The relationship among student characteristics, choice of participation mode, and student performance in technologically-supported learning environments

Technologically-supported learning (TSL) environments offer considerable promise for the enhancement of student learning through the various interaction opportunities available in the feature sets of the computer-based communication tools. At the very least, the computer-based communication provides additional venues for class participation. However, when class participation is positioned within a TSL environment, it is not clear how learning/performance benefits are associated with student predispositions toward communication mediums and computer technology, student attitudes toward participation, and student choice of participation mode. This paper describes apilot study that investigates the relationship among student characteristics (computer anxiety, communication apprehension, computer-based communication apprehension, attitudes toward participation), student choice of participation mode, and student performance in a technologically-supported learning environment

The effects of orbital precession on tropical precipitation: Mechanisms controlling precipitation changes over land and ocean

The tropical precipitation response to precessional forcing is investigated using idealized precession experiments from the Geophysical Fluid Dynamics Laboratory Coupled Model version 2.1 and mid-Holocene experiments from ten general circulation models participating in the Paleoclimate Modeling Intercomparison Project Phase III. Both sets of experiments show a seasonal land-ocean asymmetry in the tropical precipitation response: precipitation increases over land and decreases over ocean in the season with increased insolation and the opposite is true in the season with decreased insolation. This response is examined using a framework that describes how changes in net top-of-atmosphere radiation affect the atmosphere and surface energy balances. Over land, surface energy storage is small and changes in precipitation are balanced by changes in moist static energy flux divergence. Over ocean, surface energy storage is large, moist static energy flux divergence is small, and changes in precipitation are ultimately driven by changes in circulation and atmospheric stability

Longitudinal Patterns of Intimate Partner Violence, Risk, Well-Being, and Employment: Preliminary Findings

Over 7 months (June 1999 to January 2000), researchers recruited 406 women from 1 of 3 sites in a northeastern city at the point they were seeking help for violence against them by a current or former male partner. Intimate partner violence was measured with a modified version of the Revised Conflict Tactics Scale. Some form of serious violence during the previous year was reported by 88 percent of the participants. By the first 3-month follow-up period, nearly one-third of the participants reported the recurrence of some form of physical violence; 20.4 percent reported an injury; and 18.1 percent reported sexual abuse. Stalking between time 1 and time 2 was reported by 46.9 percent of participants. By the 1-year follow-up, 38.8 percent of participants reported at least some recurrence of physical violence within the past year. At time 1, a significant number of participants indicated their level of risk for future violence as high. Overall, results suggest different trajectories for violence and abuse following participants\u27 involvement with community and legal system interventions. Mean scores on each of the measures of well-being showed an overall improvement in reported quality of life at time 2 compared to time 1. An overall mean decrease in reported depressive symptoms was observed; however, this progress was not uniform. There was a slight increase in employment among the women over the 1-year period. In showing different patterns of revictimization across different types of intimate partner violence acts (physical violence, sexual abuse, and stalking), this suggests to researchers the importance of including all these categories of intimate partner violence in their protocols. Implications of the findings are also drawn for practitioners. 2 exhibits and 15 references

Longitudinal Patterns of Intimate Partner Violence, Risk, Well-Being, and Employment: Preliminary Findings

Over 7 months (June 1999 to January 2000), researchers recruited 406 women from 1 of 3 sites in a northeastern city at the point they were seeking help for violence against them by a current or former male partner. Intimate partner violence was measured with a modified version of the Revised Conflict Tactics Scale. Some form of serious violence during the previous year was reported by 88 percent of the participants. By the first 3-month follow-up period, nearly one-third of the participants reported the recurrence of some form of physical violence; 20.4 percent reported an injury; and 18.1 percent reported sexual abuse. Stalking between time 1 and time 2 was reported by 46.9 percent of participants. By the 1-year follow-up, 38.8 percent of participants reported at least some recurrence of physical violence within the past year. At time 1, a significant number of participants indicated their level of risk for future violence as high. Overall, results suggest different trajectories for violence and abuse following participants\u27 involvement with community and legal system interventions. Mean scores on each of the measures of well-being showed an overall improvement in reported quality of life at time 2 compared to time 1. An overall mean decrease in reported depressive symptoms was observed; however, this progress was not uniform. There was a slight increase in employment among the women over the 1-year period. In showing different patterns of revictimization across different types of intimate partner violence acts (physical violence, sexual abuse, and stalking), this suggests to researchers the importance of including all these categories of intimate partner violence in their protocols. Implications of the findings are also drawn for practitioners. 2 exhibits and 15 references

Women's perceptions of their healthcare experience when they choose not to breastfeed

Research Question How do women who choose not to breastfeed perceive their healthcare experience? Method This qualitative research study used a phenomenographic approach to explore the healthcare experience of women who do not breastfeed. Seven women were interviewed about their healthcare experience relating to their choice of feeding, approximately four weeks after giving birth. Six conceptions were identified and an outcome space was developed to demonstrate the relationships and meaning of the conceptions in a visual format. Findings There were five unmet needs identified by the participants during this study. These needs included equity, self sufficiency, support, education and the need not to feel pressured. Conclusion Women in this study who chose not to breastfeed identified important areas where they felt that their needs were not met. In keeping with the Code of Ethics for Nurses and Midwives, the identified needs of women who do not breastfeed must be addressed in a caring, compassionate and just manner. The care and education of women who formula feed should be of the highest standard possible, even if the choice not to breastfeed is not the preferred choice of healthcare professionals

Academic Mentoring of Social Work Faculty: A Group Experience With a Feminist Influence

Using theory and principles of group process, and influenced by feminist theory of co-mentoring, a group of social work educators met monthly in a telephone mediated support group. The purpose of the group was to offer support to faculty involved in the tenure process in the areas of teaching, scholarship, and service. This paper offers an analysis of this experience. Suggestions for improved mentoring of social work faculty will be explored and areas for further research will be identified

Effect of fixed-dose subcutaneous reslizumab on asthma exacerbations in patients with severe uncontrolled asthma and corticosteroid sparing in patients with oral corticosteroid-dependent asthma : results from two phase 3, randomised, double-blind, placebo-controlled trials

BACKGROUND: Reslizumab 3 mg/kg administered intravenously is approved for the treatment of severe eosinophilic asthma. We assessed the safety and efficacy of subcutaneous reslizumab 110 mg in two trials in patients with uncontrolled severe asthma and increased blood eosinophils. The aim was to establish whether subcutaneous reslizumab 110 mg can reduce exacerbation rates in these patients (study 1) or reduce maintenance oral corticosteroid dose in patients with corticosteroid-dependent asthma (study 2). METHODS: Both studies were randomised, double-blind, placebo-controlled, phase 3 studies. Entry criteria for study 1 were uncontrolled severe asthma, two or more asthma exacerbations in the previous year, a blood eosinophil count of 300 cells per μL or more (including no more than 30% patients with an eosinophil count <400 cells/μL), and at least a medium dose of inhaled corticosteroids with one or more additional asthma controllers. Patients in study 2 had severe asthma, a blood eosinophil count of 300 cells per μL or more, daily maintenance oral corticosteroid (prednisone 5-40 mg, or equivalent), and high-dose inhaled corticosteroids plus another controller. Patients were randomly assigned (1:1) to subcutaneous reslizumab (110 mg) or placebo once every 4 weeks for 52 weeks in study 1 and 24 weeks in study 2. Patients and investigators were masked to treatment assignment. Primary efficacy outcomes were frequency of exacerbations during 52 weeks in study 1 and categorised percentage reduction in daily oral corticosteroid dose from baseline to weeks 20-24 in study 2. Primary efficacy analyses were by intention to treat, and safety analyses included all patients who received at least one dose of study treatment. These studies are registered with ClinicalTrials.gov, NCT02452190 (study 1) and NCT02501629 (study 2). FINDINGS: Between Aug 12, 2015, and Jan 31, 2018, 468 patients in study 1 were randomly assigned to placebo (n=232) or subcutaneous reslizumab (n=236), and 177 in study 2 to placebo (n=89) or subcutaneous reslizumab (n=88). In study 1, we found no significant difference in the exacerbation rate between reslizumab and placebo in the intention-to-treat population (rate ratio 0·79, 95% CI 0·56-1·12; p=0·19). Subcutaneous reslizumab reduced exacerbation frequency compared with placebo in the subgroup of patients with blood eosinophil counts of 400 cells per μL or more (0·64, 95% CI 0·43-0·95). Greater reductions in annual exacerbation risk (p=0·0035) and longer time to first exacerbation were observed for patients with higher trough serum reslizumab concentrations. In study 2, we found no difference between placebo and fixed-dose subcutaneous reslizumab in categorised percentage reduction in daily oral corticosteroid dose (odds ratio for a lower category of oral corticosteroid use in the reslizumab group vs the placebo group, 1·23, 95% CI 0·70-2·16; p=0·47). The frequency of adverse events and serious adverse events with reslizumab were similar to those with placebo in both studies. INTERPRETATION: Fixed-dose (110 mg) subcutaneous reslizumab was not effective in reducing exacerbation frequency in patients with uncontrolled asthma and increased blood eosinophils (≥300 cells/μL), or in reducing the daily maintenance oral corticosteroid dose in patients with oral corticosteroid-dependent severe eosinophilic asthma. Higher exposures than those observed with 110 mg subcutaneous reslizumab are required to achieve maximal efficacy. FUNDING: Teva Branded Pharmaceutical Products R&D

Factors contributing to nonadherence to follow-up appointments in a resident glaucoma clinic versus primary eye care clinic.

PURPOSE: To determine the rate of adherence to follow-up appointment recommendations in a resident glaucoma clinic with no mechanism for reminders, compared to a resident cataract and primary eye care (CPEC) clinic in which telephone reminders were used, and to identify factors that contribute to adherence in each patient group. METHODS: This retrospective cohort study included subjects in the CPEC clinic who received telephone reminders and those in the glaucoma clinic who did not. Each sample was selected to have a similar proportion of follow-up recommendations for 1, 3, and 6 months. Subjects were considered adherent if they returned within a specified timeframe. RESULTS: A total of 144 subjects from the glaucoma clinic and 151 subjects from the CPEC clinic were included. There was no significant difference between follow-up adherence rates of patients who received telephone reminders and those who did not (odds ratio [OR] =1.35, 95% confidence interval [CI] 0.79-2.32, P=0.28). Patients who were on more than two ocular medications were more likely to return for follow-up (OR=3.11, 95% CI 1.53-6.35, P=0.0018). Subjects between the ages 50 and 80 years were more likely to be adherent compared to their younger and older peers (P=0.02). CONCLUSION: The follow-up adherence of patients in a CPEC clinic who received telephone reminders was similar to patients in a glaucoma clinic who did not receive any intervention to increase their adherence. Younger (⩽50 years old) and elderly (⩾80 years old) subjects, as well as patients using less than two glaucoma medications, were less likely to adhere to their follow-up appointments

"It's a can of worms": understanding primary care practitioners' behaviours in relation to HPV using the Theoretical Domains Framework

Background: The relationship between infection with high-risk human papillomavirus (HPV) and cervical cancer is transforming cervical cancer prevention. HPV tests and vaccinations have recently become available. In Ireland, as elsewhere, primary care practitioners play a key role in prevention. ATHENS (A Trial of HPV Education and Support) aims to develop a theorybased intervention to support primary care practitioners in their HPV-related practice. This study, the first step in the intervention development process, aimed to: identify HPV-related clinical behaviours that the intervention will target; clarify general practitioners’ (GPs’) and practice nurses’ roles and responsibilities; and determine factors that potentially influence clinical behaviour. A secondary objective was to informally assess the utility of the Theoretical Domains Framework (TDF) in understanding clinical behaviours in an area with an evolving evidence-base. Methods: In-depth semi-structured telephone interviews were conducted with GPs and practice nurses. The topic guide, which contained open questions and HPV-related clinical scenarios, was developed through literature review and clinical experience. Interview transcripts were content-analysed using the TDF as the coding framework. Results: 19 GPs and 14 practice nurses were interviewed. The major HPV-related clinical behaviours were: initiating a discussion about HPV infection with female patients; offering/recommending HPV vaccination to appropriate patients; and answering patients’ questions about HPV testing. While the responsibility for taking smears was considered a female role, both male and female practitioners dealt with HPV-related issues. All 12 theoretical domains arose in relation to HPV infection; the domains judged to be most important were: knowledge, emotion, social influences, beliefs about capabilities and beliefs about consequences. Eleven domains emerged in relation to HPV vaccination, with beliefs about consequences, social influences, knowledge and environmental context and resources judged to be the most important. Nine domains were relevant to HPV testing, with knowledge and beliefs about capabilities judged to be the most important. Conclusions: The findings confirm the need for an intervention to support primary care practitioners around HPV and suggest it should target a range of theoretical domains. The TDF proved valuable in analysing qualitative data collected using a topic guide not specifically designed to capture TDF domains and understanding clinical behaviours in an area with an evolving evidence-base