Veterinary student competence and confidence in calving cows after simulator training in a blended learning approach

New veterinary graduates are challenged by problem calvings often presenting as emergencies out of hours when support might not be readily on hand despite veterinary accrediting bodies stating that calving a cow is a day one competence. Simulation has been increasingly used in veterinary education and there are numerous reports of its success. Integrating simulation into the curriculum using a blended approach with online material has more limited evidence within the literature. The main aim of this study was to explore whether student confidence levels (CL) and competence (CO) in calving cows are enhanced by a blended learning approach. Over three academic study years, 347 eligible fourth year veterinary students were allocated to one of four teaching groups: lectures only (LEC, n = 60) computer assisted learning (CAL, n = 59), calving model simulator (SIM, n = 96) and CAL&SIM (n = 85). Students were asked to complete a questionnaire (before and after teaching) and were also assessed in a formative calving OSCE. For CL, students self-rated with higher confidence after exposure to the SIM (42.3, 95% CI 40.9 – 43.8) alone or blended with the CAL (44.3, 95% CI 42.8 – 45.7) when compared to both the LEC (33.3, 95% CI 31.2 – 35.5) and CAL (35.4, 95% CI 33.5 – 37.4). Multiple logistic regression identified teaching group as influencing overall CL after teaching. For CO, the proportion of pass and excellent students in the LEC teaching group (40%) was lower compared to all other teaching groups (CAL 73%, SIM 84%, CAL&SIM 87%). Regression identified that teaching group and OSCE assessor influenced OSCE pass rates. In conclusion, the implementation of a SIM as part of a blended learning approach when teaching students how to calve cows has a very positive impact on self-assessed student confidence and on competence assessed by a formative OSCE exam

Multiple congenital ocular abnormalities including microphthalmia, microphakia and aphakia in a Simmental cross bull

A 20-month-old Simmental cross bull presented to the Scottish Centre for Production Animal Health and Food Safety, University of Glasgow School of Veterinary Medicine, in April 2015 with multiple congenital ocular abnormalities including bilateral microphthalmia. We present this case as an interesting presentation of idiopathic multiple congenital ocular abnormalities in the absence of congenital abnormalities affecting other body systems. This case highlights an unusual ocular presentation and illustrates the importance of a thorough clinical examination. The prognosis for cases of multiple congenital ocular abnormalities including microphthalmia is poor as no treatment is available and welfare is often compromised. It is therefore important that cases are accurately diagnosed so appropriate management decisions can be made regarding the individual and any herd investigations that are required can be instigated

Establishment of Bovine 3D Enteroid-derived 2D monolayers

Three-dimensional (3D) intestinal enteroids are powerful in vitro models for studying intestinal biology. However, due to their closed structure direct access to the apical surface is impeded, limiting high-throughput applications of exogenous compounds and pathogens. In this study, we describe a method for generating confluent 2D enteroids from single-cell suspensions of enzymatically-dissociated ileum-derived bovine 3D enteroids. Confluent monolayers were first achieved using IntestiCult media but to establish a defined, cost-effective culture media, we also developed a bovine enteroid monolayer (BEM) medium. The monolayers cultured in BEM media proliferated extensively and formed confluent cell layers on both Matrigel-coated plastic plates and transwell inserts by day 3 of culture. The 2D enteroids maintained the epithelial cell lineages found in 3D enteroids and ileum tissue. In addition, the monolayers formed a functional epithelial barrier based on the presence of the adherens and tight junction proteins, E-cadherin and ZO-1, and electrical resistance across the monolayer was measured from day 3 and maintained for up to 7 days in culture. The method described here will provide a useful model to study bovine epithelial cell biology with ease of access to the apical surface of epithelial cells and has potential to investigate host–pathogen interactions and screen bioactive compounds

Clinical and magnetic resonance imaging findings of a cerebellar medulloblastoma in a heifer

Key Clinical Message Reports of medulloblastoma in cattle are scarce; however, this neoplasm should be included as a differential diagnosis in cases of cerebellar or central vestibular signs in young cattle. The MRI appearance of the medulloblastoma reported here, previously unreported in cattle, consisted of a T1‐weighted hypointense and T2‐weighted heterogeneously hyperintense intra‐axial mass

Editorial: From Pedagogic Research to Embedded E-Learning

This Special Issue of Reflecting Education arises from the work of the PREEL project (From Pedagogic Research to Embedded e-Learning) at the Institute of Education from 2006-2008. This project was one of nine HEA/JISC (Higher Education Academy and Joint Information Systems Committee) Pilot Pathfinder Projects and followed on from our involvement in the Pilot Benchmarking of e-Learning Programme. In the benchmarking exercise we identified a lack of coordination between research and practice in e-learning at the IoE as one of our crucial weaknesses, and so our Pilot Pathfinder project concentrated on this theme of building links between e-learning research and practice

Does Simulator Training in Teaching Undergraduate Vet Students to Calve a Cow Improve Confidence and Ensure Successful Learning Outcome?

Objective: To evaluate the impact of an online and practical blended learning approach using a calving simulator. This was assessed by the change in self-assessed confidence of 4th year BVMS students to calve a cow (ΔC) plus a formative OSCE (O). 347 eligible students over 3 years of study were allocated to: 1. No calving simulator training, lecture only in the previous year (LEC), (ΔC n=53,O n=60) 2. LEC + video of the calving simulator (computer assisted learning (CAL), (ΔC n=57, O n=59) 3. LEC + practical class delivering calving simulator training (SIM), (ΔC n=87, c n=95) 4. LEC + CAL + SIM (ΔC n=83, O n=84) Results: The OSCE pass rate outcome and mean numerical score increased (p<0.01) when students received either CAL, SIM, or both in addition to LEC, and the pass rate further increased when SIM was added to the CAL (p=0.03). Exposure to SIM increased (p<0.01) the mean numerical ΔC from LEC or LEC+CAL. The number of students with positive ΔC increased (p<0.01) when CAL was added to LEC, but far more when they received SIM independent of CAL. Conclusions: These results indicate access to the calving simulator model increases not only the calving OSCE pass rate outcome and numerical score but importantly causes the most noticeable change in confidence. Tailored blended learning approaches can increase the OSCE pass rate when added to the lecture, and online resources can positively influence student confidence of this practical task. These findings are relevant with the increased emphasis on online teaching delivery

Substance use and dietary practices among students attending alternative high schools: results from a pilot study

<p>Abstract</p> <p>Background</p> <p>Substance use and poor dietary practices are prevalent among adolescents. The purpose of this study was to examine frequency of substance use and associations between cigarette, alcohol and marijuana use and selected dietary practices, such as sugar-sweetened beverages, high-fat foods, fruits and vegetables, and frequency of fast food restaurant use among alternative high school students. Associations between multi-substance use and the same dietary practices were also examined.</p> <p>Methods</p> <p>A convenience sample of adolescents (n = 145; 61% minority, 52% male) attending six alternative high schools in the St Paul/Minneapolis metropolitan area completed baseline surveys. Students were participants in the Team COOL (Controlling Overweight and Obesity for Life) pilot study, a group randomized obesity prevention pilot trial. Mixed model multivariate analyses procedures were used to assess associations of interest.</p> <p>Results</p> <p>Daily cigarette smoking was reported by 36% of students. Cigarette smoking was positively associated with consumption of regular soda (p = 0.019), high-fat foods (p = 0.037), and fast food restaurant use (p = 0.002). Alcohol (p = 0.005) and marijuana use (p = 0.035) were positively associated with high-fat food intake. With increasing numbers of substances, a positive trend was observed in high-fat food intake (p = 0.0003). There were no significant associations between substance use and fruit and vegetable intake.</p> <p>Conclusions</p> <p>Alternative high school students who use individual substances as well as multiple substances may be at high risk of unhealthful dietary practices. Comprehensive health interventions in alternative high schools have the potential of reducing health-compromising behaviors that are prevalent among this group of students. This study adds to the limited research examining substance use and diet among at-risk youth.</p> <p>Trial registration number</p> <p>ClinicalTrials.gov: <a href="http://www.clinicaltrials.gov/ct2/show/NCT01315743">NCT01315743</a></p

Copy Number Variation and Transposable Elements Feature in Recent, Ongoing Adaptation at the Cyp6g1 Locus

The increased transcription of the Cyp6g1 gene of Drosophila melanogaster, and consequent resistance to insecticides such as DDT, is a widely cited example of adaptation mediated by cis-regulatory change. A fragment of an Accord transposable element inserted upstream of the Cyp6g1 gene is causally associated with resistance and has spread to high frequencies in populations around the world since the 1940s. Here we report the existence of a natural allelic series at this locus of D. melanogaster, involving copy number variation of Cyp6g1, and two additional transposable element insertions (a P and an HMS-Beagle). We provide evidence that this genetic variation underpins phenotypic variation, as the more derived the allele, the greater the level of DDT resistance. Tracking the spatial and temporal patterns of allele frequency changes indicates that the multiple steps of the allelic series are adaptive. Further, a DDT association study shows that the most resistant allele, Cyp6g1-[BP], is greatly enriched in the top 5% of the phenotypic distribution and accounts for ∼16% of the underlying phenotypic variation in resistance to DDT. In contrast, copy number variation for another candidate resistance gene, Cyp12d1, is not associated with resistance. Thus the Cyp6g1 locus is a major contributor to DDT resistance in field populations, and evolution at this locus features multiple adaptive steps occurring in rapid succession

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707