Endurance run increases circulating IL-6 and IL-1ra but downregulates ex vivo TNF-a and IL-1ß production

Contains fulltext : 4818.pdf (publisher's version ) (Open Access

Professionalising primary school teachers in guiding inquiry-based learning

This paper reports a pretest-posttest study about the impact of a teacher professional development (TPD) programme on primary school teachers’ knowledge of and attitude towards inquiry-based learning. A pedagogical framework of inquiry phases and domains of scientific knowledge combined with hard and soft scaffolds formed the basis for the TPD programme. A total of 59 teachers were divided between the experimental group, which participated in the TPD programme, and a control group. We measured the teachers’ subject matter knowledge (SMK) of the conceptual, epistemic, social, and procedural domain before and after the TPD programme by means of different questionnaires. In addition, we measured their knowledge of how to support their pupils during the inquiry process (PCK) and their attitude towards inquiry-based learning. The results show that our TPD programme improved teachers’ conceptual and social SMK, PCK, and attitude. Our study implicates that scaffolding different domains of scientific knowledge during the inquiry cycle is a valuable component of TPD in inquiry-based learning

High aldosterone, hypertension and adrenal adenoma in a 36-year-old pregnant patient: Is this primary aldosteronism?

A 36-year-old woman presented at 16 weeks’ gestation with severe hypertension. In comparison to the non-pregnant reference normal ranges, potassium was 3.1-3.9 mmol/L, aldosterone 2570-3000 pmol/L (N 250-2885) renin was unsuppressed (24-76.4 ng/L (N1.7–23.9)), with aldosterone to renin ratios in the reference range. An adrenal MRI scan demonstrated a 1.8 × 1.4 cm left adrenal adenoma. Primary aldosteronism was strongly suspected and surgery considered. However, she was managed conservatively with labetalol and modified-release nifedipine with no obstetric complications. Post-partum blood pressures remained elevated with normal aldosterone (539 pmol/L), unsuppressed renin (5.2 ng/L) and normal aldosterone-to-renin ratio (104 (N \u3c 144)). Suspected primary hyperaldosteronism is challenging to investigate and manage in pregnancy. The accepted screening and confirmatory tests are either contraindicated or not validated in pregnancy. Pregnancy has significant effects on the renin-angiotensin-aldosterone pathway leading to physiologic elevations in both aldosterone and renin. While primary hyperaldosteronism has been associated with poor pregnancy outcomes, optimal management in pregnancy is not clearly established

Impact of acute otitis media clinical practice guidelines on antibiotic and analgesic prescriptions: a systematic review

BACKGROUND: Clinical practice guidelines focusing on judicious use of antibiotics for childhood acute otitis media (AOM) have been introduced in many countries around the world. OBJECTIVE: To systematically review the effects of these guidelines on the prescription of antibiotics and analgesics for children with AOM. METHODS: Systematic searches of PubMed, Embase and Cochrane Library from inception to 6 June 2017 using broad search terms. Studies specifically aimed at evaluating the effects of introduction of national AOM practice guidelines on type of antibiotic and/or analgesic prescriptions were included, irrespective of design, setting or language. The Risk Of Bias In Non-randomized Studies of Interventions tool was used to assess risk of bias. RESULTS: Of 411 unique records retrieved, seven studies conducted in six different countries (France, Italy, Spain, Sweden, UK and USA (twice)) compared data before and after guideline introduction. All studies had an observational design, using longitudinal data of children aged under 15 years (n=200-4.6 million) from either routine care, insurance databases or electronic surveys. Risk of bias of all studies was judged serious to critical.Of the five studies reporting on antibiotic prescription rates, three showed a decline of 5%-12% up to 3 years after guideline introduction and two found no or negligible effect. In one US study, the initial 9% decline decreased to 5% after 4-6 years. The recommended first choice antibiotic was prescribed more frequently (9%-58% increase) after guideline introduction in four out of five studies reporting on this outcome. Analgesic prescription rates for AOM were reported in one US study and increased from 14% to 24% after guideline introduction. CONCLUSION: Based upon what is published, the effects of introduction of national clinical practice guidelines on antibiotic and analgesic prescribing for children with AOM seem modest at the most. REGISTRATION: PROSPERO: CRD42016050976

(Onder)wijs in techniek? : onderzoek naar de houding en praktijk van leraren ten aanzien van onderwijs in techniek

Al jaren wordt van alles gedaan om techniek een betere plaats in het basisonderwijs te geven. Kosten noch moeite zijn gespaard om leraren te enthousiasmeren en te scholen, om materialen te ontwikkelen en om scholen te ondersteunen bij het vormgeven van onderwijs in techniek. Maar hoe staat het er eigenlijk voor? Hoe denkt de gemiddelde leraar over onderwijs in techniek? Is hij of zij het belangrijker gaan vinden, gemakkelijker, en leuker? En wat kunnen 'externe' aanbieders doen om leraren in hun behoeften te ondersteunen? Op aanvraag van Vonk, vereniging voor techniek in het primair onderwijs en Techniektalent.nu is in het kader van het Kortlopend Onderwijsonderzoek getracht op deze vragen een antwoord te geven. Door middel van interviews en een uitgebreide online vragenlijst zijn de meningen van directeuren en leraren in het hele land verzameld. Aan bod komen meningen over het belang van onderwijs in techniek, over het aandeel techniek in het huidige onderwijs, over competenties van leraren ten aanzien van onderwijs in techniek en over de meerwaarde van activiteiten en materialen die door derden worden aangeboden aan het basisonderwijs. Ook is gekeken aan welke voorwaarden voor het implementeren van techniek directeuren en leraren vinden dat op hun school wordt voldaan. De bevindingen en daaruit afgeleide aanbevelingen staan in dit boekje beschreven, kort en bondig voor de lezer die overzicht wil krijgen, en met de mogelijkheid om dieper te graven voor wie echt wil weten hoe het zit

Dynamic response of cerebral blood flow to insulin-induced hypoglycemia

The dynamics of cerebral blood flow (CBF) at the onset of hypoglycemia may play a key role in hypoglycemia unawareness; however, there is currently a paucity of techniques that can monitor adult CBF with high temporal resolution. Herein, we investigated the use of diffuse correlation spectroscopy (DCS) to monitor the dynamics of CBF during insulin-induced hypoglycemia in adults. Plasma glucose concentrations, cortisol levels, and changes in CBF were measured before and during hypoglycemia in 8 healthy subjects. Cerebral blood flow increased by 42% following insulin injection with a delay of 17 ± 10 min, while the onset of hypoglycemia symptoms was delayed by 24 ± 11 min. The findings suggest that the onset of CBF increments precedes the appearance of hypoglycemia symptoms in nondiabetic subjects with normal awareness to hypoglycemia, and DCS could be a valuable tool for investigating the role of CBF in hypoglycemia unawareness

Inflammatory response in the acute phase of deep vein thrombosis

AbstractObjective: Deep vein thrombosis (DVT) is a multifactorial disease. Recently, inflammation has been suggested as a risk factor for DVT. The question is whether inflammation is a cause of venous thrombosis or rather a result of the thrombotic process. Methods: We studied the inflammatory response in the acute phase of DVT with interleukin-6, interleukin-8, and C-reactive protein (CRP) as inflammatory markers. Plasma concentrations were measured on the day of admission (day 0) in 40 patients with acute DVT confirmed with phlebography and in 33 patients with clinical suspicion of DVT but negative phlebography results (controls). In patients with DVT, inflammatory markers were also examined on five subsequent days. Results: On day 0, the median concentrations in plasma of interleukin-6, interleukin-8, and CRP were 15.0 pg/mL (range, <3 to 70 pg/mL), 7.0 pg/mL (range, <3 to 76 pg/mL), 37.5 mg/L (range, <7 to 164 mg/L), respectively, in the patient group and less than 3 pg/mL (range, <3 to 11 pg/mL; P <.001), 6.0 pg/mL (range, <3 to 52 pg/mL; P =.08), and 5.0 pg/L (range, <7 to 66 pg/L; P <.001), respectively, in the controls. During the next days, interleukin-6 concentration showed a gradual decline in patients with DVT from 15.0 to 5.5 pg/mL (P <.001), interleukin-8 concentration was relatively constant in time, and CRP concentration declined from 37.5 to 21.5 mg/L (P =.01). Conclusion: Our data show an apparent inflammatory response with highest measured concentrations of inflammatory markers on the day of admission and a subsequent decrease during the next days. This response supports the hypothesis that elevated inflammatory markers are a result rather than a cause of venous thrombosis. (J Vasc Surg 2002;35:701-6.