896 resultados para 3-Minute Nutrition Screening
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PURPOSE/OBJECTIVES: To determine the prevalence of malnutrition and chemotherapy-induced nausea and vomiting (CINV) limiting dietary intake in a chemotherapy unit. DESIGN Cross sectional descriptive audit. SETTING: Chemotherapy ambulatory care unit in an Australian teaching hospital. SAMPLE 121 patients receiving chemotherapy for malignancies, ≥18yrs and able to provide verbal consent. METHODS: An Accredited Practicing Dietitian collected all data. Chi-square tests were used to determine the relationship of malnutrition with variables and demographic data. MAIN RESEARCH VARIABLES: Nutritional status, weight change, BMI, prior dietetic input, CINV and CINV that limited dietary intake. FINDINGS Thirty one (26%) participants were malnourished, 12 (10%) had intake-limiting CINV, 22 (20%) reported significant weight loss and 20 (18%) required improved nutrition symptom management. High nutrition risk diagnoses, CINV, BMI and weight loss were significantly associated with malnutrition. Thirteen (35%) participants with malnutrition, significant weight loss, intake-limiting CINV and/or critically requiring improved symptom management reported no dietetic input; the majority of whom were overweight or obese. CONCLUSIONS: This audit determined over one quarter of patients receiving chemotherapy in this ambulatory setting were malnourished and the majority of patients reporting intake-limiting CINV were malnourished. IMPLICATIONS FOR NURSING Patients with malnutrition and/or intake-limiting CINV and in need of improved nutrition symptom management may be overlooked, especially patients who are overweight or obese - an increasing proportion of the Australian population. Evidence-based practice guidelines recommend implementing validated nutrition screening tools, such as the Malnutrition Screening Tool, in patients undergoing chemotherapy to identify those at risk of malnutrition requiring dietitian referral.
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Digital Storytelling is a powerful means for enabling communication and social participation. Ordinary people work with expert creative practitioners to create first person narratives for a wide and growing range of purposes, including community building, cultural engagement, brand identification and public communication. A digital story usually combines 15-30 still images and a recorded script of 100-250 words to create an original personal digital story in the form of a 2-3 minute digital video. This form of co-creative media takes advantage of newly accessible technologies but is based in the ancient and universal tradition of storytelling. Digital storytelling is being adopted internationally in a variety of institutional contexts. It was introduced at QUT by Distinguished Professor John Hartley in 2004 when he brought well known UK based digital storytelling expert Daniel Meadows to the Creative Industries Faculty to trainer researchers and Faculty in the technique. Since 2005 Creative Industries Faculty researchers have adapted digital storytelling for use in a variety of research contexts including heritage, youth welfare, health, and international development, in collaboration with a range of external partner organisations. More than 300 digital stories have been produced by QUT researchers, staff and students. These have been presented on the World Wide Web, broadcast on community media, released on DVD and exhibited in various forms. In addition CIF researchers have produced numerous journal articles, conference papers and books reporting the outcomes of research projects utilising digital storytelling in research. As a result of research activity the Creative Industries Faculty is now well positioned as a leading site for teaching and learning in digital storytelling. Faculty research activity in digital storytelling has generated interest in adapting the form for use in undergraduate and postgraduate Creative Industries curriculum and in service teaching, including short courses for external clients.
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Background Randomised controlled trials may be of limited use to evaluate the multidisciplinary and multimodal interventions required to effectively treat complex patients in routine clinical practice; pragmatic action research approaches may provide a suitable alternative. Methods A multiphase, pragmatic, action research based approach was developed to identify and overcome barriers to nutritional care in patients admitted to a metropolitan hospital hip-fracture unit. Results Four sequential action research cycles built upon baseline data including 614 acute hip-fracture inpatients and 30 purposefully sampled clinicians. Reports from Phase I identified barriers to nutrition screening and assessment. Phase II reported post-fracture protein-energy intakes and intake barriers. Phase III built on earlier results; an explanatory mixed-methods study expanded and explored additional barriers and facilitators to nutritional care. Subsequent changes to routine clinical practice were developed and implemented by the treating team between Phase III and IV. These were implemented as a new multidisciplinary, multimodal nutritional model of care. A quasi-experimental controlled, ‘before-and-after’ study was then used to compare the new model of care with an individualised nutritional care model. Engagement of the multidisciplinary team in a multiphase, pragmatic action research intervention doubled energy and protein intakes, tripled return home discharge rates, and effected a 75% reduction in nutritional deterioration during admission in a reflective cohort of hip-fracture inpatients. Conclusions This approach allowed research to be conducted as part of routine clinical practice, captured a more representative patient cohort than previously reported studies, and facilitated exploration of barriers and engagement of the multidisciplinary healthcare workers to identify and implement practical solutions. This study demonstrates substantially different findings to those previously reported, and is the first to demonstrate that multidisciplinary, multimodal nutrition care reduces intake barriers, delivers a higher proportional increase in protein and energy intake compared with baseline than other published intervention studies, and improves patient outcomes when compared with individualised nutrition care. The findings are considered highly relevant to clinical practice and have high translation validity. The authors strongly encourage the development of similar study designs to investigate complex health problems in elderly, multi-morbid patient populations as a way to evaluate and change clinical practice.
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Comprised of ten 3 minute and two 12 minutes animated episodes, featuring Polly Pockets and her friend in numerous adventures.
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This study explored pre-service secondary science teachers’ perceptions of classroom emotional climate in the context of the Bhutanese macro-social policy of Gross National Happiness. Drawing upon sociological perspectives of human emotions and using Interaction Ritual Theory this study investigated how pre-service science teachers may be supported in their professional development. It was a multi-method study involving video and audio recordings of teaching episodes supported by interviews and the researcher’s diary. Students also registered their perceptions of the emotional climate of their classroom at 3-minute intervals using audience response technology. In this way, emotional events were identified for video analysis. The findings of this study highlighted that the activities pre-service teachers engaged in matter to them. Positive emotional climate was identified in activities involving students’ presentations using video clips and models, coteaching, and interactive whole class discussions. Decreases in emotional climate were identified during formal lectures and when unprepared presenters led presentations. Emotions such as frustration and disappointment characterized classes with negative emotional climate. The enabling conditions to sustain a positive emotional climate are identified. Implications for sustaining macro-social policy about Gross National Happiness are considered in light of the climate that develops in science teacher education classes.
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Staphylococcus aureus is one of the most important bacteria that cause disease in humans, and methicillin-resistant S. aureus (MRSA) has become the most commonly identified antibiotic-resistant pathogen in many parts of the world. MRSA rates have been stable for many years in the Nordic countries and the Netherlands with a low MRSA prevalence in Europe, but in the recent decades, MRSA rates have increased in those low-prevalence countries as well. MRSA has been established as a major hospital pathogen, but has also been found increasingly in long-term facilities (LTF) and in communities of persons with no connections to the health-care setting. In Finland, the annual number of MRSA isolates reported to the National Infectious Disease Register (NIDR) has constantly increased, especially outside the Helsinki metropolitan area. Molecular typing has revealed numerous outbreak strains of MRSA, some of which have previously been associated with community acquisition. In this work, data on MRSA cases notified to the NIDR and on MRSA strain types identified with pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST), and staphylococcal cassette chromosome mec (SCCmec) typing at the National Reference Laboratory (NRL) in Finland from 1997 to 2004 were analyzed. An increasing trend in MRSA incidence in Finland from 1997 to 2004 was shown. In addition, non-multi-drug resistant (NMDR) MRSA isolates, especially those resistant only to methicillin/oxacillin, showed an emerging trend. The predominant MRSA strains changed over time and place, but two internationally spread epidemic strains of MRSA, FIN-16 and FIN-21, were related to the increase detected most recently. Those strains were also one cause of the strikingly increasing invasive MRSA findings. The rise of MRSA strains with SCCmec types IV or V, possible community-acquired MRSA was also detected. With questionnaires, the diagnostic methods used for MRSA identification in Finnish microbiology laboratories and the number of MRSA screening specimens studied were reviewed. Surveys, which focused on the MRSA situation in long-term facilities in 2001 and on the background information of MRSA-positive persons in 2001-2003, were also carried out. The rates of MRSA and screening practices varied widely across geographic regions. Part of the NMDR MRSA strains could remain undetected in some laboratories because of insufficient diagnostic techniques used. The increasing proportion of elderly population carrying MRSA suggests that MRSA is an emerging problem in Finnish long-term facilities. Among the patients, 50% of the specimens were taken on a clinical basis, 43% on a screening basis after exposure to MRSA, 3% on a screening basis because of hospital contact abroad, and 4% for other reasons. In response to an outbreak of MRSA possessing a new genotype that occurred in a health care ward and in an associated nursing home of a small municipality in Northern Finland in autumn 2003, a point-prevalence survey was performed six months later. In the same study, the molecular epidemiology of MRSA and methicillin-sensitive S. aureus (MSSA) strains were also assessed, the results to the national strain collection compared, and the difficulties of MRSA screening with low-level oxacillin-resistant isolates encountered. The original MRSA outbreak in LTF, which consisted of isolates possessing a nationally new PFGE profile (FIN-22) and internationally rare MLST type (ST-27), was confined. Another previously unrecognized MRSA strain was found with additional screening, possibly indicating that current routine MRSA screening methods may be insufficiently sensitive for strains possessing low-level oxacillin resistance. Most of the MSSA strains found were genotypically related to the epidemic MRSA strains, but only a few of them had received the SCCmec element, and all those strains possessed the new SCCmec type V. In the second largest nursing home in Finland, the colonization of S. aureus and MRSA, and the role of screening sites along with broth enrichment culture on the sensitivity to detect S. aureus were studied. Combining the use of enrichment broth and perineal swabbing, in addition to nostrils and skin lesions swabbing, may be an alternative for throat swabs in the nursing home setting, especially when residents are uncooperative. Finally, in order to evaluate adequate phenotypic and genotypic methods needed for reliable laboratory diagnostics of MRSA, oxacillin disk diffusion and MIC tests to the cefoxitin disk diffusion method at both +35°C and +30°C, both with or without an addition of sodium chloride (NaCl) to the Müller Hinton test medium, and in-house PCR to two commercial molecular methods (the GenoType® MRSA test and the EVIGENETM MRSA Detection test) with different bacterial species in addition to S. aureus were compared. The cefoxitin disk diffusion method was superior to that of oxacillin disk diffusion and to the MIC tests in predicting mecA-mediated resistance in S. aureus when incubating at +35°C with or without the addition of NaCl to the test medium. Both the Geno Type® MRSA and EVIGENETM MRSA Detection tests are usable, accurate, cost-effective, and sufficiently fast methods for rapid MRSA confirmation from a pure culture.
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Colorectal cancer is the most common cause of death due to malignancy in nonsmokers in the western world. In 1995 there were 1,757 cases of colon cancer in Ireland. Most colon cancer is sporadic, however ten percent of cases occur where there is a previous family history of the disease. In an attempt to understand the tumorigenic pathway in Irish colon cancer patients, a number of genes associated with colorectal cancer development were analysed in Irish sporadic and HNPCC colon cancer patients. The hereditary forms of colon cancer include Familial adenomatous polyposis coli (FAP) and Hereditary Non-Polyposis Colon Cancer (HNPCC). Genetic analysis of the gene responsible for FAP, (the APC gene) has been previously performed on Irish families, however the genetic analysis of HNPCC families is limited. In an attempt to determine the mutation spectrum in Irish HNPCC pedigrees, the hMSH2 and hMLHl mismatch repair genes were screened in 18 Irish HNPCC families. Using SSCP analysis followed by DNA sequencing, five mutations were identified, four novel and a previously reported mutation. In families where a mutation was detected, younger asyptomatic members were screened for the presence of the predisposing mutation (where possible). Detection of mutations is particularly important for the identification of at risk individuals as the early diagnosis of cancer can vastly improve the prognosis. The sensitive and efficient detection of multiple different mutations and polymorphisms in DNA is of prime importance for genetic diagnosis and the identification of disease genes. A novel mutation detection technique has recently been developed in our laboratory. In order to assess the efficacy and application of the methodology in the analysis of cancer associated genes, a protocol for the analysis of the K-ras gene was developed and optimised. Matched normal and tumour DNA from twenty sporadic colon cancer patients was analysed for K-ras mutations using the Glycosylase Mediated Polymorphism Detection technique. Five mutations of the K-ras gene were detected using this technology. Sequencing analysis verified the presence of the mutations and SSCP analysis of the same samples did not identify any additional mutations. The GMPD technology proved to be highly sensitive, accurate and efficient in the identification of K-ras gene mutations. In order to investigate the role of the replication error phenomenon in Irish colon cancer, 3 polyA tract repeat loci were analysed. The repeat loci included a 10 bp intragenic repeat of the TGF-β-RII gene. TGF-β-RII is involved in the TGF-β epithelial cell growth pathway and mutation of the gene is thought to play a role in cell proliferation and tumorigenesis. Due to the presence of a repeat sequence within the gene, TGFB-RII defects are associated with tumours that display the replication error phenomenon. Analysis of the TGF-β-RII 10 bp repeat failed to identify mutations in any colon cancer patients. Analysis of the Bat26 and Bat 40 polyA repeat sequences in the sporadic and HNPCC families revealed that instability is associated with HNPCC tumours harbouring mismatch repair defects and with 20 % of sporadic colon cancer tumours. No correlation between K-ras gene mutations and the RER+ phenotype was detected in sporadic colon cancer tumours.
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PURPOSE: To investigate the effects of arginine vasopressin (AVP) on Ca(2+) sparks and oscillations and on sarcoplasmic reticulum (SR) Ca(2+) content in retinal arteriolar myocytes. METHODS: Fluo-4-loaded smooth muscle in intact segments of freshly isolated porcine retinal arteriole was imaged by confocal laser microscopy. SR Ca(2+) store content was assessed by recording caffeine-induced Ca(2+) transients with microfluorimetry and fura-2. RESULTS: The frequencies of Ca(2+) sparks and oscillations were increased both during exposure to, and 10 minutes after washout of AVP (10 nM). Caffeine transients were increased in amplitude 10 and 90 minutes after a 3-minute application of AVP. Both AVP-induced Ca(2+) transients and the enhancement of caffeine responses after AVP washout were inhibited by SR 49059, a V(1a) receptor blocker. Forskolin, an activator of adenylyl cyclase, also persistently enhanced caffeine transients. Rp-8-HA-cAMPS, a membrane-permeant PKA inhibitor, prevented enhancement of caffeine transients by both AVP and forskolin. Forskolin, but not AVP, produced a reversible, Rp-8-HA-cAMPS insensitive reduction in basal [Ca(2+)](i). CONCLUSIONS: AVP activates a cAMP/PKA-dependent pathway via V(1a) receptors in retinal arteriolar smooth muscle. This effect persistently increases SR Ca(2+) loading, upregulating Ca(2+) sparks and oscillations, and may favor prolonged agonist activity despite receptor desensitization.
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Contient : 1 Instructions de CHARLES VII à Guillaume de Meny Peny, Guillaume de Vic et Jean de Saint Romain, ses ambassadeurs, de ce qu'ils ont à dire de sa part au duc de Bourgogne et à ceux de Gand, signées : « Charles ». Moulins, 11 décembre 1452. Orig ; 2 « Mynute de l'examen touchant la cedule que le feu duc Charles de Bourgogne bailla au roy pour aller à Peronne ». 28-30 mai 1478 ; 3 Minute d'un mémoire touchant le traité de Péronne ; 4 Remontrances et requêtes présentées à Charles VII par Guiot Pot et Nicolas le Bourguignon, de la part de Philippe le Bon, duc de Bourgogne, concernant « ceulx de la ville de Gand » ; avec les réponses du roi. Janvier 1452 n. st ; 5 Délibération du conseil du roi tenu à Villefranche en Berry, relative aux affaires de Bourgogne, les 26 et 28 juillet 1460 ; 6 « Poins qui ont esté acordez par le roy » Louis XI « à monseigneur de Contey, pour le fait de la reduction de la ville de Corbye ». Corbie, 11 mai 1475. Copie collationnée ; 7 Ordonnance de LOUIS XI, donnant amnistie générale des faits commis durant les guerres de Bourgogne. Selommes, 19 janvier 1477 n. st ; 8 « Reppliques aux objections de l'empereur » Frédéric III, « touchant l'armée de monseigneur le Daulphin et son alée en Autriche ». 1445 ; 9 « Raisons pour lesquelles les duché et conté de Bourgogne et les contez d'Auxerre et de Mascon ne pevent venir à madame d'Autriche ». 1477 ; 10 Notes relatives à ce qui revient au roi dans les États laissés par le duc de Bourgogne, Charles le Téméraire ; 11 « Advertissemens par manière d'abregé d'aucuns des poincts par lesquelx Charles, soy disant duc de Bourgogne, a notoyrement rompu et enfrainct les traictez, sermens et promesses qu'il avoit avecques le roy, et encouru les poynes sur ce apposées ». 1474 ? Minute ; 12 « Entreprinses que monseigneur de Charoloys et ses officiers ont faictes sur les droiz du roy et auctorité de sa coronne ». 1463 ; 13 « Abreigé des droitz que mademoiselle » Marie « de Bourgogne pretend ès terres de son père, dont il est question entre le roy » Louis XI « et elle ». 1477. Minute ; 14 « Memoire abregé pour monstrer que la duché de Bourgogne et la conté de Charoloys appartiennent au roy ». 1477. Minute ; 15 Mémoire « touchant les droiz que le roy sy a ès contés de Bourgogne et d'Artoys, en la duché de Bourgogne, et à Lisle, Douay et Orchys ». 1477. Minute ; 16 Court mémoire, en latin, sur la question de savoir si les héritiers d'un prince sont tenus d'observer les engagements de leur auteur. Après la mort de Charles le Téméraire. Minute ; 17 Court mémoire sur la question de savoir si le roi de France peut autoriser en conscience des tiers à attaquer le duc de Bourgogne. Minute ; 18 « Faiz, causes et raisons par lesquelx appert clerement que tractez faiz tant entre le roy Charles,... et le duc Phelippe de Bourgogne, lors vivant, ou moys d'octobre... mil CCCCXXXV, comme depuys, entre le roy, nostre souverain seigneur... et le feu duc Charles de Bourgogne », à Conflans en 1465 et à Péronne en 1468, « ont esté notoyrement et manifestement rompus et enfraincts par lesdits feuz ducs Phelippe et Charles ». Minute ; 19 Remontrances faites au roi Louis XI par les ambassadeurs du comte de Charolais ; 20 « Instrument des parolles dictes » par Me Jean Chuffart, doyen de l'Église de Paris, au nom de Charles VII, à Philippe, duc de Bourgogne, selon le contenu d'un article du traité d'Arras en 1435, relativement à l'assassinat de Jean-sans-Peur. En latin ; 21 « Abregé des lectres originalles qui ont esté exhibées aux commis et depputez de monseigneur d'Autriche ». 1477 ; 22 Mémoire dressé après la mort de Charles le Téméraire, concernant les droits de Louis XI sur les duché et comté de Bourgogne et les comtés de Mâcon et d'Auxerre, portant à la fin cette mention : « Intendit fait par feu Me Ge DE CUSINOT ». Deux minutes : l'une, moins incomplète que l'autre et remplissant les feuillets 105 à 115 et 122 à 166, l'autre très incomplète et remplissant les feuillets 116 à 121, dont le contenu correspond aux 11 premiers feuillets de la première ; 23 Sommation qui devait être faite de la part de Louis XI à Maximilien d'Autriche, touchant la rupture des trèves. 1478-1479 ; 24 Mémoire contenant les propositions que le roi Louis XI pourrait faire à Maximilien d'Autriche et à Marie de Bourgogne. Minute ; 25 Trève de dix jours, conclue à Lens en Artois, pour commencer le 9 septembre 1477, au lever du soleil, entre Louis XI, d'une part, et Maximilien d'Autriche et Marie de Bourgogne, d'autre part. Lens, 8 septembre 1477. Minute ; 26 Inventaire de lettres, rangées sous 17 cotes, concernant les comté et duché de Bourgogne et les droits du roi Louis XI sur iceux. Après la mort de Charles le Téméraire
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Malgré l’engouement pour les neurosciences cognitives des émotions et les nombreuses publications des dernières décennies tentant d’élucider les bases neurobiologiques des émotions, nos connaissances sur le domaine restent embryonnaires. Plusieurs questions importantes restent toujours sans réponses incluant s’il existe ou non un système unique pour le traitement de stimuli émotionnels et s’il y a ou non des différences entre les hommes et les femmes pour le traitement de stimuli émotionnels. L’objectif de cette thèse est d’apporter certains éléments de réponses à ces questions à travers une caractérisation du substrat neurobiologique impliqué dans le traitement de stimuli émotionnels visuels et dynamiques. Ce travail a été mené via l’imagerie par résonance magnétique fonctionnelle (IRMf) cérébrale. Le premier chapitre, subdivisé en quatre sections, permet de présenter la perspective dans laquelle s’inscrit la thèse. La première section de ce chapitre sert à établir certaines balises définitionnelles liées aux émotions. La seconde section, basée sur une lecture des textes originaux, retrace les faits historiques saillants de la neurobiologie des émotions allant de Charles Darwin à Joseph Ledoux. La troisième section débute où la seconde s’arrête et continue l’histoire de la neurobiologie des émotions à travers un résumé de toutes les principales méta-analyses d’imagerie fonctionnelle cérébrale des émotions. La dernière section du chapitre permet de présenter la problématique de recherche. La recherche, à proprement parler, qui constitue le corps de la thèse est ensuite présentée sous forme de trois articles. Enfin, les résultats de cette recherche et la manière dont ils s’inscrivent dans la continuité de nos connaissances actuelles font l’objet d’une discussion générale. Le premier article (chapitre II) rapporte, chez les hommes et les femmes, les régions du cerveau qui sont plus activées lors du traitement de films érotiques que lors du traitement de films dits ‘neutres’. Un chevauchement manifeste est observé entre les hommes et les femmes. Par contre, une activation significativement plus grande est observée chez les hommes pour l’hypothalamus, une région importante pour le comportement sexuel à travers la phylogénie. De plus, chez les hommes seulement, l’activation hypothalamique est corrélée à l’excitation sexuelle subjective. Comme la recherche présentée dans le premier article se sert de conditions expérimentales relativement longues pour l’IRMf (i.e. extraits de films de 3 minutes) et que ceci peut induire une nette diminution de signal en lien avec certaines contraintes de l’IRMf, le second article (chapitre III) examine les corrélats du traitement de stimuli sexuels en utilisant, cette fois, un paradigme d’IRMf classique où plusieurs extraits de films de 33 secondes sont présentés à la place. Cette étude démontre que, pour le traitement de stimuli sexuels, ce paradigme classique d’IRMf est beaucoup plus sensible que celui du premier article. De plus, comme ce paradigme mène à une reproduction des résultats du premier papier, ce travail soutient la perspective selon laquelle les paradigmes à époques courtes sont une alternative valide aux longues époques comme méthode d’étude du traitement de stimuli émotionnels. Le troisième article (chapitre IV) capitalise sur le protocole du second article et démontre que les patrons d’activation associés au visionnement de courts extraits de films induisant du dégoût, de l’amusement, ou de l’excitation sexuelle, sont très étendus. Une analyse de conjonction formelle démontre un large chevauchent de ces patrons à travers les différents affects étudiés. Enfin, le cinquième chapitre sert de discussion générale. Les questions des différences entre les hommes et les femmes dans le traitement des émotions, de l’existence ou non d’un système général pour le traitement des émotions, ainsi que de la manière dont un tel système pourrait être conçu, sont des points saillants de la discussion. Ces points sont abordés à la lumières des connaissances actuelles et des résultats des trois articles.
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This 3-minute video shows you how to combine chapters of your thesis but force footnotes to be numbered from 1 within each chapter.
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This 3-minute video shows how you can share documents during an Adobe Connect meeting - for example showing a Word document or Excel spreadsheet to the other participants.
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This short 3-minute video show how you can make a recording available to anyone on the internet and how to restrict access again. It also shows how to disable and re-enable student access to a specific recording.
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The first 3-minute video in a series introducing the new featurs of Blackboard 9.
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The third 3-minute video in a series introducing the new featurs of Blackboard 9.