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This study assessed the effectiveness of an online mathematical problem solving course designed using a social constructivist approach for pre-service teachers. Thirty-seven pre-service teachers at the Batu Lintang Teacher Institute, Sarawak, Malaysia were randomly selected to participate in the study. The participants were required to complete the course online without the typical face-to-face classes and they were also required to solve authentic mathematical problems in small groups of 4-5 participants based on the Polya’s Problem Solving Model via asynchronous online discussions. Quantitative and qualitative methods such as questionnaires and interviews were used to evaluate the effects of the online learning course. Findings showed that a majority of the participants were satisfied with their learning experiences in the course. There were no significant changes in the participants’ attitudes toward mathematics, while the participants’ skills in problem solving for “understand the problem” and “devise a plan” steps based on the Polya’s Model were significantly enhanced, though no improvement was apparent for “carry out the plan” and “review”. The results also showed that there were significant improvements in the participants’ critical thinking skills. Furthermore, participants with higher initial computer skills were also found to show higher performance in mathematical problem solving as compared to those with lower computer skills. However, there were no significant differences in the participants’ achievements in the course based on gender. Generally, the online social constructivist mathematical problem solving course is beneficial to the participants and ought to be given the attention it deserves as an alternative to traditional classes. Nonetheless, careful considerations need to be made in the designing and implementing of online courses to minimize problems that participants might encounter while participating in such courses.

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OBJECTIVES The impact of diagnostic delay (a period from appearance of first symptoms to diagnosis) on the clinical course of Crohn's disease (CD) is unknown. We examined whether length of diagnostic delay affects disease outcomes. METHODS Data from the Swiss IBD cohort study were analyzed. Patients were recruited from university centers (68%), regional hospitals (14%), and private practices (18%). The frequencies of occurrence of bowel stenoses, internal fistulas, perianal fistulas, and CD-related surgery (intestinal and perianal) were analyzed. RESULTS A total of 905 CD patients (53.4% female, median age at diagnosis 26 (20-36) years) were stratified into four groups according to the quartiles of diagnostic delay (0-3, 4-9, 10-24, and ≥25 months, respectively). Median diagnostic delay was 9 (3-24) months. The frequency of immunomodulator and/or antitumor necrosis factor drug use did not differ among the four groups. The length of diagnostic delay was positively correlated with the occurrence of bowel stenosis (odds ratio (OR) 1.76, P=0.011 for delay of ≥25 months) and intestinal surgery (OR 1.76, P=0.014 for delay of 10-24 months and OR 2.03, P=0.003 for delay of ≥25 months). Disease duration was positively associated and non-ileal disease location was negatively associated with bowel stenosis (OR 1.07, P<0.001, and OR 0.41, P=0.005, respectively) and intestinal surgery (OR 1.14, P<0.001, and OR 0.23, P<0.001, respectively). CONCLUSIONS The length of diagnostic delay is correlated with an increased risk of bowel stenosis and CD-related intestinal surgery. Efforts should be undertaken to shorten the diagnostic delay.

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Mirror masked words are embedded into a context that makes them appear as senseless patterns or as strings of unfamiliar letters. Thus, mirror masked words can be shown for several hundreds of milliseconds without being recognised as words. We sought to further investigate effects of nonsconscious reading by monitoring event-related brain potentials (ERPs) while participants observed mirror masked letter strings. ERPs were recorded while participants observed mirror masked words and nonwords. Data of 15 participants was segmented into periods of quasi-stable field topography (microstates). Microstates for masked words and nonwords were compared using randomization tests, statistical parametric scalp maps and Low Resolution Electromagnetic Tomography (LORETA). ERPs to masked words and nonwords showed significant topographic differences between 136 and 256 ms, indicating that stimuli were nonconsciously discriminated. A LORETA model localised sources of activation discriminating between masked words and nonwords in left operculum, the right superior parietal lobe and right superior temporal gyrus indicating higher current density for nonwords than for words in these areas. ERPs of mirror masked stimuli can indicate unconscious discrimination even in cases where behavioural priming is unreliable. This approach might be useful for investigating differences in early, nonconscious stages of word perception.