Reflection on-line or off-line: the role of learning technologies in encouraging students to reflect

This paper presents case studies that describe the experiences of the two authors in trying to use learning technologies to facilitate reflective thinking in their students. At the University of Leicester, a Web-based biology tutorial called ‘How Now Mad Cow’, which covers the topics of bovine spongiform encephalopathy and a new variant Creutzfeldt–Jakob disease (nvCJD). At the University of Southampton, a web-based hyper-mail discussion list to support teaching on a first year psychosocial science module for occupational therapy and physiotherapy students has been established. In both examples, the tutors had attempted to create a learning environment that would engage students in the learning experience and facilitate reflection by helping them to create meaning from the learning experience and see things in a different way. The evaluation data from both case studies provides some evidence that the learning technologies helped to facilitate reflection for some students. However, the evidence for reflection is not overwhelming and the data provides some evidence that four key factors may have influenced how successful the use of learning technologies were in facilitating reflection. These factors are the way the learning technology is used, the nature of the student groups, the role of the tutor and student preferences for ‘off-line reflection’. These are discussed and ways forward are identified

Recruiting ethnic minority participants to a clinical trial: a qualitative study

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non-commercial and is otherwise in compliance with the license.To compare the motives and experiences of different ethnic groups participating in a randomised double blind placebo-controlled trial of montelukast in preschool wheeze, and to assess parents' or guardians' understanding of trial procedures and their implications, including the collection of genetic material.National Institute of Health Research Efficacy and Mechanism Evaluation Stream(grant number: 08-43-03)

Anticipatory prescribing for end of life care in the community: a survey of community nurses in England

Anticipatory prescribing is increasingly common in the UK, yet little is known about nurses’ roles in the process. As part of a wider study to explore this, a postal survey of 575 community/district, nursing home and palliative care nurses was undertaken in two regions. Nurses report anticipatory prescriptions to be very common, and once in place they are normally used. Findings show that nurses report taking prominent roles throughout the anticipatory prescribing process and principal responsibility for administering and monitoring the medications. Many respondents recount good working relationships with GPs. However, some nurses report being challenged by: GPs who are reluctant to prescribe the medications, incorrectly written prescriptions, and difficulties in gaining access to the necessary medications. Qualitative comments indicated that being a nurse prescriber could enhance confidence to use anticipatory prescriptions. Importantly, nurses responding to the survey perceived that anticipatory prescriptions facilitated provision of good end of life care

Brain Injury Rehabilitation Outcome Measurement: Challenges and Future Directions

The Brain Injury Association of America (BIAA) published a position paper (http:// www.biausa.org/biaa-position-papers.htm) that describes the state of outcomes research in the field of brain injury and identifies the factors to consider when evaluating existing studies and embarking on future outcomes research. This commentary summarizes that article by highlighting 3 major challenges for outcome measurement in brain injury rehabilitation. It also presents opportunities for improving outcomes research through improved research design, standardization of measurement tools across the continuum with utilization of national databases, and an evidence-based approach to providing care to help move brain injury rehabilitation outcome measurement in a positive direction

Analysis of Site Effects at the Garner Valley Downhole Array Near the San Jacinto Fault

The Garner Valley downhole array is located in the geologically complicated and seismologically active San Jacinto fault zone. The choice of the site and the potential for a large earthquake there are discussed. The equipment is described in detail. The data recorded through the end of 1 April 1990 are summarized. Two large events at different locations are discussed in some detail and analyzed for amplification of the signal at the surface

Continuous sedation until death: The everyday moral reasoning of physicians, nurses and family caregivers in the UK, The Netherlands and Belgium

Copyright © 2014 Raus et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.Background - Continuous sedation is increasingly used as a way to relieve symptoms at the end of life. Current research indicates that some physicians, nurses, and relatives involved in this practice experience emotional and/or moral distress. This study aims to provide insight into what may influence how professional and/or family carers cope with such distress. Methods - This study is an international qualitative interview study involving interviews with physicians, nurses, and relatives of deceased patients in the UK, The Netherlands and Belgium (the UNBIASED study) about a case of continuous sedation at the end of life they were recently involved in. All interviews were transcribed verbatim and analysed by staying close to the data using open coding. Next, codes were combined into larger themes and categories of codes resulting in a four point scheme that captured all of the data. Finally, our findings were compared with others and explored in relation to theories in ethics and sociology. Results - The participants’ responses can be captured as different dimensions of ‘closeness’, i.e. the degree to which one feels connected or ‘close’ to a certain decision or event. We distinguished four types of ‘closeness’, namely emotional, physical, decisional, and causal. Using these four dimensions of ‘closeness’ it became possible to describe how physicians, nurses, and relatives experience their involvement in cases of continuous sedation until death. More specifically, it shined a light on the everyday moral reasoning employed by care providers and relatives in the context of continuous sedation, and how this affected the emotional impact of being involved in sedation, as well as the perception of their own moral responsibility. Conclusion - Findings from this study demonstrate that various factors are reported to influence the degree of closeness to continuous sedation (and thus the extent to which carers feel morally responsible), and that some of these factors help care providers and relatives to distinguish continuous sedation from euthanasia.The Economic and Social Research Council (UK), the Research Foundation Flanders (BE), the Flemish Cancer Association (BE), the Research Council of Ghent University (BE), the Netherlands Organization for Scientific Research (NL) and the Netherlands Organization for Health Research and Development (NL)

Dust composition and mass-loss return from the luminous blue variable R71 in the LMC

We present an analysis of mid-and far-infrared (IR) spectrum and spectral energy distribution (SED) of the LBV R71 in the LMC.This work aims to understand the overall contribution of high-mass LBVs to the total dust-mass budget of the interstellar medium (ISM) of the LMC and compare this with the contribution from low-mass asymptotic giant branch (AGB) stars. As a case study, we analyze the SED of R71. We compiled all the available photometric and spectroscopic observational fluxes from various telescopes for a wide wavelength range (0.36 -- 250\,$\mu$m). We determined the dust composition from the spectroscopic data, and derived the ejected dust mass, dust mass-loss rate, and other dust shell properties by modeling the SED of R71. We noted nine spectral features in the dust shell of R71 by analyzing Spitzer spectroscopic data. Among these, we identified three new crystalline silicate features. We computed our model spectrum by using 3D radiative transfer code MCMax. Our model calculation shows that dust is dominated by amorphous silicates, with some crystalline silicates, metallic iron, and a very tiny amount of polycyclic aromatic hydrocarbon (PAH) molecules. The presence of both silicates and PAHs indicates that the dust has a mixed chemistry. We derived a dust mass of 0.01 M$_\odot$, from which we arrive at a total ejected mass of $\approx$ 5 M$_\odot$. This implies a time-averaged dust mass-loss rate of 2.5$\times$10$^{-6}$ M$_\odot$\,yr$^{-1}$ with an explosion about 4000 years ago. We assume that the other five confirmed dusty LBVs in the LMC loose mass at a similar rate, and estimate the total contribution to the mass budget of the LMC to be $\approx$ 10$^{-5}$ M$_\odot$\,yr$^{-1}$, which is comparable to the contribution by all the AGB stars in the LMC. Based on our analysis on R71, we speculate that LBVs as a class may be an important dust source in the ISM of the LMC.Comment: 10 pages, 6 figures, 2 table

A Cryptosporidium parvum genotype shift between week old and two week old calves following administration of a prophylactic antiprotozoal

This study looked to assess the stability of Cryptosporidium parvum genotypes in calves between the final day of treatment with the antiprotozoal halofuginone lactate and seven days post-treatment. Paired faecal samples were collected on the final day of treatment and seven days later from 54 calves across seven farms in South-west England. The presence of Cryptosporidium species was detected using polymerase chain reaction targeting the 18 s rDNA. The presence and genotype of C. parvum was determined by PCR and amplicon sequencing targeting the gp60 locus. On farms where C. parvum was detected at both sampling times there was a distinct genotype shift. Detection of gp60 genotype IIaA15G2R1 decreased from 40% to 7% while IIaA17G1R1 increased from 0% to 41%, supplemented by IIaA16G3R1 in one sample. A shift in C. parvum genotypes present in calves within a one week sampling timeframe has not been described prior to this study, indicating that the timeframe is likely suitable for observing variation in C. parvum populations and interactions with antiprotozoal control strategies

What Families, Clinicians and Payors Need to Know About Transitional Rehabilitation

When a person sustains a traumatic brain injury (TBI), he and his family are thrust into a health care system that is unfamiliar and difficult to navigate. Too often, patients do not have access to the full continuum of treatment - especially transitional rehabilitation (TR). This article addresses why that is so and ways to change it

Reduction in Drinking Days and Binge Drinking Days among Patients Receiving Screening, Brief Intervention, and Referral to Treatment Services during an Emergency Department Visit: Six-month Results

Alcohol screening and brief intervention (SBI) is effective in many health-care settings. Previous research has shown significant decreases in harmful drinking due to SBI, but many studies, particularly in emergency/trauma settings, did not use a control group. Thus, it is unclear if observed decreases in harmful drinking are due to the intervention or other factors such as the hospital visit, the substance use assessment, or simply regression to the mean. This project assessed the effectiveness of an SBI program implemented at an urban hospital in the US state of Georgia