Can less be more? Comparison of an 8-item placement quality measure with the 50-item Dundee Ready Educational Environment Measure (DREEM)

Clinical clerks learn more than they are taught and not all they learn can be measured. As a result, curriculum leaders evaluate clinical educational environments. The quantitative Dundee Ready Environment Measure (DREEM) is a de facto standard for that purpose. Its 50 items and 5 subscales were developed by consensus. Reasoning that an instrument would perform best if it were underpinned by a clearly conceptualized link between environment and learning as well as psychometric evidence, we developed the mixed methods Manchester Clinical Placement Index (MCPI), eliminated redundant items, and published validity evidence for its 8 item and 2 subscale structure. Here, we set out to compare MCPI with DREEM. 104 students on full-time clinical placements completed both measures three times during a single academic year. There was good agreement and at least as good discrimination between placements with the smaller MCPI. Total MCPI scores and the mean score of its 5-item learning environment subscale allowed ten raters to distinguish between the quality of educational environments. Twenty raters were needed for the 3-item MCPI training subscale and the DREEM scale and its subscales. MCPI compares favourably with DREEM in that one-sixth the number of items perform at least as well psychometrically, it provides formative free text data, and it is founded on the widely shared assumption that communities of practice make good learning environments.

Any versus long-term prescribing of high risk medications in older people using 2012 Beers Criteria: results from three cross-sectional samples of primary care records for 2003/4, 2007/8 and 2011/12

Background: High risk medications are commonly prescribed to older US patients. Currently, less is known about high risk medication prescribing in other Western Countries, including the UK. We measured trends and correlates of high risk medication prescribing in a subset of the older UK population (community/institutionalized) to inform harm minimization efforts. Methods: Three cross-sectional samples from primary care electronic clinical records (UK Clinical Practice Research Datalink, CPRD) in fiscal years 2003/04, 2007/08 and 2011/12 were taken. This yielded a sample of 13,900 people aged 65 years or over from 504 UK general practices. High risk medications were defined by 2012 Beers Criteria adapted for the UK. Using descriptive statistical methods and regression modelling, prevalence of ‘any’ (drugs prescribed at least once per year) and ‘long-term’ (drugs prescribed all quarters of year) high risk medication prescribing and correlates were determined. Results: While polypharmacy rates have risen sharply, high risk medication prevalence has remained stable across a decade. A third of older (65+) people are exposed to high risk medications, but only half of the total prevalence was long-term (any = 38.4 % [95 % CI: 36.3, 40.5]; long-term = 17.4 % [15.9, 19.9] in 2011/12). Long-term but not any high risk medication exposure was associated with older ages (85 years or over). Women and people with higher polypharmacy burden were at greater risk of exposure; lower socio-economic status was not associated. Ten drugs/drug classes accounted for most of high risk medication prescribing in 2011/12. Conclusions: High risk medication prescribing has not increased over time against a background of increasing polypharmacy in the UK. Half of patients receiving high risk medications do so for less than a year. Reducing or optimising the use of a limited number of drugs could dramatically reduce high risk medications in older people. Further research is needed to investigate why the oldest old and women are at greater risk. Interventions to reduce high risk medications may need to target shorter and long-term use separately.

Interleukin-8 and its receptor CXCR2 in the tumour microenvironment promote colon cancer growth, progression and metastasis

BACKGROUND: Colorectal cancer (CRC) is a leading cause of death in the United States. Increased level of interleukin-8 (IL-8) and CXCR2 on tumours and in the tumour microenvironment has been associated with CRC growth, progression and recurrence in patients. Here, we aimed to evaluate the effects of tissue microenvironment-encoded IL-8 and CXCR2 on colon cancer progression and metastasis.

METHODS: A novel immunodeficient, skin-specific IL-8-expressing transgenic model was generated to evaluate colon cancer growth and metastasis. Syngeneic mouse colon cancer cells were grafted in CXCR2 knockout (KO) mice to study the contribution of CXCR2 in the microenvironment to cancer growth.

RESULTS: Elevated levels of IL-8 in the serum and tumour microenvironment profoundly enhanced the growth of human and mouse colon cancer cells with increased peri-tumoural angiogenesis, and also promoted the extravasation of the cancer cells into the lung and liver. The tumour growth was inhibited in CXCR2 KO mice with significantly reduced tumour angiogenesis and increased tumour necrosis.

CONCLUSION: Increased expression of IL-8 in the tumour microenvironment enhanced colon cancer growth and metastasis. Moreover, the absence of its receptor CXCR2 in the tumour microenvironment prevented colon cancer cell growth. Together, our study demonstrates the critical roles of the tumour microenvironment-encoded IL-8/CXCR2 in colon cancer pathogenesis, validating the pathway as an important therapeutic target.

Interleukin-8 is associated with proliferation, migration, angiogenesis and chemosensitivity in vitro and in vivo in colon cancer cell line models

Interleukin-8 (IL-8), a chemokine with a defining CXC amino acid motif, is known to possess tumorigenic and proangiogenic properties. Overexpression of IL-8 has been detected in many human tumors, including colorectal cancer (CRC), and is associated with poor prognosis. The goal of our study was to determine the role of IL-8 overexpression in CRC cells in vitro and in vivo. We stably transfected the IL-8 cDNA into two human colon cancer cell lines, HCT116 and Caco2, and selected IL-8-secreting transfectants. Real-time RT-PCR confirmed that IL-8 mRNA was overexpressed in IL-8 transfectants with 45- to 85-fold higher than parental cells. The IL-8-transfected clones secreted 19- to 28-fold more IL-8 protein than control and parental cells as detected by ELISA. The IL-8 transfectants demonstrated increased cellular proliferation, cell migration and invasion based on functional assays. Growth inhibition studies showed that IL-8 overexpression lead to a significant resistance to oxaliplatin (p < 0.0001). Inhibition of IL-8 overexpression with small interfering RNA reversed the observed increases in tumorigenic functions and oxaliplatin resistance, suggesting that IL-8 not only provides a proliferative advantage but also promotes the metastatic potential of colon cancer cells. Using a tumor xenograft model, IL-8-expressing cells formed significantly larger tumors than the control cells with increased microvessel density. Together, these findings indicate that overexpression of IL-8 promotes tumor growth, metastasis, chemoresistance and angiogenesis, implying IL-8 to be an important therapeutic target in CRC.

A Statistical Characterization of Shadowed Fading in Indoor Off-Body Communications Channels At 5.8 GHz

This paper investigates the characteristics of the shadowed fading observed in off-body communications channels at 5.8 GHz using the κ-μ / gamma composite fading model. Realistic measurements have been conducted considering four individual scenarios namely line of sight (LOS) and non-LOS (NLOS) walking, rotation and random movements within an indoor laboratory environment. It is shown that the κ-μ / gamma composite fading model provides a better fit to the fading observed in off-body communications channels compared to the conventional Nakagami-m and Rician fading models.

MMP-8 Activity Profiling In GCF Samples

Background: In healthy tissues a family of enzymes known as matrix metalloproteinases (MMPs) play an important role in regulating turnover and metabolism of connective tissue collagen. MMPs have been implicated in a wide variety of pathological conditions including periodontal disease. MMP-8 has been extensively studied in periodontal health and disease using enzyme-linked immunosorbent assay (ELISA). Although ELISA quantifies the presence of the MMP-8 protein, it is not possible to determine enzyme activity using this method. Furthermore, since members of the MMP family have poor substrate sequence specificity, a peptide substrate alone cannot differentiate the activity of MMP-8 from other MMPs that may be present in biological samples. Objectives: In the present study, a method to specifically measure MMP-8 activity in gingival crevicular fluid (GCF) samples was developed. Methods: GCF was collected from healthy patients and those with periodontal disease using Perio paper strips. Samples were stored frozen until required for analysis. A specific MMP-8 antibody was used to coat 96 well microtitre plates to selectively remove MMP-8 from the GCF samples. Following a washing step, the activity of bound MMP-8 was measured over 70 minutes using a fluorogenic (FRET) substrate. Results: GCF from healthy subjects exhibited basal MMP-8 activity but in diseased samples MMP-8 activity was significantly higher. Minimal binding of other recombinant MMPs to the specific MMP-8 antibody was observed in cross-reactivity studies. Conclusion: We show for the first time that MMP-8 activity was significantly increased in GCF from periodontitis sites compared with activity levels in healthy sites. Further studies of MMP-8 activity in GCF samples should improve our understanding of its destructive role in periodontal disease.

Isometrias: uma abordagem interdisciplinar no 8º ano de escolaridade

A sociedade atual requer indivíduos preparados para apresentar soluções inovadoras aos problemas encontrados nas mais variadas situações, sendo a criatividade considerada, na última década, uma competência essencial para o progresso. Neste contexto, emerge a necessidade da escola fomentar o seu desenvolvimento em qualquer área, e em particular, na Matemática. Por outro lado, não será alheio a este facto a promoção de um ensino, também ele, criativo. Tal ensino exige desde logo uma original, fluente e flexível gestão curricular envolvendo uma adequada seleção e ou (re) criação de tarefas relevantes, criteriosamente sequenciadas e autonomamente resolvidas pelos alunos, numa lógica de interdisciplinaridade e com recurso a tecnologia. No caso especifico das transformações geométricas isométricas, uma abordagem interdisciplinar reforçada com o recurso a ambientes de geometria dinâmica poderá constituir uma mais-valia nesse processo. Assim, desenvolveu-se este estudo, com o objetivo de avaliar o impacto de uma abordagem interdisciplinar, potenciada com o GeoGebra, no desenvolvimento de competências geométricas relacionadas com as isometrias, frisos e rosáceas, e em simultâneo, no desenvolvimento da criatividade e representações da mesma, de alunos do oitavo ano de escolaridade. Para isso desenvolveu-se um estudo de caso, centrado em três pares de alunos, que resolveram um conjunto de tarefas de natureza exploratória, com recurso ao GeoGebra e envolvendo a disciplina de Educação Visual. A análise dos dados recolhidos foi, essencialmente, de natureza qualitativa, tendo sido a observação, a inquirição e a análise documental,as principais técnicas de recolha de dados. A análise de conteúdo a que foram submetidos os dados, permitiu concluir que a implementação de uma abordagem interdisciplinar, centrada numa sequência de tarefas e aliada ao GeoGebra, potenciou a apropriação dos conhecimentos geométricos em causa e a sua aplicação. Contribuiu, também, para o desenvolvimento de atitudes favoráveis em relação à matemática e à geometria em particular. Por outro lado, os dados sugerem que tal abordagem permite obter indícios do desenvolvimento da criatividade nos alunos e de alterações a algumas das suas representações.

Abordagens didáticas dos conteúdos de Física e Química dos 8º e 10º anos na escola EB 2,3/s Dr. João de Brito Camacho em Almodôvar

Este relatório foi elaborado no âmbito do Mestrado em Ensino de Física e Química para o 3º ciclo do Ensino Básico e Secundário, e refere-se à Unidade Curricular Prática de Ensino Supervisionada (PES), iniciada em setembro de 2011, na Escola E B 2,3 Dr. João de Brito Camacho em Almodôvar. A disciplina de PES decorreu sob orientação dos seguintes elementos: Orientadora Científica da Componente de Química (Professora Doutora Maria de Lurdes Cristiano), Orientadora Científica da Componente da Física (Professor Doutor Rui Guerra) e Orientadora Cooperante (Dr.ª Raquel Forca). Contempla o desenvolvimento de diferentes atividades letivas, nas Componentes de Química e de Física, aplicadas nas turmas do 8º e do 10º ano, este do curso Científico – Humanístico de Ciências e Tecnologias. A componente de Química foi lecionada de setembro de 2011 a janeiro de 2012, a componente de Física foi lecionada de fevereiro de 2012 a julho de 2012. A prática de ensino supervisionada, contou com um total de vinte e três aulas, catorze da componente de Química e nove da componente de Física. Durante o ano letivo foram realizadas diversas atividades/projetos, nomeadamente uma visita de estudo aos “Dias Abertos” do Instituto Superior Técnico, onde os alunos para além de participarem em diversos workshops, puderam ainda assistir a diversas palestras sobre temas relacionados com a Física. O estagiário participou nas atividades do Plano Anual, dinamizando o projeto do Laboratório de Instrumentação e Física Experimental (LIP), designado por Radiação e Ambiente onde os alunos realizaram tarefas de investigação sobre os efeitos da radiação. Participou também no projeto financiado pela Fundação Calouste Gulbenkian “Podíamos ler mais”, que envolveu a leitura de obras de divulgação científica e contou com um contato via skype com autores como David Bodanis e Michaell Guillian. A entrevista a estes autores foi realizada no “II Encontro aqui há ciência, arte e palavras” que contou ainda com palestras de divulgação científica por parte dos orientadores deste estágio e pelo Professor Doutor Paulo Crawford do departamento de Física da Faculdade de Ciências da Universidade de Lisboa. Este projeto foi convidado pelo Plano Nacional de Leitura a representar o mesmo na Futurália 2012. Os alunos dinamizaram um workshop intitulado “Livros sem resistência” onde apresentaram as experiências que leram nas obras inerentes a este projeto. O Relatório de Estágio compreende seis capítulos, referências bibliográficas e apêndices. No capítulo I é feita uma introdução onde são apresentados os objetivos do trabalho, as unidades de Física e de Química focadas e a metodologia seguida. No capítulo II é efetuado o enquadramento geral, do qual faz parte uma descrição das condições de trabalho, da turma, alvo da prática de ensino supervisionada e das disciplinas / turmas da responsabilidade da Orientadora Cooperante. O capítulo III (Química – 8º e 10º ano) e o capítulo IV (Física – 8º e 10ºano) contêm a análise da bibliografia oficial associada, as planificações, as metodologias, os instrumentos de avaliação e as atividades extracurriculares realizadas. No capítulo V o mestrando dá a conhecer os projetos que foram realizados, presentes no Plano Anual de Atividades. O capítulo VI e último, proporciona uma análise reflexiva de todo o trabalho desenvolvido, associada a sugestões futuras, eventualmente mais eficazes para a aprendizagem da Física e da Química, pelos alunos.

Recensione: Nicoletta Maraschio e Domenico De Martino (ed.) (2013), Fuori l’italiano dall’università? Inglese, internazionalizzazione, politica linguistica, Roma/Bari, Laterza, coll. «Percorsi, 151», 336 p. [ISBN: 978-8-858-10591-7]

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Compte rendu: Johann Wolfgang Unger (2013), The Discursive Construction of the Scots Language : Education, Politics and Everyday Life, Amsterdam, John Benjamins, coll. « Discourse Approaches to Politics, Society and Culture, 51 », 178 p. [ISBN : 978-9-027-20642-8]

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Recensione: Giuseppe Antonelli (2014), Comunque anche Leopardi diceva le parolacce. L’italiano come non ve l’hanno mai raccontato, Milano, Mondadori, 184 p. [ISBN: 978-8-804-63476-8]

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