Curriculum developers and researchers have promoted context-based programmes to arrest waning student interest and participation in the enabling sciences at high school and university. Context-based ...programmes aim for student connections between scientific discourse and real-world contexts to elevate curricular relevance without diminishing conceptual understanding. This interpretive study explored the learning transactions in one 11th grade context-based chemistry classroom where the context was the local creek. The dialectic of agency/structure was used as a lens to examine how the practices in classroom interactions afforded students the agency for learning. The results suggest that first, fluid transitions were evident in the student-student interactions involving successful students; and second, fluid transitions linking concepts to context were evident in the students' successful reports. The study reveals that the structures of writing and collaborating in groups enabled students' agential and fluent movement between the field of the real-world creek and the field of the formal chemistry classroom. Furthermore, characteristics of academically successful students in context-based chemistry are highlighted. Research, teaching, and future directions for context-based science teaching are discussed.
Our aim was to assess national prescribing trends and determine longitudinal resistance patterns for topical antimicrobials in New Zealand. We observed a dramatic increase in fusidic acid (FA) ...resistance, and clonal expansion of FA-resistant Staphylococcus aureus. This increase was concurrent with a significant national increase in topical FA dispensing.
To assess the individual and community health effects of task shifting for emergency care in low-resource settings and underserved populations worldwide.
We systematically searched 13 databases and ...additional grey literature for studies published between 1984 and 2019. Eligible studies involved emergency care training for laypeople in underserved or low-resource populations, and any quantitative assessment of effects on the health of individuals or communities. We conducted duplicate assessments of study eligibility, data abstraction and quality. We synthesized findings in narrative and tabular format.
Of 19 308 papers retrieved, 34 studies met the inclusion criteria from low- and middle-income countries (21 studies) and underserved populations in high-income countries (13 studies). Targeted emergency conditions included trauma, burns, cardiac arrest, opioid poisoning, malaria, paediatric communicable diseases and malnutrition. Trainees included the general public, non-health-care professionals, volunteers and close contacts of at-risk populations, all trained through in-class, peer and multimodal education and public awareness campaigns. Important clinical and policy outcomes included improvements in community capacity to manage emergencies (14 studies), patient outcomes (13 studies) and community health (seven studies). While substantial effects were observed for programmes to address paediatric malaria, trauma and opioid poisoning, most studies reported modest effect sizes and two reported null results. Most studies were of weak (24 studies) or moderate quality (nine studies).
First aid education and task shifting to laypeople for emergency care may reduce patient morbidity and mortality and build community capacity to manage health emergencies for a variety of emergency conditions in underserved and low-resource settings.
Abstract
Background
The Dundee classification of cellulitis severity, previously shown to predict disease outcomes, provides an opportunity to improve the management of patients with cellulitis.
...Methods
We developed and implemented a pathway to guide the management of adults with cellulitis based on their Dundee severity class, and measured its effect on patient outcomes. We compared the outcomes in patients admitted to Auckland City Hospital (ACH) between July 2014 and July 2015 (the baseline cohort) with those in patients admitted between June 2017 and June 2018 (the intervention cohort).
Results
The median length of stay was shorter in the intervention cohort (0.7 days, interquartile range (IQR) 0.1 to 3.0 days) than in the baseline cohort (1.8 days, IQR 0.1 to 4.4 days; P < .001). The 30-day mortality rate declined from 1.8% (19/1092) in the baseline cohort to 0.7% (10/1362; P = .02) in the intervention cohort. The 30-day cellulitis readmission rate increased from 6% in the baseline cohort to 11% (P < .001) in the intervention cohort. Adherence to the ACH cellulitis antibiotic guideline improved from 38% to 48% (P < .01) and was independently associated with reduced length of stay.
Conclusions
The implementation of the Auckland cellulitis pathway, readily generalizable to other settings, improved the outcomes in patients with cellulitis, and resulted in an annual saving of approximately 1000 bed days.
The Auckland Cellulitis Pathway utilized the Dundee Cellulitis Classification and promoted oral antibiotic treatment for patients with mild disease. The pathway improved adherence to antibiotic guidelines, which resulted in reduced mortality and length of stay.
•A multiple classifier system (MCS) to classify trucks by body configuration is presented.•Inductive loop signatures combined with axle configuration from Weigh-in-Motion sensors.•Model predicts ...among 23 single unit truck and 31 semi-trailer body configurations.•MCS outperform individual base classifiers and enables accurate classification of low volume classes.
Transportation agencies tasked with forecasting freight movements, creating and evaluating policy to mitigate transportation impacts on infrastructure and air quality, and furnishing the data necessary for performance driven investment depend on quality, detailed, and ubiquitous vehicle data. Unfortunately in the US, currently available commercial vehicle data contain critical gaps when it comes to linking vehicle and operational characteristics. Leveraging existing traffic sensor infrastructure, we developed a novel, readily implementable approach of integrating two complementary data collection devices, Weigh-in-Motion (WIM) systems and advanced inductive loop detectors (ILD), to produce high resolution truck data. For each vehicle traversing a WIM site, an inductive signature was collected along with WIM measurements such as axle spacing and weight which were then used as inputs to a series of truck body classification models that encompass all truck classes in the most common axle-based Federal Highway Administration (FHWA) classification scheme in the US. Since body configuration can be linked to commodity carried, drive and duty cycle, and other distinct operating characteristics, body class data is undeniably useful for freight planning and air quality monitoring. A multiple classifier systems (MCS) method was adopted to increase the classification accuracy for minority body classes. In all, eight separate body classifications models were developed from an extensive data set of 18,967 truck records distinguishing an unprecedented total of 23 single unit truck and 31 single and semi-trailer body configurations, each with over 80% correct classification rates (CCR). Remarkably, the body class model for five axle semi-tractor trailers – the most diverse truck category – achieved MCS CCRs above 85% for several industry specific classes including refrigerated and non-refrigerated intermodal containers, livestock, and logging trailers.
The role of emotion during learning encounters in science teacher education is under-researched and under-theorized. In this case study, the authors explore the emotional climates (ECs), that is, the ...collective states of emotional arousal, of a preservice secondary science education class to illuminate practice for producing and reproducing high quality learning experiences for preservice science teachers. Theories related to the sociology of emotions informed the analyses from data sources such as preservice teachers' perceptions of the EC of their class, emotional facial expressions, classroom conversations, and cogenerative dialogue. The major outcome from the analyses was that even though preservice teachers reported high positive EC during the professor's science demonstrations, they also valued the professor's in the moment reflections on her teaching that were associated with low EC ratings. The authors co-relate EC data and preservice teachers' comments during cogenerative dialogue to expand their understanding of high quality experiences and EC in science teacher education. The study also contributes refinements to research perspectives on EC. Author abstract, ed
Abstract
Background
The Dundee classification is a simple severity assessment tool that could optimize treatment decisions and clinical outcomes in adult patients with cellulitis; however, it has not ...been validated in a large cohort.
Objectives
To determine whether the Dundee classification reliably identified those patients with cellulitis who had a higher mortality, a longer length of hospital stay or an increased risk of readmission.
Methods
We performed a retrospective study of all adults with a primary discharge diagnosis of cellulitis admitted to Auckland City Hospital from August 2013 to June 2015. We classified patients by severity using the Dundee scoring system.
Results
The 30 day all-cause mortality in adult patients with a discharge diagnosis of cellulitis was 2% (29/1462) overall, and was 1% (10/806), 2% (6/271), 3% (10/353) and 9% (3/32) in Classes 1, 2, 3 and 4 of the Dundee classification, respectively (P = 0.01). Mortality was strongly associated with age >65 years (OR 9.37, 95% CI 3.00–41.23) and with heart failure (OR 6.16, 95% CI 2.73–14.23). There were significant associations between the Dundee classification and the incidence of bacteraemia, the length of hospital stay and the rate of readmission to hospital.
Conclusions
The Dundee classification is a simple, reliable tool that can be easily applied in clinical settings to predict risk of mortality in order to determine which patients can be managed in the community with oral or intravenous therapy, and which require inpatient care.
An approach is presented to determine the most likely tour distributions and model behavior for investigating drayage truck movements in a coastal region. This was done by implementing a revised form ...of entropy maximization based on truck tours to model and better understand drayage truck tour behavior at the San Pedro Bay Ports (SPBPs) complex in Southern California. The drayage trucks at the SPBPs have features that are distinct from other commercial trucks. The tour-based entropy maximization model proposed in this paper provides an opportunity to incorporate periodically updated GPS data collected in Southern California into a large-scale tour-based model. With the dataset, four models were estimated by cargo movement: (1) year-based, (2) low period, (3) medium period, and (4) high period models. The findings were consistent with the tour patterns varying by season and by cargo movement. Furthermore, the medium period, which represented relatively steady cargo movement, indicated a better MAPE (mean absolute percent error) than did other models. This proposed approach provides a significant advantage in that the most recent touring information obtained from advanced technologies could be directly applied to the tour-based model and subsequently used to assess various strategies.
Transnational education (TNE) has grown significantly in developing countries but providing quality and scaling to large student numbers is a challenge for universities. Blended learning offers a ...potential solution for scaling at high quality. A large-scale project delivering a blended learning programme for TNE students in South-East Asia was evaluated. The aim of this research was to assess the students' perceptions of the changes from predominantly face-to-face to blended mode. A student voice survey based on self-determination theory was administered to participating students (n = 1718) to assess their needs, satisfaction and frustration levels. All students found the online resources useful. Students who had experienced the previous delivery of education experienced higher levels of frustration. Conversely, students commencing after the changes had been implemented reported higher levels of satisfaction and lower frustration. Furthermore, mature-age students who attended evening classes perceived the blended approach more positively.
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