Classtalk: A Classroom Communication System for Active Learning

This pdf file is an article describing the advantages of using Classtalk technology in the classroom to enhance classroom communication. Classtalk technology cab facilitate the presentation of questions for small group work, collec the student answers and then display histograms showing how the class answered. This new communication technology can help instructors create a more interactive, student centered classroom, especially when teaching large courses. The article describes Classtalk as a very useful tool not only for engaging students in active learning, but also for enhancing the overall communication within the classroom. This article is a selection from the electronic Journal for Computing in Higher Education. Educational levels: Graduate or professional

A qualitative exploration of nurses leaving nursing practice in China

AIM: This paper reports a theoretical understanding of nurses leaving nursing practice by exploring the processes of decision‐making by registered nurses in China on exiting clinical care. BACKGROUND: The loss of nurses through their voluntarily leaving nursing practice has not attracted much attention in China. There is a lack of an effective way to understand and communicate nursing workforce mobility in China and worldwide. DESIGN: This qualitative study draws on the constant comparative method following a grounded theory approach. METHOD: In‐depth interviews with 19 nurses who had left nursing practice were theoretically sampled from one provincial capital city in China during August 2009–March 2010. RESULTS: The core category ‘Mismatching Expectations: Individual vs. Organizational’ emerged from leavers’ accounts of their leaving. By illuminating the interrelationship between the core category and the main category ‘Individual Perception of Power,’ four nursing behaviour patterns were identified: (1) Voluntary leaving; (2) Passive staying; (3) Adaptive staying and (4) Active staying

Exploring Appropriation of Global Cultural Rituals

Adolescents, as a consequence of identification with popular culture, have been described as having homogenous consumption patterns. More recently, however, it has been recognised that ‘glocalisation’ (global practices reworked to fit local contexts) affords an opportunity for differentiation. This paper considers a recent UK phenomenon, namely that of the US high school prom, and seeks to explore the ways in which this ritual has been adopted or adapted as part of youth culture. The method employed here was mixed methods and included in-depth interviews with those who attended a prom in the last three years as well as a questionnaire distributed amongst high school pupils who were anticipating a high school prom. The findings illustrate that the high school prom in the UK is becoming increasingly integrated into the fabric of youth culture although, depending on the agentic abilities employed by the emerging adults in the sample, there is differing appropriation of this ritual event particularly in relation to attitudes towards and motivations for attending the prom. A typology of prom attendees is posited. This paper contributes to our understanding of this practice in a local context

Prevalence of diffuse pancreatic beta islet cell disease with hyperinsulinism: Problems in recognition and management

Among 77 patients with endogenous hyperinsulinism seen in 2 medical centers, diffuse islet cell disease accounted for 17 (22%) patients. Since diffuse islet cell disease poses special problems in management, its prevalence is emphasized in this report. Among these patients with diffuse islet cell disease, there were 11 patients with adenomatosis, 4 with nesidioblastosis, and 2 with islet cell hyperplasia. Six of the 77 patients were found in multiple endocrine neoplasia, type I kindreds; diffuse islet cell disease was documented in 4 of these patients. We outline principles of management in patients with diffuse islet cell disease. Frozen section microscopy failed to identify nesidioblastosis or islet cell hyperplasia. Chez 77 malades, provenant de 2 centres médicaux, qui présentaient un hyperinsulinisme endogène, 17 cas de lésions diffuses des îlots de Langerhans ont été dénombrés. Ce fait est donc loin d'être exceptionnel et cette étude a pour but de le souligner. Parmi ces 17 malades, 11 présentaient des adénomes multiples (adénomatoses), 4 des nésidoblastomes (anomalies tissulaires multifocales), 2 des hyperplasies cellulaires insulaires. Chez ces 77 malades, 6 cas de MEN type I furent individualisés, 4 d'entre eux présentaient une maladie insulaire diffuse. Les auteurs, forts de cette expériences insistent sur les principes du traitement de ce type d'affection. Ils insistent sur le fait que l'étude histologique extemporanée ne permet pas d'identifier les nésidoblastomes et les hyperplasies cellulaires insulaires et que dans 70%–80% des cas les résections pancréatiques ne permettent pas d'obtenir la guérison. Un problema constante para el cirujano que opera pacientes con hiperinsulinismo endógeno es el de qué hacer cuando no se encuentre patología en el curso de la operación una vez realizada la exploración preliminar del páncreas. Los adenomas solitarios de células beta pueden pasar desapercibidos cuando no son palpables; la identificación de la enfermedad difusa de las células insulares plantea muchos problemas. Reconocemos tres alteraciones principales de tipo difuso: adenomatosis de células beta, nesidioblastosis e hiperplasia pancreática de células beta. Además, múltiples macroadenomas pueden coexistir o no con microadenomatosis o con hiperplasia en ciertos pacientes con hiperinsulinismo. Los desórdenes de células insulares de tipo multifocal son particularmente frecuentes en pacientes con Neoplasia Endocrina Multiple Tipo I.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/41314/1/268_2005_Article_BF01654942.pd

Contingent self-definition and amorphous regions: a dynamic approach to place brand architecture

This article explores the concept of contingent self-definition, whereby place brands employ flexible self-definitional approaches in constructing their place brand architecture. Adopting a view of regions as social constructs, the article builds on and extends previous work on place brand architecture by identifying the underlying factors that drive contingent self-definition decisions. Based on an empirical study of professionals tasked with managing region brands in the Netherlands, eleven factors are identified as drivers of contingent self-definition by place brands. These factors are grouped into four thematic categories: i) external perceptions, ii) proximity, iii) brand relationships, and iv) politics and power. A dynamic approach to place brand architecture is advocated, foregrounding the amorphous character of regions as social constructs that defy reification solely as fixed territorial-administrative spaces

The management of diabetic ketoacidosis in children

The object of this review is to provide the definitions, frequency, risk factors, pathophysiology, diagnostic considerations, and management recommendations for diabetic ketoacidosis (DKA) in children and adolescents, and to convey current knowledge of the causes of permanent disability or mortality from complications of DKA or its management, particularly the most common complication, cerebral edema (CE). DKA frequency at the time of diagnosis of pediatric diabetes is 10%–70%, varying with the availability of healthcare and the incidence of type 1 diabetes (T1D) in the community. Recurrent DKA rates are also dependent on medical services and socioeconomic circumstances. Management should be in centers with experience and where vital signs, neurologic status, and biochemistry can be monitored with sufficient frequency to prevent complications or, in the case of CE, to intervene rapidly with mannitol or hypertonic saline infusion. Fluid infusion should precede insulin administration (0.1 U/kg/h) by 1–2 hours; an initial bolus of 10–20 mL/kg 0.9% saline is followed by 0.45% saline calculated to supply maintenance and replace 5%–10% dehydration. Potassium (K) must be replaced early and sufficiently. Bicarbonate administration is contraindicated. The prevention of DKA at onset of diabetes requires an informed community and high index of suspicion; prevention of recurrent DKA, which is almost always due to insulin omission, necessitates a committed team effort

Epstein-Barr virus: clinical and epidemiological revisits and genetic basis of oncogenesis

Epstein-Barr virus (EBV) is classified as a member in the order herpesvirales, family herpesviridae, subfamily gammaherpesvirinae and the genus lymphocytovirus. The virus is an exclusively human pathogen and thus also termed as human herpesvirus 4 (HHV4). It was the first oncogenic virus recognized and has been incriminated in the causation of tumors of both lymphatic and epithelial nature. It was reported in some previous studies that 95% of the population worldwide are serologically positive to the virus. Clinically, EBV primary infection is almost silent, persisting as a life-long asymptomatic latent infection in B cells although it may be responsible for a transient clinical syndrome called infectious mononucleosis. Following reactivation of the virus from latency due to immunocompromised status, EBV was found to be associated with several tumors. EBV linked to oncogenesis as detected in lymphoid tumors such as Burkitt's lymphoma (BL), Hodgkin's disease (HD), post-transplant lymphoproliferative disorders (PTLD) and T-cell lymphomas (e.g. Peripheral T-cell lymphomas; PTCL and Anaplastic large cell lymphomas; ALCL). It is also linked to epithelial tumors such as nasopharyngeal carcinoma (NPC), gastric carcinomas and oral hairy leukoplakia (OHL). In vitro, EBV many studies have demonstrated its ability to transform B cells into lymphoblastoid cell lines (LCLs). Despite these malignancies showing different clinical and epidemiological patterns when studied, genetic studies have suggested that these EBV- associated transformations were characterized generally by low level of virus gene expression with only the latent virus proteins (LVPs) upregulated in both tumors and LCLs. In this review, we summarize some clinical and epidemiological features of EBV- associated tumors. We also discuss how EBV latent genes may lead to oncogenesis in the different clinical malignancie

Global surveillance of cancer survival 1995-2009: analysis of individual data for 25,676,887 patients from 279 population-based registries in 67 countries (CONCORD-2)

BACKGROUND: Worldwide data for cancer survival are scarce. We aimed to initiate worldwide surveillance of cancer survival by central analysis of population-based registry data, as a metric of the effectiveness of health systems, and to inform global policy on cancer control. METHODS: Individual tumour records were submitted by 279 population-based cancer registries in 67 countries for 25·7 million adults (age 15-99 years) and 75,000 children (age 0-14 years) diagnosed with cancer during 1995-2009 and followed up to Dec 31, 2009, or later. We looked at cancers of the stomach, colon, rectum, liver, lung, breast (women), cervix, ovary, and prostate in adults, and adult and childhood leukaemia. Standardised quality control procedures were applied; errors were corrected by the registry concerned. We estimated 5-year net survival, adjusted for background mortality in every country or region by age (single year), sex, and calendar year, and by race or ethnic origin in some countries. Estimates were age-standardised with the International Cancer Survival Standard weights. FINDINGS: 5-year survival from colon, rectal, and breast cancers has increased steadily in most developed countries. For patients diagnosed during 2005-09, survival for colon and rectal cancer reached 60% or more in 22 countries around the world; for breast cancer, 5-year survival rose to 85% or higher in 17 countries worldwide. Liver and lung cancer remain lethal in all nations: for both cancers, 5-year survival is below 20% everywhere in Europe, in the range 15-19% in North America, and as low as 7-9% in Mongolia and Thailand. Striking rises in 5-year survival from prostate cancer have occurred in many countries: survival rose by 10-20% between 1995-99 and 2005-09 in 22 countries in South America, Asia, and Europe, but survival still varies widely around the world, from less than 60% in Bulgaria and Thailand to 95% or more in Brazil, Puerto Rico, and the USA. For cervical cancer, national estimates of 5-year survival range from less than 50% to more than 70%; regional variations are much wider, and improvements between 1995-99 and 2005-09 have generally been slight. For women diagnosed with ovarian cancer in 2005-09, 5-year survival was 40% or higher only in Ecuador, the USA, and 17 countries in Asia and Europe. 5-year survival for stomach cancer in 2005-09 was high (54-58%) in Japan and South Korea, compared with less than 40% in other countries. By contrast, 5-year survival from adult leukaemia in Japan and South Korea (18-23%) is lower than in most other countries. 5-year survival from childhood acute lymphoblastic leukaemia is less than 60% in several countries, but as high as 90% in Canada and four European countries, which suggests major deficiencies in the management of a largely curable disease. INTERPRETATION: International comparison of survival trends reveals very wide differences that are likely to be attributable to differences in access to early diagnosis and optimum treatment. Continuous worldwide surveillance of cancer survival should become an indispensable source of information for cancer patients and researchers and a stimulus for politicians to improve health policy and health-care systems