Lesson Study and Lesson Sharing: An Appealing Marriage

Lesson Study and lesson sharing are two educational initiatives that, if merged, have the potential to revolutionize how teachers plan and deliver lessons. Lesson Study is the joint production of lessons by a small team of teachers over the course of a few months. The resulting lesson plan is usually “on paper” and used only locally. Lesson sharing occurs on the Internet, providing contributing teachers with a mechanism for sharing their lessons with others. Typically a single teacher authors these shared lessons. We discuss the advantages and associated implementation barriers of each when viewed as separate activities, and then argue for their joint or merged implementation, describing how each would synergistically support the other. Not only would more vetted lessons be delivered to the Internet, but also the teacher teams participating in lesson creation would develop a much deeper understanding of pedagogy. We offer policy recommendations to support this new educational paradigm: A virtual marriage of Lesson Study and lesson sharing

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome

Barriers to implementation of new programs and pedagogies in K-12 Science, Technology, Engineering and Math Education

Thesis (S.M. in Technology and Policy)--Massachusetts Institute of Technology, Engineering Systems Division, 2013.Cataloged from PDF version of thesis.Includes bibliographical references (p. 85-97).The continued usage of poor pedagogies in K-12 classrooms, despite large pressures for teachers to change their practice, points towards systematic barriers to change. In the last few decades, there has been a national focus to improve Science, Technology, Engineering and Math (STEM) Education. Driven by their concern for developing their future workforce, science and technology companies have invested billions of dollars in improving student outcomes. Further, the federal and state governments have responded by adopting new policies meant to improve student performance. Promising new pedagogies, such as Project Based Learning or the Flipped Classroom, have been developed alongside new technologies to complement them. Yet despite this support, pedagogical practice has not drastically changed and students are primarily taught through lectures and homework sets. This thesis argues that teachers do not adopt new pedagogies because they are under short-term pressure to improve test scores, often face an uphill battle against their school culture and/or do not have deep enough pedagogical or content expertise. A causal model of pedagogical implementation barriers is developed using the results of in-depth surveys and interviews of administrators, principals and teachers. Within this model, critical points of leverage are identified that can interrupt the negative feedback loops creating pedagogical lock-in, and three case studies of international attempts at pedagogical reform are presented to illustrate effective strategies to utilize these leverage points. General policy recommendations are then developed that will remove the current system of pressures and incentives for teachers to use rote memorization and incentivize use of more effective pedagogies.by Mackenzie Douglas Hird.S.M.in Technology and Polic

Session F: Contributed Oral Papers – F1: Physics Education: Play Ball!: The House That Euclid Built

Our video begins in the classroom. One student laments to his fellow classmates that his baseball team will be forced to forfeit their next game if they cannot find a field to play on. In response, the other students suggest constructing a baseball diamond of their own. As soon as the first student agrees, they all begin brainstorming ways to go about making a 90ft x 90ft perfect square, the dimensions of a standard MLB baseball diamond. First the students try using a protractor. They soon realize, however, that the scale of their project is too massive to rely on such a small instrument. Next, the students attempt to make a square using GPS technology. This time it is the margins of error on these machines that stymie their pursuit. Finally, one of the class members who has been silent to this point suggests that the answer lies in the 2000 year-old propositions of Euclid. Suddenly, the ancient Greek geometer himself appears in the distance ready to assist our students. Using a synthesis of Euclidian proofs, the students then construct a baseball diamond in time for the game. Play ball

Session F: Contributed Oral Papers – F1: Physics Education:Messing about with Euclid

How to make Euclid educative and inspiring in a video demonstration for school students? This curiosity motivated our group of university students to participate in a university pilot program whose mission is to support students in producing educational videos that demonstrate classic experiments from history. The educational objective and the historical experiment focus of the pilot program intrigue us. We mess about while we encounter the geometry of Euclid\u27s classic text. The making of the video is woven into our own exploring and our understanding of Euclid. In turn, our exploratory process strengthens our capacity to make Euclid inspiring to school-aged audiences

Thigh-length compression stockings and DVT after stroke

Controversy exists as to whether neoadjuvant chemotherapy improves survival in patients with invasive bladder cancer, despite randomised controlled trials of more than 3000 patients. We undertook a systematic review and meta-analysis to assess the effect of such treatment on survival in patients with this disease

The politics of the anthropocene: a dialogue

This paper stages a dialogue between a human geographer and a physical geographer about the concept of the Anthropocene. The aim of the dialogue is not to arrive at an agreement about how the Anthropocene should be defined, but rather to open up the question of the politics of the concept and its definition. The dialogue revolves around three issues: (1) the politics of the debate about the geoscientific definition of the Anthropocene Epoch; (2) the relation between the geoscientific debate about the Anthropocene and the burgeoning literature on the Anthropocene in the social sciences and humanities, including human geography; (3) the relation between geoscientific and political concepts