Professional development learning environments (PDLEs) embedded in a collaborative online learning environment (COLE): Moving towards a new conception of online professional learning

© 2018, Springer Science+Business Media, LLC, part of Springer Nature. Teaching, and education in general, remain firmly rooted in the practices of the past and continue to resist the implementation of strategies and theories arising from educational research. Consequently, significant reforms have been slow to take hold in educational systems around the world. Much of the reluctance can be attributed to a widely-held misconception of the nature of learning. This project attempts to address this misconception through the development of Professional Development Learning Environments (PDLEs are a series of learning tasks and a video-based case study) embedded in an online learning environment that requires the collaboration of users to solve problems. To use a Problem-Based-Learning (PBL) approach in an online context requires a major paradigm shift as well as using tools that were not designed specifically for such a student-driven, process-centred pedagogical paradigm. This becomes a problem when online resources and systems are used for supporting in-service teacher in their pursuit of furthering their education. Although the current theories of learning and teaching may present the philosophical content of such courses, the online strategies used often conflict with the theory. To study the formal implementation of PBL as a social-constructivist pedagogical approach, into an online learning environment to provide the tools for e-learning that would be closer in design to the current thinking on the very nature of learning, the PDLEs were modified to become small reusable video clips with a structure designed to facilitate PBL and focus learners’ attention on higher order thinking skills rather than specifically on content. These modified PDLEs are referred to as Problem-Based Learning Objects (PBLOs). The PBLOs were embedded into a prototype of a Collaborative Online Learning Environment (COLE) which was developed simultaneously. The entire system was pilot tested with small groups. Preliminary results show that although many technical difficulties remain to be solved, using the environment does show evidence of some effect on beliefs about personal theories of learning, causing shifts from technical issues to those surrounding processes of learning. Our preliminary research has called attention to the potential ability of PBLO/COLE to disrupt conventional, transmission-based conceptions of online learning as content delivery. At the same time, however, our preliminary work has also indicated that learners who are not used to the collaborative opportunities provided within PBLO/COLE may still hold traditional orientations to teaching and learning as a “gold standard” to which all other options are compared. A purposeful direction for our future research will entail working with learners in PBLO/COLE over a sustained period so that they may engage in an online experience grounded in principles of socio-constructivism

Clinical course and prognosis of the lymphoproliferative disease of granular lymphocytes. A multicenter study.

Lymphoproliferative disease of granular lymphocytes (LDGL) is a recently recognized, relatively rare atypical lymphocytosis characterized by the presence of over 2000 lymphocytes with cytoplasmic azurophilic granules/mm3 in the peripheral blood. The clinical course is heterogeneous, varying from spontaneous regression to progressive, malignant disease. As a consequence, clinical intervention is not standardized. In a worldwide multicenter study, the authors observed 151 patients with LDGL for a mean follow-up time of 29 months. Forty-three patients were asymptomatic at the time of diagnosis. In the remaining cases, clinical symptoms included fever (41 cases), infections (58), neutropenia (47), anemia (17), and thrombocytopenia (12). In 69 cases, LDGL coexisted with an associated disease. Most patients had a nonprogressive clinical course despite the presence of severe symptoms. In 19 patients, death related to LDGL occurred within 48 months. The authors investigated which features at diagnosis were significantly associated with increased mortality. In the univariate analysis, lymph node and liver enlargement, fever at presentation, skin infiltration, a low (less than or equal to 5000/mm3) or high (greater than 20,000/mm3) peripheral leukocyte count, relatively low (less than or equal to 3000) or high (greater than 7000/mm3) absolute peripheral granular lymphocyte (GL) count, and a low (less than or equal to 15%) percentage of HNK-1-positive cells were found to be predictors of increased mortality. In the multivariate analysis, significant independent predictors were fever at diagnosis, a low (less than or equal to 15%) percentage of HNK-1-positive peripheral blood mononuclear cells (PBMC) and a relatively low (less than or equal to 3000) GL count. These results showed that about 25% of the patients with LDGL were diagnosed after a routine blood count and had no clinical symptoms. The remaining patients were symptomatic, with some experiencing a fatal clinical course. The author's analysis of the significant prognostic features of LDGL may help in understanding the heterogeneous nature of this syndrom

DEMONSTRATION OF CLONAL IMMUNOGLOBULIN GENE REARRANGEMENTS IN CUTANEOUS B-CELL LYMPHOMAS AND PSEUDO-B-CELL LYMPHOMAS - DIFFERENTIAL DIAGNOSTIC AND PATHOGENETIC ASPECTS.

Twenty-five patients with a benign or malignant cutaneous B-cell lymphoproliferative disease, including seven cutaneous pseudo-B-cell lymphomas, eight primary cutaneous B-cell lymphomas (CBCL), and 10 secondary cutaneous B-cell lymphomas, were investigated for the presence of clonal immunoglobulin (Ig) gene rearrangements using Southern blot hybridization analysis. The selection of pseudo-B-cell lymphomas was based on the presence of polyclonal light-chain expression with immunohistochemical analysis. All cases of CBCL demonstrated monotypic light-chain expression or absence of detectable Ig on CD20+ B cells. Clonal rearrangements of one or more Ig genes were demonstrated in four of seven cases of cutaneous pseudo-B-cell lymphomas, six of eight cases of primary CBCL, and in all cases of secondary CBCL. The observation that cutaneous pseudo-B-cell lymphomas as defined by immunohistochemical criteria often contain occult monoclonal B-cell populations implies that differentiating between pseudo-B-cell lymphomas and CBCL is not always possible by means of gene-rearrangement analysis. These findings may support the concept that cutaneous pseudo-B-cell lymphomas and primary CBCL are part of a continuous and progressive spectrum of B-cell lymphoproliferative skin disorders

Clinical course and prognosis of the lymphoproliferative disease of granular lymphocytes. A multicenter study

Lymphoproliferative disease of granular lymphocytes (LDGL) is a recently recognized, relatively rare atypical lymphocytosis characterized by the presence of over 2000 lymphocytes with cytoplasmic azurophilic granules/mm3 in the peripheral blood. The clinical course is heterogeneous, varying from spontaneous regression to progressive, malignant disease. As a consequence, clinical intervention is not standardized. In a worldwide multicenter study, the authors observed 151 patients with LDGL for a mean follow‐up time of 29 months. Forty‐three patients were asymptomatic at the time of diagnosis. In the remaining cases, clinical symptoms included fever (41 cases), infections (58), neutropenia (47), anemia (17), and thrombocytopenia (12). In 69 cases, LDGL coexisted with an associated disease. Most patients had a nonprogressive clinical course despite the presence of severe symptoms. In 19 patients, death related to LDGL occurred within 48 months. The authors investigated which features at diagnosis were significantly associated with increased mortality. In the univariate analysis, lymph node and liver enlargement, fever at presentation, skin infiltration, a low (≦ 5000/mm3) or high (> 20,000/mm3) peripheral leukocyte count, relatively low (≦ 3000) or high (> 7000/mm3) absolute peripheral granular lymphocyte (GL) count, and a low (≦ 15%) percentage of HNK‐1‐positive cells were found to be predictors of increased mortality. In the multivariate analysis, significant independent predictors were fever at diagnosis, a low (≦ 15%) percentage of HNK‐1‐positive peripheral blood mononuclear cells (PBMC) and a relatively low (≦ 3000) GL count. These results showed that about 25% of the patients with LDGL were diagnosed after a routine blood count and had no clinical symptoms. The remaining patients were symptomatic, with some experiencing a fatal clinical course. The authors' analysis of the significant prognostic features of LDGL may help in understanding the heterogeneous nature of this syndrome. Copyright © 1990 American Cancer Societ