Occupational Therapy Students’ Experiences of Team-Based Learning: A Multi-year Study

Many health sciences disciplines have adopted team-based learning (TBL) as part of their education pedagogy, with studies showing increased classroom participation and learner satisfaction. However, it will be beneficial to explore the learning experiences of occupational therapy students in TBL using a mixed methods approach. In an undergraduate occupational therapy program, students undertook three clinical modules using TBL in years two and three. This study explored their perceptions and experiences of TBL. This was a mixed methods prospective cohort study, during which two cohorts of students from Academic Year (AY) 2016 and AY2017 completed the Team-Based Learning Student Assessment Instrument (TBL-SAI) at the end of their first (midway evaluation) and third clinical module (final evaluation). In addition, they completed a semi-structured survey to share their learning experience. One-hundred twenty-seven occupational therapy students from both cohorts had full data and their results showed higher than neutral for Accountability, Preference for TBL, and Student Satisfaction sub-scales and composite scores at midway and final survey. Collectively, there were no significant changes in TBL perceptions, and no significant relationships were found between TBL-SAI scores and module results. Within the AY2017 cohort, there was positive moderate association between Accountability sub-scale midway score and module results. Qualitative analysis produced four themes: 1) power of discussion; 2) time use; 3) changed learning process and outcome; and 4) tailoring aspects of TBL to enhance learning. Occupational therapy students’ scores in the TBL-SAI domains were higher than neutral at midway and final evaluation. TBL may be a suitable method to aid learning of clinical occupational therapy knowledge

Arrows in Biology: Lack of Clarity and Consistency Points to Confusion for Learners

In this article, we begin to unpack the phenomenon of representational competence by ex¬ploring how arrow symbols are used in introductory biology textbook figures. Out of 1214 figures in an introductory biology textbook, 632 (52%) of them contained arrows that were used to represent many different concepts or processes. Analysis of these figures revealed little correlation between arrow style and meaning. A more focused study of 86 figures containing 230 arrows from a second textbook showed the same pattern of inconsistency. Interviews with undergraduates confirmed that arrows in selected textbook figures were confusing and did not readily convey the information intended by the authors. We also present findings from an online survey in which subjects were asked to infer meaning of different styles of arrows in the absence of context. Few arrow styles had intrinsic meaning to participants, and illustrators did not always use those arrows for the meanings expected by students. Thus, certain styles of arrows triggered confusion and/or incorrect conceptual ideas. We argue that 1) illustrators need to be more clear and consistent when using arrow symbols, 2) instructors need to be cognizant of the level of clarity of representations used during instruction, and 3) instructors should help students learn how to interpret representations containing arrows

Chromospheric Activity of HAT-P-11: an Unusually Active Planet-Hosting K Star

Kepler photometry of the hot Neptune host star HAT-P-11 suggests that its spot latitude distribution is comparable to the Sun's near solar maximum. We search for evidence of an activity cycle in the CaII H & K chromospheric emission $S$-index with archival Keck/HIRES spectra and observations from the echelle spectrograph on the ARC 3.5 m Telescope at APO. The chromospheric emission of HAT-P-11 is consistent with a $\gtrsim 10$ year activity cycle, which plateaued near maximum during the Kepler mission. In the cycle that we observed, the star seemed to spend more time near active maximum than minimum. We compare the $\log R^\prime_{HK}$ normalized chromospheric emission index of HAT-P-11 with other stars. HAT-P-11 has unusually strong chromospheric emission compared to planet-hosting stars of similar effective temperature and rotation period, perhaps due to tides raised by its planet.Comment: 16 pages, 8 figures; accepted to the Astrophysical Journa

RECOMMENDATIONS FOR MINIMUM TRIAL NUMBERS DURING WALKING GAIT

In a rehabilitation context, athletes may not be able to complete large numbers of trials during testing due to joint edema and pain. The purpose of this research was to determine the minimum number of trials needed to achieve a negligibly fluctuating temporal variance profile during walking gait. The time-series kinematics of the hip, knee and ankle were recorded from 10 participants, completing 11 trials each. The time-series variance of each kinematic variables were calculated for ten trials and used as a reference. Using a two-sample SPM1D {t} (α=0.05), all variance combinations (9, 8, 7, ... 3 of 11 trials) from the same participants were compared to the reference. Results showed a minimum of 7 trials were needed to achieve ’stable‘ kinematic variance during walking gait. This study provides evidence for selecting an appropriate number of walking trials in gait analysis, especially in early-stage rehabilitation for patients with joint pain or edema

Association of Regional Variation in Primary Care Physicians’ Colorectal Cancer Screening Recommendations with Individual Use of Colorectal Cancer Screening

Introduction: Studies show that the recommendations of a primary care physician for colorectal cancer screening may be one important influence on an individual's use of screening. However, another possible influence, the effect of regional differences in physicians' beliefs and recommendations on screening use, has not been assessed. Methods: We linked data from the National Health Interview Survey on the use of colorectal cancer screening by respondents aged 50 years or older, by hospital-referral region, with data from the Survey of Colorectal Cancer Screening Practices on the colorectal cancer screening recommendations of primary care physicians, by region. Our principal independent variables were the proportion of physicians in a region who recommended screening at age 50 and continuing screening at the recommended frequency. Results: On average, 53.3% of physicians in a region correctly recommended initiating colorectal cancer screening, and 64.8% advised screening at the recommended frequency. Of adults who lived in regions where less than 30% of physicians correctly recommended initiating screening, 47.3% had been screened, in contrast to 54.8% in areas where 70% or more of physicians made correct recommendations. Seventy-one percent of respondents living in regions where less than 30% of physicians advised screening at the recommended frequency were current on screening, in contrast to 79.9% of respondents living in regions where 70% or more of physicians made this recommendation. These differences were statistically significant after adjustment for individual characteristics. Conclusion: Strategies to improve colorectal cancer screening recommendations of primary care physicians may improve the use of screening for millions of Americans

Addressing Resistance to Antibiotics in Pluralist Health Systems

There is growing international concern about the threat to public health of the emergence and spread of bacteria resistant to existing antibiotics. An effective response must invest in both the development of new drugs and measures to slow the emergence of resistance. This paper addresses the former. It focuses on low and middle-income countries with pluralistic health systems, where people obtain much of their antibiotics in unorganised markets. There is evidence that these markets have enabled people to treat many infections and reduce mortality. However, they also encourage overuse of antibiotics and behaviour likely to encourage the emergence of resistance. The paper reviews a number of strategies for improving the use of antibiotics. It concludes that effective strategies need measures to ensure easy access to antibiotics, as well as those aimed at influencing providers and users of these drugs to use them appropriately.Funding for work on this paper was provided by a grant by the UK ESRC to the STEPS Centre and a grant by the UK Department for International Development to the Future Health Systems Consortium

A driving cessation program to identify and improve transport and lifestyle issues of older retired and retiring drivers

Background: This study explored the transport and lifestyle issues of older retired and retiring drivers participating in the University of Queensland Driver Retirement Initiative (UQDRIVE), a group program to promote adjustment to driving cessation for retired and retiring older drivers

Intake patterns of specific alcoholic beverages by prostate cancer status

Background: Previous studies have shown that different alcoholic beverage types impact prostate cancer (PCa) clinical outcomes differently. However, intake patterns of specific alcoholic beverages for PCa status are understudied. The study?s objective is to evaluate intake patterns of total alcohol and the three types of beverage (beer, wine, and spirits) by the PCa risk and aggressiveness status. Method: This is a cross-sectional study using 10,029 men (4676 non-PCa men and 5353 PCa patients) with European ancestry from the PCa consortium. Associations between PCa status and alcohol intake patterns (infrequent, light/moderate, and heavy) were tested using multinomial logistic regressions. Results: Intake frequency patterns of total alcohol were similar for non-PCa men and PCa patients after adjusting for demographic and other factors. However, PCa patients were more likely to drink wine (light/moderate, OR = 1.11, p = 0.018) and spirits (light/moderate, OR = 1.14, p = 0.003; and heavy, OR = 1.34, p = 0.04) than non-PCa men. Patients with aggressive PCa drank more beer than patients with non-aggressive PCa (heavy, OR = 1.48, p = 0.013). Interestingly, heavy wine intake was inversely associated with PCa aggressiveness (OR = 0.56, p = 0.009). Conclusions: The intake patterns of some alcoholic beverage types differed by PCa status. Our findings can provide valuable information for developing custom alcohol interventions for PCa patients

Cumulative Burden of Colorectal Cancer-Associated Genetic Variants Is More Strongly Associated With Early-Onset vs Late-Onset Cancer.

BACKGROUND & AIMS: Early-onset colorectal cancer (CRC, in persons younger than 50 years old) is increasing in incidence; yet, in the absence of a family history of CRC, this population lacks harmonized recommendations for prevention. We aimed to determine whether a polygenic risk score (PRS) developed from 95 CRC-associated common genetic risk variants was associated with risk for early-onset CRC. METHODS: We studied risk for CRC associated with a weighted PRS in 12,197 participants younger than 50 years old vs 95,865 participants 50 years or older. PRS was calculated based on single nucleotide polymorphisms associated with CRC in a large-scale genome-wide association study as of January 2019. Participants were pooled from 3 large consortia that provided clinical and genotyping data: the Colon Cancer Family Registry, the Colorectal Transdisciplinary Study, and the Genetics and Epidemiology of Colorectal Cancer Consortium and were all of genetically defined European descent. Findings were replicated in an independent cohort of 72,573 participants. RESULTS: Overall associations with CRC per standard deviation of PRS were significant for early-onset cancer, and were stronger compared with late-onset cancer (P for interaction = .01); when we compared the highest PRS quartile with the lowest, risk increased 3.7-fold for early-onset CRC (95% CI 3.28-4.24) vs 2.9-fold for late-onset CRC (95% CI 2.80-3.04). This association was strongest for participants without a first-degree family history of CRC (P for interaction = 5.61 × 10-5). When we compared the highest with the lowest quartiles in this group, risk increased 4.3-fold for early-onset CRC (95% CI 3.61-5.01) vs 2.9-fold for late-onset CRC (95% CI 2.70-3.00). Sensitivity analyses were consistent with these findings. CONCLUSIONS: In an analysis of associations with CRC per standard deviation of PRS, we found the cumulative burden of CRC-associated common genetic variants to associate with early-onset cancer, and to be more strongly associated with early-onset than late-onset cancer, particularly in the absence of CRC family history. Analyses of PRS, along with environmental and lifestyle risk factors, might identify younger individuals who would benefit from preventive measures