Pharmacology and the safe prescribing of drugs

Understanding the pharmacological principles and safe use of drugs is just as important in surgical practice as in any other medical specialty. With an ageing population with often multiple comorbidities and medications, as well as an expanding list of new pharmacological treatments, it is important that surgeons understand the implications of therapeutic drugs on their daily practice. The increasing emphasis on high quality and safe patient care demands that doctors are aware of preventable adverse drug reactions (ADRs) and interactions, try to minimize the potential for medication errors, and consider the benefits and harms of medicines in their patients. This chapter examines these aspects from the view of surgical practice and expands on the implications of some of the most common medical conditions and drug classes in the perioperative period. The therapeutic care of surgical patients is obvious in many circumstances – for example, antibacterial prophylaxis, thromboprophylaxis, and postoperative analgesia. However, the careful examination of other drug therapies is often critical not only to the sustained treatment of the associated medical conditions but to the perioperative outcomes of patients undergoing surgery. The benefit–harm balance of many therapies may be fundamentally altered by the stress of an operation in one direction or the other; this is not a decision that should wait until the anaesthetist arrives for a preoperative assessment or one that should be left to junior medical or nursing staff on the ward.

The effect of an enriched learning community on success and retention in chemistry courses

Since the mid-1990s, the United States has experienced a shortage of scientists and engineers, declining numbers of students choosing these fields as majors, and low student success and retention rates in these disciplines. Learning theorists, educational researchers, and practitioners believe that learning environments can be created so that an improvement in the numbers of students who complete courses successfully could be attained (Astin, 1993; Magolda & Terenzini, n.d.; O'Banion, 1997). Learning communities do this by providing high expectations, academic and social support, feedback during the entire educational process, and involvement with faculty, other students, and the institution (Ketcheson & Levine, 1999). ^ A program evaluation of an existing learning community of science, mathematics, and engineering majors was conducted to determine the extent to which the program met its goals and was effective from faculty and student perspectives. The program provided laptop computers, peer tutors, supplemental instruction with and without computer software, small class size, opportunities for contact with specialists in selected career fields, a resource library, and Peer-Led Team Learning. During the two years the project has existed, success, retention, and next-course continuation rates were higher than in traditional courses. Faculty and student interviews indicated there were many affective accomplishments as well. ^ Success and retention rates for one learning community class ( n = 27) and one traditional class (n = 61) in chemistry were collected and compared using Pearson chi square procedures ( p = .05). No statistically significant difference was found between the two groups. Data from an open-ended student survey about how specific elements of their course experiences contributed to success and persistence were analyzed by coding the responses and comparing the learning community and traditional classes. Substantial differences were found in their perceptions about the lecture, the lab, other supports used for the course, contact with other students, helping them reach their potential, and their recommendation about the course to others. Because of the limitation of small sample size, these differences are reported in descriptive terms. ^

Supplemental instruction, study habits, and the community college student

The purpose of this study was to demonstrate if the academic assistance program Supplemental Instruction (SI) facilitates the acquisition of effective study behaviors through strategies that transcend simple double-exposure to the course material. Its advocates claim it increases academic achievement using learner-centered knowledge and acquisition of effective study behaviors. SI sessions are specifically related to particular courses that students are taking. Sessions are facilitated by the SI leader who has taken the subject matter course in the past. Students review the content of the previous subject matter class using collaborative learning strategies coordinated by a SI leader. In addition, the SI leader models appropriate study behaviors in his or her interactions with the students. ^ An instructor at a large Florida community college who taught five classes of an Anatomy & Physiology I course (traditionally supported by SI) was identified. Two of the classes were randomly selected to participate in SI activities, and two classes were random chosen to participate in alternate, computer-based activities that dealt with the course content, but did not include work in developing students' study behaviors. These treatments were carried out over the course of an entire semester. Participation was mandatory. ^ Data were collected on two variables. Academic achievement in anatomy and physiology content was measured both pre- and post-treatment using an instructor developed examination. Student study behaviors were measured using pre- and post-treatment administration of the Study Behavior Inventory, a valid and reliable instrument that provides scores on three categories of study behaviors: (a) Academic self-efficacy, (b) Preparation for routine academic tasks, and (c) Preparation for long range academic tasks. Measures obtained at the end of the semester of treatment revealed no significant differences between the SI and alternative treatment groups in post-treatment achievement test score and the post-treatment scores on the three study behaviors categories when adjusted for pre-treatment scores. ^ These results suggest that the development of appropriate study behaviors requires more time than SI, as it is now implemented, can provide. In addition, results indicate that improved academic achievement may be attained through any number of means that include repeated exposure to course material. ^

Explaining the effects of class size on faculty and students

This study explored the effects of class size on faculty and students. Specifically, it examined the relationship of class size and students' participation in class, faculty interactive styles, and academic environment and how these behaviors affected student achievement (percentage of students passing). The sample was composed of 629 students in 30 sections of Algebra I at a large, urban community college. A survey was administered to the students to solicit their perceptions on their participation in class, their faculty interaction style, and the academic environment in their classes. Selected classes were observed to triangulate the findings. The relationship of class size to student participation, faculty interactive styles, and academic environment was determined by using hierarchical linear modeling (HLM). A significant difference was found on the participation of students related to class size. Students in smaller classes participated more and were more engaged than students in larger classes. Regression analysis using the same variables in small and large classes showed that faculty interactive styles significantly predicted student achievement. Stepwise regression analyses of student and faculty background variables showed that (a) students' estimate of GPA was significantly related to their achievement (r = .63); (b) older students reported more participation than did younger ones, (c) students in classes taught by female, Hispanic faculty earned higher passing grades, and (d) students' participation was greater with adjunct professors. Class observations corroborated these findings. The analysis and observational data provided sufficient evidence to warrant the conclusion that small classes were not always most effective in promoting achievement. It was found that small classes may be an artifact of ineffectual teaching, actual or by reputation. While students in small classes participate and are more engaged than students in larger classes, the class-size effect is essentially due to what happens in instruction to promote learning. The interaction of the faculty with students significantly predicted students' achievement regardless of class size. Since college students select their own classes, students do not register for classes taught by faculty with poor teaching reputation, thereby leading to small classes. Further studies are suggested to determine reasons why classes differ in size.

The influence of study and travel abroad on the personal and professional development of students in architecture design programs

International travel has significant implications on the study of architecture. This study analyzed ways in which undergraduate and graduate students benefited from the experience of international travel and study abroad. Taken from the perspective of 15 individuals who were currently or had been architecture students at the University of Miami and Florida International University or who were alumni of the University of Florida and Syracuse University, the research explored how international travel and study abroad enhanced their awareness and understanding of architecture, and how it complemented their architecture curricula. This study also addressed a more personal aspect of international travel in order to learn how the experience and exposure to foreign cultures had positively influenced the personal and professional development of the participants.^ Participants’ individual and two-person semi-structured interviews about study abroad experiences were electronically recorded and transcribed for analysis. A second interview was conducted with five of the participants to obtain feedback concerning the accuracy of the transcripts and the interpretation of the data. Sketch journals and design projects were also analyzed from five participants and used as data for the purposes of better understanding what these individuals learned and experienced as part of their study abroad.^ Findings indicated that study abroad experiences helped to broaden student understanding about architecture and urban development. These experiences also opened the possibilities of creative and professional expression. For many, this was the most important aspect of their education as architects because it heightened their interest in architecture. These individuals talked about how they had the opportunity to experience contemporary and ancient buildings that they had learned about in their history and design classes on their home campuses. In terms of personal and professional development, many of the participants remarked that they became more independent and self-reliant because of their study abroad experiences. They also displayed a sense of global awareness and were interested in the cultures of their host nations. The study abroad experiences also had a lasting influence on their professional development.^

Comparison of Belowground Biomass in C3- and C4-Dominated Mixed Communities in a Chesapeake Bay Brackish Marsh

Belowground biomass is a critical factor regulating ecosystem functions of coastal marshes, including soil organic matter (SOM) accumulation and the ability of these systems to keep pace with sea-level rise. Nevertheless, belowground biomass responses to environmental and vegetation changes have been given little emphasis marsh studies. Here we present a method using stable carbon isotopes and color to identify root and rhizomes of Schoenoplectus americanus (Pers.) Volk. ex Schinz and R. Keller (C3) and Spartina patens (Ait.) Muhl. (C4) occurring in C3− and C4-dominated communities in a Chesapeake Bay brackish marsh. The functional significance of the biomass classes we identified is underscored by differences in their chemistry, depth profiles, and variation in biomass and profiles relative to abiotic and biotic factors. C3 rhizomes had the lowest concentrations of cellulose (29.19%) and lignin (14.43%) and the lowest C:N (46.97) and lignin:N (0.16) ratios. We distinguished two types of C3 roots, and of these, the dark red C3 roots had anomalously high C:N (195.35) and lignin:N (1.14) ratios, compared with other root and rhizome classes examined here and with previously published values. The C4-dominated community had significantly greater belowground biomass (4119.1 g m−2) than the C3-dominated community (3256.9 g m−2), due to greater total root biomass and a 3.6-fold higher C3-root:rhizome ratio in the C4-dominated community. C3 rhizomes were distributed significantly shallower in the C4-dominated community, while C3 roots were significantly deeper. Variability in C3 rhizome depth distributions was explained primarily by C4 biomass, and C3 roots were explained primarily by water table height. Our results suggest that belowground biomass in this system is sensitive to slight variations in water table height (across an 8 cm range), and that the reduced overlap between C3 and C4 root profiles in the C4-dominated community may account for the greater total root biomass observed in that community. Given that future elevated atmospheric CO2 and accelerated sea-level rise are likely to increase C3 abundance in Atlantic and Gulf coast marshes, investigations that quantify how patterns of C3 and C4 belowground biomass respond to environmental and biological factors stand to improve our understanding of ecosystem-wide impacts of global changes on coastal wetlands.

The relationship between scaffolding metacognitive strategies identified through dialogue journals and second graders' reading comprehension, science achievement, and metacognition using expository text

Poor informational reading and writing skills in early grades and the need to provide students more experience with informational text have been identified by research as areas of concern. Wilkinson and Son (2011) support future research in dialogic approaches to investigate the impact dialogic teaching has on comprehension. This study (N = 39) examined the gains in reading comprehension, science achievement, and metacognitive functioning of individual second grade students interacting with instructors using dialogue journals alongside their textbook. The 38 week study consisted of two instructional phases, and three assessment points. After a period of oral metacognitive strategies, one class formed the treatment group (n=17), consisting of two teachers following the co-teaching method, and two classes formed the comparison group ( n=22). The dialogue journal intervention for the treatment group embraced the transactional theory of instruction through the use of dialogic interaction between teachers and students. Students took notes on the assigned lesson after an oral discussion. Teachers responded to students' entries with scaffolding using reading strategies (prior knowledge, skim, slow down, mental integration, and diagrams) modeled after Schraw's (1998) strategy evaluation matrix, to enhance students' comprehension. The comparison group utilized text-based, teacher-led whole group discussion. Data were collected using different measures: (a) Florida Assessments for Instruction in Reading (FAIR) Broad Diagnostic Inventory; (b) Scott Foresman end of chapter tests; (c) Metacomprehension Strategy Index (Schmitt, 1990); and (d) researcher-made metacognitive scaffolding rubric. Statistical analyses were performed using paired sample t-tests, regression analysis of covariance, and two way analysis of covariance. Findings from the study revealed that experimental participants performed significantly better on the linear combination of reading comprehension, science achievement, and metacognitive function, than their comparison group counterparts while controlling for pretest scores. Overall, results from the study established that teacher scaffolding using metacognitive strategies can potentially develop students' reading comprehension, science achievement, and metacognitive awareness. This suggests that early childhood students gain from the integration of reading and writing when using authentic materials (science textbooks) in science classrooms. A replication of this study with more students across more schools, and different grade levels would improve the generalizability of these results.

Sleep and school education

Sleep has emerged in the past decades as a key process for memory consolidation and restructuring. Given the universality of sleep across cultures, the need to reduce educational inequality, the low implementation cost of a sleep-based pedagogy, and its global scalability, it is surprising that the potential of improved sleep as a means of enhancing school education has remained largely unexploited. Students of various socio-economic status often suffer from sleep deficits. In principle, the optimization of sleep schedules both before and after classes should produce large positive benefits for learning. Here we review the biological and psychological phenomena underlying the cognitive role of sleep, present the few published studies on sleep and learning that have been performed in schools, and discuss potential applications of sleep to the school setting. Translational research on sleep and learning has never seemed more appropriate.

Childhood Attention Problems and the Development of Comorbid Symptoms at the Transition to High School: The Mediating Role of Parent and Peer Relationships

Children with Attention-Deficit/Hyperactivity Disorder (ADHD) are at increased risk for the development of depression and delinquent behavior. Children and adolescents with ADHD also experience difficulty creating/maintaining high quality friendships and parent-child relationships, and these difficulties may contribute to the development of co-morbid internalizing and externalizing symptoms in adolescence. However, there is limited research examining whether high quality friendships and parent-child relationships mediate the relation between ADHD and the emergence of these co-morbid symptoms at the transition to high school. This study examines the mediating role of relationship quality in the association between ADHD and depressive symptoms/delinquent behaviors at this developmentally significant transition point. Results revealed significant indirect effects of grade 6 attention problems on grade 9 depressive symptoms through friendship quality and quality of the mother-child relationship in grade 8. Interventions targeting parent and peer relationships may be valuable for youth with ADHD to promote successful transitions to high school.

Sleep and school education

Sleep has emerged in the past decades as a key process for memory consolidation and restructuring. Given the universality of sleep across cultures, the need to reduce educational inequality, the low implementation cost of a sleep-based pedagogy, and its global scalability, it is surprising that the potential of improved sleep as a means of enhancing school education has remained largely unexploited. Students of various socio-economic status often suffer from sleep deficits. In principle, the optimization of sleep schedules both before and after classes should produce large positive benefits for learning. Here we review the biological and psychological phenomena underlying the cognitive role of sleep, present the few published studies on sleep and learning that have been performed in schools, and discuss potential applications of sleep to the school setting. Translational research on sleep and learning has never seemed more appropriate.

Cirrhosis Diagnosis and Liver Fibrosis Staging: Transient Elastometry Versus Cirrhosis Blood Test.

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Injuries of non-lethal child physical abuse to the crania and orofacial regions: a scientific review

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Unsettling creativity: intercultural spaces, study abroad and internationlization beyond the curriculum

This chapter argues that short-term student Study Tours, coupled with preparatory and reflective classes on the home campus, are a more successful way of internationalizing the curriculum and promoting intercultural reflection than the more traditional, longer term student exchange. This is because taking students out of their comfort zones to travel overseas in a study intensive promotes greater ‘productive discomfort’ while supporting this process with classes on the home campus promotes its life changing effects.This chapter draws on two important Study Tours in Creative Writing and Creative and Commercial Entrepreneurship at Deakin University, Australia. The first is an outbound Study Tour to the United States and the second is an inbound Study Tour from India. These Study Tours foreground an important ‘unsettling’ of creativity that impacts on the students’ thinking and writing processes, and prepares them most effectively for their role as global citizens.

Frock paper scissors : a comparative case study

This paper discusses the ways in which synergies across design disciplines can be developed through student engagement on authentic design projects. The paper focuses on a comparative case study where students from the Fashion, and Communication Design discipline areas in the Creative Industries Faculty at Queensland University of Technology (QUT) work on the production of the Frock Paper Scissors magazine and web site. The Frock Paper Scissors magazine has been the focus of assessment in a Fashion and Style Journalism class for the last three years, and for the last two years, students from an Advanced Web Design class have been involved in the production of the accompanying web site, http://frockpapersissors.com/. In this paper we focus on how this authentic assessment task has been integrated into the two design (and communication) classes; discussing the different approaches taken by teaching staff, the challenges faced, and the ways in which student learning outcomes have been improved through interactions between design disciplines. The paper concludes by outlining a set of observations on how to successfully engage students from different design (and creative industries) fields on an authentic design project within their studies.

Action learning of online marketing via a global contest

Introduction: The Google Online Marketing Challenge is a global competition in which student teams run advertising campaigns for small and medium-sized businesses (SMEs) using AdWords, Google’s text-based advertisements. In 2008, its inaugural year, over 8,000 students and 300 instructors from 47 countries representing over 200 schools participated. The Challenge ran in undergraduate and graduate classes in disciplines such as marketing, tourism, advertising, communication and information systems. Combining advertising and education, the Challenge gives student hands-on experience in the increasingly important field of online marketing, engages them with local businesses and motivates them through the thrill of a global competition. Student teams receive US$200 in AdWords credits, Google’s premier advertising product that offers cost-per-click advertisements. The teams then recruit and work with a local business to devise an effective online marketing campaign. Students first outline a strategy, run a series of campaigns, and provide their business with recommendations to improve their online marketing. Teams submit two written reports for judging by 14 academics in eight countries. In addition, Google AdWords experts judge teams on their campaign statistics such as success metrics and account management. Rather than a marketing simulation against a computer or hypothetical marketing plans for hypothetical businesses, the Challenges has student teams develop and manage real online advertising campaigns for their clients and compete against peers globally.