The Nature and Role of Physical Models in Enhancing Sixth Grade Students\u27 Mental Models of Groundwater and Groundwater Processes

Through a non-experimental descriptive and comparative mixed-methods approach, this study investigated the experiences of sixth grade earth science students with groundwater physical models through an extended SE learning cycle format. The data collection was based on a series of quantitative and qualitative research tools intended to investigate students\u27 ideas and changes in ideas rather than measure their achievement. The measures included a groundwater survey, classroom observations, and one-on-one follow-up student interviews for triangulation of data sources. The research was carried out at a K-12 independent school in eastern Virginia using two classes of sixth grade earth science students (n=30). The findings suggest that physical models help students identify the components porosity and permeability with respect to water flow in groundwater systems. Higher levels of system thinking were best demonstrated in model components that allowed students to experience groundwater pollution activities and pumping groundwater wells. However, the results also indicated that due to model constraints, students can develop misconceptions during the use of physical models, specifically more complex physical models as in the Groundwater Exploration Activity Model. A pure discovery learning format while using physical models without guidance or formative assessment probes can lead to misconceptions about groundwater processes as well as confusion between model attributes and real world groundwater systems. The implications of this study relate directly to the inclusion of groundwater in the new national science standards released in 2011; A Framework for K-12 Science Standard; Practices, Crosscutting Concepts, and Core Ideas (NRC, 2011). The new national standards, as in other educational reform efforts, will have the ability to affect curricular and instructional strategies in science education. From the results of this study, it was concluded that best practices for using groundwater physical models in groundwater instruction should be through an inquiry based approach such as a 5E learning cycle, that includes both teacher guidance and feedback during model activities and incorporates an Express phase with extensive formative assessment probes for student reflection of their learning process

The Impact of Mentoring on Stress in Higher Education

The aim of this research is to understand the association between stress and involvement in a mentoring relationship within a higher education context. Three studies were carried out, within the same large UK University targeting both mentees and mentors involvement in one particular mentoring scheme, for their views and perceptions about mentoring and stress. The keys findings within this case study are that mentoring does allow both mentors and mentees to feel supported, particularly in times of pressure and stress. Mentoring helps to raise self-awareness, confidence levels and helps further develop professional relationships for both parties. Through engaging in ongoing reflection together, mentors and mentees feel that mentoring has had a positive impact on their work-related stress and has provided them with coping strategies. Ultimately, the suggestion is that involvement in mentoring provides strategies for coping with situations, the opportunity to reflect and leads to feeling valued

Indicators to assess the functionality of clubfoot clinics in low-resource settings: a Delphi consensus approach and pilot study.

Background: This study aims to determine the indicators for assessing the functionality of clubfoot clinics in a low-resource setting. Methods: The Delphi method was employed with experienced clubfoot practitioners in Africa to rate the importance of indicators of a good clubfoot clinic. The consistency among the participants was determined with the intraclass correlation coefficient. Indicators that achieved strong agreement (mean≥9 [SD <1.5]) were included in the final consensus definition. Based on the final consensus definition, a set of questions was developed to form the Functionality Assessment Clubfoot Clinic Tool (FACT). The FACT was used between February and July 2017 to assess the functionality of clinics in the Zimbabwe clubfoot programme. Results: A set of 10 indicators that includes components of five of the six building blocks of a health system-leadership, human resources, essential medical equipment, health information systems and service delivery-was produced. The most common needs identified in Zimbabwe clubfoot clinics were a standard treatment protocol, a process for surgical referrals and a process to monitor dropout of patients. Conclusions: Practitioners had good consistency in rating indicators. The consensus definition includes components of the World Health Organization building blocks of health systems. Useful information was obtained on how to improve the services in the Zimbabwe clubfoot programme

Lessons About Evaluating Health-Coverage Advocacy Across Multiple Campaigns and Foundations

This article draws on a dozen years’ experience in evaluating major consumerhealth advocacy initiatives to build the knowledge base about advocacy evaluation. The authors explain how their evaluations were strengthened by articulating a detailed theory of change and emphasizing assessment of interim outcomes from many perspectives and methods. Even with comprehensive data and integrated analysis, however, some ambiguity in the results is inevitable; there is no completely objective way to determine the effectiveness of an advocacy initiative. Moreover, sometimes solid or even exceptional advocacy efforts do not lead to desired policy outcomes. Advocacy initiatives that fail initially may be groundwork for future opportunities. Evaluators must tell a compelling story about what advocates hope to achieve, how they tried to achieve it, and the extent to which external factors helped or hindered progress. The narrative about why advocates did what they did must describe context and its influence on all aspects of advocacy campaigns, from goal setting to strategy development to implementation

The clinical pharmacology of intranasal l-methamphetamine.

BackgroundWe studied the pharmacology of l-methamphetamine, the less abused isomer, when used as a nasal decongestant.Methods12 subjects self-administered l-methamphetamine from a nonprescription inhaler at the recommended dose (16 inhalations over 6 hours) then at 2 and 4 (32 and 64 inhalations) times this dose. In a separate session intravenous phenylephrine (200 microg) and l-methamphetamine (5 mg) were given to define alpha agonist pharmacology and bioavailability. Physiological, cardiovascular, pharmacokinetic, and subjective effects were measured.ResultsPlasma l-methamphetamine levels were often below the level of quantification so bioavailability was estimated by comparing urinary excretion of the intravenous and inhaled doses, yielding delivered dose estimates of 74.0 +/- 56.1, 124.7 +/- 106.6, and 268.1 +/- 220.5 microg for ascending exposures (mean 4.2 +/- 3.3 microg/inhalation). Physiological changes were minimal and not dose-dependent. Small decreases in stroke volume and cardiac output suggesting mild cardiodepression were seen.ConclusionInhaled l-methamphetamine delivered from a non-prescription product produced minimal effects but may be a cardiodepressant

Assessment of success of the Ponseti method of clubfoot management in sub-Saharan Africa: a systematic review.

BACKGROUND: Clubfoot is one of the most common congenital deformities affecting mobility. It leads to pain and disability if untreated. The Ponseti method is widely used for the correction of clubfoot. There is variation in how the result of clubfoot management is measured and reported. This review aims to determine and evaluate how success with the Ponseti method is reported in sub-Saharan Africa. METHODS: Five databases were examined in August 2017 for studies that met the inclusion criteria of: (1) evaluation of the effect of clubfoot management; (2) use of the Ponseti method; (3) original study undertaken in sub-Saharan Africa; (4) published between 2000 and 2017. We used the PRISMA statement to report the scope of studies. The included studies were categorised according to a hierarchy of study methodologies and a 27-item quality measure identified methodological strengths and weaknesses. The definition of success was based on the primary outcome reported. RESULTS: Seventy-seven articles were identified by the search. Twenty-two articles met the inclusion criteria, of which 14 (64%) reported a primary outcome. Outcomes were predominantly reported though case series and the quality of evidence was low. Clinical assessment was the most commonly reported outcome measure and few studies reported long-term outcome. The literature available to assess success of clubfoot management is characterised by a lack of standardisation of outcomes, with different measures reporting success in 68% to 98% of cases. CONCLUSION: We found variation in the criteria used to define success resulting in a wide range of results. There is need for an agreed definition of good outcome (successful management) following both the correction and the bracing phases of the Ponseti method to establish standards to monitor and evaluate service delivery

Psychosocial concerns and needs of cancer survivors treated at a comprehensive cancer center and a community safety net hospital

The number of cancer survivors in the United States is expected to grow to 18 million by 2020 because of improved cancer treatment outcomes and the aging of the population.[1] Many cancer survivors are at increased risk for cancer recurrence and other adverse long-term physical and psychosocial conditions.[2-5] Disparities in survival are associated with inadequate or no health insurance coverage because individuals are more likely to be diagnosed with cancer at later stages,[6] and higher incidence for some cancers among African Americans.[7] Few studies have examined psychosocial health disparities during cancer survivorship,[8-13] and little is known about how psychosocial factors subsequent to diagnosis affect survival and long-term outcomes. [4,14] While clinical care relevant to survivorship outcomes is advancing, [15, 16] optimal practices for preparing survivors for treatment and transitioning off treatment have yet to be defined. [11, 15, 17] Furthermore, guidance is needed for serving minority and underserved survivor populations where health disparities exist.[7] More data are needed about incidence of adverse outcomes and their determinants, overall and in disparity populations to inform development of best practices for preventive interventions. The purpose of this study was to identify similarities and differences among two groups of survivors in (1) sources of information at time of cancer diagnosis, (2) sources of support used during and after treatment, (3) stressors and challenges during and after treatment, and (4) coping strategies[18] used during and following cancer treatment. These factors might be associated with health services use,[19] and with survivorship disparities.[20] One group was treated at Vanderbilt-Ingram Cancer Center (VICC), an NCI-designated comprehensive cancer center, and the other at Meharry Medical College (MMC), its partner medical setting that serves patients who are mostly publicly-insured and uninsured. Secondary analysis of data from focus group participants was undertaken to address the four study topics and to guide future development of interventions tailored to preferences and needs of diverse survivors

Estimating the Costs of Preventive Interventions

The goal of this article is to improve the practice and reporting of cost estimates of prevention programs. It reviews the steps in estimating the costs of an intervention and the principles that should guide estimation. We then review prior efforts to estimate intervention costs using a sample of well-known but diverse studies. Finally, we illustrate the principles with an example, the Family Bereavement Program. We conclude that example by discussing whether and how the costs of the intervention might differ when implemented in a real-world setting