In and out of preschool learning with iPads

In this chapter we describe and explain the ways we negotiated these same epistemological tensions and structural realities as we implemented the iPad loan component of the project reported in this book (hereafter: “iPad loan program”).Children who participated in the iPad loan program were able to take home one of the project iPads used in their preschool centre, much as they were able to take home books and puzzles. This component was one reflection of the ethos of “digital inclusion” that infused the project. As we noted in the introduction to this book, there is international recognition of the role that schools can play in ensuring all communities can participate in digital culture and the digital economy (e.g., European Commission, 2014; United States Government, 2013). Accordingly, we conducted the project in preschool centres where at least some groups of children were thought to enjoy less access to learning on digital platforms than others. Our goal was to put the iPad into the hands of children who might not otherwise have had access to it, while supporting teachers and parents in capitalising on the learning potential of the device for all the children. Centres nominated for the project by administrators in the preschool system all served communities that were either affected by poverty and/or diverse in language and culture.

Chickpeas! Varietal performance, wet feet and root rot, virus and salinity effects in 2012, Ascochyta management, seed quality, issues in central Queensland and effects of desiccating too early with glyphosate on seed germination

Take home messages: Plant only high quality seed that has been germ and vigour tested and treated with a registered seed dressing Avoid poorly drained paddocks and those with a history of lucerne, medics or chickpea Phytophthora root rot, PRR; do not grow Boundary if you even suspect a PRR risk Select best variety suited to soil type, farming system and disease risk Beware Ascochyta: follow recommendations for your variety and district Minimise risk of virus by retaining stubble, planting on time and at optimal rate, controlling weeds and ensuring adequate plant nutrition Test soil to determine risk of salinity and sodicity – do not plant chickpeas if ECe > 1.0-1.3 dS/m. Beware early desiccation of seed crops – know how to tell when 90-95% seeds are mature

Computational systems approach for drug target discovery

Importance of the field: The shift in focus from ligand based design approaches to target based discovery over the last two to three decades has been a major milestone in drug discovery research. Currently, it is witnessing another major paradigm shift by leaning towards the holistic systems based approaches rather the reductionist single molecule based methods. The effect of this new trend is likely to be felt strongly in terms of new strategies for therapeutic intervention, new targets individually and in combinations, and design of specific and safer drugs. Computational modeling and simulation form important constituents of new-age biology because they are essential to comprehend the large-scale data generated by high-throughput experiments and to generate hypotheses, which are typically iterated with experimental validation. Areas covered in this review: This review focuses on the repertoire of systems-level computational approaches currently available for target identification. The review starts with a discussion on levels of abstraction of biological systems and describes different modeling methodologies that are available for this purpose. The review then focuses on how such modeling and simulations can be applied for drug target discovery. Finally, it discusses methods for studying other important issues such as understanding targetability, identifying target combinations and predicting drug resistance, and considering them during the target identification stage itself. What the reader will gain: The reader will get an account of the various approaches for target discovery and the need for systems approaches, followed by an overview of the different modeling and simulation approaches that have been developed. An idea of the promise and limitations of the various approaches and perspectives for future development will also be obtained. Take home message: Systems thinking has now come of age enabling a `bird's eye view' of the biological systems under study, at the same time allowing us to `zoom in', where necessary, for a detailed description of individual components. A number of different methods available for computational modeling and simulation of biological systems can be used effectively for drug target discovery.

Combining unsupervised and invigilated assessment of introductory programming

We compared student performance on large-scale take-home assignments and small-scale invigilated tests that require competency with exactly the same programming concepts. The purpose of the tests, which were carried out soon after the take home assignments were submitted, was to validate the students' assignments as individual work. We found widespread discrepancies between the marks achieved by students between the two types of tasks. Many students were able to achieve a much higher grade on the take-home assignments than the invigilated tests. We conclude that these paired assessments are an effective way to quickly identify students who are still struggling with programming concepts that we might otherwise assume they understand, given their ability to complete similar, yet more complicated, tasks in their own time. We classify these students as not yet being at the neo-Piagetian stage of concrete operational reasoning.

The Exeter Contemporary flanged cemented acetabular component in primary total hip arthroplasty

Aims: We report on the outcome of the Exeter Contemporary flanged cemented all-polyethylene acetabular component with a mean follow-up of 12 years (10 to 13.9). This study reviewed 203 hips in 194 patients. 129 hips in 122 patients are still in situ; 66 hips in 64 patients were in patients who died before ten years, and eight hips (eight patients) were revised. Clinical outcome scores were available for 108 hips (104 patients) and radiographs for 103 hips (100 patients). Patients and Methods: A retrospective review was undertaken of a consecutive series of 203 routine primary cemented total hip arthroplasties (THA) in 194 patients. Results: There were no acetabular component revisions for aseptic loosening. Acetabular revision was undertaken in eight hips. In four hips revision was necessitated by periprosthetic femoral fractures, in two hips by recurrent dislocation, in one hip for infection and in one hip for unexplained ongoing pain. Oxford and Harris hip scores demonstrated significant clinical improvement (all p < 0.001). Radiolucent lines were present in 37 (36%) of the 103 acetabular components available for radiological evaluation. In 27 of these, the line was confined to zone 1. No component had migrated. Conclusion: Kaplan–Meier survivorship, with revision for aseptic loosening as the endpoint, was 100% at 12.5 years and for all causes was 97.8% (95% confidence interval 95.6 to 100) when 40 components remained at risk. The Exeter Contemporary flanged cemented acetabular component demonstrates excellent survivorship at 12.5 years. Take home message: The Exeter Contemporary flanged cemented acetabular component has excellent clinical outcomes and survivorship when used with the Exeter stem in total hip arthroplasty.

Triggered drug delivery from biomaterials

Importance of the field: Conventional dosing methods are frequently unable to deliver the clinical requirement of the patient. The ability to control the delivery of drugs from implanted materials is difficult to achieve, but offers promise in diverse areas such as infection-resistant medical devices and 10 responsive implants for diabetics. Areas covered in this review: This review gives a broad overview of recent progress in the use of triggers that can be used to achieve modulation of drug release rates from implantable biomaterials. In particular, these can be classified as being responsive to one or more of the following stimuli: a 15 chemical species, light, heat, magnetism, ultrasound and mechanical force. What the reader will gain: An overview of the potential for triggered drug delivery to give methods for tailoring the dose, location and time of release of a wide range of drugs where traditional dosing methods are not suitable. Particular emphasis is given to recently reported systems, and important 20 historical reports are included. Take home message: The use of externally or internally applied triggers of drug delivery to biomaterials has significant potential for improved delivery modalities and infection resistance.

Discovery and Development of a Potent and Highly Selective Small Molecule Muscarinic Acetylcholine Receptor Subtype I (mAChR 1 or M-1) Antagonist In Vitro and In Vivo Probe

This article describes the discovery and development of the first highly selective, small molecule antagonist of the muscarinic acetylcholine receptor subtype I (mAChR1 or M-1). An M-1 functional, cell-based, calcium-mobilization assay identified three distinct chemical series with initial selectivity for M-1 versus M-4. An iterative parallel synthesis approach was employed to optimize all three series in parallel, which led to the development of novel microwave-assisted chemistry and provided important take home lessons for probe development projects. Ultimately, this effort produced VU0255035, a potent (IC50 = 130 nM) and selective (>75-fold vs. M-2-M-5 and >10 mu M vs. a panel of 75 GPCRs, ion channels and transporters) small molecule M-1 antagonist. Further profiling demonstrated that VU0255035 was centrally penetrant (Brain(AUC)/Plasma(AUC) of 0.48) and active in vivo, rendering it acceptable as both an in vitro and in vivo MLSCN/MLPCN probe molecule for studying and dissecting M-1 function.

Molecular determinants of the cellular internalization of crotamine-derived peptides

Tese de doutoramento, Ciências Biomédicas (Bioquímica Médica), Universidade de Lisboa, Faculdade de Medicina, 2014

Temporomandibular Joint Ankylosis in an Infant: A Rare Cause of Difficult Airway

1.Pre-assessment data of the patient A 2-year-old boy, weighing 15 kg was admitted with a history of limited mouth opening(inter-incisor distance of 6 mm), hypoplastic and retrognathic mandible (bird face deformity) and facial asymmetry from left temporomandibular joint ankylosis (TMJA). He was born at term, after an uneventful pregnancy, and there was no report of trauma during caesarean section. No other possible aetiologies were identified. He was scheduled for mandibular osteotomy. Preoperative ENT examination revealed adenotonsillar hypertrophy. 2. Anaesthetic Plan A fiberoptic nasal intubation was performed under deep inhalation anaesthesia with sevoflurane, with the patient breathing spontaneously. Midazolam (0.05 mg.kg-1) and alfentanil (0.03 mg.kg-1) were given and anaesthesia was maintained with O2/air and sevoflurane. No neuromuscular blocking agent was administered since the surgical team needed facial nerve monitoring. 3. Description of incident During surgery an accidental extubation occurred and an attempt was made to reintubate the trachea by direct laryngoscopy. Although the osteotomy was nearly completed, the vocal cords could not be visualized (Cormack-Lehane grade IV laryngoscopic view). 4. Solving the problem Re-intubation was finally accomplished with the flexible fiberscope and the procedure was concluded without any more incidents. Extubation was performed 24 hours postoperatively with the patient fully awake. After surgery mouth opening improved to inter-incisor gap of 15 mm. 5. Lessons learned and take home message Two airways issues present in this case can lead to difficultventilation and intubation: TMJA and adenotonsillar hypertrophy. These difficulties were anticipated and managed accordingly. The accidental extubation brought to our attention the fact that, even after surgical correction, this airway remains challenging. Even with intensive jaw stretchingexercises there is a high incidence of re-ankylosis, especially in younger patients. One should bear that in mind when anaesthetizing patients with TMJA.

Exploring female graduate students' multifaceted and intersecting roles and identities in a complex educational milieu /

This qualitative phenomenological investigation explored six female Master of Education students' critical understandings of their identity and role negotiations, and their perceptions of environmental conditions that facilitated or impeded their identity explorations and negotiations within the institution. The interweaving of Feminist and Women's Development theories enabled the data to be examined under different, yet complementary, lenses. The data collection strategies included: four to five in-depth semistructured interviews, three take-home activities (involving identity mapping, object and metaphor identification, and strategy development), and the compilation of extensive interview notes as well as researcher reflections. The combination of a constant comparative method and a voice-centered method were used in tandem to analyze the data. Together they uncovered five emergent themes: (a) intricate understandings of key terms; (b) life-long learning and transformative pathways; (c) gender issues; (d) challenges, tensions, and possibilities; as well as (e) personal, professional, and educational implications. The findings underscored the possibility for both a singular static identity and dynamic multifaceted identities to exist in tandem, and the emergence of natural or logical identity intersections, as well as disjointed or colliding identity intersections. Ultimately, it is the continuous negotiation of internal and external spheres that contributes to the complexity and multidimensionality of graduate students' identities.

Factors affecting treatment decision making for women with breast cancer

This study examined the factors affecting treatment decision making for young women with early stage breast cancer. Thirty women, aged 35 to 52 years, were presented information about two equally effective chemotherapy treatments following surgery for breast cancer using an educational instrument called a "decision board." Although equally effective, the treatments differ with regards to side effects and treatment schedule. The purpose of this research was to investigate what factors affect the decision-making process. Following administration of the decision board, women were given a take-home version to review and asked to return one to two weeks later with a decision, at which time they completed a questionnaire. theoretical framework for this study was constructed from the literature on self-directed learning and critical thinking. The Overall, the factors rated most important to the treatment decision were related to quality of life, side effects, and length of treatment. Five factors were found to be rated significantly different by the women who chose one treatment versus the other in terms of importance to their decision. These were side effects in general, vomiting, hair loss, family role, and the number of trips to the cancer centre required for treatment.Implications and recommendations for patient education, research, and practice evolved from the findings of this study.

Gritos de silêncio: na voz dos familiares cuidadores de portadores da doença de Alzheimer

This work is an investigation related to issues of those who take home care of people who suffer from Alzheimer disease (AD). Thus, it is justified by the need to acknowledge how these relatives perform this task and in which ways they do this. The study has is analytical and qualitative methodology with the use of a thematic oral history approach. The subjects of the research were nine relatives of those who suffer from AD that participate in the home care group in the Candelária neighborhood in the city of Natal in Rio Grande do Norte-Brazil. The data was collected using a semi-structured questionnaire and interview that was booked in advance and had full support from the care takers. After information collection, three thematic axles were defined. After this procedure, three analisys subcategories were also defined. The first thematic axle emphasizes the so called movement of rite of passage, when the relative becomes a care taker of a person with AD. The second category deals with the care takers strategies, either related to their own behalf or on their relative. It is possible to infer that amongst other forms of help, the care taker needs to rely on a support network, such as health services, groups composed by multiprofessionals that enable better articulation between family and collaborators. The dimension related to faith and spirituality was also observed and pointed out as an important aspect in the emotional support process for these relatives. In the third axle the perspectives of struggle, conquests of the right to health and life quality of those who suffer from AD as well as their relatives was observed. These also deal with dreams and hope

Controlled transscleral drug delivery formulations to the eye: establishing new concepts and paradigms in ocular anti-inflammatory therapeutics and antibacterial prophylaxis

Importance of the field: The use of topical agents poses unique and challenging hurdles for drug delivery. Topical steroids effectively control ocular inflammation, but are associated with the well-recognized dilemma of patient compliance. Although administration of topical antimicrobials as prophylaxis is acceptable among ophthalmologists, this common practice has no sound evidence base Developing a new antimicrobial agent or delivery strategy with enhanced penetration by considering the anatomical and physiological constraints exerted by the barriers of the eye is not a commonly perceived strategy. Exploiting the permeability of the sclera, subconjunctival routes may offer a promising alternative for enhanced drug delivery and tissue targeting.Area covered in this review: Ocular drug delivery strategies were reviewed for ocular inflammation and infections clinically adopted for newer class of antimicrobials, which use a multipronged approach to limit risks of endophthalmitis.What the reader will gain: The analysis substantiates a new transscleral drug delivery therapeutic approach for cataract surgery.Take home message: A new anti-inflammatory and anti-infective paradigm that frees the patient from the nuisance of topical therapeutics is introduced, opening a large investigative avenue for future improved therapies.

Can Andean medicine coexist with biomedical healthcare? A comparison of two rural communities in Peru and Bolivia

Background It is commonly assumed that indigenous medical systems remain strong in developing countries because biomedicine is physically inaccessible or financially not affordable. This paper compares the health-seeking behavior of households from rural Andean communities at a Peruvian and a Bolivian study site. The main research question was whether the increased presence of biomedicine led to a displacement of Andean indigenous medical practices or to coexistence of the two healing traditions. Methodology Open-ended interviews and free listing exercises were conducted between June 2006 and December 2008 with 18 households at each study site. Qualitative identification of households’ therapeutic strategies and use of remedies was carried out by means of content analysis of interview transcriptions and inductive interference. Furthermore, a quantitative assessment of the incidence of culture-bound illnesses in local ethnobiological inventories was performed. Results Our findings indicate that the health-seeking behavior of the Andean households in this study is independent of the degree of availability of biomedical facilities in terms of quality of services provided, physical accessibility, and financial affordability, except for specific practices such as childbirth. Preference for natural remedies over pharmaceuticals coexists with biomedical healthcare that is both accessible and affordable. Furthermore, our results show that greater access to biomedicine does not lead to less prevalence of Andean indigenous medical knowledge, as represented by the levels of knowledge about culture-bound illnesses. Conclusions The take-home lesson for health policy-makers from this study is that the main obstacle to use of biomedicine in resource-poor rural areas might not be infrastructural or economic alone. Rather, it may lie in lack of sufficient recognition by biomedical practitioners of the value and importance of indigenous medical systems. We propose that the implementation of health care in indigenous communities be designed as a process of joint development of complementary knowledge and practices from indigenous and biomedical health traditions.

Further concerns about self-assessment: are medical students aware of their progress in clinical skills during clerkship

Background: Medical students do not accurately self-assess their competence. However, little is known about the awareness of change of competence over time. The aim of this study was to evaluate if students are aware of their progress. Summary of work: Twenty-two fourth year medical students had self- and expert-assessments of their clinical skills in musculoskeletal medicine in an OSCE like station (4 point Likert scale) at the beginning (t0) and end (t1) of their eight weeks clerkship in internal medicine. Thirteen students were assigned to the intervention of a 6x1 hour practical examination course; nine took part in the regular clinical clerkship activities only and served as controls. Summary of results/Conclusions: The intervention students significantly improved their skills (from 2.78 ± 0.36 to 3.30 ± 0.36, p<0.05) in contrast to the control students (from 3.11 ± 0.58 to 2.83 ± 0.49, n.s.). At t0, 19 students, at t1 21 out of 22 students underestimated their competence. Correlations between the change of self- and expert-assessment were r=0.43, p<0.05 (all), r=0.47, n.s. (control) and r=-0.12, n.s. (intervention), respectively. Take-home message: Medical students improving their clinical skills by an interactive course in addition to their regular clerkship activities are not aware of their progress