365 research outputs found

    Changing classroom culture, curricula, and instruction for proof and proving: how amenable to scaling up, practicable for curricular integration, and capable of producing long-lasting effects are current interventions?

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    This paper is a commentary on the classroom interventions on the teaching and learning of proof reported in the seven empirical papers in this special issue. The seven papers show potential to enhance student learning in an area of mathematics that is not only notoriously difficult for students to learn and for teachers to teach, but also critically important to knowing and doing mathematics. Although the seven papers, and the intervention studies they report, vary in many ways—student population, content domain, goals and duration of the intervention, and theoretical perspectives, to name a few—they all provide valuable insight into ways in which classroom experiences might be designed to positively influence students’ learning to prove. In our commentary, we highlight the contributions and promise of the interventions in terms of whether and how they present capacity to change the classroom culture, the curriculum, or instruction. In doing so, we distinguish between works that aim to enhance students’ preparedness for, and competence in, proof and proving and works that explicitly foster appreciation for the need and importance of proof and proving. Finally, we also discuss briefly the interventions along three dimensions: how amenable to scaling up, how practicable for curricular integration, and how capable of producing long-lasting effects these interventions are

    Effect of under-reinforcement on the flexural strength of corroded beams

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    Reinforced concrete beams are normally designed as under-reinforced to provide ductile behaviour i.e. the tensile moment of resistance, Mt(0) is less than the moment of resistance of the compressive zone, Mc. The degree of under-reinforcement (Mt(0)/Mc ratio) can depend upon the preferences of the designer in complying with design and construction constraints, codes and availability of steel reinforcement diameters and length. Mt(0)/Mc is further influenced during service life by corrosion which decreases Mt(0). The paper investigates the influence of Mt(0)/Mc on the residual flexural strength of corroded beams and determines detailing parameters (e.g. size and percentage of steel reinforcement, cover) on Mt(0)/Mc. Corroded reinforced concrete beams (100 mm · 150 mm deep) with varying Mt(0)/Mc ratios were tested in flexure. The results of the investigation were combined with the results of similar work by other researchers and show that beams with lower Mt(0)/Mc ratios suffer lower flexural strength loss when subjected to tensile reinforcement corrosion. Cover to the main steel does not directly influence Mt(0)/Mc and, thus, the residual flexural strength of corroded beams is not normally affected by increased cover. A simplified expression for estimating the residual strength of corroded beams is also given

    Overcoming limitations of current antiplatelet drugs: A concerted effort for more profitable strategies of intervention

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    Platelets play a central role in the pathophysiology of atherothrombosis, an inappropriate platelet activation leading to acute ischemic complications (acute myocardial infarction, ischemic stroke). In view of this, platelets are a major target for pharmacotherapy. Presently, the main classes of antiplatelet agents approved for the use in such complications are aspirin and fhienopyridines. Although antiplatelet treatment with these two types of drugs, alone or in combination, leads to a significant reduction of non-fatal myocardial infarction (−32%), non-fatal stroke (−25%), and of cardiovascular death (−17%), a residual risk persists

    Dynamic early identification of hip replacement implants with high revision rates. Study based on the NJR data from UK during 2004-2012

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    BACKGROUND: Hip replacement and hip resurfacing are common surgical procedures with an estimated risk of revision of 4% over 10 year period. Approximately 58% of hip replacements will last 25 years. Some implants have higher revision rates and early identification of poorly performing hip replacement implant brands and cup/head brand combinations is vital. AIMS: Development of a dynamic monitoring method for the revision rates of hip implants. METHODS: Data on the outcomes following the hip replacement surgery between 2004 and 2012 was obtained from the National Joint Register (NJR) in the UK. A novel dynamic algorithm based on the CUmulative SUM (CUSUM) methodology with adjustment for casemix and random frailty for an operating unit was developed and implemented to monitor the revision rates over time. The Benjamini-Hochberg FDR method was used to adjust for multiple testing of numerous hip replacement implant brands and cup/ head combinations at each time point. RESULTS: Three poorly performing cup brands and two cup/ head brand combinations have been detected. Wright Medical UK Ltd Conserve Plus Resurfacing Cup (cup o), DePuy ASR Resurfacing Cup (cup e), and Endo Plus (UK) Limited EP-Fit Plus Polyethylene cup (cup g) showed stable multiple alarms over the period of a year or longer. An addition of a random frailty term did not change the list of underperforming components. The model with added random effect was more conservative, showing less and more delayed alarms. CONCLUSIONS: Our new algorithm is an efficient method for early detection of poorly performing components in hip replacement surgery. It can also be used for similar tasks of dynamic quality monitoring in healthcare

    A compendium and functional characterization of mammalian genes involved in adaptation to Arctic or Antarctic environments

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    Many mammals are well adapted to surviving in extremely cold environments. These species have likely accumulated genetic changes that help them efficiently cope with low temperatures. It is not known whether the same genes related to cold adaptation in one species would be under selection in another species. The aims of this study therefore were: to create a compendium of mammalian genes related to adaptations to a low temperature environment; to identify genes related to cold tolerance that have been subjected to independent positive selection in several species; to determine promising candidate genes/pathways/organs for further empirical research on cold adaptation in mammals

    Payment for performance (P4P): any future in Italy?

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    <p>Abstract</p> <p>Background</p> <p>Pay for Performance (P4P) programs, based on provision of financial incentives for service quality, have been widely adopted to enhance quality of care and to promote a more efficient use of health care resources whilst improving patient outcomes. In Italy, as in other countries, the growing concern over the quality of health services provided and the scarcity of resources would make P4P programs a useful means of improving their performance. The aim of this paper is to evaluate whether it is possible to implement P4P programs in the Lombardy Region, in Italy, based on the existing data set.</p> <p>Methods</p> <p>Thirteen quality measures were identified regarding four clinical conditions (acute myocardial infarction (AMI), heart failure (HF), ischemic stroke and hip and knee replacement) on the basis of an international literature review. Data was collected using the database of three institutions, which included hospital discharge records (Scheda di Dimissione ospedaliera-SDO-) and letters of discharge. The study population was identified using both the Principal ICD-9-CM diagnosis codes and the discharge date. A Statistical Analysis System (SAS) program was used for the text analysis.</p> <p>Results</p> <p>It was possible to calculate almost all the parameters pertaining to the three hospitals as all the data required was available with the exception of inpatient mortality in two hospitals and smoking cessation advice/counseling in one hospital.</p> <p>Conclusions</p> <p>On the ground of this analysis, we believe that it is possible to implement a P4P program in the Lombardy Region. However, for this program to be initiated, all necessary data must be available in electronic format and uniformly collected. Moreover, several other factors must be assessed: which clinical conditions should be included, the threshold for each quality parameter, the amount of financial incentives offered and how they will be provided.</p
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