A GUIDED ORIENTATION PROCESS FOR ONLINE ADULT LEARNERS

To the MS in Applied Statistics, Analytics & Data Science program at the University of Kansas, the orientation process, between accepting an offer of admission and starting the first day of classes, takes approximately 7 steps. Students to this program, typically online non-traditional working professionals, were sent an email with directions on how to complete the steps, and the students self-guided their way through the process using the email. The steps must be completed in a specific order and some steps require overnight processing before the next step can be initiated. When students were unable to complete the process on their own, they would contact a student resource office for assistance. This utilized valuable institutional personnel time. A new guided orientation process was developed that takes a more incremental approach with one email sent for each step that includes a video link with audio and video guides on how to complete the step, tailored towards the needs of a diverse online and adult learner population. The old process continued in the Spring 2020 and Summer 2020 terms, and the new process was implemented in the Fall 2020 term. We assessed the effectiveness of the new guided orientation process at decreasing student frustration, improving student orientation experiences, decreasing the assistance students need to successfully complete the orientation steps, and improving the newly admitted student’s first impression of the institution, department, and program. Surveys were given to all students during the three 2020 terms. The results of the Spring and Summer student surveys were compared to the Fall student surveys to assess the change in students\u27 opinions, experiences, resource usages, and first impressions. Analyses showed no statistically significant improvements in student opinions or experiences. However, there was a significant improvement in students first impressions of the institution, and increased independence with establishing email and getting connected to the department LinkedIn page

A practice-centered intervention to increase screening for domestic violence in primary care practices

BACKGROUND: Interventions to change practice patterns among health care professionals have had mixed success. We tested the effectiveness of a practice centered intervention to increase screening for domestic violence in primary care practices. METHODS: A multifaceted intervention was conducted among primary care practice in North Carolina. All practices designated two individuals to serve as domestic violence resources persons, underwent initial training on screening for domestic violence, and participated in 3 lunch and learn sessions. Within this framework, practices selected the screening instrument, patient educational material, and content best suited for their environment. Effectiveness was evaluated using a pre/post cross-sectional telephone survey of a random selection of female patients from each practice. RESULTS: Seventeen practices were recruited and fifteen completed the study. Baseline screening for domestic violence was 16% with a range of 2% to 49%. An absolute increase in screening of 10% was achieved (range of increase 0 to 22%). After controlling for clustering by practice and other patient characteristics, female patients were 79% more likely to have been screened after the intervention (OR 1.79, 95% CI 1.43–2.23). CONCLUSION: An intervention that allowed practices to tailor certain aspects to fit their needs increased screening for domestic violence. Further studies testing this technique using other outcomes are needed

Rasburicase in tumor lysis syndrome of the adult: a systematic review and meta-analysis.

BackgroundThe use of rasburicase has been evaluated extensively in children, but not in adults. We review the current literature to evaluate its effect on adults.Study designSystematic review and meta-analysis.Setting & populationAdults receiving rasburicase for tumor lysis syndrome (TLS).Selection criteria for studiesElectronic databases, regulatory documents, and websites were searched up to August 7, 2012. Reference lists of published articles were examined for additional relevant references. Any controlled trial or observational studies (controlled before and after) were included. Studies considering children only or mixing data for children and adults were excluded.InterventionRasburicase for TLS.OutcomesThe primary outcome was TLS development. Secondary outcomes included percentage of patients improving, total adverse events, acute kidney failure, deaths, and serum uric acid and creatinine levels.Results21 studies (24 publications) reported data for 1,261 adult patients, 768 receiving rasburicase for either the treatment or prophylaxis of TLS; these comprised 4 controlled trials and 17 observational studies. No statistically significant differences in clinical TLS development were observed in the controlled trials between the rasburicase and control groups. For the observational studies, 7.4% of patients developed clinical TLS after rasburicase (95% CI, 1.7%-16.7%), 93.4% of patients achieved normalized serum uric acid levels after rasburicase treatment (95% CI, 91.7%-94.6%), 4.4% developed acute kidney injury (95% CI, 3.0%-6.0%), and 2.6% died (95% CI, 0.95%-5.0%). The mean reduction in serum uric acid levels ranged from 5.3-12.8 mg/dL, and for serum creatinine levels, from 0.10-2.1 mg/dL.LimitationsControlled trials differed in outcomes reported; meta-analysis was not performed.ConclusionsRasburicase is effective in reducing serum uric acid levels in adults with TLS but at a significant cost, and evidence currently is lacking in adults to report whether rasburicase use improves clinical outcomes compared with other alternatives. Until new evidence is available, use of rasburicase may be limited to adult patients with a high risk of TLS

Expression of the retinoblastoma-related gene Rb2/p130 in the pathogenesis of serous carcinoma of the ovary

The purpose of this study was to evaluate the immunohistochemical Rb2/p130 expression in a series of benign, borderline, and malignant ovarian tumors. Seventy-six operative specimens were analyzed. Frequencies and percents were calculated for variables by each of the 5 disease stage groups in increasing severity and again for the disease stage groups collapsed into benign (serous cystadenoma or endosalpingosis), low-grade [serous borderline tumors (SBT) or low-grade serous carcinoma (LGSC)] and high-grade serous carcinoma. There was no loss of expression in benign serous cystadenomas (0/18). Ten percent of SBT's (2/20), 47% of LGSC's (9/19), and 16% of HGSC's (3/16) had loss of expression. There was a significant difference in the expression during the progression from cystadenoma to SBT to LGSC. Loss of Rb2/p130 expression is a rare event in benign cystadenoma. The progression to LGSC is associated with a decrease in gene expression

Sarcopenia, obesity, and inflammation - Results from the Trial of Angiotensin Converting Enzyme Inhibition and Novel Cardiovascular Risk Factors study

Background: Age-related body-composition changes are associated with health-related outcomes in elders. This relation may be explained by inflammation and hemostatic abnormalities. Objectives: Our objectives were to evaluate the relation between body-composition measures [body mass index (BMI), total fat mass, and appendicular lean mass (aLM)] and C-reactive protein (CRP), interleukin 6 (IL-6), and plasminogen activator inhibitor 1 (PAI-1) and to explore the effect of obesity and sarcopenia on CRP, IL-6, and PAI-1 concentrations. Design: The data are from the Trial of Angiotensin Converting Enzyme Inhibition and Novel Cardiovascular Risk Factors (TRAIN) study baseline visit (n = 286; mean age = 66.0 y). Total fat mass and aLM were assessed with a dual-energy X-ray absorptiometry scan. Linear regressions were performed between body-composition measures and CRP, IL-6, or PAI-1 concentrations. The effect of sarcopenia and obesity (defined as the percentage of fat mass) on CRP, IL-6, and PAI-1 concentrations was evaluated with the use of analyses of covariance. Results: CRP and IL-6 were positively associated with both BMI [β = 0.027 (P = 0.03) and β = 0.048 (P < 0.001), respectively] and total fat mass [β = 0.049 (P < 0.001) and β = 0.055 (P < 0.001), respectively] and were inversely associated with fat-adjusted aLM [β = -0.629 (P = 0.002) and β = -0.467 (P = 0.02), respectively]. PAI-1 was positively associated with both BMI (β = 0.038, P = 0.005) and total fat mass (β = 0.032, P = 0.007). No significant interaction was found between either obesity or sarcopenia and CRP, IL-6, and PAI-1 concentrations. Obesity remained significantly associated with high CRP and IL-6 concentrations after adjustments for sarcopenia. Conclusions: CRP and IL-6 are positively associated with total fat mass and negatively associated with aLM. Obesity-associated inflammation may play an important role in the age-related process that leads to sarcopenia. The relation of inflammation with sarcopenia was not independent of any of the considered obesity indexes