Networked learning, stepping beyond the net generation and digital natives

This chapter critically examines the idea that young people have undergone a change in which exposure to digital and networked technologies has caused a step change in the character of a whole generation. The empirical and theoretical basis for this argument is reviewed and critical theoretical perspectives are assessed. Evidence from earlier research is compared and contrasted with evidence gathered from students who are said to be part of the new generation. The chapter explores the consequences of these ideas from the standpoint of networked learning. One aim of the chapter is to suggest ways in which the changes that have taken can be more adequately theorized in relation to the idea of networked learning. Arguments used to support generational change rely on a technological determinism and alternative accounts understand young people as active agents. I suggest ex-panding the notion of the agent to include persons enacting roles in collective or-ganizations. Overall the importance of the debate is that determinist arguments can close down debate and networked learning would be impoverished if this occurs

Experimental Correlation of Combined Heat and Mass Transfer for NH 3 -H 2 0 falling film absorption

vection. The main conclusion from this study is that the negative concentration gradient of the surface tension is a trigger for inducement of Marangoni convection before the additive solubility, while the imbalance of the surface tension and the interfacial tension is a trigger after the solubility limit. Acknowledgment The authors thank Mr. K. Iizuka, Tokyo University of Agriculture and Technology, for his experimental assistance. The authors acknowledge that this work has been partially funded by the Japan Science and Technology Corporation (JST). References Beutler, A., Greiter, I., Wagner, A., Hohhmann, L., Schreier, S., and Alefeld, G., 1996, "Surfactants and Fluid Properties," Int. J. Refrigeration, Vol. 19, No. 5, pp. 342-346. Chavepeyer, G" Salajan, M., Platten, J. K., and Smet, P., 1995, "InterfacialTension and Surface Adsorption in j-Heptanol/Water Systems," Journal of Colloid and Interface Science, Vol. 174, Daiguji, H,, Hihara, E., and Saito, T., 1997, "Mechanism of Absorption Enhancement by Surfactant," Int. J. Heat and Mass Transfer, Vol. 40, No. 8, pp. 1743-1752. Fujita, T., 1993, "Falling Liquid Films in Absorption Machines," Int. J. Refrigeration, Vol. 16, No. 4, pp. 282-294. Hihara, E" and Saito, T., 1993 Journal of Heat Transfer TL = temperature of the fluid far away from the plate t' = time t R = reference time u = velocity of the fluid UD = reference velocity at' = frequency X,, = distance of the transition point from the leading edge |3 = coefficient of volume expansion p = density e = amplitude (constant) 9 = nondimensional temperature u = nondimensional velocity i = y-i Introduction Transient laminar-free convection flow past an infinite vertical plate under different plate conditions was studied by many researchers. The first closed-form solutions for Prandtl number Pr = 1.0 in case of a step change in wall temperature with time was derived by Illingworth (1950) and for Pr # 1.0, he derived the solution in integral form. Siegel (1958) studied the unsteady freeconvection flow past a semi-infinite vertical plate under stepchange in wall temperature or surface heat flux by employing the momentum integral method. Experimental evidence for such a situation was presented by Goldstein and Eckert (1960). For a semi-infinite vertical plate, unsteady free-convection flow was studied analytically b

Medical populism and the COVID-19 pandemic

This paper uses the vocabulary of ‘medical populism’ to identify and analyse the political constructions of (and responses to) the COVID-19 pandemic in Brazil, the Philippines, and the United States from January to mid-July 2020, particularly by the countries’ heads of state: Jair Bolsonaro, Rodrigo Duterte, and Donald Trump. In all three countries, the leaders’ responses to the outbreak can be characterised by the following features: simplifying the pandemic by downplaying its impacts or touting easy solutions or treatments, spectacularizing their responses to crisis, forging divisions between the ‘people’ and dangerous ‘others’, and making medical knowledge claims to support the above. Taken together, the case studies illuminate the role of individual political actors in defining public health crises, suggesting that medical populism is not an exceptional, but a familiar response to them. This paper concludes by offering recommendations for global health in anticipating and responding to pandemics and infectious disease outbreaks

Preface

[No abstract available

Apixaban versus warfarin in patients with atrial fibrillation

BACKGROUND: Vitamin K antagonists are highly effective in preventing stroke in patients with atrial fibrillation but have several limitations. Apixaban is a novel oral direct factor Xa inhibitor that has been shown to reduce the risk of stroke in a similar population in comparison with aspirin. METHODS: In this randomized, double-blind trial, we compared apixaban (at a dose of 5 mg twice daily) with warfarin (target international normalized ratio, 2.0 to 3.0) in 18,201 patients with atrial fibrillation and at least one additional risk factor for stroke. The primary outcome was ischemic or hemorrhagic stroke or systemic embolism. The trial was designed to test for noninferiority, with key secondary objectives of testing for superiority with respect to the primary outcome and to the rates of major bleeding and death from any cause. RESULTS: The median duration of follow-up was 1.8 years. The rate of the primary outcome was 1.27% per year in the apixaban group, as compared with 1.60% per year in the warfarin group (hazard ratio with apixaban, 0.79; 95% confidence interval [CI], 0.66 to 0.95; P<0.001 for noninferiority; P = 0.01 for superiority). The rate of major bleeding was 2.13% per year in the apixaban group, as compared with 3.09% per year in the warfarin group (hazard ratio, 0.69; 95% CI, 0.60 to 0.80; P<0.001), and the rates of death from any cause were 3.52% and 3.94%, respectively (hazard ratio, 0.89; 95% CI, 0.80 to 0.99; P = 0.047). The rate of hemorrhagic stroke was 0.24% per year in the apixaban group, as compared with 0.47% per year in the warfarin group (hazard ratio, 0.51; 95% CI, 0.35 to 0.75; P<0.001), and the rate of ischemic or uncertain type of stroke was 0.97% per year in the apixaban group and 1.05% per year in the warfarin group (hazard ratio, 0.92; 95% CI, 0.74 to 1.13; P = 0.42). CONCLUSIONS: In patients with atrial fibrillation, apixaban was superior to warfarin in preventing stroke or systemic embolism, caused less bleeding, and resulted in lower mortality. Copyright © 2011 Massachusetts Medical Society. All rights reserved

Apixaban compared with warfarin in patients with atrial fibrillation and previous stroke or transient ischaemic attack: A subgroup analysis of the ARISTOTLE trial

Background: In the ARISTOTLE trial, the rate of stroke or systemic embolism was reduced by apixaban compared with warfarin in patients with atrial fibrillation (AF). Patients with AF and previous stroke or transient ischaemic attack (TIA) have a high risk of stroke. We therefore aimed to assess the efficacy and safety of apixaban compared with warfarin in prespecified subgroups of patients with and without previous stroke or TIA. Methods: Between Dec 19, 2006, and April 2, 2010, patients were enrolled in the ARISTOTLE trial at 1034 clinical sites in 39 countries. 18 201 patients with AF or atrial flutter were randomly assigned to receive apixaban 5 mg twice daily or warfarin (target international normalised ratio 2·0-3·0). The median duration of follow-up was 1·8 years (IQR 1·4-2·3). The primary efficacy outcome was stroke or systemic embolism, analysed by intention to treat. The primary safety outcome was major bleeding in the on-treatment population. All participants, investigators, and sponsors were masked to treatment assignments. In this subgroup analysis, we estimated event rates and used Cox models to compare outcomes in patients with and without previous stroke or TIA. The ARISTOTLE trial is registered with ClinicalTrials.gov, number NTC00412984. Findings: Of the trial population, 3436 (19%) had a previous stroke or TIA. In the subgroup of patients with previous stroke or TIA, the rate of stroke or systemic embolism was 2·46 per 100 patient-years of follow-up in the apixaban group and 3·24 in the warfarin group (hazard ratio [HR] 0·76, 95% CI 0·56 to 1·03); in the subgroup of patients without previous stroke or TIA, the rate of stroke or systemic embolism was 1·01 per 100 patient-years of follow-up with apixaban and 1·23 with warfarin (HR 0·82, 95% CI 0·65 to 1·03; p for interaction=0·71). The absolute reduction in the rate of stroke and systemic embolism with apixaban versus warfarin was 0·77 per 100 patient-years of follow-up (95% CI -0·08 to 1·63) in patients with and 0·22 (-0·03 to 0·47) in those without previous stroke or TIA. The difference in major bleeding with apixaban compared with warfarin was 1·07 per 100 patient-years (95% CI 0·09-2·04) in patients with and 0·93 (0·54-1·32) in those without previous stroke or TIA. Interpretation: The effects of apixaban versus warfarin were consistent in patients with AF with and without previous stroke or TIA. Owing to the higher risk of these outcomes in patients with previous stroke or TIA, the absolute benefits of apixaban might be greater in this population. Funding: Bristol-Myers Squibb and Pfizer. © 2012 Elsevier Ltd