Middle School Mathematics Teachers\u27 Perspective of Technology Integration: A Qualitative Case Study

Many studies have documented that technology integration increases summative assessment scores, yet many teachers do not integrate technology in their teaching. The purpose of this qualitative study was to discover the extent to which middle school mathematics educators are or are not integrating technology in a school district where summative scores were below mathematics state benchmarks. Guided by instructional constructivism and the technology acceptance model, this case study examined how teachers perceived advantages and barriers to mathematics instruction that uses technology. Five of the nine mathematics teachers at the middle school volunteered to participate in a semi-structured interview and be observed in the classroom for evidence that they used the technology in the manner they described it during their interview. Data were coded and analyzed thematically. The findings revealed that although teachers perceived technology integration as viable to student academic success, they used the interactive whiteboards either as projectors or as marker boards instead of interacting with them through educationally meaningful tasks. Predominant technology integration barriers were limited resources and technological pedagogical knowledge. To address this deficit, a professional development project was created with the goal of increasing teachers\u27 technology pedagogical integration strategies for the interactive whiteboards. Because technology is an essential part of 21st century education, positive social change can occur when teacher competence in technology integration increases, is applied in the classroom, and raises test scores. Additional positive social change can be realized as students build valuable skills that help them become positive active members of society

Sustainability and Spread of Community-based Initiatives: A case study of Community Cares, a Children’s Hospital’s 16 year effort to serve its community

The sustainability and spread of innovations is often elusive, presenting continuous challenges to clinicians and healthcare leaders. Somewhere between 33 - 70% of all innovations are reportedly not sustained, and even fewer are spread beyond the original team, or to other units within an organization. In plain language, sustainability is defined as locking in progress, while continually building upon that foundation, while spread is the exchange of knowledge and experience to others beyond the original implementing team. The literature supports the concept that sustainability is both multi-dimensional and multi-factorial and has several characteristics and pre-conditions. Tax-exempt, not-for-profit organizations in the USA must provide measurable community benefits to the populations they seek to serve. Many of these community benefits take the form of locating necessary services closer to or directly within the communities being served in order to enhance access. A case study of a 16 year effort to provide a medical home-oriented primary care model to underserved children in Houston, Texas Children’s Pediatrics’ Community Cares, is presented as illustrative of such a community benefit. Many of the characteristics and preconditions essential to a model for sustainability and spread are highlighted and the Community Cares case study is discussed from the standpoint of this framework

The value of domiciliary medication reviews – a thematic analysis of pharmacist's views

Background: Domiciliary medication reviews are thought to enable comprehensive medication reviews centred around the needs of individuals. However, there is no clear consensus on where the value of these services lie. / Aim: To determine the value of domiciliary medication reviews to service providers through semi-structured focus groups, interviews and thematic analysis. / Method: Study participants were recruited from domiciliary medication review services provided in the United Kingdom. Semi-structured focus groups and interviews were analysed using thematic analysis. / Results: Six themes were identified: the scope of domiciliary medication review services, the professional role, advantages over traditional settings, disadvantages of domiciliary medication reviews for the professional, levels of engagement and outcomes. / Conclusion: Pharmacy professionals believe that the domiciliary setting provides advantages over traditional healthcare settings when conducting medication reviews. They believe it enables a more in-depth review of an individual’s medications and needs. The traditional clinical outcomes recorded by services may not be capturing the holistic impact of domiciliary medication reviews

Transcriptome Analysis of CD4+ T Cells in Coeliac Disease Reveals Imprint of BACH2 and IFNγ Regulation

peer-reviewedData Availability: The raw sequencing reads (FASTQ files) and sequence read counts mapped to UCSC hg19 for each of the 74 transcriptomes sequenced in this study have been deposited at Gene Expression Omnibus (GEO) accession GSE69549.This project was funded by Science Foundation Ireland Grant number 09/IN.1/B2640 to RM.Genetic studies have to date identified 43 genome wide significant coeliac disease susceptibility (CD) loci comprising over 70 candidate genes. However, how altered regulation of such disease associated genes contributes to CD pathogenesis remains to be elucidated. Recently there has been considerable emphasis on characterising cell type specific and stimulus dependent genetic variants. Therefore in this study we used RNA sequencing to profile over 70 transcriptomes of CD4+ T cells, a cell type crucial for CD pathogenesis, in both stimulated and resting samples from individuals with CD and unaffected controls. We identified extensive transcriptional changes across all conditions, with the previously established CD gene IFNy the most strongly up-regulated gene (log2 fold change 4.6; Padjusted = 2.40x10-11) in CD4+ T cells from CD patients compared to controls. We show a significant correlation of differentially expressed genes with genetic studies of the disease to date (Padjusted = 0.002), and 21 CD candidate susceptibility genes are differentially expressed under one or more of the conditions used in this study. Pathway analysis revealed significant enrichment of immune related processes. Co-expression network analysis identified several modules of coordinately expressed CD genes. Two modules were particularly highly enriched for differentially expressed genes (P</iframe

Community social network pattern analysis: Development of a novel methodology using a complex, multi-level health intervention

Community social networks (CSN) include&nbsp;individuals and groups, and those with strong partnerships and relationships are well situated for implementing community-based interventions. However, information on the nature of CSN relationships required for multilevel community-based interventions is not present in the literature. Using data from the multi-level Children’s Healthy Living (CHL) trial to reduce child obesity in nine Pacific communities, this study aimed to develop a methodology based on Social Network Analysis (SNA) to understand how CSN evolved over the course of a two-year trial, as well as the characteristics of CSN most successful in impacting indicators of childhood obesity. The two-year trial was considered in four six-month intervals. Within each interval, implemented activities, as recorded in CHL monthly reports, were coded by activity implementer(s), e.g. government agency, school, or community-based group, as well as for collective efficacy impact of the activity, e.g. to leverage resources from outside the CSN or to facilitate civic engagement. Coded data were used to create CSN maps for the four time intervals, and SNA techniques examined the CSN characteristics. CSN density increased over time, as measured by the number of ties within the network. Schools, community-based groups and large organizations were identified as the primary implementers of the CHL intervention and formed a community implementer backbone. Social leveraging, i.e. linking local groups to people with authority over outside resources, was shown to be a central component in intervention success. It took time to develop strong CSN, and stronger (denser) CSN were more successful in building social cohesion and enacting community change. Findings illustrate a methodology that can be useful for tracking the development and impact of CSN

Estimating intervention dose of the multilevel multisite children’s healthy living program intervention

Increased community collective efficacy (CE), defined as social cohesion among neighbors and their willingness to intervene for common good, is associated with improved community health outcomes. However, processes to increase CE and estimate its dose within an intervention are not well understood. The 2 year Children's Healthy Living (CHL) intervention aimed to improve child behaviors known to affect obesity. We used data from CHL to estimate CE dose and examine its association with a successful outcome from CHL-reduction in children's recreational screen time. Monthly reports from nine intervention communities were quantified, and CE dose was calculated for each community overall, at 4 time intervals (6, 12, 18, and 24 months), and for each CE building block-social bonding, social bridging, social leveraging, empowerment, and civic engagement. CE dose at each time interval and change in screen time was correlated using Spearman's rho. Next, communities were categorized as having a high CE dose or a low CE dose, and differences between four high-dose and five low-dose communities were compared using a two-tailed t-test. The correlation between change in screen time and CE dose was significant (rs = 0.83, p = .003). Significantly more activities facilitating empowerment and civic engagement were conducted in high-dose communities, which were more likely to show improvements in screen time, than in low-dose communities. This method of estimating an intervention's CE dose and examining change over time and effect of CE and its building blocks on intervention outcomes shows promise

The experiences of mothers with preterm infants within the first-year post discharge from NICU: social support, attachment and level of depressive symptoms

Background: The estimated global premature birth rate for 2014 was 10.6%, equating to an estimate of 14.84 million live premature births. The experience of premature birth does not impact solely on the infant and mother as individuals but occurs in the context of a critical point in time when they are developing a relationship with one another. The aim of this study was to investigate the relationships between social support, mother to infant attachment, and depressive symptoms of mothers with preterm infants within the first 12 months' post discharge from the Neonatal Intensive Care Unit (NICU). Methods: A correlational cross-sectional study design was used. Data were collected using a four-part online survey which included the Perinatal Social Support Questionnaire (PICSS), Maternal Postnatal Attachment Scale (MPAS) and the Edinburgh Postnatal Depression Scale (EPDS) with mothers of preterm infants (n = 140). Results: The prevalence of postnatal depression was 37.9% (95% CI: 29.8 to 46.4%). In univariable analyses, history of depression (p = 0.005), aged 35-39 years (p = 0.006), no formal social support (p = 0.040), less informal social supports (p = 0.018), lower overall maternal attachment (p<0.001) and lower overall functional social support (p <0.001)were significantly associated with a higher level of depressive symptoms. Lower scores on two of the maternal attachment subscales (quality of attachment and absence of hostility) and all four of the functional social support subscales were significantly associated with a higher level of depressive symptoms (p < 0.001 for all). In the multivariable analysis, prior history of depression (p = 0.028), lower score of maternal attachment (p < 0.001) and lower emotional functional social support (p = 0.030) were significantly associated with a higher level of depressive symptoms. Conclusion: Women who experience a premature birth, have a prior history of depression, poor infant attachment and poor emotional social support have a higher level of depressive symptoms. Results emphasise the need for professionals to encourage mobilisation of maternal formal and informal social supports. It is important to intervene early to address maternal emotional well-being and enhance the developing mother-preterm infant relationship

A Novel Polymorphism of FcgammaRIIIa (CD16) Alters Receptor Function and Predisposes to Autoimmune Disease

A novel polymorphism in the extracellular domain 2 (EC2) of FcgammaRIIIA affects ligand binding by natural killer (NK) cells and monocytes from genotyped homozygous normal donors independently of receptor expression. The nonconservative T to G substitution at nucleotide 559 predicts a change of phenylalanine (F) to valine (V) at amino acid position 176. Compared with F/F homozygotes, FcgammaRIIIa expressed on NK cells and monocytes in V/V homozygotes bound more IgG1 and IgG3 despite identical levels of receptor expression. In response to a standard aggregated human IgG stimulus, FcgammaRIIIa engagement on NK cells from V/V (high-binding) homozygotes led to a larger rise in [Ca2+]i, a greater level of NK cell activation, and a more rapid induction of activation-induced cell death (by apoptosis). Investigation of an independently phenotyped normal cohort revealed that all donors with a low binding phenotype are F/F homozygotes, while all phenotypic high binding donors have at least one V allele. Initial analysis of 200 patients with SLE indicates a strong association of the low binding phenotype with disease, especially in patients with nephritis who have an underrepresentation of the homozygous high binding phenotype. Thus, the FcgammaRIIIa polymorphism at residue 176 appears to impact directly on human biology, an effect which may extend beyond autoimmune disease characterized by immune complexes to host defense mechanisms