Designing problem-based curricula: The role of concept mapping in scaffolding learning for the health sciences

While the utility of concept mapping has been widely reported in primary and secondary educational contexts, its application in the health sciences in higher education has been less frequently noted. Two case studies of the application of concept mapping in undergraduate and postgraduate health sciences are detailed in this paper. The case in undergraduate dental education examines the role of concept mapping in supporting problem-based learning and explores how explicit induction into the principles and practices of CM has add-on benefits to learning in an inquiry-based curriculum. The case in postgraduate medical education described the utility of concept mapping in an online inquiry-based module design. Specific attention is given to applications of CMapTools™ software to support the implementation of Novakian concept mapping in both inquiry-based curricular contexts.published_or_final_versio

Systematic study of constitutive cyclo-oxygenase-2 expression: role of NFκB and NFAT transcriptional pathways

Cyclooxygenase-2 (COX-2) is an inducible enzyme that drives inflammation and is the therapeutic target for widely used nonsteroidal antiinflammatory drugs (NSAIDs). However, COX-2 is also constitutively expressed, in the absence of overt inflammation, with a specific tissue distribution that includes the kidney, gastrointestinal tract, brain, and thymus. Constitutive COX-2 expression is therapeutically important because NSAIDs cause cardiovascular and renal side effects in otherwise healthy individuals. These side effects are now of major concern globally. However, the pathways driving constitutive COX-2 expression remain poorly understood. Here we show that in the kidney and other sites, constitutive COX-2 expression is a sterile response, independent of commensal microorganisms and not associated with activity of the inflammatory transcription factor NF-κB. Instead, COX-2 expression in the kidney but not other regions colocalized with nuclear factor of activated T cells (NFAT) transcription factor activity and was sensitive to inhibition of calcineurin-dependent NFAT activation. However, calcineurin/NFAT regulation did not contribute to constitutive expression elsewhere or to inflammatory COX-2 induction at any site. These data address the mechanisms driving constitutive COX-2 and suggest that by targeting transcription it may be possible to develop antiinflammatory therapies that spare the constitutive expression necessary for normal homeostatic functions, including those important to the cardiovascular-renal system

Cost-effectiveness of asthma control: an economic appraisal of the GOAL study

<i>Background</i>: The Gaining Optimal Asthma ControL (GOAL) study has shown the superiority of a combination of salmeterol/fluticasone propionate (SFC) compared with fluticasone propionate alone (FP) in terms of improving guideline defined asthma control. <i>Methods</i>: Clinical and economic data were taken from the GOAL study, supplemented with data on health related quality of life, in order to estimate the cost per quality adjusted life year (QALY) results for each of three strata (previously corticosteroid-free, low- and moderate-dose corticosteroid users). A series of statistical models of trial outcomes was used to construct cost effectiveness estimates across the strata of the multinational GOAL study including adjustment to the UK experience. Uncertainty was handled using the non-parametric bootstrap. Cost-effectiveness was compared with other treatments for chronic conditions. <i>Result</i>: Salmeterol/fluticasone propionate improved the proportion of patients achieving totally and well-controlled weeks resulting in a similar QALY gain across the three strata of GOAL. Additional costs of treatment were greatest in stratum 1 and least in stratum 3, with some of the costs offset by reduced health care resource use. Cost-effectiveness by stratum was £7600 (95% CI: £4800–10 700) per QALY gained for stratum 3; £11 000 (£8600–14 600) per QALY gained for stratum 2; and £13 700 (£11 000–18 300) per QALY gained for stratum 1. <i>Conclusion</i>: The GOAL study previously demonstrated the improvement in total control associated with the use of SFC compared with FP alone. This study suggests that this improvement in control is associated with cost-per-QALY figures that compare favourably with other uses of scarce health care resources

Graduates' perceived preparedness for dental practice from PBL and traditional curricula

The objective of this study was to compare dental graduates' perceived preparedness for practice after being educated in a problem-based learning (PBL) curriculum with those who graduated from a traditional undergraduate curriculum, both at the University of Hong Kong. A cohort of graduates from the traditional dental curriculum (1997-2001) and a cohort of graduates from the PBL curriculum (2004-08) rated their self-perceived preparedness for dental practice in fifty-nine aspects of dentistry across nine domains. Perceived preparedness for dental practice was compared at domain and item levels (accounting for multiple comparisons) using chi-square statistics. Both cohorts felt well prepared for the "bread and butter" aspects of dentistry, but less so for specific specialty disciplines. There was no significant difference between PBL and traditional graduates' self-perceived preparedness in eight of the nine domains of dental practice (P>0.05). However, in the area of orthodontics, both cohorts felt ill-prepared for practice and more so among the PBL cohort (P>0.01). For the most part, regardless of curriculum design, these dental graduates perceived themselves to be well prepared for dental practice.published_or_final_versio

Periodontal Risk Spider-web for periodontal assessment in Hong Kong Chinese

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Clinical trials on the effectiveness of an innovative powered toothbrush

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IL-1β, TNF-α and IL-10 mRNA expression in advanced chronic periodontitis

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The adjunctive use of Chinese medicine in non-surgical periodontal therapy

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Effects of short-term treatment with atorvastatin in smokers with asthma - a randomized controlled trial

<b>Background</b> The immune modulating properties of statins may benefit smokers with asthma. We tested the hypothesis that short-term treatment with atorvastatin improves lung function or indices of asthma control in smokers with asthma.<p></p> <b>Methods</b> Seventy one smokers with mild to moderate asthma were recruited to a randomized double-blind parallel group trial comparing treatment with atorvastatin (40 mg per day) versus placebo for 4 weeks. After 4 weeks treatment inhaled beclometasone (400 ug per day) was added to both treatment arms for a further 4 weeks. The primary outcome was morning peak expiratory flow after 4 weeks treatment. Secondary outcome measures included indices of asthma control and airway inflammation.<p></p> <b>Results</b> At 4 weeks, there was no improvement in the atorvastatin group compared to the placebo group in morning peak expiratory flow [-10.67 L/min, 95% CI -38.70 to 17.37, p=0.449], but there was an improvement with atorvastatin in asthma quality of life score [0.52, 95% CI 0.17 to 0.87 p=0.005]. There was no significant improvement with atorvastatin and inhaled beclometasone compared to inhaled beclometasone alone in outcome measures at 8 weeks.<p></p> <b>Conclusions</b> Short-term treatment with atorvastatin does not alter lung function but may improve asthma quality of life in smokers with mild to moderate asthma. Clinicaltrials.gov identifier: NCT0046382

A study of data-driven momentum and disposition effects in the Chinese stock market by functional data analysis

We apply a functional data analysis approach to decompose the cross-sectional Fama–French three-factor model residuals in the Chinese stock market. Our results indicate that other than Fama–French three factors, there are two orthonormal asset pricing factors describing the behavioral biases in their historical performances: between winner and loser stocks, and extreme and mediocre-performing stocks, respectively. We explain these two factors through investors’ overreaction, overconfidence and the lead-lag effect. These findings empirically show the existence of momentum and disposition effects in the Chinese stock market. A buy-and-hold mean-variance optimized portfolio incorporating these two market anomalies boosts the Sharpe ratio to 1.27