Objective
To compare disease activity and disability over 2 years in early rheumatoid arthritis (RA) before and after implementation of treat‐to‐target therapy and identify predictors of adverse ...outcome.
Methods
The Yorkshire Early Arthritis Register (YEAR) recruited 725 patients with early RA between 2002 and 2009, treated with a step‐up approach. The Inflammatory Arthritis Continuum study (IACON) recruited cases between 2010 and 2014 and treated to target. A total of 384 IACON cases met 2010 American College of Rheumatology/European League Against Rheumatism criteria. Latent growth curves of change in Disease Activity Score in 28 joints (DAS28) and the Health Assessment Questionnaire (HAQ) were compared between YEAR and IACON. Latent class growth analysis identified trajectories of change. Baseline predictors of trajectories were identified using logistic regression.
Results
The mean DAS28 over 2 years was lower in IACON than in YEAR. Latent trajectories of HAQ change in YEAR were high stable (21% of cohort), moderate reducing (35%), and low reducing (44%). Only moderate reducing (66%) and low reducing (34%) were seen in IACON. In both cohorts, female sex and fatigue predicted adverse HAQ trajectories (high stable and moderate reducing). Odds ratios (ORs) for moderate reducing compared to low reducing for women were 2.58 (95% confidence interval 95% CI 1.69, 4.49) in YEAR and 5.81 (95% CI 2.44, 14.29) in IACON. ORs per centimeter fatigue visual analog score were 1.13 (95% CI 1.07, 1.20) in YEAR and 1.16 (95% CI 1.12, 1.20) in IACON.
Conclusion
Treat‐to‐target therapy gave more favorable trajectories of change in DAS28 and HAQ, but adverse HAQ trajectory was more likely in women with greater fatigue, suggesting such patients would benefit from interventions to improve function as well as reduce inflammation.
Text Complexity: Primary Teachers' Views Fitzgerald, Jill; Hiebert, Elfrieda H.; Bowen, Kimberly ...
Literacy research and instruction,
01/2015, Letnik:
54, Številka:
1
Journal Article
Recenzirano
The research question was, "What text characteristics do primary teachers think are most important for early grades text complexity?" Teachers from across the United States accomplished a two-part ...task. First, to stimulate teachers' thinking about important text characteristics, primary teachers completed an online paired-text comparison task. While doing the task, teachers were asked to decide which texts in pairs were more complex, and they were also asked to think about which text characteristics mattered most for their decisions. Next, teachers completed a questionnaire, with primary focus on the text characteristics teachers thought mattered most for early grades text complexity. The teachers emphasized word decodability, word frequency, pictures, and word meanings, and they also referenced other characteristics. Their outlook has implications for implementation of the Common Core Standard on text complexity for young children learning to read.
Two outbreaks of norovirus and acute gastroenteritis took place in Canada between November 2016 and April 2017. Both outbreaks were linked to oysters from British Columbia (BC) coastal waters. This ...paper describes the multi-agency investigations to identify the source and control the outbreak. Public health officials conducted interviews to determine case exposures. Traceback was conducted by collecting oyster tags from restaurants and analyzing them to determine the most common farms. Oyster samples were collected from case homes, restaurants, and harvest sites and tested for the presence of norovirus. Potential environmental pollution sources were investigated to identify the source of the outbreak. Four hundred and 49 cases were identified as part of the two outbreak waves. The oysters were traced to various geographically dispersed farms in BC coastal waters. Twelve farms were closed as a result of the investigations. No environmental pollution sources could be identified as the cause of the outbreak. Similarities in the timeframe, genotype, and geographic distribution of identified oyster farms indicate that they may have been one continuous event. Genotype data indicate that human sewage contamination was the likely cause of the outbreak, although no pollution source was identified.
The purpose of the study was to address possible text complexity shifts across the past six decades for a continually best-selling first-grade core reading program. The anthologies of one publisher's ...seven first-grade core reading programs were examined using computer-based analytics, dating from 1962 to 2013. Variables were Overall Text Complexity Level and nine textcharacteristic operationalizations: number of Syllables in words and Decoding (word structure); Age of Acquisition, Abstractness, and Word Rareness (word meaning); and Intersentential Complexity, Text Density, Phrase Diversity, and Noncompressibility (discourse level). Multilevel modeling was conducted. There were three main conclusions: (1) Overall Text Complexity levels trended toward more complexity in more recent years. (2) For four of the nine text characteristics, program years were different in the text characteristic progression from the beginning to the end of the first-grade year. Initially in the fall, programs of later years exposed children to word structures (Syllables and Decoding) that were as easy or easier than in earlier years, but there was intense, and incomparable, control over gradually increasing the complexity of word structures throughout the year, ending the first-grade year with the most complex word structures of any year. Simultaneously, as compared with earlier years, there was a pronounced diminished emphasis in the later program years on selected aspects of repetition and redundancy (Text Density and Phrase Diversity) across the first-grade year. (3) Two of the six text characteristics, Age of Acquisition and Word Rareness, trended toward more complexity on average in the later program years.
National and local initiatives focused on the transformation of STEM teaching in higher education have multiplied over the last decade. These initiatives often focus on measuring change in ...instructional practices, but it is difficult to monitor such change without a national picture of STEM educational practices, especially as characterized by common observational instruments. We characterized a snapshot of this landscape by conducting the first large scale observation-based study. We found that lecturing was prominent throughout the undergraduate STEM curriculum, even in classrooms with infrastructure designed to support active learning, indicating that further work is required to reform STEM education. Additionally, we established that STEM faculty’s instructional practices can vary substantially within a course, invalidating the commonly-used teaching evaluations based on a one-time observation.
Although lecture is prominent throughout the undergraduate STEM curriculum, STEM faculty employ varied teaching practices within the same course.
Introduction: Unnatural amino acids (UAAs) share the same basic structure as proteinogenic amino acids. However, UAAs permit additional functions and applications to proteins due to their different ...side chains. Recent UAA applications include using fluorescent UAAs to label proteins. The UAA system provides an alternative method to traditional protein labeling mechanisms (antibodies, GFP, and tags, such as HA and HIS), which can affect protein functionality and topology. The purpose of this study was to visualize the hepatitis C virus (HCV) core protein using the fluorescent UAA Anap (3-(6-acetyl-2-naphthalenyl)amino-L-alanine). Methods: Huh-7.5 cells were co-transfected with HCV core plasmids containing amber stop codons at various positions throughout the coding sequence and a second plasmid encoding the orthogonal tRNA/synthetase pair that facilitates Anap incorporation. Three days post transfection, cells were stained for core protein and lipid droplets (LDs) and visualized using immunofluorescence or confocal microscopy. Results: We have optimized transfection protocols for the efficient expression of the tRNA/synthetase pair required for Anap incorporation and are able to visualize our core mutant proteins containing Anap. We have successfully substituted Anap into 11 different positions within the core, including substitutions for tryptophan, tyrosine, and phenylalanine residues. In addition, we have shown that our core mutants associate with cellular LDs, suggesting that the incorporation of the UAA did not disrupt core protein expression, stability, or cellular localization. Conclusions: We have demonstrated the establishment of a UAA incorporation system in an HCV protein without any obvious impact on core protein function. The ability to label viral proteins using fluorescent UAAs eliminates the requirement of antibodies or tags for protein visualization. In conclusion, the UAA system is a useful method to study HCV proteins and can potentially be used to label viruses for live cell and animal studies.
The present study investigated whether young Latino dual-language learners' 2-year English reading growth varied over time according to their initial overall oral English ability. We followed 41 ...Latino children for 2 years. We tested overall oral English at the beginning of the study and administered multiple curriculum-based reading assessments at the beginning, middle, and end of each of the 2 years. The main conclusions were as follows: (a) The pattern of Instructional Reading Level growth and sound- and word-level subprocesses varied according to Overall Oral English ability. However, the impact of oral English was principally for students who had extremely low initial oral English. (b) There was no differential pattern in Comprehension or Fluency growth according to initial Overall Oral English.
This paper seeks to present findings from a longitudinal action research study aimed at exploring one such innovation. Little is known about the micro-level impact of health service innovations over ...time.
The paper shows that action research is a participatory approach ideally suited to monitoring the process and outcomes of change. Over 20 months, an action researcher studied the work of four interprofessional care co-ordinators (IPCCs), whose role was intended to speed patient through-put within a London teaching hospital general medical directorate. The action researcher kept regular participant observation field notes and supplemented these data with a profile of IPCC patients (n = 407), in-depth interviews (n = 37) and focus groups (n = 16) with staff. Throughout the study, findings were regularly fed back to participants to inform practice developments.
The findings in this paper show that, in spite of the original intention for this role to provide clerical support to the multidisciplinary team, over time the role shifted beyond its implementation into practice to take on more complex work from registered nurses. This raised actual and potential governance issues that were not attended to by service managers. A complex and turbulent context disrupted managers' and practitioners' abilities to reflect on and respond to these longer-term role shifts.
This paper argues that the complex nature of the innovation and the setting in which it operated account for the role shift and the lack of attention to issues of governance. Current innovation literature suggests that implementation into routine practice represents the end-point of an innovation's journey. These findings suggest that certain innovations may in fact continue to shift in nature even after this "end-point". The conclusions drawn are likely to be of global interest to those interested in complex health service innovations.
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