Media Literacy Education

This study offers an analysis of media literacy practices and techniques used at local public middle and high schools in Colorado. Media literacy is an emerging field in education that blends literacy skills such as critical analysis and evaluation with an inquiry-based questioning process that encourages students to process information using cognitive, moral, aesthetic and emotional dimensions. This inquiry-based process is not a new educational approach; it has been used to critically evaluate literature for centuries. However, media literacy scholars argue that applying inquiry-based approaches can enhance learning across all grades and content levels by applying new methodologies. The literature reviewed suggests that the effectiveness of media literacy approaches in schools is influenced by social factors. Potter (2001) argued that students bring their own background and perspectives to the learning environment and for this reason, he believes media literacy must be measured based on a continuum and not a category; because there are different degrees of media literacy based on the strength of perspective and knowledge structures. According to Potter, people\u27s regular routines are largely conditioned by the media, enabling producers of mediated messages to shape and frame what is important. A 2003 empirical study by Hobbs and Frost found that an experimental media literacy curriculum can be used to enhance traditional literacy skills and meet traditional educational goals. The authors found that students in the media literacy treatment group scored higher than the control group in reading comprehension and viewing comprehension and recognized the longer paragraphs and fewer spelling errors of the treatment group as representing superior development in writing skills. The overall analysis of the non-fiction informational messages showed that the media literacy treatment group was better prepared to analyze media messages in regard to construction techniques, point of view, omitted information, comparison and contrast and identification of message purpose. Thoman and Jolls (2004) promote the consideration of key questions and an inquiry-based approach in analyzing and critically understanding media messages. The scholars argue that using key questions to evaluate messages promotes higher order thinking by identifying concepts and fallacies within mediated messages, focusing on the learning process and not the content. Although the question set was designed to be used with media content, the authors define media very broadly to include books and other materials prevalent in classrooms. According to Thoman and Jolls (2004) the inquiry process calls for multiple interpretations of messages, which requires observation and critical thinking. These skills can illuminate bias, challenge stereotypes and uncover the motivations of producers, exposing implicit and explicit meanings. According to the scholars, the habitual application of an inquiry-based line of questioning encourages students to think for themselves, helping them control the interpretation of what they see or hear. The literature reviewed established that media literacy is a fervent topic amongst education scholars and inquiry-based approaches can prepare and empower students to live in an information-rich world. However, little to no research evaluates local practices in Colorado compared with national media literacy initiatives, and I established my research questions based on this gap. The goals of this study were twofold: First, archival data from national media literacy organizations were researched and evaluated to outline some best practices in introducing media literacy into any curriculum. State and district documents designed as a framework for the implementation of technology and information literacy were evaluated for key terms and concepts. This evaluation suggested that although some concepts overlap between information and media literacy, such as critical evaluation, independent learning, and information analysis, there is also a gap between these two concepts. Important media literacy concepts including discussion, creation, and production are missing from the information literacy skill sets. One possibility on the district level is defining information literacy skills to the same degree that technology literacy skills are defined to help promote an inquiry-based approach. Evaluating information literacy separately from technology takes the focus off technology and establishes measurable concepts and definitions of information literacy. In addition, one might think about integrating key questions as a framework to promoting critical evaluation of all subject matter. This includes questions like: who created the message; what is communicated or implied by the message; when was the message created; where is the message being directed; how did the producers use creative techniques to capture attention; and why is this message being sent. Some teachers reported already using these questions and many agreed that this type of inquiry increases students\u27 overall literacy. Using the key questions as a framework for classifying information literacy might help characterize information skills. The archival data, in conjunction with Potter\u27s (2001) theoretical concepts of media literacy development, were used to create a survey issued to all middle and high school teachers in the Denver and Eagle County districts. The survey was constructed under the assumption that teachers are already using media content in their classrooms. The purpose of the questions was to understand what media resources are available to teachers and how they apply these resources to their particular curriculum. The survey questions teachers about their perceptions of media use and discussion in the classroom. Teachers were surveyed about the benefits and challenges of using media in the classroom, including self-censorship to avoid negative backlash. Perceptions were measured by asking scaled questions that assess current practices, available resources, and inhibiting factors. Teachers\u27 experience and perceptions of media use and discussion was evaluated within the context of the Colorado Information Literacy Standards, specific district technology and information literacy plans, and national approaches to integrating media literacy education. In an effort to position this project in the context of larger educational changes, the quantitative and qualitative responses from the survey offer specific examples of how local teachers use media to help students learn and understand differently. The survey results revealed that although media is perceived positively by teachers as a teaching tool, respondents were more likely to consider the cognitive dimension of information and media analysis. Employing the use of key questions to frame both mediated and non-mediated information addresses the moral, emotional, and aesthetic dimensions of media literacy, broadening student perspectives and knowledge structures. This critical evaluation process takes the focus off media content, and emphasizes the process by which students acquire information. Participants suggested that they use media most often to encourage participation and teach different perspectives, and the quantitative survey responses indicated that a lack of resources is the most common reason teachers avoid using and discussing media content in their classrooms. This is why the media literacy approaches are effective: They do not require any technology resources. Qualitative, open-ended survey responses revealed that many teachers also felt inadequately trained to use technology in the classroom. For this reason, schools might consider creating an orientation for teachers about the technology resources available in their schools. Successful orientations might cover the set up, use and disassembly of technology resources and could be taught by mentor teachers who are competent users of technology and comfortable using it as a teaching tool. Finally, constructing an inventory of available technology in each school would offer teachers a tangible reference list and could also facilitate the maintenance of technology resources. Significant differences were discovered between the districts regarding their agreement with statements about encouraging debate in relation to controversial content. Also, while most teachers listed a lack of resources as their main reason for avoiding information use, Eagle County teachers reported that inappropriate content inhibited their media use most often. For this reason, local districts might consider more critical perspectives when examining and teaching with media content. By focusing on critically evaluating media content, teachers stress inquiry-based learning skills and not media subject matter For example, defining media as an information source and outlining other information sources accessed by students including textbooks and traditional non-mediated materials helps students develop awareness of credibility and bias in information sources. This may include an understanding of the role of media industries as a unique information source within a democracy that is governed by distinct rules and regulations. One possibility the districts might consider is creating a resource center for teachers who wish to use media literacy approaches in their classrooms, which will facilitate the availability of resources. This could be set up in the library or faculty lounge, and promotes sharing and compilation of useful resources. Establishing a media literacy library might encourage teachers unfamiliar with media literacy approaches to participate. The development of a resource center could encourage staff development programming to more regularly consider media use and discussion. It also gives teachers access to appropriate media content. Finally, the districts might consider outlining the specific technology skills expected of students in the district documents, offering a reference list that can serve as a measurement tool. Although this doesn\u27t fall into the realm of this research, it is of interest that in Eagle County, the staff and teacher skills are specifically defined, while student skills are not. DPS did not list technology skills expected of staff or students. Establishing a framework of what skills are expected of students at each grade level provides the district with measurable concepts that can be evaluated and updated based on emerging technology and student needs. By taking the focus off of technology and technology-based skills, the district plans could shift gears to an inquiry-based framework, which would minimize the lack of resources or technology proficiency reported by teachers. By emphasizing the importance of information skills and distinguishing them clearly from technology-based skills, the Denver and Eagle County districts would encounter less difficulty in securing staff proficiency. These recommendations are based on the gaps that emerged in the quantitative and qualitative survey data. These recommendations synthesize the overlaps and identify gaps between media and information literacy skill sets, and came to fruition based on the voices of Colorado teachers. They can be implemented in any school or grade level. Although media literacy approaches focus on media as an information source, the 12 Basic Principles define media broadly to include many communication forms from books and magazines to recorded music and the Internet. For this reason, information literacy skills could be developed through the application of media literacy approaches that do not overlap with themes prevalent in the CILS. The findings of this study reveal a need for both district documents to be restructured to define separate goals, objectives, strategies and tactics for the technology and information literacy components of the plans. The survey response rate (17 %) was a limiting factor in this research. The diversity of size in the two districts researched affected the demographic diversity of the sample, resulting in a higher percentage of respondents from DPS. Further research is needed to determine whether the significant differences between the two districts apply to other regions of the state. Although the aims of this research focused on teacher perceptions and practices, future research might measure the affects on students. Implementing an experimental media literacy curriculum similar to that conducted by Hobbs and Frost (2003) on a local level would be an effective way to measure whether the integration of media literacy approaches continues to enhance student literacy. Advances in technology have caused a shift in education, requiring that students gain proficiency in computer and technology skills; however school resources are a limiting factor. By expanding the skill sets to include media literacy, schools can cultivate the critical thinking skills necessary for students to succeed in the 21st century, both independently and in the classroom

Home and Online Management and Evaluation of Blood Pressure (HOME BP) using a digital intervention in poorly controlled hypertension: randomised controlled trial

Objective: The HOME BP (Home and Online Management and Evaluation of Blood Pressure) trial aimed to test a digital intervention for hypertension management in primary care by combining self-monitoring of blood pressure with guided self-management. Design: Unmasked randomised controlled trial with automated ascertainment of primary endpoint. Setting: 76 general practices in the United Kingdom. Participants: 622 people with treated but poorly controlled hypertension (>140/90 mm Hg) and access to the internet. Interventions: Participants were randomised by using a minimisation algorithm to self-monitoring of blood pressure with a digital intervention (305 participants) or usual care (routine hypertension care, with appointments and drug changes made at the discretion of the general practitioner; 317 participants). The digital intervention provided feedback of blood pressure results to patients and professionals with optional lifestyle advice and motivational support. Target blood pressure for hypertension, diabetes, and people aged 80 or older followed UK national guidelines. Main outcome measures: The primary outcome was the difference in systolic blood pressure (mean of second and third readings) after one year, adjusted for baseline blood pressure, blood pressure target, age, and practice, with multiple imputation for missing values. Results: After one year, data were available from 552 participants (88.6%) with imputation for the remaining 70 participants (11.4%). Mean blood pressure dropped from 151.7/86.4 to 138.4/80.2 mm Hg in the intervention group and from 151.6/85.3 to 141.8/79.8 mm Hg in the usual care group, giving a mean difference in systolic blood pressure of −3.4 mm Hg (95% confidence interval −6.1 to −0.8 mm Hg) and a mean difference in diastolic blood pressure of −0.5 mm Hg (−1.9 to 0.9 mm Hg). Results were comparable in the complete case analysis and adverse effects were similar between groups. Within trial costs showed an incremental cost effectiveness ratio of £11 ($15, €12; 95% confidence interval £6 to £29) per mm Hg reduction. Conclusions: The HOME BP digital intervention for the management of hypertension by using self-monitored blood pressure led to better control of systolic blood pressure after one year than usual care, with low incremental costs. Implementation in primary care will require integration into clinical workflows and consideration of people who are digitally excluded. Trial registration: ISRCTN13790648

A blood atlas of COVID-19 defines hallmarks of disease severity and specificity.

Treatment of severe COVID-19 is currently limited by clinical heterogeneity and incomplete description of specific immune biomarkers. We present here a comprehensive multi-omic blood atlas for patients with varying COVID-19 severity in an integrated comparison with influenza and sepsis patients versus healthy volunteers. We identify immune signatures and correlates of host response. Hallmarks of disease severity involved cells, their inflammatory mediators and networks, including progenitor cells and specific myeloid and lymphocyte subsets, features of the immune repertoire, acute phase response, metabolism, and coagulation. Persisting immune activation involving AP-1/p38MAPK was a specific feature of COVID-19. The plasma proteome enabled sub-phenotyping into patient clusters, predictive of severity and outcome. Systems-based integrative analyses including tensor and matrix decomposition of all modalities revealed feature groupings linked with severity and specificity compared to influenza and sepsis. Our approach and blood atlas will support future drug development, clinical trial design, and personalized medicine approaches for COVID-19

Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo

Stakeholders’ perspectives on clinical trial acceptability and approach to consent within a limited timeframe: a mixed methods study

Objectives The Bronchiolitis Endotracheal Surfactant Study (BESS) is a randomised controlled trial to determine the efficacy of endo-tracheal surfactant therapy for critically ill infants with bronchiolitis. To explore acceptability of BESS, including approach to consent within a limited time frame, we explored parent and staff experiences of trial involvement in the first two bronchiolitis seasons to inform subsequent trial conduct.Design A mixed-method embedded study involving a site staff survey, questionnaires and interviews with parents approached about BESS.Setting Fourteen UK paediatric intensive care units.Participants Of the 179 parents of children approached to take part in BESS, 75 parents (of 69 children) took part in the embedded study. Of these, 55/69 (78%) completed a questionnaire, and 15/69 (21%) were interviewed. Thirty-eight staff completed a questionnaire.Results Parents and staff found the trial acceptable. All constructs of the Adapted Theoretical Framework of Acceptability were met. Parents viewed surfactant as being low risk and hoped their child’s participation would help others in the future. Although parents supported research without prior consent in studies of time critical interventions, they believed there was sufficient time to consider this trial. Parents recommended that prospective informed consent should continue to be sought for BESS. Many felt that the time between the consent process and intervention being administered took too long and should be ‘streamlined’ to avoid delays in administration of trial interventions. Staff described how the training and trial processes worked well, yet patients were missed due to lack of staff to deliver the intervention, particularly at weekends.Conclusion Parents and staff supported BESS trial and highlighted aspects of the protocol, which should be refined, including a streamlined informed consent process. Findings will be useful to inform proportionate approaches to consent in future paediatric trials where there is a short timeframe for consent discussions.Trial registration number ISRCTN11746266

Fracture fixation in the operative management of hip fractures (FAITH): an international, multicentre, randomised controlled trial

Background Reoperation rates are high after surgery for hip fractures. We investigated the effect of a sliding hip screw versus cancellous screws on the risk of reoperation and other key outcomes. Methods For this international, multicentre, allocation concealed randomised controlled trial, we enrolled patients aged 50 years or older with a low-energy hip fracture requiring fracture fixation from 81 clinical centres in eight countries. Patients were assigned by minimisation with a centralised computer system to receive a single large-diameter screw with a side-plate (sliding hip screw) or the present standard of care, multiple small-diameter cancellous screws. Surgeons and patients were not blinded but the data analyst, while doing the analyses, remained blinded to treatment groups. The primary outcome was hip reoperation within 24 months after initial surgery to promote fracture healing, relieve pain, treat infection, or improve function. Analyses followed the intention-to-treat principle. This study was registered with ClinicalTrials.gov, number NCT00761813. Findings Between Mar