Web based lecture technologies: blurring the boundaries between face to face and distance learning

Web based lecture technologies (WBLT) have gained popularity amongst universities in Australia as a tool for delivering lecture recordings to students in close to real time. This paper reports on a selection of results from a larger research project investigating the impact of WBLT on teaching and learning. Results show that while staff see the advantages for external students, they question the extent to which these advantages apply to internal students. In contrast both cohorts of students were positive about the benefits of the technologies for their learning and they adopted similar strategies for their use. With the help of other technologies, some external students and staff even found WBLT useful for fostering communication between internal and external students. As such, while the traditional boundary between internal and external students seems to remain for some staff, students seem to find the boundary much less clear

Extreme Dysbiosis of the Microbiome in Critical Illness.

Critical illness is hypothesized to associate with loss of "health-promoting" commensal microbes and overgrowth of pathogenic bacteria (dysbiosis). This dysbiosis is believed to increase susceptibility to nosocomial infections, sepsis, and organ failure. A trial with prospective monitoring of the intensive care unit (ICU) patient microbiome using culture-independent techniques to confirm and characterize this dysbiosis is thus urgently needed. Characterizing ICU patient microbiome changes may provide first steps toward the development of diagnostic and therapeutic interventions using microbiome signatures. To characterize the ICU patient microbiome, we collected fecal, oral, and skin samples from 115 mixed ICU patients across four centers in the United States and Canada. Samples were collected at two time points: within 48 h of ICU admission, and at ICU discharge or on ICU day 10. Sample collection and processing were performed according to Earth Microbiome Project protocols. We applied SourceTracker to assess the source composition of ICU patient samples by using Qiita, including samples from the American Gut Project (AGP), mammalian corpse decomposition samples, childhood (Global Gut study), and house surfaces. Our results demonstrate that critical illness leads to significant and rapid dysbiosis. Many taxons significantly depleted from ICU patients versus AGP healthy controls are key "health-promoting" organisms, and overgrowth of known pathogens was frequent. Source compositions of ICU patient samples are largely uncharacteristic of the expected community type. Between time points and within a patient, the source composition changed dramatically. Our initial results show great promise for microbiome signatures as diagnostic markers and guides to therapeutic interventions in the ICU to repopulate the normal, "health-promoting" microbiome and thereby improve patient outcomes. IMPORTANCE Critical illness may be associated with the loss of normal, "health promoting" bacteria, allowing overgrowth of disease-promoting pathogenic bacteria (dysbiosis), which, in turn, makes patients susceptible to hospital-acquired infections, sepsis, and organ failure. This has significant world health implications, because sepsis is becoming a leading cause of death worldwide, and hospital-acquired infections contribute to significant illness and increased costs. Thus, a trial that monitors the ICU patient microbiome to confirm and characterize this hypothesis is urgently needed. Our study analyzed the microbiomes of 115 critically ill subjects and demonstrated rapid dysbiosis from unexpected environmental sources after ICU admission. These data may provide the first steps toward defining targeted therapies that correct potentially "illness-promoting" dysbiosis with probiotics or with targeted, multimicrobe synthetic "stool pills" that restore a healthy microbiome in the ICU setting to improve patient outcomes

The Grizzly, February 10, 1997

Medical Ethicist to Speak on Campus • Gender Studies May Replace Women\u27s Studies • ECBA Candidate Speaks on Technology • Opinion: Code of Silence?; What I Think II; Politics Gone Wild; Big Brenneman is Watching, but not Paying Attention • Spirit of Life Ensemble Performs for Diversity Week • Mass Media and Society Brings Internet to the Classroom • Gymnastics Team Wins Second Straight Meet • Women Hoopsters Go 1-1 for the Week • Ursinus Men\u27s Basketball Team Downed at Pallestra • UC Wrestlers Split with Elizabethtown and Nationally Ranked Lycoming • Swimming Team Suffers Two Losseshttps://digitalcommons.ursinus.edu/grizzlynews/1396/thumbnail.jp

Inspiratory muscle training for intensive care patients: A multidisciplinary practical guide for clinicians

Objectives To describe a multidisciplinary approach to inspiratory muscle training (IMT) for patients in the intensive care unit (ICU). Background Inspiratory muscle weakness is a known consequence of prolonged mechanical ventilation, and there is emerging evidence that specific IMT can ameliorate this weakness. However, IMT is not yet standard practice in many ICUs, possibly because of the wide variety of methods reported and a lack of published practical guidelines. While the optimal parameters for IMT are yet to be established, we share our detailed methodology which has been shown to be safe in selected ventilator-dependent patients and is the only approach which has been shown to increase quality of life in ICU patients. Methods Patients who have experienced invasive mechanical ventilation for at least 7 days can commence IMT in either the ventilator-dependent phase or when weaned from mechanical ventilation. Intensity should be prescribed based on maximum inspiratory pressure, which is measurable through the tracheostomy or endotracheal tube via the ventilator or a respiratory pressure meter. Using a removable threshold device, we recommend high-intensity training (5 sets of 6 breaths at a minimum of 50% of maximum inspiratory pressure) performed once per day, supervised by the physiotherapist, with intensity increased daily such that patients can only just complete the 6th breath in each set. Results Using this high-intensity approach, IMT is likely to improve not only inspiratory muscle strength but also quality of life in patients recently weaned from mechanical ventilation of 7 days' duration or longer. Effective IMT requires a multidisciplinary approach to maximise feasibility, with doctors, nurses, and therapists working closely to optimise conditions for successful IMT. Conclusions This multidisciplinary approach to implement IMT in ICU patients should assist clinicians in translating best-available evidence into practice, with the potential to enhance patient recovery.acknowledge the financial support of the Australian Capital Territory Chief Allied Health Office in the publication of this articl

LGBT+ Histories and Historians: a report

A report by the Royal Historical Society's LGBT+ working group looking at LGBT+ histories and their place in university curriculums, libraries and galleries, as well as the conditions for LGBT+ historians. The report includes recommendations and resources for greater inclusion and understanding of LGBT+ people and of LGBT+ histories

Integration of environment and nutrition in life cycle assessment of food items: opportunities and challenges

This report is the outcome of a consensus-building project to agree on best practices for environmental and nutritional Life Cycle Assessment (nLCA) methodology, and identify future research needs. The project involved 30 nutritional and environmental LCA researchers from 18 countries. It focused on the assessment of food items (as opposed to meals or diets).Best practice recommendations were developed to address the intended purpose of an LCA study and related modeling approach, choice of an appropriate functional unit, assessment of nutritional value, and reporting nLCA results. An nLCA study should report the quantities of as many essential nutrients as possible and aim to provide information on the nutritional quality and/or health impacts in addition to nutrient quantities. Outstanding issues requiring further research attention include: defining a minimum number of nutrients to be considered in an nLCA study; treatment of nutrients to limit; use of nutrient indexes; further development of Impact Assessment methods; representation of nutritional changes that may occur during subsequent distribution and food preparation in cradle-to-gate nLCA studies; and communication of data uncertainty and variability. More data are required for different regions (particularly developing countries); for the processing, distribution, retail, and consumption life cycle stages; and for food loss and waste. Finally, there is a need to extend nLCA methodology for the assessment of meals and diets, to consider further how to account for the multi-functionality of food in a sustainability framework, and to set nLCA studies within the context of environmental limits.These results provide a robust basis for improving nLCA methodology and applying it to identify solutions that minimize the trade-offs between nourishing populations and safeguarding the environment

PURA syndrome : clinical delineation and genotype-phenotype study in 32 individuals with review of published literature

Background De novo mutations in PURA have recently been described to cause PURA syndrome, a neurodevelopmental disorder characterised by severe intellectual disability (ID), epilepsy, feeding difficulties and neonatal hypotonia. Objectives T o delineate the clinical spectrum of PURA syndrome and study genotype-phenotype correlations. Methods Diagnostic or research-based exome or Sanger sequencing was performed in individuals with ID. We systematically collected clinical and mutation data on newly ascertained PURA syndrome individuals, evaluated data of previously reported individuals and performed a computational analysis of photographs. We classified mutations based on predicted effect using 3D in silico models of crystal structures of Drosophila-derived Pur-alpha homologues. Finally, we explored genotypephenotype correlations by analysis of both recurrent mutations as well as mutation classes. Results We report mutations in PURA (purine-rich element binding protein A) in 32 individuals, the largest cohort described so far. Evaluation of clinical data, including 22 previously published cases, revealed that all have moderate to severe ID and neonatal-onset symptoms, including hypotonia (96%), respiratory problems (57%), feeding difficulties (77%), exaggerated startle response (44%), hypersomnolence (66%) and hypothermia (35%). Epilepsy (54%) and gastrointestinal (69%), ophthalmological (51%) and endocrine problems (42%) were observed frequently. Computational analysis of facial photographs showed subtle facial dysmorphism. No strong genotype-phenotype correlation was identified by subgrouping mutations into functional classes. Conclusion We delineate the clinical spectrum of PURA syndrome with the identification of 32 additional individuals. The identification of one individual through targeted Sanger sequencing points towards the clinical recognisability of the syndrome. Genotype-phenotype analysis showed no significant correlation between mutation classes and disease severity.Peer reviewe

Expert consensus and recommendations on safety criteria for active mobilization of mechanically ventilated critically ill adults

Introduction: The aim of this study was to develop consensus recommendations on safety parameters for mobilizing adult, mechanically ventilated, intensive care unit (ICU) patients. Methods: A systematic literature review was followed by a meeting of 23 multidisciplinary ICU experts to seek consensus regarding the safe mobilization of mechanically ventilated patients. Results: Safety considerations were summarized in four categories: respiratory, cardiovascular, neurological and other. Consensus was achieved on all criteria for safe mobilization, with the exception being levels of vasoactive agents. Intubation via an endotracheal tube was not a contraindication to early mobilization and a fraction of inspired oxygen less than 0.6 with a percutaneous oxygen saturation more than 90% and a respiratory rate less than 30 breaths/minute were considered safe criteria for in- and out-of-bed mobilization if there were no other contraindications. At an international meeting, 94 multidisciplinary ICU clinicians concurred with the proposed recommendations. Conclusion: Consensus recommendations regarding safety criteria for mobilization of adult, mechanically ventilated patients in the ICU have the potential to guide ICU rehabilitation whilst minimizing the risk of adverse events

Drug Resistance Mutations for Surveillance of Transmitted HIV-1 Drug-Resistance: 2009 Update

Programs that monitor local, national, and regional levels of transmitted HIV-1 drug resistance inform treatment guidelines and provide feedback on the success of HIV-1 treatment and prevention programs. To accurately compare transmitted drug resistance rates across geographic regions and times, the World Health Organization has recommended the adoption of a consensus genotypic definition of transmitted HIV-1 drug resistance. In January 2007, we outlined criteria for developing a list of mutations for drug-resistance surveillance and compiled a list of 80 RT and protease mutations meeting these criteria (surveillance drug resistance mutations; SDRMs). Since January 2007, several new drugs have been approved and several new drug-resistance mutations have been identified. In this paper, we follow the same procedures described previously to develop an updated list of SDRMs that are likely to be useful for ongoing and future studies of transmitted drug resistance. The updated SDRM list has 93 mutations including 34 NRTI-resistance mutations at 15 RT positions, 19 NNRTI-resistance mutations at 10 RT positions, and 40 PI-resistance mutations at 18 protease positions