A randomised controlled trial of supplemental oxygen versus medical air during exercise training in people with chronic obstructive pulmonary disease: Supplemental oxygen in pulmonary rehabilitation trial (SuppORT) (Protocol)

© 2016 Alison et al. Background: Oxygen desaturation during exercise is common in people with chronic obstructive pulmonary disease (COPD). The aim of the study is to determine, in people with COPD who desaturate during exercise, whether supplemental oxygen during an eight-week exercise training program is more effective than medical air (sham intervention) in improving exercise capacity and health-related quality of life both at the completion of training and at six-month follow up. Methods/Design: This is a multi-centre randomised controlled trial with concealed allocation, blinding of participants, exercise trainers and assessors, and intention-to-treat analysis. 110 people with chronic obstructive pulmonary disease who demonstrate oxygen desaturation lower than 90 % during the six-minute walk test will be recruited from pulmonary rehabilitation programs in seven teaching hospitals in Australia. People with chronic obstructive pulmonary disease on long term oxygen therapy will be excluded. After confirmation of eligibility and baseline assessment, participants will be randomised to receive either supplemental oxygen or medical air during an eight-week supervised treadmill and cycle exercise training program, three times per week for eight weeks, in hospital outpatient settings. Primary outcome measures will be endurance walking capacity assessed by the endurance shuttle walk test and health-related quality of life assessed by the Chronic Respiratory Disease Questionnaire. Secondary outcomes will include peak walking capacity measured by the incremental shuttle walk test, dyspnoea via the Dyspnoea-12 questionnaire and physical activity levels measured over seven days using an activity monitor. All outcomes will be measured at baseline, completion of training and at six-month follow up. Discussion: Exercise training is an essential component of pulmonary rehabilitation for people with COPD. This study will determine whether supplemental oxygen during exercise training is more effective than medical air in improving exercise capacity and health-related quality of life in people with COPD who desaturate during exercise. Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12612000395831 , 5th Jan,201

Defining Natural History: Assessment of the Ability of College Students to Aid in Characterizing Clinical Progression of Niemann-Pick Disease, Type C

Niemann-Pick Disease, type C (NPC) is a fatal, neurodegenerative, lysosomal storage disorder. It is a rare disease with broad phenotypic spectrum and variable age of onset. These issues make it difficult to develop a universally accepted clinical outcome measure to assess urgently needed therapies. To this end, clinical investigators have defined emerging, disease severity scales. The average time from initial symptom to diagnosis is approximately 4 years. Further, some patients may not travel to specialized clinical centers even after diagnosis. We were therefore interested in investigating whether appropriately trained, community-based assessment of patient records could assist in defining disease progression using clinical severity scores. In this study we evolved a secure, step wise process to show that pre-existing medical records may be correctly assessed by non-clinical practitioners trained to quantify disease progression. Sixty-four undergraduate students at the University of Notre Dame were expertly trained in clinical disease assessment and recognition of major and minor symptoms of NPC. Seven clinical records, randomly selected from a total of thirty seven used to establish a leading clinical severity scale, were correctly assessed to show expected characteristics of linear disease progression. Student assessment of two new records donated by NPC families to our study also revealed linear progression of disease, but both showed accelerated disease progression, relative to the current severity scale, especially at the later stages. Together, these data suggest that college students may be trained in assessment of patient records, and thus provide insight into the natural history of a disease

Students’ views of uncertainty in formal and personal science

Background: Uncertainty is a crucial element of scientific knowledge growth. Students should have some understanding of how science knowledge is developed and why scientific conclusions are considered more or less certain than others. A component of the nature of science, it is considered an important aspect of science education and allows students to recognize the limitations of scientific research. Purpose: This study examined Grades 5 and 9 students’ views of uncertainty in their personal scientific research and the formal scientific research of professionals. Sample: This study included 33 students in Grade 5 (n = 17) and Grade 9 (n = 16). The students were recruited from a charter school that emphasised inquiry instruction. Design and methods: Data were collected through interviews. Students were asked their views of their inquiry-based projects and their views of professional science. Results: Interview data and statistical analyses indicated that students recognized uncertainty in personal science, which varied across elements of the scientific process. Additionally, their views of uncertainty in formal science tended to change across grades and knowledge of uncertainty in personal and formal science were positively correlated. Conclusion: These findings offer insights into the processes by which students come to understand uncertainty in science and point to ways of fostering such knowledge through teaching practices

Gender differences in preschoolers’ understanding of the concept of life

This study investigated gender differences in North American preschoolers’ biological reasoning about the concept of ‘life’. Four-year-olds (M = 4.6, SD = 3.3 months) and five-year-olds (M = 5.6, SD = 3.8 months) were asked about the function of 13 body parts, organs, and bodily processes. Results indicated that the likelihood of mentioning the importance of body parts, organs, and bodily processes for maintaining life or preventing death was predicted by age. A concept of life was more likely to occur in boys rather than girls. Although boys had a greater understanding of life they did not outperform girls in their responses to organ/ body part function. The results demonstrate that gender differences in biological reasoning emerge during the preschool years. Implications for early science education are discussed

Teaching preschoolers about inheritance

This study aimed to promote advanced reasoning about biological inheritance in four- and five-year-olds. A total of 78 preschoolers (Experimental n = 40; Comparison n = 38) completed pre- and post-test versions of two biological reasoning tasks. The Experimental condition received 15 lessons on biological inheritance, whereas the Comparison condition received regular story time activities. The results showed that the Experimental group outperformed the Comparison group at post- test. Overall, the results are an encouraging indication that an increased understanding of biological inheritance can be effectively supported in preschool years

The Contribution of Trade Books to Early Science Literacy: In and Out of School

Lifelong science literacy begins with attitudes and interests established early in childhood. The use of trade books (i.e., a literary work intended for sale to the general public) in North American school classrooms to support the development of science literacy invites an examination of the quality of science content disseminated to students. A total of 116 trade books were examined to: (a) determine the degree to which science trade books complement expected science knowledge outcomes outlined in school curricula, and (b) compare trade book content to the goals of scientific literacy. Analysis across four science topics, Dinosaurs, Space, Inheritance, and Growth and Life Properties, revealed that this body of children’s literature is inconsistent in its coverage of curricular goals and elements of scientific literacy. Because trade books represent children’s first exposure to science, these shortcomings should be addressed if these books are to be maximally effective in promoting science literacy. Implications for using trade books in the classroom are discussed

Storytelling as a foundation to literacy development for Aboriginal children: Culturally and developmentally appropriate practices

There is substantial evidence that Aboriginal youth face serious challenges in schooling, in general, and in literacy development, specifically. Thus, it is essential to design early literacy programmes that engage Aboriginal children and produce positive outcomes. In this article, the authors propose that such programmes include oral storytelling by teachers and students because it is a precursor to reading and writing across cultures and a traditional Aboriginal teaching tool. Moreover, storytelling fits with Aboriginal epistemology -- the nature of their knowledge, its foundations, scope, and validity. The authors begin by reviewing a representative sample of the research that has examined the outcomes of early literacy instruction with Aboriginal children. Next, the authors describe Aboriginal epistemology, highlighting the role of the oral tradition. Finally, the authors describe an ongoing study aimed at supporting early literacy development through a developmentally and culturally appropriate oral storytelling instruction programme