Amalgamating Critical Thinking and Online Communication

Critical thinking as a product of student work involves analysis, interpretation, and problem solving to create new thought. There are gradations of critical thinking that score higher than others, though we consider all of them to be important towards development. The purpose of this study was to investigate the relationship among reading, writing, discourse, and reflection, and its impact on critical thinking. The researcher analyzed processes where students participated in activities that allowed for the development and demonstration of critical thinking skills. This mixed methods study was conducted in a Mid-western school district with eighth grade students for the duration of one school year. It examined how students engaged in critical thinking through online written discourse. Students shared their ideas about a topic in synchronous formats. Data sources included typed online student conversations, surveys, rubric scores, and interviews with students. Based upon the data collected from the study, this research recommends providing students with opportunities to research, analyze, interpret, and share their understandings of what they study. Furthermore, student participation --as a part of the design process within learning opportunities-- is essential for developing critical thought

Principals as Instructional Leaders as Opposed to School Managers

In the Denver metropolitan area, many elementary school principals have been focused more on management than on instructional leadership issues, even though school administrators have been charged with overseeing academic achievement based on state and federal standards. According to research, participating in these 2 disconnected roles hinders principals\u27 ability to achieve the academic and social success of their students. Guided by Bandura\u27s self-efficacy theory and Hallinger\u27s distributed leadership theories, this qualitative study explored factors that influenced 6 principals\u27 adoption of the instructional leadership role to learn how principals might shift from managing the school to becoming its instructional leader. The selection criteria for the participants were that each principal was based in a linguistically and culturally diverse, low-income community and led successfully as noted in the School Performance Framework. Data from individual interviews and a focus group were triangulated with observational data (3 observations of participants in their work role at their individual school sites) and researcher field notes. Data analysis used open coding, from which 3 core themes emerged: voice, focus, and alignment of resources. Based on these findings, the proposed project, presented as a position paper, recommends the development of a district-level policy directed toward the building of a school-site infrastructure that supports elementary principals in the role of instructional leader. The implications for positive social change at the local level include providing recommendations that might enable administrators as the instructional leader to develop and oversee an infrastructure conducive to the academic and social success of the students they serve, thus increasing the number of successful schools throughout the district study site

Development of an algorithm for the diagnosis of otitis media

Background: The relative importance of signs and symptoms in the diagnosis of otitis media has not been adequately evaluated. This has led to a large degree of variation in the criteria used to diagnose otitis media, which has resulted in inconsistencies in clinical care and discrepant research findings. Methods: A group of experienced otoscopists examined children presenting for primary care. We investigated the signs and symptoms that these otoscopists used to distinguish acute otitis media (AOM), otitis media with effusion (OME), and no effusion. We used recursive partitioning to develop a diagnostic algorithm. To assess the algorithm, we validated it in an independent dataset. Results: Bulging of the tympanic membrane (TM) was the main finding that otoscopists used to discriminate AOM from OME; information regarding the presence or absence of other signs and symptoms added little to the diagnostic process. Overall, 92% of children with AOM had a bulging TM compared with 0% of children with OME. Opacification and/or an air-fluid level was the main finding that the otoscopists used to discriminate OME from no effusion; 97% of children diagnosed with OME had an opaque TM compared with 5% of children diagnosed with no effusion. An algorithm that used bulging and opacification of the TM correctly classified 99% of ears in an independent dataset. Conclusions: Bulging of the TM was the finding that best discriminated AOM from OME. The algorithm developed here may prove to be useful in clinical care, research, and education concerning otitis media. Copyright © 2012 by Academic Pediatric Association

Physical Activity and Sedentary Behavior in Populations with Impaired Glucose Metabolism and Type 2 Diabetes Mellitus

INTRODUCTION: The high physical and economic burden of type 2 diabetes mellitus is an important public health concern. The impact of various intensities of physical activity (PA) and sedentary behavior on the development of type 2 diabetes is not well understood. Additionally, more insight into how measurement methodologies for PA and sedentary behavior affect the values of activity-related outcome variables is needed. METHODS: PA and sedentary behavior levels were assessed as part of a multi-center clinic trial of youth with type 2 diabetes from 15 U.S. centers; the Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) study. Agreement between the results of a subjective and objective measure of PA and sedentary behavior were examined. Also, accelerometer processing algorithms were examined, using data on adults in the National Health Examination and Nutrition Survey (NHANES) 2005-06, to determine how changing the definition of accelerometer non-wear impacts on important PA outcome variables. PA and sedentary behavior levels from accelerometers were also described in 1609 adults with impaired glucose tolerance or type 2 diabetes, in the multi-center Diabetes Prevention Program Outcomes Study (DPPOS). These results were compared to similarly assessed activity data for a nationally representative sample of adults. RESULTS: In TODAY youth, agreement was low between the Three Day Physical Activity Recall (3DPAR) questionnaire and accelerometer results; suggesting that the 3DPAR may not provide an accurate measure of time spent in PA or sedentary behavior in overweight/obese youth with type 2 diabetes. For NHANES adults, changing the definition of accelerometer non-wear time resulted in clinically significant differences in estimates of time spent sedentary, especially in older individuals. Compared to a nationally representative sample of adults, the DPPOS participants performed more moderate-vigorous intensity (MV) PA, but not more light intensity PA. These results likely reflect the effects of a successful lifestyle intervention on MVPA. PUBLIC HEALTH SIGNIFICANCE: The current effort advances the understanding of PA and sedentary behavior assessment methods in populations with impaired glucose tolerance and type 2 diabetes and provides estimates for the average amount of time individuals in these populations spend physically active and sedentary

Receiver Operating Characteristic (ROC) Curve: Practical Review for Radiologists

The receiver operating characteristic (ROC) curve, which is defined as a plot of test sensitivity as the y coordinate versus its 1-specificity or false positive rate (FPR) as the x coordinate, is an effective method of evaluating the performance of diagnostic tests. The purpose of this article is to provide a nonmathematical introduction to ROC analysis. Important concepts involved in the correct use and interpretation of this analysis, such as smooth and empirical ROC curves, parametric and nonparametric methods, the area under the ROC curve and its 95% confidence interval, the sensitivity at a particular FPR, and the use of a partial area under the ROC curve are discussed. Various considerations concerning the collection of data in radiological ROC studies are briefly discussed. An introduction to the software frequently used for performing ROC analyses is also presented

Group-based trajectory analysis of physical activity change in a U.S. weight loss intervention

Background: The obesity epidemic is a global concern. Standard behavioral treatment including increased physical activity, reduced energy intake, and behavioral change counseling is an effective lifestyle intervention for weight loss. Purpose: To identify distinct step count patterns among weight loss intervention participants, examine weight loss differences by trajectory group, and examine baseline factors associated with trajectory group membership. Methods: Both groups received group-based standard behavioral treatment while the experimental group received up to 30 additional, one-on-one self-efficacy enhancement sessions. Data were analyzed using group-based trajectory modeling, analysis of variance, chi-square tests, and multinomial logistic regression. Results: Participants (N = 120) were mostly female (81.8%) and white (73.6%) with a mean (SD) body mass index of 33.2 (3.8) kg/m2. Four step count trajectory groups were identified: active (>10,000 steps/day; 11.7%), somewhat active (7500–10,000 steps/day; 28.3%), low active (5000–7500 steps/day; 27.5%), and sedentary (<5000 steps/day; 32.5%). Percent weight loss at 12 months increased incrementally by trajectory group (5.1% [5.7%], 7.8% [6.9%], 8.0% [7.4%], and 13.63% [7.0%], respectively; P = .001). At baseline, lower body mass index and higher perceived health predicted membership in the better performing trajectory groups. Conclusions: Within a larger group of adults in a weight loss intervention, 4 distinct trajectory groups were identified and group membership was associated with differential weight loss

Effects of Weighted Hula-Hooping Compared to Walking on Abdominal Fat, Trunk Muscularity, and Metabolic Parameters in Overweight Subjects : A Randomized Controlled Study

Background: Weighted hula-hoops have gained popularity, but whether they indeed reshape the trunk or have beneficial metabolic effects in overweight subjects is unknown. Objectives: To determine effects of hula-hooping and walking matched for energy expenditure on android fat %, trunk muscle mass, and metabolic parameters in a randomized cross-over study. Design: We recruited 55 overweight nondiabetic subjects, who were randomized to hula-hooping (HULA) for 6 weeks using a 1.5-kg weighted hula-hoop followed by walking (WALK) for another 6 weeks or vice versa. The increments in energy expenditure were similar by HULA and WALK. Body composition (dual-energy X-ray absorptiometry) and metabolic parameters were measured at baseline and after HULA and WALK. The primary endpoint was the change in fat % in the android region. Results: A total of 53subjects (waist 92 +/- 1 cm, body mass index 28 +/- 1 kg/m(2)) completed the study. Body weight changed similarly (-0.6 +/- 0.2 vs. -0.5 +/- 0.2 kg, nonsignificant; HULA vs. WALK). During the intervention the subjects hula-hooped on average 12.8 +/- 0.5 min/day and walked 9,986 +/- 376 steps/day. The % fat in the android region decreased significantly by HULA but not by WALK (between-group change p <0.001). Trunk muscle mass increased more by HULA than by WALK (p <0.05). Waist circumference decreased more by HULA than by WALK (-3.1 +/- 0.3 cm vs. -0.7 +/- 0.4 cm, p <0.001; HULA vs. WALK). WALK but not HULA significantly lowered systolic blood pressure and increased HDL cholesterol while HULA significantly decreased LDL cholesterol. Conclusions: Hula-hooping with a weighted hula-hoop can be used to decrease abdominal fat % and increase trunk muscle mass in overweight subjects. Its LDL lowering effect resembles that described for resistance training. (c) 2019 The Author(s) Published by S. Karger AG, BaselPeer reviewe

Lung Cancer Risk after Exposure to Polycyclic Aromatic Hydrocarbons: A Review and Meta-Analysis

Typical polycyclic aromatic hydrocarbon mixtures are established lung carcinogens, but the quantitative exposure–response relationship is less clear. To clarify this relationship we conducted a review and meta-analysis of published reports of occupational epidemiologic studies. Thirty-nine cohorts were included. The average estimated unit relative risk (URR) at 100 μg/m(3) years benzo[a]pyrene was 1.20 [95% confidence interval (CI), 1.11–1.29] and was not sensitive to particular studies or analytic methods. However, the URR varied by industry. The estimated means in coke ovens, gasworks, and aluminum production works were similar (1.15–1.17). Average URRs in other industries were higher but imprecisely estimated, with those for asphalt (17.5; CI, 4.21–72.78) and chimney sweeps (16.2; CI, 1.64–160.7) significantly higher than the three above. There was no statistically significant variation of URRs within industry or in relation to study design (including whether adjusted for smoking), or source of exposure information. Limited information on total dust exposure did not suggest that dust exposure was an important confounder or modified the effect. These results provide a more secure basis for risk assessment than was previously available

Choosing a pediatric recipient for orthotopic liver transplantation

Between March 3, 1981, and June 1, 1984, 216 children were evaluated for orthotopic liver transplantation. Of the 216 patients, 117 (55%) had recelved at least one liver transplant by June 1, 1985. Fifty-five (25%) died before transplantation. The 117 patients who received transplants were grouped according to severity of disease and degree of general decompensation at the time of transplantation. The severity of a patient's medical condition with the possible exception of deep hepatic coma, did not predict outcome following orthotopic liver transplantation. Seventy variables were assessed at the time of the evaluation. Twenty-three of the 70 variables were found to have prognostic significance with regard to death from progressive liver disease before transplantation. These 23 variables were Incorporated into a multivariate model to provide a means of determining the relative risk of death among pediatric patients with end-stage liver disease. This information may allow more informed selection of candidates awaiting liver transplantation. © 1987 The C. V. Mosby Company