Flipping the classroom:an effective approach to deal with diversity at higher education

Even though the flipped classroom is an increasingly popular method in education, a literature search shows a gap in research on this method in higher education. This article describes an experiment with two central questions: (1) How do students and lecturers assess the effectiveness of the FC method? And (2) What are crucial design elements? To be able to answer these questions we designed an experiment within a large-size, interdisciplinary, course. For three years we carefully monitored and evaluated the course. A mixed-method approach was used to collect data. Our findings show a positive contribution of the FC approach to the learning experience of students. We also found that a strong link between theory and practice is essential in the course design; combined with active learning we were able to involve students and stimulate them to reach a deeper level of understanding. Moreover, we believe that the FC approach offers opportunities to have a large interdisciplinary group, with different learning needs, work together on higher attainment levels

Choosing conservative care in advanced chronic kidney disease: a scoping review of patients’ perspectives

Background. Conservative care (CC) is a viable treatment option for some patients with kidney failure. Choosing between dialys and CC can be a complex decision in which involvement of patients is desirable. Gaining insight into the experiences and preferenc of patients regarding this decision-making process is an important initial step to improve care. We aimed to identify what is know about the perspective of patients regarding decision-making when considering CC. Methods. PubMed, EMBASE and Cochrane databases were systematically searched on 23 February 2023 for qualitative and quantitati studies on patient-reported experiences on decision-making about CC. Data were analysed thematically. Results. Twenty articles were included. We identified three major themes: creating awareness about disease and treatment choic decision support and motivation to choose CC. Patients were often not aware of the option to choose CC. Patients felt supported their loved ones during the decision-making process, although they perceived they made the final decision to choose CC themselve Some patients felt pressured by their healthcare professional to choose dialysis. Reported reasons to choose CC were maintainin quality of life, treatment burden of dialysis, cost and the desire not to be a burden to others. In general, patients were satisfied wi their decision for CC. Conclusions. By focussing on the perspective of patients, we identified a wide range of patient experiences and preferences regardin the decision-making process. These findings can help to improve the complex decision-making process between dialysis and CC an to provide patient-centred care

Driving pressure during general anesthesia for open abdominal surgery (DESIGNATION) : study protocol of a randomized clinical trial

Background Intraoperative driving pressure (Delta P) is associated with development of postoperative pulmonary complications (PPC). When tidal volume (V-T) is kept constant, Delta P may change according to positive end-expiratory pressure (PEEP)-induced changes in lung aeration. Delta P may decrease if PEEP leads to a recruitment of collapsed lung tissue but will increase if PEEP mainly causes pulmonary overdistension. This study tests the hypothesis that individualized high PEEP, when compared to fixed low PEEP, protects against PPC in patients undergoing open abdominal surgery. Methods The "Driving prESsure durIng GeNeral AnesThesIa for Open abdomiNal surgery trial" (DESIGNATION) is an international, multicenter, two-group, double-blind randomized clinical superiority trial. A total of 1468 patients will be randomly assigned to one of the two intraoperative ventilation strategies. Investigators screen patients aged >= 18 years and with a body mass index <= 40 kg/m(2), scheduled for open abdominal surgery and at risk for PPC. Patients either receive an intraoperative ventilation strategy with individualized high PEEP with recruitment maneuvers (RM) ("individualized high PEEP") or one in which PEEP of 5 cm H2O without RM is used ("low PEEP"). In the "individualized high PEEP" group, PEEP is set at the level at which Delta P is lowest. In both groups of the trial, V-T is kept at 8 mL/kg predicted body weight. The primary endpoint is the occurrence of PPC, recorded as a collapsed composite of adverse pulmonary events. Discussion DESIGNATION will be the first randomized clinical trial that is adequately powered to compare the effects of individualized high PEEP with RM versus fixed low PEEP without RM on the occurrence of PPC after open abdominal surgery. The results of DESIGNATION will support anesthesiologists in their decisions regarding PEEP settings during open abdominal surgery

Development of atypical parental behavior during an inpatient family preservation intervention program

Since failed reunification is a detrimental outcome for children, particularly infants and toddlers, the aim of this study was to gain insight into support to families in multiple-problem situations to help them achieve sustainable good-enough parenting. Therefore, we examined outcomes of an assessment-based inpatient family preservation program. We prepared a thorough target-population description (n = 70) using file analysis. Next, we examined atypical parental behavior during the intervention using the Atypical Maternal Behavior Instrument for Assessment and Classification with a repeated measures design (n = 30). The family files revealed a great number of issues at the family, parent, and child levels, such as practical matters, problems in parent functioning and between parents, and difficulties in the broader environment. We found a significant decline in three dimensions of atypical parental behavior over time. This program has great potential in supporting vulnerable families in their pursuit of family preservation

A nationwide evaluation of deceased donor kidney transplantation indicates detrimental consequences of early graft loss

Early graft loss (EGL) is a feared outcome of kidney transplantation. Consequently, kidneys with an anticipated risk of EGL are declined for transplantation. In the most favorable scenario, with optimal use of available donor kidneys, the donor pool size is balanced by the risk of EGL, with a tradeoff dictated by the consequences of EGL. To gauge the consequence of EGL we systematically evaluated its impact in an observational study that included all 10,307 deceased-donor kidney transplantations performed in The Netherlands between 1990 and 2018. Incidence of EGL, defined as graft loss within 90 days, in primary transplantation was 8.2% (699/8,511). The main causes were graft rejection (30%), primary nonfunction (25%), and thrombosis or infarction (20%). EGL profoundly impacted short- and long-term patient survival (adjusted hazard ratio; 95% confidence interval: 8.2; 5.1-13.2 and 1.7; 1.3-2.1, respectively). Of the EGL recipients who survived 90 days after transplantation (617/699) only 440 of the 617 were relisted for re-transplantation. Of those relisted, only 298 were ultimately re-transplanted leading to an actual re-transplantation rate of 43%. Noticeably, re-transplantation was associated with a doubled incidence of EGL, but similar long-term graft survival (adjusted hazard ratio 1.1; 0.6-1.8). Thus, EGL after kidney transplantation is a medical catastrophe with high mortality rates, low relisting rates, and increased risk of recurrent EGL following re-transplantation. This implies that detrimental outcomes also involve convergence of risk factors in recipients with EGL. The 8.2% incidence of EGL minimally impacted population mortality, indicating this incidence is acceptable

Some like it bad: testing a model on perceiving and experiencing fictional characters

We developed an encompassing theory that explains how readers of fiction and spectators of motion pictures establish affective relationships with fictional characters (FCs). The perceiving and experiencing fictional characters (PEFiC) theory is anchored in art perception, psychological aesthetics, and social and emotion psychology and addresses both the complexity and intrinsic affectivity involved in media exposure. In a between-subject design (N = 312), engagement and appreciation were measured as a function of the ethics (good vs. bad), aesthetics (beautiful vs. ugly), and epistemics (realistic vs. unrealistic) of eight protagonists in feature movies. The PEFiC model best fit the data with a unipolarity of factors and outperformed traditional theories (identification, empathy): The trade-off between involvement and distance explained the appreciation of FCs better than either distance or involvement alone. The mediators similarity, relevance, and valence exerted significant (interaction) effects, thus complicating the results. Furthermore, the effects of mediated bad persons differed strongly from ethically good ones. Copyright © 2005, Lawrence Erlbaum Associates, Inc

Observation of weak neutral current neutrino production of J/ψJ/\psi

Observation of \jpsi production by neutrinos in the calorimeter of the CHORUS detector exposed to the CERN SPS wide-band \numu beam is reported. A spectrum-averaged cross-section $\sigma^{\mathrm{J/\psi}}$ = (6.3 $\pm$ 3.0) $\times \mathrm{10^{-41}~cm^{2}}$ is obtained for 20 GeV $\leq E_{\nu} \leq$ 200 GeV. The data are compared with the theoretical model based on the QCD Z-gluon fusion mechanism

The CHORUS neutrino oscillation search experiment

The CHORUS experiment has successfully finished run I (320~000 recorded \numu\ CC in 94/95) and performed half of run II (225~000 \numu\ CC in 96). The analysis chain was exercised on a small data sample for the muonic \tdecay\ search using for the first time fully automatic emulsion scanning. This pilot analysis, resulting in a limit \sintth \leq 3 \cdot 10^{-2}, confirms that the CHORUS proposal sensitivity (\sintth \leq 3 \cdot 10^{-4}) is within reach in two years