Strategies and challenges to facilitate situated learning in virtual worlds post-Second Life

Virtual worlds can establish a stimulating environment to support a situated learning approach in which students simulate a task within a safe environment. While in previous years Second Life played a major role in providing such a virtual environment, there are now more and more alternative—often OpenSim-based—solutions deployed within the educational community. By drawing parallels to social networks, we discuss two aspects: how to link individually hosted virtual worlds together in order to implement context for immersion and how to identify and avoid “fake” avatars so people behind these avatars can be held accountable for their actions

Risk sharing arrangements for pharmaceuticals: potential considerations and recommendations for European payers

<p>Abstract</p> <p>Background</p> <p>There has been an increase in 'risk sharing' schemes for pharmaceuticals between healthcare institutions and pharmaceutical companies in Europe in recent years as an additional approach to provide continued comprehensive and equitable healthcare. There is though confusion surrounding the terminology as well as concerns with existing schemes.</p> <p>Methods</p> <p>Aliterature review was undertaken to identify existing schemes supplemented with additional internal documents or web-based references known to the authors. This was combined with the extensive knowledge of health authority personnel from 14 different countries and locations involved with these schemes.</p> <p>Results and discussion</p> <p>A large number of 'risk sharing' schemes with pharmaceuticals are in existence incorporating both financial-based models and performance-based/outcomes-based models. In view of this, a new logical definition is proposed. This is "<it>risk sharing' schemes should be considered as agreements concluded by payers and pharmaceutical companies to diminish the impact on payers' budgets for new and existing schemes brought about by uncertainty and/or the need to work within finite budgets</it>". There are a number of concerns with existing schemes. These include potentially high administration costs, lack of transparency, conflicts of interest, and whether health authorities will end up funding an appreciable proportion of a new drug's development costs. In addition, there is a paucity of published evaluations of existing schemes with pharmaceuticals.</p> <p>Conclusion</p> <p>We believe there are only a limited number of situations where 'risk sharing' schemes should be considered as well as factors that should be considered by payers in advance of implementation. This includes their objective, appropriateness, the availability of competent staff to fully evaluate proposed schemes as well as access to IT support. This also includes whether systematic evaluations have been built into proposed schemes.</p

Iraq War mortality estimates: A systematic review

<p>Abstract</p> <p>Background</p> <p>In March 2003, the United States invaded Iraq. The subsequent number, rates, and causes of mortality in Iraq resulting from the war remain unclear, despite intense international attention. Understanding mortality estimates from modern warfare, where the majority of casualties are civilian, is of critical importance for public health and protection afforded under international humanitarian law. We aimed to review the studies, reports and counts on Iraqi deaths since the start of the war and assessed their methodological quality and results.</p> <p>Methods</p> <p>We performed a systematic search of 15 electronic databases from inception to January 2008. In addition, we conducted a non-structured search of 3 other databases, reviewed study reference lists and contacted subject matter experts. We included studies that provided estimates of Iraqi deaths based on primary research over a reported period of time since the invasion. We excluded studies that summarized mortality estimates and combined non-fatal injuries and also studies of specific sub-populations, e.g. under-5 mortality. We calculated crude and cause-specific mortality rates attributable to violence and average deaths per day for each study, where not already provided.</p> <p>Results</p> <p>Thirteen studies met the eligibility criteria. The studies used a wide range of methodologies, varying from sentinel-data collection to population-based surveys. Studies assessed as the highest quality, those using population-based methods, yielded the highest estimates. Average deaths per day ranged from 48 to 759. The cause-specific mortality rates attributable to violence ranged from 0.64 to 10.25 per 1,000 per year.</p> <p>Conclusion</p> <p>Our review indicates that, despite varying estimates, the mortality burden of the war and its sequelae on Iraq is large. The use of established epidemiological methods is rare. This review illustrates the pressing need to promote sound epidemiologic approaches to determining mortality estimates and to establish guidelines for policy-makers, the media and the public on how to interpret these estimates.</p

Spectators’ Negotiations of Risk, Masculinity and Performative Mobilities at the TT Races

This paper explores the particular assemblage of place, event and individual identity performances that occur each year in the Isle of Man in and through the TT (Tourist Trophy) motorcycle races. These road races are associated with a high degree of risk for the racers and the confluence of over 30,000 visitors and 10,000 motorcycles also presents potential risks for spectators and residents alike. Both motorcycling and risk-taking have been associated with particular forms of masculinity, notably hegemonic, working class and youthful masculinities. Using detailed surveys of spectators we argue that the TT races, while undoubtedly dominated by men and predicated on a cultural privileging of speed and skill, are grounded in varying combinations of determinate and reflexive attitudes to risk, reflecting the performance of a variety of gendered, ‘biker’ and wider identity-based positionalities. Findings also highlight a particular inter-relation of mobilities and place identities at the TT races and bring to light the highly significant and under-researched embodied, performative and emotional mobilities of spectators. The conceptual and methodological importance of (a) situated research of both mobilities and gender in specific place-temporalities and (b) wider surveys of motorcyclists to complement ethnographic studies of small cohorts are also stressed

Nature documentaries as catalysts for change: Mapping out the 'Blackfish Effect'

It is essential for us to understand what drives human behaviour if we want to tackle anthropogenic damage to the environment. Popular media can play an important role in shaping public attitudes, behaviours and norms towards wildlife, and documentaries in particular have become an increasingly prominent tool for social change. There is, however, a need for robust impact evaluation both in documentary-making and in conservation, to refine future interventions. The 2013 documentary Blackfish portrayed human–orca interactions at the US-based marine park, SeaWorld. Following its release, SeaWorld suffered financial difficulties and the company underwent structural changes, including a cessation of its orca breeding programme. These impacts have often been attributed to the Blackfish documentary, but little evidence has been provided to justify these claims. We combined an analysis of stock market data and semi-structured interviews with 26 key informants to build an in-depth contribution analysis. We used General Elimination Methodology, a qualitative impact evaluation methodology to build an understanding of the impact of Blackfish. We found a consensus among stakeholder groups that Blackfish induced negative publicity for SeaWorld and a change in people's perceptions of captivity. As a result, attendance at the park decreased and the market value of the company dropped. Blackfish catalysed a whole movement against marine mammal captivity. There were three key factors that led to its impact: the support from major distribution channels which allowed it to reach major audiences, emotional impact of the content and timing of its release. Blackfish benefitted from a perfect storm, building upon decades of activism to create an appropriate cultural climate for its release in 2013

Efeitos da terapia ultrassônica de baixa intensidade sobre o infarto agudo do miocárdio em ratos

Introdução. O infarto agudo do miocárdio (IAM) é considerado importante causa de morbidade e mortalidade no mundo e no Brasil. Novas intervenções terapêuticas estão sendo testadas isoladas ou em associação com as já existentes com o intuito de impedir a progressão ou atenuar o remodelamento no coração infartado. Dentre elas destaca-se a aplicação do Ultra-som (US) conjunto com agentes trombolíticos. Entretanto, na aplicação da energia ultrassônica como terapêutica pós-infarto é avaliado somente o seu possível efeito como agente trombolítico, não sendo investigado a sua possível implicação no processo de cicatrização da área infartada e parâmetros funcionais cardíacos. Objetivos. Diante dessas informações, nós objetivamos avaliar os efeitos da terapia ultrassônica transtorácica não-invasiva de baixa intensidade (NITUS) sobre a morfologia e função do músculo cardíaco de ratos infartados cirurgicamente após o 5° e 30° dia. Metodologia. Ratos machos Wistar (200-250g) foram pesados e divididos aleatoriamente em oito grupos com oito animais em cada grupo. Quatro grupos de animais foram submetidos à indução do IAM através da oclusão permanente da artéria coronária descendente anterior esquerda, sendo que dois destes grupos foram sacrificados no 5° dia após o IAM e as cinco aplicações da terapia ultrassônica e os outros dois grupos foram sacrificados no 30° dia após o IAM e as 5 aplicações da terapia ultrassônica. Quatro grupos de animais foram submetidos à cirurgia fictícia (Sham), sendo que dois destes grupos foram sacrificados no 5° dia após a cirurgia fictícia e as 5 aplicações da terapia ultrassônica e os outros dois grupos foram sacrificados no 30° dia após a cirurgia fictícia e as 5 aplicações da terapia ultrassônica. Os parâmetros da terapia ultrassônica foram freqüência de 1MHz, potência de 1W/cm2, modo pulsado e tempo de aplicação de 5 minutos. Para avaliação dos parâmetros funcionais foi realizado registros hemodinâmicos de todos os grupos e após a coleta dos registros os corações foram retirados para análise morfométrica a fim de avaliar a área da cicatriz do infarto. Os corações foram cortados em 4 fatias sendo retirados 3 cortes com espessura de 8 micrômetros da terceira fatia do ápice para a base, e estes foram corados com picrosírius. Foi utilizada uma câmera de vídeo para capturar uma área que contivesse todo o corte. A imagem era capturada com a utilização do programa AMCap e após a captura, esta era arquivada. A imagem arquivada era transferida para o programa ImageJ 1.42q/java no qual era marcada a área da cicatriz. De modo semelhante, era marcada toda a área da parede ventricular, para se obter a relação entre a área da cicatriz e a área total da parede ventricular. Resultados. No que concerne aos parâmetros hemodinâmicos, observamos que 30 dias após o IAM houve redução na pressão diastólica final (PDF) (mmHg) do grupo IAM+US quando comparado com grupo IAM (15±1.9 e 26±1.4; p<0.01 respectivamente). Não houve diferença significativa na área da cicatriz do infarto entre os grupos IAM e IAM+US no 5º. dia após infarto (31.6%±3.1% e 34.5%±1.6, respectivamente). Houve redução da área da cicatriz do infarto no grupo IAM+US quando comparado ao grupo IAM (21.5%±1.4% e 26.2%±1.7%; p<0.05, respectivamente) no 30º dia após IAM. Conclusão. A terapia com US dentro dos parâmetros estabelecidos, reduziu a área da cicatriz do infarto no grupo IAM+US (30 dias) bem como manteve a PDF dentro de valores fisiológicos, provavelmente por exercer influência nas fases inflamatória, proliferativa e de remodelamento, o que favorece um aumento na velocidade da resposta inflamatória por meio da mobilização de células inflamatórias como neutrófilos, macrófagos, ao mesmo tempo em que estimulou à degranulação dos mastócitos, bem como interferiu na mobilização leucocitária

Using NHANES oral health examination protocols as part of an esophageal cancer screening study conducted in a high-risk region of China

<p>Abstract</p> <p>Background</p> <p>The oral health status of rural residents in the People's Republic of China has not been extensively studied and the relationship between poor oral health and esophageal cancer (EC) is unclear. We aim to report the oral health status of adults participating in an EC screening study conducted in a rural high-risk EC area of China and to explore the relationship between oral health and esophageal dysplasia.</p> <p>Methods</p> <p>National Health and Nutrition Examination Survey (NHANES) oral health examination procedures and the Modified Gingival Index (MGI) were used in a clinical study designed to examine risk factors for esophageal cancer and to test a new esophageal cytology sampling device. This study was conducted in three rural villages in China with high rates of EC in 2002 and was a collaborative effort involving investigators from the National Institutes of Health and the Cancer Institute of the Chinese Academy of Medical Sciences.</p> <p>Results</p> <p>Nearly 17% of the study participants aged 40–67 years old were edentulous. Overall, the mean number of adjusted missing teeth (including third molars and retained dental roots) was 13.8 and 35% had 7 contacts or less. Women were more likely to experience greater tooth loss than men. The average age at the time of first tooth loss for those with no posterior functional contacts was approximately 41 years for men and 36 years for women. The mean DMFT (decayed, missing, and filled teeth) score for the study population was 8.5. Older persons, females, and individuals having lower educational attainment had higher DMFT scores. The prevalence of periodontal disease (defined as at least one site with 3 mm of attachment loss and 4 mm of pocket depth) was 44.7%, and 36.7% of the study participants had at least one site with 6 mm or more of attachment loss. Results from a parsimonious multivariate model indicate that participants with poor oral health wemore likely to have esophageal dysplasia (OR = 1.59; 95% CI 1.06, 2.39).</p> <p>Conclusion</p> <p>This report describes the first use of NHANES oral health protocols employed in a clinical study conducted outside of the United States. The extent and severity of poor oral health in this Chinese study group may be an important health problem and contributing factor to the prevalence of EC.</p