Feedback Revisited: Definitional, Structural, and Functional Issues

This article provides a more fundamental overview that addresses the following provisions associated with feedback in an integrative way. First, several linguistic and definitional issues relating to the term ‘feedback’ are discussed. Second, the article draws attention to the challenges and implications associated with online feedback being increasingly used primarily during the contemporary shift toward online learning. Then, the article spots light on the importance of feedback at multiple levels, followed by a discussion of feedback purposes and potential benefits on student learning and progress, both in the short and long term. This article seeks to contribute to the literature on formative feedback by providing a more profound understanding of the conceptualizations of feedback by incorporating definitional, structural, and functional issues about feedback both as a construct and a practice

Caregivers knowledge, practices about childhood diarrhea and pneumonia and their perceptions of lady health worker program; findings from NIGRAAN implementation research project

Background: Despite 60% coverage by Lady Health Worker (LHW) Program, 30% of child deaths in Pakistan are still due to diarrhea and pneumonia. Caregivers are an important stakeholder yet there is little information on their case management practices and utilization of LHW Program. This study explored caregivers’ knowledge and practices about childhood diarrhea and pneumonia and utility of LHW services before and after a supportive supervision intervention.Methods: Cross sectional surveys were conducted with caregivers’ (mothers) pre and post intervention in project NIGRAAN. The intervention aimed to improve LHSs clinical and supervisory skills of lady health supervisors in order to improve LHW performance and ultimately impact caregiver practices. 4250 households were surveyed. Questionnaire was adapted from PDHS 2012-13. Differences between intervention and control groups were assessed using chi square test. P-value of Results: Comparing baseline to end line, there were significant overall improvements in caregivers’knowledge of loose motion (62 to 84%) and dehydration (12 to 18%) as signs and symptoms of childhood diarrhea. There was also a significant overall increase in caregivers’ knowledge of presenting features of pneumonia- i.e. fever (58 to 86%), cough (51 to 61%) and breathing problems (25 to 57%). The proportion of caregivers seeking advice for diarrhea from public sector significantly improved in intervention arm from 20% to 29%. Private sector however remained overall preferred choice for care seeking. There was significant overall improvement in awareness about LHWs functioning (93 to 99%) and household visits (91 to 98%). Actual care seeking from LHWs however stayed low (≤ 0.3%) Conclusion: In order to improve utility and expand coverage of LHW Program interventions aimed at providing supportive supervision have the potential to improve caregiver practices and utilization of available services and decrease childhood deaths due to preventable illnesses

1825P Prevalence of cancer among e-cigarette smokers compared to non-smokers: A retrospective cross-sectional survey study of NHANES-CDC

Background: Current e-cigarette use has been rising, assuming as a safe alternative to traditional smoking. Therefore, we aim to evaluate the prevalence of cancer and types of cancers amongst e-cigarette and traditional smokers. Methods: A retrospective cross-sectional survey study was performed using NHANES (National Health And Nutrition Examination Survey) database from 2015 to 2018. History of cancer (MCQ220), type of cancers (MCQ230a), and smoking status (E-cigarette: SMQ900 or SMQ905 and Traditional smoking: SMQ020) were identified. Univariate and multivariable logistic regression analysis was performed to find out prevalence and association between e-cigarette smoking and cancer. We have excluded respondents with dual smoking. Results: Out of 154,856 participants, 7756 (5.01%) were e-cigarette users, 48625 (31.4%) were traditional smokers, 98475 (63.59%) were non-smokers. Females (49 vs 38%), Mexican Americans (20 vs 13%), high annual household income (\u3e$100,000: 23 vs 15%) were having a higher prevalence of e-cigarette smoking in comparison with traditional smoking. (p\u3c0.0001) Prevalence of cancer (any type) was 11.61%. Cancer prevalence was higher amongst traditional smokers in comparison with e-cigarette smokers. (16.77 vs 2.32%; p\u3c0.0001) E-cigarette smokers were younger at the diagnosis of 1st cancer in comparison with traditional smokers. (median: 45 vs 63-years; p\u3c0.0001) Cervical (21.99 vs 2.01%), thyroid (10.64 vs 2.45%), leukemias (8.51 vs 1.08%), and breast (12.06 vs 12.01%) cancers were more prevalent amongst e-cigarette smokers in comparison to traditional smokers. (p\u3c0.0001) In adjusted multivariable regression analysis, e-cigarette smokers [aOR: 1.3 (95%CI: 1.32-1.33); p\u3c0.0001] and traditional smokers [1.6 (1.64-1.65); p\u3c0.0001] were having higher odds of prevalence of cancer in comparison with non-smoker. Conclusions: E-cigarette smokers had an early age of cancer onset and higher odds of cancer prevalence. Females had higher use of e-cigarette and cervical, thyroid, and breast cancers were prevalent amongst e-cigarette users. More prospective studies should be planned to mitigate the risk and before considering e-cigarette as a safe alternative to traditional smoking

A genetic algorithm based approach for solving optimal power flow problem

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Type 1 diabetes genetic risk score discriminates between monogenic and Type 1 diabetes in children diagnosed at the age of < 5 years in the Iranian population

This is the final version. Available on open access from Wiley via the DOI in this recordAim To examine the extent to which discriminatory testing using antibodies and Type 1 diabetes genetic risk score, validated in European populations, is applicable in a non‐European population. Methods We recruited 127 unrelated children with diabetes diagnosed between 9 months and 5 years from two centres in Iran. All children underwent targeted next‐generation sequencing of 35 monogenic diabetes genes. We measured three islet autoantibodies (islet antigen 2, glutamic acid decarboxylase and zinc transporter 8) and generated a Type 1 diabetes genetic risk score in all children. Results We identified six children with monogenic diabetes, including four novel mutations: homozygous mutations in WFS1 (n=3), SLC19A2 and SLC29A3, and a heterozygous mutation in GCK. All clinical features were similar in children with monogenic diabetes (n=6) and in the rest of the cohort (n=121). The Type 1 diabetes genetic risk score discriminated children with monogenic from Type 1 diabetes [area under the receiver‐operating characteristic curve 0.90 (95% CI 0.83–0.97)]. All children with monogenic diabetes were autoantibody‐negative. In children with no mutation, 59 were positive to glutamic acid decarboxylase, 39 to islet antigen 2 and 31 to zinc transporter 8. Measuring zinc transporter 8 increased the number of autoantibody‐positive individuals by eight. Conclusions The present study provides the first evidence that Type 1 diabetes genetic risk score can be used to distinguish monogenic from Type 1 diabetes in an Iranian population with a large number of consanguineous unions. This test can be used to identify children with a higher probability of having monogenic diabetes who could then undergo genetic testing. Identification of these individuals would reduce the cost of treatment and improve the management of their clinical course.Wellcome TrustDiabetes U

Prevalence and correlates of depressive disorders in people with Type 2 diabetes: results from the International Prevalence and Treatment of Diabetes and Depression (INTERPRET‐DD) study, a collaborative study carried out in 14 countries

Aims To assess the prevalence and management of depressive disorders in people with Type 2 diabetes in different countries. Methods People with diabetes aged 18–65 years and treated in outpatient settings were recruited in 14 countries and underwent a psychiatric interview. Participants completed the Patient Health Questionnaire and the Problem Areas in Diabetes scale. Demographic and medical record data were collected. Results A total of 2783 people with Type 2 diabetes (45.3% men, mean duration of diabetes 8.8 years) participated. Overall, 10.6% were diagnosed with current major depressive disorder and 17.0% reported moderate to severe levels of depressive symptomatology (Patient Health Questionnaire scores >9). Multivariable analyses showed that, after controlling for country, current major depressive disorder was significantly associated with gender (women) (PPPPP<0.0001). The proportion of those with either current major depressive disorder or moderate to severe levels of depressive symptomatology who had a diagnosis or any treatment for their depression recorded in their medical records was extremely low and non-existent in many countries (0–29.6%). Conclusions Our international study, the largest of this type ever undertaken, shows that people with diabetes frequently have depressive disorders and also significant levels of depressive symptoms. Our findings indicate that the identification and appropriate care for psychological and psychiatric problems is not the norm and suggest a lack of the comprehensive approach to diabetes management that is needed to improve clinical outcomes

Clues from hypercalcaemia

British Journal of Cancer (2002) 86, 1021–1022. DOI: 10.1038/sj/bjc/6600220 www.bjcancer.co

A metabolite-derived protein modification integrates glycolysis with KEAP1-NRF2 signalling.

Mechanisms that integrate the metabolic state of a cell with regulatory pathways are necessary to maintain cellular homeostasis. Endogenous, intrinsically reactive metabolites can form functional, covalent modifications on proteins without the aid of enzymes1,2, and regulate cellular functions such as metabolism3-5 and transcription6. An important 'sensor' protein that captures specific metabolic information and transforms it into an appropriate response is KEAP1, which contains reactive cysteine residues that collectively act as an electrophile sensor tuned to respond to reactive species resulting from endogenous and xenobiotic molecules. Covalent modification of KEAP1 results in reduced ubiquitination and the accumulation of NRF27,8, which then initiates the transcription of cytoprotective genes at antioxidant-response element loci. Here we identify a small-molecule inhibitor of the glycolytic enzyme PGK1, and reveal a direct link between glycolysis and NRF2 signalling. Inhibition of PGK1 results in accumulation of the reactive metabolite methylglyoxal, which selectively modifies KEAP1 to form a methylimidazole crosslink between proximal cysteine and arginine residues (MICA). This posttranslational modification results in the dimerization of KEAP1, the accumulation of NRF2 and activation of the NRF2 transcriptional program. These results demonstrate the existence of direct inter-pathway communication between glycolysis and the KEAP1-NRF2 transcriptional axis, provide insight into the metabolic regulation of the cellular stress response, and suggest a therapeutic strategy for controlling the cytoprotective antioxidant response in several human diseases

Maintenance care for treated periodontitis patients

This paper is a review of current literature combined with clinical observations. Well-controlled maintenance care is a key consideration in the long-term prognosis of treated periodontitis patients. Periodic professional tooth cleaning every 3 to 4 months often is recommended. Furthermore, recent studies indicate a potential need for selected retreatment in problem areas, since minute residual accretions may be left behind during active therapy - even with “open” surgery. While efficient plaque control is essential for optimal results during the healing phase of periodontal therapy, periodic prophylaxis may prevent loss of clinical attachment over long periods of time even for patients with less than perfect oral hygiene.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72615/1/j.1600-051X.1987.tb02247.x.pd