Sustained impact of a short small group course with systematic feedback in addition to regular clinical clerkship activities on musculoskeletal examination skills-a controlled study.

BACKGROUND The discrepancy between the extensive impact of musculoskeletal complaints and the common deficiencies in musculoskeletal examination skills lead to increased emphasis on structured teaching and assessment. However, studies of single interventions are scarce and little is known about the time-dependent effect of assisted learning in addition to a standard curriculum. We therefore evaluated the immediate and long-term impact of a small group course on musculoskeletal examination skills. METHODS All 48 Year 4 medical students of a 6 year curriculum, attending their 8 week clerkship of internal medicine at one University department in Berne, participated in this controlled study. Twenty-seven students were assigned to the intervention of a 6×1 h practical course (4-7 students, interactive hands-on examination of real patients; systematic, detailed feedback to each student by teacher, peers and patients). Twenty-one students took part in the regular clerkship activities only and served as controls. In all students clinical skills (CS, 9 items) were assessed in an Objective Structured Clinical Examination (OSCE) station, including specific musculoskeletal examination skills (MSES, 7 items) and interpersonal skills (IPS, 2 items). Two raters assessed the skills on a 4-point Likert scale at the beginning (T0), the end (T1) and 4-12 months after (T2) the clerkship. Statistical analyses included Friedman test, Wilcoxon rank sum test and Mann-Whitney U test. RESULTS At T0 there were no significant differences between the intervention and control group. At T1 and T2 the control group showed no significant changes of CS, MSES and IPS compared to T0. In contrast, the intervention group significantly improved CS, MSES and IPS at T1 (p < 0.001). This enhancement was sustained for CS and MSES (p < 0.05), but not for IPS at T2. CONCLUSIONS Year 4 medical students were incapable of improving their musculoskeletal examination skills during regular clinical clerkship activities. However, an additional small group, interactive clinical skills course with feedback from various sources, improved these essential examination skills immediately after the teaching and several months later. We conclude that supplementary specific teaching activities are needed. Even a single, short-lasting targeted module can have a long lasting effect and is worth the additional effort.

Training primary care physicians to offer their patients faecal occult blood testing and colonoscopy for colorectal cancer screening on an equal basis: a pilot intervention with before-after and parallel group surveys.

OBJECTIVES Primary care physicians (PCPs) should prescribe faecal immunochemical testing (FIT) or colonoscopy for colorectal cancer screening based on their patient's values and preferences. However, there are wide variations between PCPs in the screening method prescribed. The objective was to assess the impact of an educational intervention on PCPs' intent to offer FIT or colonoscopy on an equal basis. DESIGN Survey before and after training seminars, with a parallel comparison through a mailed survey to PCPs not attending the training seminars. SETTING All PCPs in the canton of Vaud, Switzerland. PARTICIPANTS Of 592 eligible PCPs, 133 (22%) attended a seminar and 106 (80%) filled both surveys. 109 (24%) PCPs who did not attend the seminars returned the mailed survey. INTERVENTION A 2 h-long interactive seminar targeting PCP knowledge, skills and attitudes regarding offering a choice of colorectal cancer (CRC) screening options. OUTCOME MEASURES The primary outcome was PCP intention of having their patients screened with FIT and colonoscopy in equal proportions (between 40% and 60% each). Secondary outcomes were the perceived role of PCPs in screening decisions (from paternalistic to informed decision-making) and correct answer to a clinical vignette. RESULTS Before the seminars, 8% of PCPs reported that they had equal proportions of their patients screened for CRC by FIT and colonoscopy; after the seminar, 33% foresaw having their patients screened in equal proportions (p<0.001). Among those not attending, there was no change (13% vs 14%, p=0.8). Of those attending, there was no change in their perceived role in screening decisions, while the proportion responding correctly to a clinical vignette increased (88-99%, p<0.001). CONCLUSIONS An interactive training seminar increased the proportion of physicians with the intention to prescribe FIT and colonoscopy in equal proportions.

An interactive intervention to impact adherence to antiretroviral treatment among treatment-naive HIV-infected adults in Thailand: A pilot randomized controlled study

Background. Consistent adherence to antiretroviral treatment is necessary for a treatment success. Improving and maintaining adherence rate >95% are challenging for health care professionals. This pilot randomized controlled study aimed to evaluate the impact of the interactive intervention on adherence to GPO-VIR, to describe the feasibility of the interactive intervention in Thailand, and to illustrate the adherence self-efficacy concept among HIV treatment-naïve patients in Thailand who were starting antiretroviral treatment. ^ Methods. The study took place at three HIV clinics located in Phayao, Thailand. Twenty-three patients were randomly assigned into the experimental (n=11) and the control groups (n=12). Each participant in the experimental group and a significant person to the patient received 5 educational sessions with a nurse at the clinics and at their homes. They also received 3 follow-up evaluations during the 6-month period of the study. The participants in the control group received the standard of care provided by HIV clinical personnel plus three follow-up evaluations at the clinic. ^ Results. Seventeen patients (7 in the experimental and 10 in the control group) completed the study. The 4-day recall on the Thai ACTG Adherence Scale demonstrated adherence rate >95% for most participants from both groups. After the first measurement, no experimental group patients reporting missing ART, while one control group participant continuously skipped ART. Participants from both groups had significantly increased CD4 cell counts after the study (F(1, 15) = 29.30, p = .000), but no differences were found between two groups (F(1, 15) = .001, p = .98). Examination of the intervention showed limitations and possibilities to implement it in Thailand. Qualitative data demonstrated self-efficacy expectations, resignation and acceptance as related concepts to improve adherence outcomes. ^ Conclusions. This interactive intervention, after appropriate modifications, is feasible to apply for Thai HIV-treatment naïve patients. Because of limitations the study could not demonstrate whether the interactive intervention improved adherence to ART among HIV-treatment naïve in Thailand. A longitudinal study in a larger sample would be required to test the impact of the intervention. ^ Keyword: antiretroviral treatment, adherence, treatment-naïve, Thailand, randomized controlled study ^

Development of Interactive Materials by Engineering Students Using the Descartes Applets.

In a degree course such as Forestry Engineering, the general teaching objectives consist of explaining and helping students to understand the principles of Mechanics. For some time now we have encountered significant difficulties in teaching this subject due to the students' lack of motivation and to their insufficient prior preparation for the topic. If we add to this the discipline's inherent complexity and the students' preconceptions about the subject, these teaching difficulties become considerable. For this reason a series of didactic activities have been introduced sequentially in the teaching of this subject. This work describes the methodology, procedure and results for the action of developing a work project in groups using Descartes software. The results of this experiment can be considered very positive. Some of the critical preconceptions for learning the subject can be corrected, and the tutoring process in the classroom contributes to an improvement in teacherstudent communication. Since this scheme was established, the number of students taking part each academic year has increased, and this is the group with the greatest percentage of passing scores.

JAABA: interactive machine learning for automatic annotation of animal behavior

We present a machine learning-based system for automatically computing interpretable, quantitative measures of animal behavior. Through our interactive system, users encode their intuition about behavior by annotating a small set of video frames. These manual labels are converted into classifiers that can automatically annotate behaviors in screen-scale data sets. Our general-purpose system can create a variety of accurate individual and social behavior classifiers for different organisms, including mice and adult and larval Drosophila.

Cognitive change process during group cognitive behaviour therapy for depression

Background: This study extended that of Kwon and Oei [Kwon, S.M., Oei, T.P.S., 2003. Cognitive change processes in a group cognitive behavior therapy of depression. J. Behav. Ther. Exp. Psychiatry, 3, 73-85], which outlined a number of testable models based on Beck's cognitive theory of depression. Specifically, the current study tested the following four competing models: the causal, consequential, fully and partially interactive cognitive models in patients with major depressive disorder. Methods: A total of 168 clinically depressed outpatients were recruited into a 12-week group cognitive behaviour therapy program. Data was collected at three time points: baseline, mid- and at termination of therapy using the ATQ DAS and BD1. The data were analysed with Amos 4.01 (Arbuckle, J.L., 1999. Amos 4.1. Smallwaters, Chicago.) structural equation modelling. Results: Results indicated that dysfunctional attitudes, negative automatic thoughts and symptoms of depression reduced significantly during treatment. Both the causal and consequential models equally provided an adequate fit to the data. The fully interactive model provided the best fit. However, after removing non-significant pathways, it was found that reduced depressive symptom contributed to reduced depressogenic automatic thoughts and dysfunctional attitudes, not the reverse. Conclusion: These findings did not fully support Beck's cognitive theory of depression that cognitions are primary in the reduction of depressed mood. (c) 2006 Elsevier B.V. All rights reserved.

Motivations for group membership: The role of subjective importance and uncertainty reduction

An experiment was conducted to investigate the idea that an important motive for identifying with social groups is to reduce subjective uncertainty, particularly uncertainty on subjectively important dimensions that have implications for the self-concept (e.g., Hogg, 1996; Hogg & Mullin, 1999). When people are uncertain on a dimension that is subjectively important, they self-categorize in terms of an available social categorization and, thus, exhibit group behaviors. To test this general hypothesis, group membership, task uncertainty, and task importance were manipulated in a 2 x 2 x 2 between-participants design (N = 128), under relatively minimal group conditions. Ingroup identification and desire for consensual validation of specific attitudes were the key dependent measures, but we also measured social awareness. All three predictions were supported. Participants identified with their group (H1), and desired to obtain consensual validation from ingroup members (H2) when they were uncertain about their judgments on important dimensions, indicating that uncertainty reduction motivated participants towards embracing group membership. In addition, identification mediated the interactive effect of the independent variables on consensual validation (H3), and the experimental results were not associated with an increased sense of social awareness and, therefore, were unlikely to represent only behavioral compliance with generic social norms. Some implications of this research in the study of cults and totalist groups and the explication of genocide and group violence are discussed.

Interactive data in financial reporting:the construction of the non-professional investor

The Securities and Exchange Commission (SEC) in the United States and in particular its immediately past chairman, Christopher Cox, has been actively promoting an upgrade of the EDGAR system of disseminating filings. The new generation of information provision has been dubbed by Chairman Cox, "Interactive Data" (SEC, 2006). In October this year the Office of Interactive Disclosure was created(http://www.sec.gov/news/press/2007/2007-213.htm). The focus of this paper is to examine the way in which the non-professional investor has been constructed by various actors. We examine the manner in which Interactive Data has been sold as the panacea for financial market 'irregularities' by the SEC and others. The academic literature shows almost no evidence of researching non-professional investors in any real sense (Young, 2006). Both this literature and the behaviour of representatives of institutions such as the SEC and FSA appears to find it convenient to construct this class of investor in a particular form and to speak for them. We theorise the activities of the SEC and its chairman in particular over a period of about three years, both following and prior to the 'credit crunch'. Our approach is to examine a selection of the policy documents released by the SEC and other interested parties and the statements made by some of the policy makers and regulators central to the programme to advance the socio-technical project that is constituted by Interactive Data. We adopt insights from ANT and more particularly the sociology of translation (Callon, 1986; Latour, 1987, 2005; Law, 1996, 2002; Law & Singleton, 2005) to show how individuals and regulators have acted as spokespersons for this malleable class of investor. We theorise the processes of accountability to investors and others and in so doing reveal the regulatory bodies taking the regulated for granted. The possible implications of technological developments in digital reporting have been identified also by the CEO's of the six biggest audit firms in a discussion document on the role of accounting information and audit in the future of global capital markets (DiPiazza et al., 2006). The potential for digital reporting enabled through XBRL to "revolutionize the entire company reporting model" (p.16) is discussed and they conclude that the new model "should be driven by the wants of investors and other users of company information,..." (p.17; emphasis in the original). Here rather than examine the somewhat illusive and vexing question of whether adding interactive functionality to 'traditional' reports can achieve the benefits claimed for nonprofessional investors we wish to consider the rhetorical and discursive moves in which the SEC and others have engaged to present such developments as providing clearer reporting and accountability standards and serving the interests of this constructed and largely unknown group - the non-professional investor.

Does the Swedish Interactive Threshold Algorithm (SITA) accurately map visual field loss attributed to vigabatrin?

Background: Vigabatrin (VGB) is an anti-epileptic medication which has been linked to peripheral constriction of the visual field. Documenting the natural history associated with continued VGB exposure is important when making decisions about the risk and benefits associated with the treatment. Due to its speed the Swedish Interactive Threshold Algorithm (SITA) has become the algorithm of choice when carrying out Full Threshold automated static perimetry. SITA uses prior distributions of normal and glaucomatous visual field behaviour to estimate threshold sensitivity. As the abnormal model is based on glaucomatous behaviour this algorithm has not been validated for VGB recipients. We aim to assess the clinical utility of the SITA algorithm for accurately mapping VGB attributed field loss. Methods: The sample comprised one randomly selected eye of 16 patients diagnosed with epilepsy, exposed to VGB therapy. A clinical diagnosis of VGB attributed visual field loss was documented in 44% of the group. The mean age was 39.3 years∈±∈14.5 years and the mean deviation was -4.76 dB ±4.34 dB. Each patient was examined with the Full Threshold, SITA Standard and SITA Fast algorithm. Results: SITA Standard was on average approximately twice as fast (7.6 minutes) and SITA Fast approximately 3 times as fast (4.7 minutes) as examinations completed using the Full Threshold algorithm (15.8 minutes). In the clinical environment, the visual field outcome with both SITA algorithms was equivalent to visual field examination using the Full Threshold algorithm in terms of visual inspection of the grey scale plots, defect area and defect severity. Conclusions: Our research shows that both SITA algorithms are able to accurately map visual field loss attributed to VGB. As patients diagnosed with epilepsy are often vulnerable to fatigue, the time saving offered by SITA Fast means that this algorithm has a significant advantage for use with VGB recipients.

Interactive foresight on the Hungarian SMEs

Purpose – The aim of this study is to present a concept of interactive foresight process, its theoretical and methodological considerations and a foresight exercise concerning the development of knowledge economy in the Central Hungarian Region. Design/methodology/approach – A methodology of interactive foresight process for creating regional future concepts is developed, which is based on a specific meaning of integral futures and uses online solutions, too. Findings – Personal meetings with small and medium enterprise (SME) stakeholders and the works of interactive communications with feedbacks within and among stakeholder groups was organized around the research homepage. The networking created the interconnection and the feedbacks between the stakeholders and the futurist group in the process of shaping regional future ideas. The online networking is running. Research limitations/implications – The low number of stakeholders can limit the validity and acceptance of futures ideas created by this process. Practical implications – The developed interactive foresight process can also be applicable at different organizational levels and in different fields for shaping shared future ideas. Social implications – Application of interactive foresight process can contribute to the development of anticipatory democracy. Originality/value – A theoretically based interactive foresight process has been developed in which stakeholders can participate not only interactively in the foresight process but they can implement the achievements in their enterprising activity as well. The participants were interested in foresight and cooperative during the whole process because they learned the use of foresight tools through collective solution of practical tasks which were important for them.

A computer based approach to improve the dietary and physical activity patterns of a diverse group of adolescents

Diet and physical activity patterns have been implicated as major factors in the increasing prevalence of childhood and adolescent obesity. It is estimated that between 16 and 33 percent of children and adolescents in the United States are overweight (CDC, 2000). Moreover, the CDC estimates that less than 50% of adolescents are physically active on a regular basis (CDC, 2003). Interventions must be focused to modify these behaviors. Facilitating the understanding of proper nutrition and need for physical activity among adolescents is the first step in preventing overweight and obesity and delaying the development of chronic diseases later in life (Dwyer, 2000). The purpose of this study was to compare the outcomes of students receiving one of two forms of education (both emphasizing diet and physical activity), to determine whether a computer based intervention (CBI) program using an interactive, animated CD-ROM would elicit a greater behavior change in comparison to a traditional didactic intervention (TDI) program. A convenience sample of 254 high school students aged 14-19 participated in the 6-month program. A pre-test post-test design was used, with follow-up measures taken at three months post-intervention. ^ No change was noted in total fat, saturated fat, fruit/vegetables, or fiber intake for any of the groups. There was also no change in perceived self-efficacy or perceived social support. Results did, however, indicate an increase in nutrition knowledge for both intervention groups (p<0.001). In addition, the CBI group demonstrated more positive and sustained behavior changes throughout the course of the study. These changes included a decrease in BMI (ppre/post<0.001, ppost/follow-up<0.001), number of meals skipped (ppre/post<0.001), and soda consumption (ppre/post=0.003, ppost/follow-up=0.03) and an increase in nutrition knowledge (ppre/post<0.001, ppre/follow-up <0.001), physical activity (ppre/post<0.05, p pre/follow-up<0.01), frequency of label reading (ppre/follow-up <0.0l) and in dairy consumption (ppre/post=0.03). The TDI group did show positive gains in some areas post intervention, however a return to baseline behavior was shown at follow-up. Findings of this study suggest that compared to traditional didactic teaching, computer-based nutrition and health education has greater potential to elicit change in knowledge and behavior as well as promote maintenance of the behavior change over time. ^

The efficacy of an interactive computer system for teaching developmental mathematics to college students

Many students are entering colleges and universities in the United States underprepared in mathematics. National statistics indicate that only approximately one-third of students in developmental mathematics courses pass. When underprepared students repeatedly enroll in courses that do not count toward their degree, it costs them money and delays graduation. This study investigated a possible solution to this problem: Whether using a particular computer assisted learning strategy combined with using mastery learning techniques improved the overall performance of students in a developmental mathematics course. Participants received one of three teaching strategies: (a) group A was taught using traditional instruction with mastery learning supplemented with computer assisted instruction, (b) group B was taught using traditional instruction supplemented with computer assisted instruction in the absence of mastery learning and, (c) group C was taught using traditional instruction without mastery learning or computer assisted instruction. Participants were students in MAT1033, a developmental mathematics course at a large public 4-year college. An analysis of covariance using participants' pretest scores as the covariate tested the null hypothesis that there was no significant difference in the adjusted mean final examination scores among the three groups. Group A participants had significantly higher adjusted mean posttest score than did group C participants. A chi-square test tested the null hypothesis that there were no significant differences in the proportions of students who passed MAT1033 among the treatment groups. It was found that there was a significant difference in the proportion of students who passed among all three groups, with those in group A having the highest pass rate and those in group C the lowest. A discriminant factor analysis revealed that time on task correctly predicted the passing status of 89% of the participants. ^ It was concluded that the most efficacious strategy for teaching developmental mathematics was through the use of mastery learning supplemented by computer-assisted instruction. In addition, it was noted that time on task was a strong predictor of academic success over and above the predictive ability of a measure of previous knowledge of mathematics.^

The effect of different instructional groupings on student achievement and attitudes from a computer-based interactive videodisk biology unit

The purpose of this research study was to determine the effect of two different instructional groupings (cooperative and traditional whole-class) on student achievement and attitudes using a computer-based interactive videodisc biology unit. The subjects were 64 high school biology students assigned to two heterogeneous experimental groups, randomly selected from two preassigned summer school biology classes, one honors, the other regular. A two-group, posttest-only, control group experimental research design was utilized. Achievement at three cognitive levels and attitudes towards science laserdisc instruction were measured at the conclusion of the study. The cooperative group consistently outperformed the traditional group in achievement posttest scores. Factorial ANOVA on total (overall) achievement scores indicated that subjects in cooperative groups significantly outperformed those in the traditional group, and also that the instructional group, class level, and gender interacted in an ordinal fashion to make a significant difference in how female and male subjects were affected by the treatments depending on their class (aptitude) level. Regular level females and honors level males performed much better when in cooperative groups, whereas group membership did not appear to make a difference for either honors level females or regular level males. A t-test comparing honors level males revealed that cooperative groups were close to being significantly better in total achievement posttest scores than their traditional group counterparts. Factorial MANOVA comparing the instructional groups at three cognitive levels found no significant difference. Analysis on the attitudes posttest data also revealed that subjects in cooperative groups demonstrated more positive attitudes towards science laserdisc instruction; however these differences were not found to be significant. Significant interactions in attitudes of females and males from different class levels had the opposite effect as achievement: honors level females and regular level males demonstrated more positive attitudes towards science laserdisc instruction when in cooperative groups, whereas group membership did not appear to make a difference for honors level males, and regular level females demonstrated the lowest attitudes ratings of any group when involved in cooperative groups. This contrast between achievement and attitudinal results suggests cross-gender interaction in traditionally defined gender roles.

Into the Bends of Time and Musical Forces in Jazz: Group Interaction and Double-time in “My Foolish Heart” as performed by the Bill Evans Trio with Scott LaFaro and Paul Motian.

Into the Bends of Time is a 40-minute work in seven movements for a large chamber orchestra with electronics, utilizing real-time computer-assisted processing of music performed by live musicians. The piece explores various combinations of interactive relationships between players and electronics, ranging from relatively basic processing effects to musical gestures achieved through stages of computer analysis, in which resulting sounds are crafted according to parameters of the incoming musical material. Additionally, some elements of interaction are multi-dimensional, in that they rely on the participation of two or more performers fulfilling distinct roles in the interactive process with the computer in order to generate musical material. Through processes of controlled randomness, several electronic effects induce elements of chance into their realization so that no two performances of this work are exactly alike. The piece gets its name from the notion that real-time computer-assisted processing, in which sound pressure waves are transduced into electrical energy, converted to digital data, artfully modified, converted back into electrical energy and transduced into sound waves, represents a “bending” of time.

The Bill Evans Trio featuring bassist Scott LaFaro and drummer Paul Motian is widely regarded as one of the most important and influential piano trios in the history of jazz, lauded for its unparalleled level of group interaction. Most analyses of Bill Evans’ recordings, however, focus on his playing alone and fail to take group interaction into account. This paper examines one performance in particular, of Victor Young’s “My Foolish Heart” as recorded in a live performance by the Bill Evans Trio in 1961. In Part One, I discuss Steve Larson’s theory of musical forces (expanded by Robert S. Hatten) and its applicability to jazz performance. I examine other recordings of ballads by this same trio in order to draw observations about normative ballad performance practice. I discuss meter and phrase structure and show how the relationship between the two is fixed in a formal structure of repeated choruses. I then develop a model of perpetual motion based on the musical forces inherent in this structure. In Part Two, I offer a full transcription and close analysis of “My Foolish Heart,” showing how elements of group interaction work with and against the musical forces inherent in the model of perpetual motion to achieve an unconventional, dynamic use of double-time. I explore the concept of a unified agential persona and discuss its role in imparting the song’s inherent rhetorical tension to the instrumental musical discourse.

Interactive Learning in Library Inductions at University for the Creative Arts

Large group library inductions in a lecture theatre at the beginning of term are considered to be one of the more challenging scenarios for delivery. This article describes an activity in which students in groups of 30-90 are introduced to the library and its resources, using an activity to engage them and to connect their ideas with the content presented. The work of several educational theorists embodied in the activity is then described. The session was conceived as a collaboration between the Learning and Teaching Librarian and the Learning Development Tutor, who is responsible for supporting students with their reading, writing and critical skills. This work was done at University for the Creative Arts, where the author formerly held post as Learning and teaching Librarian.