Ethnic disparities in health and health care: a focused review of the evidence and selected examples of good practice. Executive summary

This report arises from a project commissioned by the Department of Health's Equality and Human Rights Group to produce an evidence-based review with a national perspective that addresses (i) ethnic differentials in health and healthcare and (ii) evidence of effective NHS and other action, including seective examples of good practice to illustrate each area. Rather than aiming for comprehensive coverage, the Department suggested a document that focuses on selective topics and population health priorities drawn from the NHS plan, existing and developing National Service Frameworks, and other policy documents and which, collectively, are encompassed in the NHS's 10-point Race Equality Action Plan. The authors were not asked to review the evidence on other key areas (such ashypertension, stroke, disability, etc.), ethnic disparities in the wider determinants of health, and on some specific groups such as Gypsy Travellers and refugees and asylum seekers. Some of these topics are covered in other reviews.

Cochrane Short Courses Training Application Form 2011

Application Form for Training Courses on Conducting Systematic Reviews, 2011.

The European Respiratory Society spirometry tent: a unique form of screening for airway obstruction.

In order to raise public awareness of the importance of early detection of airway obstruction and to enable many people who had not been tested previously to have their lung function measured, the European Lung Foundation and the European Respiratory Society (ERS) organised a spirometry testing tent during the annual ERS Congresses in 2004-2009. Spirometry was performed during the ERS Congresses in volunteers; all participants answered a simple, brief questionnaire on their descriptive characteristics, smoking and asthma. Portable spirometers were freely provided by the manufacturer. Nurses and doctors from pulmonary departments of local hospitals/universities gave their service for free. Lower limit of normal (LLN) and Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria for diagnosing and grading airway obstruction were used. Of 12,448 participants in six congress cities, 10,395 (83.5%) performed acceptable spirometry (mean age 51.0 ± 18.4 yrs; 25.5% smokers; 5.5% asthmatic). Airway obstruction was present in 12.4% of investigated subjects according to LLN criteria and 20.3% according to GOLD criteria. Through multinomial logistic regression analysis, age, smoking habits and asthma were significant risk factors for airway obstruction. Relative risk ratio and 95% confidence interval for LLN stage I, for example, was 2.9 (2.0-4.1) for the youngest age (≤ 19 yrs), 1.9 (1.2-3.0) for the oldest age (≥ 80 yrs), 2.4 (2.0-2.9) for current smokers and 2.8 (2.2-3.6) for reported asthma diagnosis. In addition to being a useful advocacy tool, the spirometry tent represents an unusual occasion for early detection of airway obstruction in large numbers of city residents with an important public health perspective.

A soluble hexameric form of CD40 ligand activates human dendritic cells and augments memory T cell response.

A strategy to improve the immunogenicity of candidate vaccines is to trigger the innate immune system. Triggering of CD40 at the surface of dendritic cells (DC) is essential in the induction of an efficient immune response. Although CD40 agonist antibodies have been shown to be potent inducers of immune responses in experimental models, serious safety concerns have been raised for their use in humans. In addition, the production of soluble functional CD40 ligand has been challenging and the soluble form existing so far is not developed anymore. Here, we have evaluated the potency of a new soluble form of hexameric CD40 ligand (sCD40L) to serve as an adjuvant for anti-viral T cell responses. sCD40L was able to activate human DC and to enhance virus-specific memory T cell responses. These results demonstrate that this soluble form of CD40 ligand may serve as an adjuvant for T cell response and thus provide the rationale for its potential use in T cell based vaccine strategies.

Big and Little OER

Much of the attention around OERs has been on institutional projects which make explicit learning content available. These can be classified as 'big OER' but another form of OER is that of small scale, individually produced resources using web 2.0 type services, which are classified as 'little OER'. This paper examines some of the differences between the use of these two types of OER to highlight issues in open education. These include attitudes towards reputation, the intentionality of the resource, models of sustainability, the implicit affordances of resources and the context of their hosting sites.

Innovative Applications : Open Educational Resources and Mobile Resources Repository for the Instruction of Educational Researchers in Mexico

The movement of Open Educational Resources (OER) is one of the most important trends that are helping education through the Internet worldwide. "Tecnológico de Monterrey" (http://tecvirtual.itesm.mx/) in Mexico, with other Mexican higher education institutions, is creating an Internet/web based repository of OERs and Mobile Resources for the instruction and development of educational researchers at undergraduate, Master's and Doctoral level. There is a lack of open educational resources and material available at the Internet that can help and assist the development and education of educational researchers in Spanish speaking countries. This OER repository is part of a project that is experimenting new technology for the delivery of OERs from one repository (http://catedra.ruv.itesm.mx/) through an indexed OER catalog (http://www.temoa.info/) to mobile devices (Ipod, Iphone, MP3, MP4). This paper presentation will describe and comment about this project: outcomes, best practices, difficulties and technological constraints.

The relationships between technology and open education in the development of a resilient higher education

The place of technology in the development of coherent educational responses to environmental and socio-economic disruption is here placed under scrutiny. One emerging area of interest is the role of technology in addressing more complex learning futures, and more especially in facilitating individual and social resilience, or the ability to manage and overcome disruption. However, the extent to which higher education practitioners can utilise technology to this end is framed by their approaches to the curriculum, and the socio-cultural practices within which they are located. This paper discusses how open education might enable learners to engage with uncertainty through social action within a form of higher education that is more resilient to economic, environmental and energy-related disruption. It asks whether open higher education can be (re)claimed by users and communities within specific contexts and curricula, in order to engage with an uncertain world.

The Value of Imperfection : the Wabi-Sabi Principle in Aesthetics and Learning

OER-based learning has the potential to overcome many shortcomings and problems of traditional education. It is not hampered by IP restrictions; can depend on collaborative, cumulative, iterative refinement of resources; and the digital form provides unprecedented flexibility with respect to configuration and delivery. The OER community is a progressive group of educators and learners with decades of learning research to draw from, who know that we must prepare learners for an evolving and diverse reality. Despite this OER tends to replicate the unsuccessful characteristics of traditional education. To remedy this we may need to remember the importance of imperfection, mistakes, problems, disagreement, and the incomplete for engaged learning, and relinquish our notions of perfection, acknowledging that learners learn differently and we need diverse learners. We must stretch our perceptions of quality and provide mechanisms for engaging the incredible pool of educators globally to fulfill the promise of inclusive education.

How to foster sharing of educational resources?

The future of OER is highly dependent on the future of education in general. A future that will be determined by major changes in society that demand more people with a higher education and life long learning. Each vision for the long term future needs to take the qualitative and quantitative demands into account. Backcasting from a vision we arrive at useful steps to take, some of which we managed to start up in the form of pilots as part of the European research project Share.TEC.

TwHistory : Sharing History Using Twitter

In light of the fact that several studies indicate that students can benefit from deeper understandings of the processes by which historical accounts are constructed, history educators have increasingly been focused on finding ways to teach students how to read and reason about events in the same manner as professional historians (Wineburg, 2001; Spoehr & Spoehr, 1994; Hynd, Holschuh, & Hubbard, 2004; Wiley & Voss, 1996). One possible resource for supporting this development may come out of emerging web-based technologies. New technologies and increased access to historical records and artifacts posted the Internet may be precisely the tools that can help students (Bass, Rosenzweig, & Mason, 1999). Given the right context, we believe it is possible to combine such resources and tools to create an environment for students that could strengthen their abilities to read and reason about historical events. Moreover, we believe that social media, specifically, microblogging (Nardi, Schiano, Gumbrecht, & Swartz, 2004) could play a key role.

Justifying Institutional Investment in OER Development : OERs as Marketing Vehicle

The higher education sector has become increasingly competitive and prospective students are adopting a consumerist approach to institution and programme choice. In response, higher education marketing has become more complex, market-oriented and business-like. Financial sustainability of open education resource (OER) projects is a widespread concern. This paper explores the extent to which a classical product placement framework can be applied to OERs to justify institutional funding in OER projects as a marketing investment. It is argued that OERs designed on this premise can increase cognitive, affective and conative brand outcomes while providing the traditional educational and societal benefits associated with OERs. A series of propositions are presented that may form the basis of a future research agenda.

An Ontology for Open Rubric Exchange on the Web

While the Internet has given educators access to a steady supply of Open Educational Resources, the educational rubrics commonly shared on the Web are generally in the form of static, non-semantic presentational documents or in the proprietary data structures of commercial content and learning management systems.With the advent of Semantic Web Standards, producers of online resources have a new framework to support the open exchange of software-readable datasets. Despite these advances, the state of the art of digital representation of rubrics as sharable documents has not progressed.This paper proposes an ontological model for digital rubrics. This model is built upon the Semantic Web Standards of the World Wide Web Consortium (W3C), principally the Resource Description Framework (RDF) and Web Ontology Language (OWL).

Immunological imbalance between IFN-³ and IL-10 levels in the sera of patients with the cardiac form of Chagas disease

The immune response is crucial for protection against disease; however, immunological imbalances can lead to heart and digestive tract lesions in chagasic patients. Several studies have evaluated the cellular and humoral immune responses in chagasic patients in an attempt to correlate immunological findings with clinical forms of Chagas disease. Moreover, immunoglobulins and cytokines are important for parasitic control and are involved in lesion genesis. Here, cytokine and IgG isotype production were studied, using total epimastigote antigen on sera of chagasic patients with indeterminate (IND, n = 27) and cardiac (CARD, n = 16) forms of the disease. Samples from normal, uninfected individuals (NI, n = 30) were use as controls. The results showed that sera from both IND and CARD patients contained higher levels of Trypanosoma cruzi-specific IgG1 (IgG1) antibodies than sera from NI. No difference in IgG2 production levels was observed between NI, IND and CARD patients, nor was a difference in IL-10 and IFN-³ production detected in the sera of IND, CARD and NI patients. However, IND patients displayed a positive correlation between IL-10 and IFN-³ levels in serum, while CARD patients showed no such correlation, indicating an uncontrolled inflammatory response in CARD patients. These findings support the hypothesis that a lack of efficient regulation between IFN-³ and IL-10 productions in CARD patients may lead to cardiac immunopathology.

Increased neurotransmitter release at the neuromuscular junction in a mouse model of polyglutamine disease.

In Huntington's disease (HD), the expansion of polyglutamine (polyQ) repeats at the N terminus of the ubiquitous protein huntingtin (htt) leads to neurodegeneration in specific brain areas. Neurons degenerating in HD develop synaptic dysfunctions. However, it is unknown whether mutant htt impacts synaptic function in general. To investigate that, we have focused on the nerve terminals of motor neurons that typically do not degenerate in HD. Here, we have studied synaptic transmission at the neuromuscular junction of transgenic mice expressing a mutant form of htt (R6/1 mice). We have found that the size and frequency of miniature endplate potentials are similar in R6/1 and control mice. In contrast, the amplitude of evoked endplate potentials in R6/1 mice is increased compared to controls. Consistent with a presynaptic increase of release probability, synaptic depression under high-frequency stimulation is higher in R6/1 mice. In addition, no changes were detected in the size and dynamics of the recycling synaptic vesicle pool. Moreover, we have found increased amounts of the synaptic vesicle proteins synaptobrevin 1,2/VAMP 1,2 and cysteine string protein-α, and the SNARE protein SNAP-25, concomitant with normal levels of other synaptic vesicle markers. Our results reveal that the transgenic expression of a mutant form of htt leads to an unexpected gain of synaptic function. That phenotype is likely not secondary to neurodegeneration and might be due to a primary deregulation in synaptic protein levels. Our findings could be relevant to understand synaptic toxic effects of proteins with abnormal polyQ repeats.