Educating...for what?: Inquiry and Reflection

Higgins School of the Humanities/Difficult Dialogues: Video Recording from 11/16/2011 event featuring Cynthia Enloe and Frederick Luis Aldama titled "Inquiry and Reflection" Event Description: Freedom of inquiry (and the possibilities for discovery, insight and expanding knowledge that can flow from it) is fundamental to the experience of learning. Yet rarely do we pause to ask about inquiry itself, and to consider its practices. How do we best encourage authentic inquiry, in ourselves and in our students? To what do we give our attention, and why? What promotes the possibility of new discoveries and insights? Our guests for a conversation on inquiry are Frederick Luis Aldama of Ohio State University, a prolific scholar of wide-ranging interests, and Cynthia Enloe, research professor at Clark University, whose work is characterized by her subtle and provocative curiosity, and the asking of good questions.

Liberal Education, Effective Practice, and Diversity

This session will be based on three presentations that focus on the relationship between liberal education, effective practice and diversity from different perspectives. George Kuh will present data indicating that the educational benefits of "high impact" learning experiences (such as experiential education and undergraduate research), which are significant for all students, are often greater for students from underserved and minority backgrounds than for their majority counterparts. Armando Bengochea will discuss the ways in which an emphasis on effective practice can enhance the educational experiences of students of color within a liberal arts curriculum. Steve Stemler will report on research showing that including practice-oriented criteria in assessments of student achievements and capabilities can assist colleges and universities in identifying and educating minority students with high potential to succeed both in college and beyond college.

Effective Practice and Experiential Education

The central challenge to educators in the liberal arts as in all areas of study is transfer of learning i.e. how can we design learning environments and instruction to that students will be able to use what they learn in appropriate new contexts? Alfred North Whitehead described this as the problem of ‘inert knowledge’ nearly a century ago and Dewey noted that instruction which helps students reproduce what is studied on exams might not produce the depth of understanding that allows for recognizing the relevance of what is known to a particular situation and the ability to apply it. Knowledge that is not conditionalized (i.e. in which the learner does not know when where and why it is to be used) is inert.

[Fixed-combination of losartan/hydrochlorothiazide 100 mg/25 mg. Tolerability and efficacy on blood pressure measured in the practice and for 24 hours]

BACKGROUND: A high proportion of patients with essential hypertension need a combination therapy to reach the therapeutic goal. In the present study, the tolerability and efficacy of a fixed, once daily combination of the AT1 blocker Losartan (100 mg) and the diuretic hydrochlorothiazide (HCTZ) (25 mg) for patients in the real-life situation was investigated. Special consideration was given to the results of ambulatory 24-hourblood pressure (ABP) measurements. METHODS: The open label, prospective non-interventional surveillance study took place from October 2005 to June 2006. A total of 1139 patients over 18 years in age were included whose blood pressures could not be adequately treated with HCTZ alone and for whom an individual dose titration for Losartan and HCTZ had already been performed. RESULTS: The average age (+/- standard deviation) of the patients was 61.2 +/- 11.6 years; 55.8% were men. Comorbidities were common. Specifically, left ventricular hypertrophy was present in 3.1% of the patients, coronary heart disease in 30.1%, chronic heart failure in 11.8% and status post myocardial infarction in 10.5%, respectively. In addition to the Losartan/HCTZ treatment, 61.0% of the patients received a second antihypertensive medicine. After an average treatment duration of 50.4 +/- 17.2 days, the base line systolic blood pressure of 160.8 +/- 16.3 mmHg decreased by 24.0 +/- 17.0 mmHg (-14.4%) and the diastolic blood pressure of 94.4 +/- 9.9 mmHg decreased by 11.8 +/- 10.2 mmHg (-11.8%). For the ABP measurements, the overall average systolic and diastolic blood pressures fell by 16.9 +/- 14.2 mmHg and 8.8 +/-10.3 mmHg, the day average by 17.3 +/- 14.8 mmHg and 9.0 +/- 10.2 mmHg and the night average by 15.1 +/- 17.6 mmHg and 7.8 +/- 11.7 mmHg, respectively. In twelve of the 1139 patients (1.1%), a total of 15 adverse events occurred. A causal connection with the medication was suspected in only in one case (one patient with three). CONCLUSION: The combination of Losartan/HCTZ 100/25 mg, as the exclusive therapy or in addition to other antihypertensive medicines, was for patients, many of whom who had comorbidities, in the real-life situation well tolerated and effective. The efficacy was demonstrated also during the night through ABP.

Practice and perception--a nationwide survey of therapy habits in sepsis

OBJECTIVE: To simultaneously determine perceived vs. practiced adherence to recommended interventions for the treatment of severe sepsis or septic shock. DESIGN: One-day cross-sectional survey. SETTING: Representative sample of German intensive care units stratified by hospital size. PATIENTS: Adult patients with severe sepsis or septic shock. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Practice recommendations were selected by German Sepsis Competence Network (SepNet) investigators. External intensivists visited intensive care units randomly chosen and asked the responsible intensive care unit director how often these recommendations were used. Responses "always" and "frequently" were combined to depict perceived adherence. Thereafter patient files were audited. Three hundred sixty-six patients on 214 intensive care units fulfilled the criteria and received full support. One hundred fifty-two patients had acute lung injury or acute respiratory distress syndrome. Low-tidal volume ventilation < or = 6 mL/kg/predicted body weight was documented in 2.6% of these patients. A total of 17.1% patients had tidal volume between 6 and 8 mL/kg predicted body weight and 80.3% > 8 mL/kg predicted body weight. Mean tidal volume was 10.0 +/- 2.4 mL/kg predicted body weight. Perceived adherence to low-tidal volume ventilation was 79.9%. Euglycemia (4.4-6.1 mmol/L) was documented in 6.2% of 355 patients. A total of 33.8% of patients had blood glucose levels < or = 8.3 mmol/L and 66.2% were hyperglycemic (blood glucose > 8.3 mmol/L). Among 207 patients receiving insulin therapy, 1.9% were euglycemic, 20.8% had blood glucose levels < or = 8.3 mmol/L, and 1.0% were hypoglycemic. Overall, mean maximal glucose level was 10.0 +/- 3.6 mmol/L. Perceived adherence to strict glycemic control was 65.9%. Although perceived adherence to recommendations was higher in academic and larger hospitals, actual practice was not significantly influenced by hospital size or university affiliation. CONCLUSIONS: This representative survey shows that current therapy of severe sepsis in German intensive care units complies poorly with practice recommendations. Intensive care unit directors perceive adherence to be higher than it actually is. Implementation strategies involving all intensive care unit staff are needed to overcome this gap between current evidence-based knowledge, practice, and perception.

Remote sensing of volcanic plumes using the Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER).

The Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) has been used to quantify SO2 emissions from passively degassing volcanoes. This dissertation explores ASTER’s capability to detect SO2 with satellite validation, enhancement techniques and extensive processing of images at a variety of volcanoes. ASTER is compared to the Mini UV Spectrometer (MUSe), a ground based instrument, to determine if reasonable SO2 fluxes can be quantified from a plume emitted from Lascar, Chile. The two sensors were in good agreement with ASTER proving to be a reliable detector of SO2. ASTER illustrated the advantages of imaging a plume in 2D, with better temporal resolution than the MUSe. SO2 plumes in ASTER imagery are not always discernible in the raw TIR data. Principal Component Analysis (PCA) and Decorrelation Stretch (DCS) enhancement techniques were compared to determine how well they highlight a variety of volcanic plumes. DCS produced a consistent output and the composition of the plumes was easy to identify from explosive eruptions. As the plumes became smaller and lower in altitude they became harder to distinguish using DCS. PCA proved to be better at identifying smaller low altitude plumes. ASTER was used to investigate SO2 emissions at Lascar, Chile. Activity at Lascar has been characterized by cyclic behavior and persistent degassing (Matthews et al. 1997). Previous studies at Lascar have primarily focused on changes in thermal infrared anomalies, neglecting gas emissions. Using the SO2 data along with changes in thermal anomalies and visual observations it is evident that Lascar is at the end an eruptive cycle that began in 1993. Declining gas emissions and crater temperatures suggest that the conduit is sealing. ASTER and the Ozone Monitoring Instrument (OMI) were used to determine the annual contribution of SO2 to the troposphere from the Central and South American volcanic arcs between 2000 and 2011. Fluxes of 3.4 Tg/a for Central America and 3.7 Tg/a for South America were calculated. The detection limits of ASTER were explored. The results a proved to be interesting, with plumes from many of the high emitting volcanoes, such as Villarrica, Chile, not being detected by ASTER.

Immunosuppressive treatment for acquired haemophilia: current practice and future directions in Germany, Austria and Switzerland

Acquired haemophilia is an autoimmune disorder characterised by autoantibody formation against coagulation factor VIII. Immunosuppressive treatments including steroids, cytotoxic drugs, rituximab or combinations thereof have been used to eradicate autoantibodies. Very few prospective studies exist evaluating the use of these treatments. Here, we performed a survey among 73 physicians from 57 haemophilia treatment centres in order to describe current practice patterns and critical issues for future research in acquired haemophilia. The results demonstrate a high diversity of first- and second-line treatments. Factors influencing treatment decision were underlying disorder, severity of bleeding and inhibitor titre. Frequently used first-line treatments were steroids plus cyclophosphamide (44%) and steroids alone (11%). Second-line treatment was most often rituximab (30%), with or without steroids and/or cyclophosphamide. Most participants indicated to change from first- to second-line treatment after 4 weeks in case of failure to obtain partial remission (31%), continued bleeding (40%) or continued severe bleeding requiring bypass treatment (59%). Immunoadsorption was preferred for first- and second-line treatment by 10% and 9% of participants, respectively. These results highlight critical issues in the field. Open questions and directions for future research are discussed.

Infection prevention strategies in a stem cell transplant unit: impact of change of care in isolation practice and routine use of high dose intravenous immunoglobulins on infectious complications and transplant related mortality

OBJECTIVE: Nursing in 'live islands' and routine high dose intravenous immunoglobulins after allogeneic hematopoietic stem cell transplantation were abandoned by many teams in view of limited evidence and high costs. METHODS: This retrospective single-center study examines the impact of change from nursing in 'live islands' to care in single rooms (SR) and from high dose to targeted intravenous immunoglobulins (IVIG) on mortality and infection rate of adult patients receiving an allogeneic stem cell or bone marrow transplantation in two steps and three time cohorts (1993-1997, 1997-2000, 2000-2003). RESULTS: Two hundred forty-eight allogeneic hematopoetic stem cell transplantations were performed in 227 patients. Patient characteristics were comparable in the three cohorts for gender, median age, underlying disease, and disease stage, prophylaxis for graft versus host disease (GvHD) and cytomegalovirus constellation. The incidence of infections (78.4%) and infection rates remained stable (rates/1000 days of neutropenia for sepsis 17.61, for pneumonia 6.76). Cumulative incidence of GvHD and transplant-related mortality did not change over time. CONCLUSIONS: Change from nursing in 'live islands' to SR and reduction of high dose to targeted IVIG did not result in increased infection rates or mortality despite an increase in patient age. These results support the current practice.

Everyday Sexuality and Social Work: Locating Sexuality in Professional Practice and Education

Social work has seen increased intellectual interest in sexuality. However, little attention has been paid to the relevance of everyday sexuality for professional practice or how this might be integrated within existing social work curricula. This paper proposes that knowledge about everyday sexuality is vital to social workers as they deal with a variety of clients faced with the increasing complexities brought about by late-modernity. Additionally, it is argued that this knowledge base is congruent with the ethical and political dimensions of the profession. The PLISSIT model is presented as a possible pedagogical framework for social work education in this area.

Polychoral performance practice and maestro di cappella conducting

Abstract This article disputes some basic questions concerning the coordination of seventeenth century sacred music, approaching the phenomenon through a musical species of particular interest, though largely unstudied from a performance practice point of view. Roman polychorality with its specific performing conditions offers an illuminating perspective on principles of musical direction and interaction which differ significantly from our modern access path towards these topics. The inquiry ranges from basics of performance (such as sheet music, rehearsals, direction technics, models and stylistic conditioning of the performers) over the concrete role of the maestro di cappella as well as the tactus as cornerstones of sacred music practice, up to the philosophical content the particular 'system of values', shining though this overall picture, seems to represent. On this groundwork the essay opens a discussion on conventions which have remained literally unchallenged by generations of researchers and performers.