Willing suspension of disbelief: a study in online learning through simulation, and its potential for deeper learning in Higher Education

This article describes the replacement of a 'traditionally taught' law of probate course (lectures and workshops/tutorials) with an on-line collaborative learning exercise using simulation and role-play which is referred to hereafter as the Transactional Learning Project ('TLP'). The article considers the theory that the emotional engagement that comes about through role play in simulation leads to deeper learning, a process Maharg (2010) has dubbed as the 'integration of the cognitive and the affective'. The article includes statistical analysis of student feedback on the TLP in an attempt to measure how easy it is to carry students predisposed to expect information to be 'given' rather than 'acquired' along the journey leading away from traditional didactic teaching. The project was motivated partly by the dearth of such learning practices on the Legal Practice Course. It is suggested that the findings of the project add to the body of research which tends to illustrate the success in terms of student learning from working in leaderless (i.e. where the tutor is absent from the collaborative group) groups engaged in practical tasks involving simulation

You’re making us all look bad : sexism moderates women’s experience of collective threat and intra-gender hostility toward traditional and non-traditional female subtypes

Across two studies (Ns = 265 and 735), we investigated whether women’s endorsement of hostile (HS) and benevolent sexism (BS) moderate their experience of collective threat and subsequent hostility toward traditional and non-traditional female subtypes. As expected, HS was positively associated with intra-gender hostility towards the non-traditional subtype, and these effects were mediated by collective threat. HS was negatively associated with collective threat and hostility towards the traditional subtype, but only when the target endorsed prescriptive gender beliefs that explicitly reinforced gender inequality. BS was associated with collective threat and hostility toward the non-traditional subtype, but these effects did not emerge consistently across both studies. These results suggest that women are not a homogeneous group whose members all find the same subtypes collectively threatening. Rather, the extent to which women internalize patriarchal attitudes and stereotypes influences the behaviors they find threatening and deserving of hostility

Automatic and Effective Discovery of Quantum Kernels

Quantum computing can empower machine learning models by enabling kernel machines to leverage quantum kernels for representing similarity measures between data. Quantum kernels are able to capture relationships in the data that are not efficiently computable on classical devices. However, there is no straightforward method to engineer the optimal quantum kernel for each specific use case. We present an approach to this problem, which employs optimization techniques, similar to those used in neural architecture search and AutoML, to automatically find an optimal kernel in a heuristic manner. To this purpose we define an algorithm for constructing a quantum circuit implementing the similarity measure as a combinatorial object, which is evaluated based on a cost function and then iteratively modified using a meta-heuristic optimization technique. The cost function can encode many criteria ensuring favorable statistical properties of the candidate solution, such as the rank of the Dynamical Lie Algebra. Importantly, our approach is independent of the optimization technique employed. The results obtained by testing our approach on a high-energy physics problem demonstrate that, in the best-case scenario, we can either match or improve testing accuracy with respect to the manual design approach, showing the potential of our technique to deliver superior results with reduced effort

The DREEM, part 1: measurement of the educational environment in an osteopathy teaching program

Background Measurement of the educational environment has become more common in health professional education programs. Information gained from these investigations can be used to implement and measure changes to the curricula, educational delivery and the physical environment. A number of questionnaires exist to measure the educational environment, and the most commonly utilised of these is the Dundee Ready Educational Environment Measure (DREEM). Methods The DREEM was administered to students in all year levels of the osteopathy program at Victoria University (VU), Melbourne, Australia. Students also completed a demographic survey. Inferential and correlational statistics were employed to investigate the educational environment based on the scores obtained from the DREEM. Results A response rate of 90% was achieved. The mean total DREEM score was 135.37 (+/- 19.33) with the scores ranging from 72 to 179. Some subscales and items demonstrated differences for gender, clinical phase, age and whether the student was in receipt of a government allowance. Conclusions There are a number of areas in the program that are performing well, and some aspects that could be improved. Overall students rated the VU osteopathy program as more positive than negative. The information obtained in the present study has identified areas for improvement and will enable the program leaders to facilitate changes. It will also provide other educational institutions with data on which they can make comparisons with their own programs

Hamstring Injury Trends in Major and Minor League Baseball: Epidemiological Findings From the Major League Baseball Health and Injury Tracking System.

Background: Hamstring strains are the most common injury for professional baseball players and can result in significant time on the disabled list. To date, no study has reported the current trends in hamstring strains in professional baseball. Hypothesis: Professional baseball players would have an increased incidence of hamstring strains from 2011 through 2016. Study Design: Descriptive epidemiology study. Methods: Injury data were prospectively collected from 2011 through 2016 for every Major League Baseball (MLB) and Minor League Baseball (MiLB) team and was recorded in the MLB Health and Injury Tracking System. Data collected for this study included date of injury, activity during injury, time lost, primary injury or reinjury status, and imaging findings as well as player demographic information related to level of play, age, and position for all hamstring injury events. Injury rates were reported as hamstring injuries per number of games. Results: From 2011 to 2016, there were 2633 hamstring strains in professional baseball players. The rate of hamstring strains increased in MLB from a low of 1 injury every 39 games in 2011 to a high of 1 injury every 30 games in 2016. In MiLB, there were 2192 hamstring strains, with 1 injury every 35 games in 2011 compared with 1 injury every 30 games in 2016. The majority of injuries occurred in the infielder positions (37.5%) and resulted from base running (\u3e50%), most commonly from home to first base. The most common hamstring injury was a grade 2 injury to the distal biceps femoris. The mean time missed after a hamstring injury was 14.5 days. Grade 3 and grade 2 hamstring strains resulted in significantly more days missed compared with grade 1 injuries ( Conclusion: The rate of hamstring strains in professional baseball players has increased over the past 6 years and has resulted in a significant loss of playing time. Study results indicated that these injuries are affected by injury characteristics, position played, running to first base, seasonal timing, and history of hamstring injuries

Feasibility of PROMIS CAT Administration in the Ambulatory Sports Medicine Clinic With Respect to Cost and Patient Compliance: A Single-Surgeon Experience.

Background: Pay-for-performance reimbursement models are becoming increasingly popular, but the implementation of a routine patient-reported outcome (PRO) collection system places additional burden on both the patient and the provider. The Patient-Reported Outcomes Measurement Information System (PROMIS) was developed in an effort to make PRO collection more practical and efficient, but providers may be reluctant to embrace a transition to a PROMIS-based clinical outcome registry. Hypothesis: PROMIS can be successfully incorporated into daily clinical practice, with an overall patient compliance rate of 80%. Study Design: Cross-sectional study; Level of evidence, 3. Methods: As part of routine practice, all patients presenting to a single surgeon\u27s sports medicine clinic for an appointment were asked to complete a series of PROMIS computerized adaptive tests (CATs), including PROMIS Physical Function, Physical Function-Upper Extremity, Pain Interference, and Depression subscales. Overall compliance was calculated by dividing the number of survey sets completed by the number of eligible clinic visits. Compliance rates were further assessed by patient age, type of clinic visit, and location of injury. Costs associated with this system of routine PRO collection were categorized as start-up or maintenance costs. Results: From August 7, 2017, to December 8, 2017, there were 581 patients (1109 clinic encounters) who met inclusion criteria for the study. Of the 1109 clinic encounters, there was an overall compliance rate of 91.3% (1013/1109 visits during which the patient completed the entire PROMIS survey set). Overall, the full survey set consisted of a mean 15.3 questions and took a mean of 2.6 minutes to complete. Patients who were aged ≥62 years had a significantly lower compliance rate (81.8%; Conclusion: The routine electronic collection of PROMIS scores in the ambulatory orthopaedic clinic resulted in a compliance rate of over 90%, although older patients were generally less compliant than younger patients. Our system of data collection is practical and efficient in a high-volume orthopaedic clinic and places minimal financial burden on the provider

The Effect of the Crow Hop on Elbow Stress During an Interval Throwing Program

BACKGROUND: Postoperative rehabilitation protocols after ulnar collateral ligament (UCL) reconstruction typically involve a structured interval throwing program. In an effort to minimize torque placed on the UCL, athletes are often instructed to throw with a crow hop, even at short throwing distances. However, the effect of the crow hop on medial elbow stress is unknown. PURPOSE/HYPOTHESIS: The purpose was to determine whether elbow stress differs with and without a crow hop across the throwing distances of a typical interval throwing program. We hypothesized that crow hop throws would generate lower torque on the elbow than standing throws at each distance of the interval throwing program. STUDY DESIGN: Controlled laboratory study. METHODS: Healthy high school and collegiate pitchers and position players were recruited from the surrounding area. Each player was outfitted with a wearable athletic sleeve and device that recorded elbow torque (Newton-meters), arm slot (degrees), arm speed (revolutions per minute), and shoulder rotation (degrees). Ball velocity (miles per hour) was measured using a radar gun. Players were instructed to perform 3 crow hop throws and 3 standing throws at distances of 30, 45, 60, 90, 120, 150, and 180 feet. A repeated measures analysis of variance was used to compare ball velocity, elbow torque, arm slot, arm speed, and shoulder rotation between crow hop and standing throws at each throwing distance. RESULTS: Twenty athletes participated in this study (average age, 17.8 years; range, 15-25 years). The average medial elbow torque increased at each distance for both crow hop and standing throws at distances of 30, 45, 60, and 90 feet (P \u3c .05), after which there were no significant increases in elbow torque (P \u3e .05). The average torque was higher for crow hop throws than standing throws at distances of 30 feet (13.9 N·m vs 12.0 N·m; P = .002), 45 feet (21.8 N·m vs 19.3 N·m; P = .005), and 60 feet (28.0 N·m vs 24.5 N·m; P = .02). CONCLUSION: Crow hop throws generated greater medial elbow torque than standing throws at distances up to 60 feet; however, there were no differences in elbow torque at distances greater than 60 feet between the 2 throw types. For both crow hop and standing throws, elbow stress increased at each distance interval up to 90 feet before plateauing at distances greater than 90 feet. The crow hop throwing technique does not reduce medial elbow stress during a simulated interval throwing program, and it may actually increase torque at shorter throwing distances. CLINICAL RELEVANCE: The results of our study indicate that it would be prudent for players to initially perform standing throws at shorter distances and only later be allowed to employ a natural crow hop at greater distances to minimize torque placed on the medial elbow during UCL rehabilitation protocols

Medical students' perceptions of the educational environment at an Iranian Medical Sciences University

<p>Abstract</p> <p>Background</p> <p>Students' perceptions of their educational environment have a significant impact on their behavior and academic progress. The aim of this study was to assess the perceptions of medical students concerning their educational environment at Hormozgan University of Medical Sciences in Iran.</p> <p>Methods</p> <p>In this cross-sectional study, questionnaires were distributed to 210 medical students and 182 were analyzed (response rate = 86.6%); twenty-eight questionnaires were excluded because they were incomplete or unreturned for analysis. Data were collected using a DREEM questionnaire which comprised 50 items based on the Likert scale (scores could range from 0 to 200). There were five domains to the questionnaire including students' perceptions of learning, students' perceptions of teachers, students' academic self-perceptions, students' perceptions of atmosphere and students' social self-perceptions. Data were analyzed using SPSS16 software.</p> <p>Results</p> <p>The mean age of the subjects was 21.7 years (SD = 2.7); 38.5% were male and 61.5% were female. Students' perceptions of learning, students' perceptions of teachers, students' academic self-perceptions, students' perceptions of atmosphere, students' social self-perceptions and total DREEM score were 21.2/48, 24.2/44, 15.8/32, 23.8/48, 14.5/28 and 99.6/200, respectively. There was no significant difference between male and female students in educational environment subscales, but there were significant differences between students enrolled on a basic sciences and pathophysiology course and those enrolled on a clinical course in terms of perceptions of learning, academic self-perceptions, perceptions of atmosphere and overall perceptions of educational environment (p < 0.05). The latter group rated each of the aforementioned aspects more highly than the students studying basic science and pathophysiology.</p> <p>Conclusion</p> <p>Overall, respondents assessed the educational environment as average. Therefore, improvements are required across all five domains of the educational environment.</p

Characterization of epidemiological distribution and outcome of COVID-19 in patients with hereditary hemorrhagic telangiectasia: a nationwide retrospective multi-centre study during first wave in Italy

Background: Coronavirus Disease 2019 (COVID-19) continues to have a devastating impact across the world. A number of pre-existing common clinical conditions were reported to represent risk factors for more severe COVID-19 outcomes. Hereditary Hemorrhagic Telangiectasia (HHT) is a rare vascular heritable disorders, characterized by complications secondary to visceral Arterio-Venous Malformations. The impact of HHT, as well as for many Rare Diseases (RDs) on infection susceptibility profile and clinical adverse outcome risk is an unresolved issue. Objectives: The main objectives were: to assess the clinical features and outcomes of HHT patients infected with COVID-19; to compare the relative infection risk in these patients with the Italian general population throughout the first pandemic wave; to investigate the factors potentially associated with severe COVID-19 outcome in HHT patients, and the possible impact of COVID-19 infection on HHT-related symptoms/complications. Finally, we aimed to estimate how the lockdown-associated wearing of personal protective equipment/individual protection devices could affect HHT-related telangiectasia bleeding frequency. Methods: The study is a nation-wide questionnaire-based survey, with a multi-Center retrospective cross-sectional design, addressed to the whole Italian HHT population. COVID-19 cases, occurring throughout the first pandemic wave, were collected by a questionnaire-based semi-structured interview. Only the cases ascertained by laboratory confirmation (molecular/serological) were included for epidemiological estimates. Information concerning eventual SarS-Cov-2 infection, as well as regarding HHT-related manifestations and HHT-unrelated co-morbidities were collected by the questionnaire. Prevalence data were compared to Italian general population in the same period. Results: The survey disclosed 9/296 (3.04%) COVID-19 cases, 8/9 of them being resident in Lombardy, the main epidemic epicenter. Pneumonia was reported by 4/9 patients, which prompted hospital admission and intensive care management in 2 cases. No fatal outcome was recorded. After careful refinement of epidemiological analysis, the survey evidenced overlapping infection risk in HHT compared to general population. Conclusions: COVID-19 infection profile parallels geographical distribution of epidemic foci. COVID-19 in HHT patients can lead to highly variable clinical profile, likely overlapping with that of general population. The HHT disease does not seem to involve a different approach in terms of hospital admission and access to intensive care with respect to general population