Analyses of high school band students\u27 and directors\u27 perceptions of verbal and nonverbal teaching behaviors

The purpose of this study was to document and explore the use and perception of verbal and nonverbal teaching behaviors of selected high school band directors. Participants were six successful high school band directors and members of their top-performing ensembles. Directors were videotaped during rehearsals. Videos were subsequently analyzed. Systematic observation data consisted of frequencies and percentages of conductor magnitude, filler use, and time spent on and off podium; frequency and time of each sequential pattern component; and instructional pacing. Directors and students viewed and rated video excerpts of their directors using 10-point Likert scales. Participants then completed a 22-item questionnaire, and selected students and all directors participated in interviews. Results showed that high school band directors were more disapproving than approving, mostly used complete sequential patterns, spent more time in student response than teacher talk, used fillers, spent a large amount of time moving, used more strict than expressive conducting gestures, had a mostly neutral facial expression, varied the pitch of their voice, spoke steadily with a normal voice volume, spent the most time looking at the score, and averaged longer mean student activity times than teacher activity times. Student evaluations showed that excerpts containing drill, all strict conducting, and more teacher talk than student response were rated lowest. Excerpts containing more or relatively equal amounts of student response and teacher talk, some expressive conducting, and 57% or lower levels of neutral facial expressions were rated highest. In two cases, a significant difference in excerpt ratings by principal instrument was found. Student interview results revealed a respect for director’s musical abilities and knowledge regardless of personal liking or disliking of director, a desire for more praise, and the concept of disapproving feedback as a “critique.” Director perceptions were similar but generally more critical than student perceptions. Directors rated excerpts containing high levels of neutral facial expressions and more or equal amounts of teacher talk than student response highest. They rated excerpts containing no feedback, more disapproval, or equal amounts of disapproval and approval lowest. Director perceptions did not consistently match observed events. Student perceptions were sometimes more accurate

Relations of Changes in Self-Efficacy, Exercise Attendance, Mood, and Perceived and Actual Physical Changes in Obese Women: Assessing Treatment Effects Using Tenets of Self- Efficacy Theory

Obese and sedentary women ( N = 76) initiated an exercise and nutrition program based on self-efficacy theory. Significant within-group improvements in body fat, waist size, and body mass index were found over 6 months. Changes in Physical Self-Concept (task self-efficacy) and Exercise Self-Efficacy (self-regulatory efficacy) scores, together, accounted for a significant portion of the variance in exercise session attendance, R2 = .24, F = 11.67, p \u3c .001, with both significantly contributing to the overall explained variance. Exercise attendance was significantly related to changes in Body Areas Satisfaction (β = .39) and Total Mood Disturbance (β = -.27) scores. Findings suggested a path from increased self-efficacy, to exercise attendance, to improvements in body satisfaction and overall mood. Suggestions for replication and extensions were given

Factors influencing the prescribing behaviour of independent prescriber optometrists:a qualitative study using the Theoretical Domains Framework

Purpose Whilst the number of independent prescriber (IP) optometrists in the United Kingdom is increasing, there is limited evidence describing the experiences of these individuals. The Theoretical Domains Framework (TDF) provides an evidence‐based approach to understand determinants of behaviour. This conceptual framework can enable mapping to the COM‐B behaviour change model and the wider Behaviour Change Wheel to develop interventions to optimise behaviour‐change and healthcare processes more systematically. The study aimed to use the TDF to identify the factors that influence independent prescribing behaviour, and to map these findings to the COM‐B system to elucidate the relevant intervention functions, in order to identify the support required by optometrist prescribers. Methods Using a qualitative design, semi‐structured interviews based on the TDF were undertaken with independent prescriber optometrists. Thematic analysis was used to identify themes inductively, which were then deductively mapped to the TDF and linked to the COM‐B. Results Sixteen participants (9 male, 7 female; median age 45 years, range 28–65 years), based in community (n = 10) and hospital (n = 6) settings, were interviewed. Eleven of the TDF domains were found to influence prescribing behaviour. Findings highlighted the need for good communication with patients (TDF domain: Skills, COM‐B: Capability); confidence (TDF domain: Beliefs about capabilities, COM‐B: Motivation); good networks and relationships with other healthcare professionals, e.g., general practitioners (TDF domain: Social influences, COM‐B: Opportunity; TDF domain: Social/professional role and identity, COM‐B: Motivation); the need for appropriate structure for remuneration (TDF domain: Reinforcement, COM‐B: Motivation; TDF domain: Social/professional role and identity, COM‐B: Motivation) and the provision of professional guidelines (TDF domain: Knowledge, COM‐B: Capability; TDF domain: Environmental context and resources, COM‐B Opportunity). Conclusions Having identified theory‐derived influencers on prescribing decisions by optometrists, the findings can be used to develop a structured intervention, such as a support package to help optimise prescribing by optometrists, with the ultimate goal of eye care quality improvement

Distinct fos-expressing neuronal ensembles in the ventromedial prefrontal cortex mediate food reward and extinction memories

In operant learning, initial reward-associated memories are thought to be distinct from subsequent extinction-associated memories. Memories formed during operant learning are thought to be stored in “neuronal ensembles.” Thus, we hypothesize that different neuronal ensembles encode reward- and extinction-associated memories. Here, we examined prefrontal cortex neuronal ensembles involved in the recall of reward and extinction memories of food self-administration.Wefirst trained rats to lever press for palatable food pellets for 7 d (1 h/d) and then exposed them to 0, 2, or 7 daily extinction sessions in which lever presses were not reinforced. Twenty-four hours after the last training or extinction session, we exposed the rats to either a short 15 min extinction test session or left them in their homecage (a control condition). We found maximal Fos (a neuronal activity marker) immunoreactivity in the ventral medial prefrontal cortex of rats that previously received 2 extinction sessions, suggesting that neuronal ensembles in this area encode extinction memories. We then used the Daun02 inactivation procedure to selectively disrupt ventral medial prefrontal cortex neuronal ensembles that were activated during the 15 min extinction session following 0 (no extinction) or 2 prior extinction sessions to determine the effects of inactivating the putative food reward and extinction ensembles, respectively, on subsequent nonreinforced food seeking 2 d later. Inactivation of the food reward ensembles decreased food seeking, whereas inactivation of the extinction ensembles increased food seeking. Our results indicate that distinct neuronal ensembles encoding operant reward and extinction memories intermingle within the same cortical area

MCT1 in Invasive Ductal Carcinoma: Monocarboxylate Metabolism and Aggressive Breast Cancer.

Introduction: Monocarboxylate transporter 1 (MCT1) is an importer of monocarboxylates such as lactate and pyruvate and a marker of mitochondrial metabolism. MCT1 is highly expressed in a subgroup of cancer cells to allow for catabolite uptake from the tumor microenvironment to support mitochondrial metabolism. We studied the protein expression of MCT1 in a broad group of breast invasive ductal carcinoma specimens to determine its association with breast cancer subtypes and outcomes. Methods: MCT1 expression was evaluated by immunohistochemistry on tissue micro-arrays (TMA) obtained through our tumor bank. Two hundred and fifty-seven cases were analyzed: 180 cases were estrogen receptor and/or progesterone receptor positive (ER+ and/or PR+), 62 cases were human epidermal growth factor receptor 2 positive (HER2+), and 56 cases were triple negative breast cancers (TNBC). MCT1 expression was quantified by digital pathology with Aperio software. The intensity of the staining was measured on a continuous scale (0-black to 255-bright white) using a co-localization algorithm. Statistical analysis was performed using a linear mixed model. Results: High MCT1 expression was more commonly found in TNBC compared to ER+ and/or PR+ and compared to HER-2+ (p \u3c 0.001). Tumors with an in-situ component were less likely to stain strongly for MCT1 (p \u3c 0.05). High nuclear grade was associated with higher MCT1 staining (p \u3c 0.01). Higher T stage tumors were noted to have a higher expression of MCT1 (p \u3c 0.05). High MCT1 staining in cancer cells was associated with shorter progression free survival, increased risk of recurrence, and larger size independent of TNBC status (p \u3c 0.05). Conclusion: MCT1 expression, which is a marker of high catabolite uptake and mitochondrial metabolism, is associated with recurrence in breast invasive ductal carcinoma. MCT1 expression as quantified with digital image analysis may be useful as a prognostic biomarker and to design clinical trials using MCT1 inhibitors

Non-fatal injuries in rural Burkina Faso amongst older adults, disease burden and health system responsiveness:a cross-sectional household survey

OBJECTIVES: This study aimed to evaluate the epidemiology of injury as well as patient-reported health system responsiveness following injury and how this compares with non-injured patient experience, in older individuals in rural Burkina Faso. DESIGN: Cross-sectional household survey. Secondary analysis of the CRSN Heidelberg Ageing Study dataset. SETTING: Rural Burkina Faso. PARTICIPANTS: 3028 adults, over 40, from multiple ethnic groups, were randomly sampled from the 2015 Nouna Health and Demographic Surveillance Site census. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcome was incidence of injury. Secondary outcomes were incidence of injury related disability and patient-reported health system responsiveness following injury. RESULTS: 7.7% (232/3028) of the population reported injury in the preceding 12 months. In multivariable analyses, younger age, male sex, highest wealth quintile, an abnormal Generalised Anxiety Disorder score and lower Quality of Life score were all associated with injury. The most common mechanism of injury was being struck or hit by an object, 32.8%. In multivariable analysis, only education was significantly negatively associated with odds of disability (OR 0.407, 95% CI 0.17 to 0.997). Across all survey participants, 3.9% (119/3028) reported their most recent care seeking episode was following injury, rather than for another condition. Positive experience and satisfaction with care were reported following injury, with shorter median wait times (10 vs 20 min, p=0.002) and longer consultation times (20 vs 15 min, p=0.002) than care for another reason. Injured patients were also asked to return to health facilities more often than those seeking care for another reason, 81.4% (95% CI 73.1% to 87.9%) vs 54.8% (95% CI 49.9% to 53.6%). CONCLUSIONS: Injury is an important disease burden in this older adult rural low-income and middle-income country population. Further research could inform preventative strategies, including safer rural farming methods, explore the association between adverse mental health and injury, and strengthen health system readiness to provide quality care

Multisystem inflammatory syndrome in adults: A case in a previously healthy adult

A 25-year-old previously healthy female presented to the emergency department (ED) with 5 days of rash, fevers, shortness of breath, and generalized weakness. She had presented to another ED 4 days previously and noted that her rash had improved, but her other symptoms were worsening. She had recovered from COVID-19, confirmed by positive antigen test 5 weeks prior. On ED arrival, she was afebrile and persistently tachycardic to a rate of 120 beats per minute, despite aggressive fluid resuscitation with 3L of IV crystalloid. She was found to have a troponin elevated to 0.06 ng/mL in addition to a d-dimer elevated to 1.42 mcg/mL FEU. She was admitted to the hospital where she developed hypotension requiring vasopressor support and was admitted to the intensive care unit (ICU). A transthoracic echocardiogram revealed a newly reduced ejection fraction of 31%. She was diagnosed with multisystem inflammatory syndrome in adults (MIS-A). The patient received intravenous immunoglobulin and methylprednisolone 60 mg Q12 hours while admitted. She was discharged on hospital day 3 with a prednisone taper and is currently doing well at her most recent follow-up with infectious disease