Students\u27 Perception of Value of Interactive Oral Communication as Part of Writing Course Papers

Every day students are able to discuss complex ideas relatively easily in spontaneous conversation, yet when they attempt to express complex ideas in a written paper, students often experience great difficulty. The features of face-to-face conversation and of written communication differ in a number of respects. This study examines student\u27s perceptions of peer evaluation through interactive conversation as compared to non-interactive written peer feedback. This study provides evidence that students perceive value in actively talking with others about their paper. In particular, students often prefer to talk to someone who has investment in their success and who can give them constructive, honest advice. This study provides some initial evidence that students prefer face-to-face conversing with a classmate as compared to non-interactive written peer feedback. We discuss reasons why conversing about a paper in face-to-face conversation has advantages that may benefit students in academic writing

Changes of memory B- and T-cell subsets in lupus nephritis patients

Introduction. Renal involvement in systemic lupus erythematosus (SLE) is associated with production of antibodies to double stranded DNA, deposition of immune complexes and organ damage. These processes have been linked with abnormalities in B- and T-cell memory compartments. The aim of the study was to analyze subsets of peripheral memory B-cells and T-cells in lupus nephritis (LN) patients. Material and methods. We used multicolor flow cytometry to analyze major memory subsets of peripheral blood B-cells (defined by CD27, IgD and CD21) and T-cells (CD45RA, CD45RO, CCR7) in 32 patients with active or inactive LN, and 23 control subjects. Results. Lupus nephritis patients were characterized by increased percentage of immature/early-transitional B-cells (CD27-IgD+CD21-), higher frequency of activated switched memory (SM, CD27+IgD-CD21-) and exhausted memory B-cells (CD27-IgD-), and decrease in non-switched memory (NSM, CD27+IgD+) B-cells. CD21low subsets (immature and activated B-cells) were particularly expanded in patients with active disease. In both groups of LN patients we observed decline in the absolute count of NSM B-cells. It was paralleled by lymphopenia in naïve CD4+ T-cell compartment and increase in the frequency of effector memory T-cells, and these changes were more pronounced in active LN. Conclusions. B-cell memory compartment in LN is deficient in NSM cells and during active disease it is further skewed towards SM and exhausted memory phenotypes, most likely as a cause of chronic antigenic stimulation. Parallel changes in T-helper cell subsets suggest a similar mechanism of SLE-related lymphopenia for both B-cell and T-cell compartment

Renal interstitial mast cell counts differ across classes of proliferative lupus nephritis

Systemic lupus erythematosus frequently involves the kidneys leading to significant morbidity and mortality. It is classified according to glomerular involvement pattern but tubulointerstitial lesions are also important for progression and prognosis, as seen in other kidney glomerular diseases. One of the cell types which participate in this process are mast cells. The aim of the study was to analyze the counts of tryptase-positive and chymase-positive mast cells in lupus nephritis classes II, III and IV. Material consisted of 42 renal biopsies from patients with lupus nephritis; 11 class II, 9 class III and 22 class IV. Chymase- and tryptase-containing cells were stained by immunohistochemistry and counted microscopically. Mean count of chymase-positive mast cells was 9.8/10 high power fields (hpf) for the whole group, 4.66 for class II, 11.89 for class III, and 11.51 for class IV. The mean count of tryptase-positive cells was 18.6/10 hpf for the whole group, 7.65 for class II, 25.57 for class III, and 21.23 for class IV. The differences between lupus nephritis classes were significant both for chymase- and tryptase-positive cells. Tryptase- but not chymase-positive cell counts showed a correlation with the creatinine level (R = 0.35). These results suggest that mast cells are involved to a different degree in the pathogenesis of lupus nephritis depending on the class of the disease

Costs and Effectiveness of Pharmacist-led Group Medical Visits for Type-2 Diabetes: A Multi-center Randomized Controlled Trial

Objectives The effectiveness and costs associated with addition of pharmacist-led group medical visits to standard care for patients with Type-2 Diabetes Mellitus (T2DM) is unknown. Methods Randomized-controlled-trial in three US Veteran Health Administration (VHA) Hospitals, where 250 patients with T2DM, HbA1c \u3e7% and either hypertension, active smoking or hyperlipidemia were randomized to either (1) addition of pharmacist-led group-medical-visits or (2) standard care alone for 13 months. Group (4–6 patients) visits consisted of 2-hour, education and comprehensive medication management sessions once weekly for 4 weeks, followed by quarterly visits. Change from baseline in cardiovascular risk estimated by the UKPDS-risk-score, health-related quality-of-life (SF36v) and institutional healthcare costs were compared between study arms. Results After 13 months, both groups had similar and significant improvements from baseline in UKPDS-risk-score (-0.02 ±0.09 and -0.04 ±0.09, group visit and standard care respectively, adjusted p Conclusions Addition of pharmacist-led group medical visits in T2DM achieved similar improvements from baseline in cardiovascular risk factors than usual care, but with reduction in the healthcare costs in the group visit arm 13 months after completion compared to the steady rise in cost for the usual care arm

Reactivity of pulmonary circulation and right ventricle function to inhaled nitric oxide in systemic sclerosis patients

Systemic sclerosis (SSc) is complicated by pulmonary hypertension and right ventricle (RV) failure in approximately 10% of the patients. Factors influencing the reactivity of pulmonary circulation to vasodilators are not established, while the examination of vasoreactivity is important in determining the treatment, because systemic administration of oral vasodilators can induce severe adverse events in nonresponders. The mechanism of RV failure in SSc is unclear and may result either from increased RV afterload or intrinsic myocardial disease. The aim of the study was to assess the reactivity of pulmonary circulation to inhaled nitric oxide (iNO) and to evaluate its influence on RV function in SSc patients with elevated right ventricle systolic pressure (RVSP). In 60 SSc patients aged 24–73 (58 females, two males; 33 patients with limited SSc and 27 with diffuse SSc), echocardiographic examination with tissue Doppler echocardiography (TDE) was performed. RV function was measured by systolic (S) and early diastolic (E) velocity of tricuspid annulus by TDE. In patients with RVSP >45 mmHg, the reactivity of pulmonary circulation was assessed by iNO test. High-resolution computerized tomography (HRCT) was performed to assess the extent of pulmonary fibrosis. Of 14 SSc subjects with elevated RVSP (13 females, one male; RVSP 47–62 mmHg), positive reaction to iNO was observed in five (RVSP decreased from 51.6 ± 3.7 to 32.24 ± 2.3 mmHg); nine patients were not reactive (RVSP 53.5 ± 5.7 mmHg before iNO vs. 49.6 ± 6.7 mmHg). RV systolic function was decreased in patients with elevated RVSP as compared to the patients with normal pulmonary pressure (S velocity 13.2 ± 1.3 vs. 14.4 ± 1.6 cm/s, respectively, p < 0.05). Significant increase of RV systolic function during iNO test was found in reactive patients only (S velocity before iNO 12.8 ± 1.2 cm/s, during iNO 14.5 ± 1.5 cm/s, p < 0.01). RVSP decrease strongly correlated with S velocity increase (r = 0.95, p < 0.0001). Response to iNO was found only in limited form of SSc; diffuse SSc patients showed no response. Pulmonary fibrosis on HRCT was more frequent in subjects nonreactive to iNO (67% of patients) than in the reactive group (40% of patients). The reactivity of pulmonary circulation to iNO in SSc patients with elevated RVSP was found predominantly in limited form of the disease. Pulmonary fibrosis typical for diffuse SSc was more frequent in nonreactive subjects. Elevated pulmonary pressure plays an important role in RV systolic dysfunction. Pulmonary pressure decrease during iNO test leads to the improvement of RV systolic function. Therapy for right-heart failure in reactive SSc patients should be directed, if possible, at the decrease in pulmonary resistance

Typical and top-ranked Polish private higher education: Intersectoral and intrasectoral distinctiveness

This dissertation analyzes the degree and shape of differences between private and public sectors (intersectoral) and within the private sector (intrasectoral) in Polish higher education. The intersectoral hypothesis is that Poland's two sectors are quite different and that these differences mostly follow those claimed and so far found in leading literature on private higher education globally. The intrasectoral analysis focuses on the top-ranked private institutions, for which I hypothesize characteristics of "semi-elite" institutions. The research develops eight explicit and specific intersectoral hypotheses and then, for intrasectoral analysis, eight such hypotheses on parallel subject matter—Enrollment size, Primary function, Field subject matter, Concentration of institutional offerings, Student quality, Faculty quality, Source of funding, and International orientation. Each hypothesis is investigated empirically. To do so, I refine indicators employed on other higher education topics and develop some wholly new indicators, statistical ones, on which pertinent data could be gathered. I survey top-ranked private universities to compare these to private sector averages. Interviews supplement the statistical analysis, cross-checking that analysis and extending it. The findings strongly substantiate the overall hypothesis that intersectoral differences are major and in anticipated directions. Four of the eight specific hypotheses are strongly supported, three others are moderately supported, and for only one the indicators and data are insufficient to draw a conclusion. The findings on whether the top-ranked institutions are semi-elite are mixed, though generally positive. Two hypotheses are strongly supported, three moderately supported, two supported in only limited ways, and one is basically not supported. This national case study not only fits and illustrates but also greatly fleshes out the global findings on intersectoral differences. The intrasectoral analysis—only the second large national study—proves promising for the semi-elite concept, charting new territory but revealing ambiguities and contradictions. Aside from its substantive findings, this study makes methodological strides, on both the intersectoral and intrasectoral fronts, by introducing systematically developed hypotheses, finding indicators for analyzing them, and using data to fuel the indicators. Additionally, the study provides detailed relevant material usable in policymaking by government agencies, private universities, and families

Challenges to Top-Ranked Private Universities in Poland

Although demographic change seriously threatens private higher education in Poland, part of the sector has means to cope. In contrast to the majority of private institutions, top-ranked private institutions enjoy semi-elite characteristics that shield them, not fully but partly, from negative impact on enrollment