inventory--LSI (Smith & Kolb, 1985) to explore to what extent student attitudes toward learning process and outcome of online instruction and Distance Learning are affected by their cognitive styles and learning behaviors. It finds that there are not much statistically significant differences in perceptions…

Learning outcomes for communication skills across the health professions: a systematic literature review and qualitative synthesis

PubMed Central

Denniston, Charlotte; Molloy, Elizabeth; Woodward-Kron, Robyn; Keating, Jennifer L

2017-01-01

Objective The aim of this study was to identify and analyse communication skills learning outcomes via a systematic review and present results in a synthesised list. Summarised results inform educators and researchers in communication skills teaching and learning across health professions. Design Systematic review and qualitative synthesis. Methods A systematic search of five databases (MEDLINE, PsycINFO, ERIC, CINAHL plus and Scopus), from first records until August 2016, identified published learning outcomes for communication skills in health professions education. Extracted data were analysed through an iterative process of qualitative synthesis. This process was guided by principles of person centredness and an a priori decision guide. Results 168 papers met the eligibility criteria; 1669 individual learning outcomes were extracted and refined using qualitative synthesis. A final refined set of 205 learning outcomes were constructed and are presented in 4 domains that include: (1) knowledge (eg, describe the importance of communication in healthcare), (2) content skills (eg, explore a healthcare seeker's motivation for seeking healthcare),( 3) process skills (eg, respond promptly to a communication partner's questions) and (4) perceptual skills (eg, reflect on own ways of expressing emotion). Conclusions This study provides a list of 205 communication skills learning outcomes that provide a foundation for further research and educational design in communication education across the health professions. Areas for future investigation include greater patient involvement in communication skills education design and further identification of learning outcomes that target knowledge and perceptual skills. This work may also prompt educators to be cognisant of the quality and scope of the learning outcomes they design and their application as goals for learning. PMID:28389493

Learning outcomes for communication skills across the health professions: a systematic literature review and qualitative synthesis.

PubMed

Denniston, Charlotte; Molloy, Elizabeth; Nestel, Debra; Woodward-Kron, Robyn; Keating, Jennifer L

2017-04-07

The aim of this study was to identify and analyse communication skills learning outcomes via a systematic review and present results in a synthesised list. Summarised results inform educators and researchers in communication skills teaching and learning across health professions. Systematic review and qualitative synthesis. A systematic search of five databases (MEDLINE, PsycINFO, ERIC, CINAHL plus and Scopus), from first records until August 2016, identified published learning outcomes for communication skills in health professions education. Extracted data were analysed through an iterative process of qualitative synthesis. This process was guided by principles of person centredness and an a priori decision guide. 168 papers met the eligibility criteria; 1669 individual learning outcomes were extracted and refined using qualitative synthesis. A final refined set of 205 learning outcomes were constructed and are presented in 4 domains that include: (1) knowledge (eg, describe the importance of communication in healthcare), (2) content skills (eg, explore a healthcare seeker's motivation for seeking healthcare),( 3) process skills (eg, respond promptly to a communication partner's questions) and (4) perceptual skills (eg, reflect on own ways of expressing emotion). This study provides a list of 205 communication skills learning outcomes that provide a foundation for further research and educational design in communication education across the health professions. Areas for future investigation include greater patient involvement in communication skills education design and further identification of learning outcomes that target knowledge and perceptual skills. This work may also prompt educators to be cognisant of the quality and scope of the learning outcomes they design and their application as goals for learning. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

The Spread of the Learning Outcomes Approaches across Countries, Sub-Systems and Levels: A Special Focus on Teacher Education

ERIC Educational Resources Information Center

Halász, Gábor

2017-01-01

This article is based on the outcomes of the study entitled "The application of learning outcomes approaches across Europe", which was funded by Cedefop and completed in 2015 (Wisniewski et al, 2015). The study, aiming at exploring the implementation of the learning outcomes approach in European countries, addressed two major questions:…

Dopaminergic and Prefrontal Contributions to Reward-Based Learning and Outcome Monitoring during Child Development and Aging

ERIC Educational Resources Information Center

Hammerer, Dorothea; Eppinger, Ben

2012-01-01

In many instances, children and older adults show similar difficulties in reward-based learning and outcome monitoring. These impairments are most pronounced in situations in which reward is uncertain (e.g., probabilistic reward schedules) and if outcome information is ambiguous (e.g., the relative value of outcomes has to be learned).…

The influence of the learning climate on learning outcomes from Marte Meo counselling in dementia care.

PubMed

Alnes, Rigmor Einang; Kirkevold, Marit; Skovdahl, Kirsti

2013-01-01

  To identify factors that affected the learning outcomes from Marte Meo counselling (MMC).   Although MMC has shown promising results regarding learning outcomes for staff working in dementia-specific care units, the outcomes differ.   Twelve individual interviews and four focus group interviews with staff who had participated in MMC were analysed through a qualitative content analysis.   The learning climate has considerable significance for the experienced benefit of MMC and indicate that this learning climate depends on three conditions: establishing a common understanding of the content and form of MMC, ensuring staff's willingness to participate and the opportunity to do so, and securing an arena in the unit for discussion and interactions.   Learning outcomes from MMC in dementia-specific care units appear to depend on the learning climate in the unit. Implication for nursing management  The learning climate needs attention from the nursing management when establishing Marte Meo intervention in nursing homes. The learning climate can be facilitated through building common understandings in the units regarding why and how this intervention should take place, and by ensuring clarity in the relationship between the intervention and the organization's objectives. © 2012 Blackwell Publishing Ltd.

How Do B-Learning and Learning Patterns Influence Learning Outcomes?

PubMed Central

Sáiz Manzanares, María Consuelo; Marticorena Sánchez, Raúl; García Osorio, César Ignacio; Díez-Pastor, José F.

2017-01-01

Learning Management System (LMS) platforms provide a wealth of information on the learning patterns of students. Learning Analytics (LA) techniques permit the analysis of the logs or records of the activities of both students and teachers on the on-line platform. The learning patterns differ depending on the type of Blended Learning (B-Learning). In this study, we analyse: (1) whether significant differences exist between the learning outcomes of students and their learning patterns on the platform, depending on the type of B-Learning [Replacement blend (RB) vs. Supplemental blend (SB)]; (2) whether a relation exists between the metacognitive and the motivational strategies (MS) of students, their learning outcomes and their learning patterns on the platform. The 87,065 log records of 129 students (69 in RB and 60 in SB) in the Moodle 3.1 platform were analyzed. The results revealed different learning patterns between students depending on the type of B-Learning (RB vs. SB). We have found that the degree of blend, RB vs. SB, seems to condition student behavior on the platform. Learning patterns in RB environments can predict student learning outcomes. Additionally, in RB environments there is a relationship between the learning patterns and the metacognitive and (MS) of the students. PMID:28559866

How Do B-Learning and Learning Patterns Influence Learning Outcomes?

PubMed

Sáiz Manzanares, María Consuelo; Marticorena Sánchez, Raúl; García Osorio, César Ignacio; Díez-Pastor, José F

2017-01-01

Learning Management System (LMS) platforms provide a wealth of information on the learning patterns of students. Learning Analytics (LA) techniques permit the analysis of the logs or records of the activities of both students and teachers on the on-line platform. The learning patterns differ depending on the type of Blended Learning (B-Learning). In this study, we analyse: (1) whether significant differences exist between the learning outcomes of students and their learning patterns on the platform, depending on the type of B-Learning [Replacement blend (RB) vs. Supplemental blend (SB)]; (2) whether a relation exists between the metacognitive and the motivational strategies (MS) of students, their learning outcomes and their learning patterns on the platform. The 87,065 log records of 129 students (69 in RB and 60 in SB) in the Moodle 3.1 platform were analyzed. The results revealed different learning patterns between students depending on the type of B-Learning (RB vs. SB). We have found that the degree of blend, RB vs. SB, seems to condition student behavior on the platform. Learning patterns in RB environments can predict student learning outcomes. Additionally, in RB environments there is a relationship between the learning patterns and the metacognitive and (MS) of the students.

Can Performance-Related Learning Outcomes Have Standards?

ERIC Educational Resources Information Center

Brockmann, Michaela; Clarke, Linda; Winch, Christopher

2008-01-01

Purpose: This paper aims to explain the distinction between educational standards and learning outcomes and to indicate the problems that potentially arise when a learning outcomes approach is applied to a qualification meta-framework like the European Qualification Framework, or indeed to national qualification frameworks.…

Requiring Writing, Ensuring Distance-Learning Outcomes.

ERIC Educational Resources Information Center

Mulligan, Roark; Geary, Susan

1999-01-01

Discussion of the quality of distance learning programs focuses on a study of Christopher Newport University (CPU ONLINE) that showed learning outcomes in online courses were as good as outcomes in traditional courses. Describes online writing requirements that helped students develop critical thinking skills. (Author/LRW)

A randomised study of perioperative esmolol infusion for haemodynamic stability during major vascular surgery; rationale and design of DECREASE-XIII.

PubMed

Bakker, E J; Ravensbergen, N J; Voute, M T; Hoeks, S E; Chonchol, M; Klimek, M; Poldermans, D

2011-09-01

This article describes the rationale and design of the DECREASE-XIII trial, which aims to evaluate the potential of esmolol infusion, an ultra-short-acting beta-blocker, during surgery as an add-on to chronic low-dose beta-blocker therapy to maintain perioperative haemodynamic stability during major vascular surgery. A double-blind, placebo-controlled, randomised trial. A total of 260 vascular surgery patients will be randomised to esmolol or placebo as an add-on to standard medical care, including chronic low-dose beta-blockers. Esmolol is titrated to maintain a heart rate within a target window of 60-80 beats per minute for 24 h from the induction of anaesthesia. Heart rate and ischaemia are assessed by continuous 12-lead electrocardiographic monitoring for 72 h, starting 1 day prior to surgery. The primary outcome measure is duration of heart rate outside the target window during infusion of the study drug. Secondary outcome measures will be the efficacy parameters of occurrence of cardiac ischaemia, troponin T release, myocardial infarction and cardiac death within 30 days after surgery and safety parameters such as the occurrence of stroke and hypotension. This study will provide data on the efficacy of esmolol titration in chronic beta-blocker users for tight heart-rate control and reduction of ischaemia in patients undergoing vascular surgery as well as data on safety parameters. Copyright © 2011 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Clinical evaluation of GEM 21S® and a collagen membrane with a coronally advanced flap as a root coverage procedure in the treatment of gingival recession defects: A comparative study

PubMed Central

Singh, Preetinder; Suresh, D. K.

2012-01-01

Aim: Clinical evaluation of efficacy of rhPDGF-BB plus beta tricalcium phosphate (GEM 21S®) along with a collagen membrane in root coverage using a coronally advanced flap. Materials and Methods: This human case series evaluated the clinical outcome of rhPDGF-BB with beta-tricalcium phosphate (GEM 21S®) and a collagen membrane in the treatment of recession defects using a coronally advanced flap. Patients were followed postoperatively, and healing was evaluated at 1, 3, and 6 months, with recession depth as the primary outcome measure. Results: This pioneer case series revealed a favorable tissue response to GEM 21S® and collagen membrane from both clinical and esthetic point of view in regenerative periodontal surgery. PMID:23493720

Learning Consequences of Mobile-Computing Technologies: Differential Impacts on Integrative Learning and Skill-Focused Learning

ERIC Educational Resources Information Center

Kumi, Richard; Reychav, Iris; Sabherwal, Rajiv

2016-01-01

Many educational institutions are integrating mobile-computing technologies (MCT) into the classroom to improve learning outcomes. There is also a growing interest in research to understand how MCT influence learning outcomes. The diversity of results in prior research indicates that computer-mediated learning has different effects on various…

Elemental Learning as a Framework for E-Learning

ERIC Educational Resources Information Center

Dempsey, John V.; Litchfield, Brenda C.

2013-01-01

Analysis of learning outcomes can be a complex and esoteric instructional design process that is often ignored by educators and e-learning designers. This paper describes a model of analysis that fosters the real-life application of learning outcomes and explains why the model may be needed. The Elemental Learning taxonomy is a hierarchical model…

Informal Workplace Learning among Nurses: Organisational Learning Conditions and Personal Characteristics That Predict Learning Outcomes

ERIC Educational Resources Information Center

Kyndt, Eva; Vermeire, Eva; Cabus, Shana

2016-01-01

Purpose: This paper aims to examine which organisational learning conditions and individual characteristics predict the learning outcomes nurses achieve through informal learning activities. There is specific relevance for the nursing profession because of the rapidly changing healthcare systems. Design/Methodology/Approach: In total, 203 nurses…

An International Assessment of Bachelor Degree Graduates' Learning Outcomes

ERIC Educational Resources Information Center

Coates, Hamish; Richardson, Sarah

2012-01-01

This paper examines rationales, aspirations, assumptions and methods shaping an international assessment of learning outcomes: the OECD's Assessment of Higher Education Learning Outcomes (AHELO) feasibility study. The first part of the paper is analytical, exploring formative rationales, and shaping contexts and normative perspectives that frame…

The Impact of Taiwanese College Students' Learning Motivation from Self-Determination Perspective on Learning Outcomes: Moderating Roles of Multi-Traits

ERIC Educational Resources Information Center

Ho, Sophia Shi-Huei

2017-01-01

The purpose of this study is to explore the associations among learning motivation, engagement and outcomes, and the moderating role of various traits in the relationship between deep approaches to learning and outcomes. Based on data from 2,340 students in multiple universities in Taiwan, this study proposes two alternative models, tested by…

DOE Office of Scientific and Technical Information (OSTI.GOV)

Berry, Max; Lystig, Ted; Beard, Jonathan

Purpose. To compare the learning of endovascular interventional skills by training on pig models versus virtual reality simulators. Methods. Twelve endovascular novices participated in a study consisting of a pig laboratory (P-Lab) and a virtual reality laboratory (VR-Lab). Subjects were stratified by experience and randomized into four training groups. Following 1 hr of didactic instruction, all attempted an iliac artery stenosis (IAS) revascularization in both laboratories. Onsite proctors evaluated performances using task-specific checklists and global rating scales, yielding a Total Score. Participants completed two training sessions of 3 hr each, using their group's assigned method (P-Lab x 2, P-Lab +more » VR-Lab, VR-Lab + P-Lab, or VR-Lab x 2) and were re-evaluated in both laboratories. A panel of two highly experienced interventional radiologists performed assessments from video recordings. ANCOVA analysis of Total Score against years of surgical, interventional radiology (IR) experience and cumulative number of P-Lab or VR-Lab sessions was conducted. Inter-rater reliability (IRR) was determined by comparing proctored scores with the video assessors in only the VR-Lab. Results. VR-Lab sessions improved the VR-Lab Total Score ({beta} 3.029, p = 0.0015) and P-Lab Total Score ({beta} = 1.814, p = 0.0452). P-Lab sessions increased the P-Lab Total Score ({beta} = 4.074, p < 0.0001) but had no effect on the VR-Lab Total Score. In the general statistical model, both P-Lab sessions ({beta} = 2.552, p = 0.0010) and VR-Lab sessions ({beta} 2.435, p = 0.0032) significantly improved Total Score. Neither previous surgical experience nor IR experience predicted Total Score. VR-Lab scores were consistently higher than the P-Lab scores ({delta} = 6.659, p < 0.0001). VR-Lab IRR was substantial (r = 0.649, p < 0.0008). Conclusions. Endovascular skills learned in the virtual environment may be transferable to the real catheterization laboratory as modeled in the P-Lab.« less

Specific effect of a dopamine partial agonist on counterfactual learning: evidence from Gilles de la Tourette syndrome.

PubMed

Salvador, Alexandre; Worbe, Yulia; Delorme, Cécile; Coricelli, Giorgio; Gaillard, Raphaël; Robbins, Trevor W; Hartmann, Andreas; Palminteri, Stefano

2017-07-24

The dopamine partial agonist aripiprazole is increasingly used to treat pathologies for which other antipsychotics are indicated because it displays fewer side effects, such as sedation and depression-like symptoms, than other dopamine receptor antagonists. Previously, we showed that aripiprazole may protect motivational function by preserving reinforcement-related signals used to sustain reward-maximization. However, the effect of aripiprazole on more cognitive facets of human reinforcement learning, such as learning from the forgone outcomes of alternative courses of action (i.e., counterfactual learning), is unknown. To test the influence of aripiprazole on counterfactual learning, we administered a reinforcement learning task that involves both direct learning from obtained outcomes and indirect learning from forgone outcomes to two groups of Gilles de la Tourette (GTS) patients, one consisting of patients who were completely unmedicated and the other consisting of patients who were receiving aripiprazole monotherapy, and to healthy subjects. We found that whereas learning performance improved in the presence of counterfactual feedback in both healthy controls and unmedicated GTS patients, this was not the case in aripiprazole-medicated GTS patients. Our results suggest that whereas aripiprazole preserves direct learning of action-outcome associations, it may impair more complex inferential processes, such as counterfactual learning from forgone outcomes, in GTS patients treated with this medication.

The significance of clinical experience on learning outcome from resuscitation training-a randomised controlled study.

PubMed

Jensen, Morten Lind; Lippert, Freddy; Hesselfeldt, Rasmus; Rasmussen, Maria Birkvad; Mogensen, Simon Skibsted; Jensen, Michael Kammer; Frost, Torben; Ringsted, Charlotte

2009-02-01

The impact of clinical experience on learning outcome from a resuscitation course has not been systematically investigated. To determine whether half a year of clinical experience before participation in an Advanced Life Support (ALS) course increases the immediate learning outcome and retention of learning. This was a prospective single blinded randomised controlled study of the learning outcome from a standard ALS course on a volunteer sample of the entire cohort of newly graduated doctors from Copenhagen University. The outcome measurement was ALS-competence assessed using a validated composite test including assessment of skills and knowledge. The intervention was half a year of clinical work before an ALS course. The intervention group received the course after a half-year of clinical experience. The control group participated in an ALS course immediately following graduation. Invitation to participate was accepted by 154/240 (64%) graduates and 117/154 (76%) completed the study. There was no difference between the intervention and control groups with regard to the immediate learning outcome. The intervention group had significantly higher retention of learning compared to the control group, intervention group mean 82% (CI 80-83), control group mean 78% (CI 76-80), P=0.002. The magnitude of this difference was medium (effect size=0.57). Half a year of clinical experience, before participation in an ALS course had a small but statistically significant impact on the retention of learning, but not on the immediate learning outcome.

High oestradiol concentration after ovarian stimulation is associated with lower maternal serum beta-HCG concentration and neonatal birth weight.

PubMed

Liu, Suying; Kuang, Yanping; Wu, Yu; Feng, Yun; Lyu, Qifeng; Wang, Li; Sun, Yijuan; Sun, Xiaoxi

2017-08-01

In this retrospective study, the relationship between maternal serum oestradiol and progesterone levels after fresh embryo transfer or frozen embryo transfer (FET), and serum beta-HCG levels in early pregnancy and neonatal birth weight was examined. Included for analysis were 5643 conceived singletons: 2610 after FET and 3033 after fresh embryo transfer. Outcome measures included maternal serum oestradiol, progesterone, beta-HCG levels during the peri-implantation period, birth weight and small-for-gestational-age (SGA). Results at 4, 5 and 6 weeks' gestation were as follows: serum oestradiol and progesterone levels were significantly higher in women who underwent fresh embryo transfer compared with FET (all P < 0.0001 except progesterone at 6 weeks; P = 0.009); for fresh embryo transfers, serum beta-HCG levels were significantly lower than in women who underwent FET (P < 0.0001); beta-HCG levels were negatively correlated with serum oestradiol; and birth weight was negatively correlated with serum oestradiol. Incidence of SGA in fresh embryo transfer was increased significantly compared with FET (P < 0.001). Higher maternal oestradiol levels after fresh embryo transfer was correlated with lower beta-HCG in early pregnancy, lower birth weight and higher incidence of SGA. Copyright © 2017 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

On the design of learning outcomes for the undergraduate engineer's final year project

NASA Astrophysics Data System (ADS)

Thambyah, Ashvin

2011-03-01

The course for the final year project for engineering students, because of its strongly research-based, open-ended format, tends to not have well defined learning outcomes, which are also not aligned with any accepted pedagogical philosophy or learning technology. To address this problem, the revised Bloom's taxonomy table of Anderson and Krathwohl (2001) is utilised, as suggested previously by Lee and Lai (2007), to design new learning outcomes for the final year project course in engineering education. Based on the expectations of the engineering graduate, and integrating these graduate expectations into the six cognitive processes and four knowledge dimensions of the taxonomy table, 24 learning outcomes have been designed. It is proposed that these 24 learning outcomes be utilised as a suitable working template to inspire more critical evaluation of what is expected to be learnt by engineering students undertaking final year research or capstone projects.

Science Learning Outcomes in Alignment with Learning Environment Preferences

ERIC Educational Resources Information Center

Chang, Chun-Yen; Hsiao, Chien-Hua; Chang, Yueh-Hsia

2011-01-01

This study investigated students' learning environment preferences and compared the relative effectiveness of instructional approaches on students' learning outcomes in achievement and attitude among 10th grade earth science classes in Taiwan. Data collection instruments include the Earth Science Classroom Learning Environment Inventory and Earth…

Linking Mission to Learning Activities for Assurance of Learning

ERIC Educational Resources Information Center

Yeung, Shirley Mo-ching

2011-01-01

Can accreditation-related requirements and mission statements measure learning outcomes? This study focuses on triangulating accreditation-related requirements with mission statements and learning activities to learning outcomes. This topic has not been comprehensively explored in the past. After looking into the requirements of AACSB, ISO, and…

Eliciting and Receiving Online Support: Using Computer-Aided Content Analysis to Examine the Dynamics of Online Social Support

PubMed Central

Kraut, Robert E; Levine, John M

2015-01-01

Background Although many people with serious diseases participate in online support communities, little research has investigated how participants elicit and provide social support on these sites. Objective The first goal was to propose and test a model of the dynamic process through which participants in online support communities elicit and provide emotional and informational support. The second was to demonstrate the value of computer coding of conversational data using machine learning techniques (1) by replicating results derived from human-coded data about how people elicit support and (2) by answering questions that are intractable with small samples of human-coded data, namely how exposure to different types of social support predicts continued participation in online support communities. The third was to provide a detailed description of these machine learning techniques to enable other researchers to perform large-scale data analysis in these communities. Methods Communication among approximately 90,000 registered users of an online cancer support community was analyzed. The corpus comprised 1,562,459 messages organized into 68,158 discussion threads. Amazon Mechanical Turk workers coded (1) 1000 thread-starting messages on 5 attributes (positive and negative emotional self-disclosure, positive and negative informational self-disclosure, questions) and (2) 1000 replies on emotional and informational support. Their judgments were used to train machine learning models that automatically estimated the amount of these 7 attributes in the messages. Across attributes, the average Pearson correlation between human-based judgments and computer-based judgments was .65. Results Part 1 used human-coded data to investigate relationships between (1) 4 kinds of self-disclosure and question asking in thread-starting posts and (2) the amount of emotional and informational support in the first reply. Self-disclosure about negative emotions (beta=.24, P<.001), negative events (beta=.25, P<.001), and positive events (beta=.10, P=.02) increased emotional support. However, asking questions depressed emotional support (beta=–.21, P<.001). In contrast, asking questions increased informational support (beta=.38, P<.001), whereas positive informational self-disclosure depressed it (beta=–.09, P=.003). Self-disclosure led to the perception of emotional needs, which elicited emotional support, whereas asking questions led to the perception of informational needs, which elicited informational support. Part 2 used machine-coded data to replicate these results. Part 3 analyzed the machine-coded data and showed that exposure to more emotional support predicted staying in the group longer 33% (hazard ratio=0.67, P<.001), whereas exposure to more informational support predicted leaving the group sooner (hazard ratio=1.05, P<.001). Conclusions Self-disclosure is effective in eliciting emotional support, whereas question asking is effective in eliciting informational support. Moreover, perceptions that people desire particular kinds of support influence the support they receive. Finally, the type of support people receive affects the likelihood of their staying in or leaving the group. These results demonstrate the utility of machine learning methods for investigating the dynamics of social support exchange in online support communities. PMID:25896033

Eliciting and receiving online support: using computer-aided content analysis to examine the dynamics of online social support.

PubMed

Wang, Yi-Chia; Kraut, Robert E; Levine, John M

2015-04-20

Although many people with serious diseases participate in online support communities, little research has investigated how participants elicit and provide social support on these sites. The first goal was to propose and test a model of the dynamic process through which participants in online support communities elicit and provide emotional and informational support. The second was to demonstrate the value of computer coding of conversational data using machine learning techniques (1) by replicating results derived from human-coded data about how people elicit support and (2) by answering questions that are intractable with small samples of human-coded data, namely how exposure to different types of social support predicts continued participation in online support communities. The third was to provide a detailed description of these machine learning techniques to enable other researchers to perform large-scale data analysis in these communities. Communication among approximately 90,000 registered users of an online cancer support community was analyzed. The corpus comprised 1,562,459 messages organized into 68,158 discussion threads. Amazon Mechanical Turk workers coded (1) 1000 thread-starting messages on 5 attributes (positive and negative emotional self-disclosure, positive and negative informational self-disclosure, questions) and (2) 1000 replies on emotional and informational support. Their judgments were used to train machine learning models that automatically estimated the amount of these 7 attributes in the messages. Across attributes, the average Pearson correlation between human-based judgments and computer-based judgments was .65. Part 1 used human-coded data to investigate relationships between (1) 4 kinds of self-disclosure and question asking in thread-starting posts and (2) the amount of emotional and informational support in the first reply. Self-disclosure about negative emotions (beta=.24, P<.001), negative events (beta=.25, P<.001), and positive events (beta=.10, P=.02) increased emotional support. However, asking questions depressed emotional support (beta=-.21, P<.001). In contrast, asking questions increased informational support (beta=.38, P<.001), whereas positive informational self-disclosure depressed it (beta=-.09, P=.003). Self-disclosure led to the perception of emotional needs, which elicited emotional support, whereas asking questions led to the perception of informational needs, which elicited informational support. Part 2 used machine-coded data to replicate these results. Part 3 analyzed the machine-coded data and showed that exposure to more emotional support predicted staying in the group longer 33% (hazard ratio=0.67, P<.001), whereas exposure to more informational support predicted leaving the group sooner (hazard ratio=1.05, P<.001). Self-disclosure is effective in eliciting emotional support, whereas question asking is effective in eliciting informational support. Moreover, perceptions that people desire particular kinds of support influence the support they receive. Finally, the type of support people receive affects the likelihood of their staying in or leaving the group. These results demonstrate the utility of machine learning methods for investigating the dynamics of social support exchange in online support communities.

How does tele-learning compare with other forms of education delivery? A systematic review of tele-learning educational outcomes for health professionals.

PubMed

Tomlinson, Jo; Shaw, Tim; Munro, Ana; Johnson, Ros; Madden, D Lynne; Phillips, Rosemary; McGregor, Deborah

2013-11-01

Telecommuniciation technologies, including audio and videoconferencing facilities, afford geographically dispersed health professionals the opportunity to connect and collaborate with others. Recognised for enabling tele-consultations and tele-collaborations between teams of health care professionals and their patients, these technologies are also well suited to the delivery of distance learning programs, known as tele-learning. To determine whether tele-learning delivery methods achieve equivalent learning outcomes when compared with traditional face-to-face education delivery methods. A systematic literature review was commissioned by the NSW Ministry of Health to identify results relevant to programs applying tele-learning delivery methods in the provision of education to health professionals. The review found few studies that rigorously compared tele-learning with traditional formats. There was some evidence, however, to support the premise that tele-learning models achieve comparable learning outcomes and that participants are generally satisfied with and accepting of this delivery method. The review illustrated that tele-learning technologies not only enable distance learning opportunities, but achieve comparable learning outcomes to traditional face-to-face models. More rigorous evidence is required to strengthen these findings and should be the focus of future tele-learning research.

Effects of problem-based learning vs. traditional lecture on Korean nursing students' critical thinking, problem-solving, and self-directed learning.

PubMed

Choi, Eunyoung; Lindquist, Ruth; Song, Yeoungsuk

2014-01-01

Problem-based learning (PBL) is a method widely used in nursing education to develop students' critical thinking skills to solve practice problems independently. Although PBL has been used in nursing education in Korea for nearly a decade, few studies have examined its effects on Korean nursing students' learning outcomes, and few Korean studies have examined relationships among these outcomes. The objectives of this study are to examine outcome abilities including critical thinking, problem-solving, and self-directed learning of nursing students receiving PBL vs. traditional lecture, and to examine correlations among these outcome abilities. A quasi-experimental non-equivalent group pretest-posttest design was used. First-year nursing students (N=90) were recruited from two different junior colleges in two cities (GY and GJ) in South Korea. In two selected educational programs, one used traditional lecture methods, while the other used PBL methods. Standardized self-administered questionnaires of critical thinking, problem-solving, and self-directed learning abilities were administered before and at 16weeks (after instruction). Learning outcomes were significantly positively correlated, however outcomes were not statistically different between groups. Students in the PBL group improved across all abilities measured, while student scores in the traditional lecture group decreased in problem-solving and self-directed learning. Critical thinking was positively associated with problem-solving and self-directed learning (r=.71, and r=.50, respectively, p<.001); problem-solving was positively associated with self-directed learning (r=.75, p<.001). Learning outcomes of PBL were not significantly different from traditional lecture in this small underpowered study, despite positive trends. Larger studies are recommended to study effects of PBL on critical student abilities. Copyright © 2013 Elsevier Ltd. All rights reserved.

Predictors of participation in health care at menopause.

PubMed

Kroll, J; Rothert, M; Davidson, W S; Schmitt, N; Holmes-Rovner, M; Padonu, G; Reischl, T M

2000-01-01

Patient participation in health care is widely advocated but little is known about the factors influencing patients' active participation. To learn whether attitudes and beliefs helped predict patient participation, 252 midlife women completed measures of self-efficacy, perceived barriers to participation, attitudes, subjective norms, and intentions following a decision to support intervention on menopause. Two months following the intervention, 63 women who had visited a health care provider returned questionnaires by mail regarding self-reported participation in the health care encounter and satisfaction with the decision about estrogen replacement therapy. The results were that self-efficacy (beta = .19; p < .05) significantly predicted intention to participate in the next health care encounter. Both patient intentions (beta = .40;p < .05) and perceived barriers (beta = -.27; p < .05) were significant predictors of self-reported participation. Active participation (beta = .42;p < .05) and attitude (beta =.25;p < .05) were associated with increased satisfaction with decision. Participation resulted in increased self-efficacy (beta = .30;p < .05). The conclusions were that midlife women who express more confidence in their ability to participate in their health care have greater intentions to participate. Women who experience fewer barriers to participation and have more intention to participate are more likely to report actively participating in a health care encounter, and self-reported participation and more positive attitudes toward participation are associated with greater satisfaction with decisions.

Engagement With a Trauma Recovery Internet Intervention Explained With the Health Action Process Approach (HAPA): Longitudinal Study

PubMed Central

Shoji, Kotaro; Luszczynska, Aleksandra; Benight, Charles C

2018-01-01

Background There has been a growing trend in the delivery of mental health treatment via technology (ie, electronic health, eHealth). However, engagement with eHealth interventions is a concern, and theoretically based research in this area is sparse. Factors that influence engagement are poorly understood, especially in trauma survivors with symptoms of posttraumatic stress. Objective The aim of this study was to examine engagement with a trauma recovery eHealth intervention using the Health Action Process Approach theoretical model. Outcome expectancy, perceived need, pretreatment self-efficacy, and trauma symptoms influence the formation of intentions (motivational phase), followed by planning, which mediates the translation of intentions into engagement (volitional phase). We hypothesized the mediational effect of planning would be moderated by level of treatment self-efficacy. Methods Trauma survivors from around the United States used the eHealth intervention for 2 weeks. We collected baseline demographic, social cognitive predictors, and distress symptoms and measured engagement subjectively and objectively throughout the intervention. Results The motivational phase model explained 48% of the variance, and outcome expectations (beta=.36), perceived need (beta=.32), pretreatment self-efficacy (beta=.13), and trauma symptoms (beta=.21) were significant predictors of intention (N=440). In the volitional phase, results of the moderated mediation model indicated for low levels of treatment self-efficacy, planning mediated the effects of intention on levels of engagement (B=0.89, 95% CI 0.143-2.605; N=115). Conclusions Though many factors can affect engagement, these results offer a theoretical framework for understanding engagement with an eHealth intervention. This study highlighted the importance of perceived need, outcome expectations, self-efficacy, and baseline distress symptoms in the formation of intentions to use the intervention. For those low in treatment self-efficacy, planning may play an important role in the translation of intentions into engagement. Results of this study may help bring some clarification to the question of what makes eHealth interventions work. PMID:29636323

The Effect of Gender and Race Intersectionality on Student Learning Outcomes in Engineering

ERIC Educational Resources Information Center

Ro, Hyun Kyoung; Loya, Karla I.

2015-01-01

Women and underrepresented minorities in traditionally White and male-dominated disciplines tend to report lower learning outcomes than their White peers. Adopting a feminist intersectionality framework, this study looks at the intersections of gender and race to investigate differences in self-assessed learning outcomes in engineering…

Understanding and Enacting Learning Outcomes: The Academic's Perspective

ERIC Educational Resources Information Center

Dobbins, Kerry; Brooks, Sara; Scott, Jon J. A.; Rawlinson, Mark; Norman, Robert I.

2016-01-01

Despite a detailed literature exploring the advancement of a learning outcomes approach in higher education, limited evidence exists concerning academics' use of them. This study employed a questionnaire survey and interviews with academic staff in three schools in one institution to explore their views and uses of learning outcomes. Whilst…

Forum: Learning Outcomes in Communication. "Diversity Matters" Continued: Student Learning Outcomes in Communication

ERIC Educational Resources Information Center

Wahl, Shawn T.; Williams, Kesha Morant; Berkos, Kristen M.; Disbrow, Lynn M.

2016-01-01

Using the conceptual foundation "diversity matters" (Orbe & Allen, 2008), this essay calls for research examining the NCA learning outcomes in communication related to diversity, inclusion, privilege, and intercultural communication (mostly existing in LOC 8). The authors argue this research will serve as a relevant and vital…

Learning Outcomes across Disciplines and Professions: Measurement and Interpretation

ERIC Educational Resources Information Center

Caspersen, Joakim; Frølich, Nicoline; Karlsen, Hilde; Aamodt, Per Olaf

2014-01-01

Learning outcomes of higher education are a quality tool in a changing higher education landscape but cannot be seen as neutral measures across professions and disciplines. Survey results from graduates and recent graduates indicate that prevailing measures of learning outcomes yield the same result within and across disciplinary and professional…

Learning Outcomes: A Conceptual Analysis

ERIC Educational Resources Information Center

Hussey, Trevor; Smith, Patrick

2008-01-01

Learning outcomes have become widely used in higher education, but also misused to the point of being controversial and a bureaucratic burden. This paper distinguishes three kinds of learning outcome found in current literature: (1) those used in individual teaching events; (2) those specified for modules or short courses; and (3) those specified…

Assessment of Student Learning Outcomes: Workplace, Family, and Community Roles

ERIC Educational Resources Information Center

Johnson, Cheryl A.; Heath, Claudia J.

2011-01-01

A project was conducted to assess Family Studies bachelor's degree graduates' use of learning outcomes from course competencies in personal finance, family lifespan development, intervention, and advocacy and policy, and to determine how they apply these learning outcomes to their workplace, family, and community roles. Alumni surveys completed by…

An Illustration of Diagnostic Classification Modeling in Student Learning Outcomes Assessment

ERIC Educational Resources Information Center

Jurich, Daniel P.; Bradshaw, Laine P.

2014-01-01

The assessment of higher-education student learning outcomes is an important component in understanding the strengths and weaknesses of academic and general education programs. This study illustrates the application of diagnostic classification models, a burgeoning set of statistical models, in assessing student learning outcomes. To facilitate…

Practice Characteristics that Lead to 21st Century Learning Outcomes.

ERIC Educational Resources Information Center

Law, Nancy; Lee, Y.; Chow, A.

2002-01-01

Describes a study in Hong Kong elementary and secondary schools that investigated whether innovative teaching practices that used ICT (information and communication technology) would lead to learning outcomes needed for today's knowledge society. Suggests that affective and socio-cognitive learning outcomes are more important as preparation for…

Metaphors We Teach By: The Language of "Learning Outcomes"

ERIC Educational Resources Information Center

Batten, Alicia J.

2012-01-01

This article employs George Lakoff and Mark Johnson's work on metaphor (1980) to examine the current use of the term "learning outcomes" within higher education. It argues that "learning outcomes" is an ontological metaphor (education becomes focused on results that one can understand and measure) that resonates with contemporary academic…

Erythropoiesis-stimulating agents for anaemia in adults with chronic kidney disease: a network meta-analysis.

PubMed

Palmer, Suetonia C; Saglimbene, Valeria; Mavridis, Dimitris; Salanti, Georgia; Craig, Jonathan C; Tonelli, Marcello; Wiebe, Natasha; Strippoli, Giovanni F M

2014-12-08

Several erythropoiesis-stimulating agents (ESAs) are available for treating anaemia in people with chronic kidney disease (CKD). Their relative efficacy (preventing blood transfusions and reducing fatigue and breathlessness) and safety (mortality and cardiovascular events) are unclear due to the limited power of head-to-head studies. To compare the efficacy and safety of ESAs (epoetin alfa, epoetin beta, darbepoetin alfa, or methoxy polyethylene glycol-epoetin beta, and biosimilar ESAs, against each other, placebo, or no treatment) to treat anaemia in adults with CKD. We searched the Cochrane Renal Group's Specialised Register to 11 February 2014 through contact with the Trials' Search Co-ordinator using search terms relevant to this review. Randomised controlled trials (RCTs) that included a comparison of an ESA (epoetin alfa, epoetin beta, darbepoetin alfa, methoxy polyethylene glycol-epoetin beta, or biosimilar ESA) with another ESA, placebo or no treatment in adults with CKD and that reported prespecified patient-relevant outcomes were considered for inclusion. Two independent authors screened the search results and extracted data. Data synthesis was performed by random-effects pairwise meta-analysis and network meta-analysis. We assessed for heterogeneity and inconsistency within meta-analyses using standard techniques and planned subgroup and meta-regression to explore for sources of heterogeneity or inconsistency. We assessed our confidence in treatment estimates for the primary outcomes within network meta-analysis (preventing blood transfusions and all-cause mortality) according to adapted GRADE methodology as very low, low, moderate, or high. We identified 56 eligible studies involving 15,596 adults with CKD. Risks of bias in the included studies was generally high or unclear for more than half of studies in all of the risk of bias domains we assessed; no study was low risk for allocation concealment, blinding of outcome assessment and attrition from follow-up. In network analyses, there was moderate to low confidence that epoetin alfa (OR 0.18, 95% CI 0.05 to 0.59), epoetin beta (OR 0.09, 95% CI 0.02 to 0.38), darbepoetin alfa (OR 0.17, 95% CI 0.05 to 0.57), and methoxy polyethylene glycol-epoetin beta (OR 0.15, 95% CI 0.03 to 0.70) prevented blood transfusions compared to placebo. In very low quality evidence, biosimilar ESA therapy was possibly no better than placebo for preventing blood transfusions (OR 0.27, 95% CI 0.05 to 1.47) with considerable imprecision in estimated effects. We could not discern whether all ESAs were similar or different in their effects on preventing blood transfusions and our confidence in the comparative effectiveness of different ESAs was generally very low. Similarly, the comparative effects of ESAs compared with another ESA, placebo or no treatment on all-cause mortality were imprecise.All proprietary ESAs increased the odds of hypertension compared to placebo (epoetin alfa OR 2.31, 95% CI 1.27 to 4.23; epoetin beta OR 2.57, 95% CI 1.23 to 5.39; darbepoetin alfa OR 1.83, 95% CI 1.05 to 3.21; methoxy polyethylene glycol-epoetin beta OR 1.96, 95% CI 0.98 to 3.92), while the effect of biosimilar ESAs on developing hypertension was less certain (OR 1.18, 95% CI 0.47 to 2.99). Our confidence in the comparative effects of ESAs on hypertension was low due to considerable imprecision in treatment estimates. The comparative effects of all ESAs on cardiovascular mortality, myocardial infarction (MI), stroke, and vascular access thrombosis were uncertain and network analyses for major cardiovascular events, end-stage kidney disease (ESKD), fatigue and breathlessness were not possible. Effects of ESAs on fatigue were described heterogeneously in the available studies in ways that were not useable for analyses. In the CKD setting, there is currently insufficient evidence to suggest the superiority of any ESA formulation based on available safety and efficacy data. Directly comparative data for the effectiveness of different ESA formulations based on patient-centred outcomes (such as quality of life, fatigue, and functional status) are sparse and poorly reported and current research studies are unable to inform care. All proprietary ESAs (epoetin alfa, epoetin beta, darbepoetin alfa, and methoxy polyethylene glycol-epoetin beta) prevent blood transfusions but information for biosimilar ESAs is less conclusive. Comparative treatment effects of different ESA formulations on other patient-important outcomes such as survival, MI, stroke, breathlessness and fatigue are very uncertain.For consumers, clinicians and funders, considerations such as drug cost and availability and preferences for dosing frequency might be considered as the basis for individualising anaemia care due to lack of data for comparative differences in clinical benefits and harms.

Impact of a pharmacist-driven beta-lactam allergy interview on inpatient antimicrobial therapy: A pilot project.

PubMed

Sigona, Nicholas S; Steele, Jeffrey M; Miller, Christopher D

To determine the impact of a pharmacist-driven beta-lactam allergy interview on antimicrobial therapy. Tertiary care academic medical center. Clarification of beta-lactam allergy may expand treatment options for patients and potentially improve outcomes, reduce toxicity, and reduce costs. At our institution, a pilot service using a pharmacy resident and infectious diseases clinical pharmacist was implemented to clarify beta-lactam allergy information and, where appropriate, recommend a change to the patient's antibiotic therapy. Adult patients with a documented beta-lactam allergy who had received non-penicillin antibiotics and who had undergone a beta-lactam allergy interview were identified via pharmacy intervention data. A pharmacist interviewed these patients with the use of an internally developed allergy questionnaire. Recommendations for beta-lactam therapy were made to the patient's primary medical team based on the results of the allergy interview and factors including infection type and culture results. The primary objectives were to determine the percentage of patients successfully switched to beta-lactam therapy as a result of the drug allergy interview, to identify allergy discrepancies between the electronic medical record (EMR) and pharmacist's interview, and to quantify the acceptance rate of the pharmacist's antimicrobial recommendations after drug allergy clarification. Thirty-two patients were interviewed, and 24 were candidates for a beta-lactam recommendation. As a result of the interview, 21 patients (65.6%) were successfully switched from a non-penicillin antibiotic to a cephalosporin, carbapenem, or penicillin. A discrepancy between the EMR-reported allergy and history obtained on interview was identified in 11 patients (34.4%). Medical providers accepted 87.5% of pharmacists' antimicrobial recommendations. A pharmacist-driven beta-lactam allergy interview was effective in switching eligible patients to beta-lactam therapy and identifying discrepancies between EMR-documented allergies and confirmed allergies. Antimicrobial recommendations were well received by medical providers with a high acceptance rate. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Effects of concomitant use of fibroblast growth factor (FGF)-2 with beta-tricalcium phosphate ({beta}-TCP) on the beagle dog 1-wall periodontal defect model

DOE Office of Scientific and Technical Information (OSTI.GOV)

Anzai, Jun, E-mail: anzai_jun@kaken.co.jp; Department of Periodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871; Kitamura, Masahiro, E-mail: kitamura@dent.osaka-u.ac.jp

Research highlights: {yields} Concomitant use of FGF-2 and {beta}-TCP (an osteo-conductive scaffold) significantly promotes periodontal regeneration in the severe periodontitis model (1-wall defect model) of beagle dog. {yields} FGF-2 enhanced new bone formation via {beta}-TCP at the defects. {yields} In particular, FGF-2 dramatically regenerated new periodontal ligament and cementum formations at the defects, that is one of the most important healing outcomes during the process of periodontal regeneration. {yields} Epithelial downgrowth (undesirable wound healing) was decreased by administration of FGF-2. {yields} This manuscript indicates for the first time that concomitant use of FGF-2 and {beta}-TCP is efficacious in regenerating periodontalmore » tissue following severe destruction of the tissue by progression of periodontitis. -- Abstract: The effects of concomitant use of fibroblast growth factor-2 (FGF-2) and beta-tricalcium phosphate ({beta}-TCP) on periodontal regeneration were investigated in the beagle dog 1-wall periodontal defect model. One-wall periodontal defects were created in the mesial portion of both sides of the mandibular first molars, and 0.3% FGF-2 plus {beta}-TCP or {beta}-TCP alone was administered. Radiographic evaluation was performed at 0, 3, and 6 weeks. At 6 weeks, the periodontium with the defect site was removed and histologically analyzed. Radiographic findings showed that co-administration of FGF-2 significantly increased bone mineral contents of the defect sites compared with {beta}-TCP alone. Histologic analysis revealed that the length of the regenerated periodontal ligament, the cementum, distance to the junctional epithelium, new bone height, and area of newly formed bone were significantly increased in the FGF-2 group. No abnormal inflammatory response or ankylosis was observed in either group. These findings indicate the efficacy of concomitant use of FGF-2 and {beta}-TCP as an osteoconductive material for periodontal regeneration following severe destruction by progressive periodontitis.« less

Investigating Relationships between Features of Learning Designs and Student Learning Outcomes

ERIC Educational Resources Information Center

McNaught, Carmel; Lam, Paul; Cheng, Kin Fai

2012-01-01

This article reports a study of eLearning in 21 courses in Hong Kong universities that had a blended design of face-to-face classes combined with online learning. The main focus of the study was to examine possible relationships between features of online learning designs and student learning outcomes. Data-collection strategies included expert…

Improve Outcomes Study subjects Chemistry Teaching and Learning Strategies through independent study with the help of computer-based media

NASA Astrophysics Data System (ADS)

Sugiharti, Gulmah

2018-03-01

This study aims to see the improvement of student learning outcomes by independent learning using computer-based learning media in the course of STBM (Teaching and Learning Strategy) Chemistry. Population in this research all student of class of 2014 which take subject STBM Chemistry as many as 4 class. While the sample is taken by purposive as many as 2 classes, each 32 students, as control class and expriment class. The instrument used is the test of learning outcomes in the form of multiple choice with the number of questions as many as 20 questions that have been declared valid, and reliable. Data analysis techniques used one-sided t test and improved learning outcomes using a normalized gain test. Based on the learning result data, the average of normalized gain values for the experimental class is 0,530 and for the control class is 0,224. The result of the experimental student learning result is 53% and the control class is 22,4%. Hypothesis testing results obtained t count> ttable is 9.02> 1.6723 at the level of significance α = 0.05 and db = 58. This means that the acceptance of Ha is the use of computer-based learning media (CAI Computer) can improve student learning outcomes in the course Learning Teaching Strategy (STBM) Chemistry academic year 2017/2018.

Geomorphology Drives Amphibian Beta Diversity in Atlantic Forest Lowlands of Southeastern Brazil

PubMed Central

Luiz, Amom Mendes; Leão-Pires, Thiago Augusto; Sawaya, Ricardo J.

2016-01-01

Beta diversity patterns are the outcome of multiple processes operating at different scales. Amphibian assemblages seem to be affected by contemporary climate and dispersal-based processes. However, historical processes involved in present patterns of beta diversity remain poorly understood. We assess and disentangle geomorphological, climatic and spatial drivers of amphibian beta diversity in coastal lowlands of the Atlantic Forest, southeastern Brazil. We tested the hypothesis that geomorphological factors are more important in structuring anuran beta diversity than climatic and spatial factors. We obtained species composition via field survey (N = 766 individuals), museum specimens (N = 9,730) and literature records (N = 4,763). Sampling area was divided in four spatially explicit geomorphological units, representing historical predictors. Climatic descriptors were represented by the first two axis of a Principal Component Analysis. Spatial predictors in different spatial scales were described by Moran Eigenvector Maps. Redundancy Analysis was implemented to partition the explained variation of species composition by geomorphological, climatic and spatial predictors. Moreover, spatial autocorrelation analyses were used to test neutral theory predictions. Beta diversity was spatially structured in broader scales. Shared fraction between climatic and geomorphological variables was an important predictor of species composition (13%), as well as broad scale spatial predictors (13%). However, geomorphological variables alone were the most important predictor of beta diversity (42%). Historical factors related to geomorphology must have played a crucial role in structuring amphibian beta diversity. The complex relationships between geomorphological history and climatic gradients generated by the Serra do Mar Precambrian basements were also important. We highlight the importance of combining spatially explicit historical and contemporary predictors for understanding and disentangling major drivers of beta diversity patterns. PMID:27171522

Geomorphology Drives Amphibian Beta Diversity in Atlantic Forest Lowlands of Southeastern Brazil.

PubMed

Luiz, Amom Mendes; Leão-Pires, Thiago Augusto; Sawaya, Ricardo J

2016-01-01

Beta diversity patterns are the outcome of multiple processes operating at different scales. Amphibian assemblages seem to be affected by contemporary climate and dispersal-based processes. However, historical processes involved in present patterns of beta diversity remain poorly understood. We assess and disentangle geomorphological, climatic and spatial drivers of amphibian beta diversity in coastal lowlands of the Atlantic Forest, southeastern Brazil. We tested the hypothesis that geomorphological factors are more important in structuring anuran beta diversity than climatic and spatial factors. We obtained species composition via field survey (N = 766 individuals), museum specimens (N = 9,730) and literature records (N = 4,763). Sampling area was divided in four spatially explicit geomorphological units, representing historical predictors. Climatic descriptors were represented by the first two axis of a Principal Component Analysis. Spatial predictors in different spatial scales were described by Moran Eigenvector Maps. Redundancy Analysis was implemented to partition the explained variation of species composition by geomorphological, climatic and spatial predictors. Moreover, spatial autocorrelation analyses were used to test neutral theory predictions. Beta diversity was spatially structured in broader scales. Shared fraction between climatic and geomorphological variables was an important predictor of species composition (13%), as well as broad scale spatial predictors (13%). However, geomorphological variables alone were the most important predictor of beta diversity (42%). Historical factors related to geomorphology must have played a crucial role in structuring amphibian beta diversity. The complex relationships between geomorphological history and climatic gradients generated by the Serra do Mar Precambrian basements were also important. We highlight the importance of combining spatially explicit historical and contemporary predictors for understanding and disentangling major drivers of beta diversity patterns.

Point-of-care Beta-lactam Allergy Skin Testing by Antimicrobial Stewardship Programs: A Pragmatic Multicenter Prospective Evaluation.

PubMed

Leis, Jerome A; Palmay, Lesley; Ho, Grace; Raybardhan, Sumit; Gill, Suzanne; Kan, Tiffany; Campbell, Jackie; Kiss, Alex; McCready, Janine B; Das, Pavani; Minnema, Brian; Powis, Jeff E; Walker, Sandra A N; Ferguson, Heather; Wong, Benny; Weber, Elizabeth

2017-06-01

Beta-lactam allergy skin testing (BLAST) is recommended by antimicrobial stewardship program (ASP) guidelines, yet few studies have systematically evaluated its impact when delivered at point-of-care. We conducted a pragmatic multicenter prospective evaluation of the use of point-of-care BLAST by ASPs. In staggered 3-month intervals, ASP teams at three hospitals received training by allergists to offer BLAST for eligible patients with infectious diseases receiving non-preferred beta-lactam therapy due to severity of their allergy. The primary outcome was the proportion of patients receiving the preferred beta-lactam therapy. Of 827 patients with reported beta-lactam allergy over 15-months, beta-lactam therapy was preferred among 632(76%). During baseline periods, 50% (124/246) received preferred beta-lactam therapy based on history, compared with 60% (232/386) during the intervention periods (p=0.02), which improved further to 81% (313/386) upon provision of BLAST (p<0.001) without any increase in incidence of adverse drug reactions (4% vs. 3%; p=0.4). After adjusting for patient variables and the correlation between hospitals, the intervention period was associated with a 4.5-fold greater odds of receiving preferred beta-lactam therapy (95% CI, 2.4-8.2; p<0.0001). The use of BLAST at the point-of-care across three hospital ASPs resulted in greater use of preferred beta-lactam therapy without increasing the risk of adverse drug reactions. Longer term studies are needed to better assess the safety and clinical impact of this ASP intervention. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

The effects of estrogens on learning in rats with chronic brain cholinergic deficiency in a Morris water test. Identification of the "passive swimming" component.

PubMed

Mukhina, T V; Lermontova, N N; Van'kin, G I; Oettel, M; P'chev, V K; Bachurin, S O

2004-03-01

Chronic decreases in brain cholinergic functions due to intraventricular administration of the neurotoxin AF64A were accompanied by increases in the latent period of locating an invisible platform during training of rats in a Morris water test, as compared with control sham-operated animals. Recordings of the animals' movement trajectories using a video camera along with an original computer program (Behavioral Vision) showed that administration of 17beta-estradiol and its synthetic analog J-861 (0.2 mg/kg p.o. daily for seven days before and 10 days after single intraventricular injections of AF64A) improved learning. The directivity of platform search trajectories was assessed quantitatively using a new parameter--trajectory straightness. Introduction of the "passive swimming" parameter allowed periods of immobility in water to be identified within the total latent period in animals after administration of AF64A; 17beta-estradiol but not J-861 "eliminated" these periods. The new parameters (especially trajectory straightness) allowed the ability to learn to be discriminated from decreases in mobility, including mobility losses due to study agents, in the Morris water test.

The impact of project-based learning on improving student learning outcomes of sustainability concepts in transportation engineering courses

NASA Astrophysics Data System (ADS)

Fini, Elham H.; Awadallah, Faisal; Parast, Mahour M.; Abu-Lebdeh, Taher

2018-05-01

This paper describes an intervention to enhance students' learning by involving students in brainstorming activities about sustainability concepts and their implications in transportation engineering. The paper discusses the process of incorporating the intervention into a transportation course, as well as the impact of this intervention on students' learning outcomes. To evaluate and compare students' learning as a result of the intervention, the Laboratory for Innovative Technology and Engineering Education survey instrument was used. The survey instrument includes five constructs: higher-order cognitive skills, self-efficacy, ease of learning subject matter, teamwork, and communication skills. Pre- and post-intervention surveys of student learning outcomes were conducted to determine the effectiveness of the intervention on enhancing students' learning outcomes. The results show that the implementation of the intervention significantly improved higher-order cognitive skills, self-efficacy, teamwork, and communication skills. Involving students in brainstorming activities related to sustainability concepts and their implications in transportation proved to be an effective teaching and learning strategy.

Using Formative Assessments to Improve Student Learning Outcomes: A Study of the Different Types of Formative Assessments Teachers Use to Drive Instruction and Their Effects on Student Learning

ERIC Educational Resources Information Center

Alzina, Amy

2016-01-01

Understanding the difference between summative and formative assessments is still unclear for many teachers and principals as well as the effects formative assessments have on student learning outcomes. This quantitative study was conducted to explicitly explore formative assessments as a means to improve student learning outcomes, while examining…

Considerations of the Impact of Neoliberalism and Alternative Regimes on Learning and Its Outcomes: An Empirical Example Based on the Level and Distribution of Adult Learning

ERIC Educational Resources Information Center

Desjardins, Richard

2013-01-01

This study considers the extensive critique of the impact of the "market" or "neoliberal" model on learning and its outcomes in the light of alternative models. The purpose is to consider the potential impacts of the market on learning and its outcomes and to contextualise critique by considering alternative coordination…

Effects of physiological versus pharmacological beta-carotene supplementation on cell proliferation and histopathological changes in the lungs of cigarette smoke-exposed ferrets.

PubMed

Liu, C; Wang, X D; Bronson, R T; Smith, D E; Krinsky, N I; Russell, R M

2000-12-01

There remains a remarkable discordance between the results of observational epidemiological studies and intervention trials using beta-carotene as a potential chemopreventive agent. One question that needs to be examined is whether the adverse outcomes of human beta-carotene trials are related to the large doses of beta-carotene that were administered. In the present study, ferrets were given a physiological (low) dose or a pharmacological (high) dose of beta-carotene supplementation (0.43 mg versus 2.4 mg/kg body wt/day, which is equivalent to 6 mg versus 30 mg/day in humans) and exposed to cigarette smoke for 6 months. We investigated the effects of these doses of beta-carotene on retinoid concentrations, expression of retinoic acid receptors (RARs), activator protein 1 (AP-1; c-Jun and c-Fos), cyclin D1, proliferating cellular nuclear antigen (PCNA), and histopathological changes in the lungs of both normal and cigarette smoke-exposed ferrets. Thirty-six male ferrets were treated in six groups-control, smoke-exposed (SM), low-dose beta-carotene (LBC), high-dose beta-carotene (HBC), low-dose beta-carotene plus smoke exposure (LBC+SM) or high-dose beta-carotene plus smoke exposure (HBC+SM)-for 6 months. Retinoic acid concentration and RAR beta gene expression, but not expression of RAR alpha and RAR gamma, was reduced in the lung tissue of HBC+SM, HBC, SM and LBC+SM ferrets, but not in that of LBC ferrets, as compared with the control group. Expression of AP-1 and PCNA was greater in HBC+SM, HBC, SM and LBC+SM ferrets, but not in the LBC ferrets, as compared with the control group. Increased amounts of cyclin D1 and keratinized squamous metaplasia were observed in the lung tissue of HBC+SM, HBC and SM groups but not in that of the LBC+SM, LBC or control groups. These data suggest that, in contrast with a pharmacological dose of beta-carotene, a physiological dose of beta-carotene in smoke-exposed ferrets has no potentially detrimental effects and may afford weak protection against lung damage induced by cigarette smoke.

Choice of outcomes and measurement instruments in randomised trials on eLearning in medical education: a systematic mapping review protocol.

PubMed

Law, Gloria C; Apfelbacher, Christian; Posadzki, Pawel P; Kemp, Sandra; Tudor Car, Lorainne

2018-05-17

There will be a lack of 18 million healthcare workers by 2030. Multiplying the number of well-trained healthcare workers through innovative ways such as eLearning is highly recommended in solving this shortage. However, high heterogeneity of learning outcomes in eLearning systematic reviews reveals a lack of consistency and agreement on core learning outcomes in eLearning for medical education. In addition, there seems to be a lack of validity evidence for measurement instruments used in these trials. This undermines the credibility of these outcome measures and affects the ability to draw accurate and meaningful conclusions. The aim of this research is to address this issue by determining the choice of outcomes, measurement instruments and the prevalence of measurement instruments with validity evidence in randomised trials on eLearning for pre-registration medical education. We will conduct a systematic mapping and review to identify the types of outcomes, the kinds of measurement instruments and the prevalence of validity evidence among measurement instruments in eLearning randomised controlled trials (RCTs) in pre-registration medical education. The search period will be from January 1990 until August 2017. We will consider studies on eLearning for health professionals' education. Two reviewers will extract and manage data independently from the included studies. Data will be analysed and synthesised according to the aim of the review. Appropriate choice of outcomes and measurement tools is essential for ensuring high-quality research in the field of eLearning and eHealth. The results of this study could have positive implications for other eHealth interventions, including (1) improving quality and credibility of eLearning research, (2) enhancing the quality of digital medical education and (3) informing researchers, academics and curriculum developers about the types of outcomes and validity evidence for measurement instruments used in eLearning studies. The protocol aspires to assist in the advancement of the eLearning research field as well as in the development of high-quality healthcare professionals' digital education. PROSPERO CRD42017068427.

Perimovement decrease of alpha/beta oscillations in the human nucleus accumbens.

PubMed

Stenner, Max-Philipp; Dürschmid, Stefan; Rutledge, Robb B; Zaehle, Tino; Schmitt, Friedhelm C; Kaufmann, Jörn; Voges, Jürgen; Heinze, Hans-Jochen; Dolan, Raymond J; Schoenfeld, Mircea Ariel

2016-10-01

The human nucleus accumbens is thought to play an important role in guiding future action selection via an evaluation of current action outcomes. Here we provide electrophysiological evidence for a more direct, i.e., online, role during action preparation. We recorded local field potentials from the nucleus accumbens in patients with epilepsy undergoing surgery for deep brain stimulation. We found a consistent decrease in the power of alpha/beta oscillations (10-30 Hz) before and around the time of movements. This perimovement alpha/beta desynchronization was observed in seven of eight patients and was present both before instructed movements in a serial reaction time task as well as before self-paced, deliberate choices in a decision making task. A similar beta decrease over sensorimotor cortex and in the subthalamic nucleus has been directly related to movement preparation and execution. Our results support the idea of a direct role of the human nucleus accumbens in action preparation and execution. Copyright © 2016 the American Physiological Society.

Perimovement decrease of alpha/beta oscillations in the human nucleus accumbens

PubMed Central

Dürschmid, Stefan; Rutledge, Robb B.; Zaehle, Tino; Schmitt, Friedhelm C.; Kaufmann, Jörn; Voges, Jürgen; Heinze, Hans-Jochen; Dolan, Raymond J.; Schoenfeld, Mircea Ariel

2016-01-01

The human nucleus accumbens is thought to play an important role in guiding future action selection via an evaluation of current action outcomes. Here we provide electrophysiological evidence for a more direct, i.e., online, role during action preparation. We recorded local field potentials from the nucleus accumbens in patients with epilepsy undergoing surgery for deep brain stimulation. We found a consistent decrease in the power of alpha/beta oscillations (10–30 Hz) before and around the time of movements. This perimovement alpha/beta desynchronization was observed in seven of eight patients and was present both before instructed movements in a serial reaction time task as well as before self-paced, deliberate choices in a decision making task. A similar beta decrease over sensorimotor cortex and in the subthalamic nucleus has been directly related to movement preparation and execution. Our results support the idea of a direct role of the human nucleus accumbens in action preparation and execution. PMID:27486103

Prediction of antiepileptic drug treatment outcomes using machine learning.

PubMed

Colic, Sinisa; Wither, Robert G; Lang, Min; Zhang, Liang; Eubanks, James H; Bardakjian, Berj L

2017-02-01

Antiepileptic drug (AED) treatments produce inconsistent outcomes, often necessitating patients to go through several drug trials until a successful treatment can be found. This study proposes the use of machine learning techniques to predict epilepsy treatment outcomes of commonly used AEDs. Machine learning algorithms were trained and evaluated using features obtained from intracranial electroencephalogram (iEEG) recordings of the epileptiform discharges observed in Mecp2-deficient mouse model of the Rett Syndrome. Previous work have linked the presence of cross-frequency coupling (I CFC ) of the delta (2-5 Hz) rhythm with the fast ripple (400-600 Hz) rhythm in epileptiform discharges. Using the I CFC to label post-treatment outcomes we compared support vector machines (SVMs) and random forest (RF) machine learning classifiers for providing likelihood scores of successful treatment outcomes. (a) There was heterogeneity in AED treatment outcomes, (b) machine learning techniques could be used to rank the efficacy of AEDs by estimating likelihood scores for successful treatment outcome, (c) I CFC features yielded the most effective a priori identification of appropriate AED treatment, and (d) both classifiers performed comparably. Machine learning approaches yielded predictions of successful drug treatment outcomes which in turn could reduce the burdens of drug trials and lead to substantial improvements in patient quality of life.

Prediction of antiepileptic drug treatment outcomes using machine learning

NASA Astrophysics Data System (ADS)

Colic, Sinisa; Wither, Robert G.; Lang, Min; Zhang, Liang; Eubanks, James H.; Bardakjian, Berj L.

2017-02-01

Objective. Antiepileptic drug (AED) treatments produce inconsistent outcomes, often necessitating patients to go through several drug trials until a successful treatment can be found. This study proposes the use of machine learning techniques to predict epilepsy treatment outcomes of commonly used AEDs. Approach. Machine learning algorithms were trained and evaluated using features obtained from intracranial electroencephalogram (iEEG) recordings of the epileptiform discharges observed in Mecp2-deficient mouse model of the Rett Syndrome. Previous work have linked the presence of cross-frequency coupling (I CFC) of the delta (2-5 Hz) rhythm with the fast ripple (400-600 Hz) rhythm in epileptiform discharges. Using the I CFC to label post-treatment outcomes we compared support vector machines (SVMs) and random forest (RF) machine learning classifiers for providing likelihood scores of successful treatment outcomes. Main results. (a) There was heterogeneity in AED treatment outcomes, (b) machine learning techniques could be used to rank the efficacy of AEDs by estimating likelihood scores for successful treatment outcome, (c) I CFC features yielded the most effective a priori identification of appropriate AED treatment, and (d) both classifiers performed comparably. Significance. Machine learning approaches yielded predictions of successful drug treatment outcomes which in turn could reduce the burdens of drug trials and lead to substantial improvements in patient quality of life.

How actions shape perception: learning action-outcome relations and predicting sensory outcomes promote audio-visual temporal binding

PubMed Central

Desantis, Andrea; Haggard, Patrick

2016-01-01

To maintain a temporally-unified representation of audio and visual features of objects in our environment, the brain recalibrates audio-visual simultaneity. This process allows adjustment for both differences in time of transmission and time for processing of audio and visual signals. In four experiments, we show that the cognitive processes for controlling instrumental actions also have strong influence on audio-visual recalibration. Participants learned that right and left hand button-presses each produced a specific audio-visual stimulus. Following one action the audio preceded the visual stimulus, while for the other action audio lagged vision. In a subsequent test phase, left and right button-press generated either the same audio-visual stimulus as learned initially, or the pair associated with the other action. We observed recalibration of simultaneity only for previously-learned audio-visual outcomes. Thus, learning an action-outcome relation promotes temporal grouping of the audio and visual events within the outcome pair, contributing to the creation of a temporally unified multisensory object. This suggests that learning action-outcome relations and the prediction of perceptual outcomes can provide an integrative temporal structure for our experiences of external events. PMID:27982063

How actions shape perception: learning action-outcome relations and predicting sensory outcomes promote audio-visual temporal binding.

PubMed

Desantis, Andrea; Haggard, Patrick

2016-12-16

To maintain a temporally-unified representation of audio and visual features of objects in our environment, the brain recalibrates audio-visual simultaneity. This process allows adjustment for both differences in time of transmission and time for processing of audio and visual signals. In four experiments, we show that the cognitive processes for controlling instrumental actions also have strong influence on audio-visual recalibration. Participants learned that right and left hand button-presses each produced a specific audio-visual stimulus. Following one action the audio preceded the visual stimulus, while for the other action audio lagged vision. In a subsequent test phase, left and right button-press generated either the same audio-visual stimulus as learned initially, or the pair associated with the other action. We observed recalibration of simultaneity only for previously-learned audio-visual outcomes. Thus, learning an action-outcome relation promotes temporal grouping of the audio and visual events within the outcome pair, contributing to the creation of a temporally unified multisensory object. This suggests that learning action-outcome relations and the prediction of perceptual outcomes can provide an integrative temporal structure for our experiences of external events.

Confirmation bias in human reinforcement learning: Evidence from counterfactual feedback processing

PubMed Central

Lefebvre, Germain; Blakemore, Sarah-Jayne

2017-01-01

Previous studies suggest that factual learning, that is, learning from obtained outcomes, is biased, such that participants preferentially take into account positive, as compared to negative, prediction errors. However, whether or not the prediction error valence also affects counterfactual learning, that is, learning from forgone outcomes, is unknown. To address this question, we analysed the performance of two groups of participants on reinforcement learning tasks using a computational model that was adapted to test if prediction error valence influences learning. We carried out two experiments: in the factual learning experiment, participants learned from partial feedback (i.e., the outcome of the chosen option only); in the counterfactual learning experiment, participants learned from complete feedback information (i.e., the outcomes of both the chosen and unchosen option were displayed). In the factual learning experiment, we replicated previous findings of a valence-induced bias, whereby participants learned preferentially from positive, relative to negative, prediction errors. In contrast, for counterfactual learning, we found the opposite valence-induced bias: negative prediction errors were preferentially taken into account, relative to positive ones. When considering valence-induced bias in the context of both factual and counterfactual learning, it appears that people tend to preferentially take into account information that confirms their current choice. PMID:28800597

Confirmation bias in human reinforcement learning: Evidence from counterfactual feedback processing.

PubMed

Palminteri, Stefano; Lefebvre, Germain; Kilford, Emma J; Blakemore, Sarah-Jayne

2017-08-01

Previous studies suggest that factual learning, that is, learning from obtained outcomes, is biased, such that participants preferentially take into account positive, as compared to negative, prediction errors. However, whether or not the prediction error valence also affects counterfactual learning, that is, learning from forgone outcomes, is unknown. To address this question, we analysed the performance of two groups of participants on reinforcement learning tasks using a computational model that was adapted to test if prediction error valence influences learning. We carried out two experiments: in the factual learning experiment, participants learned from partial feedback (i.e., the outcome of the chosen option only); in the counterfactual learning experiment, participants learned from complete feedback information (i.e., the outcomes of both the chosen and unchosen option were displayed). In the factual learning experiment, we replicated previous findings of a valence-induced bias, whereby participants learned preferentially from positive, relative to negative, prediction errors. In contrast, for counterfactual learning, we found the opposite valence-induced bias: negative prediction errors were preferentially taken into account, relative to positive ones. When considering valence-induced bias in the context of both factual and counterfactual learning, it appears that people tend to preferentially take into account information that confirms their current choice.

Double blind randomised controlled trial of two different breathing techniques in the management of asthma.

PubMed

Slader, C A; Reddel, H K; Spencer, L M; Belousova, E G; Armour, C L; Bosnic-Anticevich, S Z; Thien, F C K; Jenkins, C R

2006-08-01

Previous studies have shown that breathing techniques reduce short acting beta(2) agonist use and improve quality of life (QoL) in asthma. The primary aim of this double blind study was to compare the effects of breathing exercises focusing on shallow nasal breathing with those of non-specific upper body exercises on asthma symptoms, QoL, other measures of disease control, and inhaled corticosteroid (ICS) dose. This study also assessed the effect of peak flow monitoring on outcomes in patients using breathing techniques. After a 2 week run in period, 57 subjects were randomised to one of two breathing techniques learned from instructional videos. During the following 30 weeks subjects practised their exercises twice daily and as needed for relief of symptoms. After week 16, two successive ICS downtitration steps were attempted. The primary outcome variables were QoL score and daily symptom score at week 12. Overall there were no clinically important differences between the groups in primary or secondary outcomes at weeks 12 or 28. The QoL score remained unchanged (0.7 at baseline v 0.5 at week 28, p = 0.11 both groups combined), as did lung function and airway responsiveness. However, across both groups, reliever use decreased by 86% (p<0.0001) and ICS dose was reduced by 50% (p<0.0001; p>0.10 between groups). Peak flow monitoring did not have a detrimental effect on asthma outcomes. Breathing techniques may be useful in the management of patients with mild asthma symptoms who use a reliever frequently, but there is no evidence to favour shallow nasal breathing over non-specific upper body exercises.

Desensitization in patients with beta-lactam drug allergy.

PubMed

Yusin, J S; Klaustermeyer, W; Simmons, C W; Baum, M

2013-01-01

Patients with a history of beta-lactam antibiotic allergy are often admitted to the hospital with severe or life-threatening infections requiring beta-lactam antibiotics. Strict avoidance of beta lactams to such patients may prevent them from getting adequate coverage and can lead to an increase in the use of alternative antibiotics, which can predispose to antibiotic resistance. Past studies revealed a lower incidence of pen allergy then patients' histories suggest. Fortunately today, there are three options for patients presenting with a history of beta-lactam allergy. Penicillin skin testing, beta-lactam challenge or beta-lactam desensitization. Recently Pre Pen has been FDA re-approved and when combined with Pen G is a valid way to determine if patients are able to tolerate beta-lactam antibiotic. When these agents are not available one must decide about desensitization or challenge. When a patient has a positive penicillin skin test, desensitization or beta-lactam avoidance are the only options. This paper reviews the safety of beta-lactam desensitization. To perform a chart review on patients desensitised with beta lactam to determine if desensitizations can be performed safely without minimal complications. A retrospective chart review was performed on allergy and immunology inpatient consultations for beta-lactam desensitization between September 2003 and August 2006 at the Cedars-Sinai Medical Centre in Los Angeles. Patient data and outcomes of desensitization were analysed. A total of 13 intravenous desensitizations were performed on 12 patients. The patients consisted of eight females and four males with an average age of 65 years. Age range was 36-92 years old. All 13 intravenous desensitizations were completed without complications. No patient required a slower rate of desensitization or discontinuance of the desensitization. Patients were able to tolerate the initial therapeutic dose of their beta-lactam antibiotic and were then able to complete full therapeutic courses of their antibiotic. Beta-lactam antibiotic sensitivity continues to present a challenging problem for physicians. Patients with drug resistant infections who are unable to obtain skin testing or who test positive to skin tests may need either a challenge or desensitization. Desensitization, saved for those with a convincing beta-lactam hypersensitivity history is often the choice of last resort given the associated cost and risk of anaphylaxis. However, once desensitization is complete, patients are usually able to tolerate full doses of antibiotics for full treatment length with minimal side effects. Published by Elsevier Espana.

Pedagogical Significance of Wikis: Towards Gaining Effective Learning Outcomes

ERIC Educational Resources Information Center

Hewege, Chandana Rathnasiri; Perera, Liyanage Chamila Roshani

2013-01-01

Purpose: The purpose of this paper is to explore the effectiveness and pedagogical implications of integrating wikis into the curriculum and the subsequent learning outcomes of a group of Net-Gens who enrolled in an International Marketing course. The research problem of the study is: "What are the learning outcomes and pedagogical…

Learning Approaches and Outcome-Based Teaching and Learning: A Case Study in Hong Kong, China

ERIC Educational Resources Information Center

Pang, Mary; Ho, To Ming; Man, Ryan

2009-01-01

Outcome-based education is a pedagogical process which focuses on the achievement of certain specified results. Outcome-based teaching and learning (OBTL), therefore, is concerned with curriculum design and ensuring that the contents, delivery, activities, and assessments are all aligned to help facilitate students to attain specific intended…

Linking Essential Learning Outcomes and Interprofessional Collaborative Practice Competency in Health Science Undergraduates

ERIC Educational Resources Information Center

Reed, Carole-Rae; Garcia, Luis Ivan; Slusser, Margaret M.; Konowitz, Sharon; Yep, Jewelry

2017-01-01

Assessing student learning outcomes and determining achievement of the Interprofessional Collaborative Practice (IPCEP) Core Competency of Values/Ethics in a generic pre-professional Bachelor of Science in Health Science (BSHS) program is challenging. A course level Student Learning Outcome (SLO) is: "….articulate the impact of personal…

A Framework for Credit. Framework Guidelines 2. Learning Outcomes, Units and Modules.

ERIC Educational Resources Information Center

Further Education Development Agency, London (England).

This document refines and develops a 1992 proposal by Great Britain's Further Education Unit (FEU) that all kinds of student achievement be documented within a common framework involving the following procedures: describing adult learners' achievements in terms of learning outcomes; grouping the learning outcomes into coherent units; defining the…

A Perspective on Student Learning Outcome Assessment at Qatar University

ERIC Educational Resources Information Center

Al-Thani, Shaikha Jabor; Abdelmoneim, Ali; Daoud, Khaled; Cherif, Adel; Moukarzel, Dalal

2014-01-01

This paper provides a unique perspective on the student learning outcome assessment process as adopted and implemented at Qatar University from 2006 to 2012. The progress of the student learning outcome assessment and continuous improvement efforts at the university and the initiatives taken to establish a culture of assessment and evidence-based…

Doubting Learning Outcomes in Higher Education Contexts: From Performativity towards Emergence and Negotiation

ERIC Educational Resources Information Center

Addison, Nicholas

2014-01-01

Learning Outcomes models, particularly constructive alignment, are the default 'theoretical' tool underpinning HE curriculum design in the UK despite continuing doubts as to their efficacy. With reference to the literature, this article summarises the history of the Learning Outcomes movement and charts the perceived benefits and deficits of…

Toward Curriculum Convergence for Graduate Learning Outcomes: Academic Intentions and Student Experiences

ERIC Educational Resources Information Center

Matthews, Kelly E.; Mercer-Mapstone, Lucy D.

2018-01-01

Graduate learning outcomes in undergraduate science degrees increasingly are focussed on the development of transferrable skillsets. Research into, and comparisons of, the perceptions of students and academic staff on such learning outcomes has rarely been explored in science. This study used a quantitative survey to explore the perceptions of 640…

Environmental Education throughout FE. 2: A Model and Unit of Environmental Learning Outcomes. FEDA Paper.

ERIC Educational Resources Information Center

Lawrence, Allan; Parkin, Christopher

1995-01-01

This report summarizes the outcomes of the "Colleges Going Green" project that sought to develop a widely applicable core of environmental learning outcomes (curriculum objectives) and illustrative learning assignments and to review activity in colleges and provide guidance on introducing environmental policy. This report also presents a…

How Are Students' Attitudes Related to Learning Outcomes?

ERIC Educational Resources Information Center

Metsärinne, Mika; Kallio, Manne

2016-01-01

This article is a part of a research project aimed to find out how different background variables are related to learning outcomes in technology education related to the school subject Sloyd (craft). The research question of this article is: "How are ninth grade students' attitudes towards the subject related to their learning outcomes?"…

Acid-Base Learning Outcomes for Students in an Introductory Organic Chemistry Course

ERIC Educational Resources Information Center

Stoyanovich, Carlee; Gandhi, Aneri; Flynn, Alison B.

2015-01-01

An outcome-based approach to teaching and learning focuses on what the student demonstrably knows and can do after instruction, rather than on what the instructor teaches. This outcome-focused approach can then guide the alignment of teaching strategies, learning activities, and assessment. In organic chemistry, mastery of organic acid-base…

A comparative study on student perceptions of their learning outcomes in undergraduate science degree programmes with differing curriculum models

NASA Astrophysics Data System (ADS)

Matthews, Kelly E.; Firn, Jennifer; Schmidt, Susanne; Whelan, Karen

2017-04-01

This study investigated students' perceptions of their graduate learning outcomes including content knowledge, communication, writing, teamwork, quantitative skills, and ethical thinking in two Australian universities. One university has a traditional discipline-orientated curriculum and the other, an interdisciplinary curriculum in the entry semester of first year. The Science Students Skills Inventory asked students (n = 613) in first and final years to rate their perceptions of the importance of developing graduate learning outcomes within the programme; how much they improved their graduate learning outcomes throughout their undergraduate science programme; how much they saw learning outcomes included in the programme; and how confident they were about their learning outcomes. A framework of progressive curriculum development was adopted to interpret results. Students in the discipline-oriented degree programme reported higher perceptions of scientific content knowledge and ethical thinking while students from the interdisciplinary curriculum indicated higher perceptions of oral communication and teamwork. Implications for curriculum development include ensuring progressive development from first to third years, a need for enhanced focus on scientific ethics, and career opportunities from first year onwards.

The Effect of Cooperative Learning Model of Teams Games Tournament (TGT) and Students' Motivation toward Physics Learning Outcome

ERIC Educational Resources Information Center

Nadrah; Tolla, Ismail; Ali, Muhammad Sidin; Muris

2017-01-01

This research aims at describing the effect of cooperative learning model of Teams Games Tournament (TGT) and motivation toward physics learning outcome. This research was a quasi-experimental research with a factorial design conducted at SMAN 2 Makassar. Independent variables were learning models. They were cooperative learning model of TGT and…

A Psychometric Evaluation of the Anatomy Learning Experiences Questionnaire and Correlations with Learning Outcomes

ERIC Educational Resources Information Center

Choi-Lundberg, Derek L.; Williams, Anne-Marie M.; Zimitat, Craig

2017-01-01

The Anatomy Learning Experiences Questionnaire (ALEQ) was designed by Smith and Mathias to explore students' perceptions and experiences of learning anatomy. In this study, the psychometric properties of a slightly altered 34-item ALEQ (ALEQ-34) were evaluated, and correlations with learning outcomes investigated, by surveying first- and…

Cognitive Strategies for Learning from Static and Dynamic Visuals.

ERIC Educational Resources Information Center

Lewalter, D.

2003-01-01

Studied the effects of including static or dynamic visuals in an expository text on a learning outcome and the use of learning strategies when working with these visuals. Results for 60 undergraduates for both types of illustration indicate different frequencies in the use of learning strategies relevant for the learning outcome. (SLD)

Providing Opportunities for Deeper Learning. Findings from the Study of Deeper Learning Opportunities and Outcomes: Report 2

ERIC Educational Resources Information Center

Bitter, Catherine; Taylor, James; Zeiser, Kristina L.; Rickles, Jordan

2014-01-01

The "Study of Deeper Learning: Opportunities and Outcomes"--funded by the William and Flora Hewlett Foundation--aimed to determine whether students attending high schools with a mature and at least moderately well implemented approach to promoting deeper learning actually experienced greater deeper learning opportunities and outcomes…

Pygmalion in Media-Based Learning: Effects of Quality Expectancies on Learning Outcomes

ERIC Educational Resources Information Center

Fries, Stefan; Horz, Holger; Haimerl, Charlotte

2006-01-01

Two studies investigated how quality expectations affect students' outcomes of media-based learning. Experiment 1 (N=62) demonstrated that students expecting a high-end computer-based training programme learned most, whereas students expecting a programme of ambiguous quality learned least and students having no expectations performed in between.…

Student Characteristics and Learning Outcomes in a Blended Learning Environment Intervention in a Ugandan University

ERIC Educational Resources Information Center

Kintu, Mugenyi Justice; Zhu, Chang

2016-01-01

This paper explores the design of a blended learning environment in a transition from face-to-face and seeks to determine whether learner characteristics and background together with blended learning design elements are significant factors for learning outcomes such as intrinsic motivation, satisfaction, knowledge construction and learning…

Insights into Learning Profiles and Learning Outcomes within Introductory Accounting

ERIC Educational Resources Information Center

Teixeira, Cláudia; Gomes, Delfina

2017-01-01

This paper reports an empirical study aiming to explore aspects of learning and studying introductory accounting in Portuguese higher education. It specifically provides insight into patterns of learning and learning outcomes. To do so, it draws on qualitative data collected from students' answers to a semi-structured interview about their…

The association between hypertension-specific care management processes and blood pressure outcomes in US-based physician organizations.

PubMed

Wong, Ken; Smalarz, Amy; Wu, Ning; Boulanger, Luke; Wogen, Jenifer

2011-01-01

Care management processes (CMP) may be implemented in health systems to improve chronic disease quality of care. The objective of this study was to assess the relationship between the presence of hypertension-specific CMP and blood pressure (BP) control among hypertensive patients within selected physician organizations in the USA-modified version of the Physician Practice Connection Readiness Survey (PPC-RS), developed by The National Committee for Quality Assurance (NCQA), was administered to chief medical officers at 28 US-based physician organizations in 2010. Hypertension-specific survey items were added to the PPC-RS and focused on medication fill compliance, chronic disease management, and patient self-management. Demographic and clinical cross-sectional data from a random sample of 300 hypertensive patients age 18 years or older were collected at each site. Physician site and patient characteristics were reported. Regression models were used to assess the relationship between hypertension-specific physician practices and patient BP control. Eligible patients had at least a 1-year history of care with the physician organization and had an encounter within the past year of data collection. Of the 28 participating sites, most had electronic medical records that handle total functionality (71.4%) and had more than 50 staff members (78.6%). Across all sites, approximately 61% of patients had controlled BP. Regression analyses found that practices that used physician education as an effort to improve medication fill compliance demonstrated improvement in BP control (changes in systolic BP: beta coefficient = -1.366, P = .034; changes in diastolic BP: beta coefficient = -0.859, P = .056). The use of a systematic process to screen or assess patients for hypertension as a risk factor was also found to be associated with improvements in BP control (changes in diastolic BP: beta coefficient = -0.860, P = .006). In addition, physician practices that maintained a list of hypertensive patients along with the patients' associated clinical data demonstrated better BP control (currently controlled BP: beta coefficient = 0.282, P = .034; currently uncontrolled BP: beta coefficient = -0.292, P = .023). However, use of the following practices had a negative correlation with BP control: case management (changes in systolic BP: beta coefficient 1.649, P = .022; changes in diastolic BP: beta coefficient = 0.910, P = .078), follow-up for missed appointments (changes in systolic BP: beta coefficient = 0.937, P = .041; changes in diastolic BP: beta coefficient = 0.165, P = .627), adopted written evidence-based standards of care to treat hypertension (changes in systolic BP: beta coefficient = 0.985, P = .032; changes in diastolic BP: beta coefficient = 0.346, P = .305), and checklists for tests and interventions (changes in systolic BP: beta coefficient = 1.586, P = .004; changes in diastolic BP: beta coefficient = 0.938, P = .019). Findings from this multisite study provide evidence that the presence of some hypertension-specific CMP in physician organizations may be associated with better BP outcomes among hypertensive patients. In particular, patients may benefit from physician efforts to improve medication fill compliance as well as organizational monitoring of hypertensive patients and their clinical data. Further research is warranted to better assess the relationship between CMP and treatment of chronic diseases such as hypertension over time. Copyright © 2011 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

Vicarious Neural Processing of Outcomes during Observational Learning

PubMed Central

Monfardini, Elisabetta; Gazzola, Valeria; Boussaoud, Driss

2013-01-01

Learning what behaviour is appropriate in a specific context by observing the actions of others and their outcomes is a key constituent of human cognition, because it saves time and energy and reduces exposure to potentially dangerous situations. Observational learning of associative rules relies on the ability to map the actions of others onto our own, process outcomes, and combine these sources of information. Here, we combined newly developed experimental tasks and functional magnetic resonance imaging (fMRI) to investigate the neural mechanisms that govern such observational learning. Results show that the neural systems involved in individual trial-and-error learning and in action observation and execution both participate in observational learning. In addition, we identified brain areas that specifically activate for others’ incorrect outcomes during learning in the posterior medial frontal cortex (pMFC), the anterior insula and the posterior superior temporal sulcus (pSTS). PMID:24040104

Thymoquinone recovers learning function in a rat model of Alzheimer’s disease

PubMed Central

Poorgholam, Parvin; Yaghmaei, Parichehreh; Hajebrahimi, Zahra

2018-01-01

Objective: Alzheimer's disease is a neurodegenerative disorder characterized by accumulation of amyloid beta in the hippocampus. In recent decades, herbal medicine has been widely used to treat many neurodegenerative disorders,as in comparison to conventional drugs, herbal remedies exert minimal side effects. Here, the effects of thymoquinone, as the main active component of Nigella sativa, on passive avoidance memory in rat model of Alzheimer’s disease, were evaluated. Materials and Methods: Hippocampal injection of amyloid beta (Aβ) was used to induce Alzheimer’s disease in male Wistar rats, followed by intra peritoneal administrations of 5 and 10 mg/kg thymoquinone on a daily basis for 4 weeks. Animals were subjected to fear learning behavior in passive avoidance test and histopathological analysis of the hippocampus was done. Shuttle box test was used to evaluate the condition studying memory. Thioflavin-S and Hematoxylin and Eosine staining were done to confirm Aβ plaque formation and to evaluate the effect of thymoquinone on the pyramidal cells in the hippocampal CA1 region. Results: Amyloid beta caused cognitive dysfunction reflected by increasing initial and step-through latency along with plaque formation and degeneration of pyramidal cells in the hippocampus. Thymoquinone administration ameliorated this effect by significant reductions in plaque formation in CA1 region of the hippocampus and increased latency time. It also increased the number of surviving neurons in the hippocampus. Conclusion: It seems that thymoquinone improved learning function in a rat model of Alzheimer’s disease. Thus, thymoquinone could be possibly used as an anti-neurodegenerative agent for protecting hippocampal neurons against neurotoxic effects of Aβ in patients with Alzheimer’s disease. PMID:29881705

The pharmacoeconomics of peri-operative beta-blocker therapy.

PubMed

Biccard, B M; Sear, J W; Foëx, P

2006-01-01

It is widely recommended that beta-blockade be used peri-operatively as it may reduce the incidence of postoperative cardiovascular complications including death. However, there are few data concerning the cost-effectiveness of such strategies. We have analysed the pharmacoeconomics of acute beta-blockade using data from eight prospective peri-operative studies in which patients underwent elective non-cardiac surgery, and in which the incidence of adverse side-effects of treatment, as well as clinical outcomes, have been reported. The costs of treatment were based on the NHS reference costs for 2004. From these data, the number-needed-to-treat (NNT) to prevent a major cardiovascular complication (including cardiovascular death) in high-risk patients was 18.5. This is comparable to the NNT for peri-operative statin therapy. The incremental cost of peri-operative beta-blockade (costs of drug acquisition and of treating associated adverse drug events) was 67.80 pounds sterling per patient. This results in a total cost of 1254.30 pounds sterling per peri-operative cardiovascular complication prevented. However, there is evidence that in patients at lower cardiovascular risk, beta-blockers may be potentially harmful, since their adverse effects (hypotension, bradycardia) may outweigh their potential cardioprotective effects.

Early initiation of beta blockade in heart failure: issues and evidence.

PubMed

Williams, Randall E

2005-09-01

Despite clinical trials demonstrating that inhibitors of the renin-angiotensin and sympathetic nervous systems can reduce the mortality and morbidity risk associated with heart failure, these drugs have remained underutilized in general clinical practice. In particular, many patients with heart failure due to left ventricular systolic dysfunction fail to receive beta blockers, although this class of drugs, as well as other antihypertensive agents such as angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, are recommended as part of routine heart failure therapy by national expert consensus guidelines. In-hospital initiation of beta-blocker therapy may improve long-term utilization by physicians and compliance by patients through obviating many of the misperceived dangers associated with beta blockade. The following review of the clinical trial data from the Randomized Evaluation of Strategies for Left Ventricular Dysfunction (RESOLVD) trial, the Metoprolol Controlled-Release Randomized Intervention Trial in Heart Failure (MERIT-HF), the Cardiac Insufficiency Bisoprolol Study II (CIBIS-II), the Carvedilol Prospective Randomized Cumulative Survival (COPERNICUS) trial, and the Initiation Management Predischarge Process for Assessment of Carvedilol Therapy for Heart Failure (IMPACT-HF) trial on the efficacy, safety, and tolerability of beta blockers indicates that early initiation can be safely achieved and can improve patient outcomes.

Treatment of retroauricular keloids: Revision of cases treated at the ENT service of HC/UFPR

PubMed Central

Carvalho, Bettina; Ballin, Annelyse Cristine; Becker, Renata Vecentin; Ribeiro, Talita Beithum; Cavichiolo, Juliana Benthien; Ballin, Carlos Roberto; Mocellin, Marcos

2012-01-01

Summary Introduction: Keloids are benign tumors arising from abnormal healing of the skin, and there are several procedures available for their treatment. Objective: The objective of this study was to evaluate the outcomes of patients undergoing treatment of keloids after ear, nose, and throat (ENT) surgeries at our service center. Method: We conducted thorough, retrospective and prospective analysis of records of patients undergoing treatment of retroauricular keloids at our center. Results: Nine patients were evaluated, and 6 underwent resection and adjuvant beta-therapy, 2 underwent resection with local application of corticosteroids, and only 1 underwent resection without adjuvant therapy. There was no recurrence of keloids in patients that were treated with beta-therapy in the early postoperative period. One patient had relapsed despite corticosteroid administration and late beta-therapy. Discussion: Several techniques have been used for the treatment of retroauricular keloids, and beta-therapy is thought to yield the best results, followed by the use of intralesional corticosteroids. Conclusion: Treatment of retroauricular keloids remains a challenge. While new techniques are being developed, resection followed by early beta-therapy is still the best treatment option. PMID:25991935

Beta-blocker drug therapy reduces secondary cancer formation in breast cancer and improves cancer specific survival.

PubMed

Powe, Desmond G; Voss, Melanie J; Zänker, Kurt S; Habashy, Hany O; Green, Andrew R; Ellis, Ian O; Entschladen, Frank

2010-11-01

Laboratory models show that the beta-blocker, propranolol, can inhibit norepinephrine-induced breast cancer cell migration. We hypothesised that breast cancer patients receiving beta-blockers for hypertension would show reduced metastasis and improved clinical outcome. Three patient subgroups were identified from the medical records of 466 consecutive female patients (median age 57, range 28-71) with operable breast cancer and follow-up (>10 years). Two subgroups comprised 43 and 49 hypertensive patients treated with beta-blockers or other antihypertensives respectively, prior to cancer diagnosis. 374 patients formed a non-hypertensive control group. Metastasis development, disease free interval, tumour recurrence and hazards risk were statistically compared between groups. Kaplan-Meier plots were used to model survival and DM. Beta-blocker treated patients showed a significant reduction in metastasis development (p=0.026), tumour recurrence (p=0.001), and longer disease free interval (p=0.01). In addition, there was a 57% reduced risk of metastasis (Hazards ratio=0.430; 95% CI=0.200-0.926, p=0.031), and a 71% reduction in breast cancer mortality after 10 years (Hazards ratio=0.291; 95% CI=0.119-0.715, p=0.007). This proof-of-principle study showed beta-blocker therapy significantly reduces distant metastases, cancer recurrence, and cancer-specific mortality in breast cancer patients suggesting a novel role for beta-blocker therapy. A larger epidemiological study leading to randomised clinical trials is needed for breast and other cancer types including colon, prostate and ovary.

Beta-Blocker Drug Therapy Reduces Secondary Cancer Formation in Breast Cancer and Improves Cancer Specific Survival

PubMed Central

Powe, Desmond G.; Voss, Melanie J.; Zänker, Kurt S.; Habashy, Hany O.; Green, Andrew R.; Ellis, Ian O.; Entschladen, Frank

2010-01-01

Laboratory models show that the beta-blocker, propranolol, can inhibit norepinephrine-induced breast cancer cell migration. We hypothesised that breast cancer patients receiving beta-blockers for hypertension would show reduced metastasis and improved clinical outcome. Three patient subgroups were identified from the medical records of 466 consecutive female patients (median age 57, range 28-71) with operable breast cancer and follow-up (>10 years). Two subgroups comprised 43 and 49 hypertensive patients treated with beta-blockers or other antihypertensives respectively, prior to cancer diagnosis. 374 patients formed a non-hypertensive control group. Metastasis development, disease free interval, tumour recurrence and hazards risk were statistically compared between groups. Kaplan-Meier plots were used to model survival and DM. Beta-blocker treated patients showed a significant reduction in metastasis development (p=0.026), tumour recurrence (p=0.001), and longer disease free interval (p=0.01). In addition, there was a 57% reduced risk of metastasis (Hazards ratio=0.430; 95% CI=0.200-0.926, p=0.031), and a 71% reduction in breast cancer mortality after 10 years (Hazards ratio=0.291; 95% CI=0.119-0.715, p=0.007). This proof-of-principle study showed beta-blocker therapy significantly reduces distant metastases, cancer recurrence, and cancer-specific mortality in breast cancer patients suggesting a novel role for beta-blocker therapy. A larger epidemiological study leading to randomised clinical trials is needed for breast and other cancer types including colon, prostate and ovary. PMID:21317458

Action-outcome learning and prediction shape the window of simultaneity of audiovisual outcomes.

PubMed

Desantis, Andrea; Haggard, Patrick

2016-08-01

To form a coherent representation of the objects around us, the brain must group the different sensory features composing these objects. Here, we investigated whether actions contribute in this grouping process. In particular, we assessed whether action-outcome learning and prediction contribute to audiovisual temporal binding. Participants were presented with two audiovisual pairs: one pair was triggered by a left action, and the other by a right action. In a later test phase, the audio and visual components of these pairs were presented at different onset times. Participants judged whether they were simultaneous or not. To assess the role of action-outcome prediction on audiovisual simultaneity, each action triggered either the same audiovisual pair as in the learning phase ('predicted' pair), or the pair that had previously been associated with the other action ('unpredicted' pair). We found the time window within which auditory and visual events appeared simultaneous increased for predicted compared to unpredicted pairs. However, no change in audiovisual simultaneity was observed when audiovisual pairs followed visual cues, rather than voluntary actions. This suggests that only action-outcome learning promotes temporal grouping of audio and visual effects. In a second experiment we observed that changes in audiovisual simultaneity do not only depend on our ability to predict what outcomes our actions generate, but also on learning the delay between the action and the multisensory outcome. When participants learned that the delay between action and audiovisual pair was variable, the window of audiovisual simultaneity for predicted pairs increased, relative to a fixed action-outcome pair delay. This suggests that participants learn action-based predictions of audiovisual outcome, and adapt their temporal perception of outcome events based on such predictions. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

[The administration of interleukin-1beta during early postnatal develop ment impairs FGF2, but not TIMP1, mRNA expression in brain structures of adult rats].

PubMed

Trofimov, A N; Zubareva, O E; Shvarts, A P; Ishchenko, A M; Klimenko, V M

2014-09-01

According to the Neurodevelopmental hypothesis, the long-lasting cognitive deficit in schizophrenia and other types of neuropathology may occur by injurious factors, such as hypoxia, traumas, infections that take place during pre- and postnatal development, at least at early stages. These pathological conditions are often associated with the high production of pro-inflammatory cytokine interleukin-1B (IL-1B) by the cells of immune and nervous systems. We investigated the expression of genes involved in the neuroplastic regulation (Fgf2 and Timp2) in medial prefrontal cortex and dorsal and ventral regions of hippocampus of adult rats that were treated with IL-1beta between P15 and P21. The learning impairment in IL-1beta-treated rats is accompanied by lower FGF-2 mRNA levels in medial prefrontal cortex and ventral (not dorsal) hippocampus, but TIMP-1 was not affected. No differences in TIMP-1 and FGF-2 mRNA expressions were observed in untrained IL-1beta-treated when compared to control rats.

Comparing Learning Outcomes of Video-Based E-Learning with Face-to-Face Lectures of Agricultural Engineering Courses in Korean Agricultural High Schools

ERIC Educational Resources Information Center

Park, Sung Youl; Kim, Soo-Wook; Cha, Seung-Bong; Nam, Min-Woo

2014-01-01

This study investigated the effectiveness of e-learning by comparing the learning outcomes in conventional face-to-face lectures and e-learning methods. Two video-based e-learning contents were developed based on the rapid prototyping model and loaded onto the learning management system (LMS), which was available at http://www.greenehrd.com.…

Agalsidase-beta therapy for advanced Fabry disease: a randomized trial.

PubMed

Banikazemi, Maryam; Bultas, Jan; Waldek, Stephen; Wilcox, William R; Whitley, Chester B; McDonald, Marie; Finkel, Richard; Packman, Seymour; Bichet, Daniel G; Warnock, David G; Desnick, Robert J

2007-01-16

Fabry disease (alpha-galactosidase A deficiency) is a rare, X-linked lysosomal storage disorder that can cause early death from renal, cardiac, and cerebrovascular involvement. To see whether agalsidase beta delays the onset of a composite clinical outcome of renal, cardiovascular, and cerebrovascular events and death in patients with advanced Fabry disease. Randomized (2:1 treatment-to-placebo randomization), double-blind, placebo-controlled trial. 41 referral centers in 9 countries. 82 adults with mild to moderate kidney disease; 74 of whom were protocol-adherent. Intravenous infusion of agalsidase beta (1 mg per kg of body weight) or placebo every 2 weeks for up to 35 months (median, 18.5 months). The primary end point was the time to first clinical event (renal, cardiac, or cerebrovascular event or death). Six patients withdrew before reaching an end point: 3 to receive commercial therapy and 3 due to positive or inconclusive serum IgE or skin test results. Three patients assigned to agalsidase beta elected to transition to open-label treatment before reaching an end point. Thirteen (42%) of the 31 patients in the placebo group and 14 (27%) of the 51 patients in the agalsidase-beta group experienced clinical events. Primary intention-to-treat analysis that adjusted for an imbalance in baseline proteinuria showed that, compared with placebo, agalsidase beta delayed the time to first clinical event (hazard ratio, 0.47 [95% CI, 0.21 to 1.03]; P = 0.06). Secondary analyses of protocol-adherent patients showed similar results (hazard ratio, 0.39 [CI, 0.16 to 0.93]; P = 0.034). Ancillary subgroup analyses found larger treatment effects in patients with baseline estimated glomerular filtration rates greater than 55 mL/min per 1.73 m2 (hazard ratio, 0.19 [CI, 0.05 to 0.82]; P = 0.025) compared with 55 mL/min per 1.73 m2 or less (hazard ratio, 0.85 [CI, 0.32 to 2.3]; P = 0.75) (formal test for interaction, P = 0.09). Most treatment-related adverse events were mild or moderate infusion-associated reactions, reported by 55% of patients in the agalsidase-beta group and 23% of patients in the placebo group. The study sample was small. Only one third of the patients experienced clinical events, and some patients withdrew before experiencing any event. Agalsidase-beta therapy slowed progression to the composite clinical outcome of renal, cardiac, and cerebrovascular complications and death compared with placebo in patients with advanced Fabry disease. Therapeutic intervention before irreversible organ damage may provide greater clinical benefit.

Does the choice of antibiotic affect outcome in strep throat?

PubMed

Santos, Cynthia; Alerhand, Stephen; Koyfman, Alex

2015-05-01

There is insufficient evidence to show clinically meaningful differences between antibiotics for group A beta hemolytic streptococci tonsillopharyngitis. Penicillin or amoxicillin is recommended as first choice, given the absence of resistance and low cost.

The quest for fragile X biomarkers.

PubMed

Westmark, Cara J

2014-12-01

Fragile X is the most common form of inherited intellectual disability and the leading known genetic cause of autism. There is currently no cure or approved medication for fragile X although various drugs target specific disease symptoms and a large number of therapeutics are in various stages of clinical development. Multiple recent clinical trials have failed on their primary endpoints indicating that there is a compelling need for validated biomarkers and outcome measures in fragile X. There are currently no validated blood-based biomarkers to assess disease severity or to monitor drug efficacy in fragile X syndrome. Herein, we review candidate blood protein biomarkers including extracellular-regulated kinase, phosphoinositide 3-kinase, matrix metalloproteinase 9, amyloid-beta and amyloid-beta protein precursor. Bench-to-bedside plans for fragile X syndrome are severely limited by the lack of validated outcome measures. The reviewed candidate biomarkers are at early stages of validation and deserve further investigation.

Optimizing electricity consumption: A case of function learning.

PubMed

Guath, Mona; Millroth, Philip; Juslin, Peter; Elwin, Ebba

2015-12-01

A popular way to improve consumers' control over their electricity consumption is by providing outcome feedback on the cost with in-home displays. Research on function learning, however, suggests that outcome feedback may not always be ideal for learning, especially if the feedback signal is noisy. In this study, we relate research on function learning to in-home displays and use a laboratory task simulating a household to investigate the role of outcome feedback and function learning on electricity optimization. Three function training schemes (FTSs) are presented that convey specific properties of the functions that relate the electricity consumption to the utility and cost. In Experiment 1, we compared learning from outcome feedback with 3 FTSs, 1 of which allowed maximization of the utility while keeping the budget, despite no feedback about the total monthly cost. In Experiment 2, we explored the combination of this FTS and outcome feedback. The results suggested that electricity optimization may be facilitated if feedback learning is preceded by a brief period of function training. (c) 2015 APA, all rights reserved).

Preferred-Actual Learning Environment "Spaces" and Earth Science Outcomes in Taiwan

ERIC Educational Resources Information Center

Chang, Chun-Yen; Hsiao, Chien-Hua; Barufaldi, James P.

2006-01-01

This study examines the possibilities of differential impacts on students' earth science learning outcomes between different preferred-actual learning environment spaces by using a newly developed ESCLEI (Earth Science Classroom Learning Environment Instrument). The instrument emphasizes three simultaneously important classroom components:…

Enzyme replacement therapy for Anderson-Fabry disease: A complementary overview of a Cochrane publication through a linear regression and a pooled analysis of proportions from cohort studies

PubMed Central

El Dib, Regina; Gomaa, Huda; Ortiz, Alberto; Politei, Juan; Kapoor, Anil; Barreto, Fellype

2017-01-01

Background Anderson-Fabry disease (AFD) is an X-linked recessive inborn error of glycosphingolipid metabolism caused by a deficiency of alpha-galactosidase A. Renal failure, heart and cerebrovascular involvement reduce survival. A Cochrane review provided little evidence on the use of enzyme replacement therapy (ERT). We now complement this review through a linear regression and a pooled analysis of proportions from cohort studies. Objectives To evaluate the efficacy and safety of ERT for AFD. Materials and methods For the systematic review, a literature search was performed, from inception to March 2016, using Medline, EMBASE and LILACS. Inclusion criteria were cohort studies, patients with AFD on ERT or natural history, and at least one patient-important outcome (all-cause mortality, renal, cardiovascular or cerebrovascular events, and adverse events) reported. The pooled proportion and the confidence interval (CI) are shown for each outcome. Simple linear regressions for composite endpoints were performed. Results 77 cohort studies involving 15,305 participants proved eligible. The pooled proportions were as follows: a) for renal complications, agalsidase alfa 15.3% [95% CI 0.048, 0.303; I2 = 77.2%, p = 0.0005]; agalsidase beta 6% [95% CI 0.04, 0.07; I2 = not applicable]; and untreated patients 21.4% [95% CI 0.1522, 0.2835; I2 = 89.6%, p<0.0001]. Effect differences favored agalsidase beta compared to untreated patients; b) for cardiovascular complications, agalsidase alfa 28% [95% CI 0.07, 0.55; I2 = 96.7%, p<0.0001]; agalsidase beta 7% [95% CI 0.05, 0.08; I2 = not applicable]; and untreated patients 26.2% [95% CI 0.149, 0.394; I2 = 98.8%, p<0.0001]. Effect differences favored agalsidase beta compared to untreated patients; and c) for cerebrovascular complications, agalsidase alfa 11.1% [95% CI 0.058, 0.179; I2 = 70.5%, p = 0.0024]; agalsidase beta 3.5% [95% CI 0.024, 0.046; I2 = 0%, p = 0.4209]; and untreated patients 18.3% [95% CI 0.129, 0.245; I2 = 95% p < 0.0001]. Effect differences favored agalsidase beta over agalsidase alfa or untreated patients. A linear regression showed that Fabry patients receiving agalsidase alfa are more likely to have higher rates of composite endpoints compared to those receiving agalsidase beta. Conclusions Agalsidase beta is associated to a significantly lower incidence of renal, cardiovascular and cerebrovascular events than no ERT, and to a significantly lower incidence of cerebrovascular events than agalsidase alfa. In view of these results, the use of agalsidase beta for preventing major organ complications related to AFD can be recommended. PMID:28296917

Enzyme replacement therapy for Anderson-Fabry disease: A complementary overview of a Cochrane publication through a linear regression and a pooled analysis of proportions from cohort studies.

PubMed

El Dib, Regina; Gomaa, Huda; Ortiz, Alberto; Politei, Juan; Kapoor, Anil; Barreto, Fellype

2017-01-01

Anderson-Fabry disease (AFD) is an X-linked recessive inborn error of glycosphingolipid metabolism caused by a deficiency of alpha-galactosidase A. Renal failure, heart and cerebrovascular involvement reduce survival. A Cochrane review provided little evidence on the use of enzyme replacement therapy (ERT). We now complement this review through a linear regression and a pooled analysis of proportions from cohort studies. To evaluate the efficacy and safety of ERT for AFD. For the systematic review, a literature search was performed, from inception to March 2016, using Medline, EMBASE and LILACS. Inclusion criteria were cohort studies, patients with AFD on ERT or natural history, and at least one patient-important outcome (all-cause mortality, renal, cardiovascular or cerebrovascular events, and adverse events) reported. The pooled proportion and the confidence interval (CI) are shown for each outcome. Simple linear regressions for composite endpoints were performed. 77 cohort studies involving 15,305 participants proved eligible. The pooled proportions were as follows: a) for renal complications, agalsidase alfa 15.3% [95% CI 0.048, 0.303; I2 = 77.2%, p = 0.0005]; agalsidase beta 6% [95% CI 0.04, 0.07; I2 = not applicable]; and untreated patients 21.4% [95% CI 0.1522, 0.2835; I2 = 89.6%, p<0.0001]. Effect differences favored agalsidase beta compared to untreated patients; b) for cardiovascular complications, agalsidase alfa 28% [95% CI 0.07, 0.55; I2 = 96.7%, p<0.0001]; agalsidase beta 7% [95% CI 0.05, 0.08; I2 = not applicable]; and untreated patients 26.2% [95% CI 0.149, 0.394; I2 = 98.8%, p<0.0001]. Effect differences favored agalsidase beta compared to untreated patients; and c) for cerebrovascular complications, agalsidase alfa 11.1% [95% CI 0.058, 0.179; I2 = 70.5%, p = 0.0024]; agalsidase beta 3.5% [95% CI 0.024, 0.046; I2 = 0%, p = 0.4209]; and untreated patients 18.3% [95% CI 0.129, 0.245; I2 = 95% p < 0.0001]. Effect differences favored agalsidase beta over agalsidase alfa or untreated patients. A linear regression showed that Fabry patients receiving agalsidase alfa are more likely to have higher rates of composite endpoints compared to those receiving agalsidase beta. Agalsidase beta is associated to a significantly lower incidence of renal, cardiovascular and cerebrovascular events than no ERT, and to a significantly lower incidence of cerebrovascular events than agalsidase alfa. In view of these results, the use of agalsidase beta for preventing major organ complications related to AFD can be recommended.

A self-controlled case series to assess the effectiveness of beta blockers for heart failure in reducing hospitalisations in the elderly.

PubMed

Ramsay, Emmae N; Roughead, Elizabeth E; Ewald, Ben; Pratt, Nicole L; Ryan, Philip

2011-07-18

To determine the suitability of using the self-controlled case series design to assess improvements in health outcomes using the effectiveness of beta blockers for heart failure in reducing hospitalisations as the example. The Australian Government Department of Veterans' Affairs administrative claims database was used to undertake a self-controlled case-series in elderly patients aged 65 years or over to compare the risk of a heart failure hospitalisation during periods of being exposed and unexposed to a beta blocker. Two studies, the first using a one year period and the second using a four year period were undertaken to determine if the estimates varied due to changes in severity of heart failure over time. In the one year period, 3,450 patients and in the four year period, 12, 682 patients had at least one hospitalisation for heart failure. The one year period showed a non-significant decrease in hospitalisations for heart failure 4-8 months after starting beta-blockers, (RR, 0.76; 95% CI (0.57-1.02)) and a significant decrease in the 8-12 months post-initiation of a beta blocker for heart failure (RR, 0.62; 95% CI (0.39, 0.99)). For the four year study there was an increased risk of hospitalisation less than eight months post-initiation and significant but smaller decrease in the 8-12 month window (RR, 0.90; 95% CI (0.82, 0.98)). The results of the one year observation period are similar to those observed in randomised clinical trials indicating that the self-controlled case-series method can be successfully applied to assess health outcomes. However, the result appears sensitive to the study periods used and further research to understand the appropriate applications of this method in pharmacoepidemiology is still required. The results also illustrate the benefits of extending beta blocker utilisation to the older age group of heart failure patients in which their use is common but the evidence is sparse.

Dose-Fractionation Sensitivity of Prostate Cancer Deduced From Radiotherapy Outcomes of 5,969 Patients in Seven International Institutional Datasets: {alpha}/{beta} = 1.4 (0.9-2.2) Gy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Miralbell, Raymond, E-mail: Raymond.Miralbell@hcuge.ch; Institut Oncologic Teknon, Barcelona; Roberts, Stephen A.

2012-01-01

Purpose: There are reports of a high sensitivity of prostate cancer to radiotherapy dose fractionation, and this has prompted several trials of hypofractionation schedules. It remains unclear whether hypofractionation will provide a significant therapeutic benefit in the treatment of prostate cancer, and whether there are different fractionation sensitivities for different stages of disease. In order to address this, multiple primary datasets have been collected for analysis. Methods and Materials: Seven datasets were assembled from institutions worldwide. A total of 5969 patients were treated using external beams with or without androgen deprivation (AD). Standard fractionation (1.8-2.0 Gy per fraction) was usedmore » for 40% of the patients, and hypofractionation (2.5-6.7 Gy per fraction) for the remainder. The overall treatment time ranged from 1 to 8 weeks. Low-risk patients comprised 23% of the total, intermediate-risk 44%, and high-risk 33%. Direct analysis of the primary data for tumor control at 5 years was undertaken, using the Phoenix criterion of biochemical relapse-free survival, in order to calculate values in the linear-quadratic equation of k (natural log of the effective target cell number), {alpha} (dose-response slope using very low doses per fraction), and the ratio {alpha}/{beta} that characterizes dose-fractionation sensitivity. Results: There was no significant difference between the {alpha}/{beta} value for the three risk groups, and the value of {alpha}/{beta} for the pooled data was 1.4 (95% CI = 0.9-2.2) Gy. Androgen deprivation improved the bNED outcome index by about 5% for all risk groups, but did not affect the {alpha}/{beta} value. Conclusions: The overall {alpha}/{beta} value was consistently low, unaffected by AD deprivation, and lower than the appropriate values for late normal-tissue morbidity. Hence the fractionation sensitivity differential (tumor/normal tissue) favors the use of hypofractionated radiotherapy schedules for all risk groups, which is also very beneficial logistically in limited-resource settings.« less

College Student Unions: What Professionals Are Doing to Assess Learning Outcomes for Student Program Board Leaders

ERIC Educational Resources Information Center

O'Toole-Curran, Janette J.

2015-01-01

The descriptive survey employed in this study explored current assessment practices of learning outcomes, including the resources used and the learning outcomes assessed for student programming board leaders. The researcher collected data through document review and phone interviews. She interviewed 21 student activities and union advisors who are…

A Meta-Analysis of the Relationship between Learning Outcomes and Parental Involvement during Early Childhood Education and Early Elementary Education

ERIC Educational Resources Information Center

Ma, Xin; Shen, Jianping; Krenn, Huilan Y.; Hu, Shanshan; Yuan, Jing

2016-01-01

This meta-analysis examined the relationship between learning outcomes of children and educational involvement of parents during a unique period of early childhood education and early elementary education based on 100 independent effect sizes from 46 studies. Learning outcomes are academic achievement, and frameworks of parental involvement…

Aligning Learning and Talent Development Performance Outcomes with Organizational Objectives: A Proposed Model

ERIC Educational Resources Information Center

Ware, Iris

2017-01-01

The value proposition for learning and talent development (LTD) is often challenged due to human resources' inability to demonstrate meaningful outcomes in relation to organizational needs and return-on-investment. The primary role of human resources (HR) and the learning and talent development (LTD) function is to produce meaningful outcomes to…

Comparison and Evaluation of Learning Outcomes from an International Perspective: Development of a Best-Practice Process

ERIC Educational Resources Information Center

Elmgren, Maja; Ho, Felix; Åkesson, Eva; Schmid, Siegbert; Towns, Marcy

2015-01-01

Chemistry education focused on learning outcomes is increasingly practiced, providing new opportunities for international comparisons. The interest in intended learning outcomes and constructive alignment has grown in many parts of the world due to both research in higher education and political decisions. In an International Union of Pure and…

The Effect of Linked Learning Certified Pathways on Selected Student Outcomes

ERIC Educational Resources Information Center

Fitzgerald, Robert; Ottem, Randolph; Hufford, Justine

2016-01-01

This report examines outcomes for grade-12 students in academic years (AY) 2010-11, 2011-12, and 2012-13 who were enrolled in a Linked Learning certified pathway (LLCP) in California. Outcomes include student engagement in learning, measured by high school attendance and discipline events, as well as college readiness and postsecondary enrollment.…

The Other Half: Non-Tenure Track Faculty Thoughts on Student Learning Outcomes Assessment

ERIC Educational Resources Information Center

Danley-Scott, Jennifer; Scott, Gray

2014-01-01

Articles on student learning outcomes assessment often treat faculty as one homogenous body. Yet the exponential growth of contingent faculty in universities and colleges has created two distinct faculty groups with varied concerns and thoughts on everything from the future of higher education to shared governance to student learning outcomes.…

Learning Outcomes as a Key Concept in Policy Documents throughout Policy Changes

ERIC Educational Resources Information Center

Prøitz, Tine Sophie

2015-01-01

Learning outcomes can be considered to be a key concept in a changing education policy landscape, enhancing aspects such as benchmarking and competition. Issues relating to concepts of performance have a long history of debate within the field of education. Today, the concept of learning outcomes has become central in education policy development,…

Correlate of Resource Utilization and Students' Learning Outcome in Colleges of Education in South West Nigeria

ERIC Educational Resources Information Center

Ibukun, W. O.; Akinfolarin, C. A.; Alimi, O. S.

2011-01-01

This study investigated resource utilisation in vocational and technical education as a correlate of student learning outcome in selected colleges of education in south west Nigeria. The study examined the relationship between time, space and physical resource utilisation and perceived student learning outcome. The study used the descriptive…

Perceived Learning Outcomes from Participation in One Type of Registered Student Organization: Equestrian Sport Clubs

ERIC Educational Resources Information Center

Mikulec, Erin; McKinney, Kathleen

2014-01-01

Learning takes place both inside and outside of the classroom. While there are a few studies that focus on the professional, developmental, and learning outcomes of participation in student organizations, there has been insufficient research on these outcomes in sport clubs. The paper reports on the results of an online, primarily qualitative…

Internship-Related Learning Outcomes and Their Influential Factors: The Case of Vietnamese Tourism and Hospitality Students

ERIC Educational Resources Information Center

Nghia, Tran Le Huu; Duyen, Nguyen Thi My

2018-01-01

Purpose: The purpose of this paper is to explore the experiences of Tourism and Hospitality interns in Vietnam to identify dimensions of internship-related learning outcomes and factors influencing these learning outcomes. Design/methodology/approach: In total, 12 in-depth interviews were conducted with 12 interns to identify the dimensions of…

Olfactory bulb size, odor discrimination and magnetic insensitivity in hummingbirds.

PubMed

Ioalé, P; Papi, F

1989-05-01

Relative olfactory bulb size with respect to telencephalic hemispheres (olfactory ratio) was measured in five species of hummingbirds. Trochiliformes were found to be next to last among 25 avian orders with respect to olfactory bulb development. One hummingbird species, the White-vented Violetear (Colibri serrirostris), was trained in a successive go/no-go discrimination task, and learned to feed or not to feed from a container dependent on the olfactory stimuli associated with it. Test birds learned to discriminate amyl acetate vs. turpentine essence, jasmine essence vs. lavender essence, eucalyptus essence vs. no odor, beta-ionone vs. no odor, carvone vs. eucalyptol. In contrast, 1-phenylethanol vs. beta-ionone discrimination, two odorants which appear similar to humans, was unsuccessful. Using a similar procedure, attempts were made to condition a White-vented Violetear and a Versicolored Emerald (Amazilia versicolor) to magnetic stimuli. The birds were unable to discriminate between a normal field and an oscillating field (square wave, 1 Hz, amplitude +/- 0.40 G).

Application of Matrix Outcome Mapping to Constructively Align Program Outcomes and Course Outcomes in Higher Education

ERIC Educational Resources Information Center

Mazouz, Abdelkader; Crane, Keenan

2013-01-01

Establishing a link between Course Learning Outcomes (LOs) and Program Outcomes (POs) while assessing the course contents and delivery are among the most challenging issues in Higher Education. In the present study two forms were generated based on specific Course Learning Outcomes identified in the syllabus at the beginning of the teaching term:…

Goals, Motivation for, and Outcomes of Personal Learning through Networks: Results of a Tweetstorm

ERIC Educational Resources Information Center

Sie, Rory L. L.; Pataraia, Nino; Boursinou, Eleni; Rajagopal, Kamakshi; Margaryan, Anoush; Falconer, Isobel; Bitter-Rijpkema, Marlies; Littlejohn, Allison; Sloep, Peter B.

2013-01-01

Recent developments in the use of social media for learning have posed serious challenges for learners. The information overload that these online social tools create has changed the way learners learn and from whom they learn. An investigation of learners' goals, motivations and expected outcomes when using a personal learning network is…

Comparing Virtual and Location-Based Augmented Reality Mobile Learning: Emotions and Learning Outcomes

ERIC Educational Resources Information Center

Harley, Jason M.; Poitras, Eric G.; Jarrell, Amanda; Duffy, Melissa C.; Lajoie, Susanne P.

2016-01-01

Research on the effectiveness of augmented reality (AR) on learning exists, but there is a paucity of empirical work that explores the role that positive emotions play in supporting learning in such settings. To address this gap, this study compared undergraduate students' emotions and learning outcomes during a guided historical tour using mobile…

Learning Outcomes in Vocational Education: A Business Plan Development by Production-Based Learning Model Approach

ERIC Educational Resources Information Center

Kusumaningrum, Indrati; Hidayat, Hendra; Ganefri; Anori, Sartika; Dewy, Mega Silfia

2016-01-01

This article describes the development of a business plan by using production-based learning approach. In addition, this development also aims to maximize learning outcomes in vocational education. Preliminary analysis of curriculum and learning and the needs of the market and society become the basic for business plan development. To produce a…

The Effect of Flipped Learning (Revised Learning) on Iranian Students' Learning Outcomes

ERIC Educational Resources Information Center

Yousefzadeh, Malahat; Salimi, Asghar

2015-01-01

The purpose of this study was to investigate whether the flipped (revised) learning had effect on student learning outcome. Lage et al (2000) describes the flipped classroom as " Inverting the classroom means that events that have traditionally take place inside the classroom now take place outside the class and vice versa" (p.32). The…

Learning More than Expected: The Influence of Teachers' Attitudes on Children's Learning Outcomes

ERIC Educational Resources Information Center

Youn, Minjong

2016-01-01

This study employed the concept of teachers' sense of responsibility for students' learning to examine the extent to which the gap in math learning growth is reduced and whether such attitudes can improve children's learning outcomes to a degree that is above and beyond their expected achievement relative to their initial academic skills. Analysis…

Can Students' Concept of Learning Influence Their Learning Outcomes?

ERIC Educational Resources Information Center

Marouchou, Despina Varnava

2012-01-01

This paper aims to readdress the lack of empirical data concerning university learning and in particular the dynamics students' conceptions of learning may have on students' learning outcomes. This paper is written at a time when the EU commission for Higher Education (HE) through the Bologna Process declaration has put into action, since 1999, a…

Improved Characters and Student Learning Outcomes through Development of Character Education Based General Physics Learning Model

ERIC Educational Resources Information Center

Derlina; Sabani; Mihardi, Satria

2015-01-01

Education Research in Indonesia has begun to lead to the development of character education and is no longer fixated on the outcomes of cognitive learning. This study purposed to produce character education based general physics learning model (CEBGP Learning Model) and with valid, effective and practical peripheral devices to improve character…

Effect of Mastery Learning on Senior Secondary School Students' Cognitive Learning Outcome in Quantitative Chemistry

ERIC Educational Resources Information Center

Mitee, Telimoye Leesi; Obaitan, Georgina N.

2015-01-01

The cognitive learning outcome of Senior Secondary School chemistry students has been poor over the years in Nigeria. Poor mathematical skills and inefficient teaching methods have been identified as some of the major reasons for this. Bloom's theory of school learning and philosophy of mastery learning assert that virtually all students are…

The neural coding of expected and unexpected monetary performance outcomes: dissociations between active and observational learning.

PubMed

Bellebaum, C; Jokisch, D; Gizewski, E R; Forsting, M; Daum, I

2012-02-01

Successful adaptation to the environment requires the learning of stimulus-response-outcome associations. Such associations can be learned actively by trial and error or by observing the behaviour and accompanying outcomes in other persons. The present study investigated similarities and differences in the neural mechanisms of active and observational learning from monetary feedback using functional magnetic resonance imaging. Two groups of 15 subjects each - active and observational learners - participated in the experiment. On every trial, active learners chose between two stimuli and received monetary feedback. Each observational learner observed the choices and outcomes of one active learner. Learning performance as assessed via active test trials without feedback was comparable between groups. Different activation patterns were observed for the processing of unexpected vs. expected monetary feedback in active and observational learners, particularly for positive outcomes. Activity for unexpected vs. expected reward was stronger in the right striatum in active learning, while activity in the hippocampus was bilaterally enhanced in observational and reduced in active learning. Modulation of activity by prediction error (PE) magnitude was observed in the right putamen in both types of learning, whereas PE related activations in the right anterior caudate nucleus and in the medial orbitofrontal cortex were stronger for active learning. The striatum and orbitofrontal cortex thus appear to link reward stimuli to own behavioural reactions and are less strongly involved when the behavioural outcome refers to another person's action. Alternative explanations such as differences in reward value between active and observational learning are also discussed. Copyright © 2011 Elsevier B.V. All rights reserved.

The structure of observed learning outcome (SOLO) taxonomy: a model to promote dental students' learning.

PubMed

Lucander, H; Bondemark, L; Brown, G; Knutsson, K

2010-08-01

Selective memorising of isolated facts or reproducing what is thought to be required - the surface approach to learning - is not the desired outcome for a dental student or a dentist in practice. The preferred outcome is a deep approach as defined by an intention to seek understanding, develop expertise and relate information and knowledge into a coherent whole. The aim of this study was to investigate whether the structure of observed learning outcome (SOLO) taxonomy could be used as a model to assist and promote the dental students to develop a deep approach to learning assessed as learning outcomes in a summative assessment. Thirty-two students, participating in course eight in 2007 at the Faculty of Odontology at Malmö University, were introduced to the SOLO taxonomy and constituted the test group. The control group consisted of 35 students participating in course eight in 2006. The effect of the introduction was measured by evaluating responses to a question in the summative assessment by using the SOLO taxonomy. The evaluators consisted of two teachers who performed the assessment of learning outcomes independently and separately on the coded material. The SOLO taxonomy as a model for learning was found to improve the quality of learning. Compared to the control group significantly more strings and structured relations between these strings were present in the test group after the SOLO taxonomy had been introduced (P < 0.01, one tailed test for both results). The SOLO taxonomy is recommended as a model for promoting and developing a deeper approach to learning in dentistry.

Distance Travelled: Outcomes and Evidence in Flexible Learning Options

ERIC Educational Resources Information Center

Thomas, Joseph; McGinty, Sue; te Riele, Kitty; Wilson, Kimberley

2017-01-01

Flexible learning options (FLOs) provide individualised learning pathways for disengaged young people with strong emphasis on inclusivity and wellbeing support. Amidst a rapid expansion of Australia's flexible learning sector, service providers are under increasing pressure to substantiate participant outcomes. This paper stems from a national…

Processing of action- but not stimulus-related prediction errors differs between active and observational feedback learning.

PubMed

Kobza, Stefan; Bellebaum, Christian

2015-01-01

Learning of stimulus-response-outcome associations is driven by outcome prediction errors (PEs). Previous studies have shown larger PE-dependent activity in the striatum for learning from own as compared to observed actions and the following outcomes despite comparable learning rates. We hypothesised that this finding relates primarily to a stronger integration of action and outcome information in active learners. Using functional magnetic resonance imaging, we investigated brain activations related to action-dependent PEs, reflecting the deviation between action values and obtained outcomes, and action-independent PEs, reflecting the deviation between subjective values of response-preceding cues and obtained outcomes. To this end, 16 active and 15 observational learners engaged in a probabilistic learning card-guessing paradigm. On each trial, active learners saw one out of five cues and pressed either a left or right response button to receive feedback (monetary win or loss). Each observational learner observed exactly those cues, responses and outcomes of one active learner. Learning performance was assessed in active test trials without feedback and did not differ between groups. For both types of PEs, activations were found in the globus pallidus, putamen, cerebellum, and insula in active learners. However, only for action-dependent PEs, activations in these structures and the anterior cingulate were increased in active relative to observational learners. Thus, PE-related activity in the reward system is not generally enhanced in active relative to observational learning but only for action-dependent PEs. For the cerebellum, additional activations were found across groups for cue-related uncertainty, thereby emphasising the cerebellum's role in stimulus-outcome learning. Copyright © 2014 Elsevier Ltd. All rights reserved.

From feedback- to response-based performance monitoring in active and observational learning.

PubMed

Bellebaum, Christian; Colosio, Marco

2014-09-01

Humans can adapt their behavior by learning from the consequences of their own actions or by observing others. Gradual active learning of action-outcome contingencies is accompanied by a shift from feedback- to response-based performance monitoring. This shift is reflected by complementary learning-related changes of two ACC-driven ERP components, the feedback-related negativity (FRN) and the error-related negativity (ERN), which have both been suggested to signal events "worse than expected," that is, a negative prediction error. Although recent research has identified comparable components for observed behavior and outcomes (observational ERN and FRN), it is as yet unknown, whether these components are similarly modulated by prediction errors and thus also reflect behavioral adaptation. In this study, two groups of 15 participants learned action-outcome contingencies either actively or by observation. In active learners, FRN amplitude for negative feedback decreased and ERN amplitude in response to erroneous actions increased with learning, whereas observational ERN and FRN in observational learners did not exhibit learning-related changes. Learning performance, assessed in test trials without feedback, was comparable between groups, as was the ERN following actively performed errors during test trials. In summary, the results show that action-outcome associations can be learned similarly well actively and by observation. The mechanisms involved appear to differ, with the FRN in active learning reflecting the integration of information about own actions and the accompanying outcomes.

Achievement of learning outcome after implemented physical modules based on problem based learning

NASA Astrophysics Data System (ADS)

Isna, R.; Masykuri, M.; Sukarmin

2018-03-01

Implementation of Problem BasedLearning (PBL) modules can grow the students' thinking skills to solve the problems in daily life and equip the students into higher education levels. The purpose of this research is to know the achievement of learning outcome after implementation physics module based on PBL in Newton,s Law of Gravity. This research method use the experimental method with posttest only group design. To know the achievement of student learning outcomes was analyzed using t test through application of SPSS 18. Based on research result, it is found that the average of student learning outcomes after appliying physics module based on PBL has reached the minimal exhaustiveness criteria. In addition, students' scientific attitudes also improved at each meeting. Presentation activities which contained at learning sync are also able to practice speaking skills and broaden their knowledge. Looking at some shortcomings during the study, it is suggested the issues raised into learning should be a problem close to the life of students so that, the students are more active and enthusiastic in following the learning of physics.

Structure and strategies in children's educational television: the roles of program type and learning strategies in children's learning.

PubMed

Linebarger, Deborah L; Piotrowski, Jessica Taylor

2010-01-01

Educational TV has been consistently linked to children's learning. In this research, educational TV characteristics were identified, coded, and tested for their influence on children's program-specific comprehension and vocabulary outcomes. Study 1 details a content analysis of TV features including a program's macrostructure (i.e., narrative or expository) and learning strategies embedded in the macrostructure that support learning in print-based contexts. In Study 2, regression analyses were used to predict outcomes involving 71 second and third graders (average age=7.63 years). Strategies were categorized as organizing, rehearsing, elaborating, or affective in function. Outcomes were uniformly higher for narrative macrostructures. Strategies used in narratives predicted relatively homogenous relations across outcomes, whereas strategies in expositories predicted quite heterogeneous relations across outcomes. © 2010 The Authors. Child Development © 2010 Society for Research in Child Development, Inc.

How are we assessing near-peer teaching in undergraduate health professional education? A systematic review.

PubMed

Irvine, Susan; Williams, Brett; McKenna, Lisa

2017-03-01

Near Peer teaching (NPT) is reported as an effective pedagogical approach to student learning and performance. Studies in medicine, nursing and health sciences have relied mainly on self-reports to describe its benefits, focusing on psychomotor and cognitive aspects of learning. Despite increasing research reports on peer teaching internationally, little is known about the various domains of learning used in assessment of performance and objective learning outcomes of NPT. To determine the domains of learning and assessment outcomes used in NPT in undergraduate health professional education. Quantitative systematic review was conducted in accord with the PRISMA protocol and the Joanna Briggs Institute processes. A wide literature search was conducted for the period 1990-November 2015 of fourteen databases. Grey literature was undertaken from all key research articles. Studies meeting the inclusion criteria were eligible for consideration, including measured learning outcomes of near-peer teaching in undergraduate education in nursing, medicine and health sciences. Set limitations included publications after 1990 (2015 inclusive), English language and objective learning outcomes. A quality appraisal process involving two independent reviewers was used to analyse the data. Of 212 selected articles, 26 were included in the review. Terminology was confusing and found to be a barrier to the review process. Although some studies demonstrated effective learning outcomes resulting from near-peer teaching, others were inconclusive. Studies focused on cognitive and psychomotor abilities of learners with none assessing metacognition, affective behaviours or learning outcomes from quality of understanding. The studies reviewed focused on cognitive and psychomotor abilities of learners. Even though evidence clearly indicates that metacognition and affective behaviours have direct influence on learning and performance, indicating more research around this topic is warranted. Methodological quality of the studies and lack of theoretical frameworks underpinned by educational psychology may have contributed to inconsistencies in learning outcomes reported. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

The development of learning material using learning cycle 5E model based stem to improve students’ learning outcomes in Thermochemistry

NASA Astrophysics Data System (ADS)

sugiarti, A. C.; suyatno, S.; Sanjaya, I. G. M.

2018-04-01

The objective of this study is describing the feasibility of Learning Cycle 5E STEM (Science, Technology, Engineering, and Mathematics) based learning material which is appropriate to improve students’ learning achievement in Thermochemistry. The study design used 4-D models and one group pretest-posttest design to obtain the information about the improvement of sudents’ learning outcomes. The subject was learning cycle 5E based STEM learning materials which the data were collected from 30 students of Science class at 11th Grade. The techniques used in this study were validation, observation, test, and questionnaire. Some result attain: (1) all the learning materials contents were valid, (2) the practicality and the effectiveness of all the learning materials contents were classified as good. The conclution of this study based on those three condition, the Learnig Cycle 5E based STEM learning materials is appropriate to improve students’ learning outcomes in studying Thermochemistry.

Beta Adrenergic Signaling: A Targetable Regulator of Angiosarcoma and Hemangiosarcoma

PubMed Central

Dickerson, Erin B.; Bryan, Brad A.

2015-01-01

Human angiosarcomas and canine hemangiosarcomas are highly aggressive cancers thought to arise from cells of vascular origin. The pathological features, morphological organization, and clinical behavior of canine hemangiosarcomas are virtually indistinct from those of human angiosarcomas. Overall survival with current standard-of-care approaches remains dismal for both humans and dogs, and each is likely to succumb to their disease within a short duration. While angiosarcomas in humans are extremely rare, limiting their study and treatment options, canine hemangiosarcomas occur frequently. Therefore, studies of these sarcomas in dogs can be used to advance treatment approaches for both patient groups. Emerging data suggest that angiosarcomas and hemangiosarcomas utilize beta adrenergic signaling to drive their progression by regulating the tumor cell niche and fine-tuning cellular responses within the tumor microenvironment. These discoveries indicate that inhibition of beta adrenergic signaling could serve as an Achilles heel for these tumors and emphasize the need to design therapeutic strategies that target tumor cell and stromal cell constituents. In this review, we summarize recent discoveries and present new hypotheses regarding the roles of beta adrenergic signaling in angiosarcomas and hemangiosarcomas. Because the use of beta adrenergic receptor antagonists is well established in human and veterinary medicine, beta blockade could provide an immediate adjunct therapy for treatment along with a tangible opportunity to improve upon the outcomes of both humans and dogs with these diseases. PMID:29061946

High fat programming of beta cell compensation, exhaustion, death and dysfunction.

PubMed

Cerf, Marlon E

2015-03-01

Programming refers to events during critical developmental windows that shape progeny health outcomes. Fetal programming refers to the effects of intrauterine (in utero) events. Lactational programming refers to the effects of events during suckling (weaning). Developmental programming refers to the effects of events during both fetal and lactational life. Postnatal programming refers to the effects of events either from birth (lactational life) to adolescence or from weaning (end of lactation) to adolescence. Islets are most plastic during the early life course; hence programming during fetal and lactational life is most potent. High fat (HF) programming is the maintenance on a HF diet (HFD) during critical developmental life stages that alters progeny metabolism and physiology. HF programming induces variable diabetogenic phenotypes dependent on the timing and duration of the dietary insult. Maternal obesity reinforces HF programming effects in progeny. HF programming, through acute hyperglycemia, initiates beta cell compensation. However, HF programming eventually leads to chronic hyperglycemia that triggers beta cell exhaustion, death and dysfunction. In HF programming, beta cell dysfunction often co-presents with insulin resistance. Balanced, healthy nutrition during developmental windows is critical for preserving beta cell structure and function. Thus early positive nutritional interventions that coincide with the development of beta cells may reduce the overwhelming burden of diabetes and metabolic disease. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Polymorphism in beta fibrinogen -455 g/a gene was associated with diabetic in severe ischemic stroke patients

NASA Astrophysics Data System (ADS)

Ritarwan, Kiking; Kadri, Alfansuri; Juwita Sembiring, Rosita

2018-03-01

There is a association of polymorphism in the promoter region of the beta fibrinogen gene -455 G/A with enhancement plasma fibrinogen level. Diabetes mellitus is a risk factor for early neurologic deterioration in acute ischemic stroke. The prothrombotic fibrinogen protein is frequently elevated in patients with diabetes and may be association with poorer prognosis. This study evaluated the association of beta fibrinogen gene -455 G/A promoter polymorphism on modified Ranking Scale of Ischemic Stroke patients treated with diabetic and nondiabetic group. In a Cohort study design comprises 200 consecutive patients diabetic and a nondiabetic who, three months using completed a detailed outcome stroke. Of 200 samples genotype distribution were 27.1% for GG+GA and 0% for AA with diabetic and than 4.4% for GG+GA and 0.05% diabetic patients. Fibrinogen levels were higher in diabetic than nondiabetic group patients (307.7 + 106.3 vs 278 + 84 gr/dl, p=0.002). Fibrinogen level was found to be an independent predictor for diabetic patients. On Genotype GG+GA were associated wth diabetic and nondiabetic group patients. Modified Rankin Scale on day 90 were found associated with diabetic and nondiabetic patients. Conclusion: Elevated fibrinogen level is dose-dependently associated with 90 days outcome severity stroke with diabetic following ischemic stroke

The Functional Arm Scale for Throwers (FAST)-Part I: The Design and Development of an Upper Extremity Region-Specific and Population-Specific Patient-Reported Outcome Scale for Throwing Athletes.

PubMed

Sauers, Eric L; Bay, R Curtis; Snyder Valier, Alison R; Ellery, Traci; Huxel Bliven, Kellie C

2017-03-01

Upper extremity (UE) region-specific, patient-reported outcome (PRO) scales assess injuries to the UE but do not account for the demands of overhead throwing athletes or measure patient-oriented domains of health-related quality of life (HRQOL). To develop the Functional Arm Scale for Throwers (FAST), a UE region-specific and population-specific PRO scale that assesses multiple domains of disablement in throwing athletes with UE injuries. In stage I, a beta version of the scale was developed for subsequent factor identification, final item reduction, and construct validity analysis during stage II. Descriptive laboratory study. Three-stage scale development was utilized: Stage I (item generation and initial item reduction) and stage II (factor analysis, final item reduction, and construct validity) are reported herein, and stage III (establishment of measurement properties [reliability and validity]) will be reported in a companion paper. In stage I, a beta version was developed, incorporating National Center for Medical Rehabilitation Research disablement domains and ensuring a blend of sport-related and non-sport-related items. An expert panel and focus group assessed importance and interpretability of each item. During stage II, the FAST was reduced, preserving variance characteristics and factor structure of the beta version and construct validity of the final FAST scale. During stage I, a 54-item beta version and a separate 9-item pitcher module were developed. During stage II, a 22-item FAST and 9-item pitcher module were finalized. The factor solution for FAST scale items included pain (n = 6), throwing (n = 10), activities of daily living (n = 5), psychological impact (n = 4), and advancement (n = 3). The 6-item pain subscale crossed factors. The remaining subscales and pitcher module are distinctive, correlated, and internally consistent and may be interpreted individually or combined. This article describes the development of the FAST, which assesses clinical outcomes and HRQOL of throwing athletes after UE injury. The FAST encompasses multiple domains of disability and demonstrates excellent construct validity. The FAST provides a single UE region-specific and population-specific PRO scale for high-demand throwers to facilitate measurement of impact of UE injuries on HRQOL and clinical outcomes while quantifying recovery for comparative effectiveness studies.

College Students' Motivations for Engaging in International Service-Learning

ERIC Educational Resources Information Center

MacHarg, Brian

2013-01-01

As the fields of service-learning and international education are joined to form the relatively new pedagogy of international service-learning, this hybrid field requires appropriate measuring of its outcomes and motivations. Numerous studies have looked into the various outcomes of service-learning standing alone from an international experience…

Developing a Survey of Transformative Learning Outcomes and Processes Based on Theoretical Principles

ERIC Educational Resources Information Center

Stuckey, Heather L.; Taylor, Edward W.; Cranton, Patricia

2013-01-01

The purpose of this research was to develop an inclusive evaluation of "transformative learning theory" that encompassed varied perspectives of transformative learning. We constructed a validated quantitative survey to assess the potential outcomes and processes of how transformative learning may be experienced by college-educated…

Evidence of Deeper Learning Outcomes: Findings from the Study of Deeper Learning

ERIC Educational Resources Information Center

Taylor, James

2014-01-01

The "Study of Deeper Learning: Opportunities and Outcomes", funded by the William and Flora Hewlett Foundation, is a "proof-of-concept" study to determine whether students attending high schools with a mature and at least moderately well-implemented approach to promoting deeper learning experience greater deeper learning…

Learning by Helping? Undergraduate Communication Outcomes Associated with Training or Service-Learning Experiences

ERIC Educational Resources Information Center

Katz, Jennifer; DuBois, Melinda; Wigderson, Sara

2014-01-01

This study investigated communication outcomes after training or applied service-learning experiences. Pre-practicum trainees learned active listening skills over 10 weeks. Practicum students were successful trainees who staffed a helpline. Community interns were trained and supervised at community agencies. Undergraduate students in psychology…

Learning Outcomes Afforded by Self-Assessed, Segmented Video-Print Combinations

ERIC Educational Resources Information Center

Koumi, Jack

2015-01-01

Learning affordances of video and print are examined in order to assess the learning outcomes afforded by hybrid video-print learning packages. The affordances discussed for print are: navigability, surveyability and legibility. Those discussed for video are: design for constructive reflection, provision of realistic experiences, presentational…

Learning in Transformational Computer Games: Exploring Design Principles for a Nanotechnology Game

ERIC Educational Resources Information Center

Masek, Martin; Murcia, Karen; Morrison, Jason; Newhouse, Paul; Hackling, Mark

2012-01-01

Transformational games are digital computer and video applications purposefully designed to create engaging and immersive learning environments for delivering specified learning goals, outcomes and experiences. The virtual world of a transformational game becomes the social environment within which learning occurs as an outcome of the complex…

The Association Between Learning Climate and Adverse Obstetrical Outcomes in 16 Nontertiary Obstetrics-Gynecology Departments in the Netherlands.

PubMed

Smirnova, Alina; Ravelli, Anita C J; Stalmeijer, Renée E; Arah, Onyebuchi A; Heineman, Maas Jan; van der Vleuten, Cees P M; van der Post, Joris A M; Lombarts, Kiki M J M H

2017-12-01

To investigate the association between learning climate and adverse perinatal and maternal outcomes in obstetrics-gynecology departments. The authors analyzed 23,629 births and 103 learning climate evaluations from 16 nontertiary obstetrics-gynecology departments in the Netherlands in 2013. Multilevel logistic regressions were used to calculate the odds of adverse perinatal and maternal outcomes, by learning climate score tertile, adjusting for maternal and department characteristics. Adverse perinatal outcomes included fetal or early neonatal mortality, five-minute Apgar score < 7, or neonatal intensive care unit admission for ≥ 24 hours. Adverse maternal outcomes included postpartum hemorrhage and/or transfusion, death, uterine rupture, or third- or fourth-degree perineal laceration. Bias analyses were conducted to quantify the sensitivity of the results to uncontrolled confounding and selection bias. Learning climate scores were significantly associated with increased odds of adverse perinatal outcomes (aOR 2.06, 95% CI 1.14-3.72). Compared with the lowest tertile, departments in the middle tertile had 46% greater odds of adverse perinatal outcomes (aOR 1.46, 95% CI 1.09-1.94); departments in the highest tertile had 69% greater odds (aOR 1.69, 95% CI 1.24-2.30). Learning climate was not associated with adverse maternal outcomes (middle vs. lowest tertile: OR 1.04, 95% CI 0.93-1.16; highest vs. lowest tertile: OR 0.98, 95% CI 0.88-1.10). Learning climate was associated with significantly increased odds of adverse perinatal, but not maternal, outcomes. Research in similar clinical contexts is needed to replicate these findings and explore potential mechanisms behind these associations.

Machine learning of big data in gaining insight into successful treatment of hypertension.

PubMed

Koren, Gideon; Nordon, Galia; Radinsky, Kira; Shalev, Varda

2018-06-01

Despite effective medications, rates of uncontrolled hypertension remain high. Treatment protocols are largely based on randomized trials and meta-analyses of these studies. The objective of this study was to test the utility of machine learning of big data in gaining insight into the treatment of hypertension. We applied machine learning techniques such as decision trees and neural networks, to identify determinants that contribute to the success of hypertension drug treatment on a large set of patients. We also identified concomitant drugs not considered to have antihypertensive activity, which may contribute to lowering blood pressure (BP) control. Higher initial BP predicts lower success rates. Among the medication options and their combinations, treatment with beta blockers appears to be more commonly effective, which is not reflected in contemporary guidelines. Among numerous concomitant drugs taken by hypertensive patients, proton pump inhibitors (PPIs), and HMG CO-A reductase inhibitors (statins) significantly improved the success rate of hypertension. In conclusions, machine learning of big data is a novel method to identify effective antihypertensive therapy and for repurposing medications already on the market for new indications. Our results related to beta blockers, stemming from machine learning of a large and diverse set of big data, in contrast to the much narrower criteria for randomized clinic trials (RCTs), should be corroborated and affirmed by other methods, as they hold potential promise for an old class of drugs which may be presently underutilized. These previously unrecognized effects of PPIs and statins have been very recently identified as effective in lowering BP in preliminary clinical observations, lending credibility to our big data results.

The acute effect of beta-guanidinopropionic acid versus creatine or placebo in healthy men (ABC Trial): study protocol for a randomized controlled trial.

PubMed

Karamat, Fares A; Horjus, Deborah L; Haan, Yentl C; van der Woude, Lisa; Oudman, Inge; van Montfrans, Gert A; Clark, Joseph F; Brewster, Lizzy M

2015-02-22

Despite adequate treatment, up to 30% of treated antihypertensive patients with primary, uncomplicated hypertension remain uncontrolled. We proposed that high intracellular activity of the ATP regenerating enzyme creatine kinase (CK) increases pressor responses and hypertension risk. In line with this, we found that plasma CK activity after rest, a surrogate measure of tissue activity, is the main predictor of blood pressure levels and failure of antihypertensive therapy in the general population. In addition, the creatine analog and competitive oral creatine kinase inhibitor beta-guanidinopropionic acid effectively and safely reduced blood pressure in the spontaneously hypertensive rat. However, to our knowledge there are no human data on the safety of oral supplementation with this substance. Therefore, we will assess the tolerability of beta-guanidinopropionic acid in men, compared to creatine and placebo. This is a randomized, active and placebo controlled, triple blind, double dummy, single center clinical intervention trial in 24 healthy male volunteers, 18 to 50 years old, recruited in the Netherlands. The intervention consists of one week of daily oral administration of beta-guanidinopropionic acid 100 mg, creatine 5 gram, or placebo. The primary outcome is the tolerability of beta-guanidinopropionic acid as a descriptive measure, in an intent-to-treat analysis. Other outcomes include the placebo-adjusted differences with baseline in biochemical and hemodynamic parameters, including plasma markers of muscle tissue damage, urine sodium excretion, resting sitting systolic and diastolic brachial blood pressure, supine systolic and diastolic central blood pressure, pulse wave velocity and augmentation index, heart rate, cardiac contractility, cardiac output, and total peripheral resistance. There is an unfulfilled need for new conservative options to treat resistant hypertension. This study will provide first-in-men data on creatine kinase inhibition as a potential new class of antihypertensive drugs. The Netherlands National Trial Register Trialregister.nl (identifier NTR 4444) , registered 9 March 2014.

Effects of congruence between preferred and perceived learning environments in nursing education in Taiwan: a cross-sectional study.

PubMed

Yeh, Ting-Kuang; Huang, Hsiu-Mei; Chan, Wing P; Chang, Chun-Yen

2016-05-20

To investigate the effects of congruence between preferred and perceived learning environments on learning outcomes of nursing students. A nursing course at a university in central Taiwan. 124 Taiwanese nursing students enrolled in a 13-week problem-based Fundamental Nursing curriculum. Students' preferred learning environment, perceptions about the learning environment and learning outcomes (knowledge, self-efficacy and attitudes) were assessed. On the basis of test scores measuring their preferred and perceived learning environments, students were assigned to one of two groups: a 'preferred environment aligned with perceived learning environment' group and a 'preferred environment discordant with perceived learning environment' group. Learning outcomes were analysed by group. Most participants preferred learning in a classroom environment that combined problem-based and lecture-based instruction. However, a mismatch of problem-based instruction with students' perceptions occurred. Learning outcomes were significantly better when students' perceptions of their instructional activities were congruent with their preferred learning environment. As problem-based learning becomes a focus of educational reform in nursing, teachers need to be aware of students' preferences and perceptions of the learning environment. Teachers may also need to improve the match between an individual student's perception and a teacher's intention in the learning environment, and between the student's preferred and actual perceptions of the learning environment. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Examining the Effectiveness of a Learning Outcomes Assessment Program: A Four Frames Perspective

ERIC Educational Resources Information Center

Schoepp, Kevin; Tezcan-Unal, Burcu

2017-01-01

Assessment of learning outcomes at the program level is essential to evaluate whether students are achieving what is expected of them as graduates. In this article we present the results of a study in which faculty focus groups were consulted so as to understand the subjective issues that surround the learning outcomes assessment program of an…

Contextualized Measurement of Self-Efficacy and College Students' Perceived Sources of Self-Efficacy in Introductory Plant Science Courses

ERIC Educational Resources Information Center

Keefe, Lisa Madalon

2013-01-01

Institutions of higher learning are recently being held more accountable for the learning outcomes of their students. As such, universities have begun to actively measure and evaluate student learning and motivational outcomes in an effort to improve the successful outcomes of their students. To support this work, two studies were conducted to…

Effect of School and Home Factors on Learning Outcomes at Elementary School Level: A Hierarchical Linear Model

ERIC Educational Resources Information Center

Singh, Jai

2016-01-01

India is a democratic, socialistic republic that is committed to providing high quality elementary education to all children. This research paper examines and analyses the effects of school, teacher and home factors on learning outcomes in elementary schools in the urban slum areas of Varanasi city and assesses the learning outcomes of students of…

Some Learning Outcomes from a Science Programme for Pre-service Primary Teachers Undertaken in the Context of a Developing Country.

ERIC Educational Resources Information Center

Taylor, Neil; Lucas, Keith B.

2001-01-01

Studied the learning outcomes of a science teaching program for preservice teachers in Fiji using quantitative and qualitative techniques. Results for 24 teachers show that students involved in the constructivist pedagogy generally developed a deeper conceptual understanding of the topic, and in some cases these learning outcomes could be linked…

Learning Outcomes in Higher Education: Assumptions, Positions and the Views of Early-Career Staff in the UK System

ERIC Educational Resources Information Center

Hadjianastasis, Marios

2017-01-01

According to the UK Quality Assurance Agency, the adoption and use of learning outcomes has been complete across UK higher education since 2007, when it declared that "most departments and institutions have fully adopted the principles of learning outcomes". And yet, the evidence from the ground to support this statement is currently…

Learning Processes and Learning Outcomes

DTIC Science & Technology

1992-06-01

establish and maintain activation levels) may process information faster because the relevant traces in long - term memory are already activated...drill and practice, and discovery. Finally, implications for the design of computerized instructional environments are indicated. 14. SUBJECT TERMS lI...outcome. This impact may be direct, or may interact with characteristics of the learner to effect learning outcome. INITIAL STATES Conative and cognitive

The Social Outcomes of Older Adult Learning in Taiwan: Evaluation Framework and Indicators

ERIC Educational Resources Information Center

Lin, Li-Hui

2015-01-01

The purpose of this study is to explore the social outcomes of older adult learning in Taiwan. In light of our society's aging population structure, the task of establishing evaluation framework and indicators for the social outcomes of learning (SOL) as applied to older adults is urgent. In order to construct evaluation indicators for older adult…

A Critical Perspective on Learning Outcomes and the Effectiveness of Experiential Approaches in Entrepreneurship Education: Do we Innovate or Implement?

ERIC Educational Resources Information Center

Scott, Jonathan M; Penaluna, Andy; Thompson, John L

2016-01-01

Purpose: The purpose of this paper is to conduct a critical appraisal of how experiential approaches can more effectively enhance the achievement of desired learning outcomes in entrepreneurship education. In particular, the authors critique whether actual learning outcomes can be profitably used to measure effectiveness; and consider how student…

Women in STEM Majors and Professional Outcome Expectations: The Role of Living-Learning Programs and Other College Environments

ERIC Educational Resources Information Center

Szelényi, Katalin; Denson, Nida; Inkelas, Karen Kurotsuchi

2013-01-01

Using data from the 2004-2007 National Study of Living Learning Programs, the only national dataset offering longitudinal information on outcomes associated with living-learning (L/L) program participation, this study investigated the role of L/L programs and other college environments in the professional outcome expectations of women in science,…

Agents of Change: Examining the Role of Student Learning Outcomes and Assessment Coordinators in California Community Colleges

ERIC Educational Resources Information Center

Gilbert, Greg, Ed.; Buechner, Marybeth, Ed.

2007-01-01

Formally stating and assessing student learning outcomes (SLOs) is a new focus for California community colleges required by the 2002 Accreditation Standards. This paper, the first in a series, explores one aspect of this sea change across the state: the emergence of a new group of faculty leaders, Student Learning Outcomes and Assessment…

Gonadal Identity in the Absence of Pro-Testis Factor SOX9 and Pro-Ovary Factor Beta-Catenin in Mice1

PubMed Central

Nicol, Barbara; Yao, Humphrey H.-C.

2015-01-01

Sex-reversal cases in humans and genetic models in mice have revealed that the fate of the bipotential gonad hinges upon the balance between pro-testis SOX9 and pro-ovary beta-catenin pathways. Our central query was: if SOX9 and beta-catenin define the gonad's identity, then what do the gonads become when both factors are absent? To answer this question, we developed mouse models that lack either Sox9, beta-catenin, or both in the somatic cells of the fetal gonads and examined the morphological outcomes and transcriptome profiles. In the absence of Sox9 and beta-catenin, both XX and XY gonads progressively lean toward the testis fate, indicating that expression of certain pro-testis genes requires the repression of the beta-catenin pathway, rather than a direct activation by SOX9. We also observed that XY double knockout gonads were more masculinized than their XX counterpart. To identify the genes responsible for the initial events of masculinization and to determine how the genetic context (XX vs. XY) affects this process, we compared the transcriptomes of Sox9/beta-catenin mutant gonads and found that early molecular changes underlying the XY-specific masculinization involve the expression of Sry and 21 SRY direct target genes, such as Sox8 and Cyp26b1. These results imply that when both Sox9 and beta-catenin are absent, Sry is capable of activating other pro-testis genes and drive testis differentiation. Our findings not only provide insight into the mechanism of sex determination, but also identify candidate genes that are potentially involved in disorders of sex development. PMID:26108792

The presence of betapapillomavirus antibodies around transplantation predicts the development of keratinocyte carcinoma in organ transplant recipients: a cohort study.

PubMed

Genders, Roel E; Mazlom, Hadi; Michel, Angelika; Plasmeijer, Elsemieke I; Quint, Koen D; Pawlita, Michael; van der Meijden, Els; Waterboer, Tim; de Fijter, Hans; Claas, Frans H; Wolterbeek, Ron; Feltkamp, Mariet C W; Bouwes Bavinck, Jan Nico

2015-05-01

Organ transplant recipients (OTRs) have an increased risk of developing keratinocyte carcinomas (KCs). The aim of this study was to correlate infection with human papillomaviruses (HPVs) belonging to the beta genus (Beta-papillomavirus (Beta-PV)) at transplantation with later development of KCs. In a cohort study, sera collected between 1 year before and 1 year after transplantation of OTRs transplanted between 1990 and 2006 were tested for antibody responses against the L1 capsid antigen of Beta-PV and other HPV genera (Gamma-, Mu-, Nu-, and Alpha-PV) using multiplex serology. The OTRs were followed for a maximum of 22 years. Cox regression models with KC, squamous cell carcinoma (SCC), and basal cell carcinoma (BCC) as outcome variables were used. Out of 445 OTRs, 60 had developed KC: 14 developed only SCC, 24 only BCC, and 22 both types of KC. The time-dependent hazard ratio (HR) to develop either or both types of KC, adjusted for age, sex, and transplanted organ, in tested Beta-PV-seropositive OTR around the time of transplantation compared with Beta-PV-seronegative OTR was 2.9 (95% confidence interval (CI) 1.3-6.4). The HR for SCC was 2.9 (95% CI 0.99-8.5) and for BCC it was 3.1 (95% CI 1.2-8.0). There was also an association between Mu-PV seropositivity and KC, but there were no significant associations between other HPV genera tested and KC. A positive seroresponse for Beta-PV around transplantation significantly predicted the development of KC in OTRs up to 22 years later, providing additional evidence that infection with Beta-PV has a role in KC carcinogenesis.

Agalsidase alfa versus agalsidase beta for the treatment of Fabry disease: an international cohort study

PubMed Central

Biegstraaten, Marieke; Wanner, Christoph; Sirrs, Sandra; Mehta, Atul; Elliott, Perry M; Oder, Daniel; Watkinson, Oliver T; Bichet, Daniel G; Khan, Aneal; Iwanochko, Mark; Vaz, Frédéric M; van Kuilenburg, André B P; West, Michael L; Hughes, Derralynn A; Hollak, Carla E M

2018-01-01

Background Two recombinant enzymes (agalsidase alfa 0.2 mg/kg/every other week and agalsidase beta 1.0 mg/kg/every other week) have been registered for the treatment of Fabry disease (FD), at equal high costs. An independent international initiative compared clinical and biochemical outcomes of the two enzymes. Methods In this multicentre retrospective cohort study, clinical event rate, left ventricular mass index (LVMI), estimated glomerular filtration rate (eGFR), antibody formation and globotriaosylsphingosine (lysoGb3) levels were compared between patients with FD treated with agalsidase alfa and beta at their registered dose after correction for phenotype and sex. Results 387 patients (192 women) were included, 248 patients received agalsidase alfa. Mean age at start of enzyme replacement therapy was 46 (±15) years. Propensity score matched analysis revealed a similar event rate for both enzymes (HR 0.96, P=0.87). The decrease in plasma lysoGb3 was more robust following treatment with agalsidase beta, specifically in men with classical FD (β: −18 nmol/L, P<0.001), persisting in the presence of antibodies. The risk to develop antibodies was higher for patients treated with agalsidase beta (OR 2.8, P=0.04). LVMI decreased in a higher proportion following the first year of agalsidase beta treatment (OR 2.27, P=0.03), while eGFR slopes were similar. Conclusions Treatment with agalsidase beta at higher dose compared with agalsidase alfa does not result in a difference in clinical events, which occurred especially in those with more advanced disease. A greater biochemical response, also in the presence of antibodies, and better reduction in left ventricular mass was observed with agalsidase beta. PMID:29437868

Beta-blocker withdrawal among patients presenting for surgery from home

PubMed Central

Schonberger, Robert B.; Lukens, Carrie L.; Turkoglu, O. Dicle; Feinleib, Jessica L.; Haspel, Kenneth L.; Burg, Matthew M.

2012-01-01

Structured Abstract Objective This study sought to measure the incidence of perioperative beta-blocker non-compliance by patients who were prescribed chronic beta blocker therapy and presented for surgery from home. The effect of patient non-compliance on day of surgery presenting heart rate was also examined. Design Prospective observational study with outcome data obtained from review of the medical record. Setting The preoperative clinic and operating rooms of a Veterans Administration hospital. Participants Patients on chronic beta blocker therapy who presented from home for surgery. Interventions None. Measurements and Main Results Demographic and comorbidity data as well as data on self-reported compliance to beta-blocker therapy, initial day of surgery vital signs, and recent ambulatory vital signs were collected. Ten out of fifty subjects (20%; 95% CI = 9-31%) reported not taking their day of surgery beta-blocker. These self-reported non-adherers demonstrated a higher presenting heart rate on the day of surgery vs. adherent subjects (median of 78 beats per minute vs. 65 beats per minute, p=0.02 by Wilcoxon Rank-Sum Test). The difference-in-difference between baseline primary care and day of surgery heart rate was also statistically significant between compliant and non-compliant subjects (-7 beats per minute vs. +12.5 beats per minute, p<0.00001). Conclusions Patient self-report and physiologic data documented failure to take beta-blockers and possible beta-blocker withdrawal in 20% of patients who presented for surgery from home. If these findings are confirmed in larger studies, improved patient understanding of and compliance with medication instructions during preoperative visits should be a focus of future quality improvement initiatives. PMID:22418043

Learning in Educational Computer Games for Novices: The Impact of Support Provision Types on Virtual Presence, Cognitive Load, and Learning Outcomes

ERIC Educational Resources Information Center

Schrader, Claudia; Bastiaens, Theo

2012-01-01

Embedding support devices in educational computer games has been asserted to positively affect learning outcomes. However, there is only limited direct empirical evidence on which design variations of support provision influence learning. In order to better understand the impact of support design on novices' learning, the current study…

What Role Does Knowledge Quality Play in Online Students' Satisfaction, Learning and Loyalty? An Empirical Investigation in an eLearning Context

ERIC Educational Resources Information Center

Waheed, M.; Kaur, K.; Kumar, S.

2016-01-01

Quality knowledge has an impact on online students learning outcomes and loyalty. A framework that delineates the perceived eLearning knowledge quality (KQ) and its relationship with learning outcomes and loyalty is currently absent. Grounded in the KQ and information system success framework--this study presents the indicators of perceived…

Adapting the Speed of Reproduction of Audio Content and Using Text Reinforcement for Maximizing the Learning Outcome though Mobile Phones

ERIC Educational Resources Information Center

Munoz-Organero, M.; Munoz-Merino, P. J.; Kloos, Carlos Delgado

2011-01-01

The use of technology in learning environments should be targeted at improving the learning outcome of the process. Several technology enhanced techniques can be used for maximizing the learning gain of particular students when having access to learning resources. One of them is content adaptation. Adapting content is especially important when…

Learning Process and Learning Outcomes of Video Podcasts Including the Instructor and PPT Slides: A Chinese Case

ERIC Educational Resources Information Center

Pi, Zhongling; Hong, Jianzhong

2016-01-01

Video podcasts have become one of the fastest developing trends in learning and teaching. The study explored the effect of the presenting mode of educational video podcasts on the learning process and learning outcomes. Prior to viewing a video podcast, the 94 Chinese undergraduates participating in the study completed a demographic questionnaire…

Group Discussions and Test-Enhanced Learning: Individual Learning Outcomes and Personality Characteristics

ERIC Educational Resources Information Center

Stenlund, Tova; Jönsson, Fredrik U.; Jonsson, Bert

2017-01-01

This paper focuses on the factors that are likely to play a role in individual learning outcomes from group discussions, and it includes a comparison featuring test-enhanced learning. A between-groups design (N = 98) was used to examine the learning effects of feedback if provided to discussion groups, and to examine whether group discussions…

Visual Literacy Skills of Students in College-Level Biology: Learning Outcomes Following Digital or Hand-Drawing Activities

ERIC Educational Resources Information Center

Bell, Justine C.

2014-01-01

To test the claim that digital learning tools enhance the acquisition of visual literacy in this generation of biology students, a learning intervention was carried out with 33 students enrolled in an introductory college biology course. This study compared learning outcomes following two types of learning tools: a traditional drawing activity, or…

Patterns and Rates of Learning in Two Problem-Based Learning Courses Using Outcome Based Assessment and Elaboration Theory

ERIC Educational Resources Information Center

Kuruganti, Usha; Needham, Ted; Zundel, Pierre

2012-01-01

The concept of "practice makes perfect" was examined in this work in the context of effective learning. Specifically, we wanted to know how much practice was needed for students to demonstrate mastery of learning outcomes. Student learning patterns in two different university courses that use a similar education approach involving…

Getting to the Root of the Problem in Experiential Learning: Using Problem Solving and Collective Reflection to Improve Learning Outcomes

ERIC Educational Resources Information Center

Miller, Richard J.; Maellaro, Rosemary

2016-01-01

Experiential learning alone does not guarantee that students will accurately conceptualize content, or meet course outcomes in subsequent active experimentation stages. In an effort to more effectively meet learning objectives, the experiential learning cycle was modified with a unique combination of the 5 Whys root cause problem-solving tool and…

The Effectiveness of the Gesture-Based Learning System (GBLS) and Its Impact on Learning Experience

ERIC Educational Resources Information Center

Shakroum, Moamer; Wong, Kok Wai; Fung, Lance Chun Che

2016-01-01

Several studies and experiments have been conducted in recent years to examine the value and the advantage of using the Gesture-Based Learning System (GBLS).The investigation of the influence of the GBLS mode on the learning outcomes is still scarce. Most previous studies did not address more than one category of learning outcomes (cognitive,…

Application of Instructional Design Principles in Developing an Online Information Literacy Curriculum.

PubMed

Mi, Misa

2016-01-01

An online information literacy curriculum was developed as an intervention to engage students in independent study and self-assessment of their learning needs and learning outcomes, develop proficiency in information skills, and foster lifelong learning. This column demonstrates how instructional design principles were applied to create the learning experiences integrated into various courses of the medical curriculum to promote active learning of information skills and maximize self-directed learning outcomes for lifelong learning.

Critical validation studies of neurofeedback.

PubMed

Gruzelier, John; Egner, Tobias

2005-01-01

The field of neurofeedback training has proceeded largely without validation. In this article the authors review studies directed at validating sensory motor rhythm, beta and alpha-theta protocols for improving attention, memory, and music performance in healthy participants. Importantly, benefits were demonstrable with cognitive and neurophysiologic measures that were predicted on the basis of regression models of learning to enhance sensory motor rhythm and beta activity. The first evidence of operant control over the alpha-theta ratio is provided, together with remarkable improvements in artistic aspects of music performance equivalent to two class grades in conservatory students. These are initial steps in providing a much needed scientific basis to neurofeedback.

Does fear extinction in the laboratory predict outcomes of exposure therapy? A treatment analog study.

PubMed

Forcadell, Eduard; Torrents-Rodas, David; Vervliet, Bram; Leiva, David; Tortella-Feliu, Miquel; Fullana, Miquel A

2017-11-01

Fear extinction models have a key role in our understanding of anxiety disorders and their treatment with exposure therapy. Here, we tested whether individual differences in fear extinction learning and fear extinction recall in the laboratory were associated with the outcomes of an exposure therapy analog (ETA). Fifty adults with fear of spiders participated in a two-day fear-learning paradigm assessing fear extinction learning and fear extinction recall, and then underwent a brief ETA. Correlational analyses indicated that enhanced extinction learning was associated with better ETA outcome. Our results partially support the idea that individual differences in fear extinction learning may be associated with exposure therapy outcome, but suggest that further research in this area is needed. Copyright © 2017 Elsevier B.V. All rights reserved.

Learning Robotics in a Science Museum Theatre Play: Investigation of Learning Outcomes, Contexts and Experiences

NASA Astrophysics Data System (ADS)

Peleg, Ran; Baram-Tsabari, Ayelet

2017-12-01

Theatre is often introduced into science museums to enhance visitor experience. While learning in museums exhibitions received considerable research attention, learning from museum theatre has not. The goal of this exploratory study was to investigate the potential educational role of a science museum theatre play. The study aimed to investigate (1) cognitive learning outcomes of the play, (2) how these outcomes interact with different viewing contexts and (3) experiential learning outcomes through the theatrical experience. The play `Robot and I', addressing principles in robotics, was commissioned by a science museum. Data consisted of 391 questionnaires and interviews with 47 children and 20 parents. Findings indicate that explicit but not implicit learning goals were decoded successfully. There was little synergy between learning outcomes of the play and an exhibition on robotics, demonstrating the effect of two different physical contexts. Interview data revealed that prior knowledge, experience and interest played a major role in children's understanding of the play. Analysis of the theatrical experience showed that despite strong identification with the child protagonist, children often doubted the protagonist's knowledge jeopardizing integration of scientific content. The study extends the empirical knowledge and theoretical thinking on museum theatre to better support claims of its virtues and respond to their criticism.

Edutourism Taka Bonerate National Park through Scientific Approach to Improve Student Learning Outcomes

NASA Astrophysics Data System (ADS)

Hayati, R. S.

2017-02-01

This research aim is develop the potential of Taka Bonerate National Park as learning resources through edutourism with scientific approach to improve student learning outcomes. Focus of student learning outcomes are students psychomotor abilities and comprehension on Biodiversity of Marine Biota, Corals Ecosystem, and Conservation topics. The edutourism development products are teacher manual, edutourism worksheet, material booklet, guide’s manual, and Taka Bonerate National Park governor manual. The method to develop edutourism products is ADDIE research and development model that consist of analysis, design, development and production, implementation, and evaluation step. The subjects in the implementation step were given a pretest and posttest and observation sheet to see the effect of edutourism Taka Bonerate National Park through scientific approach to student learning outcomes on Biodiversity of Marine Biota, Corals Ecosystem, and Conservation topics. The data were analyzed qualitative descriptively. The research result is edutourism Taka Bonerate National Park through scientific approach can improve students learning outcomes on Biodiversity of Marine Biota, Corals Ecosystem, and Conservation topics. Edutourism Taka Bonerate National Park can be an alternative of learning method on Biodiversity of Marine Biota, Corals Ecosystem, and Conservation topics.

Half Lives for ``Irradiated'' Nonscience Majors

NASA Astrophysics Data System (ADS)

Geise, Kathleen; Hallam, Peter; Rattray, Rebecca; Stencel, Robert; Wolfe, Tristan

2014-03-01

We launched new hands-on radiation labs to supplement lecture material for undergraduate, non-science majors at the University of Denver to reinforce learning objectives during winter quarter 2014 and in order to help educate the public about nuclear energy decisions. Our learning objectives included: 1. differentiate between particle radiation and electro-magnetic radiation, 2. understand that particle radiation comes in alpha, beta and gamma types, 3. atomic and nuclear structure, 4. decay and half-life, 5. understand safe vs. unsafe doses and issues surrounding nuclear waste disposal. We used prelab surveys, prelab assessments, laboratory write-ups and quizzes to measure success with the learning objectives.

Uneventful pregnancy outcome after enzyme replacement therapy with agalsidase beta in a heterozygous female with Fabry disease: A case report.

PubMed

Germain, Dominique P; Bruneval, Patrick; Tran, Thi-Chien; Balouet, Pierre; Richalet, Bernard; Benistan, Karelle

2010-01-01

No reproductive studies have been performed with enzyme replacement therapy (ERT) for Fabry disease (FD, OMIM 301500), a lysosomal storage disorder. Therefore, use during pregnancy is theoretically contraindicated. We report the first case of agalsidase beta treatment throughout pregnancy. High-range proteinuria remained stable and the patient gave birth to a healthy boy after an uncomplicated pregnancy. The decision to administer ERT during pregnancy should be made on an individual basis, considering the FD status and possible risks. Copyright 2009 Elsevier Masson SAS. All rights reserved.

Connexins and skin disease: insights into the role of beta connexins in skin homeostasis.

PubMed

Martin, Patricia E M; van Steensel, Maurice

2015-06-01

Cell-to-cell communication triggered by connexin channels plays a central role in maintaining epidermal homeostasis. Here, we discuss the role of the beta connexin subgroup, where site-specific mutations in at least 4 of these proteins lead to distinctive non-inflammatory and inflammatory hyperproliferative epidermal disorders. Recent advances in the molecular pathways evoked and correlation with clinical outcome are discussed. The latest data provide increasing evidence that connexins in the epidermis are sensors to environmental stress and that targeting aberrant hemichannel activity holds significant therapeutic potential for inflammatory skin disorders.

Cognitive load imposed by ultrasound-facilitated teaching does not adversely affect gross anatomy learning outcomes.

PubMed

Jamniczky, Heather A; Cotton, Darrel; Paget, Michael; Ramji, Qahir; Lenz, Ryan; McLaughlin, Kevin; Coderre, Sylvain; Ma, Irene W Y

2017-03-01

Ultrasonography is increasingly used in medical education, but its impact on learning outcomes is unclear. Adding ultrasound may facilitate learning, but may also potentially overwhelm novice learners. Based upon the framework of cognitive load theory, this study seeks to evaluate the relationship between cognitive load associated with using ultrasound and learning outcomes. The use of ultrasound was hypothesized to facilitate learning in anatomy for 161 novice first-year medical students. Using linear regression analyses, the relationship between reported cognitive load on using ultrasound and learning outcomes as measured by anatomy laboratory examination scores four weeks after ultrasound-guided anatomy training was evaluated in consenting students. Second anatomy examination scores of students who were taught anatomy with ultrasound were compared with historical controls (those not taught with ultrasound). Ultrasound's perceived utility for learning was measured on a five-point scale. Cognitive load on using ultrasound was measured on a nine-point scale. Primary outcome was the laboratory examination score (60 questions). Learners found ultrasound useful for learning. Weighted factor score on "image interpretation" was negatively, but insignificantly, associated with examination scores [F (1,135) = 0.28, beta = -0.22; P = 0.61]. Weighted factor score on "basic knobology" was positively and insignificantly associated with scores; [F (1,138) = 0.27, beta = 0.42; P = 0.60]. Cohorts exposed to ultrasound had significantly higher scores than historical controls (82.4% ± SD 8.6% vs. 78.8% ± 8.5%, Cohen's d = 0.41, P < 0.001). Using ultrasound to teach anatomy does not negatively impact learning and may improve learning outcomes. Anat Sci Educ 10: 144-151. © 2016 American Association of Anatomists. © 2016 American Association of Anatomists.

Students' Characteristics, Self-Regulated Learning, Technology Self-Efficacy, and Course Outcomes in Online Learning

ERIC Educational Resources Information Center

Wang, Chih-Hsuan; Shannon, David M.; Ross, Margaret E.

2013-01-01

The purpose of this study was to examine the relationship among students' characteristics, self-regulated learning, technology self-efficacy, and course outcomes in online learning settings. Two hundred and fifty-six students participated in this study. All participants completed an online survey that included demographic information, the modified…

Learning Outcomes and Affective Factors of Blended Learning of English for Library Science

ERIC Educational Resources Information Center

Wentao, Chen; Jinyu, Zhang; Zhonggen, Yu

2016-01-01

English for Library Science is an essential course for students to command comprehensive scope of library knowledge. This study aims to compare the learning outcomes, gender differences and affective factors in the environments of blended and traditional learning. Around one thousand participants from one university were randomly selected to…

Unpacking the Learning-Work Nexus: "Priming" as Lever for High-Quality Learning Outcomes in Work-Integrated Learning Curricula

ERIC Educational Resources Information Center

Smith, Calvin; Worsfold, Kate

2015-01-01

This paper describes the impacts of work-integrated learning (WIL) curriculum components on general employability skills--professional work-readiness, self-efficacy and team skills. Regression analyses emphasise the importance of the "authenticity" of WIL placements for the development of these generic outcomes. Other curricula factors…

Six-Word Memoirs: A Content Analysis of First-Year Course Learning Outcomes

ERIC Educational Resources Information Center

Rubin, Lisa

2016-01-01

First-year courses prepare students for the transition to, and success in, college. Institutions are interested in assessing student learning outcomes to achieve institutional goals and maintain accreditation. Though it may be difficult to measure student learning and success, colleges aim to assess student learning in the classroom by setting…

Students' Learning Outcomes and Learning Experiences through Playing a Serious Educational Game

ERIC Educational Resources Information Center

Cheng, Meng-Tzu; Annetta, Len

2012-01-01

This study attempted to examine students' learning outcomes and their learning experiences through playing a Serious Educational Game. A mixed-method research design was employed collecting both quantitative and qualitative data. A total of 98 middle-school students ranging from sixth to eighth grades participated through paper-and-pencil…

Teaching Human Development: A Case for Blended Learning

ERIC Educational Resources Information Center

Cottle, Nathan R.; Glover, Rebecca J.

2011-01-01

This article makes a case for the use of blended learning in teaching human development as a means to encourage higher-order student learning outcomes. The authors review literature regarding the use and effectiveness of blended learning, discuss an illustrative example of a redesign of a human development course, present outcomes from a…

Conversational Moves That Matter: Bridging Learning Outcomes and Patterns of Speech in Informal Cross-Organizational Conversations Among Top-Level Leaders

ERIC Educational Resources Information Center

Hartung, Kyle John; Wilson, Daniel Gray

2016-01-01

Cross-organizational "learning conversations" are an important source of informal learning among professionals, though little is known about whether specific characteristics of conversational interaction contribute to different learning outcomes in such conversations. This mixed-methods study examined the relationship between…

Theoretical Perspectives Underlying the Application of Cooperative Learning in Classrooms

ERIC Educational Resources Information Center

Tran, Van Dat

2013-01-01

Cooperative learning has been the centre of worldwide attention because it has been shown to have strong effects on student learning, as well as other positive outcomes. Although the academic, social, affective and psychological outcomes of students taught by cooperative learning are more positive compared with students taught by the traditional…

Subgroup of ADNI Normal Controls Characterized by Atrophy and Cognitive Decline Associated With Vascular Damage

PubMed Central

Nettiksimmons, Jasmine; Beckett, Laurel; Schwarz, Christopher; Carmichael, Owen; Fletcher, Evan; DeCarli, Charles

2013-01-01

Previous work examining Alzheimer’s Disease Neuroimaging Initiative (ADNI) normal controls using cluster analysis identified a subgroup characterized by substantial brain atrophy and white matter hyperintensities (WMH). We hypothesized that these effects could be related to vascular damage. Fifty-three individuals in the suspected vascular cluster (Normal 2) were compared with 31 individuals from the cluster characterized as healthy/typical (Normal 1) on a variety of outcomes, including magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) biomarkers, vascular risk factors and outcomes, cognitive trajectory, and medications for vascular conditions. Normal 2 was significantly older but did not differ on ApoE4+ prevalence. Normal 2 differed significantly from Normal 1 on all MRI measures but not on Amyloid-Beta1-42 or total tau protein. Normal 2 had significantly higher body mass index (BMI), Hachinksi score, and creatinine levels, and took significantly more medications for vascular conditions. Normal 2 had marginally significantly higher triglycerides and blood glucose. Normal 2 had a worse cognitive trajectory on the Rey’s Auditory Verbal Learning Test (RAVLT) 30-min delay test and the Functional Activity Questionnaire (FAQ). Cerebral atrophy associated with multiple vascular risks is common among cognitively normal individuals, forming a distinct subgroup with significantly increased cognitive decline. Further studies are needed to determine the clinical impact of these findings. PMID:23527743

The Computational Development of Reinforcement Learning during Adolescence

PubMed Central

Palminteri, Stefano; Coricelli, Giorgio; Blakemore, Sarah-Jayne

2016-01-01

Adolescence is a period of life characterised by changes in learning and decision-making. Learning and decision-making do not rely on a unitary system, but instead require the coordination of different cognitive processes that can be mathematically formalised as dissociable computational modules. Here, we aimed to trace the developmental time-course of the computational modules responsible for learning from reward or punishment, and learning from counterfactual feedback. Adolescents and adults carried out a novel reinforcement learning paradigm in which participants learned the association between cues and probabilistic outcomes, where the outcomes differed in valence (reward versus punishment) and feedback was either partial or complete (either the outcome of the chosen option only, or the outcomes of both the chosen and unchosen option, were displayed). Computational strategies changed during development: whereas adolescents’ behaviour was better explained by a basic reinforcement learning algorithm, adults’ behaviour integrated increasingly complex computational features, namely a counterfactual learning module (enabling enhanced performance in the presence of complete feedback) and a value contextualisation module (enabling symmetrical reward and punishment learning). Unlike adults, adolescent performance did not benefit from counterfactual (complete) feedback. In addition, while adults learned symmetrically from both reward and punishment, adolescents learned from reward but were less likely to learn from punishment. This tendency to rely on rewards and not to consider alternative consequences of actions might contribute to our understanding of decision-making in adolescence. PMID:27322574

Interprofessional education for delirium care: a systematic review.

PubMed

Sockalingam, Sanjeev; Tan, Adrienne; Hawa, Raed; Pollex, Heather; Abbey, Susan; Hodges, Brian David

2014-07-01

Recent delirium prevention and treatment guidelines recommend the use of an interprofessional team trained and competent in delirium care. We conducted a systematic review to identify the evidence for the value of interprofessional delirium education programs on learning outcomes. We searched several databases and the grey literature. Studies describing an education intervention, involving two or more healthcare professions and reporting on at least one learning outcome as classified by Kirkpatrick's evaluation framework were included in this review. Ten out of 633 abstracts reviewed met the study inclusion criteria. Several studies reported on more than one learning outcome. Two studies focused on learner reactions to interprofessional delirium education; three studies focused on learning outcomes (e.g. delirium knowledge); six studies focused on learner behavior in practice; and six studies reported on learning results (e.g. patient outcomes), mainly changes in delirium rates post-intervention. Studies reporting changes in patient outcomes following the delirium education intervention used an interprofessional practice (IPP) intervention in combination with interprofessional education (IPE). Our review of the limited evidence suggests that IPE programs may influence team and patient outcomes in delirium care. More systematic studies of the effectiveness of interprofessional delirium education interventions are needed.

The effectiveness of Internet-based e-learning on clinician behaviour and patient outcomes: A systematic review.

PubMed

Sinclair, Peter M; Kable, Ashley; Levett-Jones, Tracy; Booth, Debbie

2016-05-01

The contemporary health workforce has a professional responsibility to maintain competency in practice. However, some difficulties exist with access to ongoing professional development opportunities, particularly for staff in rural and remote areas and those not enrolled in a formal programme of study. E-learning is at the nexus of overcoming these challenges. The benefits of e-learning have been reported in terms of increased accessibility to education, improved self-efficacy, knowledge generation, cost effectiveness, learner flexibility and interactivity. What is less clear, is whether improved self-efficacy or knowledge gained through e-learning influences healthcare professional behaviour or skill development, whether these changes are sustained, and whether these changes improve patient outcomes. To identify, appraise and synthesise the best available evidence for the effectiveness of e-learning programmes on health care professional behaviour and patient outcomes. A systematic review of randomised controlled trials was conducted to assess the effectiveness of e-learning programmes on clinician behaviour and patient outcomes. Electronic databases including CINAHL, Embase, ERIC, MEDLINE, Mosby's Index, Scopus and Cochrane - CENTRAL were searched in July 2014 and again in July 2015. Studies were reviewed and data extracted by two independent reviewers using the Joanna Briggs Institute standardised critical appraisal and data extraction instruments. Seven trials met the inclusion criteria for the analysis. Due to substantial instructional design, subject matter, study population, and methodological variation between the identified studies, statistical pooling was not possible and a meta-analysis could not be performed. Consequently, the findings of this systematic review are presented as a narrative review. The results suggest that e-learning was at least as effective as traditional learning approaches, and superior to no instruction at all in improving health care professional behaviour. There was variation in behavioural outcomes depending on the skill being taught, and the learning approach utilised. No papers were identified that reported the effectiveness of an e-learning programme on patient outcomes. This review found insufficient evidence regarding the effectiveness of e-learning on healthcare professional behaviour or patient outcomes, consequently further research in this area is warranted. Future randomised controlled trials should adhere to the CONSORT reporting guidelines in order to improve the quality of reporting, to allow evaluation of the effectiveness of e-learning programmes on healthcare professional behaviour and patient outcomes. Copyright © 2016 Elsevier Ltd. All rights reserved.

Presence Relates to Distinct Outcomes in Two Virtual Environments Employing Different Learning Modalities

PubMed Central

Persky, Susan; Kaphingst, Kimberly A.; McCall, Cade; Lachance, Christina; Beall, Andrew C.; Blascovich, Jim

2009-01-01

Presence in virtual learning environments (VLEs) has been associated with a number of outcome factors related to a user’s ability and motivation to learn. The extant but relatively small body of research suggests that a high level of presence is related to better performance on learning outcomes in VLEs. Different configurations of form and content variables such as those associated with active (self-driven, interactive activities) versus didactic (reading or lecture) learning may, however, influence how presence operates and on what content it operates. We compared the influence of presence between two types of immersive VLEs (i.e., active versus didactic techniques) on comprehension and engagement-related outcomes. The findings revealed that the active VLE promoted greater presence. Although we found no relationship between presence and learning comprehension outcomes for either virtual environment, presence was related to information engagement variables in the didactic immersive VLE but not the active environment. Results demonstrate that presence is not uniformly elicited or effective across immersive VLEs. Educational delivery mode and environment complexity may influence the impact of presence on engagement. PMID:19366319

Presence relates to distinct outcomes in two virtual environments employing different learning modalities.

PubMed

Persky, Susan; Kaphingst, Kimberly A; McCall, Cade; Lachance, Christina; Beall, Andrew C; Blascovich, Jim

2009-06-01

Presence in virtual learning environments (VLEs) has been associated with a number of outcome factors related to a user's ability and motivation to learn. The extant but relatively small body of research suggests that a high level of presence is related to better performance on learning outcomes in VLEs. Different configurations of form and content variables such as those associated with active (self-driven, interactive activities) versus didactic (reading or lecture) learning may, however, influence how presence operates and on what content it operates. We compared the influence of presence between two types of immersive VLEs (i.e., active versus didactic techniques) on comprehension and engagement-related outcomes. The findings revealed that the active VLE promoted greater presence. Although we found no relationship between presence and learning comprehension outcomes for either virtual environment, presence was related to information engagement variables in the didactic immersive VLE but not the active environment. Results demonstrate that presence is not uniformly elicited or effective across immersive VLEs. Educational delivery mode and environment complexity may influence the impact of presence on engagement.

Disturbance, neutral theory, and patterns of beta diversity in soil communities.

PubMed

Maaß, Stefanie; Migliorini, Massimo; Rillig, Matthias C; Caruso, Tancredi

2014-12-01

Beta diversity describes how local communities within an area or region differ in species composition/abundance. There have been attempts to use changes in beta diversity as a biotic indicator of disturbance, but lack of theory and methodological caveats have hampered progress. We here propose that the neutral theory of biodiversity plus the definition of beta diversity as the total variance of a community matrix provide a suitable, novel, starting point for ecological applications. Observed levels of beta diversity (BD) can be compared to neutral predictions with three possible outcomes: Observed BD equals neutral prediction or is larger (divergence) or smaller (convergence) than the neutral prediction. Disturbance might lead to either divergence or convergence, depending on type and strength. We here apply these ideas to datasets collected on oribatid mites (a key, very diverse soil taxon) under several regimes of disturbances. When disturbance is expected to increase the heterogeneity of soil spatial properties or the sampling strategy encompassed a range of diverging environmental conditions, we observed diverging assemblages. On the contrary, we observed patterns consistent with neutrality when disturbance could determine homogenization of soil properties in space or the sampling strategy encompassed fairly homogeneous areas. With our method, spatial and temporal changes in beta diversity can be directly and easily monitored to detect significant changes in community dynamics, although the method itself cannot inform on underlying mechanisms. However, human-driven disturbances and the spatial scales at which they operate are usually known. In this case, our approach allows the formulation of testable predictions in terms of expected changes in beta diversity, thereby offering a promising monitoring tool.

A Report from the Higher Education Review Board (HERB): Assessment of Undergraduate Student Learning Outcomes in Food Science

ERIC Educational Resources Information Center

Hartel, R. W.; Iwaoka, W. T.

2016-01-01

For the past 15 years, Institute of Food Technologists (IFT) has mandated assessment of undergraduate student learning outcomes as the basis for approving food science (FS) programs. No longer is a check-off course system sufficient to be an IFT-approved program. The 4 steps to gaining IFT approval include developing learning outcomes for all…

Improving Primary Education in Pakistan: An Examination of the Association between School Autonomy and Children's Learning Outcomes

ERIC Educational Resources Information Center

Rahim, Bushra

2017-01-01

The purpose of this study is to explore the impact of the delegation of financial authority to public primary schools through Parent-Teacher Councils (PTCs) on learning outcomes of primary school children in the Khyber Pakhtunkhwa (KP) province, Pakistan. The learning outcomes were measured in three subject areas (Urdu, English, and Mathematics).…

e-Learning in Advanced Life Support-What factors influence assessment outcome?

PubMed

Thorne, C J; Lockey, A S; Kimani, P K; Bullock, I; Hampshire, S; Begum-Ali, S; Perkins, G D

2017-05-01

To establish variables which are associated with favourable Advanced Life Support (ALS) course assessment outcomes, maximising learning effect. Between 1 January 2013 and 30 June 2014, 8218 individuals participated in a Resuscitation Council (UK) e-learning Advanced Life Support (e-ALS) course. Participants completed 5-8h of online e-learning prior to attending a one day face-to-face course. e-Learning access data were collected through the Learning Management System (LMS). All participants were assessed by a multiple choice questionnaire (MCQ) before and after the face-to-face aspect alongside a practical cardiac arrest simulation (CAS-Test). Participant demographics and assessment outcomes were analysed. The mean post e-learning MCQ score was 83.7 (SD 7.3) and the mean post-course MCQ score was 87.7 (SD 7.9). The first attempt CAS-Test pass rate was 84.6% and overall pass rate 96.6%. Participants with previous ALS experience, ILS experience, or who were a core member of the resuscitation team performed better in the post-course MCQ, CAS-Test and overall assessment. Median time spent on the e-learning was 5.2h (IQR 3.7-7.1). There was a large range in the degree of access to e-learning content. Increased time spent accessing e-learning had no effect on the overall result (OR 0.98, P=0.367) on simulated learning outcome. Clinical experience through membership of cardiac arrest teams and previous ILS or ALS training were independent predictors of performance on the ALS course whilst time spent accessing e-learning materials did not affect course outcomes. This supports the blended approach to e-ALS which allows participants to tailor their e-learning experience to their specific needs. Copyright © 2017 Elsevier B.V. All rights reserved.

Student Attitudes toward Learning, Level of Pre-Knowledge and Instruction Type in a Computer-Simulation: Effects on Flow Experiences and Perceived Learning Outcomes

ERIC Educational Resources Information Center

Winberg, T. Mikael; Hedman, Leif

2008-01-01

Attitudes toward learning (ATL) have been shown to influence students' learning outcomes. However, there is a lack of knowledge about the ways in which the interaction between ATL, the learning situation, and the level of students' prior knowledge influence affective reactions and conceptual change. In this study, a simulation of acid-base…

Evaluating the Effectiveness of Self-Created Student Screencasts as a Tool to Increase Student Learning Outcomes in a Hands-On Computer Programming Course

ERIC Educational Resources Information Center

Powell, Loreen M.; Wimmer, Hayden

2015-01-01

Computer programming is challenging to teach and difficult for students to learn. Instructors have searched for ways to improve student learning in programming courses. In an attempt to foster hands-on learning and to increase student learning outcomes in a programming course, the authors conducted an exploratory study to examine student created…

Compliance, clinical outcome, and quality of life of patients with stable angina pectoris receiving once-daily betaxolol versus twice daily metoprolol: a randomized controlled trial

PubMed Central

Kardas, Przemyslaw

2007-01-01

Background A randomized, controlled trial was conducted in an outpatient setting to examine the effect of beta-blocker dosing frequency on patient compliance, clinical outcome, and health-related quality of life in patients with stable angina pectoris. Methods One hundred and twelve beta-blockers-naive outpatients with stable angina pectoris were randomized to receive betaxolol, 20 mg once daily or metoprolol tartrate, 50 mg twice daily for 8 weeks. The principal outcome measure was overall compliance measured electronically, whereas secondary outcome measures were drug effectiveness and health-related quality of life. Results The overall compliance was 86.5 ± 21.3% in the betaxolol group versus 76.1 ± 26.3% in the metoprolol group (p < 0.01), and the correct number of doses was taken on 84.4 ± 21.6% and 64.0 ± 31.7% of treatment days, respectively (p < 0.0001). The percentage of missed doses was 14.5 ± 21.5% in the once-daily group and 24.8 ± 26.4% in the twice-daily group (p < 0.01). The percentage of doses taken in the correct time window (58.6% vs 42.0%, p = 0.01), correct interdose intervals (77.4% v 53.1%, p < 0.0001), and therapeutic coverage (85.6% vs 73.7%, p < 0.001) were significantly higher in the once-daily group. Both studied drugs had similar antianginal effectiveness. Health-related quality of life improved in both groups, but this increase was more pronounced in the betaxolol arm in some dimensions. Conclusions The study demonstrates that patient compliance with once-daily betaxolol is significantly better than with twice daily metoprolol. Similarly, this treatment provides better quality of life. These results demonstrate possible therapeutic advantages of once-daily over twice-daily beta-blockers in the treatment of stable angina pectoris. PMID:17580734

ME science as mobile learning based on virtual reality

NASA Astrophysics Data System (ADS)

Fradika, H. D.; Surjono, H. D.

2018-04-01

The purpose of this article described about ME Science (Mobile Education Science) as mobile learning application learning of Fisika Inti. ME Science is a product of research and development (R&D) that was using Alessi and Trollip model. Alessi and Trollip model consists three stages that are: (a) planning include analysis of problems, goals, need, and idea of development product, (b) designing includes collecting of materials, designing of material content, creating of story board, evaluating and review product, (c) developing includes development of product, alpha testing, revision of product, validation of product, beta testing, and evaluation of product. The article describes ME Science only to development of product which include development stages. The result of development product has been generates mobile learning application based on virtual reality that can be run on android-based smartphone. These application consist a brief description of learning material, quizzes, video of material summery, and learning material based on virtual reality.

Playing, Debugging, Learning: A Proposal between Game and Instructional Designs via Extended Prototyping

ERIC Educational Resources Information Center

Gandolfi, Enrico

2018-01-01

This article investigates the phenomenon of open and participative development (e.g. beta testing, Kickstarter projects)--i.e. extended prototyping--in digital entertainment as a potential source of insights for instructional interventions. Despite the increasing popularity of this practice and the potential implications for educators and…

Older Age as a Prognostic Factor of Attenuated Pain Recovery after Shoulder Arthroscopy

PubMed Central

Simon, Corey B.; Riley, Joseph L.; Coronado, Rogelio A.; Valencia, Carolina; Wright, Thomas W.; Moser, Michael W.; Farmer, Kevin W.; George, Steven Z.

2015-01-01

Background Shoulder pain and surgery are common among older adults. However, the extent to which older age affects recovery after shoulder surgery is not well understood. Objective To assess influence of older age on post-operative recovery factors three and six months after shoulder arthroscopy. Design Prospective Cohort Study Setting Institutional Patients Convenience sample of 139 individuals between 20 and 79 years of age who experienced shoulder pain, musculoskeletal dysfunction based on imaging and physician assessment, and were scheduled for an arthroscopic shoulder procedure. Main Outcome Measures Post-operative outcomes were compared among younger, middle-aged and older adults at pre-surgery, 3 months and 6 months after surgery using ANOVA modeling. Movement-evoked pain and an experimental laboratory correlate of pain processing were assessed at each time point. Older age influence on three and six month pain outcomes were determined via multivariate regression analyses after accounting for pre-operative, intra-operative, and post-operative prognostic factors. Results Older adults had higher movement-evoked pain intensity (F2,108 = 5.18, p=.007) and experimental pain response (F2,111 = 7.24, p=.001) at three months compared to young and middle-aged adults. After controlling for key prognostic factors, older age remained a positive predictor of three-month movement-evoked pain (R2=.05; St. Beta=.263, p=.031) and experimental pain response (R2=.07; St. Beta=.295, p=.014). Further, older age remained a positive predictor of movement-evoked pain at six months (R2=.04; St. Beta=.231, p=.004), despite no age group differences in outcome. Older age was found to be the strongest predictor of three and six month movement-evoked pain. Conclusion Older adults may experience more pain related to movement as well as endogenous pain excitation in the first few months after shoulder arthroscopy. Future age-related research should consider use of movement-evoked pain intensity and experimental pain response as pain outcomes, as well as the utility of such measures in clinical care. PMID:26376336

Assessing learning outcomes and cost effectiveness of an online sleep curriculum for medical students.

PubMed

Bandla, Hari; Franco, Rose A; Simpson, Deborah; Brennan, Kimberly; McKanry, Jennifer; Bragg, Dawn

2012-08-15

Sleep disorders are highly prevalent across all age groups but often remain undiagnosed and untreated, resulting in significant health consequences. To overcome an inadequacy of available curricula and learner and instructor time constraints, this study sought to determine if an online sleep medicine curriculum would achieve equivalent learner outcomes when compared with traditional, classroom-based, face-to-face instruction at equivalent costs. Medical students rotating on a required clinical clerkship received instruction in 4 core clinical sleep-medicine competency domains in 1 of 2 delivery formats: a single 2.5-hour face-to-face workshop or 4 asynchronous e-learning modules. Immediate learning outcomes were assessed in a subsequent clerkship using a multiple-choice examination and standardized patient station, with long-term outcomes assessed through analysis of students' patient write-ups for inclusion of sleep complaints and diagnoses before and after the intervention. Instructional costs by delivery format were tracked. Descriptive and inferential statistical analyses compared learning outcomes and costs by instructional delivery method (face-to-face versus e-learning). Face-to-face learners, compared with online learners, were more satisfied with instruction. Learning outcomes (i.e., multiple-choice examination, standardized patient encounter, patient write-up), as measured by short-term and long-term assessments, were roughly equivalent. Design, delivery, and learner-assessment costs by format were equivalent at the end of 1 year, due to higher ongoing teaching costs associated with face-to-face learning offsetting online development and delivery costs. Because short-term and long-term learner performance outcomes were roughly equivalent, based on delivery method, the cost effectiveness of online learning is an economically and educationally viable instruction platform for clinical clerkships.

Motivation and value influences in the relative balance of goal-directed and habitual behaviours in obsessive-compulsive disorder.

PubMed

Voon, V; Baek, K; Enander, J; Worbe, Y; Morris, L S; Harrison, N A; Robbins, T W; Rück, C; Daw, N

2015-11-03

Our decisions are based on parallel and competing systems of goal-directed and habitual learning, systems which can be impaired in pathological behaviours. Here we focus on the influence of motivation and compare reward and loss outcomes in subjects with obsessive-compulsive disorder (OCD) on model-based goal-directed and model-free habitual behaviours using the two-step task. We further investigate the relationship with acquisition learning using a one-step probabilistic learning task. Forty-eight OCD subjects and 96 healthy volunteers were tested on a reward and 30 OCD subjects and 53 healthy volunteers on the loss version of the two-step task. Thirty-six OCD subjects and 72 healthy volunteers were also tested on a one-step reversal task. OCD subjects compared with healthy volunteers were less goal oriented (model-based) and more habitual (model-free) to reward outcomes with a shift towards greater model-based and lower habitual choices to loss outcomes. OCD subjects also had enhanced acquisition learning to loss outcomes on the one-step task, which correlated with goal-directed learning in the two-step task. OCD subjects had greater stay behaviours or perseveration in the one-step task irrespective of outcome. Compulsion severity was correlated with habitual learning in the reward condition. Obsession severity was correlated with greater switching after loss outcomes. In healthy volunteers, we further show that greater reward magnitudes are associated with a shift towards greater goal-directed learning further emphasizing the role of outcome salience. Our results highlight an important influence of motivation on learning processes in OCD and suggest that distinct clinical strategies based on valence may be warranted.

Incorporating Learning Outcomes into an Introductory Geotechnical Engineering Course

ERIC Educational Resources Information Center

Fiegel, Gregg L.

2013-01-01

The article describes the process of incorporating a set of learning outcomes into a geotechnical engineering course. The outcomes were developed using Bloom's taxonomy and define the knowledge, skills, and abilities the students are expected to achieve upon completion of the course. Each outcome begins with an action-oriented verb corresponding…

Conventional vs. e-learning in nursing education: A systematic review and meta-analysis.

PubMed

Voutilainen, Ari; Saaranen, Terhi; Sormunen, Marjorita

2017-03-01

By and large, in health professions training, the direction of the effect of e-learning, positive or negative, strongly depends on the learning outcome in question as well as on learning methods which e-learning is compared to. In nursing education, meta-analytically generated knowledge regarding the comparisons between conventional and e-learning is scarce. The aim of this review is to discover the size of the effect of e-learning on learning outcomes in nursing education and to assess the quality of studies in which e-learning has been compared to conventional learning. A systematic search of six electronic databases, PubMed, Ovid MEDLINE®, CINAHL (EBSCOhost), Cochrane Library, PsycINFO, and ERIC, was conducted in order to identify relevant peer-reviewed English language articles published between 2011 and 2015. The quality of the studies included as well as the risk of bias in each study was assessed. A random-effects meta-analysis was performed to generate a pooled mean difference in the learning outcome. Altogether, 10 studies were eligible for the quality assessment and meta-analysis. Nine studies were evaluated as good quality studies, but not without a risk of bias. Performance bias caused a high risk in nearly all the studies. In the meta-analysis, an e-learning method resulted in test scores that were, on average, five points higher than a conventional method on a 0-100 scale. Heterogeneity between the studies was very large. The size and direction of the effect of a learning method on learning outcomes appeared to be strongly situational. We suggest that meta-regressions should be performed instead of basic meta-analyses in order to reveal factors that cause variation in the learning outcomes of nursing education. It might be necessary to perform separate meta-analyses between e-learning interventions aimed at improving nursing knowledge and those aimed at improving nursing skills. Copyright © 2016 Elsevier Ltd. All rights reserved.

Integration of reward with cost anticipation during performance monitoring revealed by ERPs and EEG spectral perturbations.

PubMed

Gheza, Davide; De Raedt, Rudi; Baeken, Chris; Pourtois, Gilles

2018-06-01

Effort expenditure has an aversive connotation and it can lower hedonic feelings. In this study, we explored the electrophysiological correlates of the complex interplay of reward processing with cost anticipation. To this aim, healthy adult participants performed a gambling task where the outcome (monetary reward vs. no-reward) and its expectancy were manipulated on a trial by trial basis while 64-channel EEG was recorded. Crucially, on some trials, the no-reward outcome could be transformed to a rewarding one, pending effort expenditure by means of an orthogonal dot clicking task, enabling us to compare at the electrophysiological level reward processing when cost was anticipated or not. We extracted and compared different markers of reward processing at the feedback level using both classical ERPs and EEG spectral perturbations in specific bands (theta, delta and beta-gamma). At the behavioral level, participants reported enhanced pleasure and relief when the outcome was rewarding but effort expenditure could be avoided, relative to a control condition where the outcome was rewarding but no extra effort was anticipated. In this condition, EEG results showed a larger Reward Positivity ERP component and increased power in the Delta and Beta-gamma bands. By comparison, cost anticipation did not influence the processing of the no-reward outcome at the FRN and frontal midline theta levels. All together, these neurophysiological results suggest that effort avoidance is associated with increased reward processing. Copyright © 2018 Elsevier Inc. All rights reserved.

Effects of team-based learning on self-regulated online learning.

PubMed

Whittaker, Alice A

2015-04-10

Online learning requires higher levels of self-regulation in order to achieve optimal learning outcomes. As nursing education moves further into the blended and online learning venue, new teaching/learning strategies will be required to develop and enhance self-regulated learning skills in nursing students. The purpose of this study was to compare the effectiveness of team-based learning (TBL) with traditional instructor-led (IL) learning, on self-regulated online learning outcomes, in a blended undergraduate research and evidence-based practice course. The nonrandomized sample consisted of 98 students enrolled in the IL control group and 86 students enrolled in the TBL intervention group. The percentage of total possible online viewing time was used as the measure of self-regulated online learning activity. The TBL group demonstrated a significantly higher percentage (p < 0.001) of self-regulated learning activities than the IL control group. The TBL group scored significantly higher on the course examinations (p = 0.003). The findings indicate that TBL is an effective instructional strategy that can be used to achieve the essential outcomes of baccalaureate nursing education by increasing self-regulated learning capabilities in nursing students.

Dynamics of EEG functional connectivity during statistical learning.

PubMed

Tóth, Brigitta; Janacsek, Karolina; Takács, Ádám; Kóbor, Andrea; Zavecz, Zsófia; Nemeth, Dezso

2017-10-01

Statistical learning is a fundamental mechanism of the brain, which extracts and represents regularities of our environment. Statistical learning is crucial in predictive processing, and in the acquisition of perceptual, motor, cognitive, and social skills. Although previous studies have revealed competitive neurocognitive processes underlying statistical learning, the neural communication of the related brain regions (functional connectivity, FC) has not yet been investigated. The present study aimed to fill this gap by investigating FC networks that promote statistical learning in humans. Young adults (N=28) performed a statistical learning task while 128-channels EEG was acquired. The task involved probabilistic sequences, which enabled to measure incidental/implicit learning of conditional probabilities. Phase synchronization in seven frequency bands was used to quantify FC between cortical regions during the first, second, and third periods of the learning task, respectively. Here we show that statistical learning is negatively correlated with FC of the anterior brain regions in slow (theta) and fast (beta) oscillations. These negative correlations increased as the learning progressed. Our findings provide evidence that dynamic antagonist brain networks serve a hallmark of statistical learning. Copyright © 2017 Elsevier Inc. All rights reserved.

Two spatiotemporally distinct value systems shape reward-based learning in the human brain.

PubMed

Fouragnan, Elsa; Retzler, Chris; Mullinger, Karen; Philiastides, Marios G

2015-09-08

Avoiding repeated mistakes and learning to reinforce rewarding decisions is critical for human survival and adaptive actions. Yet, the neural underpinnings of the value systems that encode different decision-outcomes remain elusive. Here coupling single-trial electroencephalography with simultaneously acquired functional magnetic resonance imaging, we uncover the spatiotemporal dynamics of two separate but interacting value systems encoding decision-outcomes. Consistent with a role in regulating alertness and switching behaviours, an early system is activated only by negative outcomes and engages arousal-related and motor-preparatory brain structures. Consistent with a role in reward-based learning, a later system differentially suppresses or activates regions of the human reward network in response to negative and positive outcomes, respectively. Following negative outcomes, the early system interacts and downregulates the late system, through a thalamic interaction with the ventral striatum. Critically, the strength of this coupling predicts participants' switching behaviour and avoidance learning, directly implicating the thalamostriatal pathway in reward-based learning.

Case-Based Learning in Virtual Groups--Collaborative Problem Solving Activities and Learning Outcomes in a Virtual Professional Training Course

ERIC Educational Resources Information Center

Kopp, Birgitta; Hasenbein, Melanie; Mandl, Heinz

2014-01-01

This article analyzes the collaborative problem solving activities and learning outcomes of five groups that worked on two different complex cases in a virtual professional training course. In this asynchronous virtual learning environment, all knowledge management content was delivered virtually and collaboration took place through forums. To…

Blended versus Traditional Course Delivery: Comparing Students' Motivation, Learning Outcomes, and Preferences

ERIC Educational Resources Information Center

Tseng, Hungwei; Walsh, Eamonn Joseph, Jr.

2016-01-01

This study sought to compare and assess students' experiences and perceptions in a blended and a traditional course, as well as their level of learning motivation, level of learning outcomes and skills, and learning achievement. Two instructors who were teaching 1 section of an undergraduate English literacy course using the face-to-face format…

A Learner-Centered Grading Method Focused on Reaching Proficiency with Course Learning Outcomes

ERIC Educational Resources Information Center

Toledo, Santiago; Dubas, Justin M.

2017-01-01

Getting students to use grading feedback as a tool for learning is a continual challenge for educators. This work proposes a method for evaluating student performance that provides feedback to students based on standards of learning dictated by clearly delineated course learning outcomes. This method combines elements of standards-based grading…

Student Activity and Learning Outcomes in a Virtual Learning Environment

ERIC Educational Resources Information Center

Romanov, Kalle; Nevgi, Anne

2008-01-01

The aim of the study was to explore the relationship between degree of participation and learning outcomes in an e-learning course on medical informatics. Overall activity in using course materials and degree of participation in the discussion forums of an online course were studied among 39 medical students. Students were able to utilise the…

Online Self-Regulatory Learning Behaviors as a Mediator in the Relationship between Online Course Perceptions with Achievement

ERIC Educational Resources Information Center

Barnard, Lucy; Paton, Valerie; Lan, William

2008-01-01

Positive perceptions of online course communication and collaboration have been associated with better academic outcomes, while self-regulatory learning behaviors have also been linked to academic achievement and other positive learning outcomes. In the current study, we examined whether self-regulatory learning behaviors may be considered as…

Incorporating Meaningful Gamification in a Blended Learning Research Methods Class: Examining Student Learning, Engagement, and Affective Outcomes

ERIC Educational Resources Information Center

Tan, Meng; Hew, Khe Foon

2016-01-01

In this study, we investigated how the use of meaningful gamification affects student learning, engagement, and affective outcomes in a short, 3-day blended learning research methods class using a combination of experimental and qualitative research methods. Twenty-two postgraduates were randomly split into two groups taught by the same…

Using Mobile Technologies for Assessment and Learning in Practice Settings: Outcomes of Five Case Studies

ERIC Educational Resources Information Center

Dearnley, Christine; Taylor, Jill; Hennessy, Scott; Parks, Maria; Coates, Catherine; Haigh, Jackie; Fairhall, John; Riley, Kevin; Dransfield, Mark

2009-01-01

This article presents the outcomes of the Mobile Technologies Pilot Project for the Assessment and Learning in Practice Settings (ALPS) Centre for Excellence in Teaching and Learning (CETL). ALPS is a partnership of five Higher Education Institutions (HEI) that aims to develop and improve assessment, and thereby learning, in practice settings for…

A Cross Sectional Study of the Differences between Generation, Learning Style, Modality and Learning Outcomes within a Faculty Development Program

ERIC Educational Resources Information Center

Weeks, Joseph A., Jr.

2014-01-01

This research project was a descriptive study which measured the differences between generation, learning style, modality of course delivery and learning outcomes of the education sessions for participants in the regional higher education institution's professional development program. This research study focused on the faculty development program…

Opportunities for Learning LEAP Essential Learning Outcomes: A Classroom Ethnography of an Undergraduate Shakespeare through Performance Course

ERIC Educational Resources Information Center

Went, Jeanine Belcastro

2016-01-01

The purpose of this classroom ethnography was to explore what opportunities for learning, aligning with LEAP Essential Learning Outcomes (ELO) categories, could be found in an upper-level theatre course for theatre majors at a small, selective, baccalaureate degree granting institution in the Northeastern United States. Using ethnographic data…

Pros & Cons of Using Blackboard Collaborate for Blended Learning on Students' Learning Outcomes

ERIC Educational Resources Information Center

Hamad, Mona M.

2017-01-01

Blackboard Collaborate was introduced to King Khalid University recently in the last decade; instructors and students were trained to use it in an effective way. The objective of this study is to find pros and cons of using Blackboard Collaborate for Blended Learning and its effect on students' learning outcomes. The researcher used the…

Integrating Culture into Language Teaching and Learning: Learner Outcomes

ERIC Educational Resources Information Center

Nguyen, Trang Thi Thuy

2017-01-01

This paper discusses the issue of learner outcomes in learning culture as part of their language learning. First, some brief discussion on the role of culture in language teaching and learning, as well as on culture contents in language lessons is presented. Based on a detailed review of previous literature related to culture in language teaching…

An Analysis of Learning Rate and Curricular Scope: Caution When Choosing Academic Interventions Based on Aggregated Outcomes

ERIC Educational Resources Information Center

Poncy, Brian C.; Solomon, Benjamin; Duhon, Gary; Skinner, Christopher; Moore, Kathryn; Simons, Sean

2015-01-01

We aggregated and analyzed single-case research targeting math-fact fluency to investigate whether learning (behavior change) data were sufficient to summarize and compare intervention outcomes or if learning rate (learning/cumulative instructional time) data would provide divergent effect size (ES) results. We also extracted the curricular scope…

Learning Anywhere, Anytime: Student Motivators for M-Learning

ERIC Educational Resources Information Center

Martin, Romana; McGill, Tanya; Sudweeks, Fay

2013-01-01

This paper documents the outcomes of a study that focused on identifying what motivates students to use mobile devices for learning and to engage in m-learning. An outcome of this study was to provide a better understanding of what educators should consider when adapting their course for mobile learners. The research included seven classes from…

An Approach to Improving the Learning Experience for First Year Accounting Curriculum

ERIC Educational Resources Information Center

Kirkham, Ross

2013-01-01

The purpose of this paper is to present a theoretical model to address design and assessment of accounting practice sets that will enhance learning and provide clearer learning outcomes for first year accounting students. The paper explores extant literature in developing an action plan that can be followed to maximise learning outcomes for first…

The Relationship between Socio-Economic Status, General Language Learning Outcome, and Beliefs about Language Learning

ERIC Educational Resources Information Center

Ariani, Mohsen Ghasemi; Ghafournia, Narjes

2016-01-01

The objective of this study is to explore the probable relationship between Iranian students' socioeconomic status, general language learning outcome, and their beliefs about language learning. To this end, 350 postgraduate students, doing English for specific courses at Islamic Azad University of Neyshabur participated in this study. They were…

Decoding Learning Gains: Measuring Outcomes and the Pivotal Role of the Major and Student Backgrounds. SERU Project and Consortium Research Paper. Research & Occasional Paper Series: CSHE.5.09

ERIC Educational Resources Information Center

Thomas, Gregg; Douglass, John Aubrey

2009-01-01

Throughout the world, interest in gauging learning outcomes at all levels of education has grown considerably over the past decade. In higher education, measuring "learning outcomes" is viewed by many stakeholders as a relatively new method to judge the "value added" of colleges and universities. The potential to accurately…

The Head Start Child Development and Early Learning Framework: Promoting Positive Outcomes in Early Childhood Programs Serving Children 3-5 Years Old

ERIC Educational Resources Information Center

Office of Head Start, US Department of Health and Human Services, 2010

2010-01-01

This report presents a revision of the Head Start Child Outcomes Framework (2000), renamed The Head Start Child Development and Learning Framework: Promoting Positive Outcomes in Early Childhood Programs Serving Children 3-5 Years Old. The Framework outlines the essential areas of development and learning that are to be used by Head Start programs…

A Proficiency-Based Cost Estimate of Surface Warfare Officer On-the-Job Training

DTIC Science & Technology

2011-12-01

established later in the chapter. 30 b. Proficiency Gained at Initial Training Formal training learning outcomes contribute the most to the initial...different billets call for different levels of training. Additionally, BST learning outcomes are not necessarily based on SWO PQS, and therefore...process. Without knowing BDOC learning outcomes , it is difficult to quantify proficiency-based OJT cost reductions. However, it is certain that

Effect of audience response system technology on learning outcomes in health students and professionals: an updated systematic review.

PubMed

Atlantis, Evan; Cheema, Birinder S

2015-03-01

: Audience response system (ARS) technology is a recent innovation that is increasingly being used by health educators to improve learning outcomes. Equivocal results from previous systematic review research provide weak support for the use of ARS for improving learning outcomes at both short and long terms. This review sought to update and critically review the body of controlled experimental evidence on the use of ARS technology on learning outcomes in health students and professionals. This review searched using all identified keywords both electronic databases (CINAHL, Embase, ERIC, Medline, Science Direct, Scopus, and Web of Science) and reference lists of retrieved articles to find relevant published studies for review, from 2010 to April 2014. A descriptive synthesis of important study characteristics and effect estimates for learning outcomes was done. Three controlled trials in 321 participants from the United States were included for review. ARS knowledge retention scores were lower than the control group in one study, higher than control group provided that immediate feedback was given about each question in one study, and equivalent between intervention and control groups in another study. There is an absence of good quality evidence on effectiveness of ARS technologies for improving learning outcomes in health students and professionals.

The Shape of Deeper Learning: Strategies, Structures, and Cultures in Deeper Learning Network High Schools. Findings from the Study of Deeper Learning Opportunities and Outcomes: Report 1

ERIC Educational Resources Information Center

Huberman, Mette; Bitter, Catherine; Anthony, Jennifer; O'Day, Jennifer

2014-01-01

The "Study of Deeper Learning: Opportunities and Outcomes"--funded by the William and Flora Hewlett Foundation--is a proof-of-concept study, the purpose of which was to determine whether students attending high schools with a mature and at least moderately well implemented approach to promoting deeper learning actually experienced…

Implementing Collaborative Learning in Prelicensure Nursing Curricula: Student Perceptions and Learning Outcomes.

PubMed

Schoening, Anne M; Selde, M Susan; Goodman, Joely T; Tow, Joyce C; Selig, Cindy L; Wichman, Chris; Cosimano, Amy; Galt, Kimberly A

2015-01-01

This study evaluated learning outcomes and student perceptions of collaborative learning in an undergraduate nursing program. Participants in this 3-phase action research study included students enrolled in a traditional and an accelerated nursing program. The number of students who passed the unit examination was not significantly different between the 3 phases. Students had positive and negative perceptions about the use of collaborative learning.

More Than the Sum of Its Parts: A Role for the Hippocampus in Configural Reinforcement Learning.

PubMed

Duncan, Katherine; Doll, Bradley B; Daw, Nathaniel D; Shohamy, Daphna

2018-05-02

People often perceive configurations rather than the elements they comprise, a bias that may emerge because configurations often predict outcomes. But how does the brain learn to associate configurations with outcomes and how does this learning differ from learning about individual elements? We combined behavior, reinforcement learning models, and functional imaging to understand how people learn to associate configurations of cues with outcomes. We found that configural learning depended on the relative predictive strength of elements versus configurations and was related to both the strength of BOLD activity and patterns of BOLD activity in the hippocampus. Configural learning was further related to functional connectivity between the hippocampus and nucleus accumbens. Moreover, configural learning was associated with flexible knowledge about associations and differential eye movements during choice. Together, this suggests that configural learning is associated with a distinct computational, cognitive, and neural profile that is well suited to support flexible and adaptive behavior. Copyright © 2018 Elsevier Inc. All rights reserved.

Trials in the prevention of type 1 diabetes: current and future.

PubMed

Wherrett, Diane K

2014-08-01

A major thrust in type 1 diabetes research is stopping the destruction of beta cells that leads to type 1 diabetes. Research over the past 30 years has defined genetic factors and evidence of autoimmunity that have led to the development of robust prediction models in those at high risk for type 1 diabetes. The ability to identify those at risk and the development of new agents and of collaborative research networks has led to multiple trials aimed at preventing beta cell loss. Trials at all stages of beta cell loss have been conducted: primary prevention (prior to the development of autoimmunity); secondary prevention (after autoantibodies are found) and tertiary prevention (intervening after diagnosis to maintain remaining beta cells). Studies have shown mixed results; evidence of maintained insulin secretion after the time of diagnosis has been described in a number of studies, and primary and secondary prevention is proving to be elusive. Much has been learned from the increasing number of studies in the field in terms of network creation, study design and choice of intervention that will facilitate new avenues of investigation. Copyright © 2014 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

Piperacillin-Tazobactam versus Other Antibacterial Agents for Treatment of Bloodstream Infections Due to AmpC β-Lactamase-Producing Enterobacteriaceae.

PubMed

Cheng, Lucy; Nelson, Brian C; Mehta, Monica; Seval, Nikhil; Park, Sarah; Giddins, Marla J; Shi, Qiuhu; Whittier, Susan; Gomez-Simmonds, Angela; Uhlemann, Anne-Catrin

2017-06-01

In vivo induction of AmpC beta-lactamases produces high-level resistance to many beta-lactam antibiotics in Enterobacteriaceae , often resulting in the need to use carbapenems or cefepime (FEP). The clinical effectiveness of piperacillin-tazobactam (TZP), a weak inducer of AmpC beta-lactamases, is poorly understood. Here, we conducted a case-control study of adult inpatients with bloodstream infections (BSIs) due to Enterobacter , Serratia , or Citrobacter species from 2009 to 2015 to assess outcomes following treatment with TZP compared to FEP or meropenem (MEM). We collected clinical data and screened all isolates for the presence of ampC alleles by PCR. Primary study outcomes were 30-day mortality and persistent bacteremia at ≥72 h from the time of treatment initiation. Of 493 patients with bacteremia, 165 patients met the inclusion criteria, of which 88 were treated with TZP and 77 with FEP or MEM. To minimize differences between covariates, we carried out propensity score matching, which yielded 41 matched pairs. Groups only differed by age, with patients in the TZP group significantly older ( P = 0.012). There were no significant differences in 30-day mortality, persistent bacteremia, 7-day mortality, or treatment escalation between the two treatment groups, including in the propensity score-matched cohort. PCR amplification and sequencing of amp C genes revealed the presence of amp C in isolates with cefoxitin MICs below 16 μg/ml, in particular in Serratia spp., and demonstrated that these alleles were highly genetically diverse. Taken together, TZP may be a valuable treatment option for BSIs due to AmpC beta-lactamase-producing Enterobacteriaceae , diminishing the need for broader-spectrum agents. Future studies are needed to validate these findings. Copyright © 2017 American Society for Microbiology.

Glomerular clusterin is associated with PKC-alpha/beta regulation and good outcome of membranous glomerulonephritis in humans.

PubMed

Rastaldi, M P; Candiano, G; Musante, L; Bruschi, M; Armelloni, S; Rimoldi, L; Tardanico, R; Sanna-Cherchi, S; Cherchi, S Sanna; Ferrario, F; Montinaro, V; Haupt, R; Parodi, S; Carnevali, M L; Allegri, L; Camussi, G; Gesualdo, L; Scolari, F; Ghiggeri, G M

2006-08-01

Mechanisms for human membranous glomerulonephritis (MGN) remain elusive. Most up-to-date concepts still rely on the rat model of Passive Heymann Nephritis that derives from an autoimmune response to glomerular megalin, with complement activation and membrane attack complex assembly. Clusterin has been reported as a megalin ligand in immunodeposits, although its role has not been clarified. We studied renal biopsies of 60 MGN patients by immunohistochemistry utilizing antibodies against clusterin, C5b-9, and phosphorylated-protien kinase C (PKC) isoforms (pPKC). In vitro experiments were performed to investigate the role of clusterin during podocyte damage by MGN serum and define clusterin binding to human podocytes, where megalin is known to be absent. Clusterin, C5b-9, and pPKC-alpha/beta showed highly variable glomerular staining, where high clusterin profiles were inversely correlated to C5b-9 and PKC-alpha/beta expression (P=0.029), and co-localized with the low-density lipoprotein receptor (LDL-R). Glomerular clusterin emerged as the single factor influencing proteinuria at multivariate analysis and was associated with a reduction of proteinuria after a follow-up of 1.5 years (-88.1%, P=0.027). Incubation of podocytes with MGN sera determined strong upregulation of pPKC-alpha/beta that was reverted by pre-incubation with clusterin, serum de-complementation, or protein-A treatment. Preliminary in vitro experiments showed podocyte binding of biotinilated clusterin, co-localization with LDL-R and specific binding inhibition with anti-LDL-R antibodies and with specific ligands. These data suggest a central role for glomerular clusterin in MGN as a modulator of inflammation that potentially influences the clinical outcome. Binding of clusterin to the LDL-R might offer an interpretative key for the pathogenesis of MGN in humans.

Improvement of Fabry Disease-Related Gastrointestinal Symptoms in a Significant Proportion of Female Patients Treated with Agalsidase Beta: Data from the Fabry Registry.

PubMed

Wilcox, William R; Feldt-Rasmussen, Ulla; Martins, Ana Maria; Ortiz, Alberto; Lemay, Roberta M; Jovanovic, Ana; Germain, Dominique P; Varas, Carmen; Nicholls, Katherine; Weidemann, Frank; Hopkin, Robert J

2018-01-01

Fabry disease, an X-linked inherited lysosomal storage disorder, is caused by mutations in the gene encoding α-galactosidase, GLA. In patients with Fabry disease, glycosphingolipids accumulate in various cell types, triggering a range of cellular and tissue responses that result in a wide spectrum of organ involvement. Although variable, gastrointestinal symptoms are among the most common and significant early clinical manifestations; they tend to persist into adulthood if left untreated. To further understand the effects of sustained enzyme replacement therapy (ERT) with agalsidase beta on gastrointestinal symptoms in heterozygotes, a data analysis of female patients enrolled in the Fabry Registry was conducted. To be included, females of any age must have received agalsidase beta (average dose 1.0 mg/kg every 2 weeks) for at least 2.5 years. Measured outcomes were self-reported gastrointestinal symptoms (abdominal pain, diarrhea). Outcomes at baseline and last follow-up, and their change from baseline to last follow-up, were assessed. Relevant data were available for 168 female patients. Mean age at the start of ERT was 43 years and mean treatment duration 5.7 years. Baseline pre-treatment abdominal pain was reported by 45% of females and diarrhea by 39%. At last follow-up, 31% reported abdominal pain (p < 0.01) and 27% diarrhea (p < 0.01). The results of this Fabry Registry analysis suggest that while on sustained treatment with agalsidase beta (1.0 mg/kg every 2 weeks), both abdominal pain and diarrhea improved in many female patients with Fabry disease.

Renal outcomes of agalsidase beta treatment for Fabry disease: role of proteinuria and timing of treatment initiation.

PubMed

Warnock, David G; Ortiz, Alberto; Mauer, Michael; Linthorst, Gabor E; Oliveira, João P; Serra, Andreas L; Maródi, László; Mignani, Renzo; Vujkovac, Bojan; Beitner-Johnson, Dana; Lemay, Roberta; Cole, J Alexander; Svarstad, Einar; Waldek, Stephen; Germain, Dominique P; Wanner, Christoph

2012-03-01

The purpose of this study was to identify determinants of renal disease progression in adults with Fabry disease during treatment with agalsidase beta. Renal function was evaluated in 151 men and 62 women from the Fabry Registry who received agalsidase beta at an average dose of 1 mg/kg/2 weeks for at least 2 years. Patients were categorized into quartiles based on slopes of estimated glomerular filtration rate (eGFR) during treatment. Multivariate logistic regression analyses were used to identify factors associated with renal disease progression. Men within the first quartile had a mean eGFR slope of -0.1 mL/min/1.73m(2)/year, whereas men with the most rapid renal disease progression (Quartile 4) had a mean eGFR slope of -6.7 mL/min/1.73m(2)/year. The risk factor most strongly associated with renal disease progression was averaged urinary protein:creatinine ratio (UP/Cr) ≥1 g/g (odds ratio 112, 95% confidence interval (95% CI) 4-3109, P = 0.0054). Longer time from symptom onset to treatment was also associated with renal disease progression (odds ratio 19, 95% CI 2-184, P = 0.0098). Women in Quartile 4 had the highest averaged UP/Cr (mean 1.8 g/g) and the most rapid renal disease progression: (mean slope -4.4 mL/min/1.73m(2)/year). Adults with Fabry disease are at risk for progressive loss of eGFR despite enzyme replacement therapy, particularly if proteinuria is ≥1 g/g. Men with little urinary protein excretion and those who began receiving agalsidase beta sooner after the onset of symptoms had stable renal function. These findings suggest that early intervention may lead to optimal renal outcomes.

Treatment and management of thyroid storm: analysis of the nationwide surveys: The taskforce committee of the Japan Thyroid Association and Japan Endocrine Society for the establishment of diagnostic criteria and nationwide surveys for thyroid storm.

PubMed

Isozaki, Osamu; Satoh, Tetsurou; Wakino, Shu; Suzuki, Atsushi; Iburi, Tadao; Tsuboi, Kumiko; Kanamoto, Naotetsu; Otani, Hajime; Furukawa, Yasushi; Teramukai, Satoshi; Akamizu, Takashi

2016-06-01

Thyroid storm (TS) is a life-threatening endocrine emergency. This study aimed to achieve a better understanding of the management of TS by analyzing therapeutic modalities and prognoses reported by nationwide surveys performed in Japan. Retrospective analyses were performed on clinical parameters, outcomes, and treatments in 356 TS patients. Patient disease severities assessed via Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores significantly correlated with mortality. Free triiodothyronine (FT3) and the FT3/free thyroxine (FT4) ratio inversely correlated with disease severity. Methimazole (MMI) was used in the majority of patients (78·1%), and there were no significant differences in mortality or disease severity between those treated with MMI and those receiving propylthiouracil (PTU). Patients who received inorganic iodide (KI) demonstrated higher disease severity but no change in mortality compared to those who did not. Patients treated with corticosteroids (CSs) demonstrated significantly higher disease severity and mortality than those who were not. Disease severity in patients treated with intravenous administration of beta-adrenergic antagonists (AAs) was significantly higher than those treated with oral preparations, although no significant difference in mortality was observed between these groups. In addition, mortality was significantly higher in patients treated with non-selective beta-AAs as compared with other types of beta-AAs. In Japan, MMI was preferentially used in TS and showed no disadvantages compared to PTU. In severe TS, multimodal treatment, including administration of antithyroid drugs, KI, CSs and selective beta1 -AAs may be preferable to improve outcomes. © 2015 John Wiley & Sons Ltd.

Stimulus dependent neural oscillatory patterns show reliable statistical identification of autism spectrum disorder in a face perceptual decision task.

PubMed

Castelhano, João; Tavares, Paula; Mouga, Susana; Oliveira, Guiomar; Castelo-Branco, Miguel

2018-05-01

Electroencephalographic biomarkers have been widely investigated in autism, in the search for diagnostic, prognostic and therapeutic outcome measures. Here we took advantage of the information available in temporal oscillatory patterns evoked by simple perceptual decisions to investigate whether stimulus dependent oscillatory signatures can be used as potential biomarkers in autism spectrum disorder (ASD). We studied an extensive set of stimuli (9 categories of faces) and performed data driven classification (Support vector machine, SVM) of ASD vs. Controls with features based on the EEG power responses. We carried out an extensive time-frequency and synchrony analysis of distinct face categories requiring different processing mechanisms in terms of non-holistic vs. holistic processing. We found that the neuronal oscillatory responses of low gamma frequency band, locked to photographic and abstract two-tone (Mooney) face stimulus presentation are decreased in ASD vs. the control group. We also found decreased time-frequency (TF) responses in the beta band in ASD after 350 ms, possibly related to motor preparation. On the other hand, synchrony in the 30-45 Hz band showed a distinct spatial pattern in ASD. These power changes enabled accurate classification of ASD with an SVM approach. SVM accuracy was approximately 85%. ROC curves showed about 94% AUC (area under the curve). Combination of Mooney and Photographic face stimuli evoked features enabled a better separation between groups, reaching an AUC of 98.6%. We identified a relative decrease in EEG responses to face stimuli in ASD in the beta (15-30 Hz; >350 ms) and gamma (30-45 Hz; 55-80 Hz; 50-350 ms) frequency ranges. These can be used as input of a machine learning approach to separate between groups with high accuracy. Future studies can use EEG time-frequency patterns evoked by particular types of faces as a diagnostic biomarker and potentially as outcome measures in therapeutic trials. Copyright © 2018 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

Beta-blockers for hypertension.

PubMed

Wiysonge, C S; Bradley, H; Mayosi, B M; Maroney, R; Mbewu, A; Opie, L H; Volmink, J

2007-01-24

Two recent systematic reviews found first-line beta-blockers to be less effective in reducing the incidence of stroke and the combined endpoint of stroke, myocardial infarction, and death compared to all other antihypertensive drugs taken together. However, beta-blockers might be better or worse than a specific class of drugs for a particular outcome measure so that comparing beta-blockers with all other classes taken together could be misleading. In addition, these systematic reviews did not assess the tolerability of beta-blockers relative to other antihypertensive medications. We thus undertook this review to re-assess the place of beta-blockade as first-line therapy for hypertension relative to each of the other major classes of antihypertensive drugs. To quantify the effectiveness and safety of beta-blockers on morbidity and mortality endpoints in adults with hypertension. We searched eligible studies up to June 2006 in the Cochrane Controlled Trials Register, Medline, Embase, and reference lists of previous reviews, and by contacting hypertension experts. We selected randomised controlled trials which assessed the effectiveness of beta-blockers compared to placebo, no therapy or other drug classes, as monotherapy or first-line therapy for hypertension, on mortality and morbidity endpoints in men and non-pregnant women aged 18 years or older. At least two authors independently applied study selection criteria, assessed study quality, and extracted data; with differences resolved by consensus. We expressed study results as relative risks (RR) with 95% confidence intervals (CI) and conducted quantitative analyses with trial participants in groups to which they were randomly allocated, regardless of which or how much treatment they actually received. In the absence of significant heterogeneity between studies (p>0.1), we performed meta-analysis using a fixed effects method. Otherwise, we used the random effects method and investigated the cause of heterogeneity by stratified analysis. In addition, we used the Higgins statistic (I(2)) to quantify the amount of between-study variability in effect attributable to true heterogeneity rather than chance. Thirteen randomised controlled trials (N=91,561 participants), which met our inclusion criteria, compared beta-blockers to placebo or no treatment (4 trials with 23,613 participants), diuretics (5 trials with 18,241 participants), calcium-channel blockers (CCBs: 4 trials with 44,825 participants), and renin-angiotensin system (RAS) inhibitors (3 trials with 10,828 participants). The risk of all-cause mortality was not different between first-line beta-blockers and placebo (RR 0.99, 95%CI 0.88 to 1.11, I(2)=0%), diuretics or RAS inhibitors, but was higher for beta-blockers compared to CCBs (RR 1.07, 95%CI 1.00 to 1.14, I(2)=2.2%; ARI=0.5%, NNH=200). The risk of total cardiovascular disease (CVD) was lower for first-line beta-blockers compared to placebo (RR 0.88, 95%CI 0.79 to 0.97, I(2)=21.4%, ARR=0.7%, NNT=140). This is primarily a reflection of the significant decrease in stroke (RR 0.80, 95%CI 0.66 to 0.96; I(2)=0%; ARR=0.5%, NNT=200); coronary heart disease (CHD) risk was not significantly different between beta-blockers and placebo. The effect of beta-blockers on CVD was significantly worse than that of CCBs (RR 1.18, 95%CI 1.08 to 1.29, I(2)=0%; ARI=1.3%, NNH=80), but was not significantly different from that of diuretics or RAS inhibitors. Increased total CVD was due to an increase in stroke compared to CCBs (RR 1.24, 95%CI 1.11 to 1.40, I(2)=0%; ARI=0.6%, NNH=180). There was also an increase in stroke with beta-blockers as compared to RAS inhibitors (RR 1.30, 95%CI 1.11 to 1.53, I(2)=29.1%; ARI=1.5%, NNH=65). CHD was not significantly different between beta-blockers and diuretics or CCBs or RAS inhibitors. In addition, patients on beta-blockers were more likely to discontinue treatment due to side effects than those on diuretics (RR 1.86, 95%CI 1.39 to 2.50, I(2)=78.2%, ARI=6.4% NNH=16) and RAS inhibitors (RR 1.41, 95%CI 1.29 to 1.54, I(2)=12.1%; ARI=5.5%, NNH=18), but there was no significant difference with CCBs. The available evidence does not support the use of beta-blockers as first-line drugs in the treatment of hypertension. This conclusion is based on the relatively weak effect of beta-blockers to reduce stroke and the absence of an effect on coronary heart disease when compared to placebo or no treatment. More importantly, it is based on the trend towards worse outcomes in comparison with calcium-channel blockers, renin-angiotensin system inhibitors, and thiazide diuretics. Most of the evidence for these conclusions comes from trials where atenolol was the beta-blocker used (75% of beta-blocker participants in this review). However, it is not known at present whether beta-blockers have differential effects on younger and elderly patients or whether there are differences between the different sub-types of beta-blockers.

The predictive roles of neural oscillations in speech motor adaptability.

PubMed

Sengupta, Ranit; Nasir, Sazzad M

2016-06-01

The human speech system exhibits a remarkable flexibility by adapting to alterations in speaking environments. While it is believed that speech motor adaptation under altered sensory feedback involves rapid reorganization of speech motor networks, the mechanisms by which different brain regions communicate and coordinate their activity to mediate adaptation remain unknown, and explanations of outcome differences in adaption remain largely elusive. In this study, under the paradigm of altered auditory feedback with continuous EEG recordings, the differential roles of oscillatory neural processes in motor speech adaptability were investigated. The predictive capacities of different EEG frequency bands were assessed, and it was found that theta-, beta-, and gamma-band activities during speech planning and production contained significant and reliable information about motor speech adaptability. It was further observed that these bands do not work independently but interact with each other suggesting an underlying brain network operating across hierarchically organized frequency bands to support motor speech adaptation. These results provide novel insights into both learning and disorders of speech using time frequency analysis of neural oscillations. Copyright © 2016 the American Physiological Society.

Effect of Oral Beta-Hydroxy-Beta-Methylbutyrate (HMB) Supplementation on Physical Performance in Healthy Old Women Over 65 Years: An Open Label Randomized Controlled Trial.

PubMed

Berton, Linda; Bano, Giulia; Carraro, Sara; Veronese, Nicola; Pizzato, Simona; Bolzetta, Francesco; De Rui, Marina; Valmorbida, Elena; De Ronch, Irene; Perissinotto, Egle; Coin, Alessandra; Manzato, Enzo; Sergi, Giuseppe

2015-01-01

Although older people are particularly liable to sarcopenia, limited research is available on beta-hydroxy-beta-methylbutyrate (HMB) supplementation in this population, particularly in healthy subjects. In this parallel-group, randomized, controlled, open-label trial, we aimed to evaluate whether an oral supplement containing 1.5 g of calcium HMB for 8 weeks could improve physical performance and muscle strength parameters in a group of community-dwelling healthy older women. Eighty healthy women attending a twice-weekly mild fitness program were divided into two equal groups of 40, and 32 of the treated women and 33 control completed the study. We considered a change in the Short Physical Performance Battery (SPPB) score as the primary outcome and changes in the peak torque (PT) isometric and isokinetic strength of the lower limbs, 6-minute walking test (6MWT), handgrip strength and endurance as secondary outcomes. Body composition was assessed with dual-energy X-ray absorptiometry (DXA) and peripheral quantitative computerized tomography (pQCT). The mean difference between the two groups on pre-post change were finally calculated (delta) for each outcome. After 8 weeks, there were no significant differences between the groups’ SPPB, handgrip strength or DXA parameters. The group treated with HMB scored significantly better than the control group for PT isokinetic flexion (delta = 1.56±1.56 Nm; p = 0.03) and extension (delta = 3.32±2.61 Nm; p = 0.03), PT isometric strength (delta = 9.74±3.90 Nm; p = 0.02), 6MWT (delta = 7.67±8.29 m; p = 0.04), handgrip endurance (delta = 21.41±16.28 s; p = 0.02), and muscle density assessed with pQCT. No serious adverse effects were reported in either group. In conclusion, a nutritional supplement containing 1.5 g of calcium HMB for 8 weeks in healthy elderly women had no significant effects on SPPB, but did significantly improve several muscle strength and physical performance parameters. ClinicalTrials.gov NCT02118181.

Machine Learning Leveraging Genomes from Metagenomes Identifies Influential Antibiotic Resistance Genes in the Infant Gut Microbiome

PubMed Central

Olm, Matthew R.; Morowitz, Michael J.

2018-01-01

ABSTRACT Antibiotic resistance in pathogens is extensively studied, and yet little is known about how antibiotic resistance genes of typical gut bacteria influence microbiome dynamics. Here, we leveraged genomes from metagenomes to investigate how genes of the premature infant gut resistome correspond to the ability of bacteria to survive under certain environmental and clinical conditions. We found that formula feeding impacts the resistome. Random forest models corroborated by statistical tests revealed that the gut resistome of formula-fed infants is enriched in class D beta-lactamase genes. Interestingly, Clostridium difficile strains harboring this gene are at higher abundance in formula-fed infants than C. difficile strains lacking this gene. Organisms with genes for major facilitator superfamily drug efflux pumps have higher replication rates under all conditions, even in the absence of antibiotic therapy. Using a machine learning approach, we identified genes that are predictive of an organism’s direction of change in relative abundance after administration of vancomycin and cephalosporin antibiotics. The most accurate results were obtained by reducing annotated genomic data to five principal components classified by boosted decision trees. Among the genes involved in predicting whether an organism increased in relative abundance after treatment are those that encode subclass B2 beta-lactamases and transcriptional regulators of vancomycin resistance. This demonstrates that machine learning applied to genome-resolved metagenomics data can identify key genes for survival after antibiotics treatment and predict how organisms in the gut microbiome will respond to antibiotic administration. IMPORTANCE The process of reconstructing genomes from environmental sequence data (genome-resolved metagenomics) allows unique insight into microbial systems. We apply this technique to investigate how the antibiotic resistance genes of bacteria affect their ability to flourish in the gut under various conditions. Our analysis reveals that strain-level selection in formula-fed infants drives enrichment of beta-lactamase genes in the gut resistome. Using genomes from metagenomes, we built a machine learning model to predict how organisms in the gut microbial community respond to perturbation by antibiotics. This may eventually have clinical applications. PMID:29359195

New Technique for Barium Daughter Ion Identification in a Liquid Xe-136 Double Beta Decay Experiment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fairbank, William

2016-06-08

This work addresses long-standing issues of fundamental interest in elementary particle physics. The most important outcome of this work is a new limit on neutrinoless double beta decay. This is an extremely rare and long-sought-after type of radioactive decay. If discovered, it would require changes in the standard model of the elementary constituents of matter, and would prove that neutrinos and antineutrinos are the same, a revolutionary concept in particle physics. Neutrinos are major components of the matter in the universe that are so small and so weakly interacting with other matter that their masses have not yet been discovered.more » A discovery of neutrinoless double beta decay could help determine the neutrino masses. An important outcome of the work on this project was the Colorado State University role in operating the EXO-200 neutrinoless double beta decay experiment and in analysis of the data from this experiment. One type of double beta decay of the isotope 136Xe, the two-neutrino variety, was discovered in this work. Although the other type of double beta decay, the neutrinoless variety, was not yet discovered in this work, a world’s best sensitivity of 1.9x10 25 year half-life was obtained. This result rules out a previous claim of a positive result in a different isotope. This work also establishes that the masses of the neutrinos are less than one millionth of that of electrons. A unique EXO-200 analysis, in which the CSU group had a leading role, has established for the first time ever in a liquid noble gas the fraction of daughter atoms from alpha and beta decay that are ionized. This result has important impact on other pending studies, including nucleon decay and barium tagging. Novel additional discoveries include multiphoton ionization of liquid xenon with UV pulsed lasers, which may find application in calibration of future noble liquid detectors, and studies of association and dissociation reactions of Ba + ions in gaseous xenon. Through this project, we are substantially closer to demonstrating “barium tagging”, i.e., detection of single daughter 136Ba atoms from 136Xe double beta decay. Milestones achieved include obtaining spectra of small numbers of Ba atoms and cryoprobe advances toward trapping single 136Ba atoms in solid xenon and probe extraction for detection. One of the other benefits to society is the training of six Ph.D. students in a variety of state-of-the-art technologies, half under primary support of this grant and half with partial support, with four finishing their Ph.D. degrees and two well on their way.« less

Educational outcomes and leadership to meet the needs of modern health care

PubMed Central

Spencer, J; Jordan, R

2001-01-01

If professionals are to be equipped better to meet the needs of modern health care systems and the standards of practice required, significant educational change is still required. Educational change requires leadership, and lack of educational leadership may have impeded change in the past. In practical terms standards refer to outcomes, and thus an outcome based approach to clinical education is advocated as the one most likely to provide an appropriate framework for organisational and system change. The provision of explicit statements of learning intent, an educational process enabling acquisition and demonstration of these, and criteria for ensuring their achievement are the key features of such a framework. The derivation of an appropriate outcome set should emphasise what the learners will be able to do following the learning experience, how they will subsequently approach these tasks, and what, as a professional, they will bring to their practice. Once defined, the learning outcomes should determine, in turn, the nature of the learning experience enabling their achievement and the assessment processes to certify that they have been met. Provision of the necessary educational environment requires an understanding of the close interrelationship between learning style, learning theory, and methods whereby active and deep learning may be fostered. If desired change is to prevail, a conducive educational culture which values learning as well as evaluation, review, and enhancement must be engendered. It is the responsibility of all who teach to foster such an environment and culture, for all practitioners involved in health care have a leadership role in education. Quality in Health Care(Quality in Health Care 2001;10(Suppl II):ii38–ii45) Key Words: leadership; learning; outcome based education PMID:11700378

Proinflammatory genotype of interleukin-1 and interleukin-1 receptor antagonist is associated with ESRD in proteinase 3-ANCA vasculitis patients.

PubMed

Borgmann, Stefan; Endisch, Georg; Hacker, Ulrich T; Song, Bong-Seok; Fricke, Harald

2003-05-01

Small-vessel vasculitides are associated with antineutrophil cytoplasmic antibodies (ANCAs). Cytoplasmic ANCAs are targeted mainly against proteinase 3 (PR3), whereas myeloperoxidase (MPO) is the major antigen of perinuclear ANCAs. These relapsing vasculitides show heterogeneous clinical pictures, and disease severity may vary broadly from mild local organ manifestation to acute organ failure (eg, renal failure). We tested whether two cytokine polymorphisms in the interleukin-1beta (IL-1beta) and IL-1 receptor antagonist (IL-1ra) genes, known to determine cytokine secretion, are associated with clinical manifestations and outcome of ANCA-associated vasculitides. Polymerase chain reaction and restriction fragment length polymorphism analyses were performed to determine polymorphisms in the IL-1beta and IL-1ra genes in 79 patients with PR3-ANCA, 30 patients with MPO-ANCA vasculitis, and 196 healthy controls. The frequency of the so-called proinflammatory genotype, characterized by high secretion of IL-1beta and low secretion of its antagonist IL-1ra, was increased significantly in patients with PR3-ANCA with end-stage renal disease. Patients with a renal manifestation of PR3-ANCA vasculitis have an increased risk for developing end-stage renal disease when carrying the proinflammatory IL-1beta/IL-1ra genotype. Anti-inflammatory therapy specifically antagonizing the proinflammatory effect of IL-1beta may be a promising treatment for patients with Wegener's granulomatosis with renal manifestations.

Immune Interventions to Preserve Beta Cell Function in Type 1 Diabetes

PubMed Central

Ehlers, Mario R.

2015-01-01

Type 1 diabetes (T1D) is a chronic autoimmune disease that leads to destruction of pancreatic beta cells, lifelong dependence on insulin, and increased morbidity and mortality from diabetes-related complications. Preservation of residual beta cells at diagnosis is a major goal because higher levels of endogenous insulin secretion are associated with better short- and long-term outcomes. Over the past 3 decades, a variety of immune interventions have been evaluated in the setting of new-onset T1D, including nonspecific immunosuppression, pathway-specific immune modulation, antigen-specific therapies, and cellular therapies. To date, no single intervention has produced durable remission off-therapy in the majority of treated patients, but the field has gained valuable insights into disease mechanisms and potential immunologic correlates of success. In particular, T cell-directed therapies, including therapies that lead to partial depletion or modulation of effector T (Teff) cells and preservation or augmentation of regulatory T (Treg) cells, have shown the most success and will likely form the backbone of future approaches. The next phase will see evaluation of rational combinations, comprising one or more of the following: a Teff-depleting or modulating drug, a cytokine-based tolerogenic (Treg-promoting) agent, and an antigen-specific component. The long-term goal is to reestablish immunologic tolerance to beta cells, thereby preserving residual beta cells early after diagnosis or enabling restoration of beta cell mass from autologous stem cells or induced neogenesis in patients with established T1D. PMID:26225763

Nonselective Beta-Blockers Do Not Affect Survival in Cirrhotic Patients with Ascites.

PubMed

Facciorusso, Antonio; Roy, Sunil; Livadas, Sarantis; Fevrier-Paul, Adwalia; Wekesa, Clara; Kilic, Ismail Dogu; Chaurasia, Amit Kumar; Sadeq, Mina; Muscatiello, Nicola

2018-05-03

The role of nonselective beta-blockers in cirrhotic patients with ascites has been recently questioned; however, definitive evidence in this regard is still lacking. To analyze published data on the influence of nonselective beta-blockers as compared to control group on survival of cirrhotic patients with ascites. Computerized bibliographic search on the main databases was performed. Hazard ratios from Kaplan-Meier curves were extracted in order to perform an unbiased comparison of survival estimates. Secondary outcomes were mortality in patients with refractory ascites, pooled rate of nonselective beta-blockers interruption, spontaneous bacterial peritonitis and hepato-renal syndrome incidence. Three randomized controlled trials and 13 observational studies with 8279 patients were included. Overall survival was comparable between the two groups (hazard ratio = 0.86, 0.71-1.03, p = 0.11). Study design resulted as the main source of heterogeneity in sensitivity analysis and meta-regression. Mortality in refractory ascites patients was similar in the two groups (odds ratio = 0.90, 0.45-1.79; p = 0.76). No difference in spontaneous bacterial peritonitis (odds ratio = 0.78, 0.47-1.29, p = 0.33) and hepato-renal syndrome incidence (odds ratio = 1.22, 0.48-3.09; p = 0.67) was observed. Pooled rate of nonselective beta-blockers interruption was 18.6% (5.2-32.1%). Based on our findings, nonselective beta-blockers should not be routinely withheld in patients with cirrhosis and ascites, even if refractory.

A Meta-Analysis of Educational Data Mining on Improvements in Learning Outcomes

ERIC Educational Resources Information Center

AlShammari, Iqbal A.; Aldhafiri, Mohammed D.; Al-Shammari, Zaid

2013-01-01

A meta-synthesis study was conducted of 60 research studies on educational data mining (EDM) and their impacts on and outcomes for improving learning outcomes. After an overview, an examination of these outcomes is provided (Romero, Ventura, Espejo, & Hervas, 2008; Romero, "et al.", 2011). Then, a review of other EDM-related research…

Obtaining ABET Student Outcome Satisfaction from Course Learning Outcome Data Using Fuzzy Logic

ERIC Educational Resources Information Center

Imam, Muhammad Hasan; Tasadduq, Imran Ali; Ahmad, Abdul-Rahim; Aldosari, Fahd

2017-01-01

One of the approaches for obtaining the satisfaction data for ABET "Student Outcomes" (SOs) is to transform Course Learning Outcomes (CLOs) satisfaction data obtained through assessment of CLOs to SO satisfaction data. Considering the fuzzy nature of metrics of CLOs and SOs, a Fuzzy Logic algorithm has been proposed to extract SO…

Transfer of learning and patient outcome in simulated crisis resource management: a systematic review.

PubMed

Boet, Sylvain; Bould, M Dylan; Fung, Lillia; Qosa, Haytham; Perrier, Laure; Tavares, Walter; Reeves, Scott; Tricco, Andrea C

2014-06-01

Simulation-based learning is increasingly used by healthcare professionals as a safe method to learn and practice non-technical skills, such as communication and leadership, required for effective crisis resource management (CRM). This systematic review was conducted to gain a better understanding of the impact of simulation-based CRM teaching on transfer of learning to the workplace and subsequent changes in patient outcomes. Studies on CRM, crisis management, crew resource management, teamwork, and simulation published up to September 2012 were searched in MEDLINE(®), EMBASE™, CINAHL, Cochrane Central Register of Controlled Trials, and ERIC. All studies that used simulation-based CRM teaching with outcomes measured at Kirkpatrick Level 3 (transfer of learning to the workplace) or 4 (patient outcome) were included. Studies measuring only learners' reactions or simple learning (Kirkpatrick Level 1 or 2, respectively) were excluded. Two authors independently reviewed all identified titles and abstracts for eligibility. Nine articles were identified as meeting the inclusion criteria. Four studies measured transfer of simulation-based CRM learning into the clinical setting (Kirkpatrick Level 3). In three of these studies, simulation-enhanced CRM training was found significantly more effective than no intervention or didactic teaching. Five studies measured patient outcomes (Kirkpatrick Level 4). Only one of these studies found that simulation-based CRM training made a clearly significant impact on patient mortality. Based on a small number of studies, this systematic review found that CRM skills learned at the simulation centre are transferred to clinical settings, and the acquired CRM skills may translate to improved patient outcomes, including a decrease in mortality.

Synthesis, Characterization, In Vitro Evaluation, and Preclinical Profiling of beta-Cyclodextrin Polyrotaxane Families for Use As Potential Niemann-Pick Type C Therapeutics

NASA Astrophysics Data System (ADS)

Collins, Christopher J.

Niemann-Pick Disease Type C (NPC) is a rare, autosomal recessive genetic disorder featuring a loss of proteins responsible for unesterified cholesterol (UC) trafficking through the late endosomes/lysosomes (LE/LY) of every cell of the body. Disruption of this pathway leads to abnormal accumulation and storage of UC and other lipids. A broad range of visceral and neurological symptoms result from this accumulation exhibiting a variable age of onset and a disease progression that is ultimately fatal. The disease has an incidence of approximately 1 in 120,000 live births and has no known effective treatment. beta-Cyclodextrin (beta-CD) are natural small molecules macrocycles composed of glucose units with a hydrophobic inner cavity and hydrophilic outer rims. beta-CD derivatives have recently been shown to be effective therapeutics for NPC in cellular and animal models. In the mouse model of the disease, beta-CD therapy increases overall lifetime by as much as 50% and slows the progression of neurodegeneration. The progress has led to the initiation of a National Institutes of Health phase I clinical trial. A main drawback of beta-CD administration is the poor pharmacokinetic profile characterized by rapid renal clearance of the drug through the urine. Libraries of beta-CD derivative carrying high molecular weight polyrotaxane (PR) systems have been designed to prevent glomerular filtration of the injected beta-CD dose. An initial family of unmodified beta-CD PRs was synthesized, characterized, and their therapeutic efficacy was tested in NPC fibroblasts. This was followed by screening of PRs consisting of mixed beta-CD derivative threading featuring charged sulfobutylether beta-CD. Finally, we sought to define PR structure-property effects on in vivo pharmacokinetics, biodistribution, toxicity, immunogenicity, and protein hard corona composition. This was accomplished using a family of gadolinium carrying PRs composed of triblock Pluronic co-polymers of varying molecular weights and hydrophilic/lipophilic ratios. The effect of varying threaded beta-CD derivative surface chemistry on PR mediated hemolysis and hard protein corona was also studied. Knowing if structure-property relationships exist in the in vivo performances of PR materials will help with building pre-clinical profile, selecting candidate materials for a given application, and understanding therapeutic outcomes.

Orbitofrontal cortex inactivation impairs between- but not within-session Pavlovian extinction: an associative analysis.

PubMed

Panayi, Marios C; Killcross, Simon

2014-02-01

The orbitofrontal cortex (OFC) is argued to be the neural locus of Pavlovian outcome expectancies. Reinforcement learning theories argue that extinction learning in Pavlovian procedures is caused by the discrepancy between the expected value of the outcome (US) that is elicited by a predictive stimulus (CS), and the lack of experienced US. If the OFC represents Pavlovian outcome expectancies that are necessary for extinction learning, then disrupting OFC function prior to extinction training should impair extinction learning. This was tested. In experiment 1, Long Evans rats received infusions of saline or muscimol targeting the lateral OFC prior to three appetitive Pavlovian extinction sessions. Muscimol infused into the OFC disrupted between-session but not within-session extinction behaviour. This finding was not due to muscimol infusions disrupting the memory consolidation process per se as there was no effect of muscimol infusion when administered immediately post session (experiment 2). These findings support a role for the OFC in representing outcome expectancies that are necessary for learning. A number of ways in which disrupting outcome expectancy information might block learning will be discussed in the context of traditional associative learning theories and the associative structures they depend on. Copyright © 2013 Elsevier Inc. All rights reserved.

Beta-band oscillations during passive listening to metronome sounds reflect improved timing representation after short-term musical training in healthy older adults.

PubMed

Fujioka, Takako; Ross, Bernhard

2017-10-01

Sub-second time intervals in musical rhythms provide predictive cues about future events to performers and listeners through an internalized representation of timing. While the acuity of automatic, sub-second timing as well as cognitively controlled, supra-second timing declines with ageing, musical experts are less affected. This study investigated the influence of piano training on temporal processing abilities in older adults using behavioural and neuronal correlates. We hypothesized that neuroplastic changes in beta networks, caused by training in sensorimotor coordination with timing processing, can be assessed even in the absence of movement. Behavioural performance of internal timing stability was assessed with synchronization-continuation finger-tapping paradigms. Magnetoencephalography (MEG) was recorded from older adults before and after one month of one-on-one training. For neural measures of automatic timing processing, we focused on beta oscillations (13-30 Hz) during passive listening to metronome beats. Periodic beta-band modulations in older adults before training were similar to previous findings in young listeners at a beat interval of 800 ms. After training, behavioural performance for continuation tapping was improved and accompanied by an increased range of beat-induced beta modulation, compared to participants who did not receive training. Beta changes were observed in the caudate, auditory, sensorimotor and premotor cortices, parietal lobe, cerebellum and medial prefrontal cortex, suggesting that increased resources are involved in timing processing and goal-oriented monitoring as well as reward-based sensorimotor learning. © 2017 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

The Error in Total Error Reduction

PubMed Central

Witnauer, James E.; Urcelay, Gonzalo P.; Miller, Ralph R.

2013-01-01

Most models of human and animal learning assume that learning is proportional to the discrepancy between a delivered outcome and the outcome predicted by all cues present during that trial (i.e., total error across a stimulus compound). This total error reduction (TER) view has been implemented in connectionist and artificial neural network models to describe the conditions under which weights between units change. Electrophysiological work has revealed that the activity of dopamine neurons is correlated with the total error signal in models of reward learning. Similar neural mechanisms presumably support fear conditioning, human contingency learning, and other types of learning. Using a computational modelling approach, we compared several TER models of associative learning to an alternative model that rejects the TER assumption in favor of local error reduction (LER), which assumes that learning about each cue is proportional to the discrepancy between the delivered outcome and the outcome predicted by that specific cue on that trial. The LER model provided a better fit to the reviewed data than the TER models. Given the superiority of the LER model with the present data sets, acceptance of TER should be tempered. PMID:23891930

Service-Learning in Nonprofit Organizations: Motivations, Expectations, and Outcomes

ERIC Educational Resources Information Center

Basinger, Nancy; Bartholomew, Keith

2006-01-01

This article applies theories of giving from philanthropic studies to enhance understanding of service-learning relationships between students and community partners. Focusing on the participation motivations, outcome expectations, and satisfaction levels of community partners who have recently completed work with service-learning students, the…

Personality, Organizational Orientations and Self-Reported Learning Outcomes

ERIC Educational Resources Information Center

Bamber, David; Castka, Pavel

2006-01-01

Purpose: To identify competencies connecting personality, organizational orientations and self-reported learning outcomes (as measured by concise Likert-type scales), for individuals who are learning for their organizations. Design/methodology/approach: Five concise factor scales were constructed to represent aspects of personality. Three further…

The use of errorless learning strategies for patients with Alzheimer's disease: a literature review.

PubMed

Li, Ruijie; Liu, Karen P Y

2012-12-01

The aim of this article was to review the evidence of errorless learning on learning outcomes in patients with early-stage Alzheimer's disease. A computer-aided literature search from 1999 to 2011 was carried out using MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO and PsycArticles. Keywords included 'errorless learning or practice' and 'Alzheimer's disease'. Four studies that fulfilled the inclusion criteria were selected and reviewed. Two of the studies were clinical controlled trials: one was a single-group pretest-post-test trial and the other was a multiple single-participant study. Demographic variables, design, treatment and outcome measures were summarized. Recall trials were used as the primary outcome measure. Results indicate that the use of errorless learning promotes better retention of specific types of information. Errorless learning is effective in memory rehabilitation of older adults with Alzheimer's disease. However, it would require more studies with unified outcome measures to allow for the formulation of standardized clinical protocol and recommendations.

Milk-derived or recombinant transforming growth factor-beta has effects on immunological outcomes: a review of evidence from animal experimental studies.

PubMed

Oddy, W H; McMahon, R J

2011-06-01

Identified factors from milk have been shown to improve health outcomes. One specific factor, transforming growth factor-Beta (TGF)-β, has been identified previously as having the potential to impact on immunological outcomes in the newborn offspring. The primary objective of this review was to examine the published studies that have considered TGF-β in association with immunological outcomes of experimental models. We hypothesized that oral administration of TGF-β (through human milk, cow's milk, infant formula) or recombinant TGF-β delivered via gavage, may down-regulate immune activation in newborn offspring. Animal experimental studies were identified through MEDLINE, CAB Abstracts, Biological Abstracts and Scopus. Selection criteria included well-described animal populations, sample and study design, source of TGF-β, age and immunological outcomes measured and effect size. The findings were summarized temporally in tabular format, giving an overall measure of effect based on the literature available since 1994. Animal experimental studies (n=13) were included in the review to determine an association between maternal TGF-β and immunological outcomes. Overall 92% of these studies (12/13) showed a positive association with TGF-β1 or TGF-β2, demonstrating protection against immunologically related outcomes in early life in an animal model. TGF-β is important in developing and maintaining appropriate immune responses in the offspring. TGF-β delivered orally to neonatal animals provides protection against adverse immunological outcomes, corroborating and supporting findings from human studies. Animal studies provide important clues to the pathogenesis and therapeutics of immune activation and allergy in early childhood. TGF-βs are important growth factors involved in maintaining homeostasis in the intestine, regulating inflammation and allergy development and promoting oral tolerance in infants. Thus, taken as a whole, these and our other findings suggest that this cytokine in milk may influence the development of immunological outcomes in offspring. © 2011 Blackwell Publishing Ltd.

Clinical Outcomes of Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae Infections with Susceptibilities among Levofloxacin, Cefepime, and Carbapenems

PubMed Central

Walker, Kristy J.; Klar, Amanda R.

2018-01-01

Purpose Highly resistant Gram-negative bacterial infections are associated with high mortality. Increasing resistance to standard therapy illustrates the need for alternatives when treating resistant organisms, especially extended-spectrum beta-lactamase- (ESBL-) producing Enterobacteriaceae. Methods A retrospective chart review at a community hospital was performed. Patients who developed ESBL-producing infections were included. Patients less than eighteen years old, who were pregnant, or who were incarcerated were excluded. The primary outcome was hospital mortality. The secondary outcomes included intensive care unit (ICU) mortality, ICU length of stay, and hospital length of stay. Results 113 patients with ESBL-producing infections met the criteria for review. Hospital mortality: carbapenem (16.6%), cefepime (0%), and levofloxacin (15.3%) (p=0.253). ICU mortality: carbapenem (4.5%), cefepime, (0%), and levofloxacin (3.7%) (p=0.616). Mean ICU and hospital length of stay: carbapenem (9.8 ± 16, 12.1 ± 1 days), cefepime (7.8 ± 6, 11.1 ± 10.5 days), and levofloxacin (5.4 ± 4.1, 11.1 ± 10.4 days) (p=0.805, 0.685). No predictors were clearly found between the source of infection and mortality. Conclusion Cefepime or levofloxacin can be a potential alternative agent for infections with ESBL-producing Enterobacteriaceae, and larger clinical trials investigating these outcomes are warranted. PMID:29670677