Community peer-led falls prevention presentations: What do the experts suggest?

Falls among older adults are a major problem. Despite considerable progress in falls prevention research, older adults often show low motivation to engage in recommended preventive strategies. Peer-led falls prevention education for older adults may have potential for bridging the research evidence-practice gap, thereby promoting the uptake of falls prevention strategies. We evaluated peer educators’ presentations of falls prevention education to community-dwelling older adults in regard to established criteria that were consistent with adult learning principles, the framework of health behaviour change, falls prevention guidelines, and recommendations for providing falls prevention information. We conducted a within-stage mixed model study using purposive and snowball sampling techniques to recruit 10 experts to evaluate video recordings of the delivery of three peer-led falls prevention presentations. Each expert viewed three videos and rated them using a questionnaire containing both open-ended and closed items. There was a good level of expert agreement across the questionnaire domains. Though the experts rated some aspects of the presentations highly, they thought that the presentations were mainly didactic in delivery, not consistently personally relevant to the older adult audience, and did not encourage older adults to engage in the preventive strategies that were presented. Based on the experts’ findings, we developed five key themes and recommendations for the effective delivery of peer led falls prevention presentations. These included recommending that peer educators share falls prevention messages in a more interactive and experiential manner and that uptake of strategies should be facilitated by encouraging the older adults to develop a personalised action plan. Findings suggest that if peer-led falls prevention presentations capitalise on older adults’ capability, opportunity, and motivation, the older adults may be more receptive to take up falls prevention messages

Effects of a mechanical engineering design course on students’ motivational features

Diverse learning opportunities and deep engagement are needed to support development of engineering competencies and expertise. Deep engagement evolves from productive and high-quality motivation that derives from both internal and external sources. Motivation to learn is lacking in many fields, like engineering, because it is too often assumed or ignored, rather than explicitly built into course instruction. While the lack of motivation in engineering education is clear in data-like attrition, there is little relevant research that informs the necessary changes for the field. The purpose of this study is to present a systematic approach that explicitly considers motivational elements in engineering courses. First a comprehensive set of motivational characteristics and the interrelationships for productive motivation of mechanical engineering students are identified. Students’ motivational characteristics and profiles of change over time are assessed using a multipoint predictive correlational design. This information is then used to strategically redesign motivational elements of a senior-level mechanical engineering design course. The SUCCESS framework has been used to redesign motivational features of the existing course. This paper reports results of the study, including implications for redesign of other engineering courses. Analysis of the data demonstrates the complexity of motivation in the engineering classroom, which includes addressing implicit and explicit, intrinsic and extrinsic, individual and team interaction and instruction. These elements extend not only to direct communication and interactions of instructor with students but into the full scope of the learning environment, peer-to-peer interactions, grading, (a)synchronous activities, face to face, and virtual communications. Key features of engineering students’ productive (learning and engagement-related) motivational profiles consisted of clusters of perceptual and experiential variables that were strongly correlated with motivational and learning outcomes. Tracking these factors demonstrated that they changed over time. These changes corresponded to perceptions of instructor and peer interactions, which were amenable to instructional intervention and responsive to social modeling. This study also revealed links among engineering students’ perceptions of their field of study, their own development of self-efficacy, and success expectations in both the design course and for their careers. This work revealed important distinctions between engineering students’ self-efficacy for, and engagement in, the course generally and for group tasks more specifically. These newly revealed relationships offer the opportunity to improve engineering instruction and the design of dynamic learning environments that support adaptive skill development.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline

Definitions, pathophysiology, and epidemiology of acute cholangitis and cholecystitis: Tokyo Guidelines

This article discusses the definitions, pathophysiology, and epidemiology of acute cholangitis and cholecystitis. Acute cholangitis and cholecystitis mostly originate from stones in the bile ducts and gallbladder. Acute cholecystitis also has other causes, such as ischemia; chemicals that enter biliary secretions; motility disorders associated with drugs; infections with microorganisms, protozoa, and parasites; collagen disease; and allergic reactions. Acute acalculous cholecystitis is associated with a recent operation, trauma, burns, multisystem organ failure, and parenteral nutrition. Factors associated with the onset of cholelithiasis include obesity, age, and drugs such as oral contraceptives. The reported mortality of less than 10% for acute cholecystitis gives an impression that it is not a fatal disease, except for the elderly and/or patients with acalculous disease. However, there are reports of high mortality for cholangitis, although the mortality differs greatly depending on the year of the report and the severity of the disease. Even reports published in and after the 1980s indicate high mortality, ranging from 10% to 30% in the patients, with multiorgan failure as a major cause of death. Because many of the reports on acute cholecystitis and cholangitis use different standards, comparisons are difficult. Variations in treatment and risk factors influencing the mortality rates indicate the necessity for standardized diagnostic, treatment, and severity assessment criteria