Speaking and listening: never a better time

Taking as its starting point the Rose Review's endorsement of 'a language-rich curriculum' the article discusses the value of talk as a learning medium, examining types of talk, the work of Douglas Barnes and Neil Mercer, and practical classroom activities

Militia Commission of Isaiah K. Safford as Lieutenant

Commission of Isaiah K. Safford of Dexter, as a Lieutenant of a Company of Infantry in the Third Regiment, in the First Brigade and Third Division of the Militia of the State of Maine, by Governor Jonathon G. Hunton., September 8, 1830.https://digitalcommons.library.umaine.edu/mainebicentennial/1107/thumbnail.jp

Assessing Students\u27 Acquisition of Scientific Reasoning in an Experimental Psychology Class

This pilot study is an initial exploration of a theoretical rubric proposed to describe the progress of students’ acquisition of scientific inquiry (Halonen et al., 2003, p. 196), and an application of the utility of the rubric. Twenty-two undergraduates from a woman’s college participated in two sections of experimental psychology. Students consisted of sophomores, juniors, and seniors who completed general psychology courses. Consistent with the Halonen et al. (2003) model, results indicated that authentic research experiences in the first phase of the course were positively correlated with changes in scientific thinking in a second phase. In turn, experiences in the second phase were positively correlated with evidence of advanced thinking skills in a third phase. The findings suggest that much of the basic skill knowledge acquired in the beginning lectures, textbook readings, and writing instruction of the course enhanced students’ ability to apply that knowledge in later classes and the lab components. Further, the authentic learning experiences were instrumental in fine-tuning the skills learned from the lectures and textbooks readings. As a result, the current authors advocate the use of authentic experiences in teaching research methods, as a way for teachers to transform such classes in a beneficial and systematic way, in order to enhance acquisition of scientific thinking skills and to examine changes in scientific thinking as explicated in the Halonen et al. (2003) model

Multiple uncontrolled conditions and blood pressure medication intensification: an observational study

Abstract Background Multiple uncontrolled medical conditions may act as competing demands for clinical decision making. We hypothesized that multiple uncontrolled cardiovascular risk factors would decrease blood pressure (BP) medication intensification among uncontrolled hypertensive patients. Methods We observed 946 encounters at two VA primary care clinics from May through August 2006. After each encounter, clinicians recorded BP medication intensification (BP medication was added or titrated). Demographic, clinical, and laboratory information were collected from the medical record. We examined BP medication intensification by presence and control of diabetes and/or hyperlipidemia. 'Uncontrolled' was defined as hemoglobin A1c ≥ for diabetes, BP ≥ 140/90 mmHg (≥ 130/80 mmHg if diabetes present) for hypertension, and low density lipoprotein cholesterol (LDL-c) ≥ 130 mg/dl (≥ 100 mg/dl if diabetes present) for hyperlipidemia. Hierarchical regression models accounted for patient clustering and adjusted medication intensification for age, systolic BP, and number of medications. Results Among 387 patients with uncontrolled hypertension, 51.4% had diabetes (25.3% were uncontrolled) and 73.4% had hyperlipidemia (22.7% were uncontrolled). The BP medication intensification rate was 34.9% overall, but higher in individuals with uncontrolled diabetes and uncontrolled hyperlipidemia: 52.8% overall and 70.6% if systolic BP ≥ 10 mmHg above goal. Intensification rates were lowest if diabetes or hyperlipidemia were controlled, lower than if diabetes or hyperlipidemia were not present. Multivariable adjustment yielded similar results. Conclusions The presence of uncontrolled diabetes and hyperlipidemia was associated with more guideline-concordant hypertension care, particularly if BP was far from goal. Efforts to understand and improve BP medication intensification in patients with controlled diabetes and/or hyperlipidemia are warranted.http://deepblue.lib.umich.edu/bitstream/2027.42/78266/1/1748-5908-5-55.xmlhttp://deepblue.lib.umich.edu/bitstream/2027.42/78266/2/1748-5908-5-55.pdfPeer Reviewe

Modeling plant ranges over 75 years of climate change in California, USA: temporal transferability and species traits

Species distribution model (SDM) projections under future climate scenarios are increasingly being used to inform resource management and conservation strategies. A critical assumption for projecting climate change responses is that SDMs are transferable through time, an assumption that is largely untested because investigators often lack temporally independent data for assessing transferability. Further, understanding how the ecology of species influences temporal transferability is critical yet almost wholly lacking. This raises two questions. (1) Are SDM projections transferable in time? (2) Does temporal transferability relate to species ecological traits? To address these questions we developed SDMs for 133 vascular plant species using data from the mountain ranges of California (USA) from two time periods: the 1930s and the present day. We forecast historical models over 75 years of measured climate change and assessed their projections against current distributions. Similarly, we hindcast contemporary models and compared their projections to historical data. We quantified transferability and related it to species ecological traits including physiognomy, endemism, dispersal capacity, fire adaptation, and commonness. We found that non-endemic species with greater dispersal capacity, intermediate levels of prevalence, and little fire adaptation had higher transferability than endemic species with limited dispersal capacity that rely on fire for reproduction. We demonstrate that variability in model performance was driven principally by differences among species as compared to model algorithms or time period of model calibration. Further, our results suggest that the traits correlated with prediction accuracy in a single time period may not be related to transferability between time periods. Our findings provide a priori guidance for the suitability of SDM as an approach for forecasting climate change responses for certain taxa

Medication intensification in diabetes in rural primary care: a cluster-randomised effectiveness trial

OBJECTIVE: To determine the effectiveness of a provider-based intervention to improve medication intensification among patients with diabetes. DESIGN: Effectiveness cluster-randomised trial. Baseline and follow-up cross-sections of diabetes physicians\u27 patients. SETTING: Eleven U.S. Southeastern states, 2006-2008. PARTICIPANTS: 205 Rural primary care physicians, 95 completed the study. INTERVENTION: Multicomponent interactive intervention including web-based continuing medical education (CME), performance feedback and quality improvement tools. PRIMARY OUTCOME MEASURES: Medication intensification, a dose increase of an existing medication or the addition of a new class of medication for glucose, blood pressure and lipids control on any of the three most recent office visits. RESULTS: Of 364 physicians attempting to register, 102 were randomised to the intervention and 103 to the control arms; 95 physicians (intervention, n=48; control, n=47) provided data on their 1182 of their patients at baseline (intervention, n=715; control, n=467) and 945 patients at follow-up (intervention, n=479; control, n=466). For A1c control, medication intensification increased in both groups (intervention, pre 26.4% vs post 32.6%, p=0.022; control, pre 24.8% vs post 31.1%, p=0.033) (intervention, adjusted OR (AOR) 1.37; 95% CI 1.06 to 1.76; control, AOR 1.41 (95% CI 1.06 to 1.89)); however, we observed no incremental benefit solely due to the intervention (group-by-time interaction, p=0.948). Among patients with the worst glucose control (A1c \u3e9%), intensification increased in both groups (intervention, pre 34.8% vs post 62.5%, p=0.002; control, pre 35.7% vs post 61.4%, p=0.008). CONCLUSIONS: A wide-reach, low-intensity, web-based interactive multicomponent intervention had no significant incremental effect on medication intensification for control of glucose, blood pressure or lipids for patients with diabetes of physicians practising in the rural Southeastern USA. TRIAL REGISTRATION: NCT00403091

‘Give courage to the ladies’: expansive apprenticeship for women in rural Malawi

Apprenticeship in developed and industrialised nations is increasingly understood as a theory of learning which connects workplace activity and formal study. The concept of ‘expansive apprenticeship’ defines frameworks for workforce development where participants acquire knowledge and skills which will help them in the future as well as in their current roles, whilst ‘restrictive’ apprenticeships limit opportunities for wider, lifelong learning. In developing nations apprenticeship is a traditional route to learning and employment, but apprenticeships in these contexts tend to reflect a restrictive approach characterized by narrowly defined roles and weak educational outcomes. This paper examines a project in Malawi which uses concepts of expansive apprenticeship to address barriers to female continuing education and chronic teacher shortages. The Malawi Access to Teaching Scholarship recruited one thousand women to follow a year-long combined programme of academic distance study and practical work experience in rural primary schools. The aim is to increase the numbers of women teachers in Malawi, especially in rural areas. The Scholarship materials and support structures are designed to move participants from restrictive to expansive contexts for learning so that Scholars develop hybrid roles as students, community workers and apprentice pedagogues. The programme’s resources and approach offer an innovative model of expansive apprenticeship in Sub Saharan Africa

The RhoA transcriptional program in pre-T cells

The GTPase RhoA is essential for the development of pre-T cells in the thymus. To investigate the mechanisms used by RhoA to control thymocyte development we have used Affymetrix gene profiling to identify RhoA regulated genes in T cell progenitors. The data show that RhoA plays a specific and essential role in pre-T cells because it is required for the expression of transcription factors of the Egr-1 and AP-1 families that have critical functions in thymocyte development. Loss of RhoA function in T cell progenitors causes a developmental block that pheno-copies the consequence of losing pre-TCR expression in Recombinase gene 2 (Rag2) null mice. Transcriptional profiling reveals both common and unique gene targets for RhoA and the pre-TCR indicating that RhoA participates in the pre-TCR induced transcriptional program but also mediates pre-TCR independent gene transcription

Rethinking the patient: using Burden of Treatment Theory to understand the changing dynamics of illness

<b>Background</b> In this article we outline Burden of Treatment Theory, a new model of the relationship between sick people, their social networks, and healthcare services. Health services face the challenge of growing populations with long-term and life-limiting conditions, they have responded to this by delegating to sick people and their networks routine work aimed at managing symptoms, and at retarding - and sometimes preventing - disease progression. This is the new proactive work of patient-hood for which patients are increasingly accountable: founded on ideas about self-care, self-empowerment, and self-actualization, and on new technologies and treatment modalities which can be shifted from the clinic into the community. These place new demands on sick people, which they may experience as burdens of treatment.<p></p> <b>Discussion</b> As the burdens accumulate some patients are overwhelmed, and the consequences are likely to be poor healthcare outcomes for individual patients, increasing strain on caregivers, and rising demand and costs of healthcare services. In the face of these challenges we need to better understand the resources that patients draw upon as they respond to the demands of both burdens of illness and burdens of treatment, and the ways that resources interact with healthcare utilization.<p></p> <b>Summary</b> Burden of Treatment Theory is oriented to understanding how capacity for action interacts with the work that stems from healthcare. Burden of Treatment Theory is a structural model that focuses on the work that patients and their networks do. It thus helps us understand variations in healthcare utilization and adherence in different healthcare settings and clinical contexts

The importance of post-translocation monitoring of habitat use and population growth: insights from a Seychelles Warbler (Acrocephalus sechellensis) translocation

Translocations are a valuable tool within conservation, and when performed successfully can rescue species from extinction. However, to label a translocation a success, extensive post-translocation monitoring is required, ensuring the population is growing at the expected rate. In 2011, a habitat assessment identified Frégate Island as a suitable island to host a Seychelles Warbler (Acrocephalus sechellensis) population. Later that year, 59 birds were translocated from Cousin Island to Frégate Island. Here, we determine Seychelles Warbler habitat use and population growth on Frégate Island, assessing the status of the translocation and identifying any interventions that may be required. We found that territory quality, an important predictor of fledgling production on Cousin Island, was a poor predictor of bird presence on Frégate Island. Instead, tree diversity, middle-storey vegetation density, and broad-leafed vegetation density all predicted bird presence positively. A habitat suitability map based on these results suggests most of Frégate Island contains either a suitable or a moderately suitable habitat, with patches of unsuitable overgrown coconut plantation. To achieve the maximum potential Seychelles Warbler population size on Frégate Island, we recommend habitat regeneration, such that the highly diverse subset of broad-leafed trees and a dense middle storey should be protected and replace the unsuitable coconut. Frégate Island’s Seychelles Warbler population has grown to 141 birds since the release, the slowest growth rate of all Seychelles Warbler translocations; the cause of this is unclear. This study highlights the value of post-translocation monitoring, identifying habitat use and areas requiring restoration, and ultimately ensuring that the population is growing