The Effects of a Cooperative Learning Environment on Preservice Elementary Teachers\u27 Interest in and the Application of Music into Core Academic Subjects

The purpose of this study was to examine the effect of cooperative learning on preservice elementary teachers’ interest in, and the application of music into, core academic subject lesson plans. Participants (N = 59) were preservice elementary teachers enrolled in four class sections of a music method course designed for elementary education majors at a large southern university. All members participating in the study were placed by section for eight weeks in one of two groups-an individualistic learning group or cooperative learning group. During the first 6 weeks of the study, participants worked on the Music Integration Project. The purpose of the project was to develop academic lesson plans with the integration of music. Each Music Integration Project consisted of a: (a) title page, (b) table of contents, (c) a rationale citing 2 primary sources, and (d) 10 lesson plans integrating music into core subject lesson plans. At the conclusion of the 6 weeks, participants turned in their projects, which were scored by the primary investigator using the Music Integration Project Rubrics developed by the researcher. The Integrated Music Project Rubrics consisted of three sub-rubrics: (a) Organization Rubric, (b) Rationale Rubric, and (c) Lesson Plan Rubric. During the last two weeks of the study, all of the participants were videotaped teaching an integrated music lesson. Tapes were analyzed post-hoc and the participants’ scores were recorded by using the Integration of Music Observation Map. This Map assessed each of the participant’s microteaching on ten different criteria: (a) teacher, (b) pupils, (c) process, (d) element, (e) atmosphere, (f) purpose, (g) authenticity, (h) expression, (i) degree, and (j) range. Participants also completed a pre and post-Integrated Music Project Interest Survey. The independent variable used in this study was learning environment, cooperative learning and individualistic learning. The dependent variables were the participants’ scores on the Integrated Music Project Rubrics (organization, rationale, and lesson plan), scores from the Integration Music Observation Map, and scores from the pre/post interest survey. Interjudge reliability consisted of 20% of the scores from each learning groups’ Integrated Music Project and microteaching. Interjudge reliability was calculated as a Pearson product-moment correlation and found to be high with a range of r= .82 to .96. An alpha level of .05 was set for all tests of significance. Results from the Music Integration Project showed cooperative learning participants scoring statistically significantly higher on the organization rubric, lesson plan rubric, and total scores than participants in the individualistic learning group. For the microteaching component, participants in the cooperative learning environment scored statistically significantly higher on the Integration Music Observation Map in the areas of: (a) pupils, (b) atmosphere, (c) purpose, (d) authenticity, and (e) degree. On the pre and post Integrated Music Project Interest Survey, participants in the cooperative learning group rated all areas (attention, relevance, confidence, and satisfaction) statistically significantly higher than participants in the individualistic learning environment

Using the River Ecosystem Service Index to evaluate “Free Moving Rivers” restoration measures: A case study on the Ammer river (Bavaria)

Restoring natural fluvial dynamics is fundamental for sustaining biodiversity and functional integrity of river and floodplain ecosystems. In Central Europe, however, pervasive river regulation and bank protection have greatly impaired ecosystem functioning and many water bodies fail to achieve a good ecological status within the European Water Framework Directive. The “Free Moving Rivers” approach seeks to restore the ecological integrity of rivers and floodplains by creating appropriate conditions for natural fluvial dynamics. Principal goals of the approach include removing artificial constraints on river processes and expanding the river corridor to restore natural river habitats and structures. Lacking, however, are complementary tools that evaluate and predict changes to ecosystem services (ESSs) after implementation. Here, we describe a case study of the Ammer river in Bavaria, Germany, to (i) calculate the extent of the “Free Moving Rivers” corridor, and (ii) assess changes to ESSs of a proposed river restoration measure under two alternative land-use scenarios. To do this, we apply the River Ecosystem Service Index (RESI), whereby individual ESSs are assessed in a spatially explicit way. We show how a proposed implementation of the “Free Moving Rivers” approach enhances three investigated ESSs: flood retention, sediment balance and habitat provision. We conclude that RESI is a potentially useful tool with wide applicability for restoration planning that synthesises floodplain complexity in such a way that facilitates decision making

Cost effectiveness of adherence to IDSA/ATS guidelines in elderly patients hospitalized for Community-Aquired Pneumonia

A copy of the survey questionnaire given to the expert panel regarding patient utilities. (PDF 8.28 kb

Promotion of health in older people: a randomised controlled trial of health risk appraisal in British general practice

Background: there is inadequate evidence to support currently formulated NHS strategies to achieve health promotion and preventative care in older people through broad-based screening and assessment in primary care. The most extensively evaluated delivery instrument for this purpose is Health Risk Appraisal (HRA). This article describes a trial using HRA to evaluate the effect on health behaviour and preventative-care uptake in older people in NHS primary care. Methods: a randomised controlled trial was undertaken in three London primary care group practices. Functionally independent community-dwelling patients older than 65 years (n=2,503) received a self-administered Health Risk Appraisal for Older Persons (HRA-O) questionnaire leading to computer-generated individualised written feedback to participants and general practitioners (GPs), integrated into practice information-technology (IT) systems. All primary care staff received training in preventative health in older people. The main outcome measures were self-reported health behaviour and preventative care uptake at 1-year follow-up. Results: of 2,503 individuals randomised, 2,006 respondents (80.1%) (intervention, n=940, control n=1,066) were available for analysis. Intervention group respondents reported slightly higher pneumococcal vaccination uptake and equivocal improvement in physical activity levels compared with controls. No significant differences were observed for any other categories of health behaviour or preventative care measures at 1-year follow-up. Conclusions: HRA-O implemented in this way resulted in minimal improvement of health behaviour or uptake of preventative care measures in older people. Supplementary reinforcement involving contact by health professionals with patients over and above routine clinical encounters may be a prerequisite to the effectiveness of IT-based delivery systems for health promotion in older peopl

Knowledge, Attitudes, and Practices Associated with Chronic Kidney Disease in Northern Tanzania: A Community-Based Study.

Non-communicable diseases (NCDs) are a leading cause of death among adults in sub-Saharan Africa, and chronic kidney disease (CKD) is a growing public health threat. Understanding knowledge, attitudes, and practices associated with NCDs is vital to informing optimal policy and public health responses in the region, but few community-based assessments have been performed for CKD. To address this gap, we conducted a cross-sectional survey of adults in northern Tanzania using a validated instrument. Between January and June 2014, we administered a structured survey to a random sample of adults from urban and rural communities. The validated instrument consisted of 25 items designed to measure knowledge, attitudes, and practices associated with kidney disease. Participants were also screened for CKD, diabetes, hypertension, and human immunodeficiency virus. We enrolled 606 participants from 431 urban and rural households. Knowledge of the etiologies, symptoms, and treatments for kidney disease was low (mean score 3.28 out of 10; 95% CI 2.94, 3.63). There were no significant differences by CKD status. Living in an urban setting and level of education had the strongest independent associations with knowledge score. Attitudes were characterized by frequent concern about the health (27.3%; 20.2, 36.0%), economic (73.1%; 68.2, 77.5%), and social impact (25.4%; 18.6, 33.6%) of kidney disease. Practices included the use of traditional healers (15.2%; 9.1, 24.5%) and traditional medicines (33.8%; 25.0, 43.9%) for treatment of kidney disease as well as a willingness to engage with mobile-phone technology in CKD care (94.3%; 90.1, 96.8%). Community-based adults in northern Tanzania have limited knowledge of kidney disease. However, there is a modest knowledge base upon which to build public health programs to expand awareness and understanding of CKD, but these programs must also consider the variety of means by which adults in this population meet their healthcare needs. Finally, our assessment of local attitudes suggested that such public health efforts would be well-received

Chlorpromazine for schizophrenia: a Cochrane systematic review of 50 years of randomised controlled trials

BACKGROUND: Chlorpromazine (CPZ) remains one of the most common drugs used for people with schizophrenia worldwide, and a benchmark against which other treatments can be evaluated. Quantitative reviews are rare; this one evaluates the effects of chlorpromazine in the treatment of schizophrenia in comparison with placebo. METHODS: We sought all relevant randomised controlled trials (RCT) comparing chlorpromazine to placebo by electronic and reference searching, and by contacting trial authors and the pharmaceutical industry. Data were extracted from selected trials and, where possible, synthesised and random effects relative risk (RR), the number needed to treat (NNT) and their 95% confidence intervals (CI) calculated. RESULTS: Fifty RCTs from 1955–2000 were included with 5276 people randomised to CPZ or placebo. They constitute 2008 person-years spent in trials. Meta-analysis of these trials showed that chlorpromazine promotes a global improvement (n = 1121, 13 RCTs, RR 0.76 CI 0.7 to 0.9, NNT 7 CI 5 to 10), although a considerable placebo response is also seen. People allocated to chlorpromazine tended not to leave trials early in both the short (n = 945, 16 RCTs, RR 0.74 CI 0.5 to 1.1) and medium term (n = 1861, 25 RCTs, RR 0.79 CI 0.6 to 1.1). There were, however, many adverse effects. Chlorpromazine is sedating (n = 1242, 18 RCTs, RR 2.3 CI 1.7 to 3.1, NNH 6 CI 5 to 8), increases a person's chances of experiencing acute movement disorders, Parkinsonism and causes low blood pressure with dizziness and dry mouth. CONCLUSION: It is understandable why the World Health Organization (WHO) have endorsed and included chlorpromazine in their list of essential drugs for use in schizophrenia. Low- and middle-income countries may have more complete evidence upon which to base their practice compared with richer nations using recent innovations

Novel VPS13B Mutations in Three Large Pakistani Cohen Syndrome Families Suggests a Baloch Variant with Autistic-Like Features.

BackgroundCohen Syndrome (COH1) is a rare autosomal recessive disorder, principally identified by ocular, neural and muscular deficits. We identified three large consanguineous Pakistani families with intellectual disability and in some cases with autistic traits.MethodsClinical assessments were performed in order to allow comparison of clinical features with other VPS13B mutations. Homozygosity mapping followed by whole exome sequencing and Sanger sequencing strategies were used to identify disease-related mutations.ResultsWe identified two novel homozygous deletion mutations in VPS13B, firstly a 1 bp deletion, NM_017890.4:c.6879delT; p.Phe2293Leufs*24, and secondly a deletion of exons 37-40, which co-segregate with affected status. In addition to COH1-related traits, autistic features were reported in a number of family members, contrasting with the "friendly" demeanour often associated with COH1. The c.6879delT mutation is present in two families from different regions of the country, but both from the Baloch sub-ethnic group, and with a shared haplotype, indicating a founder effect among the Baloch population.ConclusionWe suspect that the c.6879delT mutation may be a common cause of COH1 and similar phenotypes among the Baloch population. Additionally, most of the individuals with the c.6879delT mutation in these two families also present with autistic like traits, and suggests that this variant may lead to a distinct autistic-like COH1 subgroup

A Randomized Trial of Effects of Health Risk Appraisal Combined With Group Sessions or Home Visits on Preventive Behaviors in Older Adults

Background. To explore effects of a health risk appraisal for older people (HRA-O) program with reinforcement, we conducted a randomized controlled trial in 21 general practices in Hamburg, Germany. Methods. Overall, 2,580 older patients of 14 general practitioners trained in reinforcing recommendations related to HRA-O-identified risk factors were randomized into intervention (n = 878) and control (n = 1,702) groups. Patients (n = 746) of seven additional matched general practitioners who did not receive this training served as a comparison group. Patients allocated to the intervention group, and their general practitioners, received computer-tailored written recommendations, and patients were offered the choice between interdisciplinary group sessions (geriatrician, physiotherapist, social worker, and nutritionist) and home visits (nurse). Results. Among the intervention group, 580 (66%) persons made use of personal reinforcement (group sessions: 503 [87%], home visits: 77 [13%]). At 1-year follow-up, persons in the intervention group had higher use of preventive services (eg, influenza vaccinations, adjusted odds ratio 1.7; 95% confidence interval 1.4-2.1) and more favorable health behavior (eg, high fruit/fiber intake, odds ratio 2.0; 95% confidence interval 1.6-2.6), as compared with controls. Comparisons between intervention and comparison group data revealed similar effects, suggesting that physician training alone had no effect. Subgroup analyses indicated favorable effects for HRA-O with personal reinforcement, but not for HRA-O without reinforcement. Conclusions. HRA-O combined with physician training and personal reinforcement had favorable effects on preventive care use and health behavio