Problem Solving Incorporated into Blending Learning in Nursing Masters Degree

Online and face-to-face learning are integrated in a teaching format called blended learning. In recent years, educators have begun to use blended learning for a number of education related purposes. Typically, blended learning is used to involve the nurse students in a more active and constructive learning process. In a pilot project, five modules of a Masters nursing course were redesigned and implemented in blending learning format. While redesigning the modules, the first challenge was to assure the balance between online and face-to-face classroom activities. The second was to incorporate problem solving phases into blended learning in an efficient way. Moodle is the learning management system used for the online teaching and learning activities. The preliminary results concern the description of the redesign process of the five modules and their implementation. Some critical issues emerged and they must be corrected to improve the teachers\u2019 involvement and the redesign

Assessing risk of breast cancer in an ethnically South-East Asia population (results of a multiple ethnic groups study)

10.1186/1471-2407-12-529BMC Cancer12-BCMA

Inhibition of Hypoxia-Inducible Factor-1α (HIF-1α) Protein Synthesis by DNA damage inducing agents

10.1371/journal.pone.0010522PLoS ONE55

A New Model of Delirium Care in the Acute Geriatric Setting: Geriatric Monitoring Unit

<p>Abstract</p> <p>Background</p> <p>Delirium is a common and serious condition, which affects many of our older hospitalised patients. It is an indicator of severe underlying illness and requires early diagnosis and prompt treatment, associated with poor survival, functional outcomes with increased risk of institutionalisation following the delirium episode in the acute care setting. We describe a new model of delirium care in the acute care setting, titled Geriatric Monitoring Unit (GMU) where the important concepts of delirium prevention and management are integrated. We hypothesize that patients with delirium admitted to the GMU would have better clinical outcomes with less need for physical and psychotropic restraints compared to usual care.</p> <p>Methods/Design</p> <p>GMU models after the Delirium Room with adoption of core interventions from Hospital Elder Life Program and use of evening bright light therapy to consolidate circadian rhythm and improve sleep in the elderly patients. The novelty of this approach lies in the amalgamation of these interventions in a multi-faceted approach in acute delirium management. GMU development thus consists of key considerations for room design and resource planning, program specific interventions and daily core interventions. Assessments undertaken include baseline demographics, comorbidity scoring, duration and severity of delirium, cognitive, functional measures at baseline, 6 months and 12 months later. Additionally we also analysed the pre and post-GMU implementation knowledge and attitude on delirium care among staff members in the geriatric wards (nurses, doctors) and undertook satisfaction surveys for caregivers of patients treated in GMU.</p> <p>Discussion</p> <p>This study protocol describes the conceptualization and implementation of a specialized unit for delirium management. We hypothesize that such a model of care will not only result in better clinical outcomes for the elderly patient with delirium compared to usual geriatric care, but also improved staff knowledge and satisfaction. The model may then be transposed across various locations and disciplines in the acute hospital where delirious patients could be sited.</p> <p>Trial Registration</p> <p>Current Controlled Trials <a href="http://www.controlled-trials.com/ISRCTN52323811">ISRCTN52323811</a></p

Synergistic Apoptosis Induction in Leukemic Cells by the Phosphatase Inhibitor Salubrinal and Proteasome Inhibitors

Cells adapt to endoplasmic reticulum (ER)-stress by arresting global protein synthesis while simultaneously activating specific transcription factors and their downstream targets. These processes are mediated in part by the phosphorylation-dependent inactivation of the translation initiation factor eIF2alpha. Following restoration of homeostasis protein synthesis is resumed when the serine/threonine-protein phosphatase PP1 dephosphorylates and reactivates eIF2alpha. Proteasome inhibitors, used to treat multiple myeloma patients evoke ER-stress and apoptosis by blocking the ER-associated degradation of misfolded proteins (ERAD), however, the role of eIF2alpha phosphorylation in leukemic cells under conditions of proteasome inhibitor-mediated ER stress is currently unclear.Bcr-Abl-positive and negative leukemic cell lines were used to investigate the functional implications of PP1-related phosphatase activities on eIF2alpha phosphorylation in proteasome inhibitor-mediated ER stress and apoptosis. Rather unexpectedly, salubrinal, a recently identified PP1 inhibitor capable to protect against ER stress in various model systems, strongly synergized with proteasome inhibitors to augment apoptotic death of different leukemic cell lines. Salubrinal treatment did not affect the phosphorlyation status of eIF2alpha. Furthermore, the proapoptotic effect of salubrinal occurred independently from the chemical nature of the proteasome inhibitor, was recapitulated by a second unrelated phosphatase inhibitor and was unaffected by overexpression of a dominant negative eIF2alpha S51A variant that can not be phosphorylated. Salubrinal further aggravated ER-stress and proteotoxicity inflicted by the proteasome inhibitors on the leukemic cells since characteristic ER stress responses, such as ATF4 and CHOP synthesis, XBP1 splicing, activation of MAP kinases and eventually apoptosis were efficiently abrogated by the translational inhibitor cycloheximide.Although PP1 activity does not play a major role in regulating the ER stress response in leukemic cells, phosphatase signaling nevertheless significantly limits proteasome inhibitor-mediated ER-stress and apoptosis. Inclusion of specific phosphatase inhibitors might therefore represent an option to improve current proteasome inhibitor-based treatment modalities for hematological cancers

Penyediaan dan pencirian nanokomposit epoksi berpenguat getah asli terepoksida

Komposit epoksi berpengisi hibrid OMMT (organo-monmorilonit) dan getah asli terepoksida (ENR) telah dihasilkan dengan menggunakan kaedah penyemperitan berskru kembar pusingan searah. Ujian regangan ke atas sistem epoksi yang dihasilkan menunjukkan modulus Young bagi komposit hibrid epoksi adalah lebih tinggi daripada resin tanpa pengisi dan nilai modulus didapati meningkat dengan peningkatan komposisi OMMT dalam matriks (setinggi 40% peningkatan). Hal ini dipercayai adalah disebabkan oleh sifat tegar lapisan MMT. Sementara itu, peningkatan luas permukaan kawasan antara fasa ekoran kehadiran fasa penambah didapati telah mengurangkan tegasan alah dan terikan akhir komposit hibrid yang dihasilkan. Pemeriksaan mikrostruktur komposit hibrid epoksi melalui TEM dan XRD mendedahkan taburan OMMT dalam matriks epoksi dengan susunan interkalasi dan pengelupasan. Analisis DSC ke atas sampel yang termatang menunjukkan bahawa Tgsistem komposit hibrid adalah rendah berbanding dengan sistem perduaan (E5B dan E5LE). Pengurangan ketumpatan taut silang disyaki merupakan punca penyusutan Tg ini

Effects of liquid natural rubber (LNR) on the mechanical properties of LNR toughened epoxy composite

The effects of liquid natural rubber (LNR) on the morphology and mechanical properties of rubber modified epoxy were investigated. Epoxy composites were prepared in four different compositions of LNR (3, 5, 7 and 9phr) by using twin screw extruder. The samples for tensile, fracture toughness and impact tests were prepared according to ASTM D 638, D 5045 and D 256. The elastomeric nature of rubber can act as energy dissipating centre to cause the ductile fracture for the rubber modified epoxy. They was an obvious increment of fracture toughness where maximum value was observed with 3 phr LNR. A clear increment of impact strength at 3 phr LNR was observed, followed by a small increment at 5 phr and no further increment at 7 and 9 phr LNR. The tensile strength showed a similar trend with impact strength and Young’s modulus. SEM micrographs showed an increment of rubber particle size when the amount of LNR was increased and caused the mechanical properties to drop

Three-year outcome of phase-specific early intervention for first-episode psychosis: a cohort study in Hong Kong.

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Validation of the Gail model for predicting individual breast cancer risk in a prospective nationwide study of 28,104 Singapore women

10.1186/bcr3104Breast Cancer Research141-BCRR