Real-life assessment of chronic rhinosinusitis patients using mobile technology : The mySinusitisCoach project by EUFOREA

Background Chronic rhinosinusitis (CRS) is a chronic inflammatory disease associated with a substantial personal and socioeconomic burden. Monitoring of patient-reported outcomes by mobile technology offers the possibility to better understand real-life burden of CRS. Methods This study reports on the cross-sectional evaluation of data of 626 users of mySinusitisCoach (mSC), a mobile application for CRS patients. Patient characteristics of mSC users were analysed as well as the level of disease control based on VAS global rhinosinusitis symptom score and adapted EPOS criteria. Results The mSC cohort represents a heterogeneous group of CRS patients with a diverse pattern of major symptoms. Approximately half of patients reported nasal polyps. 47.3% of all CRS patients were uncontrolled based on evaluation of VAS global rhinosinusitis symptom score compared to 40.9% based on adapted EPOS criteria. The impact of CRS on sleep quality and daily life activities was significantly higher in uncontrolled versus well-controlled patients. Half of patients had a history of FESS (functional endoscopic sinus surgery) and reported lower symptom severity compared to patients without a history of FESS, except for patients with a history of more than 3 procedures. Patients with a history of FESS reported higher VAS levels for impaired smell. Conclusion Real-life data confirm the high disease burden in uncontrolled CRS patients, clearly impacting quality of life. Sinus surgery improves patient-reported outcomes, but not in patients with a history of more than 3 procedures. Mobile technology opens a new era of real-life monitoring, supporting the evolution of care towards precision medicine.Peer reviewe

Teachers’ attitudes and practices in integrated STEM education

Integrated STEM education has the potential to improve students’ achievement in, attitudes toward and motivation for STEM domains (Stohlmann, Moore & Roehrig, 2012). However, to optimally profit from its possible benefits, integrated STEM should be taught effectively. Therefore this research aims at investigating how teachers’ attitudes and school context are related with their classroom practices. Insight into this relationship can provide useful tools for improving the implementation of integrated STEM education. Three questionnaires (for teachers’ attitudes, classroom practices and school context) were developed, validated and distributed among 245 integrated STEM teachers in Flanders. The concept of integrated STEM education was defined by means of five key principles: integration of STEM content, problem-centered learning, inquiry learning, design-based learning and cooperative learning. For each of the key principles a structural equation model (SEM) was developed. Results indicate a significant relationship between attitudes and classroom practices for all five aspects (range 0.275 to 0.483). Moreover, context factors were found to have a direct effect on classroom practices for three of the principles (integration, problem-centered learning and cooperative learning) and indirect effects for the other two principles. These findings suggest that targeting teachers’ attitudes along with specific context factors could benefit the effective implementation of integrated STEM education.status: publishe

The influence of teachers' attitudes and school context on instructional practices in integrated STEM education

This paper uses structural equation modelling (SEM) to examine the influence of teachers' attitudes and school context on reported instructional practices in integrated STEM (Science, Technology, Engineering and Mathematics). Instead of using an overall measure for integrated STEM, five specific characteristics (integration, problem-centered, inquiry-based, design-based, and cooperative learning) are examined to get a more in-depth and nuanced insight into the factors influencing implementation. For each STEM characteristic, teachers’ attitudes are positively linked with instructional practices Moreover, different aspects of school context influence instructional practices either directly or indirectly. Opportunities for ameliorating the implementation of integrated STEM are discussed.status: publishe

Measuring teachers’ attitudes toward teaching integrated STEM: instrument development and validation

The shortage of graduates in Science, Technology, Engineering and Mathematics (STEM), has led to numerous attempts to increase students’ interest in STEM by providing learning experiences called ‘Integrated STEM’. This is an overarching term for all learning environments that involve teams of students in relevant, authentic problems that integrate content from multiple STEM disciplines. However, often teachers’ instructional practices seem to not alter, due to a lack of change in their attitudes toward teaching integrated STEM. Therefore, a close examination of these attitudes is necessary. This paper attempts to contribute to this challenge by proposing a framework for the measurement of secondary teachers’ attitudes toward teaching integrated STEM. To achieve this, the concepts of ‘integrated STEM’ and ‘attitudes’ were thoroughly operationalized and combined. Integrated STEM was defined by means of five STEM-principles: integration of STEM content, problem-centered learning, inquiry learning, design-based learning and cooperative learning. Moreover, the concept of attitude was divided in five subdimensions: Perceived Difficulty, Perceived Relevance, Anxiety, Enjoyment and Self-Efficacy. In order to find confirmation for this framework, a questionnaire was developed and validated in a pilot study with 130 secondary school teachers in Flanders. The results of this pilot study indicate that the questionnaire is a valid and reliable instrument and therefore confirm the proposed theoretical framework.status: publishe

Development and Validation of an Instrument for Measuring Teachers’ Attitudes Toward Teaching Integrated Stem

The shortage of graduates in Science, Technology, Engineering and Mathematics (STEM), has led to numerous attempts to increase students’ interest in STEM by providing learning experiences called ‘Integrated STEM’. However, often teachers’ instructional practices seem to not alter, due to a lack of change in their attitudes toward teaching integrated STEM. Therefore, a close examination of these attitudes is necessary. This paper proposes a framework for the measurement of secondary teachers’ attitudes toward teaching integrated STEM. Furthermore, in order to find confirmation for this framework, a questionnaire was developed and validated in a pilot study with 130 secondary school teachers in Flanders. The results of this pilot study indicate that the questionnaire is a valid and reliable instrument and therefore confirm the theoretical framework in which attitude consists of five subscales: Perceived Difficulty, Perceived Relevance, Anxiety, Enjoyment and Self-Efficacy.nrpages: 26status: publishe

Predictive factors of teachers’ attitudes toward teaching integrated STEM

Integrated STEM (Science, Technology, Engineering and Mathematics) education is an emerging approach to improve students’ interest and achievement in STEM disciplines. However, the implementation of integrated STEM education depends strongly on teachers’ competence, which entails, among others, teachers’ attitudes. Nonetheless, not much is known about the factors that influence teachers’ attitudes toward teaching integrated STEM. Therefore this paper uses a survey method to get insight in the relationship between three groups of variables and teachers’ attitudes toward teaching integrated STEM: school context variables, teacher background characteristics and their personal attitudes. The results of the multiple regression analyses reveal five variables that are positively linked with teachers’ attitudes: non-teaching work experience, professional development, personal relevance of science, personal relevance of technology and social context. Moreover two variables show a negative correlation with teachers’ attitudes toward teaching integrated STEM: having more than 20 years of teaching experience and experience in mathematics. The results of this study provide valuable information about factors related with teachers’ attitudes toward teaching integrated STEM and are useful when attempting to improve teachers’ attitudes. Moreover, the results can also be deployed by school administrators to guide them when composing a team of teachers to implement integrated STEM education.status: publishe

The SARS-CoV-2 and other human coronavirus spike proteins are fine-tuned towards temperature and proteases of the human airways.

The high transmissibility of SARS-CoV-2 is related to abundant replication in the upper airways, which is not observed for the other highly pathogenic coronaviruses SARS-CoV and MERS-CoV. We here reveal features of the coronavirus spike (S) protein, which optimize the virus towards the human respiratory tract. First, the S proteins exhibit an intrinsic temperature preference, corresponding with the temperature of the upper or lower airways. Pseudoviruses bearing the SARS-CoV-2 spike (SARS-2-S) were more infectious when produced at 33°C instead of 37°C, a property shared with the S protein of HCoV-229E, a common cold coronavirus. In contrast, the S proteins of SARS-CoV and MERS-CoV favored 37°C, in accordance with virus preference for the lower airways. Next, SARS-2-S-driven entry was efficiently activated by not only TMPRSS2, but also the TMPRSS13 protease, thus broadening the cell tropism of SARS-CoV-2. Both proteases proved relevant in the context of authentic virus replication. TMPRSS13 appeared an effective spike activator for the virulent coronaviruses but not the low pathogenic HCoV-229E virus. Activation of SARS-2-S by these surface proteases requires processing of the S1/S2 cleavage loop, in which both the furin recognition motif and extended loop length proved critical. Conversely, entry of loop deletion mutants is significantly increased in cathepsin-rich cells. Finally, we demonstrate that the D614G mutation increases SARS-CoV-2 stability, particularly at 37°C, and, enhances its use of the cathepsin L pathway. This indicates a link between S protein stability and usage of this alternative route for virus entry. Since these spike properties may promote virus spread, they potentially explain why the spike-G614 variant has replaced the early D614 variant to become globally predominant. Collectively, our findings reveal adaptive mechanisms whereby the coronavirus spike protein is adjusted to match the temperature and protease conditions of the airways, to enhance virus transmission and pathology