Case-Based Learning for Dysphagia Continuing Education: Participant Perceptions on Facilitators and Barriers

Case-based learning (CBL) is a valuable approach to healthcare education, fostering deeper learning, clinical reasoning, and decision-making skills, especially in complex medical conditions such as dysphagia. For speech-language pathologists who manage dysphagia, a CBL approach provides interactive hands-on learning opportunities. We examined the benefits and challenges of a CBL approach to dysphagia continuing education using participant feedback. Twenty participants who attended the Alabama Dysphagia Collective Conference in September 2023 in Tuscaloosa, AL completed a Likert-style survey evaluating attitudes and opinions toward a CBL conference design. Participants also provided open-ended feedback on the facilitators, barriers, clinical practice implementation, new skills learned, perspective gained, and future recommendations for this style of learning, reflections which were then analyzed to identify recurring themes. Participants overwhelmingly supported a CBL format, with largely positive perceptions related to conference outcomes, expectations, relevancy, and value of topics presented. Specifically, participants reported facilitators of real-world relevancy of topics, collaboration and networking opportunities, conference format and facility environment, and quality of the speakers. Challenges reported included access to resources, challenges surrounding discussions due to varied clinical backgrounds, and duration of certain parts of the conference. Overall, participants appeared to value the CBL approach to dysphagia continuing education, suggesting that it allows for applicability of real-world topics and provides networking and collaboration opportunities. Future research could expand upon the exploratory nature and limited sample size of this study and examine the implications of both the facilitators and barriers reported

Examination of Late Palaeolithic archaeological sites in northern Europe for the preservation of cryptotephra layers

We report the first major study of cryptotephra (non-visible volcanic ash layers) on Late Palaeolithic archaeological sites in northern Europe. Examination of 34 sites dating from the Last Termination reveals seven with identifiable cryptotephra layers. Preservation is observed in minerogenic and organic deposits, although tephra is more common in organic sediments. Cryptotephra layers normally occur stratigraphically above or below the archaeology. Nearby off-site palaeoclimate archives (peat bogs and lakes <0.3 km distant) were better locations for detecting tephra. However in most cases the archaeology can only be correlated indirectly with such cryptotephras. Patterns affecting the presence/absence of cryptotephra include geographic position of sites relative to the emitting volcanic centre; the influence of past atmospherics on the quantity, direction and patterns of cryptotephra transport; the nature and timing of local site sedimentation; sampling considerations and subsequent taphonomic processes. Overall, while tephrostratigraphy has the potential to improve significantly the chronology of such sites many limiting factors currently impacts the successful application

The RESET project: constructing a European tephra lattice for refined synchronisation of environmental and archaeological events during the last c. 100 ka

This paper introduces the aims and scope of the RESET project (. RESponse of humans to abrupt Environmental Transitions), a programme of research funded by the Natural Environment Research Council (UK) between 2008 and 2013; it also provides the context and rationale for papers included in a special volume of Quaternary Science Reviews that report some of the project's findings. RESET examined the chronological and correlation methods employed to establish causal links between the timing of abrupt environmental transitions (AETs) on the one hand, and of human dispersal and development on the other, with a focus on the Middle and Upper Palaeolithic periods. The period of interest is the Last Glacial cycle and the early Holocene (c. 100-8 ka), during which time a number of pronounced AETs occurred. A long-running topic of debate is the degree to which human history in Europe and the Mediterranean region during the Palaeolithic was shaped by these AETs, but this has proved difficult to assess because of poor dating control. In an attempt to move the science forward, RESET examined the potential that tephra isochrons, and in particular non-visible ash layers (cryptotephras), might offer for synchronising palaeo-records with a greater degree of finesse. New tephrostratigraphical data generated by the project augment previously-established tephra frameworks for the region, and underpin a more evolved tephra 'lattice' that links palaeo-records between Greenland, the European mainland, sub-marine sequences in the Mediterranean and North Africa. The paper also outlines the significance of other contributions to this special volume: collectively, these illustrate how the lattice was constructed, how it links with cognate tephra research in Europe and elsewhere, and how the evidence of tephra isochrons is beginning to challenge long-held views about the impacts of environmental change on humans during the Palaeolithic. © 2015 Elsevier Ltd.RESET was funded through Consortium Grants awarded by the Natural Environment Research Council, UK, to a collaborating team drawn from four institutions: Royal Holloway University of London (grant reference NE/E015905/1), the Natural History Museum, London (NE/E015913/1), Oxford University (NE/E015670/1) and the University of Southampton, including the National Oceanography Centre (NE/01531X/1). The authors also wish to record their deep gratitude to four members of the scientific community who formed a consultative advisory panel during the lifetime of the RESET project: Professor Barbara Wohlfarth (Stockholm University), Professor Jørgen Peder Steffensen (Niels Bohr Institute, Copenhagen), Dr. Martin Street (Romisch-Germanisches Zentralmuseum, Neuwied) and Professor Clive Oppenheimer (Cambridge University). They provided excellent advice at key stages of the work, which we greatly valued. We also thank Jenny Kynaston (Geography Department, Royal Holloway) for construction of several of the figures in this paper, and Debbie Barrett (Elsevier) and Colin Murray Wallace (Editor-in-Chief, QSR) for their considerable assistance in the production of this special volume.Peer Reviewe

Why High-Performance Modelling and Simulation for Big Data Applications Matters

Modelling and Simulation (M&S) offer adequate abstractions to manage the complexity of analysing big data in scientific and engineering domains. Unfortunately, big data problems are often not easily amenable to efficient and effective use of High Performance Computing (HPC) facilities and technologies. Furthermore, M&S communities typically lack the detailed expertise required to exploit the full potential of HPC solutions while HPC specialists may not be fully aware of specific modelling and simulation requirements and applications. The COST Action IC1406 High-Performance Modelling and Simulation for Big Data Applications has created a strategic framework to foster interaction between M&S experts from various application domains on the one hand and HPC experts on the other hand to develop effective solutions for big data applications. One of the tangible outcomes of the COST Action is a collection of case studies from various computing domains. Each case study brought together both HPC and M&S experts, giving witness of the effective cross-pollination facilitated by the COST Action. In this introductory article we argue why joining forces between M&S and HPC communities is both timely in the big data era and crucial for success in many application domains. Moreover, we provide an overview on the state of the art in the various research areas concerned

New Preventive Programs of the Polish Hypertension Society in Gdansk. Part I: SOPKARD

Badania ogólnopolskie przeprowadzone metodą sondażu reprezentatywnego pod koniec 1997 roku wskazały na utrzymywanie się niedostatecznego wykrywania (46%) oraz niewielkiej skuteczności leczenia (8,5%) nadciśnienia tętniczego, a także na pogarszanie się sytuacji, szczególnie w małych miastach i na wsi. Realizując pilną potrzebę wprowadzania kompleksowych działań na rzecz skutecznej prewencji nadciśnienia, Oddział Gdański PTNT opracował i wdrożył, na podstawie sprawdzonych wzorów szwedzkich, tak zwany Program Sopocki (SOPKARD). Program ma charakter usługowy i badawczy. Jego celem jest poprawa wykrywania i skuteczności leczenia nadciśnienia tętniczego, cukrzycy i hipercholesterolemii. Co roku na badania w Sopocie zapraszani są wszyscy mieszkańcy kończący w danym roku kalendarzowym 40 i 50 lat. Projekt realizują pielęgniarki i lekarze podstawowej opieki zdrowotnej we współpracy z Akademią Medyczną w Gdańsku, Pomorską Kasą Chorych i samorządem lokalnym. Program ma charakter pilotowy dla innych miast Pomorza. Działania edukacyjne z wykorzystaniem mediów i akcje pomiarów ciśnienia obejmują wszystkich mieszkańców miasta. Badanie epidemiologiczne przeprowadzone przed rozpoczęciem programu jednoznacznie potwierdziło celowość i potencjalną opłacalność tego typu działań. W Sopocie, w grupie 50-latków połowa pali papierosy, tylko dwie trzecie mieszkańców mierzy sobie ciśnienie, u 45% stwierdzono nadciśnienie tętnicze (kryterium 140/90 mm Hg), tylko 5% spośród osób z nadciśnieniem jest skutecznie leczonych; o cukrzycy wie 4%, podczas gdy u 13% mieszkańców glikemia na czczo wynosi powyżej 126 mg/dl. Zorganizowana we wrześniu bieżącego roku w Sopocie konferencja z udziałem Minister Zdrowia Franciszki Cegielskiej, przedstawicieli Sejmu i Senatu RP, Kas Chorych oraz autorytetów medycznych i dziennikarzy miała na celu zintegrowanie różnych środowisk w celu skutecznej prewencji chorób serca i naczyń w Polsce.Representative survey performed in 1997 in Poland showed still low awareness of hypertension (46%) and poor control ofhigh blood pressure (8.5%), with the worst situation in small towns and villages. To intensify preventive measures we have implemented a new preventive program in Sopot (small town nearby Gdansk) based on models worked out in Sweden. Its aim is to increase detection and control of arterial hypertension, diabetes mellitus and hypercholesterolaemia. It is also a pilot program for other cities in Gdansk region. The program (SOPKARD) is intended to provide service to the community of Sopot, and to yield valid research material. It is based on co-operation between primary health care, university authorities and health insurance companies. Estimated minimum duration is 10 years. SOPKARD is addressed to those Sopot inhabitants who within the period 1999-2009 will reach the age of 40 and 50 years. The representative survey performed to measure the prevalence of cardiovascular risk factors among citizens of Sopot fully confirmed the necessity of such programs. In the group of 50-year-old inhabitants, half of them smoked cigarettes, only two thirds were aware of their blood pressure level, 45% were hypertensives (criterion 140/90 mm Hg). Among hypertensive subjects, only in 5% blood pressure was well controlled. Fasting blood glu- cose > 126 mg/dl was found in 13% of respondents, and only 4% declared to have diabetes. The aim of the conference, which inaugurated the program, was to develop an agreement between medical experts, journalists and representatives from different political groups to improve control ofcardiovascular diseases in our region and in Poland

Peatland Microbial Communities as Indicators of the Extreme Atmospheric Dust Deposition

We investigated a peat profile from the Izery Mountains, located within the so-called Black Triangle, the border area of Poland, Czech Republic, and Germany. This peatland suffered from an extreme atmospheric pollution during the last 50 years, which created an exceptional natural experiment to examine the impact of pollution on peatland microbes. Testate amoebae (TA), Centropyxis aerophila and Phryganella acropodia, were distinguished as a proxy of atmospheric pollution caused by extensive brown coal combustion. We recorded a decline of mixotrophic TA and development of agglutinated taxa as a response for the extreme concentration of Al (30 g kg−1) and Cu (96 mg kg−1) as well as the extreme amount of fly ash particles determined by scanning electron microscopy (SEM) analysis, which were used by TA for shell construction. Titanium (5.9 %), aluminum (4.7 %), and chromium (4.2 %) significantly explained the highest percentage of the variance in TA data. Elements such as Al, Ti, Cr, Ni, and Cu were highly correlated (r>0.7, p<0.01) with pseudostome position/body size ratio and pseudostome position. Changes in the community structure, functional diversity, and mechanisms of shell construction were recognized as the indicators of dust pollution. We strengthen the importance of the TA as the bioindicators of the recent atmospheric pollution

An adaptive ant colony optimization framework for scheduling environmental flow management alternatives under varied environmental water availability conditions

Human water use is increasing and, as such, water for the environment is limited and needs to be managed efficiently. One method for achieving this is the scheduling of environmental flow management alternatives (EFMAs) (e.g., releases, wetland regulators), with these schedules generally developed over a number of years. However, the availability of environmental water changes annually as a result of natural variability (e.g., drought, wet years). To incorporate this variation and schedule EFMAs in a operational setting, a previously formulated multiobjective optimization approach for EFMA schedule development used for long-term planning has been modified and incorporated into an adaptive framework. As part of this approach, optimal schedules are updated at regular intervals during the planning horizon based on environmental water allocation forecasts, which are obtained using artificial neural networks. In addition, the changes between current and updated schedules can be minimized to reduce any disruptions to longterm planning. The utility of the approach is assessed by applying it to an 89km section of the River Murray in South Australia. Results indicate that the approach is beneficial under a range of hydrological conditions and an improved ecological response is obtained in a operational setting compared with previous longterm approaches. Also, it successfully produces trade-offs between the number of disruptions to schedules and the ecological response, with results suggesting that ecological response increases with minimal alterations required to existing schedules. Overall, the results indicate that the information obtained using the proposed approach potentially aides managers in the efficient management of environmental water.J. M. Szemis, H. R. Maier, and G. C. Dand

Variable structure robot control systems: The RAPP approach

International audienceThis paper presents a method of designing variable structure control systems for robots. As the on-board robot computational resources are limited, but in some cases the demands imposed on the robot by the user are virtually limitless, the solution is to produce a variable structure system. The task dependent part has to be exchanged, however the task governs the activities of the robot. Thus not only exchange of some task-dependent modules is required, but also supervisory responsibilities have to be switched. Such control systems are necessary in the case of robot companions, where the owner of the robot may demand from it to provide many services.