Learning to think critically through Socratic dialogue:Evaluating a series of lessons designed for secondary vocational education

This study reports the evaluation of a lesson series, developed in collaboration with teachers and experts, to generate a research-based solution for teaching critical thinking through Socratic dialogue in secondary vocational education. The lesson series has been evaluated for feasibility and tailoring to different target groups of students by five citizenship education teachers and 85 students. Data consisted of self-report questionnaires by teachers and students, complemented with observations of lessons. Results show that lessons based on Socratic dialogue for teaching critical thinking to students in secondary vocational education are considered a promising educational intervention. Teachers considered the lessons as feasible and well-tailored to their students and were able to implement the lessons in their classrooms. Students were motivated to participate, and their motivation did not decrease significantly during the lesson series. At the same time, students tended to be more motivated when the value of learning to think critically for their future profession was clearly substantiated. Practical implications from the evaluation of the lesson series were that, in addition to participating in Socratic dialogue, students need clear learning objectives and short assignments to remain active.</p

U-Pb ages, Pb-Os isotope ratios, and platinum-group element (PGE) composition of the west-central Madagascar flood basalt province

The Mailaka lava succession (central-western Madagascar) forms part of the Madagascar large igneous province and is characterized by basaltic to picritic basalt lava flows and minor evolved flows. In situ U-Pb dating of zircon in rhyodacites yields concordant ages of 89.7 \ub1 1.4 and 90.7 \ub1 1.1 Ma. Therefore, the capping rhyodacitic unit of the Mailaka lava succession was emplaced just after the underlying basalt sequence (dated paleontologically at Coniacian-Turonian). Two geochemically different lava series are present. A transitional series ranging from picritic basalts to basalts has incompatible element abundances and Pb, Os, and Nd isotope ratios within the range of mid-ocean ridge basalts. In addition, the concentrations of platinum-group elements (Ir<0.35 ng/g, Ru<0.17 ng/g, Pd p 1.0-1.6 ng/g) in the transitional basalts are generally lower than in basaltic lavas from oceanic plateaus (e.g., Ontong Java and Kerguelen) and other continental flood basalt provinces (e.g., Deccan and Etendeka). A tholeiitic series ranges from picritic basalts to rhyodacites and has relatively high concentrations of trace elements (e.g., Rb, Ba, Th, and light lanthanides) and the Pb-Sr-Nd and Os isotopic characteristic of magmas that have assimilated continental crust. The Pb isotope ratios of tholeiitic andesites indicate the involvement of a component highly depleted in radiogenic Pb, very likely old lower crust. Energy-constrained- assimilation-fractional-crystallization modeling indicates that the rhyodacites may be the result of 3c25% assimilation of upper continental crust, with a ratio between assimilated mass and subtracted solid of 3c0.35. An andesite with low Pb isotope ratios may be the result of 3c8% assimilation of lower continental crust with a mass assimilated/mass accumulated ratio of 3c0.1. Interaction of mantle-derived magmas with crustal lithologies of different age and evolutionary history thus occurred in this sector of the flood basalt province. Contamination of mantle-derived rocks by material of different crustal domains is a process also observed in other large igneous provinces, such as the Deccan Traps

Una Visión General del Sistema Financiero Colombiano

Desde finales de los 80 el sistema financiero colombiano ha experimentado cambios sensibles. En efecto, la liberalización financiera, el fortalecimiento de la regulación prudencial, la conversión de un número importante de sociedades en establecimientos de crédito, el aumento en los requisitos de capital, etc. han determinado un cambio de perfil en el sistema. Adicionalmente, en el pasado reciente las autoridades han tomado medidas en cuanto a la estructura de los encajes, aumentos en los requisitos de capital, el acceso al crédito externo, etc. que afectan de manera importante a las entidades financieras. A raíz de estas medidas ha surgido un debate acerca del tipo de sistema financiero que resulta más deseable para Colombia. La discusión es de vital importancia puesto que la estructura de encajes, las formas de intervención del Banco de la República en los mercados cambiario y monetario, la supervisión y todo el aparato regulatorio deben ser consistentes con el tipo de sistema que se desee. Con el fin de contribuir al debate, en este documento se presenta una breve descripción del estado actual del sistema financiero y su evolución reciente, se plantea una reflexión normativa acerca del tipo de sistema financiero que puede resultar más deseable y, finalmente,se presentan algunas recomendaciones.

Predicting substance use behavior among South African adolescents: The role of leisure experiences across time

Using seven waves of data, collected twice a year from the 8th through the 11th grades in a low-resource community in Cape Town, South Africa, we aimed to describe the developmental trends in three specific leisure experiences (leisure boredom, new leisure interests, and healthy leisure) and substance use (cigarettes, alcohol, and marijuana) behaviors and to investigate the ways in which changes in leisure experiences predict changes in substance use behaviors over time. Results indicated that adolescents’ substance use increased significantly across adolescence, but that leisure experiences remained fairly stable over time. We also found that adolescent leisure experiences predicted baseline substance use and that changes in leisure experiences predicted changes in substance use behaviors over time, with leisure boredom emerging as the most consistent and strongest predictor of alcohol, cigarette, and marijuana use. Implications for interventions that target time use and leisure experiences are discussed.Web of Scienc

Off-pump coronary artery bypass grafting provides complete revascularization with reduced myocardial injury, transfusion requirements, and length of stay: A prospective randomized comparison of two hundred unselected patients undergoing off-pump versus conventional coronary artery bypass grafting

AbstractObjective: Retrospective comparisons of selected patients undergoing off-pump versus conventional on-pump coronary artery bypass grafting have yielded inconsistent results and raised concerns about completeness of revascularization in off-pump coronary artery bypass grafting. Methods: Two hundred unselected patients referred for elective primary coronary artery bypass grafting were randomly assigned to undergo off-pump coronary artery bypass grafting with an Octopus tissue stabilizer (Medtronic, Inc, Minneapolis, Minn) or conventional coronary artery bypass grafting with cardiopulmonary bypass by a single surgeon. Revascularization intent determined before random assignment was compared with the revascularization performed. All management followed strict, unbiased, criteria-driven protocols. Patients and nonoperative care providers were blinded to surgical group. Results: Baseline characteristics were similar. The number of grafts performed per patient (mean ± SD 3.39 ± 1.04 for off-pump coronary artery bypass grafting, 3.40 ± 1.08 for conventional coronary artery bypass grafting) and the index of completeness of revascularization (number of grafts performed/number of grafts intended, 1.00 ± 0.18 for off-pump coronary artery bypass grafting, 1.01 ± 0.09 for conventional coronary artery bypass grafting) were similar. Likewise, the index of completeness of revascularization was similar between groups for the lateral wall. Combined hospital and 30-day mortalities and stroke rates were similar. Postoperative myocardial serum enzyme measures were significantly lower after off-pump coronary artery bypass grafting, suggesting less myocardial injury. Adjusted postoperative thromboelastogram indices, fibrinogen, international normalized ratio, and platelet levels all showed significantly less coagulopathy after off-pump coronary artery bypass grafting. Patients undergoing off-pump coronary artery bypass grafting received fewer units of blood, were more likely to avoid transfusion altogether, and had a higher hematocrit at discharge. Cardiopulmonary bypass was an independent predictor of transfusion (odds ratio 2.42, P =.0073) by multivariate analysis. More patients undergoing off-pump coronary artery bypass grafting were extubated in the operating room and within 4 hours. Postoperative length of stay (in days) was shorter for off-pump coronary artery bypass grafting (5.1 ± 6.5 for off-pump coronary artery bypass grafting, 6.1 ± 8.2 for conventional coronary artery bypass grafting, P =.005 by Wilcoxon test). One patient (in the conventional coronary artery bypass grafting group) required angioplasty for graft closure within 30 days. Conclusions: When compared with conventional coronary artery bypass grafting with cardiopulmonary bypass, off-pump coronary artery bypass grafting achieved similar completeness of revascularization, similar in-hospital and 30-day outcomes, shorter length of stay, reduced transfusion requirement, and less myocardial injury.J Thorac Cardiovasc Surg 2003;125:797-80

Off-pump coronary artery bypass grafting provides complete revascularization with reduced myocardial injury, transfusion requirements, and length of stay: A prospective randomized comparison of two hundred unselected patients undergoing off-pump versus conventional coronary artery bypass grafting

AbstractObjective: Retrospective comparisons of selected patients undergoing off-pump versus conventional on-pump coronary artery bypass grafting have yielded inconsistent results and raised concerns about completeness of revascularization in off-pump coronary artery bypass grafting. Methods: Two hundred unselected patients referred for elective primary coronary artery bypass grafting were randomly assigned to undergo off-pump coronary artery bypass grafting with an Octopus tissue stabilizer (Medtronic, Inc, Minneapolis, Minn) or conventional coronary artery bypass grafting with cardiopulmonary bypass by a single surgeon. Revascularization intent determined before random assignment was compared with the revascularization performed. All management followed strict, unbiased, criteria-driven protocols. Patients and nonoperative care providers were blinded to surgical group. Results: Baseline characteristics were similar. The number of grafts performed per patient (mean ± SD 3.39 ± 1.04 for off-pump coronary artery bypass grafting, 3.40 ± 1.08 for conventional coronary artery bypass grafting) and the index of completeness of revascularization (number of grafts performed/number of grafts intended, 1.00 ± 0.18 for off-pump coronary artery bypass grafting, 1.01 ± 0.09 for conventional coronary artery bypass grafting) were similar. Likewise, the index of completeness of revascularization was similar between groups for the lateral wall. Combined hospital and 30-day mortalities and stroke rates were similar. Postoperative myocardial serum enzyme measures were significantly lower after off-pump coronary artery bypass grafting, suggesting less myocardial injury. Adjusted postoperative thromboelastogram indices, fibrinogen, international normalized ratio, and platelet levels all showed significantly less coagulopathy after off-pump coronary artery bypass grafting. Patients undergoing off-pump coronary artery bypass grafting received fewer units of blood, were more likely to avoid transfusion altogether, and had a higher hematocrit at discharge. Cardiopulmonary bypass was an independent predictor of transfusion (odds ratio 2.42, P =.0073) by multivariate analysis. More patients undergoing off-pump coronary artery bypass grafting were extubated in the operating room and within 4 hours. Postoperative length of stay (in days) was shorter for off-pump coronary artery bypass grafting (5.1 ± 6.5 for off-pump coronary artery bypass grafting, 6.1 ± 8.2 for conventional coronary artery bypass grafting, P =.005 by Wilcoxon test). One patient (in the conventional coronary artery bypass grafting group) required angioplasty for graft closure within 30 days. Conclusions: When compared with conventional coronary artery bypass grafting with cardiopulmonary bypass, off-pump coronary artery bypass grafting achieved similar completeness of revascularization, similar in-hospital and 30-day outcomes, shorter length of stay, reduced transfusion requirement, and less myocardial injury.J Thorac Cardiovasc Surg 2003;125:797-80

Sorafenib for advanced and refractory desmoid tumors

BACKGROUND Desmoid tumors (also referred to as aggressive fibromatosis) are connective tissue neoplasms that can arise in any anatomical location and infiltrate the mesentery, neurovascular structures, and visceral organs. There is no standard of care. METHODS In this double-blind, phase 3 trial, we randomly assigned 87 patients with progressive, symptomatic, or recurrent desmoid tumors to receive either sorafenib (400- mg tablet once daily) or matching placebo. Crossover to the sorafenib group was permitted for patients in the placebo group who had disease progression. The primary end point was investigator-assessed progression-free survival; rates of objective response and adverse events were also evaluated. RESULTS With a median follow-up of 27.2 months, the 2-year progression-free survival rate was 81% (95% confidence interval [CI], 69 to 96) in the sorafenib group and 36% (95% CI, 22 to 57) in the placebo group (hazard ratio for progression or death, 0.13; 95% CI, 0.05 to 0.31; P<0.001). Before crossover, the objective response rate was 33% (95% CI, 20 to 48) in the sorafenib group and 20% (95% CI, 8 to 38) in the placebo group. The median time to an objective response among patients who had a response was 9.6 months (interquartile range, 6.6 to 16.7) in the sorafenib group and 13.3 months (interquartile range, 11.2 to 31.1) in the placebo group. The objective responses are ongoing. Among patients who received sorafenib, the most frequently reported adverse events were grade 1 or 2 events of rash (73%), fatigue (67%), hypertension (55%), and diarrhea (51%). CONCLUSIONS Among patients with progressive, refractory, or symptomatic desmoid tumors, sorafenib significantly prolonged progression-free survival and induced durable responses