From soliciting answers to eliciting reasoning: Questioning our questions in digital math tasks

How can classroom teachers and task designers pose questions to promote students’ reasoning? The authors share a Toy Car task, developed in Desmos, then provide three design principles guiding task questions

Shoulder injury reduction with post-offer testing

This is the publisher's version, also available electronically from http://iospress.metapress.com/content/4311322087360k74/?issue=2&genre=article&spage=113&issn=1051-9815&volume=39.Objective: This study is an interventional evaluation of a post-offer employment testing. The study is designed to determine if shoulder injury rates are lowered when employees are placed at jobs they demonstrate the physical ability to perform. Methods: A physical capacity evaluation based testing protocol was utilized to determine if each new employee had the physical work capacity to perform the job for which they were hired. Injuries to the shoulder were specifically scrutinized. The interventional group was compared to a historical control. Results: The incidence of shoulder injuries was 0% in the tested group and 3.8% in the untested historical control. Over a 6 year study timeframe the utilization of physical capacity testing for work placement appeared to be the major factor in decreasing work related shoulder injuries. The annual cost of administering the tests for three years was 9,543, while the net annual cost savings was124,451. This represented a 37% decrease in medical costs for shoulder and other work-related injuries. For every dollar spent on testing there was a $14 savings in medical costs secondary to injury prevention. Conclusion: The use of post-offer physical capacity testing resulted in a substantial and noticeable decrease in shoulder related non-accidental injuries. Furthermore, it is evident that a properly conceived and implemented post-offer testing program may help in the reduction of work-related injuries

Weight Watchers on prescription: an observational study of weight change among adults referred to Weight Watchers by the NHS.

BACKGROUND: The scale of overweight and obesity in the UK places a considerable burden on the NHS. In some areas the NHS has formed partnerships with commercial companies to offer weight management services, but there has been little evaluation of these schemes.This study is an independent audit of the Weight Watchers NHS Referral scheme and evaluates the weight change of obese and overweight adults referred to Weight Watchers (WW) by the NHS. METHOD: Data was obtained from the WW NHS Referral Scheme database for 29,326 referral courses started after 2nd April 2007 and ending before 6th October 2009 [90% female; median age 49 years (IQR 38-61 years); median BMI 35.1 kg/m2 (IQR 31.8-39.5 kg/m2). Participants received vouchers (funded by the PCT following referral by a healthcare professional) to attend 12 WW meetings. Body weight was measured at WW meetings and relayed to the central database. RESULTS: Median weight change for all referrals was -2.8 kg [IQR -5.9--0.7 kg] representing -3.1% initial weight. 33% of all courses resulted in loss of ≥5% initial weight. 54% of courses were completed. Median weight change for those completing a first course was -5.4 kg [IQR -7.8--3.1 kg] or -5.6% of initial weight. 57% lost ≥5% initial weight. CONCLUSIONS: A third of all patients who were referred to WW through the WW NHS Referral Scheme and started a 12 session course achieved ≥5% weight loss, which is usually associated with clinical benefits. This is the largest audit of NHS referral to a commercial weight loss programme in the UK and results are comparable with other options for weight loss available through primary care.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

A Longitudinal Study of Pediatricians Early in their Careers: PLACES

The American Academy of Pediatrics (AAP) launched the Pediatrician Life and Career Experience Study (PLACES), a longitudinal study that tracks the personal and professional experiences of early career pediatricians, in 2012. We used a multipronged approach to develop the study methodology and survey domains and items, including review of existing literature and qualitative research with the target population. We chose to include 2 cohorts of US pediatricians on the basis of residency graduation dates, including 1 group who were several years out of residency (2002–2004 Residency Graduates Cohort) and a second group who recently graduated from residency at study launch (2009–2011 Residency Graduates Cohort). Recruitment into PLACES was a 2-stage process: (1) random sample recruitment from the target population and completion of an initial intake survey and (2) completion of the first Annual Survey by pediatricians who responded positively to stage 1. Overall, 41.2% of pediatricians randomly selected to participate in PLACES indicated positive interest in the study by completing intake surveys; of this group, 1804 (93.7%) completed the first Annual Survey and were considered enrolled in PLACES. Participants were more likely to be female, AAP members, and graduates of US medical schools compared with the target sample; weights were calculated to adjust for these differences. We will survey PLACES pediatricians 2 times per year. PLACES data will allow the AAP to examine career and life choices and transitions experienced by early-career pediatricians

Independent Living Oldest-Old and Their Primary Health Provider: A Mixed Method Examination of the Influence of Patient Personality Characteristics

This convergent mixed methods study examined 35 healthy, independent living individuals\u27 (over 85 years) perceptions of their relationship with their primary health provider (PHP) and health practices. The relationship between PHP relationship perceptions and locus of control (LOC), resilience, and self-efficacy was explored through surveys and interviews. The majority indicated they visited their PHP just for preventative care; the number of PHP visits per year was significantly lower than reported for individuals over 85 by the CDC, possible reasons for this finding are provided. A positive relationship between LOC, resiliency, and self-efficacy for the oldest-old was found. Few participants indicated their PHP had discussed normal changes with aging. This study has deepened understanding of the complexity inherent to the healthy oldest-olds\u27 relationship with their PHP. The findings suggest this relationship relates to the PHP\u27s personal characteristics, the elderly patients\u27 personality, and the influence of the accompanying patient escort

Independent Living Oldest-Old and Their Primary Health Provider: A Mixed Method Examination of the Influence of Patient Personality Characteristics

This convergent mixed methods study examined 35 healthy, independent living individuals\u27 (over 85 years) perceptions of their relationship with their primary health provider (PHP) and health practices. The relationship between PHP relationship perceptions and locus of control (LOC), resilience, and self-efficacy was explored through surveys and interviews. The majority indicated they visited their PHP just for preventative care; the number of PHP visits per year was significantly lower than reported for individuals over 85 by the CDC, possible reasons for this finding are provided. A positive relationship between LOC, resiliency, and self-efficacy for the oldest-old was found. Few participants indicated their PHP had discussed normal changes with aging. This study has deepened understanding of the complexity inherent to the healthy oldest-olds\u27 relationship with their PHP. The findings suggest this relationship relates to the PHP\u27s personal characteristics, the elderly patients\u27 personality, and the influence of the accompanying patient escort

FEV1 over time in patients with connective tissue disease-related bronchiolitis

SummaryBackgroundFibrosis or inflammation of the bronchioles is a well-known manifestation of connective tissue disease (CTD). However, the natural history of CTD-related bronchiolitis is largely unknown.MethodsWe analyzed consecutive patients evaluated at National Jewish Health (Denver, CO) from 1998 to 2008 with CTD and surgical lung biopsy-confirmed bronchiolitis. Linear mixed effects models were used to estimate the longitudinal postbronchodilator FEV1 %predicted (%pred) course and differences between subjects with or without constrictive bronchiolitis (CB).ResultsOf 28 subjects with a mean age of 53 ± 9 years, fourteen (50%) had CB. The most common CTD diagnosis was rheumatoid arthritis (n = 14; 50%). There were no significant differences in demographics, smoking status, underlying CTD diagnoses, 6-min walk distance, dyspnea score or drug therapy between subjects with CB and those with cellular bronchiolitis. Three subjects with CB (11%) and four with cellular bronchiolitis (14%) died. Compared with subjects with CB, those with cellular bronchiolitis had higher mean FEV1 %pred at all times. There were no significant differences in FEV1 %pred slope within- or between-groups (CB vs. cellular bronchiolitis) preceding surgical lung biopsy or afterward.ConclusionSubjects with CTD-related CB had lower FEV1 %pred values than those with CTD-related cellular bronchiolitis at all time points, but FEV1 %pred remained stable over time in both groups regardless of therapy received

Duration of Rheumatoid Arthritis and the Risk of Developing Interstitial Lung Disease

Age of ILD onset is similar in patients with RA-UIP and RA-NSIP but duration of RA before ILD onset differs

Outcomes in patients with gunshot wounds to the brain.

Introduction:Gunshot wounds to the brain (GSWB) confer high lethality and uncertain recovery. It is unclear which patients benefit from aggressive resuscitation, and furthermore whether patients with GSWB undergoing cardiopulmonary resuscitation (CPR) have potential for survival or organ donation. Therefore, we sought to determine the rates of survival and organ donation, as well as identify factors associated with both outcomes in patients with GSWB undergoing CPR. Methods:We performed a retrospective, multicenter study at 25 US trauma centers including dates between June 1, 2011 and December 31, 2017. Patients were included if they suffered isolated GSWB and required CPR at a referring hospital, in the field, or in the trauma resuscitation room. Patients were excluded for significant torso or extremity injuries, or if pregnant. Binomial regression models were used to determine predictors of survival/organ donation. Results:825 patients met study criteria; the majority were male (87.6%) with a mean age of 36.5 years. Most (67%) underwent CPR in the field and 2.1% (n=17) survived to discharge. Of the non-survivors, 17.5% (n=141) were considered eligible donors, with a donation rate of 58.9% (n=83) in this group. Regression models found several predictors of survival. Hormone replacement was predictive of both survival and organ donation. Conclusion:We found that GSWB requiring CPR during trauma resuscitation was associated with a 2.1% survival rate and overall organ donation rate of 10.3%. Several factors appear to be favorably associated with survival, although predictions are uncertain due to the low number of survivors in this patient population. Hormone replacement was predictive of both survival and organ donation. These results are a starting point for determining appropriate treatment algorithms for this devastating clinical condition. Level of evidence:Level II