Stem cell-related "self-renewal" signature and high epidermal growth factor receptor expression associated with resistance to concomitant chemoradiotherapy in glioblastoma

PURPOSE: Glioblastomas are notorious for resistance to therapy, which has been attributed to DNA-repair proficiency, a multitude of deregulated molecular pathways, and, more recently, to the particular biologic behavior of tumor stem-like cells. Here, we aimed to identify molecular profiles specific for treatment resistance to the current standard of care of concomitant chemoradiotherapy with the alkylating agent temozolomide. PATIENTS AND METHODS: Gene expression profiles of 80 glioblastomas were interrogated for associations with resistance to therapy. Patients were treated within clinical trials testing the addition of concomitant and adjuvant temozolomide to radiotherapy. RESULTS: An expression signature dominated by HOX genes, which comprises Prominin-1 (CD133), emerged as a predictor for poor survival in patients treated with concomitant chemoradiotherapy (n = 42; hazard ratio = 2.69; 95% CI, 1.38 to 5.26; P = .004). This association could be validated in an independent data set. Provocatively, the HOX cluster was reminiscent of a "self-renewal" signature (P = .008; Gene Set Enrichment Analysis) recently characterized in a mouse leukemia model. The HOX signature and EGFR expression were independent prognostic factors in multivariate analysis, adjusted for the O-6-methylguanine-DNA methyltransferase (MGMT) methylation status, a known predictive factor for benefit from temozolomide, and age. Better outcome was associated with gene clusters characterizing features of tumor-host interaction including tumor vascularization and cell adhesion, and innate immune response. CONCLUSION: This study provides first clinical evidence for the implication of a "glioma stem cell" or "self-renewal" phenotype in treatment resistance of glioblastoma. Biologic mechanisms identified here to be relevant for resistance will guide future targeted therapies and respective marker development for individualized treatment and patient selection.

Self-assessment insufficiently predicts performance in emergency skills

Background: Residents demonstrate a broad range of performance levels for clinical skills, with some at an inadequate level. Adequate self-assessment is important for life long learning. However, its accuracy is questioned extensively. The aim of this study was to evaluate how far the residents’ self-assessment predicts their performance in an expert assessment of emergency skills. Summary of work: Twelve skills were identified as being relevant for the emergency duties of residents in smaller hospitals. Fifteen first-year residents from the departments of internal medicine and general surgery at a district hospital rated their performance on a questionnaire (self-assessment). This was followed by a structured, practical in vivo assessment by an anaesthesiologist (expert assessment). For both, a visual analogue scale from 0 to 10 was used, on which 0 stands for novice and 10 for expert. Predictive validity was described by Spearman’s correlation, which was significant in 3 out of 12 skills only. Median correlation (r) was 0.50 (range 0.16 to 0.93). Conclusion: At the beginning of postgraduate training, self-assessment alone is not sufficient to guide self-directed learning. Take-home message: At the beginning of their residency, physicians need structured feedback in emergency skills which can be offered by anaesthesiologists.

Gaze perception in social anxiety and social anxiety disorder

Clinical observations suggest abnormal gaze perception to be an important indicator of social anxiety disorder (SAD). Experimental research has yet paid relatively little attention to the study of gaze perception in SAD. In this article we first discuss gaze perception in healthy human beings before reviewing self-referential and threat-related biases of gaze perception in clinical and non-clinical socially anxious samples. Relative to controls, socially anxious individuals exhibit an enhanced self-directed perception of gaze directions and demonstrate a pronounced fear of direct eye contact, though findings are less consistent regarding the avoidance of mutual gaze in SAD. Prospects for future research and clinical implications are discussed.

Self-recognition in primates: phylogeny and the salience of species-typical features.

Self-recognition has been explored in nonlinguistic organisms by recording whether individuals touch a dye-marked area on visually inaccessible parts of their face while looking in a mirror or inspect parts of their body while using the mirror's reflection. Only chimpanzees, gorillas, orangutans, and humans over the age of approximately 2 years consistently evidence self-directed mirror-guided behavior without experimenter training. To evaluate the inferred phylogenetic gap between hominoids and other animals, a modified dye-mark test was conducted with cotton-top tamarins (Saguinus oedipus), a New World monkey species. The white hair on the tamarins' head was color-dyed, thereby significantly altering a visually distinctive species-typical feature. Only individuals with dyed hair and prior mirror exposure touched their head while looking in the mirror. They looked longer in the mirror than controls, and some individuals used the mirror to observe visually inaccessible body parts. Prior failures to pass the mirror test may have been due to methodological problems, rather than to phylogenetic differences in the capacity for self-recognition. Specifically, an individual's sensitivity to experimentally modified parts of its body may depend crucially on the relative saliency of the modified part (e.g., face versus hair). Moreover, and in contrast to previous claims, we suggest that the mirror test may not be sufficient for assessing the concept of self or mental state attribution in nonlinguistic organisms.

The design studio as liminal space

The context of this research focuses on the efficacy of design studio as a form of teaching and learning. The established model of project-based teaching makes simple parallels between studio and professional practice. However, through comparison of the discourses it is clear that they are of different character. The protocols of the tutorial tradition can act to position the tutor as a defender of the knowledge community rather than a discourse guide for the student. The question arises as to what constitutes the core knowledge that would enable better self-directed study. Rather than focus on key knowledge, there has been an attempt in other fields to agree and share ‘threshold concepts’ within disciplinary knowledge. Meyer and Land describe threshold concepts as representing “a transformed way of understanding, or interpreting or viewing something without which the learner cannot progress [1]. The tutor’s role should be to assist in transforming student’s understanding through the mastery of the ‘troublesome knowledge’ that threshold concepts may embody. Teaching and learning environments under such approaches have been described as ‘liminal’: holding the learner in an ‘in-between’ state new understanding may be difficult and involve identity shifts. Research on the consequence of pressures on facilities and studio space concur, and indicate that studio spaces can be much better used in assisting the path of learning [2]. Through an overview map of threshold concepts, the opportunities for blended learning in supporting student learning in the liminal space of the design studio become much clearer [3] Design studio needs to be recontextualised within the discourse of higher education scholarship, based on a clarified curriculum built from an understanding of what constitutes its threshold concepts. The studio needs to be reconsidered as a space quite unlike that of the practitioner, a liminal space. 1. Meyer, J.H.F. and R. Land, Threshold concepts and troublesome knowledge. Overcoming Barriers to Student Learning: Threshold concepts and troublesome knowledge., 2006: p. 19. 2. Cai, H. and S. Khan, The Common First Year Studio in a Hot-desking Age: An Explorative Study on the Studio Environment and Learning. Journal for Education in the Built Environment 2010. 5(2): p. 39-64. 3. Pektas, S.T., The Blended Design Studio: An Appraisal of New Delivery Modes in Design Education. Procedia - Social and Behavioral Sciences, 2012. 51(0): p. 692-697.

La carpeta de aprendizaje y la evaluación entre iguales de los estudiantes. Resultados de una innovación docente en los estudios universitarios de las artes

Students reflect more on their learning in course subjects when they participate in managing their teaching–learning environment. As a form of guided participation, peer assessment serves the following purposes: (a) it improves the student’s understanding of previously established learning objectives; (b) it is a powerful metacognitive tool; (c) it transfers to the student part of the responsibility for assessing learning, which means deciding which learning activities are important and choosing the degree of effort a course subject will require; (d) it emphasizes the collective aspect of the nature of knowledge; and (e) the educational benefits derived from peer assessment clearly justify the efforts required to implement activities. This paper reports on the relative merits of a learning portfolio compiled during fine arts-related studies in which peer assessment played an important role. The researchers analyzed the student work load and the final marks students received for compulsory art subjects. They conclude that the use of a closed learning portfolio with a well-structured, sequential and analytical design can have a positive effect on student learning and that, although implementing peer assessment may be complex and students need to become familiar with it, its use is not only feasible but recommendable.

Student attitudes to plagiarism and collusion within computer science

There is a widespread perception among staff in Computer Science that plagiarism is a major problem particularly in the form of collusion in programming exercises. While departments often make use of electronic detection measures, the time consumed prosecuting plagiarism offences remains a problem. As a result departments continue to seek ways to reduce the amount of plagiarism and collusion that occurs. This paper reports the findings of a questionnaire based study which attempted to assess the students' attitudes to the issues involved in the hope that such an understanding might result in practical measures for minimizing the problem. The study revealed that while students did understand the definition of plagiarism in its most extreme cases they were often confused about less clear-cut situations. Changes in the previous experience of incoming students meeting modules originally designed on the assumption that students already had some programming background and were equipped for self-directed study would also appear to be a contributory factor in the extent of collusion in programming exercises.

Weight loss and attrition in overweight and obese young women during a 36- week internet-based lifestyle intervention

Background: Young women are at high risk of weight gain yet few studies have examined the long-term effectiveness of weight loss programs in this group. This study aimed to investigate the effects of a self-directed internet-based lifestyle program on body weight in young women.

Methods: Overweight or obese young women (BMI 33.4 ± 0.3 kg/m2, age 27.8 ± 0.3 years) were initially randomized to General lifestyle advice (G) or Structured lifestyle advice (S) via in-person and website support for 12 weeks (Phase I). After Phase I, all participants were supported through a self-directed internet-based program for 36 weeks (Phase II). The internet-based program included a structured hypocaloric diet, physical activity program, self-monitoring tools, peer group forum and monthly emails. Body weight, energy intake and physical activity were measured at week 0, week 12, week 24 and week 48. Adherence to self-regulatory behaviors was measured at week 48. Mixed model analyses were conducted to determine changes in body weight, energy intake and physical activity.

Results: A total of 203 overweight or obese young women commenced Phase I and 130 commenced Phase II. In Phase I, S group had significantly greater weight loss than G group (4.2 &plusmn; 0.6 kg vs 0.6 &plusmn; 0.3 kg, P<0.001). In Phase II, both groups had significant weight loss over time without significant group differences (-0.8 &plusmn; 1.1kg vs -0.8 &plusmn; 0.6, P>0.05). Forty-one percent (53/130) of the participants who commenced Phase II completed the internet-based intervention. Dropouts had a higher baseline BMI, were more likely to be married or in a de facto relationship, and more likely to have at least one child.

Conclusions: A self-directed internet-based program could be effective in providing support in maintaining weight loss on a structured lifestyle program in young women over 36 weeks. Further research is required to maintain engagement in young women who were married/in a de facto relationship or have children.

Beyond construction…..A cross-disciplinary approach to improved learning and teaching in built environment degrees

More than 3.4 million people die each year from water, sanitation and hygiene-related causes. Lack of access to clean water and sanitation kills those most vulnerable in the third world. Leadership in managing cross-disciplinary teams is required to present economical, viable community-based solutions. This project utilised the skills of undergraduates across different disciplines of construction, project management, engineering, design, and communication, to work alongside industry mentors in a team to design, build and present an innovative, sustainable water sanitation solution for a Bangladesh community. The semester-long project enabled undergraduate students to develop skills in client relationships, teamwork, and communication as well as discipline skills of project management and construction. The real-world problem necessitated a paradigm shift away from discipline-based knowledge transference towards skills for the future. The project utilised approaches such as negotiated curriculum and assessment; self-directed, flexible participation in learning; use of social media as a learning tool and cross-disciplinary teamwork. Results from student surveys and interviews indicate that this project directly enhanced students’ work-readiness skills and recognition of the importance of problem solving using cross-disciplinary understandings. Students reported greater self-confidence for tackling future workplace challenges. The results also illustrate strong levels of student satisfaction with the cross-disciplinary approach and the importance of skills in client relationships. The project and its outcomes have implications for how learning and teaching occurs in built environment disciplines and has the potential to create significant impact on the calibre of future built environment graduates.

Pilot CBT trial for anxiety in alcohol use disorders treatment

Purpose – The purpose of this paper is to test the effectiveness of a self-directed cognitive behavioural therapy (CBT) booklet allowing immediate access to treatment for anxiety during alcohol use disorder (AUD) interventions. Design/methodology/approach – Parallel pilot randomised controlled trial: 69 individuals in AUD treatment, continued to receive treatment alone (control: n=29) or in addition, a self-directed, four week CBT booklet to manage anxiety (intervention: n=40). Primary outcome measures were changes in state (SAnx) and trait anxiety (TAnx) at four weeks. Secondary outcome measures were changes in adaptive (ACop), maladaptive (MCop) coping and quality of life (QoL, physical (PHQoL), psychological (PSQoL), social (SQoL), environment (EQoL)) at four weeks. Findings – Participants had significantly higher SAnx (p<0.01) and TAnx (p<0.01) baseline scores compared to the general population. There were no statistically significant group changes in SAnx or TAnx (p>0.05). Control group allocation predicted improvement in ACop (p<0.01), MCop (p<0.05), PHQoL (p<0.01), PSQoL (p<0.05) and SQoL (p<0.01); CBT group allocation predicted improvement in EQoL (p=0.05). All effect sizes were small to moderate (Cohen’s d<0.50). Percentage of book completion did not determine changes in anxiety, coping or quality of life. Originality/value – A four week self-directed CBT booklet did not significantly reduce anxiety during AUD treatment. Larger sample sizes will determine the most suitable treatment delivery mode for this type of CBT.

Apprendre à être un Leader dans un Programme de Leadership: Perceptions, Éxpérience Préalable en Leadership et Sexe de l’Étudiant

The purpose of this study was to examine whether leadership can be learned through the Community Recreation and Leadership Training (CRLT) program and how effective the program is in terms of changing the perceptions and abilities of the students. The intentions of the researcher were to discover crucial learning moments as perceived by students and to gain insights that could lead to future improvements to enhance and enrich learning in a leadership program. To continue to be a viable program and to keep step with the demands of the recreation/leisure industry and society's wide-ranging needs, this study may help to inform the program's 'action plan' for continued success. This study employed a mixed method approach to determine how college students develop effective leadership ability in a three-year Community Recreation and Leadership Training (CRLT) college career program. First, a number of statistical tests were carried out to examine the four research questions used to guide the study. The SPSS software was used to analyze the data collected. The first research question asked how perceptions of leadership change as a result of being in a three-year leadership program. This study, using the Student Leadership Practice Inventory (SLPI), compared the five SLPI leadership dimensions by year. The SLPI was administered to all the first, second, and third year CRLT students ( N = 84). A one-way analysis of variance in participants' scores was conducted. No significant differences were revealed in any of the five dimensions of the SLPI among the first, second, and third year students at p < .05. However, two dimensions (model and encourage) approached significance and may hint at a possible influence the program is having on its students as they progress into the third year. The second research question asked whether perceptions of leadership vary by gender. Comparing the mean scores between the males and females on the five dimensions of the SLPI, no significant differences were found. The third research question asked whether prior leadership experience results in better academic performance for CRLT students in their 1st term. A one-way analysis of variance was conducted to evaluate the relationship between prior leadership experience and mean scores on academic performance. No significant correlations were found between grades and low, medium, or high levels of prior leadership experience F(2,79) = 2.67, p = .08. A correlation coefficient was also computed to determine whether there was a relationship between the Recreation Leadership I course grade and prior leadership experience. The correlation coefficient (.02) was statistically significant, r(80) = .24, p < .05. However, further studies with a larger sample size would be necessary to help determine this. The fourth question asked whether there was a correlation between students' first semester grades and their scores on the Student Leadership Practice Inventory (SLPI). Bivariate correlations (Pearson) were computed for the five SLPI dimensions with academic performance. None of the correlations using the five SLPI indicators was significant. Qualitative data was examined to discover what factors and experiences help students to assert a more effective leadership role. The study relied on content analysis of personal statements, and focus groups. Student perceptions of an effective leader, students' perceptions of their own abilities, and the strengths of the program were explored. A content analysis of the 'Personal Statements' was carried out to determine how students defined leadership prior to their having had any formal teaching in a college program. The result of the analysis of personal statements provided eight leadership categories used as an initial baseline for the study. Six focus groups (totaling N = 30) were conducted. Students responded to four key questions: how they define leadership. What is the single most effective quality of a leader? What leadership skills did they feel they had gained? How had the program helped them obtain their skills? Students credited the CRLT program with helping them develop a variety of leadership skills. Students revealed that they had gained skills such as confidence, knowledge and understanding of people's needs, and becoming more self-directed. They attributed their skill development to such things as good course design, intensive outdoor education and fieldwork courses, "hands on" learning approaches, group work, skill practice, the support they received from teachers, and encouragement they were given by their peers. A common finding among genders was defining an effective leader as someone who is "confident". However, the definition of the most important quality of a leader varied by gender. While males showed a tendency to prefer a leader being "confident," females preferred a leader being a "teacher".

An historical analysis of the development of thinking in the principal writings of Malcolm Knowles

Malcolm Shepherd Knowles was a key writer and theorist in the field of adult education in the United States. He died in 1997 and left a large legacy of books and journal articles. This thesis traced the development of his thinking over the 46-year period from 1950 to 1995. It examined the 25 works authored, co-authored, edited, reissued and revised by him during that period. The writings were scrutinised using a literature research methodology to expose the theoretical content, and a history of thought lens to identify and account for the development of major ideas. The methodology enabled a gradual unfolding of the history. A broadly-consistent and sequential pattern of thought focusing on the notion of andragogy emerged. The study revealed that after the initial phases of exploratory thinking, Knowles developed a practical-theoretical framework he believed could function as a comprehensive theory of adult learning. As his thinking progressed, his theory developed into a unified framework for human resource development and, later, into a model for the development of self-directed lifelong learners. The study traced the development of Knowles’ thinking through the phases of thought, identified the writings that belonged within each phase and produced a series of diagrammatic representations showing the evolution of his conceptual framework. The production of a history of the development of Knowles’ thought is the major outcome of the study. In addition to plotting the narrative sequence of thought-events, the history helps to explicate the factors and conditions that influenced Knowles’ thinking and to show the interrelationships between ideas. The study should help practitioners in their use and appreciation of Knowles’ works.

Transforming Queensland VET : Challenges and Opportunities (Volume 3)

The volume is the third in a series that addresses change and development in the delivery of VET programs in Queensland. The chapters address a breadth of issues that relate to the changing landscape for teaching and learning in VET programs through e-learning. Organisational change is a key focus of this volume. James Waterson examines business and pedagogical perspectives for SkillsTech Australia to create teaching and learning environments that will enrich the learning experience for staff and students. Kerry Emerson explores the ways in which printing teachers might change current practices in order to deliver their training to apprentices and trainees – off-the-job, onthe- job and online, through e-learning. The chapter by Erik Dodwell takes up issues of user-friendly RPL interviews and the challenges to develop a model that may be applied consistently across all industry areas using conversational interviews. The chapters by Linda Roberston, Nina Woodrow, and Anushka Weerackody discuss teaching and learning for specific groups of students. Linda Roberston proposes a vision for learning support teachers in which the learner is encouraged to be a self-directed and autonomous learner who is capable of utilising e-learning resources and is information literate. Nina Woodrow presents a case for the diminished sense of occupational identity by adult literacy teachers and the implications of this loss of expertise across the VET sector. Constructive strategies for change are outlined. The chapter by Anushka Weerackody explores ideas to enhance the practices of ESL teachers in TAFE Queensland through an online community of practice. The issues of on-the-job training through e-learning for various trades is considered by Anne-Louise Johnston and the benefits and challenges for SkillsTech Australia in developing training partnerships with industry to deliver these changes. These papers were completed by the authors as a part of their postgraduate studies at QUT. The views reported are those of the authors and should not be attributed to the Queensland Department of Education and Training. Donna Berthelsen and Lauren Vogel Faculty of Education Queensland University of Technology December 2009

Enhancing the capacity of oncology nurses to provide supportive care for patients with advanced cancer : evaluation of an educational intervention

Aim: This study aimed to enhance the capacity of oncology nurses to provide supportive care for patients with advanced cancer who have dependent children. ---------- Method: This was a pilot study of an educational intervention comprising a study-developed self-directed learning manual, supported by a day-long communication skills training workshop. Evaluation pre- and post-training included measures of stress and burnout, self-reports of confidence and attitudes, responses to clinical vignettes and video-taped interviews with simulated patients.---------- Results: Nurses found the educational intervention highly acceptable, and reported increased confidence in their ability to provide information and support for parents, and to initiate discussion about emotional issues. There were significant improvements in general communication skills and skills specific to this training, as well as reduced use of blocking.---------- Conclusion: Brief communication skills training supplemented with tailored educational resources can enhance confidence skills and knowledge of oncology nurses regarding their supportive care of parents with advanced cancer.