Behavior change theory, content and delivery of interventions to enhance adherence in chronic respiratory disease: A systematic review

Background: We sought to describe the theory used to design treatment adherence interventions, the content delivered, and the mode of delivery of these interventions in chronic respiratory disease. Methods: We included randomized controlled trials of adherence interventions (compared to another intervention or control) in adults with chronic respiratory disease (8 databases searched; inception until March 2015). Two reviewers screened and extracted data: post-intervention adherence (measured objectively); behavior change theory, content (grouped into psychological, education and self-management/supportive, telemonitoring, shared decision-making); and delivery. “Effective” studies were those with p < 0.05 for adherence rate between groups. We conducted a narrative synthesis and assessed risk of bias. Results: 12,488 articles screened; 46 included studies (n = 42,91% in OSA or asthma) testing 58 interventions (n = 27, 47% were effective). Nineteen (33%) interventions (15 studies) used 12 different behavior change theories. Use of theory (n = 11,41%) was more common amongst effective interventions. Interventions were mainly educational, self-management or supportive interventions (n = 27,47%). They were commonly delivered by a doctor (n = 20,23%), in face-to-face (n = 48,70%), one-to-one (n = 45,78%) outpatient settings (n = 46,79%) across 2–5 sessions (n = 26,45%) for 1–3 months (n = 26,45%). Doctors delivered a lower proportion (n = 7,18% vs n = 13,28%) and pharmacists (n = 6,15% vs n = 1,2%) a higher proportion of effective than ineffective interventions. Risk of bias was high in >1 domain (n = 43, 93%) in most studies. Conclusions: Behavior change theory was more commonly used to design effective interventions. Few adherence interventions have been developed using theory, representing a gap between intervention design recommendations and research practice.

Political participation as public pedagogy : The Educational Situation in Young People´s Political Conversations in Social Media

In this article we argue that young people’s political participation in the social media can be considered ‘public pedagogy’. The argument builds on a previous empirical analysis of a Swedish net community called Black Heart. Theoretically, the article is based on a particular notion of public pedagogy, education and Hannah Arendt’s expressive agonism. The political participation that takes place in the net community builds up an educational situation that involves central characteristics: communication, community building, a strong content focus and content production, argumentation and rule following. These characteristics pave the way for young people’s public voicing, experiencing, preferences and political interests that guide their everyday political life and learning – a phenomenon that we understand as a form of public pedagogy. 

The Usability of a Commercial Game Physics Engine to Develop Physics Educational Materials: an Investigation

Commercial computer games contain “physics engine” components, responsible for providing realistic interactions among game objects. The question naturally arises of whether these engines can be used to develop educational materials for high school and university physics education. To answer this question, the author's group recently conducted a detailed scientific investigation of the physics engine of Unreal Tournament 2004 (UT2004). This article presents their motivation, methodology, and results. The author presents the findings of experiments that probed the accessibility and fidelity of UT2004's physics engine, examples of educational materials developed, and an evaluation of their use in high school classes. The associated pedagogical implications of this approach are discussed, and the author suggests guidelines for educators on how to deploy the approach. Key resources are presented on an associated Web site.

Educational sciences in the Netherlands: state of affairs and challenges

This paper reports on the state of affairs of the „Erziehungswissenschaften“ in the Netherlands. For this description of the educational sciences we primarily rely on a report written in 2014 by a committee that prepared a discipline plan educational sciences (CSO 2014). This report was commissioned by the association of universities in the Netherlands (VSNU ...), the umbrella association of research universities. Such reports regularly are prepared to describe the state of affairs of a discipline and advice on policies for the future development of a discipline. For the educational sciences, the committee was composed of representatives of most universities at the level of university executive boards, faculty deans and department chairs. (DIPF/Orig.)

Recent educational changes at higher educational level in Pakistan: English language teachers' perceptions and practices

Higher Education Institutes (HEIs) of any country could be a source of providing professionals to the country in many fields. By doing so, HEIs could play a pivotal role in the economic growth of the country. In Pakistan, it seems that, in the wake of this realization, steps have been taken to reform Higher Education. Drawing on the Triple I model of educational change covering Initiation, Implementation and Institutionalization (Fullan, 2007) this study focuses on the planning and implementation of reforms in the Education system of Pakistan at higher education level that have been introduced by the Higher Education Commission (HEC) since its inception in 2002. Kennedy’s model of hierarchical subsystems affecting innovation and Chin and Benne’s (1985) description of strategies for implementing change also provided guidelines for analyzing the changes in education in the country to highlight the role that the authorities expect the language teacher to play in the process of implementing these changes. A qualitative method is followed in this study to gather data from English language teachers at three universities of the Khyber Pakhtunkhwa province of Pakistan. A questionnaire was developed to look into the perceptions of English language teachers regarding the impact of these reforms. This was followed up by interviews. Responses from 28 teachers were received through questionnaire out of which 9 teachers were interviewed for detailed analysis of their perceptions. Thematic Content analysis was used to analyze and interpret the data. Some of the most significant changes that the respondents reported knowledge of included the introduction of Semester System, extending the Bachelors degree to four years from two years, promotion of research culture, and increased teachers’ autonomy in classroom practices. Implications of these reforms for English teachers’ professional development were also explored. The data indicate that the teachers generally have a positive attitude towards the changes. However, the data also show concerns that teachers have about the practical effectiveness of these changes in improving English language teaching and learning in Pakistani Universities. Some of the areas of concern are worries regarding resources, the assessment system, the number of qualified teachers, and instability in the educational policy. They are concerned about the training facilities and quality of the professional training available to them. Moreover, they report that training opportunities for their professional development are not available to all the teachers equally. Despite the HEC claims of providing regular training opportunities, the majority of the teachers did not receive any formal training in the last three years, while some teachers were able to access these opportunities multiple times. Through the recent reforms HEC has empowered the teachers in conducting the learning/teacher processes but this extra power has reduced their accountability and they can exercise these powers without any check on them. This empowerment is limited to the classroom and there appears to be no or minimal involvement in decision making at the top level of policy making. Such lack of involvement in the policy decisions seems to be generating a lack of sense of ownership among the teachers (Fullan 2003a:6). Although Quality Enhancement Cells have been developed in the universities to assure the desired quality of education, they might need a more active role to contribute in achieving the level of enhancement in education expected from them. Based on the perceptions of the respondents of this study and the review of the relevant literature, it is argued that it is unlikely for the reforms to be institutionalized if teachers are not given the right kind of awareness at the initiation stage and are not prepared at the implementation stage to cope with the challenge of a complex process. The teachers participating in this study, in general, have positive and enthusiastic attitudes towards most of the changes, in spite of some reservations. It could also be interesting to see if the power centers of the Pakistani Higher Education appreciate this enthusiasm and channel it for a strong Higher Education system in the country.

The effect of mobile technology as an active student response system on the acquisition of U.S. history content of secondary students with specific learning disabilities

Students with specific learning disabilities (SLD) typically learn less history content than their peers without disabilities and show fewer learning gains. Even when they are provided with the same instructional strategies, many students with SLD struggle to grasp complex historical concepts and content area vocabulary. Many strategies involving technology have been used in the past to enhance learning for students with SLD in history classrooms. However, very few studies have explored the effectiveness of emerging mobile technology in K-12 history classrooms. ^ This study investigated the effects of mobile devices (iPads) as an active student response (ASR) system on the acquisition of U.S. history content of middle school students with SLD. An alternating treatments single subject design was used to compare the effects of two interventions. There were two conditions and a series of pretest probesin this study. The conditions were: (a) direct instruction and studying from handwritten notes using the interactive notebook strategy and (b) direct instruction and studying using the Quizlet App on the iPad. There were three dependent variables in this study: (a) percent correct on tests, (b) rate of correct responses per minute, and (c) rate of errors per minute. ^ A comparative analysis suggested that both interventions (studying from interactive notes and studying using Quizlet on the iPad) had varying degrees of effectiveness in increasing the learning gains of students with SLD. In most cases, both interventions were equally effective. During both interventions, all of the participants increased their percentage correct and increased their rate of correct responses. Most of the participants decreased their rate of errors. ^ The results of this study suggest that teachers of students with SLD should consider a post lesson review in the form of mobile devices as an ASR system or studying from handwritten notes paired with existing evidence-based practices to facilitate students’ knowledge in U.S. history. Future research should focus on the use of other interactive applications on various mobile operating platforms, on other social studies subjects, and should explore various testing formats such as oral question-answer and multiple choice. ^

The use of digital educational resources : the contribution of research in the supervised teaching practice in basic education

This article aims to reflect on the impact of Information and Communication Technologies (ICT) in the educational context, focusing on the potential contributions of the use of Digital Educational Resources (RED) in the process of teaching and learning. For this purpose, the results of the use of the RED will be presented:. Digital Classroom - The World's 1st Year Carochinha The study was accomplished in a class of the 1st grade of the 1st CEB, composed of 27 students, aged 6-7 years in Castelo Branco City Schools Group within the Supervised Teaching Practice. The results obtained after the analysis and processing of the data showed that when using this RED students show they have acquired the content covered by the fact that they enhanced levels of greater interest, commitment, motivation, commitment and initiative in the course of activities proposals. But, perhaps because they are students of 1st year of the 1st CEB, do not neglect the presence and monitoring of the teacher and the use of paper-based resources. This means that there should be a complementarity that reconciles the human factor (teacher), with the use of digital media resources and paper support resources (Manual).

The European Educational Research Association: people, practices and policy over the last 20 years

From a pragmatic point of view, it is the people who make an organisation, but organisations are both people and structures, and not least organisations develop culture. One of the significant features of the European Educational Research Association (EERA) as an organisation is that many of its activities are run by people on a voluntary basis. Apart from a small office, now in Berlin, which oversees and handles the everyday management, participation on Council, reviewing and programming for ECER (European Conference on Educational Research), managing networks, etc. are all undertaken as voluntary work by academics from across Europe (and beyond). From the large group of people who are currently sustaining these activities, many have participated from the beginning, but many others, after having been once at the conference, returned and got engaged in the work, for instance within one of the networks. Among the many who participate in EERA activities, there is a diversity of reasons for doing so, but there seems to be something which is recurring in what people say about why they do it. One of these recurring ideas is that the discursive norms of the organisation are enforced in the context of welcoming people and ideas, and second, there exists an intellectual generosity and egalitarianism which encourages newcomers to participate rather than protect themselves. We believe that this tells something about what EERA and ECER are about.

Mathematical pedagogical content knowledge in early childhood education: A study in initial teacher education in Portugal

The study aims to explore the specificity of mathematics Pedagogical Content Knowledge in Early Childhood Education Pedagogy. The pedagogy of ECE (Siraj-Blatchford, 2010) and the didactics of ECE (Pramling & Pramling-Samuelsson, 2011) suggest dimensions of knowledge that require strong content and PC knowledge of teachers. Recent studies about PCK of ECE teachers highlight similar specific dimensions: organization of educational environment and interactions with children (Lee, 2010, McCray, 2008, Rojas, 2008). The current framework for ECE Teacher Education in Portugal (since 2007) focuses both content knowledge and subject didactics. PCK has been labelled the 'great unknown' in ECE (Rojas, 2008) in traditions where the child's development is considered as the main knowledge base for ECE (Chen & McNamee, 2006, Cullen, 2005, Hedges & Cullen, 2005). We studied the perspectives of 27 initial teacher education students about knowledge for teaching and about ECE Pedagogy. We used one open-ended questionnaire and students' analysis of episodes focusing children's answers or discourse relevant for mathematics (about high numbers and square root). The questionnaire was anonymous and students’ permission to use the answers was obtained. In the questionnaire, interactions with children (62%) and organization of the educational environment (38%) are highlighted as the most important focus for the teacher. Students suggested tasks that were adult planned and oriented to further the situations presented in the episodes. Very few references to children's exploratory actions (Bonawitz et al., 2011) were made. The specificity of ECE (child initiated activities, e.g.) needs to be further developed in initial teacher education.

Taurine Supplementation Increases K(atp) Channel Protein Content, Improving Ca2+ Handling And Insulin Secretion In Islets From Malnourished Mice Fed On A High-fat Diet.

Pancreatic β-cells are highly sensitive to suboptimal or excess nutrients, as occurs in protein-malnutrition and obesity. Taurine (Tau) improves insulin secretion in response to nutrients and depolarizing agents. Here, we assessed the expression and function of Cav and KATP channels in islets from malnourished mice fed on a high-fat diet (HFD) and supplemented with Tau. Weaned mice received a normal (C) or a low-protein diet (R) for 6 weeks. Half of each group were fed a HFD for 8 weeks without (CH, RH) or with 5% Tau since weaning (CHT, RHT). Isolated islets from R mice showed lower insulin release with glucose and depolarizing stimuli. In CH islets, insulin secretion was increased and this was associated with enhanced KATP inhibition and Cav activity. RH islets secreted less insulin at high K(+) concentration and showed enhanced KATP activity. Tau supplementation normalized K(+)-induced secretion and enhanced glucose-induced Ca(2+) influx in RHT islets. R islets presented lower Ca(2+) influx in response to tolbutamide, and higher protein content and activity of the Kir6.2 subunit of the KATP. Tau increased the protein content of the α1.2 subunit of the Cav channels and the SNARE proteins SNAP-25 and Synt-1 in CHT islets, whereas in RHT, Kir6.2 and Synt-1 proteins were increased. In conclusion, impaired islet function in R islets is related to higher content and activity of the KATP channels. Tau treatment enhanced RHT islet secretory capacity by improving the protein expression and inhibition of the KATP channels and enhancing Synt-1 islet content.

A New Extraction Approach To Correct The Effect Of Apparent Increase In The Secoiridoid Content After Filtration Of Virgin Olive Oil.

In the current study, a new approach has been developed for correcting the effect that moisture reduction after virgin olive oil (VOO) filtration exerts on the apparent increase of the secoiridoid content by using an internal standard during extraction. Firstly, two main Spanish varieties (Picual and Hojiblanca) were submitted to industrial filtration of VOOs. Afterwards, the moisture content was determined in unfiltered and filtered VOOs, and liquid-liquid extraction of phenolic compounds was performed using different internal standards. The resulting extracts were analyzed by HPLC-ESI-TOF/MS, in order to gain maximum information concerning the phenolic profiles of the samples under study. The reduction effect of filtration on the moisture content, phenolic alcohols, and flavones was confirmed at the industrial scale. Oleuropein was chosen as internal standard and, for the first time, the apparent increase of secoiridoids in filtered VOO was corrected, using a correction coefficient (Cc) calculated from the variation of internal standard area in filtered and unfiltered VOO during extraction. This approach gave the real concentration of secoiridoids in filtered VOO, and clarified the effect of the filtration step on the phenolic fraction. This finding is of great importance for future studies that seek to quantify phenolic compounds in VOOs.

Effect Of Aloe Vera Application On The Content And Molecular Arrangement Of Glycosaminoglycans During Calcaneal Tendon Healing.

Although several treatments for tendon lesions have been proposed, successful tendon repair remains a great challenge for orthopedics, especially considering the high incidence of re-rupture of injured tendons. Our aim was to evaluate the pharmacological potential of Aloe vera on the content and arrangement of glycosaminoglycans (GAGs) during tendon healing, which was based on the effectiveness of A. vera on collagen organization previously observed by our group. In rats, a partial calcaneal tendon transection was performed with subsequent topical A. vera application at the injury site. The tendons were treated with A. vera ointment for 7 days and excised on the 7(th) , 14(th) , or 21(st) day post-surgery. Control rats received ointment without A. vera. A higher content of GAGs and a lower amount of dermatan sulfate were detected in the A. vera-treated group on the 14(th) day compared with the control. Also at 14 days post-surgery, a lower dichroic ratio in toluidine blue stained sections was observed in A. vera-treated tendons compared with the control. No differences were observed in the chondroitin-6-sulfate and TGF-β1 levels between the groups, and higher amount of non-collagenous proteins was detected in the A. vera-treated group on the 21(st) day, compared with the control group. No differences were observed in the number of fibroblasts, inflammatory cells and blood vessels between the groups. The application of A. vera during tendon healing modified the arrangement of GAGs and increased the content of GAGs and non-collagenous proteins.

Root Canal Content From Primary Endodontic Infection And Upregulation Of Gelatinases In Fibroblast Cells.

To investigate endotoxin levels from primary endodontic infections before and after chemomechanical preparation (CMP) and to determine their antigenicity against 3T3 fibroblasts through gelatinolytic activity of matrix metalloproteinases (MMPs). Twenty-four root canals with primary endodontic infection and apical periodontitis were selected. Samples were collected using paper points before (S1) and after chemomechanical preparation (CMP) (S2). The limulus amebocyte lysate assay was used for endotoxin measurement. Fibroblasts were stimulated with root canal contents for 24 h. Supernatants of cell cultures stimulated with root canal contents were collected after 24 h to determine the levels of MMP-2 and MMP-9 gelatinolytic activity using the zymography technique. Friedman and Wilcoxon tests were used to compare the amount of endotoxin before (S1) and after CMP (S2) (P < 0.05). Data obtained from gelatinolytic activity were analysed using anova and Tukey's tests (P < 0.05). Endotoxin was recovered in 100% of the samples. There was a significant reduction in endotoxin levels after CMP (P < 0.05). A correlation was found between the levels of endotoxins and MMP-2 expression (P < 0.05). Root canal contents of initial samples (S1) induced significantly greater MMP-2 expression by fibroblasts when compared to S2 and the nonstimulated group (P < 0.05). No gelatinolytic activity of MMP-9 was observed in S1, S2 and control group. Root canal contents from primary endodontic infections had gelatinolytic activity for MMP-2. Moreover, CMP was effective in reducing endotoxin levels and their antigenicity against fibroblasts on gelatinolytic activity.

Proinflammatory Activity Of Primarily Infected Endodontic Content Against Macrophages After Different Phases Of The Root Canal Therapy.

This study investigated the presence of target bacterial species and the levels of endotoxins in teeth with apical periodontitis. Levels of inflammatory mediators (interleukin [IL]-1β and tumor necrosis factor [TNF]-α) were determined after macrophage stimulation with endodontic content after different phases of endodontic therapy using different irrigants. Thirty primarily infected root canals were randomly assigned into 3 groups according to the irrigant used for root canal preparation (n = 10 per group): GI: 2.5% sodium hypochlorite, GII: 2% chlorhexidine gel, and GIII (control group): saline solution. Root canal samples were taken by using paper points before (s1) and after root canal instrumentation (s2), subsequently to 17% EDTA (s3), after 30 days of intracanal medication (Ca[OH]2 + saline solution) (s4), and before root canal obturation (s5). Polymerase chain reaction (16S recombinant DNA) and limulus amebocyte lysate assay were used for bacterial and endotoxin detection, respectively. Macrophages were stimulated with the root canal contents for IL-1β/TNF-α measurement using enzyme-linked immunosorbent assay. Porphyromonas gingivalis (17/30), Porphyromonas endodontalis (15/30), and Prevotella nigrescens (11/30) were the most prevalent bacterial species. At s1, endotoxins were detected in 100% of the root canals (median = 32.43 EU/mL). In parallel, substantial amounts of IL-1β and TNF-α were produced by endodontic content-stimulated macrophages. At s2, a significant reduction in endotoxin levels was observed in all groups, with GI presenting the greatest reduction (P < .05). After a root canal rinse with EDTA (s3), intracanal medication (s4), and before root canal obturation (s5), endotoxin levels reduced without differences between groups (P < .05). IL-1β and TNF-α release decreased proportionally to the levels of residual endotoxin (P < .05). Regardless of the use of sodium hypochlorite or CHX, the greatest endotoxin reduction occurs after chemomechanical preparation. Increasing steps of root canal therapy associated with intracanal medication enhances endotoxin reduction, leading to a progressively lower activation of proinflammatory cells such as macrophages.

A motivação de alunos no contexto da progressão continuada

This study investigated the intrinsic and extrinsic motivacional orientations of students in the context of the educational continuous progression. The sample was composed of 160 subjects of second, fourth, sixth and eighth grades of the elementary school. Data was collected by means of the presentation of histories involving the intrinsic, extrinsic motivation and the educational continuous progression system. Subjects were interviewed individually. Their answers were transcribed verbatim and submitted to content analysis. Results indicated that a expressive percentage of students did not know the educational system of continuous progression. Students revealed a predominantly intrinsic motivation orientation with advances in age and in school grade level, even though knowing that they will not repeat any school grade. This study pointed out the importance of deepening our knowledge concerning the impact of the educational continuous progression in students' motivation to learn.