299 research outputs found

    The nature and rationale of the robotic curriculum in elementary school

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    Background and Objective:As widespread changes have occurred in the community, the use of technology has also expanded. To effectively prepare for and cope with evolving of this century we need to design and develop special curricula. Educational robotics is an advanced technology that requires special attention. In the past few decades, robotics has attracted the attention of researchers and teachers as a valuable tool in developing cognitive / social skills of students and in supporting the learning of subjects in science, mathematics, language, and technology. There are several important reasons why young students should be exposed to robotics. As our world becomes more and more technologically advanced, students need to early experience so that to feel comfortable with and be aware of technology. In addition, the inclusion of robotics in the school curriculum will help prepare students to enter the job market with technological literacy. Robotics is an attractive approach to technology training due to its interdisciplinary nature, which requires expertise in a wide range of fields from mathematics to aesthetics. This can attract the interest and engagement of students who have not been successful in traditional subject matters. The purpose of this paper is to explain the philosophical orientation and educational robotics foundations at the primary school level so that policymakers, engineers and curriculum developers can formulate curriculum models for implementation. Methods: In this research, educational robotics was analyzed and synthesized using the synthesis research method. Valid documents and research from the last four decades have been selected and categorized using a criterion-based purposive sampling technique. Findings: Synthesis findings indicate that robotics in schools work in two ways as an independent subject and as an educational enabler serving other topics. Logical justification of it is based on constructivist, including epistemological (personal and multidisciplinary), psychological (attention to motivation, creativity and etc.) and sociological foundations (interaction, predictability and etc.). Conclusion: In order to design a curriculum, a planner must first pay attention to the nature of the subject or knowledge and then proceed to develop a plan based on the orientations of the curriculum. Because the subject is robotics training in elementary school, the planner must pay attention to its nature first. The findings of this synthesis showed that robotics can serve in schools at all levels as an independent subject or as an educational enabler in the service of other subjects. Therefore, it is necessary to differentiate between the concepts of robotic training and training robotics. In robotics training, the subject is robot training; but in educational robotics, the robot is considered as a method, tool or technique that is used to teach other subjects.   ===================================================================================== COPYRIGHTS  ©2019 The author(s). This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, as long as the original authors and source are cited. No permission is required from the authors or the publishers.  ====================================================================================

    Comparison of the Value of Nursing Work Environments in Hospitals Across Different Levels of Patient Risk

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    Importance The literature suggests that hospitals with better nursing work environments provide better quality of care. Less is known about value (cost vs quality). Objectives To test whether hospitals with better nursing work environments displayed better value than those with worse nursing environments and to determine patient risk groups associated with the greatest value. Design, Setting, and Participants A retrospective matched-cohort design, comparing the outcomes and cost of patients at focal hospitals recognized nationally as having good nurse working environments and nurse-to-bed ratios of 1 or greater with patients at control group hospitals without such recognition and with nurse-to-bed ratios less than 1. This study included 25 752 elderly Medicare general surgery patients treated at focal hospitals and 62 882 patients treated at control hospitals during 2004-2006 in Illinois, New York, and Texas. The study was conducted between January 1, 2004, and November 30, 2006; this analysis was conducted from April to August 2015. Exposures Focal vs control hospitals (better vs worse nursing environment). Main Outcomes and Measures Thirty-day mortality and costs reflecting resource utilization. Results This study was conducted at 35 focal hospitals (mean nurse-to-bed ratio, 1.51) and 293 control hospitals (mean nurse-to-bed ratio, 0.69). Focal hospitals were larger and more teaching and technology intensive than control hospitals. Thirty-day mortality in focal hospitals was 4.8% vs 5.8% in control hospitals (P \u3c .001), while the cost per patient was similar: the focal-control was −163(95163 (95% CI = −542 to 215;P=.40),suggestingbettervalueinthefocalgroup.Forthefocalvscontrolhospitals,thegreatestmortalitybenefit(17.3215; P = .40), suggesting better value in the focal group. For the focal vs control hospitals, the greatest mortality benefit (17.3% vs 19.9%; P \u3c .001) occurred in patients in the highest risk quintile, with a nonsignificant cost difference of 941 per patient (53701vs53 701 vs 52 760; P = .25). The greatest difference in value between focal and control hospitals appeared in patients in the second-highest risk quintile, with mortality of 4.2% vs 5.8% (P \u3c .001), with a nonsignificant cost difference of −862(862 (33 513 vs $34 375; P = .12). Conclusions and Relevance Hospitals with better nursing environments and above-average staffing levels were associated with better value (lower mortality with similar costs) compared with hospitals without nursing environment recognition and with below-average staffing, especially for higher-risk patients. These results do not suggest that improving any specific hospital’s nursing environment will necessarily improve its value, but they do show that patients undergoing general surgery at hospitals with better nursing environments generally receive care of higher value

    Examining Causes of Racial Disparities in General Surgical Mortality: Hospital Quality Versus Patient Risk

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    BACKGROUND: Racial disparities in general surgical outcomes are known to exist but not well understood. OBJECTIVES: To determine if black-white disparities in general surgery mortality for Medicare patients are attributable to poorer health status among blacks on admission or differences in the quality of care provided by the admitting hospitals. RESEARCH DESIGN: Matched cohort study using Tapered Multivariate Matching. SUBJECTS: All black elderly Medicare general surgical patients (N=18,861) and white-matched controls within the same 6 states or within the same 838 hospitals. MEASURES: Thirty-day mortality (primary); others include in-hospital mortality, failure-to-rescue, complications, length of stay, and readmissions. RESULTS: Matching on age, sex, year, state, and the exact same procedure, blacks had higher 30-day mortality (4.0% vs. 3.5%, P\u3c0.01), in-hospital mortality (3.9% vs. 2.9%, P\u3c0.0001), in-hospital complications (64.3% vs. 56.8% P\u3c0.0001), and failure-to-rescue rates (6.1% vs. 5.1% P\u3c0.001), longer length of stay (7.2 vs. 5.8 d, P\u3c0.0001), and more 30-day readmissions (15.0% vs. 12.5%, P\u3c0.0001). Adding preoperative risk factors to the above match, there was no significant difference in mortality or failure-to-rescue, and all other outcome differences were small. Blacks matched to whites in the same hospital displayed no significant differences in mortality, failure-to-rescue, or readmissions. CONCLUSIONS: Black and white Medicare patients undergoing the same procedures with closely matched risk factors displayed similar mortality, suggesting that racial disparities in general surgical mortality are not because of differences in hospital quality. To reduce the observed disparities in surgical outcomes, the poorer health of blacks on presentation for surgery must be addressed

    Characteristics Associated With Differences in Survival Among Black and White Women With Breast Cancer

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    Importance Difference in breast cancer survival by race is a recognized problem among Medicare beneficiaries. Objective To determine if racial disparity in breast cancer survival is primarily attributable to differences in presentation characteristics at diagnosis or subsequent treatment. Design, Setting, and Patients Comparison of 7375 black women 65 years and older diagnosed between 1991 to 2005 and 3 sets of 7375 matched white control patients selected from 99 898 white potential controls, using data for 16 US Surveillance, Epidemiology and End Results (SEER) sites in the SEER-Medicare database. All patients received follow-up through December 31, 2009, and the black case patients were matched to 3 white control populations on demographics (age, year of diagnosis, and SEER site), presentation (demographics variables plus patient comorbid conditions and tumor characteristics such as stage, size, grade, and estrogen receptor status), and treatment (presentation variables plus details of surgery, radiation therapy, and chemotherapy). Main Outcomes and Measures 5-Year survival. Results The absolute difference in 5-year survival (blacks, 55.9%; whites, 68.8%) was 12.9% (95% CI, 11.5%-14.5%; P \u3c .001) in the demographics match. This difference remained unchanged between 1991 and 2005. After matching on presentation characteristics, the absolute difference in 5-year survival was 4.4% (95% CI, 2.8%-5.8%; P \u3c .001) and was 3.6% (95% CI, 2.3%-4.9%; P \u3c .001) lower for blacks than for whites matched also on treatment. In the presentation match, fewer blacks received treatment (87.4% vs 91.8%; P \u3c .001), time from diagnosis to treatment was longer (29.2 vs 22.8 days; P \u3c .001), use of anthracyclines and taxols was lower (3.7% vs 5.0%; P \u3c .001), and breast-conserving surgery without other treatment was more frequent (8.2% vs 7.3%; P = .04). Nevertheless, differences in survival associated with treatment differences accounted for only 0.81% of the 12.9% survival difference. Conclusions and Relevance In the SEER-Medicare database, differences in breast cancer survival between black and white women did not substantially change among women diagnosed between 1991 and 2005. These differences in survival appear primarily related to presentation characteristics at diagnosis rather than treatment differences

    Dynamics of Adrenal Steroids Are Related to Variations in Th1 and Treg Populations during Mycobacterium tuberculosis Infection in HIV Positive Persons

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    Tuberculosis (TB) remains the most frequent cause of illness and death from an infectious agent, and its interaction with HIV has devastating effects. We determined plasma levels of dehydroepiandrosterone (DHEA), its circulating form DHEA-suphate (DHEA-s) and cortisol in different stages of M. tuberculosis infection, and explored their role on the Th1 and Treg populations during different scenarios of HIV-TB coinfection, including the immune reconstitution inflammatory syndrome (IRIS), a condition related to antiretroviral treatment. DHEA levels were diminished in HIV-TB and HIV-TB IRIS patients compared to healthy donors (HD), HIV+ individuals and HIV+ individuals with latent TB (HIV-LTB), whereas dehydroepiandrosterone sulfate (DHEA-s) levels were markedly diminished in HIV-TB IRIS individuals. HIV-TB and IRIS patients presented a cortisol/DHEA ratio significantly higher than HIV+, HIV-LTB and HD individuals. A positive correlation was observed between DHEA-s and CD4 count among HIV-TB individuals. Conversely, cortisol plasma level inversely correlated with CD4 count within HIV-TB individuals. M. tuberculosis-specific Th1 lymphocyte count was increased after culturing PBMC from HIV-TB individuals in presence of DHEA. We observed an inverse correlation between DHEA-s plasma level and Treg frequency in co-infected individuals, and CD4+FoxP3+ Treg frequency was increased in HIV-TB and IRIS patients compared to other groups. Strikingly, we observed a prominent CD4+CD25-FoxP3+ population across HIV-TB and HIV-TB IRIS patients, which frequency correlated with DHEA plasma level. Finally, DHEA treatment negatively regulated FoxP3 expression without altering Treg frequency in co-infected patients. These data suggest an enhancing role for DHEA in the immune response against M. tuberculosis during HIV-TB coinfection and IRIS

    Crop Updates 2000 - Oilseeds

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    This session covers seventeen papers from different authors: Introduction, Paul Carmody, Centre for Cropping Systems CANOLA AGRONOMY 2. Genotype, location and year influence the quality of canola grown across southern Australia, PingSi1, Rodney Mailer2, Nick Galwey1 and David Turner1, 1Plant Sciences, Faculty of Agriculture, The University of Western Australia, 2Agricultural Research Institute, New South Wales Agriculture 3. Development of Pioneer® Canola varieties for Australian market,Kevin Morthorpe, StephenAddenbrooke, Pioneer Hi-Bred Australia Pty Ltd 4. Canola, Erucic Acid, Markets and Agronomic Implications, Peter Nelson, The Grain Pool of Western Australia 5. The control of Capeweed in Clearfield Production System for Canola, Mike Jackson and ScottPaton, Cyanamid Agriculture Pty Ltd 6. Responsiveness of Canola to Soil Potassium Levels: How Low Do We Have To Go? Ross Brennan, Noeleen Edwards, Mike Bolland and Bill Bowden,Agriculture Western Australia 7. Adaption of Indian Mustard (Brassica juncea) in the Mediterranean Environment of South Western Australia, C.P. Gunasekera1, L.D. Martin1, G.H. Walton2 and K.H.M. Siddique2 1Muresk Institute of Agriculture, Curtin University of Technology, Northam, 2Agriculture Western Australia 8. Physiological Aspects of Drought Tolerance in Brassica napus and B.juncea, Sharon R. Niknam and David W. Turner, Plant Sciences, Faculty of Agriculture, The University of Western Australia 9. Cross resistance of chlorsulfuron-resistant wild radish to imidazolinones, Abul Hashem, Harmohinder Dhammu and David Bowran, Agriculture Western Australia 10. Canola Variety and PBR Update 2000, From The Canola Association of Western Australia 11. Development of a canola ideotype for the low rainfall areas of the western Australian wheat belt, Syed H. Zaheer, Nick W. Galwey and David W. Turner, Faculty of Agriculture, The University of Western Australia DISEASE MANAGEMENT 12. Evaluation of fungicides for the management of blackleg in canola, Ravjit Khangura and Martin J. Barbetti, Agriculture Western Australia 13. Impact-IFÒ: Intergral in the control of Blackleg, Peter Carlton, Trials Coordinator, Elders Limited 14. Forecasting aphid and virus risk in canola, Debbie Thackray, Jenny Hawkes and Roger Jones, Agriculture Western Australia and Centre for Legumes in Mediterranean Agriculture 15. Beet western yellow virus in canola: 1999 survey results, wild radish weed reservoir and suppression by insecticide, Roger Jones and Brenda Coutts, Agriculture Western Australia 16. Are canola crops resilient to damage by aphids and diamond back moths? Françoise Berlandier, Agriculture Western Australia ECONOMIC OUTLOOK 17. Outlook for prices and implications for rotations, Ross Kingwell1,2, Michael O’Connell1 and Simone Blennerhasset11Agriculture Western Australia 2University of Western Australi

    Hyperbaric treatment for children with autism: a multicenter, randomized, double-blind, controlled trial

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    <p>Abstract</p> <p>Background</p> <p>Several uncontrolled studies of hyperbaric treatment in children with autism have reported clinical improvements; however, this treatment has not been evaluated to date with a controlled study. We performed a multicenter, randomized, double-blind, controlled trial to assess the efficacy of hyperbaric treatment in children with autism.</p> <p>Methods</p> <p>62 children with autism recruited from 6 centers, ages 2–7 years (mean 4.92 ± 1.21), were randomly assigned to 40 hourly treatments of either hyperbaric treatment at 1.3 atmosphere (atm) and 24% oxygen ("treatment group", n = 33) or slightly pressurized room air at 1.03 atm and 21% oxygen ("control group", n = 29). Outcome measures included Clinical Global Impression (CGI) scale, Aberrant Behavior Checklist (ABC), and Autism Treatment Evaluation Checklist (ATEC).</p> <p>Results</p> <p>After 40 sessions, mean physician CGI scores significantly improved in the treatment group compared to controls in overall functioning (p = 0.0008), receptive language (p < 0.0001), social interaction (p = 0.0473), and eye contact (p = 0.0102); 9/30 children (30%) in the treatment group were rated as "very much improved" or "much improved" compared to 2/26 (8%) of controls (p = 0.0471); 24/30 (80%) in the treatment group improved compared to 10/26 (38%) of controls (p = 0.0024). Mean parental CGI scores significantly improved in the treatment group compared to controls in overall functioning (p = 0.0336), receptive language (p = 0.0168), and eye contact (p = 0.0322). On the ABC, significant improvements were observed in the treatment group in total score, irritability, stereotypy, hyperactivity, and speech (p < 0.03 for each), but not in the control group. In the treatment group compared to the control group, mean changes on the ABC total score and subscales were similar except a greater number of children improved in irritability (p = 0.0311). On the ATEC, sensory/cognitive awareness significantly improved (p = 0.0367) in the treatment group compared to the control group. Post-hoc analysis indicated that children over age 5 and children with lower initial autism severity had the most robust improvements. Hyperbaric treatment was safe and well-tolerated.</p> <p>Conclusion</p> <p>Children with autism who received hyperbaric treatment at 1.3 atm and 24% oxygen for 40 hourly sessions had significant improvements in overall functioning, receptive language, social interaction, eye contact, and sensory/cognitive awareness compared to children who received slightly pressurized room air.</p> <p>Trial Registration</p> <p>clinicaltrials.gov NCT00335790</p
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