A diagnostic guide of selected conditions for helping to identify children who present with visually related reading problems

In order to properly identify and treat those children with visually related reading problems, a diagnostic flow chart was developed to assist optometrists with this task. This diagnostic tool addresses ten of the most commonly encountered visual problems associated with reading. It is a user friendly product that easily moves between some of the common signs/symptoms presented by your patients and an appropriate diagnostic condition. Within each diagnostic condition are the following sections: a short description, other signs and symptoms, and suggested treatment options for this condition. This diagnostic flow chart and CD are included in the appendix section of this document and is available for anyone\u27s use. Our hope is that optometrists will find this product useful and therefore, children with visually related reading problems will receive the proper treatment so that they can reach their full potential

Creative Exercises in General Chemistry: A Student-Centered Assessment

Creative exercises (CEs) are a form of assessment in which students are given a prompt and asked to write down as many distinct, correct, and relevant facts about the prompt as they can. Students receive credit for each fact that they include that is related to the prompt and distinct from the other facts they list. With CEs, students have an opportunity to demonstrate their knowledge and the opportunity to select the information that they believe is related to the prompt. In addition, CEs encourage students to connect concepts because any relevant information presented can assist them in completing the CEs. This paper describes the use of CEs in a collegelevel chemistry class, including student answers to the CEs and a survey of students\u27 impression of CEs

The BTB/POZ zinc finger protein Broad-Z3 promotes dendritic outgrowth during metamorphic remodeling of the peripheral stretch receptor dbd

<p>Abstract</p> <p>Background</p> <p>Various members of the family of BTB/POZ zinc-finger transcription factors influence patterns of dendritic branching. One such member, <it>Broad</it>, is notable because its BrZ3 isoform is widely expressed in <it>Drosophila </it>in immature neurons around the time of arbor outgrowth. We used the metamorphic remodeling of an identified sensory neuron, the dorsal bipolar dendrite sensory neuron (dbd), to examine the effects of BrZ3 expression on the extent and pattern of dendrite growth during metamorphosis.</p> <p>Results</p> <p>Using live imaging of dbd in <it>Drosophila </it>pupae, we followed its normal development during metamorphosis and the effect of ectopic expression of BrZ3 on this development. After migration of its cell body, dbd extends a growth-cone that grows between two muscle bands followed by branching and turning back on itself to form a compact dendritic bundle. The ectopic expression of the BrZ3 isoform, using the GAL4/UAS system, caused dbd's dendritic tree to transform from its normal, compact, fasciculated form into a comb-like arbor that spread over on the body wall. Time-lapse analysis revealed that the expression of BrZ3 caused the premature extension of the primary dendrite onto immature myoblasts, ectopic growth past the muscle target region, and subsequent elaboration onto the epidermis. To control the timing of expression of BrZ3, we used a temperature-sensitive GAL80 mutant. When BrZ3 expression was delayed until after the extension of the primary dendrite, then a normal arbor was formed. By contrast, when BrZ3 expression was confined to only the early outgrowth phase, then ectopic arbors were subsequently formed and maintained on the epidermis despite the subsequent absence of BrZ3.</p> <p>Conclusions</p> <p>The adult arbor of dbd is a highly branched arbor whose branches self-fasciculate to form a compact dendritic bundle. The ectopic expression of BrZ3 in this cell causes a premature extension of its growth-cone, resulting in dendrites that extend beyond their normal muscle substrate and onto the epidermis, where they form a comb-shaped, ectopic arbor. Our quantitative data suggest that new ectopic arbor represents an 'unpacking' of the normally fasciculated arbor onto the epidermis. These data suggest that the nature of their local environment can change dendrite behavior from self-adhesion to self-avoidance.</p

Establishing Open-Ended Assessments: Investigating the Validity of Creative Exercises

Open-ended assessments, defined as assessments with a large set of possible correct answers, by nature lend themselves to concerns regarding accurate and consistent grading. This article describes one particular open-ended assessment, named Creative Exercises (CE), designed for promoting students\u27 interconnection of concepts in a college general chemistry setting. The article presents evidence concerning several aspects of validity, including the extent scores represent chemistry knowledge and the extent scoring is consistent across three graders. The evidence is also presented in the context of what is known about concept maps, a commonly employed open-ended assessment in chemistry. Implications for the administration of CEs and the appropriateness of measuring students\u27 hierarchical organization of knowledge are also discussed as a result of this comparison

Beyond the team: understanding interprofessional work in two North American ICUs

OBJECTIVE: To examine the ways in which healthcare professionals work together in the ICU setting, through a consideration of the contextual, organizational, processual, and relational factors that impact their interprofessional collaboration. DESIGN: Data from over 350 hours of ethnographic observation and 35 semistructured interviews with clinicians in two ICUs were collected by two medical anthropologists over a period of 6 months. SETTING: Medical surgical ICUs in two urban research hospitals in Canada and the United States. MAIN RESULTS: Although the concept of teamwork is often central to interventions to improve patient safety in the ICU, our observations suggest that this concept does not fully describe how interprofessional work actually occurs in this setting. With the exception of crisis situations, most interprofessional interactions in the two ICUs we studied could be better described as forms of interprofessional work other than teamwork, which include collaboration, coordination, and networking. CONCLUSIONS: A singular notion of team is too reductive to account for the ways in which work happens in the ICU and therefore cannot be taken for granted in quality improvement initiatives or among healthcare professionals in this setting. Adapting -interventions to the complex nature of interprofessional work and each ICUs unique local context is an important and necessary step to ensure the delivery of safe and effective patient care

Healthy Human T-Cell Responses to Aspergillus fumigatus Antigens

Aspergillus fumigatus is associated with both invasive and allergic pulmonary diseases, in different hosts. The organism is inhaled as a spore, which, if not cleared from the airway, germinates into hyphal morphotypes that are responsible for tissue invasion and resultant inflammation. Hyphae secrete multiple products that function as antigens, evoking both a protective (T(H)1-T(H)17) and destructive allergic (T(H)2) immunity. How Aspergillus allergens (Asp f proteins) participate in the development of allergic sensitization is unknown.To determine whether Asp f proteins are strictly associated with T(H)2 responses, or represent soluble hyphal products recognized by healthy hosts, human T cell responses to crude and recombinant products were characterized by ELISPOT. While responses (number of spots producing IFN-gamma, IL-4 or IL-17) to crude hyphal antigen preparations were weak, responses to recombinant Asp f proteins were higher. Recombinant allergens stimulated cells to produce IFN-gamma more so than IL-4 or IL-17. Volunteers exhibited a diverse CD4+ and CD8+ T cell antigen recognition profile, with prominent CD4 T(H)1-responses to Asp f3 (a putative peroxismal membrane protein), Asp f9/16 (cell wall glucanase), Asp f11 (cyclophilin type peptidyl-prolyl isomerase) and Asp f22 (enolase). Strong IFN-gamma responses were reproduced in most subjects tested over 6 month intervals.Products secreted after conidial germination into hyphae are differentially recognized by protective T cells in healthy, non-atopic individuals. Defining the specificity of the human T cell repertoire, and identifying factors that govern early responses may allow for development of novel diagnostics and therapeutics for both invasive and allergic Aspergillus diseases

The "ART" of Linkage: Pre-Treatment Loss to Care after HIV Diagnosis at Two PEPFAR Sites in Durban, South Africa

BACKGROUND. Although loss to follow-up after antiretroviral therapy (ART) initiation is increasingly recognized, little is known about pre-treatment losses to care (PTLC) after an initial positive HIV test. Our objective was to determine PTLC in newly identified HIV-infected individuals in South Africa. METHODOLOGY/PRINCIPAL FINDINGS. We assembled the South African Test, Identify and Link (STIAL) Cohort of persons presenting for HIV testing at two sites offering HIV and CD4 count testing and HIV care in Durban, South Africa. We defined PTLC as failure to have a CD4 count within 8 weeks of HIV diagnosis. We performed multivariate analysis to identify factors associated with PTLC. From November 2006 to May 2007, of 712 persons who underwent HIV testing and received their test result, 454 (64%) were HIV-positive. Of those, 206 (45%) had PTLC. Infected patients were significantly more likely to have PTLC if they lived =10 kilometers from the testing center (RR=1.37; 95% CI: 1.11-1.71), had a history of tuberculosis treatment (RR=1.26; 95% CI: 1.00-1.58), or were referred for testing by a health care provider rather than self-referred (RR=1.61; 95% CI: 1.22-2.13). Patients with one, two or three of these risks for PTLC were 1.88, 2.50 and 3.84 times more likely to have PTLC compared to those with no risk factors. CONCLUSIONS/SIGNIFICANCE. Nearly half of HIV-infected persons at two high prevalence sites in Durban, South Africa, failed to have CD4 counts following HIV diagnosis. These high rates of pre-treatment loss to care highlight the urgent need to improve rates of linkage to HIV care after an initial positive HIV test.US National Institute of Allergy and Infectious Diseases (R01 AI058736, K24 AI062476, K23 AI068458); the Harvard University Center for AIDS Research (P30 AI42851); National Institutes of Health (K24 AR 02123); the Doris Duke Charitable Foundation (Clinical Scientist Development Award); the Harvard University Program on AID