The proof of the pudding is in the eating? Implementation of cooperative learning:Differences in teachers’ attitudes and beliefs

In the current study differences between primary school teachers classified as high-performing in their implementation of cooperative learning (CL) in their classrooms and teachers who were less successful in implementing cooperative learning were investigated. The levels of implementation of cooperative learning differed significantly between teachers, especially in teaching students the needed cooperative behaviours. Based on semi-structured interviews, it was found that low-performing CL teachers struggle more with student behaviour during cooperative learning, while high-performing CL teachers feel more able to regulate student behaviour. We concluded that teachers who differed in their teacher performance of implementation of cooperative learning also differed in their attitudes and beliefs about this approach. An integrated model on professional development and teacher change is proposed to interpret the results of differences between teachers. This model shows that positive attitudes and beliefs before implementation, but also experiencing positive student outcomes (incl. positive student behaviour) during implementation are important factors in making cooperative learning successful in practice. We suggest that teachers should be prevented from entering a negative spiral in which they experience student behaviour during cooperative learning only as difficult and, therefore, do not succeed in improving students’ cognitive and behavioural outcomes

TWEAK and its receptor Fn14 in the synovium of patients with rheumatoid arthritis compared to psoriatic arthritis and its response to tumour necrosis factor blockade

Objective: To investigate the expression of tumour necrosis factor (TNF)-like weak inducer of apoptosis (TWEAK) and its receptor fibroblast growth factor inducible 14 (Fn14) in the inflamed synovium of patients with arthritis, as TWEAK blockade has been observed to have a beneficial effect in an animal model of rheumatoid arthritis (RA). Methods: Synovial tissue (ST) biopsies were obtained from 6 early, methotrexate-naive patients with RA as well as 13 patients with RA and 16 patients with psoriatic arthritis (PsA) who were matched for treatment and disease duration. Serial ST samples were obtained from a separate cohort of 13 patients with RA before and after infliximab treatment. TWEAK and Fn14 expression was evaluated by immunohistochemistry and digital image analysis. Results: TWEAK and Fn14 were clearly expressed in ST of patients with RA and PsA. TWEAK expression was significantly higher in RA (sub) lining samples compared to PsA (p = 0.005 and p = 0.014, respectively), but Fn14 expression was comparable. Double immunofluorescence showed TWEAK and Fn14 expression on fibroblast-like synoviocytes and macrophages, but not T cells. Of interest, persistent TWEAK and Fn14 expression was found after anti-TNF therapy. Conclusions: TWEAK and Fn14 are abundantly expressed in the inflamed synovium of patients with RA and PsA. This raises the possibility that blocking TWEAK/Fn14 signalling could be of therapeutic benefit in inflammatory arthriti

Анализ влияния глобальных угроз на устойчивое развитие стран и регионов мира с помощью байесовских сетей доверия

Застосовано байєсівські мережі довіри для встановлення на якісному рівні причинно-наслідкових залежностей між глобальними загрозами і індексами сталого розвитку. Використання запропонованих в роботі методів синтезу мережі довіри та узагальнення результатів моделвання дозволило отримати цілісну інтерпетацію процесів впливу глобальних загроз на сталий розвиток країн і регіонів світу.Belief Bayesian Networks are used to establish the qualitative cause-effect relationships between global threats and indices of sustainable development. The method of belief network synthesis and the method of final results generalization were proposed. This made it possible to obtain a holistic understanding of effects of global threats to the sustainable development of countries and regions of the world

Long-term functional outcome of distal radius fractures is associated with early post-fracture bone stiffness of the fracture region:An HR-pQCT exploratory study

\u3cp\u3eIdentifying determinants of long-term functional outcome after a distal radius fracture is challenging. Previously, we reported on the association between early HR-pQCT measurements and clinical outcome 12 weeks after a conservatively treated distal radius fracture. We extended the follow-up and assessed functional outcome after two years in relation to early HR-pQCT derived bone parameters. HR-pQCT scans of the fracture region were performed in 15 postmenopausal women with a distal radius fracture at 1-2 (baseline), 3-4 weeks and 26 months post-fracture. Additionally, the contralateral distal radius was scanned at baseline. Bone density, micro-architecture parameters and bone stiffness using micro-finite element analysis (μFEA) were evaluated. During all visits, wrist pain and function were assessed using the patient-rated wrist evaluation questionnaire (PRWE), quantifying functional outcome with a score between 0 and 100. Two-year PRWE was associated with torsional and bending stiffness 3-4 weeks post-fracture (R2: 0.49, p = 0.006 and R2: 0.54, p = 0.003, respectively). In contrast, early micro-architecture parameters of the fracture region or contralateral bone parameters did not show any association with long-term outcome. This exploratory study indicates that HR-pQCT with μFEA performed within four weeks after a distal radius fracture captures biomechanical fracture characteristics that are associated with long-term functional outcome and therefore could be a valuable early outcome measure in clinical trials and clinical practice.\u3c/p\u3

Seeing blue: negotiating the politics of Avatar media activism

This thesis examines how the Hollywood blockbuster Avatar (2009) has been taken-up in media activism directed towards Indigenous struggles against imperialism. It assumes the importance of locating this phenomenon within the discursive and material regimes that mediate, enable, and constrain it. I therefore offer a contextualised analysis of the film and media relating to its appropriation, which focuses on the representational practices and structural mechanisms that inform the production, circulation, and reception of the texts. This approach emphasises the tensions and contradictions that underpin activists’ relationship to the media they mobilise. Such contradictions are particularly apparent in relation to the politics of race that shape Avatar, the Indigenous activism that references it, and the media regimes that make this possible. The very forces that marginalise Indigenous voices empower auteur James Cameron to speak on their behalf and to be heard. Activists must also negotiate the tension between co-opting media spectacle and being commercialised as spectacle. However, refusing a simple critique of the representations activists deploy as media spectacles, I argue for a model that foregrounds the alliances that they seek to engender. Drawing on the work of feminist scholars Oliver (2001) and Deslandes (2010), I signal a theoretical approach that focuses on how the mediated spectator relates to such representations and insists on the spectator’s responsibility to respond. Acknowledging that the tensions that animate Avatar media activism can be both constrictive and creative, this project seeks a model that maximises the potential for the latter. It thus resists the paralysis of activism that can come with critiquing how we fight for the world we imagine

Nationwide implementation of a decision aid on vaginal birth after cesarean:a before and after cohort study

Woman with a history of a previous cesarean section (CS) can choose between an elective repeat CS (ERCS) and a trial of labor (TOL), which can end in a vaginal birth after cesarean (VBAC) or an unplanned CS. Guidelines describe women's rights to make an informed decision between an ERCS or a TOL. However, the rates of TOL and vaginal birth after CS varies greatly between and within countries. The objective of this study is to asses nation-wide implementation of counselling with a decision aid (DA) including a prediction model, on intended delivery compared to care as usual. We hypothesize that this may result in a reduction in practice variation without an increase in cesarean rates or complications. In a multicenter controlled before and after cohort study we evaluate the effect of nation-wide implementation of a DA. Practice variation was defined as the standard deviation (SD) of TOL percentages. A total of 27 hospitals and 1,364 women were included. A significant decrease was found in practice variation (SD TOL rates: 0.17 control group vs. 0.10 intervention group following decision aid implementation, p=0.011). There was no significant difference in the ERCS rate or overall CS rates. A 21% reduction in the combined maternal and perinatal adverse outcomes was seen. Nationwide implementation of the DA showed a significant reduction in practice variation without an increase in the rate of cesarean section or complications, suggesting an improvement in equality of care

Topical Imiquimod Treatment of High-grade Cervical Intraepithelial Neoplasia (TOPIC-3):A Nonrandomized Multicenter Study

Topical imiquimod could be an alternative, noninvasive, treatment modality for high-grade cervical intraepithelial neoplasia (CIN). However, evidence is limited, and there are no studies that compared treatment effectiveness and side effects of topical imiquimod cream to standard large loop excision of the transformation zone (LLETZ) treatment. A multi-center, nonrandomized controlled trial was performed among women with a histologic diagnosis of CIN 2/3. Women were treated with either vaginal imiquimod (6.25 mg 3 times weekly for 8 to 16 wk) or LLETZ according to their own preference. Successful treatment was defined as the absence of high-grade dysplasia at the first follow-up interval after treatment (at 20 wk for the imiquimod group and at 26 wk for the LLETZ group). Secondary outcome measures were high-risk human papillomavirus (hrHPV) clearance, side effects, and predictive factors for successful imiquimod treatment. Imiquimod treatment was successful in 60% of women who completed imiquimod treatment and 95% of women treated with LLETZ. hrHPV clearance occurred in 69% and 67% in the imiquimod group and LLETZ group, respectively. This study provides further evidence on topical imiquimod cream as a feasible and safe treatment modality for high-grade CIN. Although the effectiveness is considerably lower than LLETZ treatment, imiquimod treatment could prevent initial surgical treatment in over 40% of women and should be offered to a selected population of women who wish to avoid (repeated) surgical treatment of high-grade CIN

Development and Internal Validation of a Multivariable Prediction Model for Adrenocortical-Carcinoma-Specific Mortality

Adrenocortical carcinoma (ACC) has an incidence of about 1.0 per million per year. In general, survival of patients with ACC is limited. Predicting survival outcome at time of diagnosis is a clinical challenge. The aim of this study was to develop and internally validate a clinical prediction model for ACC-specific mortality. Data for this retrospective cohort study were obtained from the nine centers of the Dutch Adrenal Network (DAN). Patients who presented with ACC between 1 January 2004 and 31 October 2013 were included. We used multivariable Cox proportional hazards regression to compute the coefficients for the prediction model. Backward stepwise elimination was performed to derive a more parsimonious model. The performance of the initial prediction model was quantified by measures of model fit, discriminative ability, and calibration. We undertook an internal validation step to counteract the possible overfitting of our model. A total of 160 patients were included in the cohort. The median survival time was 35 months, and interquartile range (IQR) 50.7 months. The multivariable modeling yielded a prediction model that included age, modified European Network for the Study of Adrenal Tumors (mENSAT) stage, and radical resection. The c-statistic was 0.77 (95% Confidence Interval: 0.72, 0.81), indicating good predictive performance. We developed a clinical prediction model for ACC-specific mortality. ACC mortality can be estimated using a relatively simple clinical prediction model with good discriminative ability and calibration

Social networks in relation to self-reported symptomatic infections in individuals aged 40-75 - the Maastricht study.

Most infections are spread through social networks (detrimental effect). However, social networks may also lower infection acquisition (beneficial effect). This study aimed to examine associations between social network parameters and prevalence of self-reported upper and lower respiratory, gastrointestinal and urinary tract infections in a population aged 40-75