Paraphrases and summaries: A means of clarification or a vehicle for articulating a preferred version of student accounts?

The use of group discussions as a means to facilitate learning from experiences is well documented in adventure education literature. Priest and Naismith (1993) assert that the use of the circular discussion method, where the leader poses questions to the participants, is the most common form of facilitation in adventure education. This paper draws on transcripts of facilitation sessions to argue that the widely advocated practice of leader summaries or paraphrases of student responses in these sessions functions as a potential mechanism to control and sponsor particular knowledge(s). Using transcripts from recorded facilitation sessions the analysis focuses on how the leader paraphrases the students’ responses and how these paraphrases or ‘formulations’ function to modify or exclude particular aspects of the students’ responses. I assert that paraphrasing is not simply a neutral activity that merely functions to clarify a student response, it is a subtle means by which the leader of the session can, often inadvertently or unknowingly, alter the student’s reply with the consequence of favouring particular knowledge(s). Revealing the subtle work that leader paraphrases perform is of importance for educators who claim to provide genuine opportunities for students to learn from their experience

Perceptions of health, healthy decision-making, and living: A study of young mothers living in Jamaica

Purpose: Adolescent health, including sexual health and pregnancy, are topics of concern for healthcare providers, family members, communities, and teens around the world. These concerns and their ramifications are apparent in the Caribbean nation of Jamaica. In a population based study done in Jamaica, of the total participants aged 15-19, one-third of females and half of the males reported being sexually active within the last year (Ishida, Stupp & McDonald, 2011). While the Age Specific Fertility Rate (ASFR) for adolescents in this same age group is declining, the Jamaica National Family Planning Board (JNFB) (2008), reports there are still 72 births per 1000 women identified in 2008, previously in 2002, there were 79 per 1,000. And, in 2008, approximately 82% of these pregnancies were unplanned (JNFB, 2008). Pregnancy is not the only a concern for these Jamaican teens, as teenage pregnancy is unlawful in the country and sexually transmitted infections (STIs) are still a veritable risk. With 79% of females between the ages of 15-24 reporting using contraception at first sexual intercourse a help to keeping pregnancy rates down, only 49% of females reported using a condom at last intercourse, and 48% of females reporting using a condom with each encounter with a non-steady partner. (Serbanescue, Ruiz & Suchdev, 2010; JNFB, 2008). This lapse in condom use and possibly barrier contraception use, is detrimental to the reproductive health of these young adults and gravely indicates the need for further education. While the literature is replete with sexual health information and curricula directed toward adolescents, there is a paucity of knowledge regarding this specific group of teenagers living in Jamaica. Identifying health interventions is crucial to this population s well-being. Young mothers may incur health risks associated with lifestyle and decision-making; availability of supports and resources; and challenges related to stress and time limitations associated with pregnancy, breastfeeding and parenting. Teen perceptions about health, healthy decision-making and healthy lifestyles may guide development of interventions designed to promote health. Nursing students, as part of a service learning activity, traveled to Jamaica to provide health instruction to young mothers in a residential home. The young mothers participated in focus groups, which provided beneficial information identifying some of the gaps in knowledge of general and sexual health in this vulnerable population. Thematic analysis of focus group transcripts and study findings may be useful as they inform health intervention development. Methods: This qualitative study was conducted at a residential home for young mothers in Kingston, Jamaica, during the spring of 2016. To be considered eligible to participate in the focus groups, the young women needed to be residents of the setting, aged 12-17 and either pregnant and/or parenting. The focus groups were conducted by the researchers and audiotaped; one researcher led the groups while another observed and took marginal notes during the process. The participants received $10 (US) and a healthy snack. Data were analyzed for content, then organized into topics with frequency of responses used to construct themes. Results: The participants in the discussion included thirteen teenage mothers, whose ages ranged from twelve years old to seventeen years old. The ages of their babies ranged from two weeks to nine months old. All thirteen girls were either currently attending school or planned on returning to school when their babies were old enough. From the discussion with the young mothers, three themes emerged. The themes were: Personal Meaning of Health, Considerations in Health Decision-Making, and Thoughts on Healthy Living. Conclusion: The study of young mothers perceptions about health, health decision-making, and healthy lifestyles yielded important insights into the thoughts and behaviors of young women in Jamaica. Due to social and political laws and beliefs, young women in Jamaica who become pregnant experience marginalization and duress associated with isolation, financial stressors, and stigma. These exacerbate the vulnerability inherent of adolescence, pregnancy, and parenting. The nurse has an integral role to provide education, counseling, and resources to enhance the supports and reduce the challenges young mothers confront in their personal quests to attain and maintain health. Perhaps, even more important is the need for nursing advocacy to influence the gender issues associated with subjugating young women, with little stigma associated with fathering a pregnancy, to address bullying via empathy-building strategies, and providing interventions and resources to foster parenting, including mothering and fathering interventions, to ensure health of the current and future generations in Caribbean countries

Two adhesive systems cooperatively regulate axon ensheathment and myelin growth in the CNS

Central nervous system myelin is a multilayered membrane produced by oligodendrocytes to increase neural processing speed and efficiency, but the molecular mechanisms underlying axonal selection and myelin wrapping are unknown. Here, using combined morphological and molecular analyses in mice and zebrafish, we show that adhesion molecules of the paranodal and the internodal segment work synergistically using overlapping functions to regulate axonal interaction and myelin wrapping. In the absence of these adhesive systems, axonal recognition by myelin is impaired with myelin growing on top of previously myelinated fibers, around neuronal cell bodies and above nodes of Ranvier. In addition, myelin wrapping is disturbed with the leading edge moving away from the axon and in between previously formed layers. These data show how two adhesive systems function together to guide axonal ensheathment and myelin wrapping, and provide a mechanistic understanding of how the spatial organization of myelin is achieved

Diversity in collaborative research communities: a multicultural, multidisciplinary thesis writing group in public health

Writing groups for doctoral students are generally agreed to provide valuable learning spaces for Ph.D. candidates. Here an academic developer and the eight members of a writing group formed in a Discipline of Public Health provide an account of their experiences of collaborating in a multicultural, multidisciplinary thesis writing group. We consider the benefits of belonging to such a group for Ph.D. students who are operating in a research climate in which disciplinary boundaries are blurring and where an increasing number of doctoral projects are interdisciplinary in nature; in which both academic staff and students come from enormously diverse cultural and language backgrounds; and in which teamwork, networking and collaboration are prized but not always proactively facilitated. We argue that doctoral writing groups comprising students from diverse cultural and disciplinary backgrounds can be of significant value for postgraduates who wish to collaborate on their own academic development to improve their research writing and communication skills; at the same time, such collaborative work effectively builds an inclusive, dynamic research community.Cally Guerin, Vicki Xafis, Diana V. Doda, Marianne H. Gillam, Allison J. Larg, Helene Luckner, Nasreen Jahan, Aris Widayati and Chuangzhou X

Insights into replicative senescence of human testicular peritubular cells

There is evidence for an age-related decline in male reproductive functions, yet how the human testis may age is not understood. Human testicular peritubular cells (HTPCs) transport sperm, contribute to the spermatogonial stem cell (SSC) niche and immune surveillance, and can be isolated and studied in vitro. Consequences of replicative senescence of HTPCs were evaluated to gain partial insights into human testicular aging. To this end, early and advanced HTPC passages, in which replicative senescence was indicated by increased cell size, altered nuclear morphology, enhanced beta-galactosidase activity, telomere attrition and reduced mitochondrial DNA (mtDNA), were compared. These alterations are typical for senescent cells, in general. To examine HTPC-specific changes, focused ion beam scanning electron microscopy (FIB/SEM) tomography was employed, which revealed a reduced mitochondrial network and an increased lysosome population. The results coincide with the data of a parallel proteomic analysis and indicate deranged proteostasis. The mRNA levels of typical contractility markers and growth factors, important for the SSC niche, were not significantly altered. A secretome analysis identified, however, elevated levels of macrophage migration inhibitory factor (MIF) and dipeptidyl peptidase 4 (DPP4), which may play a role in spermatogenesis. Testicular DPP4 may further represent a possible drug target

Avaliação de grupos genéticos em sistema de produção leiteiro intensivo a pasto no Acre.

O objetivo deste estudo foi avaliar o uso de grupos genéticos bovinos para produção de leite em sistema intensivo de pastagem no Acre. Foram utilizados dados de produção leiteira de 46 matrizes do grupo genético Girolando e 59 do cruzamento Nelore x Holandesa denominado Nelorando em propriedade localizada no município de Rio Branco, AC. Foram analisados os parâmetros de produção de leite, intervalo entre partos, duração de lactação e produção de leite ajustada para 270 dias de 167 lactações com 1.499 controles de produção diária agrupados em quatro épocas do ano de controle. As estimativas dos parâmetros genéticos foram obtidas pelo método REML/BLUP. A média estimada para produção de leite aos 270 dias de lactação e o desvio-padrão foram de 2.474,70 ± 256,52 para o grupo Girolando e 2.542,03 ± 269,36 para o grupo Nelorando com médias diárias de produção e desvio-padrão de 9,28 ± 2,49 e 10,23 ± 2,8, respectivamente. O intervalo entre partos médio encontrado na propriedade foi 12,85 meses (12,88 para Girolando e 12,83 para Nelorando). A duração de lactação para o grupo Girolando foi de 288,13 dias e para Nelorando de 273,47 dias. Para os parâmetros estudados não houve diferença significativa entre os grupos. Conclui-se que os grupos genéticos não divergem entre si e os efeitos ambientais são contornados quando se faz uso de tecnologias que favorecem a uniformidade de forrageiras com boa qualidade nutricional.Editores técnicos: Rodrigo Souza Santos; Fabiano Marçal Estanislau

Arterial blood pressure during early sepsis and outcome

OBJECTIVE: To evaluate the association between arterial blood pressure (ABP) during the first 24 h and mortality in sepsis. DESIGN: Retrospective cohort study. SETTING: Multidisciplinary intensive care unit (ICU). PATIENTS AND PARTICIPANTS: A total of 274 septic patients. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: Hemodynamic, and laboratory parameters were extracted from a PDMS database. The hourly time integral of ABP drops below clinically relevant systolic arterial pressure (SAP), mean arterial pressure (MAP), and mean perfusion pressure (MPP = MAP - central venous pressure) levels was calculated for the first 24 h after ICU admission and compared with 28-day-mortality. Binary and linear regression models (adjusted for SAPS II as a measure of disease severity), and a receiver operating characteristic (ROC) analysis were applied. The areas under the ROC curve were largest for the hourly time integrals of ABP drops below MAP 60 mmHg (0.779 vs. 0.764 for ABP drops below MAP 55 mmHg; P or = 60 mmHg may be as safe as higher MAP levels during the first 24 h of ICU therapy in septic patients. A higher MAP may be required to maintain kidney function

Impact of Plasmodium falciparum infection on the frequency of moderate to severe anaemia in children below 10 years of age in Gabon

BACKGROUND: Improving the understanding of childhood malarial anaemia may help in the design of appropriate management strategies. METHODS: A prospective observational study over a two-year period to assess the burden of anaemia and its relationship to Plasmodium falciparum infection and age was conducted in 8,195 febrile Gabonese children. RESULTS: The proportion of children with anaemia was 83.6% (n = 6830), higher in children between the ages of six and 23 months. Those under three years old were more likely to develop moderate to severe anaemia (68%). The prevalence of malaria was 42.7% and P. falciparum infection was more frequent in children aged 36-47 months (54.5%). The proportion of anaemic children increased with parasite density (p 60%), but was unrelated to P. falciparum parasitaemia. CONCLUSION: Malaria is one of the main risk factors for childhood anaemia which represents a public health problem in Gabon. The risk of severe malarial anaemia increases up the age of three years. Efforts to improve strategies for controlling anaemia and malaria are needed

Perioperative infusion of low- dose of vasopressin for prevention and management of vasodilatory vasoplegic syndrome in patients undergoing coronary artery bypass grafting-A double-blind randomized study

Preoperative medication by inhibitors of angiotensin-converting enzyme (ACE) in coronary artery patients predisposes to vasoplegic shock early after coronary artery bypass grafting. Although in the majority of the cases this shock is mild, in some of them it appears as a situation, "intractable" to high-catecholamine dose medication. In this study we examined the possible role of prophylactic infusion of low-dose vasopressin, during and for the four hours post-bypass after cardiopulmonary bypass, in an effort to prevent this syndrome. In addition, we studied the influence of infused vasopressin on the hemodynamics of the patients, as well as on the postoperative urine-output and blood-loss. In our study 50 patients undergoing coronary artery bypass grafting were included in a blind-randomized basis. Two main criteria were used for the eligibility of patients for coronary artery bypass grafting: ejection fraction between 30-40%, and patients receiving ACE inhibitors, at least for four weeks preoperatively. The patients were randomly divided in two groups, the group A who were infused with 0.03 IU/min vasopressin and the group B who were infused with normal saline intraoperativelly and for the 4 postoperative hours. Measurements of mean artery pressure (MAP), central venous pressure (CVP), systemic vascular resistance (SVR), ejection fracture (EF), heart rate (HR), mean pulmonary artery pressure (MPAP), cardiac index (CI) and pulmonary vascular resistance (PVR) were performed before, during, and after the operation. The requirements of catecholamine support, the urine-output, the blood-loss, and the requirements in blood, plasma and platelets for the first 24 hours were included in the data collected. The incidence of vasodilatory shock was significantly lower (8% vs 20%) in group A and B respectively (p = 0,042). Generally, the mortality was 12%, exclusively deriving from group B. Postoperatively, significant higher values of MAP, CVP, SVR and EF were recorded in the patients of group A, compared to those of group B. In group A norepinephrine was necessary in fewer patients (p = 0.002) and with a lower mean dose (p = 0.0001), additive infusion of epinephrine was needed in fewer patients (p = 0.001), while both were infused for a significant shorter infusion-period (p = 0.0001). Vasopressin administration (for group A) was associated with a higher 24 hour diuresis) (0.0001)