Introducing change in the citizenship education curriculum of a Hong Kong primary school through action research

This action research project reports the trial of an action learning pedagogy in the citizenship education curriculum of a primary school in Hong Kong. The project was a response to Learning to Learn - The Way Forward in Curriculum Development published by the Curriculum Development Council (CDC) in 2001. The document recommended that implementation of moral and civic education should be child-centred and should allow students to participate actively in learning. The study adopted both qualitative and quantitative methods. It consisted of three cycles of action research: (1) demonstration teaching by the researcher; (2) classroom teaching by a teacher in the school; (3) service learning. Five moral values: respect for others, civic and social concern, collaboration, participation, and self-regulation were identified from the CDC document, in order to investigate changes in the second and third cycles. The response and reactions of students suggested that action learning was effective in the aspects of knowledge, skills and values in the first cycle. However, the reactions of the four teacher-observers caused changes in implementation of action learning pedagogy in the second cycle. In the second cycle, the classroom teaching conducted by a teacher suggested that an action learning pedagogy provided opportunities for participation. Data illustrated that students displayed significant change in collaboration and participation but did not show obvious change in the other three values. After initial problems, the experimental teacher became more confident and competent in use of the action learning pedagogy. The third cycle was a service learning project in a special school for serious mentally handicapped children. A questionnaire on the five moral values was conducted before and after the service learning project. The questionnaire consisted of two parts: Part I was composed of 30 items; each described a scenario of five moral behaviours; and Part II focused on 10 moral values. Results of Part I did not show many significant changes. However, the results of Part II showed significant changes in the post-test survey. Qualitative data indicated that students demonstrated significant changes in the five moral values identified from the CDC document. The results of the research were partially encouraging. Students' learning was enhanced. However, the results also revealed problems in the implementation of the action learning pedagogy, for example the teachers' workload at a time of rapid reforms of the education system

Cultural Competence Amongst Undergraduate Healthcare Students (Spring 2019)

As students in the healthcare field, we want to be able to provide care that best serves the needs of a culturally diverse patient body. This study aims to look at whether healthcare students at City Tech are able to clearly define and understand the concepts of cultural competence and implicit bias in their healthcare encounters. Our research expands upon existing data from the previous year. We opened the scope of the project to include students in non-healthcare majors to understand how the general student population perceives their healthcare encounters. While focusing on improving our data analysis, we distributed two revised questionnaires: one for healthcare students and one for general education. The results from this revised study will give us a look into the students’ current understanding of implicit bias and cultural competence, and help us with patient interactions in our clinical encounters

Safe system demonstration project in a remote Aboriginal and Torres Strait Islander community

This paper reports on key findings and recommendations of the first known application of a comprehensive Safe System audit in a remote Aboriginal and Torres Strait Islander community; commissioned by the Indigenous Road Safety Working Group with funding from Austroads. The audit was conducted in Bidyadanga WA in collaboration with the Bidyadanga Community Council during June-August 2010, including: review of policy, management and police records; physical observation of roads, speeds and vehicles; and interviews with community members and local stakeholders including regarding road user issues and vehicle access. Bidyadanga was found to have high quality roads and safe speeds within residential areas, with limited need for upgrades and new work; however, several issues were identified on roads to access the nearest town, including a high crash “blackspot” location. Access to safe vehicles was limited. Unlicensed driving, lack of child restraints, drink driving and fatigue were key road user concerns. Needs for across-government improvements in policy and management were identified. Cost effective actions were identified. This project demonstrated that application of the Safe System was feasible in a remote Aboriginal community, while lessons learned can be adapted and applied nationally to improve Aboriginal road safety

Proinsulin Secretion Is a Persistent Feature of Type 1 Diabetes

OBJECTIVE: Abnormally elevated proinsulin secretion has been reported in type 2 and early type 1 diabetes when significant C-peptide is present. We questioned whether individuals with long-standing type 1 diabetes and low or absent C-peptide secretory capacity retained the ability to make proinsulin. RESEARCH DESIGN AND METHODS: C-peptide and proinsulin were measured in fasting and stimulated sera from 319 subjects with long-standing type 1 diabetes (≥3 years) and 12 control subjects without diabetes. We considered three categories of stimulated C-peptide: 1) C-peptide positive, with high stimulated values ≥0.2 nmol/L; 2) C-peptide positive, with low stimulated values ≥0.017 but <0.2 nmol/L; and 3) C-peptide <0.017 nmol/L. Longitudinal samples were analyzed from C-peptide-positive subjects with diabetes after 1, 2, and 4 years. RESULTS: Of individuals with long-standing type 1 diabetes, 95.9% had detectable serum proinsulin (>3.1 pmol/L), while 89.9% of participants with stimulated C-peptide values below the limit of detection (<0.017 nmol/L; n = 99) had measurable proinsulin. Proinsulin levels remained stable over 4 years of follow-up, while C-peptide decreased slowly during longitudinal analysis. Correlations between proinsulin with C-peptide and mixed-meal stimulation of proinsulin were found only in subjects with high stimulated C-peptide values (≥0.2 nmol/L). Specifically, increases in proinsulin with mixed-meal stimulation were present only in the group with high stimulated C-peptide values, with no increases observed among subjects with low or undetectable (<0.017 nmol/L) residual C-peptide. CONCLUSIONS: In individuals with long-duration type 1 diabetes, the ability to secrete proinsulin persists, even in those with undetectable serum C-peptide

Response to COVID-19 vaccination in patients on cancer therapy:Analysis in a SARS-CoV-2-naïve population

Background: Cancer patients have increased morbidity and mortality from COVID-19, but may respond poorly to vaccination. The Evaluation of COVID-19 Vaccination Efficacy and Rare Events in Solid Tumors (EVEREST) study, comparing seropositivity between cancer patients and healthy controls in a low SARS-CoV-2 community-transmission setting, allows determination of vaccine response with minimal interference from infection. Methods: Solid tumor patients from The Canberra Hospital, Canberra, Australia, and healthy controls who received COVID-19 vaccination between March 2021 and January 2022 were included. Blood samples were collected at baseline, pre-second vaccine dose and at 1, 3 (primary endpoint), and 6 months post-second dose. SARS-CoV-2 anti-spike-RBD (S-RBD) and anti-nucleocapsid IgG antibodies were measured. Results: Ninety-six solid tumor patients and 20 healthy controls were enrolled, with median age 62 years, and 60% were female. Participants received either AZD1222 (65%) or BNT162b2 (35%) COVID-19 vaccines. Seropositivity 3 months post vaccination was 87% (76/87) in patients and 100% (20/20) in controls (p =.12). Seropositivity was observed in 84% of patients on chemotherapy, 80% on immunotherapy, and 96% on targeted therapy (differences not satistically significant). Seropositivity in cancer patients increased from 40% (6/15) after first dose, to 95% (35/37) 1 month after second dose, then dropped to 87% (76/87) 3 months after second dose. Conclusion: Most patients and all controls became seropositive after two vaccine doses. Antibody concentrations and seropositivity showed a decrease between 1 and 3 months post vaccination, highlighting need for booster vaccinations. SARS-CoV-2 infection amplifies S-RBD antibody responses; however, cannot be adequately identified using nucleocapsid serology. This underlines the value of our COVID-naïve population in studying vaccine immunogenicity.</p

Glucocorticoid signaling enhances expression of glucose-sensing molecules in immature pancreatic beta-like cells derived from murine embryonic stem cells in vitro

Pluripotent stem cells may serve as an alternative source of beta-like cells for replacement therapy of type 1 diabetes; however, the beta-like cells generated in many differentiation protocols are immature. The maturation of endogenous beta cells involves an increase in insulin expression starting in late gestation and a gradual acquisition of the abilities to sense glucose and secrete insulin by week 2 after birth in mice; however, what molecules regulate these maturation processes are incompletely known. Here, we aim to identify small molecules that affect immature beta cells. A cell-based assay, employing pancreatic beta-like cells derived from murine embryonic stem (ES) cells harboring a transgene containing an Insulin 1-promoter driven enhanced green fluorescent protein reporter, was used to screen a compound library (NIH Clinical Collection-003). Cortisone, a glucocorticoid, was among five positive hit compounds. Quantitative RT-PCR analysis revealed that glucocorticoids enhance the gene expression of not only insulin 1 but also glucose transporter-2 (Glut2; Slc2a2) and glucokinase (Gck), two molecules important for glucose sensing. Mifepristone, a pharmacological inhibitor of glucocorticoid receptor (GR) signaling, reduced the effects of glucocorticoids on Glut2 and Gck expression. The effects of glucocorticoids on ES-derived cells were further validated in immature primary islets. Isolated islets from 1-week-old mice had an increased Glut2 and Gck expression in response to a 4-day treatment of exogenous hydrocortisone in vitro. Gene deletion of GR in beta cells using rat insulin 2 promoter-driven Cre crossed with GRflox/flox mice resulted in a reduced gene expression of Glut2, but not Gck, and an abrogation of insulin secretion when islets were incubated in 0.5 mM D-glucose and stimulated by 17 mM D-glucose in vitro. These results demonstrate that glucocorticoids positively regulate glucose sensors in immature murine beta-like cells

The in-plane paraconductivity in La_{2-x}Sr_xCuO_4 thin film superconductors at high reduced-temperatures: Independence of the normal-state pseudogap

The in-plane resistivity has been measured in $La_{2-x}Sr_xCuO_4$ (LSxCO) superconducting thin films of underdoped ($x=0.10,0.12$), optimally-doped ($x=0.15$) and overdoped ($x=0.20,0.25$) compositions. These films were grown on (100)SrTiO$_3$ substrates, and have about 150 nm thickness. The in-plane conductivity induced by superconducting fluctuations above the superconducting transition (the so-called in-plane paraconductivity, $\Delta\sigma_{ab}$) was extracted from these data in the reduced-temperature range 10^{-2}\lsim\epsilon\equiv\ln(T/\Tc)\lsim1. Such a $\Delta\sigma_{ab}(\epsilon)$ was then analyzed in terms of the mean-field--like Gaussian-Ginzburg-Landau (GGL) approach extended to the high-$\epsilon$ region by means of the introduction of a total-energy cutoff, which takes into account both the kinetic energy and the quantum localization energy of each fluctuating mode. Our results strongly suggest that at all temperatures above Tc, including the high reduced-temperature region, the doping mainly affects in LSxCO thin films the normal-state properties and that its influence on the superconducting fluctuations is relatively moderate: Even in the high-$\epsilon$ region, the in-plane paraconductivity is found to be independent of the opening of a pseudogap in the normal state of the underdoped films.Comment: 35 pages including 10 figures and 1 tabl

Framework for a Community Health Observing System for the Gulf of Mexico Region: Preparing for Future Disasters

© Copyright © 2020 Sandifer, Knapp, Lichtveld, Manley, Abramson, Caffey, Cochran, Collier, Ebi, Engel, Farrington, Finucane, Hale, Halpern, Harville, Hart, Hswen, Kirkpatrick, McEwen, Morris, Orbach, Palinkas, Partyka, Porter, Prather, Rowles, Scott, Seeman, Solo-Gabriele, Svendsen, Tincher, Trtanj, Walker, Yehuda, Yip, Yoskowitz and Singer. The Gulf of Mexico (GoM) region is prone to disasters, including recurrent oil spills, hurricanes, floods, industrial accidents, harmful algal blooms, and the current COVID-19 pandemic. The GoM and other regions of the U.S. lack sufficient baseline health information to identify, attribute, mitigate, and facilitate prevention of major health effects of disasters. Developing capacity to assess adverse human health consequences of future disasters requires establishment of a comprehensive, sustained community health observing system, similar to the extensive and well-established environmental observing systems. We propose a system that combines six levels of health data domains, beginning with three existing, national surveys and studies plus three new nested, longitudinal cohort studies. The latter are the unique and most important parts of the system and are focused on the coastal regions of the five GoM States. A statistically representative sample of participants is proposed for the new cohort studies, stratified to ensure proportional inclusion of urban and rural populations and with additional recruitment as necessary to enroll participants from particularly vulnerable or under-represented groups. Secondary data sources such as syndromic surveillance systems, electronic health records, national community surveys, environmental exposure databases, social media, and remote sensing will inform and augment the collection of primary data. Primary data sources will include participant-provided information via questionnaires, clinical measures of mental and physical health, acquisition of biological specimens, and wearable health monitoring devices. A suite of biomarkers may be derived from biological specimens for use in health assessments, including calculation of allostatic load, a measure of cumulative stress. The framework also addresses data management and sharing, participant retention, and system governance. The observing system is designed to continue indefinitely to ensure that essential pre-, during-, and post-disaster health data are collected and maintained. It could also provide a model/vehicle for effective health observation related to infectious disease pandemics such as COVID-19. To our knowledge, there is no comprehensive, disaster-focused health observing system such as the one proposed here currently in existence or planned elsewhere. Significant strengths of the GoM Community Health Observing System (CHOS) are its longitudinal cohorts and ability to adapt rapidly as needs arise and new technologies develop

A tailored approach to horizon scanning for cancer medicines

BACKGROUND: Horizon scanning (HS) is the systematic identification of emerging therapies to inform policy and decision-makers. We developed an agile and tailored HS methodology that combined multi-criteria decision analysis weighting and Delphi rounds. As secondary objectives, we aimed to identify new medicines in melanoma, non-small cell lung cancer and colorectal cancer most likely to impact the Australian government's pharmaceutical budget by 2025 and to compare clinician and consumer priorities in cancer medicine reimbursement.METHOD: Three cancer-specific clinician panels (total n = 27) and a consumer panel (n = 7) were formed. Six prioritisation criteria were developed with consumer input. Criteria weightings were elicited using the Analytic Hierarchy Process (AHP). Candidate medicines were identified and filtered from a primary database and validated against secondary and tertiary sources. Clinician panels participated in a three-round Delphi survey to identify and score the top five medicines in each cancer type.RESULTS: The AHP and Delphi process was completed in eight weeks. Prioritisation criteria focused on toxicity, quality of life (QoL), cost savings, strength of evidence, survival, and unmet need. In both curative and non-curative settings, consumers prioritised toxicity and QoL over survival gains, whereas clinicians prioritised survival. HS results project the ongoing prevalence of high-cost medicines. Since completion in October 2021, the HS has identified 70 % of relevant medicines submitted for Pharmaceutical Benefit Advisory Committee assessment and 60% of the medicines that received a positive recommendation.CONCLUSION: Tested in the Australian context, our method appears to be an efficient and flexible approach to HS that can be tailored to address specific disease types by using elicited weights to prioritise according to incremental value from both a consumer and clinical perspective.POLICY SUMMARY: Since HS is of global interest, our example provides a reproducible blueprint for adaptation to other healthcare settings that integrates consumer input and priorities.</p