This study describes an approach to history education which leverages augmented reality (AR). Currently, most learning interventions with AR are designed from the paradigm of an expert‐led model of ...teaching, where the AR artefact is created by a domain expert; under such a paradigm, the learner has limited ownership of the process of artefact production. The project reported in this paper aimed to broaden the application of AR in education, specifically to history education, by exploring the affordances of such technology in mediating student‐led learning activities, using an approach known as learner‐generated augmentation. The current Singapore Secondary History syllabus adopts an inquiry‐based approach. The need to memorize key facts is still an important part in formulating historical arguments. The study involved the design of a learning activity to help students memorize historical information more effectively by building upon the established memory technique of Memory Palace/method of loci. In this activity, students used a free AR mobile application—Just a Line—to sketch out memory palaces of key information from a prose passage. This activity was trialled on student‐teachers who are majoring in History at the National Institute of Education, Singapore. After they had sketched their memory palaces in three dimensions, they were interviewed on their experience. Samples of their learning artefacts (their sketches) and analyses of their comments, are reported. No claim is made with respect to the absolute efficacy of the approach, given the limited number of participants in the study. The intent of this paper is instead to invite exploration and debate around the wider affordances of AR for learning.
Practitioner Notes
What is already known about this topic
So far, initiatives which use augmented reality (AR) in learning have been designed from the paradigm of an expert‐led, rather than student‐centred, model of teaching.
The learner‐generated augmentation approach offers a possible way of designing student‐centred learning interventions with AR technology.
One of the known challenges of learning history is the accurate recall of historical facts.
Memory palace/method of loci is one strategy that can be used to aid memorization, but it suffers from certain limitations.
What this paper adds
The study described in this paper aims to address the challenges of accurately recalling historical facts, through the use of freely‐available cross‐platform AR software for smartphones.
The study takes advantage of the affordances of AR to improve the memory palace/method of loci strategy by providing ways for learners to represent their tacit imaginations of the memory palace more explicitly.
Learners can be encouraged to understand that their everyday environments are actually potential contexts for more authentic learning.
Implications for practice and/or policy
This study demonstrates the possibility of using AR technologies as part of student‐centred learning.
This study demonstrates the feasibility of applying the Learner‐Generated Augmentation approach to subject disciplines such as the Social Sciences, which emphasize the socially‐constructed interpretation of events.
The study demonstrates the feasibility of using AR technology to build upon the memory palace/method of loci strategy, so that the effectiveness of the latter is less dependent on the abilities of the learner for imagination, thereby making the subject discipline more accessible to a wider cohort of learners.
The study suggests that the memory palaces which result from the approach may be used by learners and their peers/teachers as part of Assessment for Learning.
As this is the second application of the approach of Learner‐Generated Augmentation to a subject discipline (the original application being in Chemistry) the study suggests that the approach may be translated beyond its original application in the Natural Sciences to the Social Sciences as well.
Virtual worlds have affordances to enhance collaborative learning in authentic contexts. Despite the potential of collaborative learning with a virtual world, few studies investigated whether it is ...more effective in student achievements than teacher‐directed instruction. This study investigated the effectiveness of collaborative problem solving and collaborative observation using virtual worlds. Secondary school students (n = 101) participated in the study as part of their coursework in three geography classes. This study found that collaborative problem solving and observation were more effective in facilitating and maintaining intrinsic motivation than teacher‐directed instruction. Students in the collaborative observation condition outperformed those in the other conditions when it came to knowledge gains. Lastly, collaborative problem solving and observation were more beneficial for group performance than teacher‐directed instruction. These results were discussed in regard to the impacts of interactive learning and the cognitive load of using virtual worlds.
Suboptimal weight gain during pregnancy is a potentially modifiable risk factor. We aimed to investigate the association between suboptimal gestational weight gain and severe adverse birth outcomes ...by pre-pregnancy body mass index (BMI) categories, including obesity class I to III.
We conducted a population-based study of pregnant women with singleton hospital births in Washington State, US, between 2004 and 2013. Optimal, low, and excess weight gain in each BMI category was calculated based on weight gain by gestational age as recommended by the American College of Obstetricians and Gynecologists and the Institute of Medicine. Primary composite outcomes were (1) maternal death and/or severe maternal morbidity (SMM) and (2) perinatal death and/or severe neonatal morbidity. Logistic regression was used to obtain adjusted odds ratios (AORs) and 95% confidence intervals. Overall, 722,839 women with information on pre-pregnancy BMI were included. Of these, 3.1% of women were underweight, 48.1% had normal pre-pregnancy BMI, 25.8% were overweight, and 23.0% were obese. Only 31.5% of women achieved optimal gestational weight gain. Women who had low weight gain were more likely to be African American and have Medicaid health insurance, while women with excess weight gain were more likely to be non-Hispanic white and younger than women with optimal weight gain in each pre-pregnancy BMI category. Compared with women who had optimal weight gain, those with low gestational weight gain had a higher rate of maternal death, 7.97 versus 2.63 per 100,000 (p = 0.027). In addition, low weight gain was associated with the composite adverse maternal outcome (death/SMM) in women with normal pre-pregnancy BMI and in overweight women (AOR 1.12, 95% CI 1.04-1.21, p = 0.004, and AOR 1.17, 95% CI 1.04-1.32, p = 0.009, respectively) compared to women in the same pre-pregnancy BMI category who had optimal weight gain. Similarly, excess gestational weight gain was associated with increased rates of death/SMM among women with normal pre-pregnancy BMI (AOR 1.20, 95% CI 1.12-1.28, p < 0.001) and obese women (AOR 1.12, 95% CI 1.01-1.23, p = 0.019). Low gestational weight gain was associated with perinatal death and severe neonatal morbidity regardless of pre-pregnancy BMI, including obesity classes I, II, and III, while excess weight gain was associated with severe neonatal morbidity only in women who were underweight or had normal BMI prior to pregnancy. Study limitations include the ascertainment of pre-pregnancy BMI using self-report, and lack of data availability for the most recent years.
In this study, we found that most women do not achieve optimal weight gain during pregnancy. Low weight gain was associated with increased risk of severe adverse birth outcomes, and in particular with maternal death and perinatal death. Excess gestational weight gain was associated with severe adverse birth outcomes, except for women who were overweight prior to pregnancy. Weight gain recommendations for this group may need to be reassessed. It is important to counsel women during pregnancy about specific risks associated with both low and excess weight gain.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
PurposeThe purpose of this study is to examine the reform initiatives that began with a focus towards change in the teaching and learning in Singapore classrooms with technology ...integration.Design/methodology/approachThe methodology used in this study is review and descriptive narrative of educational technology polices, initiatives and projects.FindingsThe Ministry of Education, Singapore, has ensured that schools had infrastructure, leadership and necessary teacher training to successfully implement the initiatives.Originality/valueThe descriptions of the implementations are valuable lessons for other national systems in the region and beyond, seeking to integrate information and communications technology (ICT) in their education systems.
IMPORTANCE: Although high body mass index (BMI) is associated with adverse birth outcomes, the association with severe maternal morbidity is unclear. OBJECTIVE: To examine the association between ...prepregnancy BMI and severe maternal morbidity. DESIGN, SETTING, AND PARTICIPANTS: Retrospective population-based cohort study including all singleton hospital births in Washington State, 2004-2013. Demographic data and morbidity diagnoses were obtained from linked birth certificates and hospitalization files. EXPOSURES: Prepregnancy BMI (weight in kilograms divided by height in meters squared) categories included underweight (<18.5), normal BMI (18.5-24.9), overweight (25.0-29.9), obesity class 1 (30.0-34.9), obesity class 2 (35.0-39.9), and obesity class 3 (≥40). MAIN OUTCOMES AND MEASURES: Composite severe maternal morbidity or mortality included life-threatening conditions and conditions leading to serious sequelae (eg, amniotic fluid embolism, hysterectomy), complications requiring intensive care unit admission, and maternal death. Logistic regression was used to obtain adjusted odds ratios (ORs) and adjusted rate differences with 95% confidence intervals, adjusted for confounders (eg, maternal age and parity). RESULTS: Overall, 743 630 women were included in the study (mean age, 28.1 SD, 6.0 years; 41.4% nulliparous). Prepregnancy BMI was distributed as follows: underweight, 3.2%; normal weight, 47.5%; overweight, 25.8%; obesity class 1, 13.1%; obesity class 2, 6.2%; and obesity class 3, 4.2%. Rates of severe maternal morbidity or mortality were 171.5, 143.2, 160.4, 167.9, 178.3 and 202.9 per 10 000 women, respectively. Adjusted ORs were 1.2 (95% CI, 1.0-1.3) for underweight women; 1.1 (95% CI, 1.1-1.2) for overweight women; 1.1 (95% CI, 1.1-1.2) for women with class 1 obesity; 1.2 (95% CI, 1.1-1.3) for women with class 2 obesity; and 1.4 (95% CI, 1.3-1.5) for women with class 3 obesity compared with women with normal BMI. Absolute risk increases (adjusted rate differences per 10 000 women, compared with women with normal BMI) were 28.8 (95% CI, 12.2-47.2) for underweight women, 17.6 (95% CI, 10.5-25.1) for overweight women, 24.9 (95% CI, 15.7-34.6) for women with class 1 obesity, 35.8 (95% CI, 23.1-49.5) for women with class 2 obesity, and 61.1 (95% CI, 44.8-78.9) for women with class 3 obesity. CONCLUSIONS AND RELEVANCE: Among pregnant women in Washington State, low and high prepregnancy BMI, compared with normal BMI, were associated with a statistically significant but small absolute increase in severe maternal morbidity or mortality.
The measurement of blood pressure (BP) is critical to the treatment and management of many medical conditions. High blood pressure is associated with many chronic disease conditions, and is a major ...source of mortality and morbidity around the world. For outpatient care as well as general health monitoring, there is great interest in being able to accurately and frequently measure BP outside of a clinical setting, using mobile or wearable devices. One possible solution is photoplethysmography (PPG), which is most commonly used in pulse oximetry in clinical settings for measuring oxygen saturation. PPG technology is becoming more readily available, inexpensive, convenient, and easily integrated into portable devices. Recent advances include the development of smartphones and wearable devices that collect pulse oximeter signals. In this article, we review (i) the state-of-the-art and the literature related to PPG signals collected by pulse oximeters, (ii) various theoretical approaches that have been adopted in PPG BP measurement studies, and (iii) the potential of PPG measurement devices as a wearable application. Past studies on changes in PPG signals and BP are highlighted, and the correlation between PPG signals and BP are discussed. We also review the combined use of features extracted from PPG and other physiological signals in estimating BP. Although the technology is not yet mature, it is anticipated that in the near future, accurate, continuous BP measurements may be available from mobile and wearable devices given their vast potential.
Vitamin D Toxicity Lim, Kenneth; Thadhani, Ravi
Brazilian Journal of Nephrology,
06/2020, Letnik:
42, Številka:
2
Journal Article
Recenzirano
Odprti dostop
Abstract Fortification of food products with vitamin D was central to the eradication of rickets in the early parts of the 20th century in the United States. In the subsequent almost 100 years since, ...accumulating evidence has linked vitamin D deficiency to a variety of outcomes, and this has paralleled greater public interest and awareness of the health benefits of vitamin D. Supplements containing vitamin D are now widely available in both industrialized and developing countries, and many are in the form of unregulated formulations sold to the public with little guidance for safe administration. Together, this has contributed to a transition whereby a dramatic global increase in cases of vitamin D toxicity has been reported. Clinicians are now faced with the challenge of managing this condition that can present on a spectrum from asymptomatic to acute life-threatening complications. This article considers contemporary data on vitamin D toxicity, and diagnostic and management strategies relevant to clinical practice.
Resumo A suplementação de produtos alimentares com vitamina D foi fundamental para a erradicação do raquitismo no início do século XX nos Estados Unidos. Nos quase 100 anos subsequentes, o acúmulo de evidências vinculou a deficiência de vitamina D a uma variedade de desfechos, e isso tem levantado grande interesse público e conscientização dos benefícios à saúde da vitamina D. Os suplementos que contêm vitamina D estão agora amplamente disponíveis tanto nos países desenvolvidos quanto naqueles em desenvolvimento, e muitos estão na forma de formulações não regulamentadas, vendidas ao público com poucas orientações para uma administração segura. Juntos, isso contribuiu para uma transição na qual um aumento global dramático nos casos de toxicidade da vitamina D tem sido relatado. Médicos agora enfrentam o desafio de tratar essa condição que pode apresentar um espectro de complicações assintomáticas a agudas, com risco de vida. Este artigo considera dados atualizados sobre a toxicidade da vitamina D e estratégias de diagnóstico e manejo relevantes para a prática clínica.
Summary
Antiretroviral therapy (ART) has improved outcomes for human immunodeficiency virus‐associated non‐Hodgkin lymphoma (HIV‐NHL). This is an analysis of 44 patients with HIV with Burkitt ...lymphoma (HIV‐BL) and diffuse large B‐cell lymphoma (HIV‐DLBCL) treated in Australia over a 10‐year period (2009–2019) during the ART and rituximab era. At HIV‐NHL diagnosis, the majority of presenting patients had adequate CD4 counts and undetectable HIV viral load <50 copies/mL. More than 80% of patients received chemotherapy with curative intent, rituximab, and concurrent ART with chemotherapy (immunotherapy). R‐CODOX‐M/IVAC or R‐Hyper‐CVAD (55%) were most commonly used in HIV‐BL. CHOP (58%) was the most commonly used chemotherapy backbone for HIV‐DLBCL, although 45% of patients received more intense chemotherapy regimens. Overall, 93% of patients who received curative therapy completed their intended course. The 2‐year progression‐free survival (PFS) and overall survival (OS) for the HIV‐BL cohort was 67% and 67% respectively. The 2‐year PFS and OS for the HIV‐DLBCL cohort was 77% and 81% respectively. Treatment related mortality was 5%. In all, 83% of patients achieved a CD4 count of >0.2 ×109/L 6 months after the end of treatment. Current Australian practice favours the treatment of HIV‐BL and HIV‐DLBCL similarly to the HIV‐negative population with the use of concurrent ART, achieving outcomes comparable to the HIV‐negative population.
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