Initiating e-learning by stealth, participation and consultation in a late majority institution

The extent to which opportunities afforded by e-learning are embraced by an institution can depend in large measure on whether it is perceived as enabling and transformative or as a major and disruptive distraction. Most case studies focus on the former. This paper describes how e-learning was introduced into the latter environment. The sensitivity of competing pressures in a research intensive university substantially influenced the manner in which e-learning was promoted. This paper tells that story, from initial stealth to eventual university acknowledgement of the relevance of e-learning specifically to its own context

Recurrent and High‐frequency Use of the Emergency Department by Pediatric Patients

Objectives The authors sought to describe the epidemiology of and risk factors for recurrent and high‐frequency use of the emergency department (ED) by children. Methods This was a retrospective cohort study using a database of children aged 0 to 17 years, inclusive, presenting to 22 EDs of the Pediatric Emergency Care Applied Research Network (PECARN) during 2007, with 12‐month follow‐up after each index visit. ED diagnoses for each visit were categorized as trauma, acute medical, or chronic medical conditions. Recurrent visits were defined as any repeat visit; high‐frequency use was defined as four or more recurrent visits. Generalized estimating equations (GEEs) were used to measure the strength of associations between patient and visit characteristics and recurrent ED use. Results A total of 695,188 unique children had at least one ED visit each in 2007, with 455,588 recurrent ED visits in the 12 months following the index visits. Sixty‐four percent of patients had no recurrent visits, 20% had one, 8% had two, 4% had three, and 4% had four or more recurrent visits. Acute medical diagnoses accounted for most visits regardless of the number of recurrent visits. As the number of recurrent visits per patient rose, chronic diseases were increasingly represented, with asthma being the most common ED diagnosis. Trauma‐related diagnoses were more common among patients without recurrent visits than among those with high‐frequency recurrent visits (28% vs. 9%; p < 0.001). High‐frequency recurrent visits were more often within the highest severity score classifications. In multivariable analysis, recurrent visits were associated with younger age, black or Hispanic race or ethnicity, and public health insurance. Conclusions Risk factors for recurrent ED use by children include age, race and ethnicity, and insurance status. Although asthma plays an important role in recurrent ED use, acute illnesses account for the majority of recurrent ED visits. Resumen Objetivos Describir la epidemiología y los factores de riesgo de revista e hiperfrecuentación del servicio de urgencias (SU) por parte de los pacientes pediátricos. Metodología Estudio de cohorte retrospectivo mediante una base de datos de niños entre 0 y 17 años inclusive, que acudieron a 22 SU de la Pediatric Emergency Care Applied Research Network durante 2007, con un seguimiento de 12 meses tras cada visita índice. Los diagnósticos del SU de cada visita se clasificaron como traumatológico, médico agudo o enfermedades médicas crónicas. Las revisitas se definieron como cualquier visita repetida; la hiperfrecuentación se definió como cuatro o más revisitas. Se utilizaron ecuaciones de estimación generalizada para medir la fuerza de las asociaciones entre las características al paciente y la visita y la revisita del SU. Resultados Un total de 695.188 niños tuvieron al menos una visita al SU en 2007, con 455.588 revisitas al SU en los 12 meses tras las visitas índice. Un 64% de los pacientes no tuvieron revisitas, un 20% tuvo una, un 8% tuvo dos, un 4% tuvo tres y un 4% tuvo cuatro o más revisitas. Los diagnósticos médicos agudos representan la mayoría de las visitas, con independencia del número de revisitas. A medida que el número de revisitas por paciente aumentaba, las enfermedades crónicas estaban más representadas, y el asma fue el diagnóstico más común en el SU. Los diagnósticos relacionados con lo traumatológico fueron más frecuentes entre los pacientes sin revisitas que entre aquéllos con hiperfrecuentación (28% vs. 9%; p < 0,001). La alta frecuencia de revisitas fue más frecuente en las clasificaciones de gravedad más altas. En el análisis multivariable, las revisitas se asociaron con una edad más joven, raza o etnia negra o hispana, y la tenencia de un seguro de salud público. Conclusiones Los factores de riesgo para la revisita al SU por los niños incluyen la edad, la raza o etnia, y el tipo de seguro médico. Aunque el asma juega un papel importante en la revisita al SU, las enfermedades agudas representan la mayoría de la revistas al SU.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/106853/1/acem12347.pd

Whole season net community production in the Weddell Sea

Abstract Depletions of total CO 2 , nitrate, phosphate and silicate in the surface layer were calculated for cruise ANT XXII/3 with FS Polarstern in March 2005 for estimating the annual net community production. East-west across the Weddell Sea the variation of all depletions is similar, but this holds to a lesser extent for silicate. Depletions in March 2005 are 2-3 times larger than those in January 1993 for the same transect. Very low N:P and C:P depletion ratios seem to point to dominance of diatoms, in the central Weddell Sea more than in the margin. Estimates of annual net community productions are about 1.8 and 3.5 mol C m ¡2 year ¡1 for the interior Weddell Sea and a near-margin region, respectively. The region does not comply with the classical view of a marginal ice zone with high productivity. Net community production is similar to annual export production, implying that remineralization in the ensuing winter be minor

Adoption of Electronic Medical Record-Based Decision Support for Otitis Media in Children

Substantial investment in electronic health records (EHRs) has provided an unprecedented opportunity to use clinical decision support (CDS) to increase guideline adherence. To inform efforts to maximize adoption, we characterized the adoption of an otitis media (OM) CDS system, the impact of performance feedback on adoption, and the effects of adoption on guideline adherence

Prevalence of head lice and hygiene practices among women over twelve years of age in Sindh, Balochistan, and North West Frontier Province: National Health Survey of Pakistan, 1990-1994

Background: Head lice infestation is an infection of the scalp and skin which causes blood loss, discomfort, and social and psychological distress with the possibility of secondary bacterial infections occurring at scratch sites. In Pakistan, although some small scale studies have been conducted to investigate prevalence of head lice in school children and the general population, no population based estimates have been reported. The National Health Survey of Pakistan (NHSP 1990 - 94) was a nationally representative health examination survey of the Pakistani population. The NHSP is the first population based household survey to collect data on the prevalence of head lice in adult women in Pakistan. In this paper we use data from the NHSP to present an epidemiological profile of personal hygiene practices and head lice infestation among women aged 12 years or older in three provinces of Pakistan, Balochistan, Sindh and North West Frontier Province (NWFP). Results: Overall about 7% women aged 12 years and older suffered from head lice infestation. Multivariable logistic regression analysis identified factors independently associated with presence of head lice. Age less than 16 years and crowding at home were associated with higher infestation-rates. The impact of household socio-economic status on infestation rates among women was different in urban and rural settings, urban women with low socio-economic status were more vulnerable than similar women in rural settings. Bathing infrequently in summer was associated with higher prevalence rates only in Sindh, possibly due to the fact that among the three provinces Sindh has a hotter and more humid summer. Conclusions: The results of our analysis of NHSP indicate high levels of head lice infestation among girls and women in the three Provinces. The epidemiological profile of hygienic practices of women indicated that NWFP and Balochistan as compared to Sindh, and rural as compared to urban areas were less developed with respect to access to water supply and soap for maintaining personal hygiene. Simple and cost-effective measures such as provision of water and soap, and improving awareness regarding maintaining personal hygiene can contribute significantly towards improving public health status of the women in Pakistan

The GEOTRACES Intermediate Data Product 2014

The GEOTRACES Intermediate Data Product 2014 (IDP2014) is the first publicly available data product of the international GEOTRACES programme, and contains data measured and quality controlled before the end of 2013. It consists of two parts: (1) a compilation of digital data for more than 200 trace elements and isotopes (TEIs) as well as classical hydrographic parameters, and (2) the eGEOTRACES Electronic Atlas providing a strongly inter-linked on-line atlas including more than 300 section plots and 90 animated 3D scenes. The IDP2014 covers the Atlantic, Arctic, and Indian oceans, exhibiting highest data density in the Atlantic. The TEI data in the IDP2014 are quality controlled by careful assessment of intercalibration results and multi-laboratory data comparisons at cross-over stations. The digital data are provided in several formats, including ASCII spreadsheet, Excel spreadsheet, netCDF, and Ocean Data View collection. In addition to the actual data values the IDP2014 also contains data quality flags and 1-? data error values where available. Quality flags and error values are useful for data filtering. Metadata about data originators, analytical methods and original publications related to the data are linked to the data in an easily accessible way. The eGEOTRACES Electronic Atlas is the visual representation of the IDP2014 data providing section plots and a new kind of animated 3D scenes. The basin-wide 3D scenes allow for viewing of data from many cruises at the same time, thereby providing quick overviews of large-scale tracer distributions. In addition, the 3D scenes provide geographical and bathymetric context that is crucial for the interpretation and assessment of observed tracer plumes, as well as for making inferences about controlling processes

Butterfly Abundance and Diversity in Different Habitat Types in the Usangu Area, Ruaha National Park

Insects are key fauna species that respond quickly to disturbances and environmental changes. They act as good indicators of habitat, community, or ecosystem quality. Among the great diversity of insects, butterflies stand as ideal bio-indicators for ecosystem function and are sensitive to changes in habitat composition and structure. This study was carried out to examine the diversity and abundance of butterflies across the restored habitats in Usangu area part of Ruaha National Park (RUNAPA) from May 2022 to June 2022 using the walking transect method supplemented by sweep nets and butterfly baited traps. A total of six transects of 1 km in length were laid in the four main habitat types selected in Usangu area including grassland, Miombo woodland, Vachellia/Commiphora woodland, and riverine forest. Searches were conducted in the morning and evening. The Miombo woodland and riverine forest habitats exhibited relatively higher species diversity, richness, evenness, abundance, and a higher number of habitat-restricted species, while Vachellia/Commiphora woodland and grassland habitats recorded the lowest diversity and abundance as well as the lowest number of habitat-restricted species. Family Nymphalidae was the most dominant followed by Pieridae while Papilionidae and Hesperiidae were scarce in the study area. This study clearly shows the importance of Miombo woodland and riverine forest habitats in sustaining rich butterfly diversity and abundance in Usangu area. The two habitats must be effectively managed and conserved for sustaining ecological health and integrity of Usangu area. The Usangu area’s Miombo woodland and riverine forest habitats have immense potential for butterfly tourism and they can offer an excellent opportunity to promote conservation efforts and raise public awareness. However, it is crucial to monitor these habitats closely as any environmental changes that may occur could harm the butterfly diversity and abundance in the area. Preserving this wilderness to maintain a thriving butterfly population is of utmost importance

The alarming state of freshwater biodiversity in Canada

Little is known about the current state of freshwater biodiversity in Canada, one of the countries with the greatest amount of surface waters in the world. To address this knowledge gap, we compiled a list of all available assessments of conservation status for freshwater species (over 3000 taxa) and further evaluated the overall status of six distinct taxonomic groups, focusing on organisms reliant on fresh waters (i.e., aquatic plants, invertebrates (with a focus on freshwater mussels), fishes, herpetofauna (reptiles and amphibians), birds, and mammals). Overall, 11.7% of all freshwater species of plants and animals assessed were found to be at risk (i.e., listed as Threatened , Endangered , or Extirpated ) and 17.9% identified as Special Concern . We found that 37.9% of species lacked sufficient data to enable their status to be assessed. Data gaps in Canada\u27s assessment of its freshwater species were most prevalent in invertebrates (excluding freshwater mussels). Given the alarming state of freshwater biodiversity in Canada, we conclude by providing recommendations that focus on evaluating temporal trends and informing conservation actions

Induction of Long-Term Memory CD8(+) T Cells for Recall of Viral Clearing Responses against Influenza Virus

Induction of cytotoxic T-cell-mediated virus-clearing responses by influenza virus T cell determinant-containing peptide immunogens was examined. The most potent synthetic immunogens for eliciting pulmonary viral-clearing responses contained peptides representing determinants for CD4 and CD8 T cells (TH and CTL peptides, respectively) together with two or four palmitic acid (Pal) groups. Inoculated in adjuvant, these Pal2- or Pal4-CTL-TH lipopeptides and the nonlipidated CTL peptide induced equivalent levels of cytolytic activity in the primary effector phase of the response. The ability to recall lytic responses, however, diminished much more rapidly in CTL peptide-primed than in lipopeptide-primed mice. By 15 months postpriming, the recalled lytic activity in lipopeptide-inoculated mice remained potent, but the response induced by the CTL peptide was weak. Enumeration of specific gamma interferon-secreting CD8 T cells revealed that a greater number of these T cells had entered or remained in the memory pool in lipopeptide-primed mice, arguing for a quantitative rather than qualitative enhancement of the response on recall. Addition of either the lipid or the TH peptide to the CTL peptide was not sufficient to provide these long-lived antiviral responses, but inclusion of both components augmented the response. CD4 T cells elicited by the lipopeptides did not influence the rate of viral clearance upon challenge and most likely had a role in induction or maintenance of the memory response. It therefore appears that the lipopeptide immunogens, although not significantly superior at inducing primary effector CD8 T cells, elicit a much more effective memory population, the recall of which may account for their superiority in inducing pulmonary protection after viral challenge