247 research outputs found

    Mediated and collaborative learning for students with learning disabilities : This is about life, it\u27s the rules of life.

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    Many approaches have been developed to help students with learning disabilities become independent learners. One such program, developed by the National Institute for Learning Disabilities (NILD), is a one-on-one model of educational therapy that is designed to stimulate students\u27 neurological weaknesses and improve deficits in perception and/or cognition. As an educational therapist, I am always looking for ways to enhance my ability to mediate my students\u27 learning and to help them transfer what is learned in educational therapy to other settings. In my search I became acquainted with the Cognitive Enrichment Advantage (CEA) approach to learning. As an adaptation of Feuerstein\u27s theory of mediated learning, the CEA approach gives students an explicit way to learn how to learn that I saw could be incorporated within the NILD Educational Therapy™ Model. I chose a case study approach and used action research as a way to examine my \u27new\u27 practice systematically and carefully. The purpose of this study was to look at my practice to see what my students, their parents and I would experience if I focused on mediated learning as we collaboratively developed meta-strategic knowledge through the learning of CEA\u27s Building Blocks of Thinking and Tools of Learning. I collected data through a reflective journal, audio recordings of student research team meetings, parents\u27 focus group meetings, and individual exit interviews of students and their parents. I analyzed data in multiple ways to ensure validity. My students and I used the CEA approach during educational therapy and research team meetings. The findings showed that the students could use meta-strategic knowledge to develop learning strategies that were meaningful to them and transferable to other settings. The findings from parent meetings and interviews also showed that learning the CEA approach was helpful to them as they mediated their children\u27s learning. Implications for future research focused on the possible need for more collaboration within the one-on-one educational therapy model, the need for parent training workshops, and the call for further research to validate the findings of this study. Suggestions for NILD\u27s corporate use of these findings also were given

    Cultural Resources Investigations Along Whiteoak Bayou, Harris County, Texas

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    In 1986, cultural resources investigations were carried out to prepare a synthesis of the archeology of the Whiteoak Bayou area in western Harris County, Texas, and to conduct subsurface testing at prehistoric sites that may be affected by the U.S. Army Corps of Engineers Upper Whiteoak Bayou Flood Damage Reduction Project. The tasks undertaken during these investigations are: (1) background research into the environment and archeology of the area; (2) historic/archival research and reconnaissance survey to summarize the historical development of Whiteoak Bayou and to identify any important sites in the project area; (3) intensive survey of Vogel Creek, a tributary to Whiteoak Bayou, to assess the potential for intact cultural remains; (4) National Register testing and assessment of nine aboriginal sites; (5) geoarcheological investigations to establish the geological context of the archeological remains, to identify the depositional environments represented, and to establish an alluvial sequence for the project area; and (6) analysis of a large collection of artifacts from 46 Whiteoak Bayou sites made prior to 1986 by members of the Houston Archeological Society, as well as the materials recovered during 1986. The nine archeological sites tesLed during this project are 41HR241, 4lHR259, 41HR273, 41HR278, 41HR279, 41HR283, 41HR290, 41HR298, and 41HR541. The testing showed that only three -- 41HR259, 41HR273, and 41HR541 -- have substantial, intact cultural deposits. Two of these -- 41HR273 and 41HR541 -- are judged to be eligible for listing on the National Register of Historic Places and for designation as State Archeological Landmarks. One site, 4lHR259, is currently listed on the National Register, although the remaining part of this site is judged to have a limited potential to yield additi0nal information. The other seven sites are judged to be ineligible for listing

    The eMERGE Network: A consortium of biorepositories linked to electronic medical records data for conducting genomic studies

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    <p>Abstract</p> <p>Introduction</p> <p>The eMERGE (electronic MEdical Records and GEnomics) Network is an NHGRI-supported consortium of five institutions to explore the utility of DNA repositories coupled to Electronic Medical Record (EMR) systems for advancing discovery in genome science. eMERGE also includes a special emphasis on the ethical, legal and social issues related to these endeavors.</p> <p>Organization</p> <p>The five sites are supported by an Administrative Coordinating Center. Setting of network goals is initiated by working groups: (1) Genomics, (2) Informatics, and (3) Consent & Community Consultation, which also includes active participation by investigators outside the eMERGE funded sites, and (4) Return of Results Oversight Committee. The Steering Committee, comprised of site PIs and representatives and NHGRI staff, meet three times per year, once per year with the External Scientific Panel.</p> <p>Current progress</p> <p>The primary site-specific phenotypes for which samples have undergone genome-wide association study (GWAS) genotyping are cataract and HDL, dementia, electrocardiographic QRS duration, peripheral arterial disease, and type 2 diabetes. A GWAS is also being undertaken for resistant hypertension in ≈2,000 additional samples identified across the network sites, to be added to data available for samples already genotyped. Funded by ARRA supplements, secondary phenotypes have been added at all sites to leverage the genotyping data, and hypothyroidism is being analyzed as a cross-network phenotype. Results are being posted in dbGaP. Other key eMERGE activities include evaluation of the issues associated with cross-site deployment of common algorithms to identify cases and controls in EMRs, data privacy of genomic and clinically-derived data, developing approaches for large-scale meta-analysis of GWAS data across five sites, and a community consultation and consent initiative at each site.</p> <p>Future activities</p> <p>Plans are underway to expand the network in diversity of populations and incorporation of GWAS findings into clinical care.</p> <p>Summary</p> <p>By combining advanced clinical informatics, genome science, and community consultation, eMERGE represents a first step in the development of data-driven approaches to incorporate genomic information into routine healthcare delivery.</p

    Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

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    Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

    Long-Term Benefits from Early Antiretroviral Therapy Initiation in HIV Infection

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    BACKGROUND: For people with HIV and CD4+ counts >500 cells/mm3, early initiation of antiretroviral therapy (ART) reduces serious AIDS and serious non-AIDS (SNA) risk compared with deferral of treatment until CD4+ counts are 500 cells/mm3, excess risk of AIDS and SNA associated with delaying treatment initiation was diminished after ART initiation, but persistent excess risk remained. (Funded by the National Institute of Allergy and Infectious Diseases and others.)

    The epidemiology of adolescents living with perinatally acquired HIV: A cross-region global cohort analysis

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    Background Globally, the population of adolescents living with perinatally acquired HIV (APHs) continues to expand. In this study, we pooled data from observational pediatric HIV cohorts and cohort networks, allowing comparisons of adolescents with perinatally acquired HIV in “real-life” settings across multiple regions. We describe the geographic and temporal characteristics and mortality outcomes of APHs across multiple regions, including South America and the Caribbean, North America, Europe, sub-Saharan Africa, and South and Southeast Asia. Methods and findings Through the Collaborative Initiative for Paediatric HIV Education and Research (CIPHER), individual retrospective longitudinal data from 12 cohort networks were pooled. All children infected with HIV who entered care before age 10 years, were not known to have horizontally acquired HIV, and were followed up beyond age 10 years were included in this analysis conducted from May 2016 to January 2017. Our primary analysis describes patient and treatment characteristics of APHs at key time points, including first HIV-associated clinic visit, antiretroviral therapy (ART) start, age 10 years, and last visit, and compares these characteristics by geographic region, country income group (CIG), and birth period. Our secondary analysis describes mortality, transfer out, and lost to follow-up (LTFU) as outcomes at age 15 years, using competing risk analysis. Among the 38,187 APHs included, 51% were female, 79% were from sub-Saharan Africa and 65% lived in low-income countries. APHs from 51 countries were included (Europe: 14 countries and 3,054 APHs; North America: 1 country and 1,032 APHs; South America and the Caribbean: 4 countries and 903 APHs; South and Southeast Asia: 7 countries and 2,902 APHs; sub-Saharan Africa, 25 countries and 30,296 APHs). Observation started as early as 1982 in Europe and 1996 in sub-Saharan Africa, and continued until at least 2014 in all regions. The median (interquartile range [IQR]) duration of adolescent follow-up was 3.1 (1.5–5.2) years for the total cohort and 6.4 (3.6–8.0) years in Europe, 3.7 (2.0–5.4) years in North America, 2.5 (1.2–4.4) years in South and Southeast Asia, 5.0 (2.7–7.5) years in South America and the Caribbean, and 2.1 (0.9–3.8) years in sub-Saharan Africa. Median (IQR) age at first visit differed substantially by region, ranging from 0.7 (0.3–2.1) years in North America to 7.1 (5.3–8.6) years in sub-Saharan Africa. The median age at ART start varied from 0.9 (0.4–2.6) years in North America to 7.9 (6.0–9.3) years in sub-Saharan Africa. The cumulative incidence estimates (95% confidence interval [CI]) at age 15 years for mortality, transfers out, and LTFU for all APHs were 2.6% (2.4%–2.8%), 15.6% (15.1%–16.0%), and 11.3% (10.9%–11.8%), respectively. Mortality was lowest in Europe (0.8% [0.5%–1.1%]) and highest in South America and the Caribbean (4.4% [3.1%–6.1%]). However, LTFU was lowest in South America and the Caribbean (4.8% [3.4%–6.7%]) and highest in sub-Saharan Africa (13.2% [12.6%–13.7%]). Study limitations include the high LTFU rate in sub-Saharan Africa, which could have affected the comparison of mortality across regions; inclusion of data only for APHs receiving ART from some countries; and unavailability of data from high-burden countries such as Nigeria. Conclusion To our knowledge, our study represents the largest multiregional epidemiological analysis of APHs. Despite probable under-ascertained mortality, mortality in APHs remains substantially higher in sub-Saharan Africa, South and Southeast Asia, and South America and the Caribbean than in Europe. Collaborations such as CIPHER enable us to monitor current global temporal trends in outcomes over time to inform appropriate policy responses

    Erratum to: Methods for evaluating medical tests and biomarkers

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    [This corrects the article DOI: 10.1186/s41512-016-0001-y.]

    A communal catalogue reveals Earth’s multiscale microbial diversity

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    Our growing awareness of the microbial world’s importance and diversity contrasts starkly with our limited understanding of its fundamental structure. Despite recent advances in DNA sequencing, a lack of standardized protocols and common analytical frameworks impedes comparisons among studies, hindering the development of global inferences about microbial life on Earth. Here we present a meta-analysis of microbial community samples collected by hundreds of researchers for the Earth Microbiome Project. Coordinated protocols and new analytical methods, particularly the use of exact sequences instead of clustered operational taxonomic units, enable bacterial and archaeal ribosomal RNA gene sequences to be followed across multiple studies and allow us to explore patterns of diversity at an unprecedented scale. The result is both a reference database giving global context to DNA sequence data and a framework for incorporating data from future studies, fostering increasingly complete characterization of Earth’s microbial diversity

    The Scientific Foundation for Personal Genomics: Recommendations from a National Institutes of Health–Centers for Disease Control and Prevention Multidisciplinary Workshop

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    The increasing availability of personal genomic tests has led to discussions about the validity and utility of such tests and the balance of benefits and harms. A multidisciplinary workshop was convened by the National Institutes of Health and the Centers for Disease Control and Prevention to review the scientific foundation for using personal genomics in risk assessment and disease prevention and to develop recommendations for targeted research. The clinical validity and utility of personal genomics is a moving target with rapidly developing discoveries but little translation research to close the gap between discoveries and health impact. Workshop participants made recommendations in five domains: (1) developing and applying scientific standards for assessing personal genomic tests; (2) developing and applying a multidisciplinary research agenda, including observational studies and clinical trials to fill knowledge gaps in clinical validity and utility; (3) enhancing credible knowledge synthesis and information dissemination to clinicians and consumers; (4) linking scientific findings to evidence-based recommendations for use of personal genomics; and (5) assessing how the concept of personal utility can affect health benefits, costs, and risks by developing appropriate metrics for evaluation. To fulfill the promise of personal genomics, a rigorous multidisciplinary research agenda is needed
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