Computer education: new perspectives

Computer technologies were introduced into educational contexts over two decades ago and while there is some argument about the extent to which computers have realised their potential, they have undoubtedly had a significant impact on education. A look into any school will reveal computers being used widely by clerical staff, teachers and children. It is clear that computers are here to stay, but it is less clear as to how effectively they are being used in the learning process. Teachers not only need to use computers but they need to use them well, and in order to do this they must understand what computer technology can offer and the ways in which such technology can be used in teaching and learning

Wild beasts and other curiosities: West Australian research, issues and innovations in early childhood education

Editorial Is it true that young children need to play more, that perceptual-motor programs don\u27t work, or that schools can learn lessons from child care? Do you know how to turn children into \u27greenies\u27, help them express the wild beast within, or use computers to develop vital skills? If you\u27re unsure, outraged, confused or curious, then this book is for you! Practitioners and academics in early childhood have written these papers for the Edith Cowan Memorial Conference for Early Childhood in 1996. The chapters are diverse in style and topic, but are linked by the authors\u27 deep interest in the education and welfare of children 0-8 in Western Australia. Some papers broach new and controversial topics, while others cast new light on old favourites. Many topics are complex, and few answers are clear-cut. Some chapters report current projects, and represent the growing number of practitioners who are refining their skills as researchers. Skimming down the contents pages, it is easy to see why the challenges of early childhood are increasing. Practitioners are expected to do a great deal, and to know a great deal, and the knowledge base keeps changing and expanding

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Vitamin D in health and disease: Current perspectives

Despite the numerous reports of the association of vitamin D with a spectrum of development, disease treatment and health maintenance, vitamin D deficiency is common. Originating in part from the diet but with a key source resulting from transformation by exposure to sunshine, a great deal of the population suffers from vitamin D deficiency especially during winter months. It is linked to the treatment and pathogenesis and/or progression of several disorders including cancer, hypertension, multiple sclerosis, rheumatoid arthritis, osteoporosis, muscle weakness and diabetes. This widespread deficiency of Vitamin D merits consideration of widespread policies including increasing awareness among the public and healthcare professionals